title: Gingival crevicular fluid elastase-inhibitor complex: correlation with clinical indices and subgingival flora.
abstract: This investigation analyzed, in a cross-sectional study, the possible relationship between gingival crevicular fluid (GCF) elastase-like protease (ELP) levels and the periodontal clinical parameters or the presence of specific bacteria in subgingival plaque. A total of 388 periodontal sites from 8 adult periodontitis patients were examined for plaque index (PII), gingival index (GI), pocket depth (PD) and alveolar bone loss (ABL). GCF ELP levels were determined as ELP alpha-1 protease inhibitor (ELP-alpha 1-PI) complex levels with a commercially available ELISA. Subgingival plaque samples were tested for the presence of Bacteroides gingivalis, B. intermedius and Actinobacillus actinomycetemcomitans by indirect immunofluorescence (IF) microscopy. GCF ELP-alpha 1-PI levels were then correlated with clinical periodontal indices and proportions of IF-positive bacteria per site. Statistically significant positive correlations were found between GCF ELP-alpha 1-PI concentrations and subgingival Bacteroides proportions. When the sites examined were analyzed depending on the level of each clinical parameter, the levels of these correlations changed. A. actinomycetemcomitans correlated highly (r = 0.716) with ABL for sites with low GI score. The correlations between GCF ELP-alpha 1-PI and B. gingivalis (r = 0.642) or B. intermedius (r = 0.774) were the highest for ABL less than or equal to 20% and PD less than or equal to 3 mm, respectively. The strong association between GCF ELP-alpha 1-PI concentrations and subgingival bacteria previously associated with advancing periodontitis indicates that measurement of GCF ELP-alpha 1-PI concentrations may be useful in the evaluation of periodontal sites, especially those with very little or no tissue destruction.
authors.affiliation: Department of Periodontology, Phillipps University of Marburg, F.R.G.
authors.forename: G G
authors.initials: GG
authors.lastname: Zafiropoulos
authors.forename: L
authors.initials: L
authors.lastname: Flores-de-Jacoby
authors.forename: G
authors.initials: G
authors.lastname: Todt
authors.forename: G
authors.initials: G
authors.lastname: Kolb
authors.forename: K
authors.initials: K
authors.lastname: Havemann
authors.forename: D N
authors.initials: DN
authors.lastname: Tatakis
mesh_terms: D000188:Actinobacillus / Q000302:isolation & purification; D000328:Adult; D016301:Alveolar Bone Loss / Q000473:pathology; D000704:Analysis of Variance; D001439:Bacteroides / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003430:Cross-Sectional Studies; D003773:Dental Plaque / Q000382:microbiology*; D003774:Dental Plaque Index; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D005883:Gingival Crevicular Fluid / Q000201:enzymology*; D006801:Humans; D019272:Leukocyte Elastase; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000032:analysis* / Q000097:blood; D010512:Periodontal Index; D010518:Periodontitis / Q000382:microbiology*; D000515:alpha 1-Antitrypsin / Q000032:analysis*
chemical_list: D000515:alpha 1-Antitrypsin; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase