Association of peptidoglycan recognition protein 1 to post‐myocardial infarction and periodontal inflammation: A subgroup report from the PAROKRANK (Periodontal Disease and the Relation to Myocardial Infarction) study

Abstract

Background: Peptidoglycan recognition protein 1 (PGLYRP1) is an antimicrobial and proinflammatory innate immunity protein activated during infections. We aimed to investigate whether PGYLRP1 and associated molecules of the immune response in saliva is a cumulative outcome result of both MI and periodontal inflammation. Methods and Results:Two hundred patients with MI and another 200 matched non-MI controls were included. A full-mouthexamination was conducted to assess periodontal inflammation and collection of stimulated saliva was performed 6 to 10 weeks after the first MI. PGLYRP1, triggering receptor expressed on myeloid cells 1 (TREM-1), interleukin-1 beta (IL-1β) were analyzed by ELISA.Matrix metalloproteinase (MMP)-8 levels were determined by IFMA. Compared to controls, MI patients showed higher salivary PGLYRP1, but not TREM-1 levels.The difference in PGLYRP1 levels remained after adjustment for covariates. In MI patients, the PGLYRP1 levels positively correlated with BOP and PPD 4 to 5 mm. Among non-MI subjects, the levels of PGLYRP1 correlated positively and significantly with BOP and total PPD. Salivary PGLYRP1 concentrations also showed strong positive correlations with levels of TREM-1, IL-1β and MMP-8. In multivariate linear regression analysis, in MI patients, BOP and former smokingstatus displayed an association with salivary PGLYRP1 concentration. Conclusion:MI patients showed higher salivary PGLYRP1 levels than healthy controls, also after adjusting for smoking, sex, age and periodontal health status. Salivary levels of PGLYRP1 may reflect the overall inflammatory burdenThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Association of salivary TREM‐1 and PGLYRP1 inflammatory markers with non‐communicable diseases

“…For example, absence of bleeding is a reliable predictor of periodontal stability, and over 60% of the sites that lost attachment during a follow-up of over 50 months were in patients with mean BOP ≥ 30% (Joss et al, 1994;Lang et al, 1990). Of note, gingival bleeding is a determinant of the levels of both markers in saliva, which has also been shown in a previous study (Rathnayake et al, 2022).…”

“…TREM‐1 saliva levels were also elevated in both children with cystic fibrosis and systematically healthy children in the presence of gingivitis compared to periodontal health (Yucel et al, 2020). Furthermore, a positive correlation was reported between TREM‐1 serum and saliva levels in patients with periodontitis (Bostanci, Oztürk, et al, 2013), as well as between TREM‐1 and PGLYRP1 levels both in serum and saliva (Bostanci, Oztürk, et al, 2013; Inanc et al, 2021; Rathnayake et al, 2022; Silbereisen et al, 2019; Yucel et al, 2020). Aside from this, collection of saliva, compared to blood, is simple, cheap and non‐invasive (Giannobile, 2012; Taylor & Preshaw, 2016).…”

“…TREM‐1, first described as a blood biomarker for sepsis (Bouchon et al, 2001; Gibot et al, 2004; Gibot & Cravoisy, 2004), has since then been studied in various biofluids in systemic infectious and chronic inflammatory conditions, with elevated TREM‐1 biomarker levels being described, among others, in rheumatoid arthritis (Inanc et al, 2021; Kuai et al, 2009), bowel diseases (Park et al, 2009; Tzivras et al, 2006), heart disease (Kimmoun et al, 2022; Ortiz et al, 2020; Wang et al, 2018), diabetes (Thorsen et al, 2017), and cancer (Ho et al, 2008; Kuemmel et al, 2018; Liao et al, 2012). Elevated PGLYRP1 levels in blood and/or saliva have been described, for example, in heart disease (Han et al, 2021; Ortiz et al, 2020; Rathnayake et al, 2022; Rohatgi et al, 2009) and rheumatoid arthritis (Inanc et al, 2021; Luo et al, 2019). All these diseases are classified as non‐communicable diseases (Wolf et al, 2021).…”

Value of gingival crevicular fluid TREM‐1, PGLYRP1, and IL‐1β levels during menopause

“…11 Increasing plaque mass was found to be associated with higher PGLYRP1 levels in saliva. [12][13][14] Besides the bacterial challenge, evidence suggests the presence of other factors that interfere with TREM-1 function or expression. Clinical studies reported relationship between elevated TREM-1 serum levels and noninfectious inflammatory diseases such as rheumatoid arthritis, 15,16 and Behçet's disease.…”

“…Peptidoglycan recognition protein 1 (PGLYRP1), the functional ligand of TREM‐1, is being secreted upon bacterial challenge 11 . Increasing plaque mass was found to be associated with higher PGLYRP1 levels in saliva 12–14 . Besides the bacterial challenge, evidence suggests the presence of other factors that interfere with TREM‐1 function or expression.…”