Estimation of Salivary and Serum Ceruloplasmin Levels in Subjects with and Without Chronic Periodontitis - A Comparative Biochemical Study.
Journal Title: International Journal of Dental Science and Innovative Research (IJDSIR) - Year 2019, Vol 2, Issue 3
Abstract
Introduction Periodontitis is a group of inflammatory diseases characterized by loss of connective tissue attachment and alveolar bone destruction. The initiation and the progression of periodontitis are dependent on the presence of complex sub gingival microbial communities. Although the bacteria are the etiological agents in periodontitis, the ecological interactions between the host and the pathogens determine the disease progression.1–3 If left untreated, the disease progresses with the loss of collagen fibers, apical migration of the junctional epithelium, resulting in alveolar bone destruction, eventually leading to tooth mobility and finally loss of teeth.4 Diagnosis of periodontal diseases at an early stage reduces the morbidity rate of the teeth. However diagnosis of the periodontal diseases and identifying the patients who are at risk always possess a challenge to the clinicians. Conventional periodontal diagnostic parameters used clinically include probing pocket depths, bleeding on probing, clinical attachment levels, plaque index, and radiographs assessing alveolar bone level.5 The advantages of these conventional diagnostic tools are their ease of use, their cost-effectiveness, and they are relatively non-invasive. Traditional diagnostic procedures have its own limitations of assessing only past tissue destructions and not the current disease status.6 Advances in oral and periodontal disease diagnostic research are moving toward methods whereby periodontal risk can be identified and quantified by objective measures such as biomarkers.7 A biomarker is a substance measured objectively and evaluated as an indicator of normal biologic processes, pathological processes, or pharmacological responses to a therapeutic intervention. Biological media like Saliva, Serum and Gingival Crevicular Fluid are used to determine biomarkers in periodontal diseases. It has been a feature of periodontal diseases that it creates an area of local inflammation as well as systemic inflammation, which are indicated by elevated serum levels of various pro-inflammatory markers such as alkaline phosphatase, tumor necrosis factor α, interleukin-1, C-reactive protein, vascular endothelial growth factor,8-10 and reduced levels of various anti-inflammatory markers especially the interleulkin-10.11One such pro-inflammatory marker for periodontal disease recognized in recent times is the Ceruloplasmin. Ceruloplasmin was first described in 1948 by Holmberg and Laurell as the blue plasma protein.12 This α-2 glycoprotein (mw,130kd) is the main copper metal binding protein in blood, binding upwards of 90% of total circulating copper.13 Elevated levels of Ceruloplasmin are associated with increased serum and synovial fluid copper and have been associated with inflammatory disease.14 The normal serum Ceruloplasmin levels ranges from150 to 300,µg/ml and can increase to as much as 900,µg/ml during inflammation.15,16 The corresponding elevation in copper levels observed was believed to play a protective role, a view supported by an enhanced inflammatory response in copper-deficient rats.17,18 This protective role was assumed to be due to the ability of copper to affect prostaglandin production.19 Ceruloplasmin itself was recently described as an anti-inflammatory agent due to its ability to act as a scavenger of superoxide anion radicals, (0-2)20,21 which can be generated by PMNs during inflammation and lead to tissue damage.22 A Study conducted by Iwata et al proved that Ceruloplasmin levels were increased in cases of localized aggressive periodontitis and caused priming of the neutrophils in localized aggressive periodontitis.23 It was also observed that as the clinical attachment loss increased corresponding to the percentage of bleeding sites, the serum level of Ceruloplasmin showed higher values.24 With this background this study aimed 1. To estimate and compare Salivary Ceruloplasmin levels in Subjects with Chronic Periodontitis and without Chronic Periodontitis. 2. To estimate and compare Serum Ceruloplasmin levels in Subjects with Chronic Periodontitis and without Chronic Periodontitis.
Authors and Affiliations
Dr Harini K.
Keywords
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