Salivary Enzymes Potential Markers for Periodontal Disease

Objective: Periodontal disease results the production ofdifferent enzymes that are released by epithelial orinflammatory cells. There are important enzymes associatedwith cellular alteration and cell death like: Lactatedehydrogenase (LDH), Creatine Kinase (CK), Alkaline andAcidic phosphatase (ALP, ACP). Enzymatic activity changesresults in changes health and metabolic changes in Gingivaland Periodontal condition.Design of study: We have examined the activity of CK, LDH,ALP and ACP in saliva from patients with periodontal diseasebefore and after periodontal treatment (experimental group –40samples) and in saliva from healthy patients (control group –30 samples). Periodontal disease was determined based onclinical parameters (gingival index (GI), bleeding on probing(BOP), probing depth (PD). Patients with periodontal diseasewere under periodontal treatment.Results: Results showed statistically significant increases ofactivity of CK, LDH, ALP and ACP in saliva from patients withperiodontal disease in relation to control group. There ispositive correlation between the examined salivary enzymesand value of the gingival index. After periodontal therapy theactivity of all salivary enzymes was significantly decreased.Conclusions: Based on these results, it can be stated thatactivity of these enzymes in saliva, as biochemical markers forperiodontal tissue damage, may be useful in diagnosis,prognosis and evaluation of therapy effects in periodontaldisease.

Estimation of salivary neopterin in chronic periodontitis.

Background: Periodontal diseases are the most common bacterial infection predominantly associated with Gram‑negative microorganisms that exist in the subgingival biofilm. Analysis of saliva provides a noninvasive means of evaluating the role of the host response in periodontal disease. Though salivary enzymes can be used as the biomarkers, neopterin has been recently used as one of the important diagnostic tools in the field of periodontics. Hence, we aimed to identify the neopterin levels in unsimulated saliva from the chronic periodontitis patients and compare them with the periodontally healthy subjects. Materials and Methods: Twenty subjects participated in the study and were categorized as the experimental group (chronic periodontitis patients) and control groups (healthy subjects). Unstimulated saliva samples were collected from both the groups for neopterin estimation. Neopterin in saliva was estimated using Shimadzu High Performance Liquid Chromatography with LC‑20AD pump system, equipped with RF‑10 AXL fluorescence detector. Statistical Analysis Used: Data were expressed as mean ± SD and analyzed using GraphPad Prism version 6.0 (California, USA). Statistical analysis was done by Student’s t‑test Results: The neopterin level in unstimulated saliva was found to be higher in the experimental group than the control group with P ≤ 0.05. Conclusions: The chronic periodontitis patients showed higher neopterin level in unstimulated saliva as compared to control. Hence, neopterin can be used as a potential biomarker for identification of the periodontal disease in its initial stage can help in preventing the disease progression.

Study of clinical parameters in chronic periodontitis.

Back ground: Periodontitis is a chronic inflammatory disease, causes changes in peripheral blood markers with slight abnormal lipid profile including the production of different enzymes that are released by stromal, epithelial or inflammatory cells. These changes reflect metabolic changes in the gingival and periodontium in inflammation. Design of study: This important cohort study includes 54 subjects as chronic periodontitis patients along with 26 healthy age matched controls of both sexes, In this study, different peripheral blood markers (Neutrophils,WBC,RBC,Thrombocytes and Hb%), major inflammation markers (plasma Homocysteine, CRP),Total lipid profile (Cholesterol, TGL,HDL, LDL) and salivary enzymes (CK, LDH,AST, ALT, ALP, ACP and GGT) are studied to evaluate diagnosis, prognosis and therapeutic effects in this disease. Results: Due to stasis of blood stream in periodontitis causes margination of central blood stream cells and finally there will be significant correlation in Neutrophils (r=0.342), WBC(r=0.431),thrombocytes(r=0.216),RBC(r=-0.183)Hblevel(r=-0.162).Inflammation markers and total lipid profile also show significant positive correlation: plasma homocystein (r=0.763),C-reactive protein(r=0.842),Total cholesterol,TGL,LDL (r=0.134,0.529,0.293) except HDL(r= -0.734). Salivary enzymes (CK-0.923, LDH-0.314, AST-0.841, ALT-0.832,ALP-0.782, ACP-0.826 and GGT-0.794) with gingival index and pocket depth. Conclusion: By studying this simple, economical clinical parameters we can assess the damage of periodontal tissue and useful in prediction of future risk of atherosclerosis in chronic periodontal patients.