Persson L, Bergström J, Ito H, Gustafsson A
Karolinska Institutet, Department of Periodontology, Stockholm, Sweden.
J Periodontol. 2001 Jan;72(1):90-5. doi: 10.1902/jop.2001.72.1.90.
Tobacco smoking has considerable negative effects on periodontal health. The mechanisms behind these effects are incompletely understood but may be related to the host response. The aim of the present study was to investigate the influence of tobacco smoking on the gingival crevicular fluid (GCF) levels of elastase, lactoferrin (LF), alpha-1-antitrypsin (alpha-1-AT), and alpha-2-macroglobulin (alpha-2-MG) under periodontally diseased conditions.
The study population included 15 smokers (5 women and 10 men) aged 34 to 69 years and 17 non-smokers (5 women and 12 men) aged 31 to 81 years. Clinical registration of gingival index (GI), plaque index (PI), probing depth, as well as sampling of GCF were made at 3 sites with severe lesions and 3 sites with moderate lesions in each individual. The elastase activity was measured with a chromogenic low molecular substrate and the LF, alpha-1-AT, and alpha-2-MG concentrations with ELISA.
The results showed that, with regard to severe lesions, smokers had a significantly lower concentration of alpha-2-MG as well as significantly lower total amounts of alpha-2-MG and alpha-1-AT than non-smokers. With regard to moderate lesions, smokers tended to exhibit a lower concentration of alpha-2-MG, but the difference was not statistically significant. Comparing moderate and severe lesions, smokers exhibited no gradual increase with disease severity in contrast to non-smokers, who showed significantly or almost significantly increased levels of LF and alpha-2-MG in severe as compared to moderate lesions.
The present results indicate that the levels of alpha-2-MG and alpha-1-AT are suppressed in smokers with periodontitis, suggesting that smoking interferes with these protease inhibitors. This may be one mechanism by which smoking affects the inflammatory response.
吸烟对牙周健康有相当大的负面影响。这些影响背后的机制尚未完全了解，但可能与宿主反应有关。本研究的目的是调查在牙周疾病条件下吸烟对龈沟液（GCF）中弹性蛋白酶、乳铁蛋白（LF）、α-1抗胰蛋白酶（α-1-AT）和α-2巨球蛋白（α-2-MG）水平的影响。
研究人群包括15名年龄在34至69岁的吸烟者（5名女性和10名男性）和17名年龄在31至81岁的非吸烟者（5名女性和12名男性）。对每个个体在3个重度病变部位和3个中度病变部位进行牙龈指数（GI）、菌斑指数（PI）、探诊深度的临床记录以及GCF采样。用发色性低分子底物测量弹性蛋白酶活性，用酶联免疫吸附测定法测量LF、α-1-AT和α-2-MG浓度。
结果显示，在重度病变方面，吸烟者的α-2-MG浓度以及α-2-MG和α-1-AT的总量显著低于非吸烟者。在中度病变方面，吸烟者的α-2-MG浓度往往较低，但差异无统计学意义。与非吸烟者相比，吸烟者在中度和重度病变之间没有随着疾病严重程度而逐渐增加，而非吸烟者在重度病变中LF和α-2-MG水平与中度病变相比显著或几乎显著升高。
目前的结果表明，牙周炎吸烟者的α-2-MG和α-1-AT水平受到抑制，表明吸烟会干扰这些蛋白酶抑制剂。这可能是吸烟影响炎症反应的一种机制。
