Diagnostic Biomarkers Related to Periodontal Disease Activity in Diabetic
Status:
Completed
Trial end date:
2012-06-01
Target enrollment:
Participant gender:
Summary
The purpose of the study was to monitor the activity of periodontal disease and suggest
potential biomarkers related to active periodontal disease in patients with chronic
periodontitis (PD) associated or not with type 2 diabetes mellitus (DM), based on the
evaluation of the profile of gene expression of periodontal sites and the evaluation of
inflammatory salivary proteins. Two hundred and five periodontal patients were enrolled, but
only 41 exhibited ≥ 1 mm attachment loss in at least three periodontal site (active sites) 2
months after non-surgical periodontal therapy. The final sample was: 21 patients with chronic
periodontitis (PD group) and 20 with chronic periodontitis and diabetes (PD+DM group).
Fifteen periodontal- and systemically healthy patients were included as control group. Saliva
collection, glycated hemoglobin measurement, periodontal examination and radiographs were
conducted before and 2 months after non-surgical periodontal therapy. Radiographic
subtraction was performed from pairs of the radiographs. Measurements of the areas with
density loss were recorded. Gingival biopsies of active and non-active sites with similar
clinical parameters were harvested for Real Time Polymerase Chain Reaction Array gene
expression analysis. Saliva samples were analyzed by Multiplex Cytokine Profiling Immunoassay
for analysis of protein expression. The clinical attachment loss mean was higher in the PD+DM
group (p<0.05). There was a high correlation between clinical attachment loss and darkened
radiographic areas in active sites of the PD group and PD+DM group. When compared PD group to
PD+DM, patients with diabetes had an up-regulated profile. Active sites of the PD group
showed nine genes (specific chemokines, interleukins and receptors) differentially expressed
with an up-regulated profile. Active sites of the PD+DM group showed six genes (specific
chemokines, interleukins and receptors) differentially expressed with an up-regulated
profile. After periodontal therapy, there was a reduction of some salivary proteins in both
periodontal groups, but not significant. In conclusion, it was possible to identify genes
differentially expressed in active sites from both groups, which may be considered useful in
indicating potential biomarkers for the diagnosis of periodontitis; salivary proteins show a
trend in distinguishing the standard of health and disease and may be used in the future as
potential biomarkers of periodontitis with or without diabetes.
Phase:
Phase 3
Details
Lead Sponsor:
University of Sao Paulo
Collaborator:
Fundação de Amparo à Pesquisa do Estado de São Paulo