Analysis of calprotectin, PMN elastase, MMP-8 and IL-1β in microliter volumes of gingival crevicular fluid - suitability as prognostic factors for the recession after soft tissue management
InstitutionsUKU. Klinik für Zahnärztliche Prothetik
UKU. Zentrale Einrichtung Klinische Chemie (ZEKCh)
Gingival tissue displacement by retraction cords may lead to gingival tissue system break down. It is not exactly known which enzymes and cytokines are involved in the development of gingival recessions but since IL-1β, MMP-8, neutrophil elastase and MRP 8/14 calprotectin are involved in the collagen turnover in periodontal tissues; it is suspected that this pathway may also be involved in the gingival recession formation. The aim of the study was to develop a methodology for the reproducible analysis of neutrophil elastase; MMP-8, MRP8/14 (calprotectin) and IL-1β in µL gingival crevicular fluid (GCF) volumes by using well examined factors such as IL-1β as control values for the interpretation of GCF sampling and its analysis. The intentions was to determine, if these enzymes may be used as markers to predict the occurrence of gingival recessions after soft tissue management. This is provided that the initial concentrations and their concentrations trends during the treatment process are examined and known. The study consisted of 6 appointments in order to asses and follow up on the development of the concentration and change trends over time and to decide, if these enzymes may be used as prognosis markers. The study was carried out on 40 systemically healthy patients. Gingival crevicular fluid samples were obtained from healthy sites of the first incisors and first molars using Periopaper® by a standardized sampling protocol. Neutrophil elastase, IL-1β, MMP-8 and MRP8/14 calprotectin were analyzed using commercial ELISA kit and Bio-Plex Cytokine Assay Kit. MMPs were measured using the Fluorokin MAP Multiplex Human MMP Panel on the Luminex 200 system. All markers were measured in nearly all samples. The obtained results were reproducible for every patient and in accordance with the expected values. The aforementioned markers can be measured simultaneously in infinitesimal volumes of GCF. Hereby the IL-1β did not show the expected changes over time and the neutrophil elastase measurements showed inconsistent results. MMP-8 and MRP8/14 calprotectin both showed a good correlation to the theoretically assumed level of inflammation. The increase after 6 hours was significant for both markers. MRP8/14 (calprotectin) was always found in abundance and was very stable compared to the other markers under examination. The MMP-8 results support the MRP8/14 findings. While neutrophil elastase was not found to be a promising marker for the aim of this trial, calprotectin may be an auspicious biomarker for the prediction and follow-up of inflammatory reaction. While neutrophil elastase was not found to be a promising marker for the aim of this trial, calprotectin may be an auspicious biomarker for the prediction and follow-up of inflammatory reaction.
Subject HeadingsZahnprothetik [GND]
Leukocyte Elastase [GND]
Gingival recession [MeSH]
Gingival crevicular fluid [MeSH]