Alpha-1-antitrypsin deficiency and periodontitis, a pilot study

Proteases are capable of tissue breakdown. Plasma and gingival crevicular fluid (GCF) contain antiproteases, such as alfa-1-antitirypsin (AAT). Lack of AAT may lead to periodontal destruction. The aim was to study if periodontal parameters and elastase in GCF and plasma are different in AAT deficient subjects compared to subjects without AAT deficiency. Material & methods: 30 subjects were included, 20 of whom with severe AAT deficiency. Ten of them suffered from chronic obstructive pulmonary disease (group 1) and 10 were asymptomatic (group 2). Ten control subjects (group 3) were recruited from a public dental clinic. The examination comprised GCF, Gingival index (GI), Plaque Index (PlI), probing pocket depth (PPD) and radiography. GCF was collected with paper strips (Periopaper®). Plasma AAT concentration was measured by nephelometry and AAT in GCF with ELISA. Elastase activity and protein in plasma and GCF were determined by spectrophotometry. Results: The mean values for GI, PlI, PPD and the radiological measurements did not show any statistically significant differences between the groups. AAT in GCF and plasma did not show any significant difference between group 1 and 2 but a statistical difference in comparison with group 3. Elastase in GCF and plasma did not show any difference between the three groups. In conclusion no differences were found between AAT deficient subjects and healthy controls in this limited material