Bone remodeling biomarkers of periodontal disease in saliva.
BACKGROUND
Tumor necrosis factor-alpha (TNF-alpha), C-telopeptide pyridinoline cross-links of type I collagen (ICTP), and receptor activator of nuclear factor-kappa B ligand (RANKL) have been associated with bone remodeling and periodontal tissue destruction. This study evaluated the level of these biomarkers in saliva with respect to periodontal disease status.


METHODS
Levels of TNF-alpha in unstimulated whole saliva of 74 adults (35 subjects with moderate to severe periodontal disease and 39 healthy controls) and salivary levels of RANKL and ICTP of a subset of 21 subjects and 21 matched controls were examined using enzyme immunosorbent assays in a case-control clinical study.


RESULTS
Salivary levels of TNF-alpha were detected in all subjects, whereas levels of ICTP and RANKL were detected in only a minority of subjects. Mean salivary levels of TNF-alpha were significantly higher in individuals with periodontal disease (mean: 4.33 pg/ml) than in controls (mean: 2.03 pg/ml; P = 0.02), with a maximum level (27.96 pg/ml) observed in periodontitis. Subjects with salivary TNF-alpha levels above a threshold of 5.75 pg/ml (i.e., two standard deviations above the mean of the controls) had significantly more sites with bleeding on probing, probing depths >/=4 mm, and attachment loss > or =2 mm (P < or =0.01).


CONCLUSIONS
Salivary levels of TNF-alpha were elevated in patients who had clinical indicators of periodontitis, suggesting that this biomarker may serve in a panel of salivary biomarkers that could facilitate the screening, diagnosis, and management of periodontal disease.
Brandon D
BD
Frodge
Jeffrey L
JL
Ebersole
Richard J
RJ
Kryscio
Mark V
MV
Thomas
Craig S
CS
Miller
D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification; D015415:Biomarkers / Q000032:analysis; D016723:Bone Remodeling / Q000502:physiology*; D016022:Case-Control Studies; D024042:Collagen Type I / Q000032:analysis*; D005260:Female; D005884:Gingival Hemorrhage / Q000145:classification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000032:analysis*; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D010518:Periodontitis / Q000145:classification*; D053245:RANK Ligand / Q000032:analysis*; D012463:Saliva / Q000737:chemistry*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D055815:Young Adult
D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; D053245:RANK Ligand; D014409:Tumor Necrosis Factor-alpha; C052929:collagen type I trimeric cross-linked peptide