Smith Q T, Wang Y D, Sim B
Department of Oral Science, School of Dentistry, University of Minnesota, Minneapolis 55455.
Arch Oral Biol. 1994 Apr;39(4):301-6. doi: 10.1016/0003-9969(94)90121-x.
Gingival crevicular fluid (GCF) was collected from two healthy, two gingivitis and two periodontitis sites of two groups of individuals presenting for treatment of chronic adult periodontitis (group 1, 25 subjects; group 2, seven subjects) and from distal approximal sites of two incisors and one molar of 10 subjects with periodontal health. GCF eluates of periodontitis group 1 and controls, prepared by a technique that lysed polymorphonuclear leucocytes (PMN) in the samples, were assayed for functional neutrophil elastase (NE) and immunoreactive alpha 1-antitrypsin (alpha 1-AT) and alpha 1-antitrypsin-neutrophil elastase complex (alpha 1-AT-NE). Periodontitis group 2 GCF eluates, generated by a method that did not disrupt PMNs, were assayed for functional NE in the presence and absence of a specific NE inhibitor. A greater amount of NE (ng/5-s sample) was found in eluates of GCF from diseased sites irrespective of whether or not the eluates contained products of lysed PMNs. However, the GCF eluates prepared without disrupting PMNs contained only about one-tenth as much NE as eluates of corresponding sites that included constituents of lysed PMNs. The amount of alpha-AT in GCF was insufficient to inactivate most of the NE available for release into the gingival sulcus at either healthy or diseased sites. In addition, much of the alpha 1-AT in GCF was not complexed with NE under conditions of excess NE. More than 90% of the NE in GCF from each site category was inactivated by the NE specific inhibitor. It is concluded, because of the large quantity of NE available in PMNs compared to the amount of NE inhibitors in GCF, that at least locally transient free NE occurs, which contributes to tissue destruction in chronic adult periodontitis.
从两组前来治疗慢性成人牙周炎的个体（第1组，25名受试者；第2组，7名受试者）的两个健康部位、两个牙龈炎部位和两个牙周炎部位收集龈沟液（GCF），并从10名牙周健康受试者的两颗切牙和一颗磨牙的远中邻面部位收集龈沟液。通过一种使样本中的多形核白细胞（PMN）裂解的技术制备的牙周炎第1组和对照组的GCF洗脱液，检测其功能性中性粒细胞弹性蛋白酶（NE）、免疫反应性α1-抗胰蛋白酶（α1-AT）和α1-抗胰蛋白酶-中性粒细胞弹性蛋白酶复合物（α1-AT-NE）。通过一种不破坏PMN的方法产生的牙周炎第2组GCF洗脱液，在有和没有特异性NE抑制剂的情况下检测功能性NE。在患病部位的GCF洗脱液中发现了更多的NE（ng/5秒样本），无论洗脱液是否含有裂解PMN的产物。然而，未破坏PMN制备的GCF洗脱液中的NE含量仅为相应部位含有裂解PMN成分的洗脱液的十分之一左右。在健康或患病部位，GCF中α-AT的量不足以使大部分可释放到龈沟中的NE失活。此外，在NE过量的条件下，GCF中的大部分α1-AT未与NE结合。每个部位类别的GCF中90%以上的NE被NE特异性抑制剂灭活。得出的结论是，由于PMN中可用的NE量与GCF中NE抑制剂的量相比很大，至少局部会出现短暂的游离NE，这导致了慢性成人牙周炎中的组织破坏。
