Do salivary and serum collagenases have a role in an association between obstructive sleep apnea syndrome and periodontal disease? A preliminary case-control study

Arch Oral Biol. 2015 Jan;60(1):134-43. doi: 10.1016/j.archoralbio.2014.09.006. Epub 2014 Oct 5.


Objectives: Despite increasing evidence for an association of obstructive sleep apnea syndrome (OSAS) and periodontal disease, the pathophysiological linking mechanisms remain unclear. This study aims to evaluate the salivary and serum matrix metalloproteinase-2, -8, -9 (MMP-2, -8, -9), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), myeloperoxidase (MPO), neutrophil elastase (NE), neutrophil gelatinase-associated lipocalin (NGAL), as well as degree of activation of MMP-2, -9 of patients with and without OSAS.

Design: A total of 50 individuals were included in the study. There were 13, 17 and 20 individuals, respectively in the control (non-OSAS) group, mild-to-moderate OSAS and severe OSAS groups. Saliva, serum samples and clinical periodontal parameters were collected. Biofluid samples were analysed by immunofluorometric assay (IFMA), enzyme-linked immunosorbent assay (ELISA), western immunoblotting and gelatine zymography. Statistical analyses were performed using D'Agostino-Pearson omnibus normality test, Kruskal-Wallis test and Spearman rho rank correlation analysis.

Results: There were no statistically significant differences in clinical periodontal parameters between the study groups. Salivary NE and proMMP-2 levels were significantly lower in the OSAS groups than the control group (p<0.05). Serum proMMP-9 concentration and the degree of MMP-9 activation in saliva were significantly lower in the severe OSAS group than the control group (p<0.05). There were significant correlations between salivary and serum proMMP-9 and -2 concentrations (p<0.05). Serum proMMP-2, NE and salivary proMMP-9 and -2 negatively correlated with indicators of OSAS severity (p<0.05).

Conclusions: The present findings do not support a pathophysiological link between the severity of OSAS and clinical periodontal status via neutrophil enzymes or MMPs.

Keywords: Matrix metalloproteinases; Obstructive sleep apnea syndrome; Periodontal disease; Saliva; Serum; Tissue inhibitor of matrix metalloproteinases-1.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins / metabolism
  • Adult
  • Biomarkers / metabolism
  • Blotting, Western
  • Case-Control Studies
  • Collagenases / metabolism*
  • Enzyme Precursors / metabolism
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fluoroimmunoassay
  • Humans
  • Leukocyte Elastase / metabolism
  • Lipocalin-2
  • Lipocalins / metabolism
  • Male
  • Matrix Metalloproteinase 8 / metabolism
  • Matrix Metalloproteinase 9 / metabolism
  • Middle Aged
  • Periodontal Diseases / enzymology*
  • Peroxidase / metabolism
  • Proto-Oncogene Proteins / metabolism
  • Saliva / enzymology*
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / enzymology*
  • Tissue Inhibitor of Metalloproteinase-1 / metabolism


  • Acute-Phase Proteins
  • Biomarkers
  • Enzyme Precursors
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Proto-Oncogene Proteins
  • Tissue Inhibitor of Metalloproteinase-1
  • Peroxidase
  • Leukocyte Elastase
  • Collagenases
  • pro-matrix metalloproteinase 9
  • Matrix Metalloproteinase 8
  • Matrix Metalloproteinase 9