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Amplified Crevicular Leukocyte Activity in Aggressive Periodontal Disease

¹ Department of Periodontology and Oral Biology, Goldman School of Dental Medicine, Boston University, Boston, MA, USA;
² Institute of Physiological Chemistry, University of Marburg, Germany; and
³ Department of Periodontology, School of Dental Medicine, University of Münster, Germany;

* corresponding author, Bussardstrasse 6, D-59071 Hamm, Germany, rainer_buchmann{at}yahoo.de

Exaggerated neutrophil responses are a critical component in the pathogenesis of periodontal disease. We investigated whether leukocyte activity in aggressive periodontitis (AP) is increased compared with that in chronic periodontitis (CP) by gingival crevicular fluid (GCF) analysis of myeloperoxidase (MPO), beta-N-acetyl-hexosaminidase (beta-NAH), cathepsin D (CD), and elastase-alpha-1-proteinase inhibitor complex (alpha-1-EPI) before and 6 months after therapy. Initial AP neutrophil responses were significantly amplified compared with those in CP (MPO, 3.2-fold; beta-NAH, 37.5-fold; CD, 2.2-fold; alpha-1-EPI, 1.4-fold; p < 0.05). Surgical therapy resulted in a significant reduction of GCF markers compared with non-surgical treatment. However, the changes in clinical parameters were not different between AP and CP (P > 0.05). Analysis of the results suggests that the local inflammatory response in AP is characterized by increased release of inflammatory mediators of neutrophil origin into the GCF. Analysis of the data further suggests that surgical therapy is a more predictable method for removal of the pro-inflammatory etiology.

KEY WORDS: aggressive periodontitis • inflammation • gingival crevicular fluid • PMN enzymes • protease-complexed elastase • host defense mechanisms