口腔种植体周围炎患者牙龈中组织蛋白酶B及Beclin-1的表达及临床意义

Expression and clinical significance of cathepsin B and Beclin-1 in the gingival tissues of patients with peri-implantitis

目的:探讨口腔种植体周围炎患者牙龈中组织蛋白酶B(Cat B)及Beclin-1的表达及临床意义。方法:选择124例口腔种植体周围炎患者病变牙龈组织作为实验组,124例健康牙龈组织(阻生牙拔除)为对照组,分别采用实时荧光定量PCR和蛋白免疫印迹法(Western blot)检测Cat B和Beclin-1 mRNA及蛋白表达量。统计术后1年口腔种植体周围炎患者种植体松动、脱落情况。Logistic多因素回归分析影响口腔种植体周围炎患者种植体松动/脱落的有关因素。制作受试者工作特征曲线(ROC),分析牙龈组织中Cat B、Beclin-1 mRNA表达量对口腔种植体周围炎患者种植体松动/脱落发生的预测价值。采用SPSS 21.0软件包对数据进行统计学分析。结果:实验组牙龈组织中Cat B、Beclin-1 mRNA及蛋白表达量均显著高于对照组(P<0.05)。口腔种植体周围炎患者术后1年种植体松动/脱落发生率为16.94%。松动/脱落组合并糖尿病占比、吸烟史占比、种植体负载时间、降钙素原(PCT)、牙龈组织中Cat B及Beclin-1 mRNA表达量显著高于未松动/脱落组(P<0.05)。Logistic多因素分析结果显示,PCT、Cat B及Beclin-1 mRNA均为影响口腔种植体周围炎患者种植体松动/脱落的危险因素(OR=2.751、3.414、3.196,P<0.05)。ROC分析显示,牙龈组织中Cat B、Beclin-1 mRNA表达量对口腔种植体周围炎患者种植体松动/脱落发生进行预测的最佳截断点分别为1.42、2.51,灵敏度分别为61.90%、76.19%,特异度分别为76.70%、60.19%,AUC分别为0.728、0.771。结论:与牙龈健康者相比,口腔种植体周围炎患者牙龈组织中Cat B、Beclin-1 mRNA均呈高表达,且牙龈组织中Cat B、Beclin-1 mRNA表达量对口腔种植体周围炎患者种植体松动/脱落发生的预测价值较高,可作为临床评估种植体松动/脱落发生的重要参考指标。

PURPOSE:To explore the changes and clinical significance of cathepsin B(Cat B)and Beclin-1 expression in the gingival tissues of patients with peri-implantitis.METHODS:One hundred and twenty-four cases with peri-implantitis were collected as the experimental group,and 124 cases of healthy gingival tissues(due to impacted tooth extraction)as the control group.The expression of Cat B and Beclin-1 mRNA and protein in the gingival tissues of the two groups were detected by RT-PCR and Western blot,respectively.One year after operation,the patients with peri-implantitis were classified into loosing/dropping group and non-loosing/dropping group.The clinical data of patients in the two groups were analyzed.Logistic multivariate regression analysis was conducted to evaluate related factors affecting implant loosing/dropping in patients with peri-implantitis.A receiver operating characteristic curve(ROC)was made to analyze the predictive value of Cat B and Beclin-1 mRNA expression in gingival tissue for the occurrence of implant loosing/dropping in patients with peri-implantitis.SPSS21.0 software package was used for data analysis.RESULTS:Cat B and Beclin-1 mRNA and protein expression in the gingival tissues of the experimental group was significantly higher than those of the control group(P<0.05).The incidence of implant loosing/dropping in patients with peri-implantitis was 16.94%one year after operation.The prevalence of diabetes,smoking history,implant loading time,procalcitonin(PCT),and the expression of Cat B and Beclin-1 mRNA in gingival tissue in the loosing/dropping group were significantly higher than those in the non-loosing/dropping group(P<0.05).Logistic multivariate analysis showed that PCT,Cat B and Beclin-1 mRNA were risk factors affecting the occurrence of implant loosing/dropping in patients with peri-implantitis(OR=2.751,3.414,3.196,P<0.05).ROC analysis showed that the best cut-off points for the expression of Cat B and Beclin-1 mRNA in gingival tissue to predict the occurrence of implant loosing/dropping in patients with peri-implantitis were 1.42 and 2.51,respectively,and the sensitivities were 61.90%and 76.19%,respectively;specificity was 76.70%,60.19%,and AUC was 0.728 and 0.771,respectively.CONCLUSIONS:Compared with healthy gingiva,Cat B and Beclin-1 mRNA in the gingival tissues of patients with peri-implantitis are both highly expressed,and the expression of Cat B and Beclin-1 mRNA in the gingival tissues has an effect on peri-implant inflammation.The predictive value of the occurrence of implant loosening/dropping in patients is high,and it can be used as an important reference index for clinical evaluation of the occurrence of implant loosing/dropping.