Effectiveness of periodontal intervention on the levels of N-terminal pro-brain natriuretic peptide in chronic periodontitis patients
Keywords:Brain natriuretic peptide, Cardiovascular biomarker, Nonsurgical periodontal therapy, NT-proBNP, Periodontal disease
Background: N-terminal-pro-brain natriuretic peptide (NT-proBNP) is an inactive hormone that is seen during inflammation and is a known biomarker of cardiovascular disease (CVD). Evidence suggests that periodontitis has a bidirectional relationship with CVD and NT-proBNP has a potential role in periodontal disease. However, there is no evidence on the impact of nonsurgical periodontal therapy (NSPT) on the levels of NT-proBNP in gingival crevicular fluid (GCF) and serum in patients with chronic periodontitis. Hence, the aim of this study was to compare the levels of NT-proBNP in GCF and serum in patients with chronic generalized periodontitis.
Materials and methods: GCF and serum samples were collected in 19 patients with chronic periodontitis before and after NSPT after 6 weeks and the cumulative or reduction in values of NT-proBNP in GCF and serum was assessed. NT-proBNP levels in GCF and serum were determined by enzyme-linked immunosorbent assay.
Results: The concentrations of NT-proBNP were significantly reduced in GCF and serum after NSPT. Statistically significant difference of NT-proBNP concentration between pre- and postgroups in GCF was apparent (p < 0.0001), whereas statistically nonsignificant results in NT-proBNP serum levels when compared at baseline to postoperative state with mean of 61.77 (22.6 standard deviation [SD]) preoperatively and 72.67 (51.86 SD) postoperatively (p = 0.0007) was observed.
Conclusion: Significant reduction of NT-proBNP concentrations in GCF and serum in patients with chronic periodontitis subjected to NSPT was observed. This may account for a significant relation between periodontal disease, bacteremia, and CVD.
Leira Y, Blanco J. Brain natriuretic peptide serum levels in periodontitis. J Periodontal Res. 2018;53(4):575-581. https://doi.org/10.1111/jre.12547 PMID:29633261
Jensen J, Ma LP, Fu MLX, Svaninger D, Lundberg PA, Hammarsten O. Inflammation increases NT-proBNP and the NT-proBNP/BNP ratio. Clin Res Cardiol. 2010;99(7):445-452. https://doi.org/10.1007/s00392-010-0140-z PMID:20229122
Dale JC, Steindel SJ, Walsh M. Early morning blood collections: a College of American Pathologists Q-Probes study of 657 institutions. Arch Pathol Lab Med. 1998;122(10):865-870. PMID:9786345
Sorita A, Patterson A, Landazuri P, et al. The feasibility and impact of midnight routine blood draws on laboratory orders and processing time. Am J Clin Pathol. 2014;141(6):805-810. https://doi.org/10.1309/AJCPPL8KFH3KFHNV PMID:24838324
Eke PI, Dye BA, Wei L, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015;86(5):611-622. https://doi.org/10.1902/jop.2015.140520 PMID:25688694
Dikbas I, Tanalp J, Tomruk CO, Koksal T. Evaluation of reasons for extraction of crowned teeth: a prospective study at a university clinic. Acta Odontol Scand. 2013;71(3-4):848-856. https://doi.org/10.3109/00016357.2012.680908 PMID:22554248
Bullon P, Newman HN, Battino M. Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction? Periodontol 2000. 2014;64(1):139-153. https://doi.org/10.1111/j.1600-0757.2012.00455.x PMID:24320961
Iacopino AM, Cutler CW. Pathophysiological relationships between periodontitis and systemic disease: recent concepts involving serum lipids. J Periodontol. 2000;71(8):1375-1384. https://doi.org/10.1902/jop.2000.71.8.1375 PMID:10972656
Sophia K II, Suresh S, Sudhakar U Sr, et al. Comparative evaluation of serum and gingival crevicular fluid periostin levels in periodontal health and disease: a biochemical study. Cureus. 2020;12(3):e7218. https://doi.org/10.7759/cureus.7218 PMID:32274276
Khlgatian M, Nassar H, Chou HH, Gibson FC III, Genco CA. Fimbria-dependent activation of cell adhesion molecule expression in Porphyromonas gingivalis-infected endothelial cells. Infect Immun. 2002;70(1):257-267. https://doi.org/10.1128/IAI.70.1.257-267.2002 PMID:11748191
Dhadse P, Gattani D, Mishra R. The link between periodontal disease and cardiovascular disease: how far we have come in last two decades? J Indian Soc Periodontol. 2010;14(3):148-154. https://doi.org/10.4103/0972-124X.75908 PMID:21760667
Mohan M, Jhingran R, Bains VK, et al. Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus. J Periodontal Implant Sci. 2014;44(4):158-168. https://doi.org/10.5051/jpis.2014.44.4.158 PMID:25177517
Goutoudi P, Diza E, Arvanitidou M. Effect of periodontal therapy on crevicular fluid interleukin-6 and interleukin-8 levels in chronic periodontitis. Int J Dent. 2012;2012:362905. https://doi.org/10.1155/2012/362905 PMID: 22114600
Elmeadawy SH, El-Sharkawy HM, Elbayomy A. Effect of nonsurgical periodontal therapy on systemic pro-inflammatory and vascular endothelial biomarkers and serum lipid profile in chronic periodontitis patients. Egyptian Dent J. 2017;63(3):2421-2433. https://doi.org/10.21608/edj.2017.76059
Cui D, Li H, Lei L, Chen C, Yan F. Nonsurgical periodontal treatment reduced aortic inflammation in ApoE(-/-) mice with periodontitis. Springerplus. 2016;5(1):940. https://doi.org/10.1186/s40064-016-2637-z PMID:27386384
Linkai D, Chunjie L, Qian L, Yukui Z, Hongwei Z. Periodontal treatment for cardiovascular risk factors: a systematic review. West China J Stomatol. 31(5):463-467. PMID 24298794
Zeng XT, Leng WD, Lam YY, et al. Periodontal disease and carotid atherosclerosis: a meta-analysis of 17,330 participants. Int J Cardiol. 2016;203:1044-1051. https://doi.org/10.1016/j.ijcard.2015.11.092 PMID:26638053
Gupta M, Chaturvedi R, Jain A. Role of cardiovascular disease markers in periodontal infection: understanding the risk. Indian J Dent Res. 2015;26(3):231-236. https://doi.org/10.4103/0970-9290.162873 PMID:26275186
Waghmare AS, Vhanmane PB, Savitha B, Chawla RL, Bagde HS. Bacteremia following scaling and root planing: a clinico-microbiological study. J Indian Soc Periodontol. 2013;17(6):725-730. https://doi.org/10.4103/0972-124X.124480 PMID:24554880
How to Cite
Copyright (c) 2022 Ibrahim Fazal, Bhavya Shetty, Umesh Yadalam, Safiya Fatima Khan, Manjusha Nambiar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors contributing to Journal of Circulating Biomarkers agree to publish their articles under the Creative Common Attribution Non Commercial 4.0 (CC-BY-NC 4.0) license, which allows third parties to re-use the work without permission as long as the work is properly referenced and the use is non-commercial.