Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy

J Periodontal Res. 2017 Jun;52(3):574-581. doi: 10.1111/jre.12425. Epub 2016 Oct 26.


Background and objective: The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on clinical parameters and gingival crevicular fluid levels of tissue/blood vessel-type plasminogen activator (t-PA) and plasminogen activator inhibitor-2 (PAI-2) in patients with periodontitis, with or without rheumatoid arthritis (RA).

Material and methods: Fifteen patients with RA and chronic periodontitis (RA-P), 15 systemically healthy patients with chronic periodontitis (H-P) and 15 periodontally and systemically healthy volunteers (C) were included in the study. Plaque index, gingival index, probing pocket depth, clinical attachment level, bleeding on probing, gingival crevicular fluid t-PA and PAI-2 levels, erythrocyte sedimentation rate, serum C-reactive protein and disease activity score were evaluated at baseline and 3 mo after mechanical nonsurgical periodontal therapy.

Results: All periodontal clinical parameters were significantly higher in the RA-P and H-P groups compared with the C group (p < 0.001) and decreased significantly after treatment (p < 0.001). Pretreatment t-PA levels were highest in the RA-P group and significantly decreased post-treatment (p = 0.047). Pre- and post-treatment PAI-2 levels were significantly lower in controls compared with both periodontitis groups (p < 0.05). Gingival crevicular fluid volume and the levels of t-PA and PAI-2 were significantly correlated.

Conclusion: In patients with periodontitis and RA, nonsurgical periodontal therapy reduced the pretreatment gingival crevicular fluid t-PA levels, which were significantly correlated with gingival crevicular fluid PAI-2 levels. The significantly higher t-PA and PAI-2 gingival crevicular fluid levels in periodontal patients, regardless of systemic status, suggest that the plasminogen activating system plays a role in the disease process of periodontitis.

Keywords: gingival crevicular fluid; periodontitis; plasminogen activator inhibitor-2; rheumatoid arthritis; tissue plasminogen activator.

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / metabolism*
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Chronic Periodontitis / complications*
  • Chronic Periodontitis / metabolism
  • Chronic Periodontitis / therapy
  • Dental Plaque Index
  • Dental Scaling
  • Female
  • Gingival Crevicular Fluid / chemistry*
  • Humans
  • Male
  • Middle Aged
  • Periodontal Attachment Loss / complications
  • Periodontal Attachment Loss / metabolism
  • Periodontal Attachment Loss / therapy
  • Periodontal Index
  • Plasminogen Activator Inhibitor 2 / analysis*
  • Plasminogen Activators / analysis*
  • Root Planing


  • Plasminogen Activator Inhibitor 2
  • C-Reactive Protein
  • Plasminogen Activators