Sorsa T, Ingman T, Suomalainen K, Halinen S, Saari H, Konttinen Y T, Uitto V J, Golub L M
Department of Periodontology, University of Helsinki, Finland.
J Clin Periodontol. 1992 Feb;19(2):146-9. doi: 10.1111/j.1600-051x.1992.tb00454.x.
Accelerated periodontal tissue destruction in patients with labile insulin-dependent diabetes mellitus (DM) and localized juvenile periodontitis (LJP) has been suggested to be related to functional abnormalities of neutrophils. We have recently found that collagenase in gingival crevicular fluid (GCF) of adult periodontitis patients is primarily derived from neutrophils and that neutrophil collagenase activity is more sensitive to inhibition by tetracyclines than collagenase produced by fibroblasts. This study is to characterize the cellular sources, activation and inhibition of collagenase in GCF of DM patients and to compare it with collagenase in LJP GCF. We found differences which may have therapeutic implications. Specific doxycycline inhibition tests revealed that GCF collagenase in DM is derived from neutrophils, whereas the enzyme in LJP originates primarily from fibroblasts. Oxidant, sodium hypochlorite, activated efficiently GCF collagenase of DM but not LJP patients. In contrast, plasmin activated LJP GCF collagenase but not that of DM patients. In GCF of DM patients 50-60% of collagenase existed in an active form, whereas in LJP GCF, the enzyme was almost completely in a latent form. The results suggest that collagenase in GCF of periodontitis patients with labile DM is primarily derived from neutrophils and that tetracycline therapy may be an effective adjunct in treatment aimed at controlling the periodontal breakdown in these patients. On the other hand, in LJP the anti-collagenase property of tetracyclines may be less important for control of periodontal tissue destruction because of the tetracycline-resistance of fibroblast collagenase.
胰岛素依赖型不稳定糖尿病（DM）和局限性青少年牙周炎（LJP）患者牙周组织破坏加速，这被认为与中性粒细胞的功能异常有关。我们最近发现，成人牙周炎患者龈沟液（GCF）中的胶原酶主要来源于中性粒细胞，并且中性粒细胞胶原酶活性比成纤维细胞产生的胶原酶对四环素抑制更敏感。本研究旨在鉴定DM患者GCF中胶原酶的细胞来源、激活和抑制情况，并将其与LJP GCF中的胶原酶进行比较。我们发现了可能具有治疗意义的差异。特异性强力霉素抑制试验表明，DM患者GCF中的胶原酶来源于中性粒细胞，而LJP患者GCF中的胶原酶主要来源于成纤维细胞。氧化剂次氯酸钠能有效激活DM患者的GCF胶原酶，但不能激活LJP患者的。相反，纤溶酶能激活LJP患者GCF中的胶原酶，但不能激活DM患者的。在DM患者的GCF中，50% - 60%的胶原酶以活性形式存在，而在LJP GCF中，该酶几乎完全以潜伏形式存在。结果表明，不稳定DM牙周炎患者GCF中的胶原酶主要来源于中性粒细胞，四环素治疗可能是控制这些患者牙周破坏的有效辅助治疗方法。另一方面，在LJP中，由于成纤维细胞胶原酶对四环素耐药，四环素的抗胶原酶特性对控制牙周组织破坏可能不太重要。
