The relationship between TGF-beta and periodontal status in HIV+ patients

Objectives: The purpose of this study was to investigate the relationship between transforming growth factor-beta (TGF-beta) in gingival crevicular fluid (GCF) and periodontal status in HIV+ patients. Methods: Medical and demographic variables including age, race, cigarette smoking, oral hygiene practices, current CD4 cell count and viral load values were recorded. Clinical measurements including gingival index, plaque index, bleeding index, probing depth (PD), attachment loss (AL) and GCF samples were taken from 3 periodontitis sites (GI\u3e0, PD\u3e4mm, AL\u3e2mm), 3 gingivitis sites (GI\u3e0, PD\u3c4mm, AL=0), 2 healthy sites (including sites with gingival recession, GI=0, PD\u3c4mm, AL\u3e2mm) of each of the 11 HIV+ patients at baseline and 6-month visits by means of paper strips. GCF TGF-beta levels were determined by sandwich ELISA assays. SAS statistical package was used to analyze the data. Results: The mean amounts of GCF TGF-beta in diseased sites were significantly higher in gingivitis and periodontitis sites than in healthy sites (p \u3c 0.0001). An active site was defined as a site that had 2mm or more attachment loss during 6-month study period. GCF levels of TGF-beta were highly correlated with probing depth, attachment loss, age, pack years, CD4, viral load at baseline and 6-month visits (0.0001 \u3c p \u3c 0.05). Repeated measures analysis of 9 active sites versus 79 inactive sites indicated that GCF TGF-beta levels were significantly higher in active sites than in inactive sites (p \u3c 0.0001). Conclusion: These data indicate that sites with high GCF levels of TGF-beta in HIV+ patients are at significantly greater risk for progression of periodontitis. This study was supported by NIDCR grant DE12417 and University of the Pacific Arthur A. Dugoni School of Dentistry