Gingival Crevicular Fluid Myeloperoxidase Research Articles

Adjunctive Effects of a Sub-Antimicrobial Dose of Doxycycline on Clinical Parameters and Potential Biomarkers of Periodontal Tissue Catabolism.

Objectives: The aim of the present randomized, double-blind, placebo-controlled, parallel-arm study was to examine the effectiveness of a sub-antimicrobial dose of doxycycline (SDD) in combination with nonsurgical periodontal therapy, compared to nonsurgical periodontal therapy alone, on potential gingival crevicular fluid (GCF) biomarkers of periodontal tissue catabolism related to the clinical outcomes over a 12-month period. Materials and Methods: GCF was collected and clinical parameters were recorded from 30 periodontitis patients randomized either to an SDD or placebo group. The SDD group received SDD (20 mg) b.i.d for 3 months plus scaling and root planing (SRP), while the placebo group was given placebo capsules b.i.d for 3 months plus SRP. The patients were evaluated every 3 months during the 12-month study period. At each visit, clinical parameters and GCF sampling were repeated. Matrix metalloproteinase (MMP)-8, MMP-9, MMP-13, myeloperoxidase (MPO), osteoprotegerin (OPG), and tartrate-resistant acid phosphatase-5 (TRAP-5) were determined by IFMA and ELISA. Results: Significant improvements were observed in all clinical parameters in both groups over 12 months (p < 0.0125) while the SDD group showed significantly better reduction in gingival index (GI) and pocket depth and a gain in clinical attachment compared to the placebo group (p < 0.05). GCF MMP-8 and OPG levels significantly reduced in the SDD group compared to baseline (p < 0.05). GCF MMP-9 significantly decreased in both groups compared to baseline (p < 0.05). GCF MPO significantly decreased at 3 and 9 months in the SDD group, while it significantly decreased at 6 months in the placebo group (p < 0.05). TRAP and MMP-13 could be detected in none of the samples. Conclusions: The present results indicate that three months of adjunctive usage of SDD to nonsurgical periodontal therapy compared to nonsurgical periodontal therapy alone in periodontitis patients results in further improvement of clinical periodontal parameters and GCF markers of periodontal tissue breakdown over a 12-month period. Beneficial effects of adjunctive SDD therapy is likely to be related to the reduced levels of two major periodontitis-associated MMPs, MMP-8 and -9, and their potential oxidative activator MPO.

Comparative analysis of the potential effect of phase I therapy on gingival crevicular fluid myeloperoxidase levels in non-diabetic and diabetic patients with periodontitis

Objectives: To evaluate the effect of periodontal therapy on clinical parameters as well as on myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus and of systemically healthy individuals. Materials and Methods: 24 type 2 DM patients subjects, and 21 systemically healthy individuals, both groups with chronic periodontitis, and systemically and periodontally healthy individuals were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), and gingival bleeding time index (GBI), as well as GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy. GCF enzyme activity was spectrophotometrically analyzed. Possible correlation between clinical periodontal status and MPO activity was also evaluated. Results: Despite the relatively stable clinical measures and GCF MPO content in the periodontally-healthy subjects, the clinical periodontal status improved, as significant reductions were observed in all of the clinical parameters in periodontitis patients with and without diabetes (p<0.05). GCF MPO activity presented with significant reductions in both of the periodontally-diseased groups after phase I treatment (p<0.05), however it could not reach to the level of periodontal health (p<0.05). Conclusions: Periodontal inflammation is likely to play the major role in the higher MPO activity observed at diseased sites, while diabetes mellitus do not seem to further increase the production of this enzyme. Periodontal treatment can provide successful improvement in clinical periodontal parameters and reduction in enzyme profile of GCF in diabetics.

Periodontal disease in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) and periodontal disease (inflammatory diseases of the tissues around teeth) are common disorders associated with diabetes and cardiometabolic risk. Comprehensively examining the periodontal status in PCOS, this study suggests that the susceptibility for periodontal disease may significantly increase in patients with PCOS compared with healthy young women, and that local/periodontal oxidant status appears to be affected in PCOS.

GCF and serum myeloperoxidase and matrix metalloproteinase-13 levels in renal transplant patients

Aim The rationale of this study was to address whether local or systemic changes reflect proteolytic (matrix metalloproteinase-13) or oxidative (myeloperoxidase) stress in renal transplant patients receiving cyclosporine-A (CsA) and having gingival overgrowth (GO), in patients receiving CsA therapy and having no GO and patients receiving tacrolimus therapy. Material and methods Gingival crevicular fluid (GCF) samples were collected from sites with (GO+) and without GO (GO−) in CsA patients having GO; GO− sites in CsA patients having no GO; sites from tacrolimus, gingivitis and healthy subjects. GCF and serum myeloperoxidase (MPO) and matrix metalloproteinase-13 (MMP-13) levels were determined by ELISA. Results GO+ sites in CsA patients having GO had elevated GCF MPO levels than those of CsA patients having no GO, tacrolimus and healthy subjects ( p < 0.005), but comparable to those of gingivitis. GCF MPO levels were higher in GO+ compared to GO− sites in CsA patients having GO ( p < 0.05). Patient groups had similar, but higher GCF MMP-13 levels than healthy group. Conclusions These results show that CsA and tacrolimus therapy have not a significant effect on GCF MPO and MMP-13 levels, and gingival inflammation seems to be the main reason for their elevations.

Gingival Crevicular Fluid Myeloperoxidase in Periodontitis and Pancreatic Cancer

Resumen en: Objective: To determine the association between levels of GCF myeloper oxidase (GM), periodontitis and pancreatic cancer. Method: This was a double blind...

The effect of smoking on gingival crevicular fluid levels of myeloperoxidase

To compare the gingival crevicular fluid (GCF) myeloperoxidase (GM) levels in smokers and non-smokers. This study comprised 45 subjects: (a) 12 smokers with periodontitis, (b) 10 non-smokers with periodontitis, (c) 11 smokers with healthy periodontium, and (d) 12 non-smokers with healthy periodontium were recruited for the study and their GM levels were analyzed. GM levels were significantly higher in smokers with periodontitis compared with others. Hence, more incidence of mutagenesis and cytotoxicity were noted at sites of inflammation mediated by GM in smokers compared with non-smokers.

The effect of non‐surgical periodontal therapy on peroxidase activity in diabetic patients: a case–control pilot study

To evaluate the effect of periodontal therapy on clinical parameters as well as on total salivary peroxidase (TSP) activity and myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus (DM2) and of systemically healthy individuals. Twenty DM2 subjects with inadequate metabolic control (test group) and 20 systemically healthy individuals (control group), both groups with chronic periodontitis, were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), clinical attachment level (CAL), visible plaque index (VPI), bleeding on probing (BOP), gingival bleeding index (GBI) and presence of suppuration (SUP), as well as TSP activity and GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy. At baseline and 3 months post-treatment, the test group presented a higher percentage of sites with VPI and BOP (p<0.01). MPO activity in the GCF presented lower values (p<0.05) for the test group at both baseline and the post-treatment period. The periodontal treatment resulted in a significant improvement of most clinical and enzymatic parameters for both groups (p<0.05). In both groups, the periodontal therapy was effective in improving most clinical parameters and in reducing salivary and GCF enzymatic activity. The diabetic individuals presented lower MPO activity in the GCF.

Effect of Systemically Administered Naproxen Sodium on Clinical Parameters and Myeloperoxidase and Elastase‐Like Activity Levels in Gingival Crevicular Fluid

The present study was conducted to determine the possible effect of naproxen sodium on clinical status and the enzymatic profile of gingival crevicular fluid (GCF) when given as adjunct to periodontal treatment. A total of 34 subjects with chronic periodontitis were selected and divided into two groups to receive either naproxen sodium or placebo. At baseline, GCF samples were obtained and probing depths (PD), gingival index (GI), plaque index (PI), and gingival bleeding index (GBI) scores were recorded. In the non-steroidal anti-inflammatory drug (NSAID) group, patients were treated with a protocol consisting of baseline periodontal treatment (scaling, root planing) and naproxen sodium (275 mg) administration daily for 6 weeks. In the placebo group, patients received the same treatment except placebo was given instead of naproxen sodium. At the end of the experimental period, clinical recordings and GCF sampling were repeated. Myeloperoxidase (MPO) and elastase-like enzyme activity (ELA) levels were determined in GCF samples by a spectrophotometric method. GCF enzymatic content was calculated both as total enzyme activity and enzyme concentration. All of the clinical parameters, except mean GBI, were significantly lower in the experimental group (P <0.05). At baseline and at the end of the experimental period, there were no significant differences between the NSAID and placebo groups regarding GCF MPO and ELA levels in either mode of data presentation (P <0.05). However, in the NSAID group, mean ELA concentration (P = 0.002) and mean total ELA (P = 0.003) presented significant decreases with treatment. Also, with treatment, a general reduction in MPO levels was seen; however, this difference was not significant. Although constant and stable correlations between GCF enzyme levels and clinical parameters could not be found, positive and strong correlations were observed between total enzyme activity and enzyme concentrations. Based on the positive clinical effect and the ELA profile of GCF, it can be suggested that NSAIDs given as an adjunct to baseline periodontal treatment could be beneficial in the outcome of treatment.

Resolution of crevicular fluid leukocyte activity in patients treated for aggressive periodontal disease.

Enhanced neutrophil responses play a critical role in the activation of the innate immune system and causation of aggressive periodontitis (AgP). The hypothesis that comprehensive periodontal treatment expedites resolution of amplified leukocyte activity and facilitates the reconstitution of periodontal health was tested. Four different gingival crevicular fluid (GCF) markers from 14 patients were characterized prior to and at 3, 6, 12, 24, and 36 months after periodontal therapy. GCF myeloperoxidase (MPO), beta-N-acetyl-hexosaminidase (beta-NAH), and beta-glucuronidase (beta-G) were determined spectrophotometrically, and cathepsin D (CD) by liquid scintillation counting using [14C] hemoglobin as substrate. The primary outcome was long-term stability of periodontal health. In untreated AgP, GCF markers were significantly amplified (MPO: 1.9-fold; beta-NAH: 1.3-fold; beta-G: 1.7-fold; CD: 4.7-fold). Following periodontal therapy, the leukocyte activity was significantly dampened (0.3- to 0.5-fold), and paralleled with a sustained improvement of periodontal health (P < 0.05). Thereafter and at 3 years, GCF leukocyte responses remained on a physiologic low level compatible to normal immune function. Comprehensive treatment of AP induces a downregulation of amplified crevicular neutrophil activity. The release of the innate immune system from exacerbating damage elicits a successful reconstitution of long-term periodontal health with no setbacks seen after 3 years.

The importance of data presentation regarding gingival crevicular fluid myeloperoxidase and elastase-like activity in periodontal disease and health status.

The enzymatic profile of gingival crevicular fluid (GCF) is being analyzed with increasing interest, but related studies lack a general consensus on most methodological points, including the appropriate mode of data presentation. GCF myeloperoxidase (MPO) and elastase-like activity (ELA) levels were spectrophotometrically determined on a total of 60 subjects who were divided into three equal subgroups as early-onset periodontitis (EOP), adult periodontitis (AP), and healthy. GCF enzyme levels were calculated and evaluated both as total enzyme activity and enzyme concentration. The correlations between these GCF enzymes and clinical periodontal status were also analyzed. With both modes of data presentation, the results regarding MPO activity were consistent. When presented either as total MPO activity or MPO concentration, the periodontally healthy group showed significantly lower MPO activity than the two patient groups (P<0.05). However, two modes of data presentation did not match when GCF ELA was concerned. When data were reported as total ELA, the healthy group exhibited lower enzyme activity (0.02 +/- 0.001 U) than EOP (0.04 +/- 0.01 U) and AP (0.06 +/- 0.02 U) groups; but when reported as concentration, the highest ELA levels were seen in the healthy group (221 +/- 31.53 nmol/min/ml), followed by AP (98.63 +/- 23.03 nmol/min/ml) and EOP (70.49 +/- 12.02 nmol/min/ml) (P<0.05). A strong-positive and significant correlation existed between GCF MPO and ELA. Correlations with clinical parameters were mostly observed with total activities. The findings of the present study confirm the relationship between GCF ELA and MPO activity and periodontal disease and also support the functional relativity between the two enzymes. Furthermore, based on these findings, it can be suggested that data presentation by use of total activity seems to be more sensitive in both the reflection of the actual enzymatic profile of GCF and also the existing clinical periodontal status. For each GCF component, the validity of different modes of data presentation should be considered.

Myeloperoxidase activity in peripheral blood, neutrophil crevicular fluid and whole saliva of patients with periodontal disease.

Mean levels of myeloperoxidase (MPO) activity were determined in samples of gingival crevicular fluid (GCF), whole saliva and peripheral blood neutrophils from patients with rapidly progressive periodontitis (RPP) and adult periodontitis (AP) using a spectrophotometric method. The mean neutrophil MPO activity in the RPP group was 563.1 +/- 137.05 U/l x 10(6)/ml, that in the AP group was 483.3 +/- 88.81 U/l x 10(6)/ml, and that in the control group was 220.6 +/- 26.7 U/l x 10(6)/ml. The mean GCF MPO activity in the RPP group was 15.13 +/- 2.34 U/mg, which was significantly higher than in the other two groups. The mean whole saliva MPO activity in the RPP group was 0.14 +/- 0.04 U/ml, that in the AP group was 0.11 +/- 0.02 U/ml, and that in the control group was 0.05 +/- 0.06 U/ml. MPO activity detected in the samples was significantly increased in the patient groups when compared to the healthy subjects. The highest MPO activity was found in the RPP group. The present findings suggest a relationship between MPO activity and the pattern and severity of periodontal breakdown. Also the increased MPO activity in periodontally diseased patients can be attributed to the increased number of neutrophils, the degranulation of these cells and also their hyperactive state in the presence of chronic antigenic stimulation.

Crevicular fluid myeloperoxidase at healthy, gingivitis and periodontitis sites

The volume and myeloperoxidase (MPO) activity of gingival crevicular fluid (GCF) collected with filter paper strips for 30 s from the sulcus of healthy, gingivitis and periodontitis sites of Chinese subjects were measured. MPO/site and MPO/microliter GCF were both greater at gingivitis and periodontitis sites than at healthy sites. Enzyme activity was similar at the 2 categories of diseased sites. Mean GCF volume and MPO activity were calculated for all samples from healthy, gingivitis and periodontitis sites with GI 0, 1, 2 and 0 + 1. GCF volume, MPO/site and MPO/microliter GCF all were greater at GI 2 than GI 0 or 0 + 1. These data indicate that increased GCF MPO previously observed at periodontitis sites is not specific to such sites. Rather increased GCF MPO likely occurs when additional polymorphonuclear leukocytes enter the sulcus as a result of gingival inflammation. A second sample was obtained from 22 sites 4 weeks after the initial collection. These samples were collected for 5 s rather than 30 s. The GCF volume, MPO/site and MPO/microliters GCF were each greater in samples collected for 30 s rather than 5 s. Correlation coefficients showed that the amount of GCF and MPO activity of the fluid collected for 5 s and 30 s was dependent upon the site even though the 5-s and 30-s samples were collected 4 weeks apart.