Résumé
Background: Pre-term Premature Rupture of Membranes (PPROM) is attributable to several causes including asymptomatic bacterial vaginosis among Caucasians and is commoner among black pregnant women. While malaria and high Body Mass Index (BMI) have been reported among Nigerians, the influence of metalloproteinases on PPROM has never been studied in Nigeria. Methods: A qualitative estimation of active matrixmetalloproteinase-8 (a-MMP-8) to assess the effect of chronic periodontitis on time to conception led to an accidental discovery of widespread elevation of a-MMP-8 among pregnant participants. Values of a-MMP-8 were compared across demographics of participants as well as educational status, BMI and other parameters. Results : One hundred and seventeen of 134 participants (117, 87.3%) had elevated a-MMP-8 based on a novel qualitative assessment using salivary diagnostics. Levels were increased across independent of age, Estimated Gestational Age(EGA), BMI, educational level and trimester. Conclusion: This population of black pregnant women exhibited higher a-MMP-8 levels than reported among pregnant Caucasians independent of demographics, educational level and trimester of pregnancy. Reasons for the association need to be further investigated.
Résumé
La periodontitis constituye la infección bacteriana más prevalente a nivel mundial y representa un factor de riesgo para diversas patologías sistémicas. El estado de inflamación y destrucción periodontal se manifiestan a través de la presencia de biomarcadores en el suero y fluidos orales, tales como el fluido gingival crevicular (FGC), saliva y enjuague oral. Enzimas como las metaloproteinasas de matriz (MMP) y mieloperoxidasa, constituyen biomarcadores potenciales para ensayos moleculares complementarios a la clínica de uso en el sillón dental. A continuación se presenta una revisión de la literatura respecto de la aplicación potencial del análisis de metaloproteinasas de matriz extracelular (MMPs) en el diagnóstico complementario de las enfermedades periodontales. Se ha demostrado que los niveles de MMP-9, -13 y particularmente de MMP-8, se asocian con el grado de inflamación periodontal, y pueden diferenciar entre sujetos sanos, con gingivitis, periodontitis y peri-implantitis, mientras que la mejoría de los parámetros clínicos en respuesta al tratamiento periodontal se asocia con la reducción de la activación y niveles de estas enzimas en FGC, como así también en el suero. Se concluye que la determinación, particularmente de MMP-8 en fluidos orales presenta un elevado potencial como complemento de los métodos clínicos tradicionales para identificar a los pacientes con periodontitis o en riesgo de desarrollar la enfermedad, monitorear fases del tratamiento y mejoría de signos periodontales e incluso evaluar el estado de inflamación sistémica.
Periodontal disease is the most common bacterial infection worldwide and it can contribute to enhance the risk for the development of several systemic diseases. The status of periodontal inflammation and destruction can be reflected in biomarker measurement in serum and oral fluids, like gingival crevicular fluid (GCF), saliva and mouth-rinse. Some enzymes, such as matrix metalloproteinases (MMPs) and myeloperoxidase are potential candidates for chair-side point-of-care oral fluid assays. This review is focused on the utility of matrix metalloproteinase (MMP) analysis in oral fluid as a complementary diagnostic method to chronic periodontitis. Levels of MMP-9,-13 and specially of MMP-8, reflect oral inflammatory status and discriminate among healthy, gingivitis, periodontitis and periimplantitis individuals, whereas MMP levels and activation in GCF and serum are in line with the improvement of clinical parameters in response to periodontal treatment. As a conclusion, MMP-8 assessment in GCF could represent a helpful adjunctive method to traditional diagnostics to identify periodontitis or patients at risk to develop the disease, monitor treatment phases, improvement of periodontal signs and even screen the systemic inflammation status.