Authors' Response: “Diagnostic accuracy of a point‐of‐care aMMP‐8 test in the discrimination of periodontal health and disease”

Active Matrix Metalloproteinase-8 (aMMP-8) Versus Total MMP-8 in Periodontal and Peri-Implant Disease Point-of-Care Diagnostics

“…Recent studies have shown aMMP-8 to be an applicable biomarker to be implemented in the new 2017 classification systems' stages and grades of periodontitis and peri-implantitis assessment [26][27][28][29][30][31][32]43,44]. In contrast, total MMP-8 (ELISA, enzyme-linked immunosorbent assay) has not been able, to the authors knowledge, to differentiate different stages of periodontitis, whereas aMMP-8 has [26][27][28][36][37][38]40,42].…”

“…To be catalytically competent, i.e., collagenolytic and proteolytic, latent proMMP-8 requires activation by other host and microbial proteases and/or by reactive oxygen radicals to aMMP-8, which can process and degrade collagens, extracellular matrix components, nonmatrix bioactive molecules, complement components, serpins and insulin-receptor [12,16]. Regarding the irreversible tissue destruction pathogenesis of oral diseases, periodontitis and peri-implantitis, as well as systemic diseases such as diabetes, sepsis, meningitis, kidney diseases, pancreatitis, chronic obstructive pulmonary disease (COPD), cardiovascular diseases (CVD) and cancers; the key collagenolytic MMP has been demonstrated to be aMMP-8 (i.e., collagenase-2/neutrophil collagenase) [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. aMMP-8 is catalytically competent and tissue destructive enzyme in the clinically active disease sites and progressive lesions in these oral and systemic diseases [16].…”

“…Diagnostic studies and technologies attempting to utilize total MMP-8 as a diagnostic biomarker for periodontitis and peri-implantitis have shown contrasting outcomes as some of the studies have revealed relatively good diagnostic ability of total MMP-8 to discriminate periodontal and peri-implant health and disease, while many others have clearly shown the opposite [33][34][35][36][37][38][39][40][41][42]. So far, only studies on aMMP-8 oral fluid diagnostic biomarker analysis with different and independent techniques and technologies have repeatedly and consistently proved to be successful [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Recent studies have shown aMMP-8 to be an applicable biomarker to be implemented in the new 2017 classification systems' stages and grades of periodontitis and peri-implantitis assessment [26][27][28][29][30][31][32]43,44].…”

“…So far, only studies on aMMP-8 oral fluid diagnostic biomarker analysis with different and independent techniques and technologies have repeatedly and consistently proved to be successful [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Recent studies have shown aMMP-8 to be an applicable biomarker to be implemented in the new 2017 classification systems' stages and grades of periodontitis and peri-implantitis assessment [26][27][28][29][30][31][32]43,44]. In contrast, total MMP-8 (ELISA, enzyme-linked immunosorbent assay) has not been able, to the authors knowledge, to differentiate different stages of periodontitis, whereas aMMP-8 has [26][27][28][36][37][38]40,42].…”

“…Recent studies have shown aMMP-8 to be an applicable biomarker to be implemented in the new 2017 classification systems' stages and grades of periodontitis and peri-implantitis assessment [26][27][28][29][30][31][32]43,44]. In contrast, total MMP-8 (ELISA, enzyme-linked immunosorbent assay) has not been able, to the authors knowledge, to differentiate different stages of periodontitis, whereas aMMP-8 has [26][27][28][36][37][38]40,42]. Diagnostic studies and technologies a empting to utilize total MMP-8 as a diagnostic biomarker for periodontitis and peri-implantitis have shown contrasting outcomes as some of the studies have revealed relatively good diagnostic ability of total MMP-8 to discriminate periodontal and peri-implant health and disease, while many others have clearly shown the opposite [33][34][35][36][37][38][39][40][41][42].…”