Faculty of Life Sciences & Medicine, King's College London, London, UK.
Kings College London Dental Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
J Clin Periodontol. 2020 Mar;47(3):289-308. doi: 10.1111/jcpe.13218. Epub 2019 Dec 26.
To systematically assess the diagnostic value of host-derived salivary biomarkers based on their reported sensitivity and specificity in relation to clinical parameters of periodontal disease diagnosis in adults.
Comprehensive search of PubMed, Nature, Cochrane and OVID (Embase, MEDLINE [R] and PsycINFO) was conducted up to 1 August 2018, using key terms relevant to the research questions and Cochrane methodology, supplemented by a grey literature search. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS- 2) tool was used to assess the methodological quality of all included studies.
Seven studies were included in the review. Macrophage inflammatory protein-1αlpha (MIP-1α), interleukin-1beta (IL-1β), interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8) were identified as diagnostically acceptable biomarkers for periodontal disease. Overall, the combination of IL-6 and MMP-8 showed best diagnostic performance. Also, a combination of the four key biomarkers (IL-1β, IL-6, MMP-8 and MIP-1α) showed promising results for distinction between gingivitis and periodontitis, as well as for periodontitis compared with gingival health. Results are interpreted with caution due to limitations in the number of studies included and their quality.
Certain salivary biomarkers can potentially be useful in combination and singularly for the diagnosis of periodontal disease. However, further methodically robust research is required to validate these biomarkers.
系统评估基于宿主来源的唾液生物标志物的诊断价值,根据其在成人牙周病诊断的临床参数方面的报告灵敏度和特异性进行评估。
截至 2018 年 8 月 1 日,通过关键词检索 PubMed、Nature、Cochrane 和 OVID(Embase、MEDLINE[R] 和 PsycINFO)数据库,并辅以灰色文献检索,以补充文献内容。使用修订后的诊断准确性研究质量评估工具(QUADAS-2)评估所有纳入研究的方法学质量。
共纳入 7 项研究。巨噬细胞炎性蛋白-1α(MIP-1α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和基质金属蛋白酶-8(MMP-8)被认为是牙周病有诊断价值的生物标志物。总体而言,IL-6 和 MMP-8 的联合检测具有最佳的诊断性能。此外,四项关键生物标志物(IL-1β、IL-6、MMP-8 和 MIP-1α)的联合检测结果显示,其在鉴别龈炎和牙周炎以及牙周炎与牙龈健康方面具有良好的诊断效果。由于纳入研究数量及其质量的限制,结果需要谨慎解释。
某些唾液生物标志物可能具有潜在的临床应用价值,可单独或联合用于牙周病的诊断。然而,需要进一步进行方法学稳健的研究来验证这些生物标志物。