Relationship between C‐telopeptide pyridinoline cross‐links (ICTP) and putative periodontal pathogens in periodontitis

Abstract

Crevicular fluid pyridinoline cross-linked carboxyterminal telopeptide of type 1 collagen (ICTP) is predictive for future alveolar bone loss in experimental periodontitis in dogs. The present study sought to relate ICTP to a panel of subgingival species in subjects exhibiting various clinical presentations such as health (n=7), gingivitis (n=8) and periodontitis (n=21). 28 subgingival plaque and GCF samples were taken from mesiobuccal sites in each of 36 subjects. The presence and levels of 40 subgingival taxa were determined in plaque samples using whole genomic DNA probes and checkerboard DNA-DNA hybridization. GCF ICTP levels were quantified using radioimmunoassay (RIA). Clinical assessments made at the same sites included: BOP, gingival redness, plaque, pocket depth, and attachment level. Differences among ICTP levels in the 3 subject groups were sought using the Kruskal-Wallis test. Relationships between ICTP levels and clinical parameters as well as subgingival species were determined by regression analysis. The results demonstrated significant differences among disease categories for GCF ICTP levels for healthy (1.1+0.6 pg/site (mean±SEM)) gingivitis (14.8±6.6 pg/site) and peridontitis subjects (30.3+5.7 pg/site) (p=0.0017). ICTP levels related modestly to several clinical parameters. Regression analysis indicated that ICTP levels correlated strongly with mean subject levels of several periodontal pathogens including B. forsythus, P. gingivalis, P. intermedia, P. nigrescens and T. denticola (p<0.01). The data indicate that there is a positive relationship between the putative bone resorptive marker ICTP and periodontal pathogens. Keywordsperiodontitis; gingival crevicular fluid; periodontal pathogens; bone resorption; pyridinoline crosslinks; human studies One of the limitations in periodontology is the inability to detect actively deteriorating sites in patients susceptible to periodontal disease. Currently, the clinician diagnoses periodontal disease based upon clinical diagnostic aids such as radiographs and probing depth measurements (Armitage 1996). These diagnostics are effective in determining disease status, but are poor predictors of future disease activity (Haffajee et al. 1983. Recent advances in the diagnosis of metabolic skeletal disorders have lead to the investigation of markers of periodontal alveolar bone loss (Giannobile 1997 Hämäläinen 1994,Giannobile et al. 1995, Shibutani et al. 1997) and peri-implantitis (Oringer et al. 1998).Pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP) is derived from the carboxyterminal telopeptide regions of type I collagen cross-linked via pyridinoline or deoxypyridinoline . Following procollagen synthesis and its release into the maturing extracellular matrix, collagen fibrils undergo post-translational modification resulting in cross-links between the telopeptide regions of type I collagen chains by lysyl oxidase. The ICTP cross-link contains two carboxyterminal telopeptides of the α 1 chain and one helical region fro...

Effect of Non‐Surgical Periodontal Therapy on C‐Telopeptide Pyridinoline Cross‐Links (ICTP) and Interleukin‐1 Levels

“…Previous reports analyzing ICTP levels in GCF have consistently compared total amounts of GCF versus concentration, and the most predictive results were found when total amounts were normalized by the time of collection. [8][9][10][11] The mean total amount of ICTP present at baseline in this cohort of periodontitis subjects was similar to previous investigations that measured ICTP levels in untreated periodontitis subjects. 8,11,27 In contrast, Palys et al 9 reported lower ICTP levels among a group of previously treated periodontitis subjects participating in a periodontal maintenance program.…”

“…Talonpoika and Hämäläinen 27 utilized a similar stratification scheme based upon probing depth and also reported significantly higher ICTP levels among untreated periodontitis subjects at sites with deep PD (i.e., 4 to 10 mm). However, Palys et al 9 reported no significant differences in ICTP levels at sites exhibiting different PD among a cohort of treated periodontitis patients. These investigators did detect higher levels of ICTP at shallow sites in both a gingivitis and periodontitis cohort compared to periodontally healthy subjects.…”

“…7 The presence of ICTP in GCF has been associated with bone and attachment loss in experimental and natural periodontitis. 8,9 In an experimental periodontitis model, ICTP was found to be highly sensitive and predictive for future radiographic bone loss as measured by computer-assisted digital radiography. 8 More recently, it has been demonstrated that ICTP is elevated in periodontal patients exhibiting high levels of putative periodontal pathogens including Bacteroides forsythus, Porphyromonas gingivalis, Fusobacterium nucleatum subspecies, and Treponema denticola.…”

“…8 More recently, it has been demonstrated that ICTP is elevated in periodontal patients exhibiting high levels of putative periodontal pathogens including Bacteroides forsythus, Porphyromonas gingivalis, Fusobacterium nucleatum subspecies, and Treponema denticola. 9 Elevated levels of ICTP have also been observed around dental implants colonized by organisms associated with disease progression. 10 Finally, treatment with a matrix metalloproteinase (MMP) inhibitor significantly reduced ICTP levels in patients exhibiting active periodontal disease.…”

Materiomics for Oral Disease Diagnostics and Personal Health Monitoring: Designer Biomaterials for the Next Generation Biomarkers

“…One particular example can be using DNA probes to differentiate healthy, gingivitis, and periodontitis subjects using DNA-DNA hybridization techniques (Palys et al, 1998).…”