Figueredo C M S, Areas A, Miranda L A, Fischer R G, Gustafsson A
Institute of Odontology, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden.
J Clin Periodontol. 2004 Aug;31(8):615-9. doi: 10.1111/j.1600-051X.2004.00532.x.
The aim of this study was to evaluate the short-term effect of non-surgical periodontal treatment on protease activity in gingival crevicular fluid (GCF) of patients with chronic periodontitis.
After clinical examination, in which pocket probing depth, probing attachment level, plaque and bleeding indices were recorded, gingival fluid samples from 21 chronic periodontitis patients were collected from gingivitis (GP) and periodontitis (PP) sites with an intracrevicular washing method. Samples were taken in the same way from a group of patients with gingivitis alone (GG). The periodontitis patients received non-surgical periodontal treatment and were re-evaluated 30 days later. We compared elastase and collagenase activities before and after treatment. The former activity was measured with a low-weight substrate (S-2484) and inhibited by alpha-1-antitrypsin. Matrix-metalloproteinase-8 (MMP-8) was measured with an ELISA and collagenolytic activity with fluorescein-conjugated collagen type I as substrate.
All clinical parameters showed a significant improvement after treatment (p<0.05) which was accompanied by a significant reduction in the values of total elastase activity, free elastase, MPP-8 and collagenolytic activity in both GP and PP sites (p<0.05). However, the latter sites continued to have higher levels of MMP-8 and collagenolytic activity than the former ones after treatment. The free elastase activity and the proportion of free elastase in GP and PP samples after treatment remained higher than in untreated GG samples.
This study shows that the clinical improvements after non-surgical treatment are accompanied by reductions in protease and neutrophil activities.
本研究旨在评估非手术牙周治疗对慢性牙周炎患者龈沟液(GCF)中蛋白酶活性的短期影响。
临床检查记录牙周袋探诊深度、探诊附着水平、菌斑和出血指数后,采用龈沟内冲洗法从21例慢性牙周炎患者的牙龈炎(GP)和牙周炎(PP)部位采集龈沟液样本。以同样方式从一组单纯牙龈炎患者(GG)中采集样本。牙周炎患者接受非手术牙周治疗,并在30天后重新评估。比较治疗前后的弹性蛋白酶和胶原酶活性。前者活性用低分子量底物(S - 2484)测定,并受α-1抗胰蛋白酶抑制。用酶联免疫吸附测定法(ELISA)测定基质金属蛋白酶-8(MMP - 8),以荧光素偶联的I型胶原为底物测定胶原分解活性。
治疗后所有临床参数均有显著改善(p<0.05),同时GP和PP部位的总弹性蛋白酶活性、游离弹性蛋白酶、MPP - 8和胶原分解活性值均显著降低(p<0.05)。然而,治疗后PP部位的MMP - 8和胶原分解活性水平仍高于GP部位。治疗后GP和PP样本中的游离弹性蛋白酶活性及游离弹性蛋白酶比例仍高于未治疗的GG样本。
本研究表明,非手术治疗后的临床改善伴随着蛋白酶和中性粒细胞活性的降低。