Frodge Brandon D, Ebersole Jeffrey L, Kryscio Richard J, Thomas Mark V, Miller Craig S
J Periodontol. 2008 Oct;79(10):1913-9. doi: 10.1902/jop.2008.080070.
Tumor necrosis factor-alpha (TNF-alpha), C-telopeptide pyridinoline cross-links of type I collagen (ICTP), and receptor activator of nuclear factor-kappa B ligand (RANKL) have been associated with bone remodeling and periodontal tissue destruction. This study evaluated the level of these biomarkers in saliva with respect to periodontal disease status.
Levels of TNF-alpha in unstimulated whole saliva of 74 adults (35 subjects with moderate to severe periodontal disease and 39 healthy controls) and salivary levels of RANKL and ICTP of a subset of 21 subjects and 21 matched controls were examined using enzyme immunosorbent assays in a case-control clinical study.
Salivary levels of TNF-alpha were detected in all subjects, whereas levels of ICTP and RANKL were detected in only a minority of subjects. Mean salivary levels of TNF-alpha were significantly higher in individuals with periodontal disease (mean: 4.33 pg/ml) than in controls (mean: 2.03 pg/ml; P = 0.02), with a maximum level (27.96 pg/ml) observed in periodontitis. Subjects with salivary TNF-alpha levels above a threshold of 5.75 pg/ml (i.e., two standard deviations above the mean of the controls) had significantly more sites with bleeding on probing, probing depths >/=4 mm, and attachment loss > or =2 mm (P < or =0.01).
Salivary levels of TNF-alpha were elevated in patients who had clinical indicators of periodontitis, suggesting that this biomarker may serve in a panel of salivary biomarkers that could facilitate the screening, diagnosis, and management of periodontal disease.
肿瘤坏死因子-α（TNF-α）、I型胶原C端肽吡啶啉交联物（ICTP）以及核因子-κB受体激活剂配体（RANKL）与骨重塑和牙周组织破坏有关。本研究评估了这些生物标志物在唾液中的水平与牙周疾病状态的关系。
在一项病例对照临床研究中，采用酶联免疫吸附测定法检测了74名成年人（35名中度至重度牙周疾病患者和39名健康对照者）非刺激性全唾液中TNF-α的水平，以及21名受试者及其匹配对照者唾液中RANKL和ICTP的水平。
所有受试者均检测到唾液中TNF-α的水平，而只有少数受试者检测到ICTP和RANKL的水平。牙周疾病患者唾液中TNF-α的平均水平（均值：4.33 pg/ml）显著高于对照组（均值：2.03 pg/ml；P = 0.02），在牙周炎患者中观察到最高水平（27.96 pg/ml）。唾液中TNF-α水平高于5.75 pg/ml阈值（即高于对照组均值两个标准差）的受试者，探诊出血部位、探诊深度≥4 mm以及附着丧失≥2 mm的部位明显更多（P≤0.01）。
患有牙周炎临床指标的患者唾液中TNF-α水平升高，表明该生物标志物可能有助于组成一组唾液生物标志物，从而促进牙周疾病的筛查、诊断和管理。
