吸烟对成人牙周炎患者口腔弹性蛋白酶活性的影响。

Effect of cigarette smoking on oral elastase activity in adult periodontitis patients.

作者信息

Pauletto N C, Liede K, Nieminen A, Larjava H, Uitto V J

机构信息

Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver.

出版信息

J Periodontol. 2000 Jan;71(1):58-62. doi: 10.1902/jop.2000.71.1.58.

DOI:10.1902/jop.2000.71.1.58

PMID:10695939

Abstract

BACKGROUND

We have previously reported that elastase activity in oral fluids is significantly increased in most adult periodontitis patients. In some patients, however, elastase levels remain low despite the presence of deep periodontal pockets. In this study we explored whether or not smoking is related to the unexpected low elastase values in these patients.

METHODS

We determined what proportion of the periodontitis patients that showed low oral elastase values were smokers. Paraffin-stimulated saliva or oral rinse samples (3 ml of water, 30 second rinse) were assayed for elastase activity by incubating with 1 mM succinyl-alanyl-alanyl-valine-p-nitroanilide for 20 hours at 37 degrees C, and the color formation read with a spectrophotometer. Neutrophil numbers were analyzed by staining the cells in the oral rinse smear samples.

RESULTS

In 2 patient groups, one in Helsinki, Finland (n = 46) and the other in Vancouver, British Columbia (n = 25), 63% and 83%, respectively, of the adult periodontitis patients who had one or more pockets > or =6 mm and had low oral elastase values (increase of optical density <0.5) were smokers. Non-smoking periodontitis patients had elevated neutrophil numbers compared to healthy subjects, while the smoking patients showed no significant change. Next we analyzed elastase levels in stimulated whole saliva in a group of smokers (n = 300) and those who had quit smoking (n = 102). Smokers had significantly lower oral elastase levels than former smokers in both advanced and moderate periodontitis groups. In this subject group, 56% of all smokers with periodontitis (at least one pocket > or =6 mm) had oral elastase values less than 0.5 U while only 31% of those patients who had quit smoking had low values.

CONCLUSIONS

Cigarette smoking leads to lowered elastase and neutrophil levels in the oral cavity. The oral neutrophil elastase assay, therefore, cannot be used to measure the periodontal status of smokers.

摘要

背景

我们之前报道过，大多数成人牙周炎患者口腔液中的弹性蛋白酶活性显著升高。然而，在一些患者中，尽管存在深牙周袋，弹性蛋白酶水平仍保持较低。在本研究中，我们探讨了吸烟是否与这些患者中意外的低弹性蛋白酶值有关。

方法

我们确定了口腔弹性蛋白酶值低的牙周炎患者中吸烟者的比例。通过与1 mM琥珀酰 - 丙氨酰 - 丙氨酰 - 缬氨酸 - 对硝基苯胺在37℃孵育20小时，然后用分光光度计读取颜色形成情况，来检测石蜡刺激的唾液或口腔冲洗样本（3 ml水，30秒冲洗）中的弹性蛋白酶活性。通过对口腔冲洗涂片样本中的细胞进行染色来分析中性粒细胞数量。

结果

在两个患者组中，一个在芬兰赫尔辛基（n = 46），另一个在加拿大不列颠哥伦比亚省温哥华（n = 25），有一个或多个深度≥6 mm牙周袋且口腔弹性蛋白酶值低（光密度增加<0.5）的成人牙周炎患者中，分别有63%和83%是吸烟者。与健康受试者相比，非吸烟牙周炎患者的中性粒细胞数量升高，而吸烟患者则无显著变化。接下来，我们分析了一组吸烟者（n = 300）和戒烟者（n = 102）刺激全唾液中的弹性蛋白酶水平。在重度和中度牙周炎组中，吸烟者的口腔弹性蛋白酶水平均显著低于曾经吸烟者。在该受试者组中，所有患有牙周炎（至少一个牙周袋≥6 mm）的吸烟者中有56%的口腔弹性蛋白酶值低于0.5 U，而戒烟患者中只有31%的值较低。