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Objective: Periodontitis is an infection that results from an imbalance between periodontopathic microorganisms and the local and systemic host defense. This study analyzed saliva samples of patients with periodontitis for several biomarkers of host response., Method and Materials: Saliva was collected from 13 patients with chronic periodontitis, seven patients with aggressive periodontitis, and 13 periodontally healthy control subjects. Diverse markers of host response representing innate and adaptive immune response as well as antioxidative variables were determined., Results: Patients with aggressive periodontitis had significantly higher values of lipid peroxidation and cathepsin C activity in saliva. The highest activities of neutrophil elastase, proteinase 3, and superoxide dismutase were measured in chronic periodontitis patients. Levels of antimicrobial peptides HNPs 1-3 were significantly highest in chronic periodontitis patients than in aggressive periodontitis or control subjects. Immunoglobulin G levels directed against Aggregatibacter actinomycetemcomitans were highest in aggressive periodontitis patients, while those directed against Porphyromonas gingivalis were highest in chronic periodontitis patients. Immunoglobulin A levels directed against these periodontopathogens did not differ among the groups., Conclusion: Chronic periodontitis patients showed higher levels of markers primarily associated with combating infection. The levels of markers known mainly for tissue damage were higher in aggressive periodontitis patients. Neutrophil-related markers may be able to identify and differentiate patients with periodontitis.

Introduction: During periodontitis, an innate immune response to bacterial challenge is primarily mediated by neutrophils. We compared neutrophilic content and the level of neutrophil-derived antimicrobial peptides in gingival crevicular fluid (GCF) in two clinical forms of severe periodontitis., Methods: GCF was collected from 14 patients with aggressive periodontitis, 17 patients with chronic periodontitis, and nine healthy subjects. Samples were analyzed for periodontopathogen load using real-time polymerase chain reactions. The amounts of myeloperoxidase and alpha-defensins (HNP1-3) were determined by enzyme-linked immunosorbent assay, and the level of cathelicidin (hCAP18/LL-37) was assayed by Western blot., Results: Myeloperoxidase concentration was not correlated with levels of LL-37 and HNP1-3 in samples from patients, compared to controls. The amount of HNP1-3 was twofold and fourfold higher in patients with aggressive and chronic periodontitis, respectively. Those with chronic disease had significantly elevated amounts of mature LL-37. The increased concentration of both peptides in chronic periodontitis correlated with the load of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola., Conclusion: The lack of a correlation between LL-37, HNP1-3, and myeloperoxidase content suggests that neutrophils are not the sole source of these bactericidal peptides in the GCF of patients with periodontitis; and that other cells contribute to their local production. The bacterial proteases of P. gingivalis, T. forsythia, and T. denticola might degrade hCAP18/LL-37, because the 11-kDa cathelicidin-derived fragment was present in GCF collected from pockets infected with these bacteria. Collectively, it appears that a local deficiency in LL-37 can be considered as a supporting factor in the pathogenesis of severe cases of periodontitis.