title: Do salivary and serum collagenases have a role in an association between obstructive sleep apnea syndrome and periodontal disease? A preliminary case-control study.
abstract: OBJECTIVE
  Despite increasing evidence for an association of obstructive sleep apnea syndrome (OSAS) and periodontal disease, the pathophysiological linking mechanisms remain unclear. This study aims to evaluate the salivary and serum matrix metalloproteinase-2, -8, -9 (MMP-2, -8, -9), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), myeloperoxidase (MPO), neutrophil elastase (NE), neutrophil gelatinase-associated lipocalin (NGAL), as well as degree of activation of MMP-2, -9 of patients with and without OSAS.
  
  
  METHODS
  A total of 50 individuals were included in the study. There were 13, 17 and 20 individuals, respectively in the control (non-OSAS) group, mild-to-moderate OSAS and severe OSAS groups. Saliva, serum samples and clinical periodontal parameters were collected. Biofluid samples were analysed by immunofluorometric assay (IFMA), enzyme-linked immunosorbent assay (ELISA), western immunoblotting and gelatine zymography. Statistical analyses were performed using D'Agostino-Pearson omnibus normality test, Kruskal-Wallis test and Spearman rho rank correlation analysis.
  
  
  RESULTS
  There were no statistically significant differences in clinical periodontal parameters between the study groups. Salivary NE and proMMP-2 levels were significantly lower in the OSAS groups than the control group (p<0.05). Serum proMMP-9 concentration and the degree of MMP-9 activation in saliva were significantly lower in the severe OSAS group than the control group (p<0.05). There were significant correlations between salivary and serum proMMP-9 and -2 concentrations (p<0.05). Serum proMMP-2, NE and salivary proMMP-9 and -2 negatively correlated with indicators of OSAS severity (p<0.05).
  
  
  CONCLUSIONS
  The present findings do not support a pathophysiological link between the severity of OSAS and clinical periodontal status via neutrophil enzymes or MMPs.
authors.affiliation: Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
authors.forename: Nejat
authors.initials: N
authors.lastname: Nizam
authors.affiliation: Department of Chest Diseases, School of Medicine, Ege University, İzmir, Turkey.
authors.forename: Ozen K
authors.initials: OK
authors.lastname: Basoglu
authors.affiliation: Department of Chest Diseases, School of Medicine, Ege University, İzmir, Turkey.
authors.forename: Mehmet S
authors.initials: MS
authors.lastname: Tasbakan
authors.affiliation: University of Helsinki, Institute of Dentistry and Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Holthöfer
authors.affiliation: University of Helsinki, Institute of Dentistry and Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Tervahartiala
authors.affiliation: University of Helsinki, Institute of Dentistry and Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland; Division of Periodonlogy, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
authors.affiliation: Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey. Electronic address: nurcan.buduneli@ege.edu.tr.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Buduneli
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015153:Blotting, Western; D016022:Case-Control Studies; D017364:Collagenases / Q000378:metabolism*; D004792:Enzyme Precursors / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015200:Fluoroimmunoassay; D006801:Humans; D019272:Leukocyte Elastase / Q000378:metabolism; D000071068:Lipocalin-2; D054834:Lipocalins / Q000378:metabolism; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D010510:Periodontal Diseases / Q000201:enzymology*; D009195:Peroxidase / Q000378:metabolism; D011518:Proto-Oncogene Proteins / Q000378:metabolism; D012463:Saliva / Q000201:enzymology*; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000201:enzymology*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000378:metabolism
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D004792:Enzyme Precursors; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D019715:Tissue Inhibitor of Metalloproteinase-1; D009195:Peroxidase; D019272:Leukocyte Elastase; D017364:Collagenases; C120487:pro-matrix metalloproteinase 9; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9
keywords: Matrix metalloproteinases; Obstructive sleep apnea syndrome; Periodontal disease; Saliva; Serum; Tissue inhibitor of matrix metalloproteinases-1