title: Salivary Matrix Metalloproteinase-8 and -9 and Myeloperoxidase in Relation to Coronary Heart and Periodontal Diseases: A Subgroup Report from the PAROKRANK Study (Periodontitis and Its Relation to Coronary Artery Disease).
abstract: OBJECTIVE
  Matrix metalloproteinase (MMP) -8, -9 and myeloperoxidase (MPO) are inflammatory mediators. The potential associations between MMP-8, -9, MPO and their abilities to reflect cardiovascular risk remains to be evaluated in saliva. The objective of this study was to investigate the levels and associations of salivary MMP-8, -9, MPO and tissue inhibitors of metalloproteinase (TIMP)-1 in myocardial infarction (MI) patients and controls with or without periodontitis.
  
  
  METHODS
  200 patients with a first MI admitted to coronary care units in Sweden from May 2010 to December 2011 and 200 controls matched for age, gender, residential area and without previous MI were included. Dental examination and saliva sample collection was performed 6-10 weeks after the MI in patients and at baseline in controls. The biomarkers MMP -8, -9, MPO and TIMP-1 were analyzed by time-resolved immunofluorescence assay (IFMA), Western blot and Enzyme-Linked ImmunoSorbent Assay (ELISA).
  
  
  RESULTS
  After compensation for gingivitis, gingival pockets and smoking, the mean salivary levels of MMP-8 (543 vs 440 ng/mL, p = 0.003) and MPO (1899 vs 1637 ng/mL, p = 0.02) were higher in non-MI subjects compared to MI patients. MMP-8, -9 and MPO correlated positively with clinical signs of gingival/periodontal inflammation while TIMP-1 correlated mainly negatively with these signs. The levels of latent and active forms of MMP-8 did not differ between the MI and non-MI groups. Additionally, MMP-8, MPO levels and MMP-8/TIMP-1 ratio were significantly higher in men compared to women with MI.
  
  
  CONCLUSIONS
  This study shows that salivary levels of the analyzed biomarkers are associated with periodontal status. However, these biomarkers could not differentiate between patients with or without a MI. These findings illustrate the importance to consider the influence of oral conditions when analyzing levels of inflammatory salivary biomarkers.
authors.affiliation: Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden.
authors.forename: Nilminie
authors.initials: N
authors.lastname: Rathnayake
authors.affiliation: Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Gustafsson
authors.affiliation: Karolinska Institutet, Karolinska University Hospital Solna, Department of Medicine, Cardiology Unit, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Norhammar
authors.affiliation: Karolinska Institutet, Karolinska University Hospital Solna, Department of Medicine, Cardiology Unit, Stockholm, Sweden.
authors.forename: Barbro
authors.initials: B
authors.lastname: Kjellström
authors.affiliation: Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden; Department of Periodontology, Faculty of Odontology, Malmo University, Malmo, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Klinge
authors.affiliation: Karolinska Institutet, Karolinska University Hospital Solna, Department of Medicine, Cardiology Unit, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.affiliation: University of Helsinki, Helsinki University Central Hospital, Department of Oral and Maxillofacial Diseases, Helsinki, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Tervahartiala
authors.affiliation: Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden; University of Helsinki, Helsinki University Central Hospital, Department of Oral and Maxillofacial Diseases, Helsinki, Finland; University of Helsinki, Helsinki University Central Hospital, Department of Periodontology, Helsinki, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
mesh_terms: D000368:Aged; D015415:Biomarkers; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism*; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology / Q000378:metabolism; D009195:Peroxidase / Q000378:metabolism*; D012307:Risk Factors; D012463:Saliva / Q000201:enzymology*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000378:metabolism
chemical_list: D015415:Biomarkers; D019715:Tissue Inhibitor of Metalloproteinase-1; D009195:Peroxidase; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9