PERIO - Periodontal Practice Today
PERIO - Periodontal Practice Today 4 (2007), No. 2     13. June 2007
PERIO - Periodontal Practice Today 4 (2007), No. 2  (13.06.2007)

Page 129-138


Elastase activity in GCF and saliva relates to both clinical parameters and protease inhibitor levels in patients with severe periodontitis
Booth, Veronica / Cox, Stephen W / Rodriguez-Gonzalez, Eva Maria / Eley, Barry M
Introduction: Elastase activity may contribute to the pathogenesis of periodontal disease, but its activity is modulated by inhibitors. Our aim was to investigate which clinical and biochemical factors influence elastase activity in gingival crevicular fluid (GCF) and whole mouth saliva (WMS).
Study design: Saliva and GCF were collected from 19 patients with severe periodontitis. Clinical parameters were recorded at sampled sites. Active elastase and cathepsin B were measured using peptide substrates. Secretory leukocyte protease inhibitor (SLPI) and α1-proteinase inhibitor (α1PI) were measured with immunosorbant assays. Stepwise regression models were developed to explain how clinical and biochemical variables influenced elastase activity in GCF and saliva.
Results: GCF elastase activity was significantly related to the probing depth of sampled sites, profuse bleeding and individual variation (r2 = 0.55, p < 0.007). When GCF cathepsin B, SLPI and α1PI were added to the model, individual variations and probing depths were no longer significant and there was an inverse relationship between elastase activity and the inhibitors (r2 = 0.79, p < 0.0002). Salivary elastase activity was explained in the clinical model by patient age, supragingival plaque and profuse bleeding (r2 = 0.57, p < 0.02). However, it related more strongly to levels of GCF elastase and salivary protease inhibitors (r2 = 0.91, p < 0.0001).
Conclusions: Salivary elastase activity was strongly related to GCF elastase and probably derived from GCF. Elastase activity in GCF and saliva related better to the levels of other proteases and inhibitors in those fluids than to the clinical variables. SLPI may be an important inhibitor of elastase activity in the periodontium.

Keywords: chronic periodontitis, elastase, gingival crevicular fluid (GCF), saliva, secretory leukocyte protease inhibitor (SLPI)