Department of Oral Health Sciences, University of Washington, Seattle, WA, USA.
J Periodontal Res. 2012 Apr;47(2):228-35. doi: 10.1111/j.1600-0765.2011.01425.x. Epub 2011 Oct 27.
Our previous study showed that protease inhibitors were attenuated by the periodontal pathogen Porphyromonas gingivalis in cultured gingival epithelial cells. We hypothesize that fewer protease inhibitors would be present in more advanced periodontal disease sites, where the level of P. gingivalis may be high. The goal of this study was to investigate the relationship between the protease inhibitor [secretory leukocyte protease inhibitor (SLPI), elastase-specific inhibitor (ELAFIN) and squamous cell carcinoma antigen (SCCA)] levels in gingival crevicular fluid and the number of P. gingivalis micro-organisms in subgingival plaque.
Plaque samples from subjects without (n = 18) and with moderate to advanced periodontitis (n = 41) were used to quantify P. gingivalis using real-time PCR. Protease inhibitor levels in the gingival crevicular fluid of all the subjects were determined by ELISA.
P. gingivalis was detected in 68.3% of patients with periodontitis, while 16.7% of subjects without periodontitis had a detectable level of P. gingivalis. Patients with periodontitis and P. gingivalis in their plaque exhibited lower SLPI and ELAFIN levels (p < 0.001) compared with control subjects without periodontitis. Secretory leukocyte protease inhibitor was also reduced (p < 0.05) in gingival crevicular fluid of periodontitis patients without a detectable level of P. gingivalis. Periodontitis patients with high vs. low levels of P. gingivalis exhibited reciprocal mean levels of SLPI and ELAFIN concentrations.
The reduced concentrations of SLPI and ELAFIN may contribute to the loss of host protective capacity and increase susceptibility to breakdown from chronic infection. The work of this investigation may aid in finding diagnostic and prognostic markers in periodontal health and disease and may also help in finding pharmacological targets directed against periodontal inflammation.
我们之前的研究表明，蛋白酶抑制剂在培养的牙龈上皮细胞中被牙周病原体牙龈卟啉单胞菌所削弱。我们假设，在牙周病进展更严重的部位，蛋白酶抑制剂的含量会更低，因为那里牙龈卟啉单胞菌的水平可能很高。本研究的目的是调查龈沟液中蛋白酶抑制剂（分泌型白细胞蛋白酶抑制剂 [SLPI]、弹性蛋白酶特异性抑制剂 [ELAFIN] 和鳞状细胞癌抗原 [SCCA]）水平与龈下菌斑中牙龈卟啉单胞菌微生物数量之间的关系。
使用实时 PCR 定量检测无（n = 18）和有中重度牙周炎（n = 41）受试者的菌斑样本中的牙龈卟啉单胞菌。所有受试者的龈沟液中的蛋白酶抑制剂水平均通过 ELISA 测定。
牙周炎患者中 68.3%检测到牙龈卟啉单胞菌，而无牙周炎的受试者中有 16.7%检测到牙龈卟啉单胞菌。与无牙周炎的对照组相比，患有牙周炎且菌斑中存在牙龈卟啉单胞菌的患者的 SLPI 和 ELAFIN 水平较低（p < 0.001）。在龈沟液中未检测到牙龈卟啉单胞菌的牙周炎患者中，SLPI 也降低（p < 0.05）。牙龈卟啉单胞菌水平高与低的牙周炎患者的 SLPI 和 ELAFIN 浓度呈相反的均值水平。
SLPI 和 ELAFIN 浓度降低可能导致宿主保护能力丧失，并增加对慢性感染的易感性。本研究的工作可能有助于在牙周健康和疾病中找到诊断和预后标志物，也可能有助于找到针对牙周炎症的药物靶点。
