| Summary: | 碩士 === 高雄醫學大學 === 牙醫學研究所碩士班 === 95 === Objectives: Studies have proved that periodontitis is a typical inflammatory disease and cardiovascular disease (CVD) is influenced by inflammatory factors of these diseases. Previous studies have suggested the relationships between CVD and periodontitits. Some inflammatory biomarkers, such as MMP-9, PAI-1 and GPx of periodontitis were found to have important influences both on periodontitis and CVD. The definite relations of these markers between them were not found. As a result, the purpose of this study is to find the difference of these three biomarker between healty controls and patients with periodontitis, and the changes of these biomarkers before and after phase I periodontal therapy. We analyzed clinical periodontal and cardiovascular parameters to understand the relationships between periodontitis and CVD.
Material and Methods: gingival crevicular fluid (GCF) and plasma samples were collected from 10 periodontally healthy controls and 16 periodontitits patients. GCF and plasma samples were colleted again one month after phase I periodontal therapy. Periodontal and cardiovascular parameters were also recorded at the time of sample collection. The MMP-9 and PAI-1 levels were measured with commercial ELISA kits and GPx activity was measured with a commercial biochemical kit.
Results: No significant difference of three markers was found between patients with periodontitis and periodontally healthy controls, but periodontitis group had higher mean total amounts in GCF and concentration in plasma of MMP-9 than healthy controls. However they were not statistically differernt. Significant decreases in the total amounts (32.52±32.89 vs.13.94±17.82 ng, p=0.003), concentration (10.46±8.89 vs. 5.41±6.17 ng/dl, p=0.029) in GCF and concentration in plasma (99.56±55.75 vs. 65.82±43.51 ng/dl, p=0.018) of MMP-9 were found after phase I periodontal therapy. The changes of gingival index and MMP-9 level in GCF had significant positive relationship. The concentration in plasma of PAI-1 had decrease tendency after periodontal therapy (80.99±27.64 vs. 68.71±16.62 ng/dl, p=0.051), but no significant difference was found in GCF levels of PAI-1 after phase I periodontal therapy. Significantly increase in the GPx activity in GCF after phase I periodontal therapy(7.45±3.13 vs. 11.76±5.63 U/ml), but no significant difference was found in plasma. Periodontally healthy and periodontitis groups had no significant difference in the cardiovascular parameters including intima-media wall thickness(IMT) of carotid artery and ankle brachial index(ABI). Both IMT and ABI had no significant change after phase I periodontal therapy.
Conclusion: MMP-9 had significant differences both in GCF and plasma levels before and after periodontal therapy. This shows that MMP-9 levels in circulation decrease after periodontal therapy. PAI-1 had lower concentration in plasma after therapy, but no significant change in GCF was found. GPx activity significantly increased in GCF, but no significant difference was found in plasma. No significant change of ABI and IMT after phase I periodontal therapy. The periodontal therapy had significant influence on three biomarkers, especially MMP-9, but we need more studies to understand more significant relationships between periondotitis and CVD.
|
|---|
