Comparative analysis of gingival crevicular fluid neopterin levels in health and periodontal disease: A biochemical study

Abstract

Periodontitis involves intricate interactions of the biofilm with the host immunoinflammatory response and subsequent alterations in bone and connective tissue homeostasis. Neopterin is a marker, belonging to the class of pteridines, which is associated with cell-mediated immunity. It is produced by interferon-γ stimulated macrophages. The levels of neopterin in body fluids are elevated in infections, autoimmune diseases, malignancies and allograft rejections. This investigation was designed to estimate the levels of neopterin in gingival crevicular fluid (GCF) in health, chronic gingivitis and chronic periodontitis. Thirty subjects were divided into three groups of ten subjects each as with healthy periodontium (Group 1), chronic gingivitis (Group 2) and chronic periodontitis (Group 3). The GCF samples were obtained from the subjects by placing color-coded calibrated, volumetric, micro-capillary pipettes extracrevicularly. The samples were placed in plastic vials and stored at -70°C until the time of neopterin estimation using enzyme immunoassay. The mean neopterin level in Group 3 (126.28 ± 37.70 nmol/L) is significantly higher than the mean neopterin level in Group 1 (48.66 ± 18.82 nmol/L) and Group 2 (70.68 ± 18.26 nmol/L) (P < 0.05). However, there is no significant relationship between neopterin levels and various clinical parameters in each study group (P > 0.05). The results of our study indicate that the neopterin levels in GCF are positively associated with periodontal disease, which may provide a useful tool in monitoring its progression. Nevertheless, further longitudinal studies are required with larger sample sizes in which neopterin levels are progressively estimated and compared to baseline values.