Mrs Bindhu Koshy
Validation of diagnostic and prognostic biomarkers in GCF for monitoring periodontal disease.
Active destruction of the bone in chronic diseases like periodontitis is episodic and site specific. Currently, there are no tests that provide a direct, quantitative measure of the extent of periodontal disease in patients. Patient diagnosis currently relies on subjective examination to determine pocket depth and whether there is bleeding on probing. The diagnostic examination therefore, only informs that tissue loss has occurred since the last evaluation and fails to inform whether bone is being lost actively at the time of examination. Consequently, it is estimated that the absence of an objective, specific and quantitative test for active periodontal disease has led to the misdiagnosis of periodontal disease in over 70% of patients, resulting in costly and inappropriate treatment (Lang et al, 1986). Our current research addresses the need for a diagnostic chair-side immuno-assay to evaluate active tissue destruction during periodontal disease. The assay utilizes the diagnostic value of gingival crevicular fluid(GCF), an inflammatory exudate which arises from the underlying periodontal tissues. GCF contains a wide array of potential biomarkers derived from host and bacterial origin. These biomarkers have potential as either prognostic indicators towards indicating potential disease susceptibility within a patient (and therefore requires closer monitoring) or diagnostic indicators of active periodontal destruction (therefore informing the necessity for treatment), which is not possible to achieve using current clinical indices. We now wish to build on previous studies to evaluate the potential for a range of biomarkers derived from the degradation of the bone extracellular matrix, stimulation of the host immune response and bone resorptive pathways during inflammation and cytokine markers indicating resolution of inflammation.
- Proteoglycan metabolites as biomarkers derived from the degradation of the extracellular matrix
- Profiles of pro- and anti-inflammatory cytokines present in GCF and as potential prognostic markers
- Biological justification supporting the clinical use for cytokine profiling