Influence of combinations of bacteria on the levels of prostaglandin E2, interleukin-1β, and granulocyte elastase in gingival crevicular fluid and on the severity of periodontal disease

Background: The aim of this study was to investigate the simultaneous presence of periodontal microbiota on inflammatory markers in gingival crevicular fluid from individuals with periodontal diseases. Methods: A total of 82 individuals with periodontal disease (mean age: 54.3 +/- 3.0 years) and 31 periodontally healthy individuals (mean age: 53.2 +/- 3.0 years) were randomly chosen and underwent clinical oral examinations in 2003 with the determination of the dental plaque index (PI), gingival index (GI), and periodontal probing depth (PD). The simultaneous presence of polymerase chain reaction (PCR)-assessed periodontal bacteria, levels of prostaglandin E-2 (PGE(2)), granulocyte elastase, interleukin 1-beta (IL-1 beta), and total protein concentration were determined from the pockets. Marginal bone height percent was measured on x-rays. Analysis of variance and chi(2) tests were used to analyze the results. Results: In sites with Tannerella forsythensis, levels of PGE(2) (pg/site), granulocyte elastase (monoclonal antibodies (mAbs)/site), and total protein (mg/ml) were significantly higher than in sites without T forsythensis (P < 0.05, P < 0.01, and P < 0.05, respectively). Those with periodontal disease with simultaneous presence of T forsythensis and Porphyromonas gingivalis, or T forsythensis and Prevotella, nigrescens, showed significantly higher PI and GI, deeper PD, more loss of attachment, and more release of PGE2 and granulocyte elastase than did periodontitis patients without these bacteria. Conclusion: The simultaneous presence of T forsythensis and P. gingivalis, or T forsythensis and P. nigrescens, seemed to promote the release of subgingival inflammatory mediators and seemed to be associated with more severe periodontal disease.