Proteolytic enzymes as indicators of periodontal health in gingival crevicular fluid of patients with Sjögren's syndrome

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Abstract
The present study characterizes the periodontal status of patients with Sjögren's syndrome (SS) and measures collagenase, elastase and gelatinase in gingival crevicular fluid (GCF) from these patients compared with adult individuals with periodontitis and healthy controls. The periodontal status was assessed by the Gingival Bleeding Index (GBI), the Visible Plaque Index (VPI), and pocket depth. Activity measurements were performed for collagenase with SDS‐PAGE/ laser densitometry, for elastase spectrophotometrically using a synthetic N‐succinyl‐Ala‐Ala‐Val p‐nitroanilide peptide substrate, and for gelatinase with zymography. Seven of the 8 patients with SS and xerostomia showed a periodontium comparable to that seen in healthy controls. The GCF collagenase and elastase were significantly lower in patients with SS and in healthy controls than in patients with adult periodontitis. It was noteworthy that the one SS patient with periodontitis had high GCF collagenase and elastase activity. In all study groups multiple forms of gelatinases were present, indicating that they represent constitutively expressed proteinases involved in normal tissue remodeling processes. Our findings suggest that periodontal pockets/GCF form a micromilieu not affected by involvement of glandular tissue and, therefore, patients with SS show, clinically and biochemically, a periodontal status comparable to that seen in healthy controls.