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Ullbro C, Kinnby B, Lindberg P, Matsson L: Tissue plasminogen activator (t-PA) and placental plasminogen activator inhibitor (PAI-2) in gingival crevicular fluid from patients with Papillon–Lefèvre syndrome. J Clin Periodontol 2004; doi: 10.1111/j.1600-051X.2004.00551.x. © Blackwell Munksgaard, 2004. Numerous patients with Papillon–Lefèvre syndrome (PLS) express a severe periodontal inflammation that results in premature loss of deciduous and permanent teeth. The plasminogen activating (PA) system is involved in physiological and pathological processes including epithelial healing, extracellular proteolysis and local inflammatory reactions. The aim of the study was to explore a possible role of the PA system in patients with PLS. Samples of gingival crevicular fluid (GCF) were collected from areas with gingival infection in 20 patients with PLS and in 20 healthy controls. The concentration of tissue plasminogen activator (t-PA) and inhibitor (PAI-2) was measured with ELISA. The median level of PAI-2 was significantly higher ( p<0.01) in PLS patients than in the controls, while the median value of t-PA did not differ between the groups. No difference in t-PA or PAI-2 levels was found regarding age, gender or presence of active periodontal disease. The findings indicate an atypical activity of the PA system with a disturbed epithelial function in PLS patients, suggesting that the periodontal destruction seen in patients with PLS is secondary to a hereditary defect in the defense system. [ABSTRACT FROM AUTHOR]

The plasminogen activating system plays an important role in tissue proteolysis in physiological as well as pathological processes. Earlier studies have shown high concentrations of the plasminogen activator t-PA as well as its inhibitor PAI-2 in gingival crevicular fluid (GCF). In addition, gingival inflammatory reactions have been related to increases in t-PA and PAI-2. In order to explore the potential role of the plasminogen activating system for the development of destructive periodontal disease, the aim of this study was to assess the balance of the activator t-PA to the inhibitor PAI-2 in GCF from patients, clinically defined to represent different periodontal conditions. The Progression Group consisted of 12 periodontitis patients with 1 or more sites having shown an increased pocket depth of »= 3 mm during the last 2 years of maintenance care and with »= 8 unchanged or improving sites during the period. The Non Progression Group consisted of patients who had shown a decreased or unchanged pocket depth of all sites during the last 3 years of maintenance care. Sampling of GCF was done with small disks of Millipore-filter, and t-PA and PAI-2 were analyzed with ELISAs. There was no difference in the t-PA/PAI-2 ratio between the two groups. However, an intra-individual comparison within the Progression Group showed a higher ratio at the deteriorating sites than at the stable sites. Even though no difference was found between the groups, the higher t-PAfPAI-2 ratio at the deteriorating sites in the Progression Group suggests an involvement of the plasminogen activating system in the proteolytic events leading to breakdown of the tooth supporting tissues. [ABSTRACT FROM AUTHOR]

In chronic periodontitis, subgingival biofilms induce an inflammatory response leading to periodontal tissue destruction which may cause tooth loss. The response includes exudation of fluid (GCF) from the gingival pocket, giving rise to a protein-rich micro-environment in the biofilm. We hypothesize that proteolytic activity in biofilms is a virulence factor contributing to sustained inflammation. To study the influence of GCF on proteolytic activity in a periodontitis-associated biofilm, a multi-species consortium (Porphyromonas gingivalis, Fusobacterium nucleatum, Parvimonas micraandStreptococcus constellatus) was grown in 10% equine serum (to model GCF) or BHI (control) for 2-5 days. Cell-associated and secreted proteolytic activity was investigated with zymography, fluorometry or fluorescent substrates in combination with fluorescencein situhybridization (FISH). After 2 days, streptococci dominated the consortium in BHI whereas in serum diversity was maintained over 5 days. The serum consortium also developed proteolytic activity, which was absent in BHI. Zymography revealed an array of secreted proteases. FISH revealed proteolytic activity associated with the cell surface ofP. gingivalisandF. nucleatumbut notP. micraorS. constellatus. Thus, serum favored survival ofP. gingivalisandF. nucleatumas well as production of proteases that can act as virulence factors in chronic periodontitis. [ABSTRACT FROM AUTHOR]