title: Granulocyte elastase, matrix metalloproteinase-8 and prostaglandin E2 in gingival crevicular fluid in matched clinical sites in smokers and non-smokers with persistent periodontitis.
abstract: OBJECTIVE
  Smokers with persistent periodontitis may have granulocytes with impaired function. This study aimed to determine the levels of granulocyte elastase, matrix metalloproteinase-8 (MMP-8) and prostaglandin E2 (PGE2) in gingival crevicular fluid (GCF) in smokers and non-smokers with persistent periodontitis.
  
  
  METHODS
  We analyzed GCF from 70 matched sites in 29 periodontitis and 6 gingivitis sites in 34 subjects, 17 smokers, and 17 non-smokers. We also analyzed separately GCF from 28 of these subjects, 14 smokers and 14 non-smokers in 14 matched periodontitis sites. The following measurements were made: elastase complexed to alpha1-antitrypsin (EA-alpha1AT) and MMP-8 with ELISA, functional elastase with a chromogenic substrate, and PGE2 with radioimmunoassay (125I RIA). The significance of the findings was determined with Mann-Whitney test.
  
  
  RESULTS
  In the 29 matched periodontitis sites, smokers had significantly more functional elastase (p<0.005) and more EA-alpha1AT (p<0.05) than non-smokers. In the 14 matched periodontitis sites in 14 smokers and 14 non-smokers, the former had significantly more functional elastase than the latter (p<0.001). A significant correlation was found between EA-alpha1AT and MMP-8 in smokers (p<0.05) and non-smokers (p<0.001) and a positive correlation between levels of functional elastase and MMP-8 in non-smokers (r2=0.98; p<0.001).
  
  
  CONCLUSIONS
  Granulocyte function seems to be impaired in smokers with persistent periodontitis. The cells react to the bacterial challenge by releasing serine proteases, which reflect the degradation of connective tissue. The risk of progression of the disease is therefore higher in smokers with persistent periodontitis than in non-smokers.
authors.affiliation: Department of Periodontology and Oral Dental Hygiene, Institute of Odontology, Karolinska Institutet, Stockholm, Sweden. birgitta.soder@ofa.ki.se
authors.forename: Birgitta
authors.initials: B
authors.lastname: Söder
authors.forename: L J
authors.initials: LJ
authors.lastname: Jin
authors.forename: S
authors.initials: S
authors.lastname: Wickholm
mesh_terms: D016022:Case-Control Studies; D002863:Chromogenic Compounds; D003774:Dental Plaque Index; D015232:Dinoprostone / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry* / Q000201:enzymology; D005891:Gingivitis / Q000201:enzymology / Q000378:metabolism; D006801:Humans; D007457:Iodine Radioisotopes; D019272:Leukocyte Elastase / Q000032:analysis*; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000032:analysis*; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000201:enzymology / Q000378:metabolism*; D011863:Radioimmunoassay; D019275:Radiopharmaceuticals; D015842:Serine Proteinase Inhibitors; D012737:Sex Factors; D012907:Smoking / Q000378:metabolism*; D018709:Statistics, Nonparametric; D000515:alpha 1-Antitrypsin
chemical_list: D002863:Chromogenic Compounds; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D015842:Serine Proteinase Inhibitors; D000515:alpha 1-Antitrypsin; D019272:Leukocyte Elastase; D020784:Matrix Metalloproteinase 8; D015232:Dinoprostone