title: Effects of Standardised Fermented Papaya Gel on Clinical Symptoms, Inflammatory Cytokines, and Nitric Oxide Metabolites in Patients with Chronic Periodontitis: An Open Randomised Clinical Study.
abstract: The clinical efficacy of topical administration of standardised fermented papaya gel (SFPG), known to have antioxidant and anti-inflammatory properties, versus conventional therapy was evaluated in a group of 84 patients with moderate-to-severe periodontitis, randomly assigned to control group (n = 45) undergoing traditional pharmacologic/surgical protocols or to experimental group (n = 39), additionally treated with intragingival pocket SFPG (7 g) applications (15 min daily for 10 days). Patients undergoing SFPG treatment showed significant (P < 0.05), durable improvement of three major clinical indices of disease severity: reduced bleeding (day 7), plaque and gingival conditions (day 14), and consistent gingival pocket depth reduction (day 45). Proinflammatory nitric oxide metabolites reached normal values in plasma (day 14) and gingival crevicular fluid (GCF) at day 45 with SFPG applications compared to controls that did not reach normalisation. Levels of highly increased proinflammatory (IL-1B, IL-6) and suppressed anti-inflammatory (IL-10) cytokines normalised in the SFPG group by days 14 (plasma) and 45 (GCF), but never in the control group. Although not acting directly as antibiotic, SFPG acted in synergy with human granulocytes blocking adaptive catalase induction in S. aureus in response to granulocyte-derived oxidative stress, thus enhancing intracellular bacterial killing.
authors.affiliation: Kabardino-Balkar Berbekov's State University, 176 Chernishevskogo Street, Nal'chik 360000, Russia.
authors.forename: Zaira F
authors.initials: ZF
authors.lastname: Kharaeva
authors.affiliation: Kabardino-Balkar Berbekov's State University, 176 Chernishevskogo Street, Nal'chik 360000, Russia.
authors.forename: Lyana R
authors.initials: LR
authors.lastname: Zhanimova
authors.affiliation: Kabardino-Balkar Berbekov's State University, 176 Chernishevskogo Street, Nal'chik 360000, Russia.
authors.forename: Magomet Sh
authors.initials: MSh
authors.lastname: Mustafaev
authors.affiliation: Medena AG, 16 Industriestrasse, 8910 Affoltern am Albis, Switzerland.
authors.forename: Chiara
authors.initials: C
authors.lastname: De Luca
authors.affiliation: Medena AG, 16 Industriestrasse, 8910 Affoltern am Albis, Switzerland.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mayer
authors.affiliation: Natural Health Farm, 39 Jalan Pengacara U1/48, Temasya Industrial Park, 40150 Shah Alam, Selangor, Malaysia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Chung Sheun Thai
authors.affiliation: Natural Health Farm, 39 Jalan Pengacara U1/48, Temasya Industrial Park, 40150 Shah Alam, Selangor, Malaysia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Tiew Siok Tuan
authors.affiliation: Centre of Innovative Biotechnological Investigations "Nanolab", 197 Vernadskiy Prospekt, Moscow 119571, Russia.
authors.forename: Liudmila G
authors.initials: LG
authors.lastname: Korkina
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D029441:Carica / Q000737:chemistry*; D055113:Chronic Periodontitis / Q000188:drug therapy* / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D005881:Gingiva / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism*
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D016207:Cytokines; D009569:Nitric Oxide