Salivary E‐cadherin as a biomarker for diagnosis and predicting grade of periodontitis

Abstract

Objectives To determine the abilities of salivary E‐cadherin to differentiate between periodontal health and periodontitis and to discriminate grades of periodontitis. Background E‐cadherin is the main protein responsible for maintaining the integrity of epithelial‐barrier function. Disintegration of this protein is one of the events associated with the destructive forms of periodontal disease leading to increase concentration of E‐cadherin in the oral biofluids. Materials and Methods A total of 63 patients with periodontitis (case) and 35 periodontally healthy subjects (control) were included. For each patient, periodontal parameters including bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded. Concentration of salivary E‐cadherin was determined by ELISA. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to determine the diagnostic potentials of E‐cadherin. Results Level of salivary E‐cadherin was significantly higher in periodontitis cases than controls. The ROC analysis showed that salivary E‐cadherin exhibits excellent sensitivity and specificity (AUC 1.000) to differentiate periodontal health from periodontitis with a cutoff concentration equal to 1.325 ng/mL. The AUCs of E‐cadherin to differentiate grade A from grade B and C periodontitis were 0.731 (cutoff point = 1.754 ng/mL) and 0.746 (cutoff point = 1.722 ng/mL), respectively. However, the AUC of salivary E‐cadherin to differentiate grade B from grade C periodontitis was lower (0.541). Additionally, BOP and PPD were significantly and positively correlated with the concentration of salivary E‐cadherin. Conclusion Salivary E‐cadherin exhibited excellent sensitivity and specificity to differentiate periodontitis from a healthy periodontium. The level of accuracy of E‐cadherin was also sufficient to recognize grade A periodontitis from grade B and C periodontitis.

Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients

“…Indeed, the level of soluble E-cadherin in saliva of periodontitis patients has also been found to be significantly higher than in healthy counterparts. 21,22 Consistently, this work demonstrated that the level of GCF E-cadherin significantly reduced after treatment and following the restoration of the healthy state of the periodontium.…”

“…Destruction of AJs and the release of the unbounded E‐cadherin due to proteolytic cleavage is evident in a range of inflammatory diseases 18–20 . Consistent with this observation, the level of soluble E‐cadherin in salivary samples of periodontitis patients was found to be significantly higher than in healthy controls 21,22 . Furthermore, immunohistochemical analysis of periodontally diseased tissue samples demonstrated reduced E‐cadherin levels 16 …”

“…Additionally, PPD, GCF volume, soluble E‐cadherin and TAC exhibited good sensitivity levels to predict the success of NSPT. This study was initially designed to investigate the predictive potential of GCF biomarkers for periodontal therapy and was predicated on the fact that periodontal‐associated inflammation results in increased oxidative stress and destruction of the epithelial barrier associated with release of epithelial adhesion molecules 14,22 . The findings of this study suggested that NSPT restored homeostasis of epithelial lining together with decreasing oxidative stress in the pocket microenvironment.…”

“…Increasing oxidative stress is a shared risk factor between periodontitis 12 and EMT process 27 which recently linked to pathogenesis of periodontitis 16 . Consistently, the level of soluble E‐cadherin has been shown to increase significantly in oral fluids from periodontally diseased subjects, compared with healthy controls, 22 as a consequence of periodontitis‐associated destructive events. Consequently, we hypothesized that mechanical eradication of bacterial load from subgingival area would restore redox potential to normal levels thereby restoring soluble E‐cadherin levels in GCF.…”

“…[18][19][20] Consistent with this observation, the level of soluble E-cadherin in salivary samples of periodontitis patients was found to be significantly higher than in healthy controls. 21,22 Furthermore, immunohistochemical analysis of periodontally diseased tissue samples demonstrated reduced E-cadherin levels. 16 Successful periodontal therapy outcomes are the goal of appropriately targeted treatment plans.…”