Gingival Crevicular Fluid: Biomarkers of Periodontal Tissue Activity

Abstract

The lack of precise clinical criteria for assessment of periodontal disease has led to a search for alternative means of determining active disease sites, prognosis of future sites of breakdown, and response to therapy. This review highlights the potential array of biomarkers present in gingival crevicular fluid and which may relate to existing or predicted tissue regions undergoing metabolic change and derived from bacterial or host-cell-derived products. Among the former may be listed endotoxin, amines, butyrate, and a variety of enzymes and their inhibitors, such as trypsin-like proteases and bacterial collagenase. Arising from host cells is a variety of leucocytic hydrolase enzymes, lactoferrin, and lysozyme. These appear to be useful inflammatory markers and may be distinguished from products of connective tissue breakdown which include collagenous and non-collagenous products, including collagen peptides, osteonectin, and fibronectin. The proteoglycans have found particular favor as biomarkers of possible bone-resorptive activity. Attention has also been directed at the immune response, including comment on immunoglobulins, complement, eicosanoids, and cytokines. This review lists available information on the presence of these in gingival sulcus fluid and wherever possible relates their presence to disease activity.

Assessment of the alkaline phosphatase level in gingival crevicular fluid, as a biomarker to evaluate the effect of scaling and root planing on chronic periodontitis: An in vivostudy

“…[89] The main cells that contribute to the constituents of GCF are polymorphonuclear lymphocytes, macrophages, and plasma cells. [10] Unlike serum and saliva that are the commonly used sources for assessment of biomarkers, GCF is site specific, conveniently sampled, and contains components derived from both the host and the bacteria. Conversely only extremely small volume of fluid is available from a single site, and so GCF needs highly sensitive techniques for quantitative analysis.…”

“…[8] Analysis of the gingival crevicular fluid provides a noninvasive method of studying the host response factors in the periodontium during the initial diagnosis and treatment. [910] Binder et al . [11] demonstrated a strong positive relationship between the levels of the enzyme in GCF and previous disease activity.…”

Glycosaminoglycans in Gingival Crevicular Fluid of Patients With Periodontal Class II Furcation Involvement Before and After Guided Tissue Regeneration. A Pilot Study

“…10,11 Of these, glycosaminoglycans (GAG) have been identified as one of the many biochemical components of GCF. 12 Gingival crevicular fluid from healthy gingiva appears to contain only the non-sulfated glycosaminoglycan hyaluronan, whereas fluid from inflamed sites has, in addition to hyaluronan, both dermatan sulfate and chondroitin-4-sulfate. 13 Sulfated glycosaminoglycans identified as chondroitin-4-sulfate have also been detected at sites of untreated advanced periodontitis and at sites where active bone remodeling would be expected, such as recent extraction sockets, teeth showing evidence of trauma from occlusion, and teeth undergoing orthodontic tooth movement.…”

Abnormally High Levels of Cystatin S in Submandibular Glands, Saliva, and Gingiva of Plaque-resistant Rats

“…No clear compositional differences have been discovered except some reports on the cystatin C or S in whole and parotid saliva (Henskens et al, 1993(Henskens et al, , 1994 1996), although many biomarkers-namely, antibacterial factors, metabolic products, bacterial enzymes, cytokines, and enzymes of host cells-have been elucidated in the gingival crevicular fluid obtained from patients with periodontitis (Embery and Waddington, 1994). The present study was thus designed to determine whether there are clear biomarkers in the saliva of rats with and without naturally occurring gingivitis, with the plaque-susceptible and plaque-resistant rats used as animal models.…”