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Cited by 10Oral microbiology and periodontitis researchSalivary Gland Disorders and FunctionsPeriodontal Regeneration and Treatments

Salivary secretory leukocyte protease inhibitor levels in patients with stage 3 grade C periodontitis: a comparative cross-sectional study

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Afacan, Beral, Öztürk, Veli Özgen, Emingil, Gülnur, Köse, Timur, Mitsakakis, Konstantinos, Bostanci, Nagihan·2022·Scientific Reports
DOI 10.1038/s41598-022-24295-2PMC PMC9732338
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Abstract

Secretory leukocyte protease inhibitor (SLPI) is an anti-protease that protects mucosal tissue integrity owing to its anti-microbial and immunomodulatory properties. This study aimed to investigate SLPI levels in periodontal diseases, and analyze the potential correlation with clinical periodontal parameters. Whole saliva samples were obtained from healthy (n = 24), gingivitis (n = 24) and patients with stage 3 grade C periodontitis (n = 24). SLPI was measured by ELISA and normalized by total protein. Receiver operating characteristics (ROC) curve was used for estimating the area under the curve (AUC). The normalized SLPI levels were significantly reduced in periodontitis compared with gingivitis (4.84-fold) or health (1.83-fold) and negatively correlated with periodontal parameters. The ROC curves showed a good predictor value of the SLPI for differentiation of periodontitis versus health or gingivitis (AUC ≥ 0.80). This study demonstrates that the levels of SLPI are high in periodontal health, further elevated in gingivitis, but eventually decreased in severe periodontitis beyond the former two states. This observation may have broader implications in the context of inflammatory diseases affecting the oral mucosa, as it shows that the bacterial burden is disturbing the homeostatic balances of anti-microbial and anti-protease factors in the oral cavity.

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  • Upregulation of serine-type endopeptidase inhibitor activity in the rapid group may indicate an attempt to counterbalance inflammatory processes associated with calculus formation.

    “One example was proteins linked to ‘serine‐type endopeptidase inhibitor activity’. These inflammatory pathways are known to surge in gingivitis and wane in advanced periodontitis (Afacan et al. 2022), thus their upregulation may indicate an attempt to counterbalance the inflammatory processes associated with calculus formation.”

    From Dental Calculus Formation Rate: The Role of Salivary Proteome and Metaproteome (2025) · cites this paper as Afacan et al. 2022

    The Results report significantly lower salivary SLPI levels in stage 3 grade C periodontitis than in gingivitis, while the Discussion describes only a trend toward higher SLPI in gingivitis than in periodontal health. The paper measures this protease inhibitor, not a surge and decline of inflammatory pathways generally. The sentence’s proposed link to calculus formation is the citing authors’ own interpretation, not a finding attributed to Afacan et al. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Afacan, B., Öztürk, V. Ö., Emingil, G., Köse, T., Mitsakakis, K., & Bostanci, N.
Affiliations
  • Adnan Menderes University (TR)
  • Ege University (TR)
  • University of Freiburg (DE)
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2022-12-08
Volume
12
Issue
1
Pages
21267-21267
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-022-24295-2
PMC
PMC9732338
OpenAlex
W4311892930
Cited by
10
References
50
Citations by year
2026: 1 · 2025: 5 · 2024: 4
FWCI
2.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • The present study was funded by the author´s institutions.
  • Karolinska Institute
Topics
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Medicine › Physiology › Salivary Gland Disorders and Functions
  • Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
Keywords
secretory leukocyte protease inhibitor, periodontitis, gingivitis, whole saliva, periodontal parameters, bacterial load, periodontal diagnosis
MeSH terms
Cross-Sectional Studies, Humans, Periodontitis, Secretory Leukocyte Peptidase Inhibitor

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