Periodontal status and neutrophilic enzyme levels in gingival crevicular fluid during pregnancy and postpartum.
BACKGROUND
Pregnancy induces or enhances susceptibility to gingivitis; however, the presence and role of neutrophilic enzymes in pregnancy-related gingivitis are not well known. The present study demonstrates the relationship between neutrophilic enzymes in gingival crevicular fluid (GCF) and periodontal status during pregnancy and postpartum.


METHODS
At baseline, 30 periodontally healthy pregnant women (Pr group) and 24 non-pregnant women (N-Pr group) as their controls participated in the study. The Pr group was examined once per each trimester and twice during postpartum and the N-Pr group three times (on successive months). During each visit, GCF samples were collected from all first molars, and clinical measurements (visible plaque index, bleeding on probing [BOP], probing depth [PD], and clinical attachment level) were recorded. The samples were analyzed for matrix metalloproteinase (MMP)-8, polymorphonuclear neutrophil (PMN) elastase, myeloperoxidase (MPO), and tissue inhibitor of matrix metalloproteinase (TIMP)-1. Their levels were compared to the periodontal status at the collection site.


RESULTS
In the Pr group, BOP and PD scores significantly increased between the first and second trimester, indicating pregnancy gingivitis. This increased inflammation was not reflected by the enzymes examined in GCF; the amounts of PMN elastase decreased continuously during the follow-up period, and those of MPO and MMP-8 did not increase until delivery, whereas TIMP-1 amounts remained stable throughout the follow-up period. In the N-Pr group, all parameters remained steady.


CONCLUSIONS
Despite an increased susceptibility to gingivitis during mid-pregnancy, the host response does not seem to activate its own degradative enzymes.
Gürsoy
Mervi
M
Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland. mervi.gursoy@tyks.fi.
Könönen
Eija
E
Gürsoy
Ulvi K
UK
Tervahartiala
Taina
T
Pajukanta
Riitta
R
Sorsa
Timo
T
D000328:Adult; D015331:Cohort Studies; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000201:enzymology*; D005884:Gingival Hemorrhage / Q000145:classification / Q000201:enzymology; D005891:Gingivitis / Q000145:classification / Q000201:enzymology; D006801:Humans; D019272:Leukocyte Elastase / Q000032:analysis; D008137:Longitudinal Studies; D020784:Matrix Metalloproteinase 8 / Q000032:analysis; D009504:Neutrophils / Q000201:enzymology*; 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 / Q000378:metabolism*; D011248:Pregnancy Complications / Q000145:classification / Q000201:enzymology; D011264:Pregnancy Trimesters / Q000378:metabolism; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000032:analysis; D055815:Young Adult
D019715:Tissue Inhibitor of Metalloproteinase-1; D009195:Peroxidase; D019272:Leukocyte Elastase; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8