Activin-A and Interleukin-1β Levels in Periodontitis
Condition: Periodontitis; Gingivitis; Periodontal Health
MeSH terms: Gingivitis; Periodontitis
Study type: Observational [Patient Registry]

Summary: 
      Activin-A belongs to the transforming growth factor-beta superfamily and is a multifunctional
      cytokine that plays a role in inflammation, immune response, tissue repair and regeneration.
      Proinflammatory cytokine interleukin-1beta (IL-1β) can increase Activin-A expression in
      various cell types. This study aims to evaluate gingival crevicular fluid (GCF) and salivary
      Activin-A and IL-β levels in stage III periodontitis. Seventy-five systemically healthy and
      non-smoker volunteers consisting of 23 stage III periodontitis, 26 gingivitis and 26
      periodontally healthy were enrolled. Full-mouth clinical periodontal indices were recorded,
      unstimulated whole saliva and GCF samples were obtained, Activin-A and IL-1β total amounts
      were determined by enzyme-linked immunosorbent assay. Statistical comparisons were performed
      using non-parametric tests.
    

Detailed description: 
      Participants were divided into three groups according to the diagnostic criteria proposed by
      the Classification of Periodontal and Peri-implant Diseases and Conditions; I. Periodontitis
      group (n=23), II. Gingivitis group (n=26) III. Periodontally healthy group (n=26)

      Clinical periodontal indices included probing depth (PD), clinical attachment loss (CAL), the
      dichotomous scoring of bleeding on probing (BOP +/-), gingival index (GI), and plaque index
      (PI). Clinical recordings were performed at six points (mesiobuccal, buccal, distobuccal,
      mesiopalatal/mesiolingual, palatal/lingual, and distopalatal/distolingual) of all teeth,
      except the 3rd molars, by a single investigator using a conventional periodontal probe.

      Interproximal radiographic bone loss on the digital panoramic radiographs were evaluated, as
      the ratio of the distance between the bone crest and the cemento-enamel junction to the
      length of the root.

      GCF and unstimulated whole saliva samples were obtained 1 day following the clinical
      periodontal measurements. Immediately after saliva collection, GCF was collected from the
      buccal aspects of non-contiguous interproximal sites in two single-rooted teeth via steril
      paper strips. Fluid samples were obtained from two deepest pockets in periodontitis group and
      the most inflamed sites with clinical signs of redness or edema in gingivitis group. In the
      periodontally healthy groups, samples were taken from the sites without visible inflammation.
      All samples were stored at -80 °C until further analysis.

      Measurement of Activin-A and IL-1β levels in GCF and saliva samples were performed by the
      commercially available enzyme-linked immunosorbent assay (ELISA) kits. While GCF cytokine
      levels were expressed as both total amounts at two samples per 30 s and concentrations,
      salivary cytokine levels were presented as concentrations.

      A statistical software package was used for all data analyses. If the clinical and
      biochemical data did not present normal distribution as checked by Shapiro Wilk's normality
      test, the analyses were performed by using nonparametric methods. The Kruskal-Wallis test
      with Dunn-Bonferroni post hoc method was applied to compare the study groups regarding
      clinical indices and oral biofluid levels of Activin-A and IL-1β. The presence and degree of
      linear association of cytokine levels in GCF and saliva with clinical indices were analyzed
      by Spearman rank correlation coefficient. p<0.05 was considered as a threshold for
      statistical significance.
    

Intervention name(s): Periodontal clinical measurements, GCF and saliva sampling
Intervention type(s): Other
Intervention description(s): Clinical periodontal indices included probing depth (PD), clinical attachment loss (CAL), the dichotomous scoring of bleeding on probing (BOP +/-), gingival index (GI), and plaque index (PI). Clinical recordings were performed at six points (mesiobuccal, buccal, distobuccal, mesiopalatal, palatal, and distopalatal) of all teeth, except the 3rd molars.
GCF and saliva samples were obtained 1 day following the clinical measurements. Unstimulated whole saliva was collected from all participants. GCF was sampled with paper strips from two deepest pockets in periodontitis group; the most inflamed sites with clinical signs of redness or edema in gingivitis group; and the sites without visible inflammation in periodontally healthy group. GCF and saliva samples were stored at -80 °C until further analysis.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        This prospective case-control study consecutively enrolled 75 individuals (39 females and
        36 males and; aged 27 to 48 years; mean age, 37.30 ± 5.10 years) from the Department of
        Periodontology, School of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey, in the
        period from March 2019 to January 2020.
      
Biospecimen description: 
      Gingival crevicular fluid and saliva