Oral Health Prev Dent. 2023 Feb 16;21:61-68. doi: 10.3290/j.ohpd.b3904349.
Periodontitis is associated with caspase and proinflammatory mediators, such as caspase-1 and tumor necrosis factor-alpha (TNF-α). The aim of this study was to evaluate the salivary levels of caspase-1 and TNF-α and determine their accuracy in differentiating periodontitis patients from individuals with a healthy periodontium.
This case-control study enrolled 90 subjects, aged 30 to 55, attending the Department of Periodontics at Baghdad's outpatient clinic. Patients were initially screened to evaluate their eligibility for recruitment. After applying inclusion/exclusion criteria, subjects with a healthy periodontium were included in group 1 (controls), while subjects with periodontitis were included in group 2 (patients). The salivary levels of caspase-1 and TNF-α in participants' unstimulated saliva were measured using an enzyme-linked immunosorbent assay (ELISA). Then the periodontal status was determined using the following indices: full-mouth plaque, full-mouth bleeding on probing, probing pocket depth, clinical attachment level, and gingival recession.
TNF-α and caspase-1 salivary levels were higher in periodontitis patients than in healthy controls and were positively correlated with all clinical parameters. A positive significant correlation between TNF-α and caspase-1 salivary levels was noticed. For differentiating periodontal health and periodontitis, the area under the curve (AUC) values of TNF-α and caspase-1 were 0.978 and 0.998, while the proposed cut-off points were 128.163 pg/ml and 1.626 ng/ml, respectively.
The present findings supported a previous discovery that periodontitis patients have significantly higher levels of salivary TNF-α. In addition, there was a positive correlation between the salivary levels of TNF-α and caspase-1. Furthermore, caspase-1 and TNF-α showed high sensitivity and specificity in the diagnosis of periodontitis, as well as distinguishing periodontitis from periodontal health.
牙周炎与半胱氨酸蛋白酶和促炎介质有关，如半胱氨酸蛋白酶-1 和肿瘤坏死因子-α（TNF-α）。本研究旨在评估唾液中半胱氨酸蛋白酶-1 和 TNF-α的水平，并确定其区分牙周炎患者和牙周健康个体的准确性。
这项病例对照研究纳入了 90 名年龄在 30 至 55 岁之间的受试者，他们在巴格达门诊的牙周科就诊。患者最初接受筛选，以评估其纳入研究的资格。在应用纳入/排除标准后，将牙周健康的受试者纳入第 1 组（对照组），而将牙周炎患者纳入第 2 组（患者组）。使用酶联免疫吸附试验（ELISA）测量参与者未刺激唾液中的半胱氨酸蛋白酶-1 和 TNF-α的水平。然后使用以下指标确定牙周状况：全口菌斑、全口探诊出血、探诊袋深度、临床附着水平和牙龈退缩。
与健康对照组相比，牙周炎患者的 TNF-α和半胱氨酸蛋白酶-1 的唾液水平更高，且与所有临床参数呈正相关。TNF-α和半胱氨酸蛋白酶-1 的唾液水平之间存在正显著相关性。为了区分牙周健康和牙周炎，TNF-α和半胱氨酸蛋白酶-1 的曲线下面积（AUC）值分别为 0.978 和 0.998，而建议的截断值分别为 128.163 pg/ml 和 1.626 ng/ml。
本研究结果支持先前的发现，即牙周炎患者的唾液 TNF-α水平显著升高。此外，TNF-α的唾液水平与半胱氨酸蛋白酶-1 之间存在正相关。此外，半胱氨酸蛋白酶-1 和 TNF-α在诊断牙周炎以及区分牙周炎和牙周健康方面具有高灵敏度和特异性。
