Levels of matrix metalloproteinase-1 (MMP-1), MMP-2, MMP-3, osteopontin, pentraxin-3, and thymic stromal lymphopoietin in crevicular fluid samples from peri-implantitis, periodontitis, and healthy sites

Abstract

Aim: Periodontitis and peri-implantitis are chronic inflammatory diseases characterized by the destruction of supporting tissues. Despite some similarities, it is essential to understand the differences in how these diseases elicit unique host responses within the oral tissues, including the production of selected matrix metalloproteinases (MMPs) and inflammatory mediators involved in tissue remodelling. The aim of this study was to evaluate the levels of proteolytic enzymes MMP-1, MMP-2, MMP-3, as well as the inflammatory mediators osteopontin (OPN), pentraxin-3 (PTX3), and thymic stromal lymphopoietin (TSLP) in crevicular fluid samples collected from healthy, periodontitis-affected, and peri-implantitis sites.

Methods: Gingival crevicular fluid (GCF) and peri-implant crevicular fluid (PICF) samples were collected from healthy and diseased teeth and implant sites of 163 patients. The MMP-1, MMP-2, MMP-3, OPN, PTX3, and TSLP levels were determined using commercially available immunoassays. A linear mixed model procedure was adopted for multilevel analyses, using biomarker levels as the outcome variable to compare two types of sites. The diagnostic accuracy of the biomarkers was evaluated by Youden's index to estimate the sensitivity, specificity and the area under curve (AUC).

Results: The levels of MMP-1, MMP-2, MMP-3, OPN, and TSLP were higher at sites with periodontitis and peri-implantitis compared to the levels at sites with healthy teeth and healthy implants. No significant differences were observed in the levels of the measured markers between the sites diagnosed with periodontitis and those diagnosed with peri-implantitis. The highest diagnostic potential at implant sites was found for MMP-2 (AUC = 0.74) and TSLP (AUC = 0.72). The highest AUC (0.82) at tooth sites was found for OPN.

Conclusions: The findings indicate that the proteolytic enzyme MMP-2 and the cytokine TSLP might be potential biomarkers for both periodontitis and peri-implantitis, whereas the proinflammatory cytokine OPN may serve as a biomarker for periodontitis. Further studies are required to confirm the utility of these biomarkers and explore their potential clinical applications.

Keywords: biomarkers; crevicular fluid; inflammatory mediators; matrix metalloproteinases; periodontitis; peri‐implantitis.

FIGURE 1

Diagnostic power analysis, Receiver Operating Characteristic (ROC) curves for biomarkers with AUC >0.70 at implant and tooth sites. (A) MMP‐2 at implant sites (B) TSLP at implant sites (C) MMP‐2 at tooth sites (D) OPN at tooth sites (E) TSLP at tooth sites. AUC, area under the ROC curve; MMP, Matrix metalloproteinase; OPN, Osteopontin; PTX3, Pentraxin‐3; TSLP, Thymic stromal lymphopoietin.

FIGURE 2

A heatmap based on data using Spearman's correlation coefficient (r) values. Colours signify the degree of correlation (full scale shown on the right). Ih, implant site healthy; Ipi, implant site peri‐implantitis; Th, tooth site healthy; Tp, tooth site periodontitis.