Restorative Dentistry and Endodontics

  • 제36권3호
  • /
  • Pages.196-202
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  • 2011
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  • 2234-7658(pISSN)
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  • 2234-7666(eISSN)
대한치과보존학회 (The Korean Academy of Conservative Dentistry)
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근관 삼출액에서의 기질금속단백분해효소-8과 substance P의 수준에 관한 연구

Matrix metalloproteinase-8 and substance P levels in root canal exudates of nonvital teeth

  • 신수정 (연세대학교 치과대학 치과보존학교실) ;
  • 이우철 (서울대학교 치의학 전문대학원 치과보존학교실) ;
  • 이재일 (서울대학교 치의학 전문대학원 구강병리학교실) ;
  • 백승호 (서울대학교 치의학 전문대학원 치과보존학교실) ;
  • 금기연 (서울대학교 치의학 전문대학원 치과보존학교실) ;
  • 손원준 (서울대학교 치의학 전문대학원 치과보존학교실) ;
  • 배광식 (서울대학교 치의학 전문대학원 치과보존학교실)
  • Shin, Su-Jung (Department of Conservative Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Woo-Cheol (Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Lee, Jae-Il (Department of Oral Pathology, School of Dentistry, Seoul National University) ;
  • Baek, Seung-Ho (Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Kum, Kee-Yeon (Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Shon, Won-Jun (Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Bae, Kwang-Shik (Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University)
  • 투고 : 2011.03.10
  • 심사 : 2011.04.04
  • 발행 : 2011.05.31
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초록

연구목적: 근관 치료를 전후로 근관 삼출액을 추출하여 MMP-8과 SP의 양을 측정하고 근관 치료에 따른 변화 및 이들간이 상관관계를 보는 것을 본 연구의 목적으로 하였다. 연구 재료 및 방법: 치수괴사, 혹은 이전 근관 치료 후 치근단 병소가 있어서 근관 치료가 예정된 35개의 치아를 대상으로 하였으며, 근관 치료 첫날, 2주 후, 4주 후 paper point를 이용하여 근관 삼출액을 채취하였다. MMP-8과 SP의 양은 enzyme-linked immunosorbent assay (ELISA)를 이용하여 정량 하였다. 삼출액의 채취 시점에 따른 MMP-8, SP 양의 변화 및 환자의 통증 정도, 임상증상에 따른 MMP-8, SP의 변화는 mixed model을 이용하여 통계 분석하였으며 MMP-8과 SP의 상관관계는 Pearson correlation coefficient를 구하여 분석하였다(p < 0.05). 결과: 근관치료가 진행됨에 따라 MMP-8, SP의 양은 유의성 있게 감소하였으며(p < 0.0001), 환자의 통증이나 타진검사 시 반응이 SP의 발현에 영향을 주는 것으로 나타났다. MMP-8의 경우 SP와 미약한 양의 상관관계가 있었지만 환자의 증상이나 다른 임상검사와 상관관계가 발견되지 않았다. 결론: 본 실험에서 사용된 paper point를 이용한 근관 삼출액의 채취를 통하여 치근단 염증과정에서 발현되는 MMP-8, SP를 검출할 수 있었으며 특히 SP의 경우 환자의 증상과 보다 관련이 깊은 것으로 나타났다.

Objectives: The aim of this study was to investigate levels of matrix metalloproteinase-8 (MMP-8) and substance P (SP) in root canal exudates during root canal treatment (RCT) of nonvital, painful teeth. Materials and Methods: Patients scheduled for nonsurgical RCT were prospectively selected; the study was performed after obtaining informed consent from the patients and was approved by the Institutional Review Board for Clinical Research of Gangnam Severance Hospital, Yonsei University (3-2008-0118). Canal exudates samples were collected using sterilized paper points from teeth scheduled for RCT across three different time periods. MMP-8 and SP levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using a mixed model analysis and the Pearson correlation analysis (p < 0.05). Results: MMP-8 and SP levels in GCF were decreased during RCT (p < 0.0001), and they showed a weak positive correlation to each other (p < 0.05). Patients' subjective pain levels and the response from percussion test were significantly related to SP level. Conclusions: This study demonstrated that periradicular inflammation endodontic origin can elevate SP and MMP-8 levels in root canal exudates. Interestingly, SP level of canal exudates showed a possibility of being used as an indicator of pain due to periapical pathosis.

키워드

참고문헌

  1. Heyeraas KJ, Kvinnsland I, Byers MR, Jacobsen EB. Nerve fibers immunoreactive to protein gene product 9.5, calcitonin gene-related peptide, substance P, and neuropeptide Y in the dental pulp, periodontal ligament, and gingiva in cats. Acta Odontol Scand 1993;51:207-221. https://doi.org/10.3109/00016359309040569
  2. Agan S, Sonmez S, Serdar M. The effect of topical doxycycline usage on gingival crevicular fluid MMP-8 levels of chronic and aggressive periodontitis patients: a pilot study. Int J Dent Hyg 2006;4:114-121. https://doi.org/10.1111/j.1601-5037.2006.00174.x
  3. Biyikoglu B, Buduneli N, Kardecler L, Aksu K, Pitkala M, Sorsa T. Gingival crevicular fluid MMP-8 and -13 and TIMP-1 levels in patients with rheumatoid arthritis and inflammatory periodontal disease. J Periodontol 2009;80:1307-1314. https://doi.org/10.1902/jop.2009.090130
  4. Hanioka T, Takaya K, Matsumori Y, Matsuse R, Shizukuishi S. Relationship of the substance P to indicators of host response in human gingival crevicular fluid. J Clin Periodontol 2000;27:262-266. https://doi.org/10.1034/j.1600-051x.2000.027004262.x
  5. Hanemaaijer R, Sorsa T, Konttinen YT, Ding Y, Sutinen M, Visser H, van Hinsbergh VW, Helaakoski T, Kainulainen T, Ronka H, Tschesche H, Salo T. Matrix metalloproteinase-8 is expressed in rheumatoid synovial fibroblasts and endothelial cells. Regulation by tumor necrosis factor-alpha and doxycycline. J Biol Chem 1997;272:31504-31509. https://doi.org/10.1074/jbc.272.50.31504
  6. Palosaari H, Wahlgren J, Larmas M, Ronka H, Sorsa T, Salo T, Tjaderhane L. The expression of MMP-8 in human odontoblasts and dental pulp cells is down-regulated by TGF-beta1. J Dent Res 2000;79:77-84. https://doi.org/10.1177/00220345000790011401
  7. Avellan NL, Sorsa T, Tervahartiala T, Mantyla P, Forster C, Kemppainen P. Painful tooth stimulation elevates matrix metalloproteinase-8 levels locally in human gingival crevicular fluid. J Dent Res 2005;84:335-339. https://doi.org/10.1177/154405910508400408
  8. Awawdeh LA, Lundy FT, Linden GJ, Shaw C, Kennedy JG, Lamey PJ. Quantitative analysis of substance P, neurokinin A and calcitonin gene-related peptide in gingival crevicular fluid associated with painful human teeth. Eur J Oral Sci 2002;110:185-191. https://doi.org/10.1034/j.1600-0447.2002.21236.x
  9. Wahlgren J, Salo T, Teronen O, Luoto H, Sorsa T, Tja-derhane L. Matrix metalloproteinase-8 (MMP-8) in pulpal and periapical inflammation and periapical rootcanal exudates. Int Endod J 2002;35:897-904. https://doi.org/10.1046/j.1365-2591.2002.00587.x
  10. Figueredo CM, Areas A, Miranda LA, Fischer RG, Gustafsson A. The short-term effectiveness of non-surgical treatment in reducing protease activity in gingival crevicular fluid from chronic periodontitis patients. J Clin Periodontol 2004;31:615-619. https://doi.org/10.1111/j.1600-051X.2004.00532.x
  11. Apajalahti S, Sorsa T, Railavo S, Ingman T. The in vivo levels of matrix metalloproteinase-1 and -8 in gingival crevicular fluid during initial orthodontic tooth movement. J Dent Res 2003;82:1018-22. https://doi.org/10.1177/154405910308201216
  12. Emingil G, Afacan B, Tervahartiala T, Toz H, Atilla G, Sorsa T. Gingival crevicular fluid and serum matrix metalloproteinase-8 and tissue inhibitor of matrix metalloproteinase-1 levels in renal transplant patients undergoing different immunosuppressive therapy. J Clin Periodontol 2008;35:221-229. https://doi.org/10.1111/j.1600-051X.2007.01192.x
  13. Ingman T, Tervahartiala T, Ding Y, Tschesche H, Haerian A, Kinane DF, Konttinen YT, Sorsa T. Matrix metalloproteinases and their inhibitors in gingival crevicular fluid and saliva of periodontitis patients. J Clin Periodontol 1996;23:1127-1132. https://doi.org/10.1111/j.1600-051X.1996.tb01814.x
  14. Mantyla P, Stenman M, Kinane DF, Tikanoja S, Luoto H, Salo T, Sorsa T. Gingival crevicular fluid collagenase-2 (MMP-8) test stick for chair-side monitoring of periodontitis. J Periodontal Res 2003;38:436-439. https://doi.org/10.1034/j.1600-0765.2003.00677.x
  15. Okuda K, Miyazaki A, Momose M, Murata M, Nomura T, Kubota T, Wolff LF, Yoshie H. Levels of tissue inhibitor of metalloproteinases-1 and matrix metalloproteinases-1 and -8 in gingival crevicular fluid following treatment with enamel matrix derivative (EMDOGAIN). J Periodontal Res 2001;36:309-316. https://doi.org/10.1034/j.1600-0765.2001.360506.x
  16. Passoja A, Ylipalosaari M, Tervonen T, Raunio T, Knuuttila M. Matrix metalloproteinase-8 concentration in shallow crevices associated with the extent of periodontal disease. J Clin Periodontol 2008;35:1027-1031. https://doi.org/10.1111/j.1600-051X.2008.01329.x
  17. Munjal SK, Prescher N, Struck F, Sorsa T, Maier K, Netuschil L. Evaluation of immunoassay-based MMP-8 detection in gingival crevicular fluid on a point-of-care platform. Ann N Y Acad Sci 2007;1098:490-492. https://doi.org/10.1196/annals.1384.018