Alpagot T, Bell C, Lundergan W, Chambers D W, Rudin R
University of the Pacific School of Dentistry, San Francisco, CA 94115, USA. talpagot@uop-edu
J Clin Periodontol. 2001 Apr;28(4):353-9. doi: 10.1034/j.1600-051x.2001.028004353.x.
To determine whether matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in gingival crevicular fluid (GCF) could serve as prognostic factors for the progression of periodontitis, we monitored GCF MMP-3 and TIMP-1 and periodontal status of selected sites in 40 medically healthy subjects over a 6-month period.
Clinical measurements including gingival index (GI), plaque index, bleeding on probing, suppuration, probing depth (PD), attachment loss (AL), and GCF samples were taken from 2 healthy sites (including sites with gingival recession, GI=0 PD < or =3 mm; AL < or =2 mm) and 2 periodontitis sites (GI > or =1; PD > or =5 mm; AL > or =3 mm) of each patient at baseline, 3-month and 6-month visits by means of sterile paper strips. GCF levels of MMP-3 and TIMP-1 were determined by sandwich ELISA assays.
The mean amounts of MMP-3 and TIMP-1 in diseased sites were significantly higher than in healthy sites (p<0.0001). Significantly higher GCF levels of MMP-3 and TIMP-1 were found at progressing sites than in nonprogressing periodontitis sites (0.001<p<0.01). A progressing site was defined as a site which had > or =2 mm loss of attachment during 6- month study period. GCF levels of MMP-3 were highly correlated with clinical measurements taken at baseline, 3-month and 6-month visits (p<0.001). TIMP-1 levels were only moderately correlated with probing depth and attachment level (p<0.01). Step-wise multiple regression analysis was performed to construct models for the prediction of probing depth and attachment loss increases. The most parsimonious regression models which had the best R2 values included the following variables and accounted for the indicated % of variability. The regression model for the prediction of probing depth increase included MMP-3, smoking pack-years, TIMP-1 and accounted for 53% of the variability. The best model for the prediction of attachment loss increase included MMP-3, smoking pack-years, age, TIMP-1 and explained 59% of the variability.
These data indicate that sites with high GCF levels of MMP-3 and TIMP-1 are at significantly greater risk for progression of periodontitis.
为了确定龈沟液（GCF）中的基质金属蛋白酶-3（MMP-3）和金属蛋白酶组织抑制剂-1（TIMP-1）是否可作为牙周炎进展的预后因素，我们在6个月的时间里监测了40名身体健康受试者选定部位的GCF中MMP-3和TIMP-1以及牙周状况。
在基线、3个月和6个月复诊时，通过无菌纸条从每位患者的2个健康部位（包括牙龈退缩部位，牙龈指数（GI）=0，探诊深度（PD）≤3 mm；附着丧失（AL）≤2 mm）和2个牙周炎部位（GI≥1；PD≥5 mm；AL≥3 mm）采集临床测量指标，包括牙龈指数（GI）、菌斑指数、探诊出血、化脓、探诊深度（PD）、附着丧失（AL）以及GCF样本。通过夹心酶联免疫吸附测定法测定GCF中MMP-3和TIMP-1的水平。
患病部位MMP-3和TIMP-1的平均含量显著高于健康部位（p<0.0001）。进展部位的GCF中MMP-3和TIMP-1水平显著高于非进展性牙周炎部位（0.001<p<0.01）。进展部位定义为在6个月研究期间附着丧失≥2 mm的部位。GCF中MMP-3的水平与基线、3个月和6个月复诊时的临床测量指标高度相关（p<0.001）。TIMP-1水平仅与探诊深度和附着水平中度相关（p<0.01）。进行逐步多元回归分析以构建预测探诊深度和附着丧失增加的模型。具有最佳R2值的最简约回归模型包括以下变量，并解释了所示的变异百分比。预测探诊深度增加的回归模型包括MMP-3、吸烟包年数、TIMP-1，解释了53%的变异。预测附着丧失增加的最佳模型包括MMP-3、吸烟包年数、年龄、TIMP-1，解释了59%的变异。
这些数据表明，GCF中MMP-3和TIMP-1水平高的部位发生牙周炎进展的风险显著更高。
