Kapila Y et al.,(2016) The Role of Apoptotic Factors in Assessing Progression of Periodontal Disease. Int J Dentistry Oral Sci. 3(9), 318-325. 318 OPEN ACCESS http://scidoc.org/IJDOS.php The Role of Apoptotic Factors in Assessing Progression of Periodontal Disease Research Article Dabiri D1, Halubai S1, Layher M1, Klausner C1, Makhoul H1, Lin GH1,2, Eckert G3, Abuhussein H1, Kamarajan P4, Kapila Y1, 4* 1 Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, USA. 2 Department of Surgical Sciences, Marquette University School of Dentistry, USA 3 Department of Biostatistics, Indiana University, USA. 4 Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, USA. International Journal of Dentistry and Oral Science (IJDOS) ISSN: 2377-8075 Introduction The mechanisms responsible for periodontal disease progression remain unclear. However, recent studies suggest that apoptosis or programmed cell death may be one mechanism underlying the pathophysiology of periodontal disease progression [1, 2]. Ap- optosis plays a critical role in the regulation of the host immune response and inflammation and can be modulated by various stimuli, including cytokines, bacterial and viral infections, immune cells themselves, and changes in growth factors, nutrients, and the extracellular matrix [3]. One of the best-defined apoptotic pathways is mediated by the death receptor Fas and Fas ligand (FasL) complex. The Fas recep- tor is expressed on many cell types that include gingival fibro- blasts, skin keratinocytes, and T cells [4-6]. Apoptotic cells are present in diseased gingiva [7]. During cell apoptosis, a sequential activation of cysteine proteases, called caspases, plays a central role in the execution phase of apoptosis. Caspase-3 is one of the key executor caspases that regulates a number of critical cellular *Corresponding Author: Yvonne L. Kapila, DDS, PhD, Professor, Vice-Chair Periodontology, Department of Orofacial Sciences, University of California San Francisco, School of Dentistry, 513 Parnassus Avenue, S612, Box 0422, San Francisco, CA 94143, USA. Tel: 415-502-4683 Fax: 415-476-4204 E-mail: Yvonne.Kapila@ucsf.edu Received: August 09, 2016 Accepted: August 31, 2016 Published: September 03, 2016 Citation: Kapila Y et al., (2016) The Role of Apoptotic Factors in Assessing Progression of Periodontal Disease. Int J Dentistry Oral Sci. 3(9), 318-325. doi: http://dx.doi.org/10.19070/2377-8075-1600064 Copyright: Kapila Y© 2016. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Abstract Background: The mechanisms responsible for periodontal disease progression remain unclear. However, recent studies suggest that apoptosis may be one mechanism underlying the pathophysiology of periodontal disease progression. This pilot study is the 3 month follow-up of our published baseline study on the presence of apoptotic factors in serum, saliva, and gingival crevicular fluid (GCF) and their association with periodontal disease severity and activity. Methods: GCF samples were obtained from 37 adult patients with chronic periodontitis (CP) and 7 healthy controls. Clinical measurements, including probing depth (PD), clinical attachment level (CAL), and radiographs, were used to evaluate data by sites and to classify patients into healthy, mild, and moderate/severe CP groups. Enzyme-linked immunosorbent assays were used to measure apoptosis or DNA fragmentation levels in GCF. Western immunoblotting was used to detect several apoptotic proteins, Fas, FasL, sFasL, and caspase-3 expression and its cleavage products in GCF. Results: At the patient level clinical and apoptotic measurements change minimally over time. At the site level, DNA fragmen- tation levels increase with increasing PDs at 3 months and ba