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Alpha1-antitrypsin (alpha1-AT) is a serum protease inhibitor with a well established role in bodily defense against destructive inflammatory diseases. alpha1-AT exhibits inheritable genetic polymorphism (Pi types). Certain Pi types have been shown to predispose to emphysema and, in this study, also appear to be related to increased chronic periodontitis susceptibility.

This investigation was designed to gain information on the relative levels of salivary immunoglobulins in patients with acute necrotizing ulcerative gingivitis as compared to patients with clinically healthy gingival tissue. Relative levels of salivary immunoglobulins in diseased and healthy patients were measured and standard antisera to human immunoglobulins were used to detect any host antibody production in both parotid fluid and whole saliva. Salivary samples were analyzed for five classes of immunoglobulins: IgG, IgM, IgA, IgAsec, and IgE. Healthy individuals showed no detectable concentration of IgM or IgE in whole saliva or parotid fluid. IgG, IgA, and IgAsec were present in all samples. Individuals with acute necrotizing ulcerative gingivitis demonstrated no detectable concentration of IgM in whole saliva or parotid fluid, IgE in normal individuals was not detectable; therefore, it was not included in the acute necrotizing ulcerative gingivitis analysis. There was a decrease in parotid fluid concentrations of IgG, IgA, and IgAsec. Whole saliva showed a decreased concentration of IgG and IgA. The IgAsec concentration was increased in whole saliva. At the 5% level of significance, the “Students” t test illustrates that in acute necrotizing ulcerative gingivitis patients IgG, IgA and IgAsec concentrations in parotid fluid demonstrate a significant difference in relative concentrations as compared to the normal individuals. Whole saliva IgA and IgAsec concentrations were significantly different. Whole saliva IgG concentrations were not significantly different at this level. The Chi‐square test at the 5% level of significance illustrates the same order of significance as in “Student” t test, for the relative frequency of salivary immunoglobulins in acute necrotizing ulcerative gingivitis patients as compared to normal individuals. The decreased salivary immunoglobulin concentration observed in acute necrotizing ulcerative gingivitis patients, as compared to normal individuals, suggests that an immune defect—hypogammaglobulinemia—may be the primary factor in the etiology of acute necrotizing ulcerative gingivitis. The increased whole saliva IgAsec concentration illustrated in acute necrotizing ulcerative gingivitis patients, as compared to normal individuals, suggests that “pathotopic potentiation” may be responsible for such an increase.

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