Longitudinal study of salivary proteinases during pregnancy and postpartum.
OBJECTIVE
Matrix metalloproteinases (MMPs) and their regulators are connected to periodontal inflammation and destruction. However, the presence and role of the salivary MMPs in pregnancy-related gingivitis are not well known. Our longitudinal study aimed to monitor salivary proteinase levels and possible changes, and relate them to periodontal status during pregnancy and postpartum.


METHODS
Salivary samples were collected from 30 periodontally healthy pregnant women five times (once during each trimester, 4-6 wk after delivery and after lactation) and, as their controls, from 24 non-pregnant women three times (during successive months). Periodontal examination included visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level measurements. Matrix metalloproteinase-8 levels were measured by immunofluorometric assay, and MMP-2 and MMP-9 levels and molecular forms by gelatin zymography. Salivary elastase, myeloperoxidase and tissue inhibitor of matrix metalloproteinase-1 levels were measured by ELISA.


RESULTS
Elastase concentrations maintained stable during the follow-up, while myeloperoxidase concentrations increased significantly after delivery. During pregnancy, MMP-8 concentrations were significantly lower than postpartum concentrations, being lowest during the second trimester and highest after delivery, and varying inversely to pregnancy gingivitis, observed as elevated percentages of bleeding on probing and probing pocket depth during the second and third trimester. In pregnant women, the highest MMP-2 and MMP-9 levels were found in saliva after lactation. In the control group, both clinical and enzymological findings remained stable during the follow-up period.


CONCLUSIONS
Our results suggest that hormonal changes during pregnancy induce or enhance susceptibility to gingivitis, while salivary proteinase and myeloperoxidase levels are reduced.
Gürsoy
M
M
Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Institute of Dentistry, University of Helsinki, Helsinki, Finland. mervi.latva-aho@helsinki.fi
Könönen
E
E
Tervahartiala
T
T
Gürsoy
U K
UK
Pajukanta
R
R
Sorsa
T
T
D000328:Adult; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000145:classification / Q000201:enzymology; D005891:Gingivitis / Q000201:enzymology; D006801:Humans; D007774:Lactation / Q000378:metabolism; D008137:Longitudinal Studies; D020778:Matrix Metalloproteinase 2 / Q000032:analysis; D020784:Matrix Metalloproteinase 8 / Q000032:analysis; D020780:Matrix Metalloproteinase 9 / Q000032:analysis; D010196:Pancreatic Elastase / Q000032:analysis; D010447:Peptide Hydrolases / Q000032:analysis*; D017622:Periodontal Attachment Loss / Q000145:classification / Q000201:enzymology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000201:enzymology; D009195:Peroxidase / Q000032:analysis; D049590:Postpartum Period / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000201:enzymology; D011264:Pregnancy Trimesters / Q000378:metabolism; D012471:Salivary Proteins and Peptides / Q000032:analysis*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000032:analysis; D055815:Young Adult
D012471:Salivary Proteins and Peptides; D019715:Tissue Inhibitor of Metalloproteinase-1; D009195:Peroxidase; D010447:Peptide Hydrolases; D010196:Pancreatic Elastase; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9