Oral fluid matrix metalloproteinase (MMP)-8 as a diagnostic tool in chronic periodontitis

Abstract

Periodontal diseases that affect the marginal and apical periodontium result from the interaction between bacterial biofilm and the host response. Oral fluid biomarkers might aid clinical diagnosis. Matrix metalloproteinases (MMPs) are a family of 24 proteases that act in physiological and pathological conditions. They can degrade almost all extracellular matrix constituents and regulate inflammatory processes. They are mainly inhibited by tissue inhibitors of metalloproteinases. The aim of this study was to perform a current literature review with a special reference on the diagnostic and clinical utility of oral fluid MMPs, especially MMP-8, and their inhibitors in periodontal and oral diseases. MMP-8 is the main collagenolytic MMP detected in oral fluids, such as saliva, oral mouthrinse, gingival crevicular fluid, and peri-implant fluid. MMP-8, and potentially MMP-9, in oral fluids represent strong biomarker candidates associated especially with periodontal disease diagnosis, severity, progression, and follow-up. Additionally, they show diagnostic potential for systemic conditions, such as pregnancy, myocardial infarction, and smoking. A commercially available mouthrinse, active MMP-8 chair-side/ point-of-care lateral flow immunoassay, shows enough sensitivity and specificity to detect clinical signs of periodontitis. The current literature supports that high MMP-8 levels reflect the loss of periodontal supporting tissues rather than inflammation, representing a potentially useful sidediagnostic point-of-care oral disease biomarker, especially in periodontal diseases.

Active Matrix Metalloproteinase-8 Point-of-Care (PoC)/Chairside Mouthrinse Test vs. Bleeding on Probing in Diagnosing Subclinical Periodontitis in Adolescents

“…According to several studies [1,2,6,7,8,9,10,11], the progression of periodontitis is reflected as an excessive elevation and activation of MMP-8 in oral fluids. This stage can be measured using a point-of-care lateral flow collagenase-2 immunotest [1,12,13,14,15,16,17,18,19,20,21,22,23]. Currently, this active MMP-8 (aMMP-8) point-of-care (PoC)/chairside mouthrinse test exists and is available as a visual and a quantitative point-of-care aMMP-8 test [13].…”

“…Thus, there is a real incentive to develop new and better methods to determine periodontal health. The aMMP-8 PoC test has been validated in different ethnic populations as a reliable tool to differentiate periodontal health and disease [12,13,14,15,16,17,18,19,20,21,22,23]. It is inexpensive, quick and easy to use, and, most importantly, a standardized, non-invasive, and safe point-of-care test, which makes it a promising candidate as a chairside test for periodontal diseases.…”

A point‐of‐care test of active matrix metalloproteinase‐8 predicts triggering receptor expressed on myeloid cells‐1 (TREM‐1) levels in saliva

“…22,23 Activated matrix metalloproteinase-8 (aMMP-8) is already known as one of the most validated periodontitis biomarkers. 24,29,30,[36][37][38][39][40][41][42][43][44][45][46] Moreover, previously there have been found a moderate positive association/correlation between MMP-8/PGLYRP1 axis and TREM-1 levels among adults, 14 but to the best of authors' knowl-edge, this association hasn't been studied among adolescent subjects before. [24][25][26][27][28][29][30][31][32][33][34][35] This stage can be measured using a point-of-care (PoC) lateral flow collagenase-2 (aMMP-8) immunotest.…”

“…[24][25][26][27][28][29][30][31][32][33][34][35] This stage can be measured using a point-of-care (PoC) lateral flow collagenase-2 (aMMP-8) immunotest. 24,29,30,[36][37][38][39][40][41][42][43][44][45][46] Moreover, previously there have been found a moderate positive association/correlation between MMP-8/PGLYRP1 axis and TREM-1 levels among adults, 14 but to the best of authors' knowl-edge, this association hasn't been studied among adolescent subjects before. A non-invasive, quick, easy to use, and inexpensive aMMP-8 PoC test, which is currently available also as a quantitative PoC aMMP-8 test, may be also a potential tool for PoC detection of salivary TREM-1 levels and as such for detection of periodontal and systemic inflammation.…”

Levels of Selected Matrix Metalloproteinases, Their Inhibitors in Saliva, and Oral Status in Juvenile Idiopathic Arthritis Patients vs. Healthy Controls

“…They also control cellular and inflammatory processes by a limited proteolysis of bioactive substances (enzymes, chemokines, cytokines, growth factors, components of the complement system, receptors, etc.) [14]. MMPs are produced by the majority of normal cells, among others, fibroblasts, mast cells, osteoblasts, odontoblasts, dendritic cells, microglia cells, smooth muscle myocytes, keratinocytes, and endothelial cells.…”