Comparison of the Serum and Salivary Levels of NT-proBNP in Systemically Healthy Subjects with Mild, Moderate and Severe Chronic Periodontitis
Abstract
Background: To assess and compare the serum and salivary levels of NT-pro BNP in otherwise systemically healthy subjects with mild, moderate, and severe chronic periodontitis.
Methods: The subjects for this study were selected from the Out-patient Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai. A total of 24 subjects were selected and divided into three groups which included Group I with6periodontally and systemically healthy subjects, Group II with6 systemically healthy subjects with mild chronic periodontitis, Group III with6 systemically healthy subjects with moderate chronic periodontitis, and group IV with 6 systemically healthy subjects with severe chronic periodontitis. After measuring the periodontal parameters, blood and saliva samples were collected and the levels of NT-proBNP were estimated using an ELISA kit (Abbkine).
Results: The mean value of plaque index, modified gingival index, probing pocket depth and clinical attachment level were higher in Group II, Group III, and Group IV compared to Group I. The mean value of NT-proBNP increased with the increasing severity of the periodontal disease. Intergroup comparison of the mean difference of serum and salivary NT-proBNP levels was found to be statistically significant. Karl Pearson correlation analysis between salivary and serum NT-proBNP and other parameters like plaque index, modified gingival index, probing pocket depth, and clinical attachment level showed a very strong positive correlation (P<0.001).
Conclusion: Our findings suggest that serum and salivary NT-pro-BNP could serve as a potential biomarker for periodontitis. Further studies are required to explore the mechanism and to understand the cause-effect relationship between NT-proBNP and periodontitis.
References
Temelli B, Yetkin Ay Z, Savaş HB, Aksoy F, KumbulDoğuç D, Uskun E, et al. Circulation levels of acute phase proteins pentraxin 3 and serum amyloid A in atherosclerosis have correlations with periodontal inflamed surface area. J Appl Oral Sci 2018; 26.e2017-0322. doi: https://doi.org/10.1590/1678-7757-2017-0322
Dhingra R, Vasan RS. Biomarkers in cardiovascular disease: Statistical assessment and section on key novel heart failure biomarkers. Trends Cardiovasc Med 2017; 27(2):123-33. doi: https://doi.org/10.1016/j.tcm.2016.07.005
Pandit K, Mukhopadhyay P, Ghosh S, Chowdhury S. Natriuretic peptides: Diagnostic and therapeutic use. Indian J Endocrinol Metab 2011; 15Suppl4:S345-53. doi: https://doi.org/10.4103/2230-8210.86978
Nakagawa Y, Nishikimi T, Kuwahara K. Atrial and brain natriuretic peptides: Hormones secreted from the heart. Peptides 2019; 111:18-25. doi: https://doi.org/10.1016/j.peptides.2018.05.012
Pandey KN. Guanylyl cyclase/atrial natriuretic peptide receptor-A: role in the pathophysiology of cardiovascular regulation. Can J Physiol Pharmacol 2011; 89(8):557-73. doi: https://doi.org/10.1139/y11-054
Weber M, Hamm C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart 2006; 92(6):843-9. doi: https://doi.org/10.1136/hrt.2005.071233
Ozturk TC, Unluer E, Denizbasi A, Guneysel O, Onur O. Can NT-proBNP be used as a criterion for heart failure hospitalization in emergency room? J Res Med Sci 2011; 16(12):1564-71. https://pubmed.ncbi.nlm.nih.gov/22973364/
Ogawa T, de Bold AJ. Brain natriuretic Peptide production and secretion in inflammation. J Transplant 2012; 2012:962347. doi: https://doi.org/10.1155/2012/962347
Leira Y, Blanco J. Brain natriuretic peptide serum levels in periodontitis. J Periodontal Res 2018; 53(4):575-81. doi: https://doi.org/10.1111/jre.12547
Löe, H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol 1967; 38(6):610–616. doi: https://doi.org/10.1902/jop.1967.38.6.610
Lobene RR, Weatherford T, Ross NM, Lamm RA, Menaker L. A modified gingival index for use in clinical trials. Clin Prev Dent 1986;8(1):3-6. https://pubmed.ncbi.nlm.nih.gov/3485495/
Fröhlich H, Herrmann K, Franke J, Karimi A, Tager T, Cebola R, et al. Periodontitis in Chronic Heart Failure. Tex Heart Inst J 2016; 43(4):297-304. doi: https://dx.doi.org/10.14503%2FTHIJ-15-5200
Bando S, Soeki T, Matsuura T, Tobiume T, Ise T, Kusunose K, et al. Plasma brain natriuretic peptide levels are elevated in patients with cancer. PLoS One 2017; 12(6):e0178607. doi: https://dx.doi.org/10.1371%2Fjournal.pone.0178607
Guo S, Barringer F, Zois NE, Goetze JP, Ashina M. Natriuretic peptides and cerebral hemodynamics. Regul Pept 2014; 192-193:15-23. doi: https://doi.org/10.1016/j.regpep.2014.07.003
Chiurchiù V, Izzi V, D'Aquilio F, Carotenuto F, Di Nardo P, Baldini PM. Brain Natriuretic Peptide (BNP) regulates the production of inflammatory mediators in human THP-1 macrophages. Regul Pept 2008; 148(1-3):26-32. doi: https://doi.org/10.1016/j.regpep.2008.02.009
Foo JY, Wan Y, Kostner K, Arivalagan A, Atherton J, Cooper-White J et al. NT-ProBNP levels in saliva and its clinical relevance to heart failure. PLoS One 2012; 7(10):e48452. doi: https://doi.org/10.1371/journal.pone.0048452
Raj C, Barik AK, Shivamanjumath RG, Rath HM. Role of neuropeptides in etiopathogenesis of periodontal inflammation: an overview. Int J Contemp Dent 2011; 2(5):105-09.
Wlosowicz M, Kaplon BW, Gorska R. Periodontitis in relation to selected parameters of cardiovascular system in the group of patients with acute myocardial infarction. J Stoma 2012; 65(5):636-653.
