Azurocidin in gingival crevicular fluid as a potential biomarker of chronic periodontitis
Abstract
Background and Objective: Azurocidin is a neutrophil‐derived protein in gingival crevicular fluid (GCF) which, according to relevant studies, might correlate with periodontal disease. The aim of the present study was to evaluate azurocidin as a potential biomarker for chronic periodontitis. Material and Methods: One hundred and one patients participated in the study, divided into two groups. Forty‐eight were included in the periodontally healthy group (HP) and fifty‐three in the chronic periodontitis group (CP). Clinical indices included probing depth (PD), recession (REC), clinical attachment level (CAL), bleeding on probing (BOP) and plaque (PL). Pooled GCF samples were collected with paper strips, freezed in liquid nitrogen (−196°C), stored at −80°C, and the levels of azurocidin were analyzed with ELISA. Values were transformed and expressed for comparisons in pg/30 s sample. Statistical comparisons were performed using non‐parametric tests (Mann‐Whitney) at the 0.05 level. Furthermore, the diagnostic accuracy of the procedure was assessed with receiver operator characteristic curves (ROC), areas under the curve (AUC), and the Youden's J Index calculated. Results: Demographic data were comparable between the two groups. Clinical parameters and the levels of azurocidin were statistically significantly higher in the CP group when compared to the HP group (Mann‐Whitney test, P < .05). Quantitative data from ELISA demonstrated a high diagnostic accuracy of azurocidin, with AUC calculated higher than 0.9 at the 0.000 level. Conclusion: Azurocidin in GCF is a promising biomarker for periodontal disease. The results of the present study agree with previous studies in the literature showing an up‐regulated trend in the levels of azurocidin in periodontitis patients.
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AZU levels in GCF are significantly higher in patients with chronic periodontitis compared to periodontally healthy patients.
“Significantly higher levels are found in patients with chronic periodontitis compared to periodontally healthy patients”
From Potential Impact of Prosthetic Biomaterials on the Periodontium: A Comprehensive Review (2023) · cites this paper as [103]
AZU is involved in the pathogenesis of periodontal disease.
“indicating that this protein is also involved in PD pathogenesis [103,154,155].”
From Potential Impact of Prosthetic Biomaterials on the Periodontium: A Comprehensive Review (2023) · cites this paper as [103]
Cites
O’Leary, T. J., Drake, R. B., & Naylor, J. E. (1972) · Journal of Periodontology · doi:10.1902/jop.1972.43.1.38 · Cited by 2,552 · see citing works
Periodontal diagnoses and classification of periodontal diseases
Armitage, G. C. (2004) · Periodontology 2000 · doi:10.1046/j.0906-6713.2002.003421.x · Cited by 779 · see citing works
Tonetti, M. S., Claffey, N. M., & on behalf of the European Workshop in Periodontology group C (2005) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2005.00822.x · Cited by 617 · see citing works
Denny, P., Hagen, F. K., Hardt, M., Liao, L., Yan, W., Arellanno, M., Bassilian, S., Bedi, G. S., Boontheung, P., Cociorva, D., et al. (2008) · Journal of Proteome Research · doi:10.1021/pr700764j · Cited by 445 · see citing works
Gingival crevicular fluid as a source of biomarkers for periodontitis
Barros, S. P., Williams, R. C., Offenbacher, S., & Morelli, T. (2015) · Periodontology 2000 · doi:10.1111/prd.12107 · Cited by 422 · see citing works
Buduneli, N., & Kinane, D. F. (2011) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2010.01670.x · Cited by 348 · see citing works
Proteolytic host cell enzymes in gingival crevice fluid.
Uitto, V., Overall, C., & McCulloch, C. (2003) · Periodontology 2000 · doi:10.1034/j.1600-0757.2003.03106.x · Cited by 272 · see citing works
Disease progression: identification of high‐risk groups and individuals for periodontitis
Heitz‐Mayfield, L. J. A. (2005) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2005.00803.x · Cited by 261 · see citing works
Origin and function of the cellular components in gingival crevice fluid
Delima, A. J., & Dyke, T. E. V. (2003) · Periodontology 2000 · doi:10.1034/j.1600-0757.2003.03105.x · Cited by 258 · see citing works
Potential for gingival crevice fluid measures as predictors of risk for periodontal diseases.
Champagne, C., Buchanan, W., Reddy, M., Preisser, J., Beck, J., & Offenbacher, S. (2003) · Periodontology 2000 · doi:10.1034/j.1600-0757.2003.03110.x · Cited by 228 · see citing works
Campanelli, D., Detmers, P., Nathan, C., & Gabay, J. E. (1990) · Journal of Clinical Investigation · doi:10.1172/jci114518 · Cited by 216 · see citing works
Shafer, W. M., Martin, L., & Spitznagel, J. (1984) · Infection and Immunity · doi:10.1128/iai.45.1.29-35.1984 · Cited by 210 · see citing works
Xie, H., Rhodus, N. L., Griffin, R. J., Carlis, J. V., & Griffin, T. J. (2005) · Molecular & Cellular Proteomics · doi:10.1074/mcp.d500008-mcp200 · Cited by 165 · see citing works
Host-derived diagnostic markers for periodontitis: do they exist in gingival crevice fluid?
Loos, B., & Tjoa, S. T. (2005) · Periodontology 2000 · doi:10.1111/j.1600-0757.2005.00129.x · Cited by 164 · see citing works
Bostancı, N., Heywood, W., Mills, K. A., Parkar, M. H., Nibali, L., & Donos, N. (2010) · Journal of Proteome Research · doi:10.1021/pr900941z · Cited by 145 · see citing works
Comparative proteomic analysis of whole saliva from chronic periodontitis patients
Gonçalves, L. D. R., Soares, M. R., Nogueira, F. C. S., Saraiva-Garcia, C., Camisasca, D. R., Domont, G. B., Feitosa, A. C. R., Pereira, D. D. A., Zingali, R. B., & Alves, G. (2010) · Journal of Proteomics · doi:10.1016/j.jprot.2010.02.018 · Cited by 144 · see citing works
Leppilahti, J. M., Hernández‐Ríos, P. A., Gamonal, J. A., Tervahartiala, T., Brignardello‐Petersen, R., Mantyla, P., Sorsa, T., & Hernández, M. (2014) · Journal of Clinical Periodontology · doi:10.1111/jcpe.12223 · Cited by 138 · see citing works
Al-Majid, A., Alassiri, S., Rathnayake, N., Tervahartiala, T. I., Gieselmann, D., & Sorsa, T. A. (2018) · International Journal of Dentistry · doi:10.1155/2018/7891323 · Cited by 120 · see citing works
Alassiri, S., Pärnänen, P., Rathnayake, N., Johannsen, G., Heikkinen, A. M., Lazzara, R., van der Schoor, P., van der Schoor, J. G., Tervahartiala, T. I., Gieselmann, D., et al. (2018) · Disease Markers · doi:10.1155/2018/1306396 · Cited by 119 · see citing works
Amur, S., Frueh, F. W., Lesko, L. J., & Huang, S. M. (2008) · Biomarkers in Medicine · doi:10.2217/17520363.2.3.305 · Cited by 116 · see citing works
Salivary Diagnostics—Point-of-Care diagnostics of MMP-8 in dentistry and medicine
Rathnayake, N., Gieselmann, D., Heikkinen, A. M., Tervahartiala, T. I., & Sorsa, T. A. (2017) · Diagnostics · doi:10.3390/diagnostics7010007 · Cited by 112 · see citing works
Clinical and technical considerations in the analysis of gingival crevicular fluid
Wassall, R. R., & Preshaw, P. M. (2015) · Periodontology 2000 · doi:10.1111/prd.12109 · Cited by 110 · see citing works
Salazar, M. G., Jehmlich, N., Murr, A., Dhople, V. M., Holtfreter, B., Hammer, E., Völker, U., & Kocher, T. (2013) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12130 · Cited by 108 · see citing works
Baliban, R. C., Sakellari, D., Li, Z., DiMaggio, P. A., Garcia, B. A., & Floudas, C. A. (2011) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2011.01805.x · Cited by 99 · see citing works
Self-citationCovalent structure of two novel neutrophile leucocyte‐derived proteins of porcine and human origin
Flodgaard, H. J., ØSTERGAARD, E., Bayne, S. J., Svendsen, A., Thomsen, J., Engels, M. F. M., & Wollmer, A. (1991) · European Journal of Biochemistry · doi:10.1111/j.1432-1033.1991.tb15942.x · Cited by 99 · see citing works
Characterization of two azurphil granule proteases with active-site homology to neutrophil elastase.
WILDE, C. G., Snable, J. L., Griffith, J. E., & Scott, R. W. (1990) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(19)39936-3 · Cited by 87 · see citing works
Grant, M. M., Creese, A. J., Barr, G., Ling, M. R., Scott, A. E., Matthews, J. B., Griffiths, H. R., Cooper, H. J., & Chapple, I. (2010) · Journal of Proteome Research · doi:10.1021/pr100446f · Cited by 86 · see citing works
Periodontal diagnosis and treatment – where does the future lie?
Chapple, I. (2009) · Periodontology 2000 · doi:10.1111/j.1600-0757.2009.00319.x · Cited by 73 · see citing works
Choi, Y.-J., Heo, S.-H., Lee, J.-M., & Cho, J.-Y. (2011) · Proteome Science · doi:10.1186/1477-5956-9-42 · Cited by 71 · see citing works
Almeida, R. P., Vanet, A., Witko-Sarsat, V., Melchior, M., McCabe, D., & Gabay, J. E. (1996) · Protein Expression and Purification · doi:10.1006/prep.1996.0053 · Cited by 46 · see citing works
Baliban, R. C., Sakellari, D., Li, Z., Guzman, Y. A., Garcia, B. A., & Floudas, C. A. (2012) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12037 · Cited by 40 · see citing works
Self-citationGuzman, Y. A., Sakellari, D., Papadimitriou, K., & Floudas, C. A. (2018) · Journal of Periodontal Research · doi:10.1111/jre.12575 · Cited by 29 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Potential Impact of Prosthetic Biomaterials on the Periodontium: A Comprehensive Review
Alarcón-Sánchez, M. A., Heboyan, A., Fernandes, G. V. D. O., Castro-Alarcón, N., & Romero-Castro, N. S. (2023) · Molecules · doi:10.3390/molecules28031075 · Cited by 52 · see citing works
“fractalkine (CX3CL1) have recently been proposed as potential markers of periodontal disease [103,104].”
BackgroundUtility of gingival crevicular fluid components for periodontal diagnosis
Buduneli, N., Bıyıkoğlu, B., & Kinane, D. F. (2024) · Periodontology 2000 · doi:10.1111/prd.12595 · Cited by 58 · see citing works
Cationic Antimicrobial Peptides Are Leading the Way to Combat Oropathogenic Infections
Lin, B., Li, R., Handley, T. N. G., Wade, J. D., Li, W., & O’brien-simpson, N. M. (2021) · ACS Infectious Diseases · doi:10.1021/acsinfecdis.1c00424 · Cited by 46 · see citing works
Host Markers of Periodontal Diseases: Meta‐Analysis of Diagnostic Accuracy Studies
Rakić, M., Calciolari, E., Grant, M. M., Radovanović, S., Bostancı, N., & Preshaw, P. M. (2025) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.14167 · Cited by 24 · see citing works
Impact of peri‐implantitis on the proteome biology of crevicular fluid: A pilot study
Halstenbach, T., Nelson, K., Iglhaut, G., Schilling, O., & Fretwurst, T. (2022) · Journal of Periodontology · doi:10.1002/jper.22-0461 · Cited by 26 · see citing works
Interplay between Humoral and CLA+ T Cell Response against Candida albicans in Psoriasis
de Jesús‐Gil, C., Nicolàs, L. S. S., Ruiz‐Romeu, E., Ferrán, M., Soria-Martínez, L., García‐Jiménez, I., Chiriac, A. E., Casanova-Seuma, J. M., Armenteros, J. M. F., Owens, S. L., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22041519 · Cited by 19 · see citing works
Xanthopoulou, V., Räisänen, I. T., Sorsa, T. A., Tortopidis, D., & Sakellari, D. (2024) · Clinical and Experimental Dental Research · doi:10.1002/cre2.883 · Cited by 10 · see citing works
Self-citationFaulkner, E., Mensah, A., Rodgers, A. M., McMullan, L., & Courtenay, A. J. (2022) · Diagnostics · doi:10.3390/diagnostics12040919 · Cited by 9 · see citing works
Microscopic observations of SARS‐CoV‐2 like particles in different oral samples
Belhaouari, D. B., Baudoin, J., Lagier, J., Monnet‐Corti, V., Scola, B. L., & Antezack, A. (2022) · European Journal Of Oral Sciences · doi:10.1111/eos.12903 · Cited by 7 · see citing works
Cagna, D. R., Donovan, T. E., McKee, J. R., Eichmiller, F. C., Metz, J. E., Albouy, J.-P., Marzola, R., Murphy, K. G., & Troeltzsch, M. (2021) · Journal of Prosthetic Dentistry · doi:10.1016/j.prosdent.2021.06.014 · Cited by 5 · see citing works
Kayar, N. A., Üstün, K., Gözlü, M., Haliloğlu, S., & Alptekin, N. Ö. (2021) · Clinical Oral Investigations · doi:10.1007/s00784-021-03838-3 · Cited by 5 · see citing works
Salivary levels of azurocidin and soluble azurophilic granules in periodontal disease
Al-Ghurabi, B. H., Jasim, F. S., & Ameer, L. A. A. (2024) · Journal of Medicine and Life · doi:10.25122/jml-2023-0286 · Cited by 3 · see citing works
Alarcón‐Sánchez, M. A., Martínez, S. M. L., Montaño, R. R., Becerra‐Ruiz, J. S., Martínez‐Bugarin, C. H., Mosaddad, S. A., & Heboyan, A. G. (2025) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2025.106256 · Cited by 1 · see citing works
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Watanabe, M., Kobayashi, Y., Ishida, M., Tajima, A., Tanigaki, S., & Morisada, T. (2025) · Reproductive Sciences · doi:10.1007/s43032-025-01795-w
Yang, W., & Dong, W. (2025) · Bratislavské lekárske listy/Bratislava medical journal · doi:10.1007/s44411-025-00131-7
Yang, W., Zhang, W., & Huo, Y. (2025) · Global Insights in Medicine and Nursing · doi:10.65140/gimn202501.5
Kaliappan, N., Arunmozhi, P., Jayavel, K., Rajasekar, S., & Thenumgal, S. J. (2026) · Journal of Oral Biology and Craniofacial Research · doi:10.1016/j.jobcr.2026.101492
- Authors
- Nalmpantis, D., Gatou, A., Fragkioudakis, I., Margariti, A., Skoura, L., & Sakellari, D.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- Corresponding author
- Sakellari, Dimitra
- Venue
- Journal of Periodontal Research
- Publisher
- Wiley
- Published
- 2019-10-14
- Volume
- 55
- Issue
- 2
- Pages
- 209-214
- ISSN
- 0022-3484 (ISSN-L)
- 1600-0765
- OpenAlex
- W2979956661
- Cited by
- 17
- References
- 32
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 4
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Periodontal Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- PlacControl Ltd
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Health Sciences › Health Professions › Pharmacy › Oral and gingival health research
- Keywords
- heparin-binding protein, gingival crevicular fluid, chronic periodontitis, periodontal biomarkers, diagnostic accuracy, clinical attachment level, probing depth, bleeding on probing, periodontal plaque
- MeSH terms
- Blood Proteins, Cross-Sectional Studies, Gingival Crevicular Fluid, Humans, Middle Aged, Periodontal Index, Biomarkers, Case-Control Studies, Periodontal Attachment Loss, Antimicrobial Cationic Peptides, Chronic Periodontitis
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