Ziebolz Dirk, Schmalz Gerhard, Kauffels Anne, Widmer Florian, Widmer Katja, Slotta Jan E, Mausberg Rainer F, Kollmar Otto
Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.
Clin Oral Investig. 2017 Apr;21(3):745-752. doi: 10.1007/s00784-016-1821-4. Epub 2016 Apr 13.
The aim of this single-center cross-sectional study was to detect the prevalence of selected periodontal pathogenic bacteria and active matrix metalloproteinase-8 (aMMP-8) level in patients before (preLTx) and after liver transplantation (postLTx).
Periodontal pocket depth (PPD) and clinical attachment loss (CAL) were assessed. Subgingival biofilm samples were analyzed using polymerase chain reaction (PCR) to detect 11 common periodontal pathogens. Gingival crevicular fluid (GCF) samples were analyzed with enzyme-linked immunosorbent assay (ELISA) to determine aMMP-8 level and assigned to a scoring system: score 0: 0-8 ng/ml, score 1: 8-20 ng/ml, and score 2: >20 ng/ml. The following were used for the statistical analysis: t test, Mann-Whitney U test, Fishers test (α = 5 %).
In total, 110 patients (preLTx: n = 35, postLTx: n = 75) could be included in the study. Periodontal findings were not significantly different between groups. In microbiological analysis, a significantly higher prevalence of Campylobacter rectus in preLTx group was detected (p = 0.03). Significantly more patients with score 0 in postLTx group (p = 0.024) and significantly more patients with score 1 in preLTx group were found (p = 0.004). Furthermore, aMMP-8 concentrations for patients with moderate periodontitis were significantly lower in postLTx group compared to preLTx group (p = 0.045). Additionally, in postLTx group, aMMP-8 concentration was significantly higher in patients with severe periodontitis compared to those with no/mild periodontitis (p = 0.016).
LTx appears to affect aMMP-8 level, but not bacterial findings in patients after LTx.
Determination of aMMP-8 level in patients after LTx with immunosuppressive medication might lead to wrong interpretation of the results.
这项单中心横断面研究的目的是检测肝移植术前(preLTx)和术后(postLTx)患者中特定牙周病原菌的患病率以及活性基质金属蛋白酶-8(aMMP-8)水平。
评估牙周袋深度(PPD)和临床附着丧失(CAL)。使用聚合酶链反应(PCR)分析龈下生物膜样本,以检测11种常见的牙周病原体。用酶联免疫吸附测定(ELISA)分析龈沟液(GCF)样本,以确定aMMP-8水平,并将其分为评分系统:评分0:0 - 8 ng/ml,评分1:8 - 20 ng/ml,评分2:>20 ng/ml。采用以下方法进行统计分析:t检验、曼-惠特尼U检验、费舍尔检验(α = 5%)。
总共110名患者(preLTx:n = 35,postLTx:n = 75)可纳入本研究。两组之间的牙周检查结果无显著差异。在微生物学分析中,检测到preLTx组中直肠弯曲菌的患病率显著更高(p = 0.03)。发现postLTx组中评分0的患者明显更多(p = 0.024),preLTx组中评分1的患者明显更多(p = 0.004)。此外,与preLTx组相比,postLTx组中中度牙周炎患者的aMMP-8浓度显著更低(p = 0.045)。此外,在postLTx组中,重度牙周炎患者的aMMP-8浓度显著高于无/轻度牙周炎患者(p = 0.016)。
肝移植似乎会影响aMMP-8水平,但不影响肝移植术后患者的细菌检查结果。
在接受免疫抑制药物治疗的肝移植术后患者中测定aMMP-8水平可能会导致对结果的错误解读。