Matrix metalloproteinases: contribution to pathogenesis, diagnosis and treatment of periodontal inflammation.
Matrix metalloproteinases (MMPs) form a family of enzymes that mediate multiple functions both in the tissue destruction and immune responses related to periodontal inflammation. The expression and activity of MMPs in non-inflamed periodontium is low but is drastically enhanced to pathologically elevated levels due to the dental plaque and infection-induced periodontal inflammation. Soft and hard tissue destruction during periodontitis and peri-implantitis are thought to reflect a cascade of events involving bacterial virulence factors/enzymes, pro-inflammatory cytokines, reactive oxygen species and MMPs. However, recent studies suggest that MMPs can also exert anti-inflammatory effects in defence of the host by processing anti-inflammatory cytokines and chemokines, as well as by regulating apoptotic and immune responses. MMP-inhibitor (MMPI)-drugs, such as doxycycline, can be used as adjunctive medication to augment both the scaling and root planing-treatment of periodontitis locally and to reduce inflammation systematically. Furthermore, MMPs present in oral fluids (gingival crevicular fluid (GCF), peri-implant sulcular fluid (PISF), mouth-rinses and saliva) can be utilized to develop new non-invasive, chair/bed-side, point-of-care diagnostics for periodontitis and dental peri-implantitis.
Sorsa
Timo
T
Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital (HUCH), Institute of Dentistry, University of Helsinki, Helsinki, Finland. timo.sorsa@helsinki.fi
Tjäderhane
Leo
L
Konttinen
Yrjö T
YT
Lauhio
Anneli
A
Salo
Tuula
T
Lee
Hsi-Ming
HM
Golub
Lorne M
LM
Brown
David L
DL
Mäntylä
Päivi
P
D016207:Cytokines / Q000378:metabolism; D015921:Dental Implants / Q000009:adverse effects; D015870:Gene Expression; D006801:Humans; D061965:Matrix Metalloproteinase Inhibitors; D020782:Matrix Metalloproteinases / Q000737:chemistry / Q000235:genetics / Q000378:metabolism*; D010518:Periodontitis / Q000175:diagnosis / Q000188:drug therapy / Q000201:enzymology* / Q000209:etiology; D011401:Promoter Regions, Genetic
D016207:Cytokines; D015921:Dental Implants; D061965:Matrix Metalloproteinase Inhibitors; D020782:Matrix Metalloproteinases