Long-term effect of periodontal treatment on gingival crevicular fluid level of Cathepsin K in chronic periodontitis patients with type 2 diabetes mellitus

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Auttaporn Chaisalee
Thanis Chaturamaytanon
Ananya Promsudthi
Rudee Surarit


Objective: Cathepsin K (CTSK), a cysteine protease, is predominantly expressed by osteoclasts. CTSK levels were monitored in gingival crevicular fluid (GCF) to observe osteoclastic activity in response to periodontal treatment and supportive periodontal therapy (SPT) in individuals with chronic periodontitis (CP) and type 2 diabetes mellitus (DM).

Materials and methods: Periodontal parameters and GCF were collected from 14 individuals with CP+DM and 14 individuals with CP but no DM at baseline (T1), 8 weeks after scaling and root planing (T2) and after SPT of 9-28 months, average 18.06 months (T3, n=9 in each group). Five participants with gingival health and no DM (GH group) were recruited at T3 to study CTSK levels in GCF and saliva. CTSK was detected by enzyme linked immunoassay (ELISA).

Results: At the baseline, there were no significant differences in periodontal parameters and CTSK between the CP+DM and CP groups. At T2, both groups showed significant clinical improvement (p < 0.05) and decreased CTSK in GCF (p < 0.05). Comparing between groups, CP+DM group showed a significantly higher amount of CTSK than CP group (p < 0.01). At T3, CP+DM and CP groups showed significant improvement in all periodontal parameters compared to baseline. By contrast, some GCF parameters rebounded. The CP+DM, CP and GH groups showed no significant differences in GCF and salivary fluid parameters of CTSK at T3. A strong positive correlation between the relative amounts of CTSK to total protein in GCF and saliva was found in the CP+DM group (r=0.94, p= 0.005).

Conclusions: Periodontal treatment decreased CTSK in GCF; however, CP+DM group had a significantly higher amount of CTSK than CP group. However, good compliance with SPT in CP+DM and CP groups maintained good periodontal health, with comparable CTSK levels in GCF in both groups. All three groups had detectable CTSK in saliva.


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Chaisalee A, Chaturamaytanon T, Promsudthi A, Surarit R. Long-term effect of periodontal treatment on gingival crevicular fluid level of Cathepsin K in chronic periodontitis patients with type 2 diabetes mellitus. M Dent J [Internet]. 2021 Apr. 26 [cited 2023 Dec. 5];41(1):1-18. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/242477
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