Ebersole Jeffrey L, Nagarajan Radhakrishnan, Akers David, Miller Craig S
Center for Oral Health Research, College of Dentistry, University of Kentucky Lexington, KY, USA.
Division of Biomedical Informatics, College of Public Health, University of Kentucky Lexington, KY, USA.
Front Cell Infect Microbiol. 2015 Aug 19;5:62. doi: 10.3389/fcimb.2015.00062. eCollection 2015.
Generally, clinical parameters are used in dental practice for periodontal disease, yet several drawbacks exist with the clinical standards for addressing the needs of the public at large in determining the current status/progression of the disease, and requiring a significant amount of damage before these parameters can document disease. Therefore, a quick, easy and reliable method of assessing and monitoring periodontal disease should provide important diagnostic information that improves and speeds treatment decisions and moves the field closer to individualized point-of-care diagnostics.
This report provides results for a saliva-based diagnostic approach for periodontal health and disease based upon the abundance of salivary analytes coincident with disease, and the significant progress already made in the identification of discriminatory salivary biomarkers of periodontitis.
We evaluated biomarkers representing various phases of periodontitis initiation and progression (IL-1ß, IL-6, MMP-8, MIP-1α) in whole saliva from 209 subjects categorized with periodontal health, gingivitis, and periodontitis.
Evaluation of the salivary analytes demonstrated utility for individual biomarkers to differentiate periodontitis from health. Inclusion of gingivitis patients into the analyses provided a more robust basis to estimate the value of each of these analytes. Various clinical and statistical approaches showed that pairs or panels of the analytes were able to increase the sensitivity and specificity for the identification of disease.
Salivary concentrations of IL-1ß, IL-6, MMP-8, MIP-1α alone and in combination are able to distinguish health from gingivitis and periodontitis. The data clearly demonstrated a heterogeneity in response profiles of these analytes that supports the need for refinement of the standard clinical classifications if we are to move toward precision/personalized dentistry for the twenty-first century.
一般来说,临床参数用于牙科实践中诊断牙周疾病,但现有的临床标准在满足广大公众需求以确定疾病当前状态/进展方面存在若干缺陷,并且在这些参数能够记录疾病之前需要大量组织损伤。因此,一种快速、简便且可靠的评估和监测牙周疾病的方法应能提供重要的诊断信息,从而改善并加速治疗决策,使该领域更接近个性化即时诊断。
本报告介绍了一种基于唾液的牙周健康与疾病诊断方法的结果,该方法基于与疾病相关的唾液分析物丰度,以及在鉴定牙周炎鉴别性唾液生物标志物方面已经取得的重大进展。
我们评估了209名被分类为牙周健康、牙龈炎和牙周炎的受试者全唾液中代表牙周炎起始和进展各个阶段的生物标志物(白细胞介素-1β、白细胞介素-6、基质金属蛋白酶-8、巨噬细胞炎性蛋白-1α)。
对唾液分析物的评估表明,单个生物标志物可用于区分牙周炎与健康状态。将牙龈炎患者纳入分析为估计每种分析物的价值提供了更有力的依据。各种临床和统计方法表明,这些分析物的组合能够提高疾病识别的敏感性和特异性。
唾液中白细胞介素-1β、白细胞介素-6、基质金属蛋白酶-8、巨噬细胞炎性蛋白-1α的浓度单独或联合使用能够区分健康与牙龈炎及牙周炎。数据清楚地表明这些分析物的反应谱存在异质性,这支持了如果我们要迈向21世纪的精准/个性化牙科,就需要完善标准临床分类的观点。