ASSOCIATION OF MCP-1 AND sCD40-L IN GINGIVAL CREVICULAR FLUID AND SALIVA OF CHRONIC PERIODONTITIS SUBJECTS WITH CARDIOVASCULAR DISEASE’S (CVD’S) – A CASE CONTROL STUDY

Abstract

Periodontal disease refers to pathologic inflammatory response affecting the supporting structures including alveolar bone, gingival connective tissue surrounding the teeth. Characteristically it is chronic in nature, preceded by oral biofilm formation accompanied with the deposition of bacterial plaque and calculus. Periodontitis is the sixth leading cause of human chronic degenerative disease that increases the risk for CVD’s due to the strong correlation between the subgingival microbiota and the pathogens present in the vascular lesions. Periodontitis if left untreated, results in alveolar bone loss and exfoliation of the involved teeth. Traditional periodontal diagnostic methods included assessment of clinical parameters and radiographs. Though efficient, these conventional techniques are inherently limited in that only a historical perspective, not current appraisal, of disease status can be determined. Advances in the use of oral fluids as possible biological samples for objective measures of current disease state, treatment monitoring, and prognostic indicators have boosted saliva and other oral-based fluids to the forefront of technology. Oral fluids contain locally and systemically derived mediators of periodontal disease, including microbial, host response, and bone-specific resorptive markers. Amogst them most important biomarkers in oral fluids are MCP-1 and sCD40 L that represent inflammatory mediators, collagen degradation and bone turnover-related molecules that have emerged as possible measures of periodontal disease activity. So this study has aimed to determine the association between elevated levels of MCP-1 and sCD40 L in saliva and Gingival Crevicular Fluid, of severely affected Chronic Periodontitis patients with well established progression and acute precipitation of Cardio vascular disease. A total of 84 subject’s 42 cases and 42 controls between the age of 35- 68 with severe periodontitis along with horizontal alveolar bone loss ( grade 4) having cardiac disease were selected as cases and individuals with periodontitis without cardiac diseases were opted as controls in the study. After informed consent detailed demographics, cardiovascular, medical and family history of the patients, grading of alveolar bone loss, periodontal and gingival status, probing depth, gingival index, plaque index, clinical attachment level was carefully recorded on the evaluation form. GCF and Salivary samples were extruded and the sCD40 L and MCP -1 levels were quantified in a solid phase, sand which technique using Elisa kit. This study identified a correlation of the bio molecular vii markers sCD40-L and MCP -1 that constitute an important pathway leading to cardiovascular loads in chronic periodontal patients. The significant positive results were observed that suggests that these two inflammatory mediators, soluble CD40 ligand (sCD40 L) and monocyte chemoattractant protein-1 (MCP-1) has been established in progression and acute precipitation of CVD's and this pathway is considered as one of the mechanisms that may lead to increasing severity of periodontal disease and its systemic effects. Timely detection and diagnosis of disease significantly affect the clinical management of periodontal patients by offering earlier, less invasive, and more cost-effective treatment therapies. This study will also educate the patients to look for a collaborative effort of health practitioner and dentists for early monitoring and intervention along with appropriate oral hygiene care that will potentially reduce systemic cardiac illness in chronically affected periodontal patients