Effects of Smoking and Vitamin D3 on the Levels of Human Cathelicidin Peptide LL-37

Evaluation of Gingival Crevicular Fluid Levels of LL-37 and Serum Vitamin D3 Levels in Smoker and Non-Smoker Patients With Chronic Periodontitis

The aims of our study were 1) to evaluate levels of gingival crevicular fluid( GCF) human cathelicidin peptide LL-37 and serum vitamin D3 in smoker and non-smoker patients with chronic periodontitis(CP) 2) to determine whether any correlation between GCF LL-37 and vitamin D3 serum levels exist and 3) to asses the correlation between clinical parameters and biochemical markers

Study Overview

• Status: Completed
• Conditions: Periodontitis
• Intervention / Treatment: Other: LL-37 levels in Gingival crevicular fluid; Other: Serum Vitamin D3 levels; Other: Clinical parameters

Detailed Description

Background: Cathelicidin LL-37, an antimicrobial peptide, is part of the host innate immune response in the oral cavity. The aims of this study are to evaluate; gingival crevicular fluid (GCF) levels of LL-37, serum vitamin D3 levels and periodontal clinical recordings in smoker and nonsmoker patients with chronic periodontitis (CP).

Methods:

This study consisted a total of 60 volunteers including 20 smoker patients with CP (CP-1 group), 20 non-smoker patients with CP (CP-2 group) and 20 periodontally healthy subjects (CTRL group). Prior to participation, the design and purpose of the research were explained to each subjects, and written informed consent form was obtained from 60 individuals before the study.

The periodontal status of the patients were determined by measuring the probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI) All clinical parameters were measured on six sites per tooth from the full-mouth teeth (mesiobuccal, distobuccal,midbuccal, mesiolingual, distolingual and midlingual) using a William's periodontal probe calibrated in millimeters by the same examiner. All samples were obtained on the day following clinical examinations of the individuals. The deepest six pockets site per individual were chosen for collection of GCF across both of the periodontitis groups. Six pocket locations showing a lack of clinical inflammation were also tested to guarantee collection of a sufficient volume of GCF across the CTRL groups.

GCF levels of LL-37 were measured by ELISA and serum levels of vitamin D3 were analysed by High-performance liquid chromatography (HPLC). Statistical analysis were performed.

• Study Type: Observational
• Enrollment (Actual): 60

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 35 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The volunteers participitating in the study were choosen from among individuals scheduled to undergo either dental treatment or dental check at the Deparment of Perioodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.

Description

Inclusion Criteria for chronic periodontitis groups:

• Clinical attachment loss ≥ 5mm
• Probing depth ≥5mm
• Bone loss affecting >30% of the existing teeth on clinical and radiographic examination
• gingival index (GI) score> 1

Inclusion criteria for control group:

• full-mouth PD was≤ 3mm,
• Gingival index <1
• there was no indication of Attachment Loss or no radiographic evidence of alveolar bone loss in control group.
• Non-smokers.

Smoking criteria for groups:

• patients smoked more than 10 cigarettes in a day
• smoking for 3 or more years,

Exclusion Criteria:

• systemic condition (diabetes, cardiovascular disease, immunologic disorders, hepatitis, e.g.)
• pregnancy, lactation or menopause term,
• antibiotic treatment or non-steroidal anti-inflammatory medications within the last 3 months before the study,
• non-surgical periodontal treatment during the last 6 months before the study,
• treatment with Vitamin D supplementation before the study

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Smoker patients with chronic periodontitis	Other: LL-37 levels in Gingival crevicular fluid; Collected gingival crevicular fluid; Other: Serum Vitamin D3 levels; Collected serum; Other: Clinical parameters; Recorded plague index, gingival index, probing depth, clinical attachment level
non-smoker patients with chronic periodontitis	Other: LL-37 levels in Gingival crevicular fluid; Collected gingival crevicular fluid; Other: Serum Vitamin D3 levels; Collected serum; Other: Clinical parameters; Recorded plague index, gingival index, probing depth, clinical attachment level
periodontally healthy patients	Other: LL-37 levels in Gingival crevicular fluid; Collected gingival crevicular fluid; Other: Serum Vitamin D3 levels; Collected serum; Other: Clinical parameters; Recorded plague index, gingival index, probing depth, clinical attachment level

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Serum D3 Vitamin levels	The plasma levels of vitamin D3 were greater in the CP-2 group than in the CP-1 group. But, no statistically significant difference was determined between the CP groups (P>0.05)	Baseline
Gingival Crevicular fluid(GCF) LL-37 levels	The concentration of LL-37 in GCF was significantly higher in both of the CP groups than in the CTRL group (p<0.001). Although GCF LL-37 concentration levels were greater in the CP-1 group than in the CP-2 group, the difference did not reach the statistical significance between the CP groups (p>0.05).	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Plaque index (PI)	The full-mouth and sample sites PI recordings were significantly higher in both CP groups (CP-1 and CP-2) than in the CTRL group (p<0.001). were measured on six sites per tooth from the full-mouth teeth	Baseline
GCF volume	The GCF volume was notably higher in both CP groups than in CTRL group (p<0.001).	Baseline
gingival index (GI)	The full-mouth and sample sites GI recordings were significantly higher in both CP groups (CP-1 and CP-2) than in the CTRL group (p<0.001).	Baseline
Probing depth (PD)	The full-mouth and sample sites PD recordings were significantly higher in both CP groups (CP-1 and CP-2) than in the CTRL group (p<0.001).	Baseline
Clinical attachment level (CAL)	The full-mouth and sample sites CAL recordings were significantly higher in both CP groups (CP-1 and CP-2) than in the CTRL group (p<0.001).	Baseline

Collaborators and Investigators

• Sponsor: Gazi University
• Investigators: Principal Investigator: Şeyma BOZKURT DOĞAN, Professor, University; Principal Investigator: Elifcan Kıvrak, PhD, University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2011
• Primary Completion (Actual): July 1, 2012
• Study Completion (Actual): July 1, 2015

Study Registration Dates

• First Submitted: April 17, 2019
• First Submitted That Met QC Criteria: April 19, 2019
• First Posted (Actual): April 22, 2019

Study Record Updates

• Last Update Posted (Actual): April 22, 2019
• Last Update Submitted That Met QC Criteria: April 19, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Keywords: Vitamin D; Serum; periodontitis; Gingival crevicular fluid; LL-37
• Additional Relevant MeSH Terms: Stomatognathic Diseases; Periodontal Diseases; Mouth Diseases; Periodontitis; Physiological Effects of Drugs; Micronutrients; Vitamins; Bone Density Conservation Agents; Calcium-Regulating Hormones and Agents; Vitamin D; Cholecalciferol
• Other Study ID Numbers: 03/2011-27

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No