Chronic periodontal disease is associated with single-nucleotide polymorphisms of the human TLR-4 gene.

Periodontitis is an inflammatory disease affecting the connective tissue surrounding the teeth leading to tooth loss. Pathogens associated with periodontitis interact with Toll-like receptors (TLRs) to induce cytokines causing and aggravating disease. We screened 197 individuals suffering from generalized periodontitis for the presence of Asp299Gly and Thr399Ile of TLR-4 as well as Arg753Gln of TLR-2 in comparison to matched controls. Single-nucleotide polymorphisms (SNPs) of TLR-4 were elevated among patients (odd's ratio 3.650, 95% CI 1.573-8.467, P < or = 0.0001), while no difference was observed for TLR-2. TLR-4 SNPs were correlated with chronic periodontitis (odd's ratio 5.562, 95% CI 2.199-14.04, P < or = 0.0001), but not with aggressive periodontitis. This observation was confirmed employing a group of periodontally healthy probands over 60 years of age. These data demonstrate that genetic variants of TLR-4 may act as risk factors for the development of generalized chronic periodontitis in humans.

Aspartat aminotransferase--a marker of periodontal disease activity.

Active and inactive periodontal pockets exist in periodontal disease and the progression of periodontitis is episodic and cyclical. Current diagnostic tests do not distinguish between active and inactive lesions. Objective assessment of disease activity could significantly affect periodontal therapy. Aspartat aminotransferase (AST) activity in gingival crevicular fluid is a potential quantitative marker of periodontal disease activity. Thirty-six patients with periodontitis, twenty with adult periodontitis and sixteen with rapidly progressive periodontitis were evaluated clinically prior to treatment and AST activity in periodontal pockets was determined prior to and after initial therapy. Clinical measures included plaque index, gingival inflammation degree and attachment loss. The results show that AST levels do not correlate with clinical indices and that they decrease after treatment. AST is a possible novel biochemical marker of periodontal disease activity independent of commonly used clinical measures. It could also be useful for early monitoring of treatment success.

Inflammatory mediators in saliva of patients with rapidly progressive periodontitis during war stress induced incidence increase.

Rapidly progressive periodontitis (RPP) results from the interaction between the periodontal microflora and the host. Stress is believed to play an important role in determining host responses, and it has been proposed that hyperactivity of host defense mechanisms significantly increases tissue destruction typical for this disease. During a period of four months we have diagnosed 20 patients with acute RPP, all of them active participants in battles of the Croatian liberation war with posttraumatic stress disorder (PTSD) related symptoms. In these patients we analyzed biochemical parameters in unstimulated saliva and performed microbiological analyses of periodontal pockets. These findings were compared with those of patients with adult periodontitis (AP), edentulous and healthy persons, none of whom participated in the war. Persons with AP had reduced concentrations of host humoral defense factors in saliva (C-reactive protein, C3 component of complement, and aplha alpha 2-macroglobulin), while patients with RPP had increased concentration of interleukin-6 (IL-6). IL-6 is released by host inflammatory cells and is a mediator of bone resorption. Actinobacillus actinomycetemcommitans and Peptostreptococcus were more frequently isolated from patients with RPP. We interpret these results as indicators of the importance of stress in the causation of RPP, with host inflammatory hyperactivity playing an important role in tissue destruction, specially alveolar bone resorption possibly caused by increased local levels of IL-6.