[The elastase activity in gingival crevicular fluid from rapidly progressive periodontitis]

It is now generally accepted that polymorphonuclear neutrophil (PMN) chemotactic defect increases the patient's susceptibility to early-onset periodontitis. However, some reports including ours have failed to show defective PMN chemotaxis in rapidly progressive periodontitis(RPP) patients. The purpose of the study was to survey the role of PMN in the progression of RPP.

The elastase activity in gingival crevicular fluid from 22 RPP patients and 11 healthy controls were studied. For the control group and 12 RPP patients, 30 s GCF and clinical data were obtained at the first visit. For other 10 RPP patients, 30 s GCF and clinical data were collected prior to treatment and 4 weeks after scaling and root-planing. The elastase activity was measured with a low molecular weight substrate (L-Pyroglutamyl-L-prolyl-L-valine-p-nitroaniline, S2484) specific for granulocyte elastase.

The pre-treatment elastase activity was much higher (0.63 +/- 0.38, Abs/site) in RPP patients than that in control subjects (0.07 +/- 0.05, Abs/site). The elastase activity was positively correlated with GCF volume, probing depth, attachment loss and gingival bleeding. Scaling and root-planing resulted in decrease of both clinical data and elastase activity.

These results suggested that PMN with the increased accumulation or the increased release of lysosomal enzymes may play a role in the pathogenesis of RPP.