Correlation between Gingival Crevicular Fluid Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases Expression and Clinical Parameters in Periodontal Disease Classification (2017)

抄録

 Purpose: Human gingival crevicular fluid (GCF) comprises various bioactive substances, including tissue-destructive factors such as matrix metalloproteinases (MMPs) and inflammatory cytokines, and has the potential to be used as a bioinformatics tool without invasive sampling. In 2017, the Classification of Periodontal and Peri-Implant Diseases and Conditions was reported at the World Workshop jointly held by the American Academy of Periodontology and the European Federation of Periodontology. However, the criteria for biomarkers of gingival sulcal exudate in the Grade Classification are without sufficient advantages or evidence data. In this study, we analyzed the correlation between GCF volume, total protein concentration, changes in tissue-destructive factors (MMP), tissue-destructive inhibitors (tissue inhibitors of metalloproteinases, TIMP), and clinical profiles such as probing depth (PD), bleeding on probing (BOP) rate, and periodontal inflamed surface area (PISA) for each patient classified according to Grade in the Periodontal Disease Classification (2017) at the initial visit. We aimed to improve the accuracy of diagnosis by Grade based on tissue-destructive factors in GCF by analyzing the correlations between clinical profiles, such as PD, BOP, and PISA.

 Methods: In total, 184 patients (Grade A: 38, Grade B: 124, Grade C: 22) with chronic periodontitis and 14 healthy volunteers (Control) were included in this study. Periodontal clinical parameters were recorded, GCF was obtained at the initial visit, and the concentrations of MMP-8, MMP-9, TIMP-1, and TIMP-2 were measured using antibody membrane assay and enzyme-linked immunosorbent assay. Correlations with BOP rate and PISA were also evaluated.

 Results: The GCF volume and total protein concentration increased with Grade progression (p＜0.05); BOP rate (r＝0.569) and PISA (r＝0.622) showed a positive correlation with the GCF volume. MMP-8 and MMP-9 expressions increased with the progression of Grade (p＜0.05), whereas TIMP-1 expression decreased after Grades B and C (p＜0.05). When comparing the correlation with BOP rate and PISA, MMP-8 and MMP-9 showed a positive correlation, whereas TIMP-1 showed a negative correlation (BOP rate: MMP-8, r＝0.850; MMP-9, r＝0.517; TIMP-1, r＝−0.657; PISA: MMP-8, r＝0.837; MMP-9, r＝0.459; TIMP-1, r＝−0.571).

 Conclusion: The expression levels of MMP-8, MMP-9, and TIMP-1 in GCF were useful indicators in differentiating the Grade.