Alpha
1
antitr
psin
deficienc
and
periodontitis
Alpha
-1
-antitrypsin
deficiency
and
periodontitis
Alpha
1
antitrypsin
deficiency and
periodontitis
-a
pilot
study
Wallin Bengts son V 1 ,Piitula ine n E 2 ,Ha mbe rg K 3 ,C h ri st in a Lindh 4 ,Bra tthall G 5a pilo
t study
Wallin Bengts son V , Piitula ine n E , Ha mbe rg K , Christina Lindh , Bra tthall GIt
is
important
to
identify
risk
patients
for
periodontitis
Proteases
It is important to identify
risk patients
for
periodontitis
. Proteases,
such
as
elastase
are
enzymes
which
are
capable
of
tissue
such as
elastase
, are enzymes which are capable of tissue
breakdown
in
g
ingivitis
periodontitis
and
pulmonary
diseases
breakdown in
gingivitis,
periodontitis
and pulmonary diseases.
Plasma
and
gingival
crevicular
fluid
(GCF)
contain
antiproteases
,
Plasma and gingival
crevicular
fluid
(GCF)
contain
antiproteases
,
such
as
alpha
-1
-antitrypsin
(AAT).
The
aim
w
as
to
study
if
such as
alpha
1
antitrypsin (AAT). The aim was to study if
periodontitis
is
more
common
among
AAT
deficient
subjects
periodontitis
is more common among AAT deficient subjects
compared
to
subjects
without
AAT
deficiency.
compared to
subjects without
AAT deficiency.
T abl e 2. T h e am ou nt of p rot ein , el as ta se an d A A T in G C FMaterial and
methods
30 bj t i l d d 20 f h Gr ou p 1 Gr ou p 2 Gr ou p 3 Gr ou p 1 Gr ou p 1 Gr ou p 230 subjects were included, 20 of
whom with severe AAT deficiency genotype PiZZ Gr ou p 1 Gr ou p 2 Gr ou p 3 Gr ou p 1 vs Gr ou p 1 vs Gr ou p 2 vs with severe AAT deficiency, genotype PiZZ . Ten of
them suffered from chronic
Gr ou p 2 (P -va lu es ) Gr ou p 3 (P -va lu es ) Gr ou p 3 (P -va lu es ) obstructive pulmonary disease (group 1) di ( 2) T (P va lu es ) (P va lu es ) (P va lu es ) and ten were asymptomatic (group 2). Ten control subjects (group 3) were recruited Pr ot ei n n g/u l GCF 53. 207 84. 830 57. 583 NS NS NS
control subjects (group
3) were recruited from a publi c dental clini c. The GCF Elas ta se 38. 720 57. 585 30. 002 NS N S NS p examination comprised GCF, Gingival Ma bs /p ro te in AA T / t i 00 17 0 018 00 43 NS 00 03 00 05 index (GI ),
Plaque index (PII)
, probing pocket depth (PPD) and radiography AA T /pr ot ei n 0. 017 0. 018 0. 043 NS 0. 003 0. 005 pocket depth (PPD) and radiography. GCF w as collected w ith paper strips AA T n g/u l GC F 0. 847 1. 250 2. 451 NS 0. 063 N S GCF
was collected with paper
strips (Periopaper®). Plasma AAT concentration was measured by nephelometry and AAT in GCF w ith Ta bl e 3 T he am ount of pr ot ei n el ast ase and A A T in pl asm a T abl e 1. D em og raphic data and r es u lt s of t h e l ung f unc ti on te st s. P er ce n tage of the p re d ic te dv al u es of F or ce de xp ir at or yV ol u m e ino n e se co n d (F E V 1) an dF or ce dV it al nephelometry and AAT in GCF with ELISA Elastase activity and protein in Ta bl e 3 . T he am ount of pr ot ei n, elast ase and A A T in plasm a. pr ed ic te d val u es of F or ce d e xpi ra to ry V ol u m e in one s ec ond (F E V 1) and F or ce d V it al C apac ity (F V C ) ar e s h ow n. T h e l ung f unc ti on t es ts w er e pe rf or m ed 15 m inute s af te r ELISA. Elastase activity and protein in
plasma and GCF were determined
by Gr ou p 1 Gr ou p 2 Gr ou p 3 Gr ou p 1 vs Gr ou p 1 vs Gr ou p 2 vs inhal ed br onc h odil at or (1.0 m g T er butall ine ). spectrophotomet ry. Pulmonary function tt f d ith d i vs Gr ou p 2 vs Gr ou p 3 vs Gr ou p 3 C at egor y Gr ou p 1 Gr ou p 2 Gr ou p 3 tests were performed with dynamic spirometry includi ng forced expiratory p (P -v al ue s) p (P -v al ue s) p (P -v al ue s) AA T sy m pt om at ic AA T as ym pt om at ic Hea lth y co nt ro ls spirometry , includi ng forced expiratory
volume in one second (FEV
1 ) and Prot ein ug/ ul 60 160 59 773 60 014 NS NS NS sy m pt om at ic (n =10) as ym pt om at ic (n =10) co nt ro ls (n = 10 ) M/ W 5/5 5/5 4/6 ( 1 ) forced vital capacity (FVC). Prot ein ug/ ul pl asm a 60. 160 59. 773 60. 014 NS NS NS Me n/ W om en 5/5 5/5 4/6
Results
El ast ase Ma bs /p ro te in 19. 513 1382. 200 662. 200 NS NS NS M ea n age ( ra ng e) 59 ( 42-74 ) 47 ( 22-65 ) 49 ( 22-71 )Results
The m ean values for GI, PII, PPD and Ma bs /p ro te in A A T/ pr ot ein 0. 004 0. 004 0. 026 NS 0. 0000 0. 0000 Fo rm er s m ok er s 7 5 3 The mean values for GI, PII, PPD and the radiological measurements did not p M( S D ) FE V 1( % di t d) 59 9 (15 3) ** 94 3 (7 4) 10 2 1 (17 6) show any significant difference between the gro ps AAT in GCF and plasma AA T u g/ ul p la sm a 0. 229 0. 217 1. 524 NS 0. 0000 0. 0000 Mea n ( S D ) F E V 1 ( % pr edi ct ed) 59. 9 ( 15 .3) ** 94. 3 ( 7. 4) 10 2. 1 ( 17 .6 ) the groups. AAT in GCF and plasma did not show any significant difference M ea n ( S D) F V C ( % p redi ct ed) 84. 6 ( 18 .1) * 98. 8 ( 17 .3) 106. 8 ( 14 .6) did notshow any significant difference
between
group 1 and 2 but
a statistical
Conclusion
M ea n (SD ) F E V 1/F V C ra tio (% ) 59 (1 5) * 79 (6 ) 80 (8 ) difference in comparison with group 3. El t iG C F d l di d tAAT showed statistical difference
in
GCF and plasma compared
to **p<0 00 01 vs AAT sy m pt om ati c an d he al th y co nt ro ls Elastase in
GCF and plasma did
not show any difference between the three
the control group.
Otherwise no differences
were found between
p<0. 00 01 vs . AAT s ym ptom at ic an d he al th y co nt ro ls * p<0. 01 vs . A A T s ym ptom at ic an d he al th y co nt ro ls show any difference between the three groups.
AAT deficient subjects and healthy controls
in this limited material.
gp 1 P er iodont o logy , Public D ental H e alth Ser vices, Kristianstad gy ,, 2 R espiratory M edicine, Lund U n iver sity 3 Cario lo g y 4 R ad iology 5 P er iodon to logy Malmo U n ive rsity S we d e n 3 Cario lo g y, 4 R adiology, 5 P er iodon to logy , Malmo Unive rsity Swed e n
