Aggressive Periodontitis Clinical Trial
Official title:
The Evaluation of MCP-1 and CCR-2 Gene Polymorphisms Frequency and The Effects of This Polymorphism on Gene Expression in Patients With Aggressive Periodontitis
The aim of this study is to estimate genetic impact of MCP-1 -2518 and its receptor CCR2 -190 polymorphisms on AgP patients among Turkish individuals and whether MCP-1 genotype effects mRNA levels of Peripheral Blood Mononuclear Cell Leukocyte (PBML)
Differences in structure of gene or non genetic factors such as nutrition/environmental
factors may alter functional gene product: mRNA/protein which play crucial roles in immune
system. This can lead developing defective immune responses, exacerbation of current
inflammation and increased host susceptibility to inflammatory diseases. Monocyte functions
can be critical with regard to getting individuals susceptible to periodontitis. Similarly
Garrison and Nichols (1989) reported that hyper-inflammatory monocyte phenotype can be
deterministic in periodontal destruction. For this reason, regulation of MCP-1 and CCR2
expression, which have an essential role in defense system, may be a crucial step for
managing inflammatory diseases as well as periodontitis.
Because of complex genetic nature of periodontal disease, we hypothesized that gene
polymorphisms of MCP-1 and CCR2 could be associated with AgP and could alter the production
of functional proteins, as a result might influence the susceptibility. Therefore, the
primary aim of this study was to estimate genetic impact of MCP-1 and its receptor CCR2
polymorphisms on AgP patients among Turkish individuals and secondary outcome was whether
MCP-1 genotype effects mRNA levels of PBML.
A total of 215 Turkish subjects from inner Anatolia including, 108 Aggressive periodontitis
(AgP) and 107 age, gender and ethnic matched periodontally healthy (H) controls were
recruited in this cross-sectional case control study. The control group included
periodontally healthy volunteers from staff and other subjects referring to the School of
Dentistry. The diagnosis of subjects were established on the basis of clinical and
radiographic examination. Periodontally H control group (n:107) had <3mm probing Depth (PD),
<2 gingival Index (GI) and no signs of interproximal attachment loss and a history of
periodontal disease. Patients with AgP (n:108) were diagnosed by the 1999 International
World Workshop for a Classification of Periodontal Diseases and Conditions. The AgP group
included individuals diagnosed with localized AgP (LAgP) or generalized AgP (GAgP) who were
otherwise healthy. Periodontal attachment loss ≥4 mm not involving more than two permanent
teeth, other than the first molars and incisors were diagnosed with LAgP (n: 43); patients
with involvement of at least three teeth, other than the first molars and incisors with an
attachment loss ≥4 mm were diagnosed with GAgP (n: 65) Genomic DNA was isolated from a
peripheral blood sample obtained from each subject. Gene polymorphisms of MCP-1 -2518 A/G
and CCR2 -190 G/A were analyzed by a standard polymerase chain reaction-restriction fragment
length polymorphism (PCR-RFLP) assay. Gene expression levels were quantified in peripheral
blood leukocytes from 25 AgP and 15 periodontally H controls by quantitative real-time PCR.
Threshold cycles (Ct ) values obtained from the RT-PCR analysis based on SYBR Green
detection and data was normalized via ΔC t .
Sample size was determined by power analysis prior to study. According to this; an expected
difference 20% in allele frequencies with 80% power, and % 95 confidence interval it was
calculated that minimum of 102 patients were necessary in each group with a significance
level of 0.05. ( ⃰ G. Power: 3.1.2). When comparing the numeric characteristics between H
and AgP groups,non-parametric Mann-Whitney U test; between H, LAgP and GAgP groups then
Kruskal Wallis with Bonferroni correction were calculated.
Deviations from Hardy-Weinberg equilibrium were assessed in the H and AgP groups based on
genotype distribution for MCP-1 -2518 and CCR2 -190 by using a chi-squared test. The
differences in genotype and allele frequencies between groups were also detected by the
chi-square test. We used independent samples t-test for comparison of gene expression levels
between groups and one way ANOVA was used to determine the effect of MCP-1 -2518 genotype on
gene expression, based on log-transformed data. Significance level was P = 0.05.
;
Observational Model: Case Control, Time Perspective: Cross-Sectional
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