Proteases and inhibitors in the plasma of patients with periodontal disease.
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Biomedical subjects
Publications and source records attributed to G G Zafiropoulos.
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The purpose of this work was to study the elastase content of PMNs, the elastase alpha1-protease inhibitor complex, and the protease inhibitors in the plasma of patients with periodontal disease as compared with healthy subjects. We examined 11 patients with localized juvenile periodontitis (LJP), 15 patients with rapidly progressive periodontitis (RPP), and 22 healthy control subjects (HS). Our findings showed a significantly higher value for elastase like protease (ELP) complex in both patient groups than for the control group. In RPP patients, the ELP content of PMNs was below that in healthy subjects. Correlation between the ELP complex and the ELP content of PMN's was significantly positive. No such correlation could be discovered in the LJP group between the quantity of a1Pl and its inhibitory capacity, which may suggest a functional disorder involving the a1Pl of these patients. The imbalance existing between the different protease inhibitors is perhaps an explanation of the extensive tissue destruction occurring in periodontal disease as a result of the unrestrained effect of released granulocyte enzymes in the case of defective inhibition.
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PMN chemotactic function and oxydative metabolism were investigated in 13 patients with rapidly progressive periodontitis (RPP) and 9 patients with localized juvenile periodontitis (LJP) using a chemotaxis assay (CHA), luminol chemiluminescence (CL) and nitroblue-tetrazolium (NBT) tests. In the LJP patients there was a significantly lower CHA than in the RPP patients (less than 40%). Three out of the 13 RPP patients displayed a cell-dependent increase of CHA and in 3, the reduced CHA measured was serum-associated whilst among the 9 LJP patients, a cell-dependent defect of CHA was present in 5 patients, a serum-associated defect in one patient and a combined cell- and serum-associated defect was found in another patient. The average values of CL in the RPP patients were significantly lower (1309.3 +/- 814.2) than those measured in the LJP group (2208 +/- 826.9). In contrast, the mean NBT test values indicated a lower phagocytic function in the LJP patients than in the RPP ones suggesting also the presence of a serum-dependent factor in RPP and that of a combined cell- and serum-response in LJP. According to these results, the neutrophil dysfunction in RPP, as indicated by both the chemotaxis and the oxydative metabolism nature, was frequently associated with a serum factor.
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