Association between aMMP-8 Chairside Test for Chronic Periodontitis and Selected Reproductive Health Parameters

Show full item record

Permalink

http://urn.fi/URN:ISBN:978-951-51-4058-6
Title: Association between aMMP-8 Chairside Test for Chronic Periodontitis and Selected Reproductive Health Parameters
Author: Nwhator, Solomon Olusegun
Date: 2018-08-21
ISBN: 978-951-51-4058-6
URI: http://hdl.handle.net/10138/238976
http://urn.fi/URN:ISBN:978-951-51-4058-6
Abstract: There are many established measures of chronic periodontitis but with many limitations. The problem with these established measures is that they assess past disease rather the present physiology of periodontal tissues. To overcome these limitations, scientists conceived the idea of a novel system to assess chronic periodontitis accurately and predictably. A novel system is sought that will favorably compare with established measures, while overcoming their limitations, and also providing high validity, sensitivity, specificity, reliability, and reproducibility. To investigate how a potential candidate for this system works, a series of studies were conducted in Nigeria and Helsinki. The goal was to assess how well a novel point-of-care test (aMMP-8 chairside test) measures up to these desirable objectives. The series of studies were conducted to investigate the validity in terms of sensitivity and specificity for chronic periodontitis. To achieve our objectives, in study (I), we assessed chronic periodontitis using a novel aMMP-8 test -neutrophil collagenase-2 lateral flow immunoassay. This test qualitatively detects the presence of matrix metalloproteinase-8. Its correlation with established measures of CP, like bleeding on probing (BOP) and probing pocket depth (PPD), was then assessed. The neutrophil collagenase-2 immunoassay was 96% sensitive for poor oral hygiene, 95% sensitive for chronic periodontitis, and 83% sensitive for BOP. In all instances, chronic periodontitis was regarded as two sites with PPD or BOP. The reproducibility of the novel aMMP-8 chairside test was investigated in study (II), where oral health and periodontal assessment was performed on adolescents at the Kotka Health Center in Finland. The sensitivity of the aMMP-8 test for 2 sites with PPD ≥ 4 mm was 63.6% and specificity 100%. Thus, the test is effective in recognizing oral inflammatory burden in adults and adolescents with early signs of periodontitis. Bacterial biofilm has been established as the primary etiological agent for chronic periodontitis. Similarly, the oral manifestations of systemic diseases and conditions that predispose to chronic periodontitis are well-reported in the literature. The impact of chronic periodontitis on systemic health, however, has been under-reported until a few decades ago. Thus, the validity, sensitivity, specificity, reliability and reproducibility of the aMMP-8 chairside test was first established. After this, its applicability was assessed in the primary health care setting, as it applies to dentistry as well as general health. The role of chronic periodontitis (CP) on fertility-related events was of a particular interest in this investigation. In study III, the levels of MMP-8 were assessed in pregnant women and a widespread (87.3%) elevation of active matrixmetalloproteinase-8 was evident among the black pregnant Nigerians. Independent of demographics, educational level, and trimester, positive test results were more abundant among the study subjects than what could be anticipated from previous studies performed on proteolytic enzymes in saliva. Finally, the link between chronic periodontitis and time to conception (TTC) was investigated in study IV using the aMMP-8 test. Through a cross-sectional hospital survey involving 58 fertility clinic attendees and 70 pregnant controls, the odds of increased conception were higher with the aMMP-8-test-assessed periodontitis risk (OR 0.157, 95% CI 0.041-0.600, P < 0.01).aMMP-8 suuhuuhde-tuolinvierustestin validointi aikuisten ja nuorten alkavaan parodontiittiin/preparodontiittiin Neutrofiili kollagenaasi, kollagenaasi-2, matriksi metalloproteinaasi (MMP)-8 on ien- ja hammasistuke- (hammasimplantti) sairauksien pääasiallinen kollagenolyyttinen, proteolyyttinen kudostuhon aiheuttaja tulehtuneessa ikenessä ja alveoliluussa. Dysbioottinen parodontopatogeeninen plakki eli bakteerit ja niiden virulenssitekijät ja proteaasit kykenevät indusoimaan MMP-8:n synteesin ja degranulaation ja lisäksi aktivoimaan latentin proMMP-8:n aktiiviseksi, katalyyttisesti kompetentiksi aMMP-8:ksi. aMMP-8:n pitoisuus suunesteessä (sylki, suuhuuhde, ientaskuneste, hammasimplanttineste) kohoaa, heijastaen edeltäen ja ennustaen, kliinistä ja eritoten aktiivista ien- ja hammasistukesairautta. Raskaustesti-tyyppinen suuneste-aMMP-8 –testi on toimiva ja käyttökelpoinen parodontiitin ja peri-implantiitin biomarkkeri. Helsingin yliopiston ja Tukholman Karolinska Instututetin parodontologian professorin ja ylihammaslääkärin Timo Sorsan keksimä, patentoima ja kehittämä aMMP-8 suuhuuhde tuolinvierustesti (PerioSafe®) validoitiin HLL Solomon Nwhatorin väitöskirjatyössä aikuisparodontiitille Nigeriassa ja nuorten alkavalle parodontiitille/preparodontiitille Suomessa. Testin sensitiivisyys parodontiitille on 95% ja spesifisyys 80 – 90%; testi siis tunnisti iensairaat aikuiset ja nuoret, eikä tehnyt terveistä sairaita. Testi havaittiin tarkemmaksi ja käyttö kelpoisemmaksi kuin perinteinen parodontologinen ”bleeding-on-probing/verenvuotoa koetettaessa” –määritys. Afrikkalaisilla naisilla aMMP-8 –testipositiivisuutta eli parodontiittia esiintyi laajalti raskaina olevilla naisilla ja testipositiivisuus/parodontiitti viivästytti merkitsevästi raskaaksi tulemista. Nuorten alkavan parodonttiin/preparodontiitin testi löysi tehokkaasti ja tarkasti. Väitöskirjatyön tulokset osoittivat, että aMMP-8 suuhuuhde tuolin-vierustesti on kätevä diagnostinen väline parodontiitin diagnostiikkaan, ja ao. testiä voivat käyttää ja myös lääkärit, suuhygienistit, sairaanhoitajat ja kätilöt. Testi on ei-invasiivinen eikä siis aiheuta koskaan bakteremiaa poiketen täten edukseen invasiivisesta ja aina bakteremiaa aiheuttavasta ”bleeding-on-probing/verenvuotoa koeteltaessa” -testauksesta. Sittemmin kvalitatiivisesta raskaustesti-tyyppisestä testistä (PerioSafe®) on kehitetty kaupallisesti saatava kvantitatiivinen testi (PerioSafe®/OralLyser®).


Files in this item

Total number of downloads: Loading...

Files Size Format View
associat.pdf 12.57Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record