Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey.
Department of Biostatistics, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
J Periodontal Res. 2020 Aug;55(4):511-518. doi: 10.1111/jre.12738. Epub 2020 Mar 10.
Developmental endothelial locus-1 (Del-1), lymphocyte function-associated antigen-1 (LFA-1), and interleukin 17 (IL-17) play critical roles in transendothelial migration of neutrophils in periodontal diseases. The aim of this study was to evaluate salivary Del-1, IL-17, and LFA-1 protein levels in patients with gingivitis (G), chronic periodontitis (CP), and generalized aggressive periodontitis (GAP).
A total of 180 systemically healthy, non-smoking patients (45 periodontally healthy (H) and 45 G, 50 CP, and 40 GAP) individuals (between March 2014 and February 2016) were included in this study according to Armitage's (1999) classification. Clinical periodontal parameters, including clinical attachment level, probing depth, plaque index, and gingival index, were recorded. Del-1, IL-17, and LFA-1 protein expression levels were measured in unstimulated saliva samples collected from patients by using enzyme-linked immunosorbent assays. Kruskal-Wallis and Mann-Whitney U tests were used for multiple comparisons and post hoc statistical analyses, respectively. ROC curve analysis was used to evaluate the sensitivity and specificity of Del-1, IL-17, and LFA-1 in distinguishing periodontal disease from health and gingivitis.
It was found a high level of IL-17 and a low level of Del-1 in the CP and GAP, as compared to the G and H groups (P < .001). Nevertheless, we found LFA-1 levels were higher in the GAP than in the CP or G groups (P = .00). Consistently, LFA-1 levels were lower in the H and G groups than in the CP and GAP groups (P = .00). The combination of three biomarkers was found as the best predictor yielded exhibited the highest AUC [0.893, 0.845-0.94 (%95 CI) P < .001] in discriminating periodontal disease from health and gingivitis.
Salivary Del-1, LFA-1, and IL-17 levels might be useful markers for determining the clinical health and disease status of patients with periodontitis. However, further studies that evaluate the level of salivary Del-1, LFA-1, and IL-17 before and after periodontal therapy are required to understand the exact roles of these cytokines during the periodontal healing period.
发育内皮定位-1(Del-1)、淋巴细胞功能相关抗原-1(LFA-1)和白细胞介素 17(IL-17)在牙周病中性粒细胞的跨内皮迁移中发挥关键作用。本研究旨在评估龈炎(G)、慢性牙周炎(CP)和广泛性侵袭性牙周炎(GAP)患者唾液中 Del-1、IL-17 和 LFA-1 蛋白水平。
根据 Armitage(1999 年)的分类,本研究共纳入 180 名系统健康、不吸烟的患者(牙周健康 45 例,G 45 例,CP 50 例,GAP 40 例)。记录临床牙周参数,包括临床附着水平、探诊深度、菌斑指数和牙龈指数。通过酶联免疫吸附试验(ELISA)测量患者非刺激性唾液样本中 Del-1、IL-17 和 LFA-1 的蛋白表达水平。Kruskal-Wallis 和 Mann-Whitney U 检验分别用于多重比较和事后统计分析。ROC 曲线分析用于评估 Del-1、IL-17 和 LFA-1 区分牙周病与健康和龈炎的敏感性和特异性。
与 G 和 H 组相比,CP 和 GAP 组的 IL-17 水平较高,而 Del-1 水平较低(P<.001)。然而,我们发现 LFA-1 水平在 GAP 组高于 CP 或 G 组(P=.00)。一致地,H 和 G 组的 LFA-1 水平低于 CP 和 GAP 组(P=.00)。三种生物标志物的组合被发现是区分牙周病与健康和龈炎的最佳预测指标,其 AUC 最高[0.893,0.845-0.94(%95 CI),P<.001]。
唾液 Del-1、LFA-1 和 IL-17 水平可能是确定牙周病患者临床健康和疾病状态的有用标志物。然而,需要进一步研究评估牙周治疗前后唾液 Del-1、LFA-1 和 IL-17 的水平,以了解这些细胞因子在牙周愈合期间的确切作用。