title: Matrix metalloproteinases and myeloperoxidase in gingival crevicular fluid provide site-specific diagnostic value for chronic periodontitis.
abstract: OBJECTIVE
  To identify the diagnostic accuracy of gingival crevicular fluid (GCF) candidate biomarkers to discriminate periodontitis from the inflamed and healthy sites, and to compare the performance of two independent matrix metalloproteinase (MMP)-8 immunoassays.
  
  
  METHODS
  Cross sectional study. GCF (N = 58 sites) was collected from healthy, gingivitis and chronic periodontitis volunteers and analysed for levels of azurocidin, chemokine ligand 5, MPO, TIMP-1 MMP-13 and MMP-14 by ELISA or activity assays. MMP-8 was assayed by immunofluorometric assay (IFMA) and ELISA. Statistical analysis was performed using linear mixed-effects models and Bayesian statistics in R and Stata V11.
  
  
  RESULTS
  MMP-8, MPO, azurocidin and total MMP-13 and MMP-14 were higher in periodontitis compared to gingivitis and healthy sites (p < 0.05). A very high correlation between MPO and MMP-8 was evident in the periodontitis group (r = 0.95, p < 0.0001). MPO, azurocidin and total levels of MMP-8, MMP-13 and MMP-14 showed high diagnostic accuracy (≥0.90), but only MMP-8 and MPO were significantly higher in the periodontitis versus gingivitis sites. MMP-8 determined by IFMA correlated more strongly with periodontal status and showed higher diagnostic accuracy than ELISA.
  
  
  CONCLUSIONS
  MPO and collagenolytic MMPs are highly discriminatory biomarkers for site-specific diagnosis of periodontitis. The comparison of two quantitative MMP-8 methods demonstrated IFMA to be more accurate than ELISA.
authors.affiliation: Institute of Dentistry, University of Helsinki, Helsinki, Finland.
authors.forename: Jussi M
authors.initials: JM
authors.lastname: Leppilahti
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Hernández-Ríos
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Gamonal
authors.forename: Taina
authors.initials: T
authors.lastname: Tervahartiala
authors.forename: Romina
authors.initials: R
authors.lastname: Brignardello-Petersen
authors.forename: Paivi
authors.initials: P
authors.lastname: Mantyla
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
authors.forename: Marcela
authors.initials: M
authors.lastname: Hernández
mesh_terms: D000328:Adult; D023181:Antimicrobial Cationic Peptides / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D002352:Carrier Proteins / Q000032:analysis; D054365:Chemokine CXCL5 / Q000032:analysis; D055113:Chronic Periodontitis / Q000175:diagnosis* / Q000378:metabolism; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D015200:Fluoroimmunoassay / Q000379:methods; D005883:Gingival Crevicular Fluid / Q000737:chemistry* / Q000201:enzymology; D005891:Gingivitis / Q000175:diagnosis / Q000378:metabolism; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D008297:Male; D053509:Matrix Metalloproteinase 13 / Q000032:analysis; D053511:Matrix Metalloproteinase 14 / Q000032:analysis; D020784:Matrix Metalloproteinase 8 / Q000032:analysis; D020782:Matrix Metalloproteinases / Q000032:analysis*; D008875:Middle Aged; D018945:Monocyte Chemoattractant Proteins / Q000032:analysis; D017622:Periodontal Attachment Loss / Q000175:diagnosis / Q000378:metabolism; D010514:Periodontal Pocket / Q000175:diagnosis / Q000378:metabolism; D009195:Peroxidase / Q000032:analysis*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000032:analysis
chemical_list: C062991:AZU1 protein, human; D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D001798:Blood Proteins; C486263:CXCL5 protein, human; D002352:Carrier Proteins; D054365:Chemokine CXCL5; D018836:Inflammation Mediators; D018945:Monocyte Chemoattractant Proteins; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; D009195:Peroxidase; C507079:MMP13 protein, human; D053509:Matrix Metalloproteinase 13; D020782:Matrix Metalloproteinases; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8; C507086:MMP14 protein, human; D053511:Matrix Metalloproteinase 14
keywords: biomarkers; chronic periodontitis; gingival crevicular fluid; matrix metalloproteinases; myeloperoxidase; sensitivity; specificity