Salivary Matrix Metalloproteinase-8 and -9 and Myeloperoxidase in Relation to Coronary Heart and Periodontal Diseases: A Subgroup Report from the PAROKRANK Study (Periodontitis and Its Relation to Coronary Artery Disease)

PLoS One. 2015 Jul 1;10(7):e0126370. doi: 10.1371/journal.pone.0126370. eCollection 2015.

Abstract

Background and objective: Matrix metalloproteinase (MMP) -8, -9 and myeloperoxidase (MPO) are inflammatory mediators. The potential associations between MMP-8, -9, MPO and their abilities to reflect cardiovascular risk remains to be evaluated in saliva. The objective of this study was to investigate the levels and associations of salivary MMP-8, -9, MPO and tissue inhibitors of metalloproteinase (TIMP)-1 in myocardial infarction (MI) patients and controls with or without periodontitis.

Materials and methods: 200 patients with a first MI admitted to coronary care units in Sweden from May 2010 to December 2011 and 200 controls matched for age, gender, residential area and without previous MI were included. Dental examination and saliva sample collection was performed 6-10 weeks after the MI in patients and at baseline in controls. The biomarkers MMP -8, -9, MPO and TIMP-1 were analyzed by time-resolved immunofluorescence assay (IFMA), Western blot and Enzyme-Linked ImmunoSorbent Assay (ELISA).

Results: After compensation for gingivitis, gingival pockets and smoking, the mean salivary levels of MMP-8 (543 vs 440 ng/mL, p = 0.003) and MPO (1899 vs 1637 ng/mL, p = 0.02) were higher in non-MI subjects compared to MI patients. MMP-8, -9 and MPO correlated positively with clinical signs of gingival/periodontal inflammation while TIMP-1 correlated mainly negatively with these signs. The levels of latent and active forms of MMP-8 did not differ between the MI and non-MI groups. Additionally, MMP-8, MPO levels and MMP-8/TIMP-1 ratio were significantly higher in men compared to women with MI.

Conclusions: This study shows that salivary levels of the analyzed biomarkers are associated with periodontal status. However, these biomarkers could not differentiate between patients with or without a MI. These findings illustrate the importance to consider the influence of oral conditions when analyzing levels of inflammatory salivary biomarkers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers
  • Case-Control Studies
  • Chronic Periodontitis / complications
  • Chronic Periodontitis / epidemiology
  • Chronic Periodontitis / metabolism*
  • Comorbidity
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / drug therapy
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / metabolism*
  • Female
  • Humans
  • Male
  • Matrix Metalloproteinase 8 / metabolism*
  • Matrix Metalloproteinase 9 / metabolism*
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / metabolism
  • Peroxidase / metabolism*
  • Risk Factors
  • Saliva / enzymology*
  • Tissue Inhibitor of Metalloproteinase-1 / metabolism

Substances

  • Biomarkers
  • Tissue Inhibitor of Metalloproteinase-1
  • Peroxidase
  • Matrix Metalloproteinase 8
  • Matrix Metalloproteinase 9

Grant support

The study was financially supported by the Swedish National Graduate School in Odontological Science, the Swedish Dental Society, AFA Insurance, the Heart and Lung Foundation, the Stockholm County Council (ALF project), VR Research Funding and the Academy of Finland and Helsinki University Central Hospital Research Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.