The role of matrix metalloproteinase 2 (MMP-2 ) in chronic periodontitis

Speaker: Yeh Feng-wei Tutor: Maria Amparo

SPEAKER: YEH FENG-WEI TUTOR: MARIA AMPARO VILA CABALLER

The role of matrix metalloproteinase 2 (MMP-2 ) in chronic periodontitis

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What is the function of MMPs in our body?

• Matrix metalloproteinase is like a worker also the body guard.• When our bodies get into some trouble, they will call the security to

resist the foreign enemy.

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MMPs (Matrix metalloproteases)

• MMPs are proteases which are found in combination with Zn2+metal ions.

• They are capable of degrading all types of extracellular matrix proteins, but also can process a number of bioactive molecules (such as; fibrocartilage degradation).

• MMPs are a group of enzymes that in concert are responsible for the degradation of most extracellular matrix proteins during organogenesis, growth and normal tissue turnover.

• MMP-2 plays an important role in fibrocartilage degradation in internal derangement of the mandibular joint.

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MMP-2

• is present on the cartilage and in synovial fluid • is a gelatinase• MMP-2 allows living organisms to hydrolyse gelatin into its sub-

components (polypeptides, peptides and amino acids).– You can detect MMP-2 by Immunostaining: A positive signal was

observed in the cytoplasm of chondrocytes and in their surrounding matrix.

– ELISA– 2D electrophoresis

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Periodontitis

• Periodontitis is a progressive disease of the tooth supporting apparatus affecting gingiva, periodontal ligament, root cement and alveolar bone.

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Chronic periodontitis

• A common, painless, slow progressing disease, characterized by specific clinical features:– Gingival inflammation

• § Bleeding on probing (BOP)• § Loss of clinical attachment• § Loss of alveolar bone• § Periodontal pocket (>3mm)

– Variable features include:• § Gingival enlargement• § Gingival recession • § Root furcation involvement• § Tooth drifting • § Tooth exfoliation• § Tooth mobility

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Classification of periodontitis• According to “Classification of periodontal diseases and conditions,

Armitage,1999” and be further classified on the basis of extent and severity.

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Possible role of mmp-2 in chronic periodontitis?

• MMP-2 is present in the synovial fluid junction (periodontal ligament) and cartilage, and degrades protein and collagen fibers.

• Chronic periodontitis symptoms include– Inflammation caused by MMP-2, MMP-8 AND MMP-9– Tooth mobility caused by MMP-8 and MMP-9

• Due to the gelatinase function of MMP-2, we hypothesize that MMP-2 may also be associated with tooth mobility caused by periodontitis

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Smoking and Periodontitis

• Smoking is one of the main modifiable risk factors for chronic periodontitis.– Smokers tend to have poorer periodontal health and a poor

response to periodontal treatment.– Approximately half as much improvement following surgical or

non-surgical therapy.– Surgical therapy is used by tetracycline or doxycycline with root

planning surgery treatment.• Tetracycline or doxycycline can inhibit MMPs to decrease

inflammation of periodontal tissue, functioning as tissue inhibitors of metalloproteinases (TIMP).

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Clinical trail patients selection:

• According to “Classification of periodontal diseases and conditions, Armitage,1999”(table 2).

• In Chronic periodontitis patients who have the syndrome of Blood of probing (BoP), Localized sites (≤30% sites) the amount of clinical attachment loss (CAL) more than 1 or 2mm CAL are selected and classified the smoking or non-smoking people groups.

• There are 3 groups to identify the patient according to the dosage.

1. More than 10 cigarettes per day.( Group 1)2. Lower than 10 cigarettes per day (Group 2)3. Non-smoking patients. (Group control)

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Methodology:

• The article review is about Chronic periodontitis and MMP-2 assay from 1991 to 2012 in the data base (SAGE journals and NCBI pubmed).

• 83 articles were found, and 60 articles were excluded, 23 articles from 1991 to 2012 were included. One Chinese studies with English outline was included.

• Inclusion criteria is the language included English and Chinese both and the outline from 1991 to 2012 and be realized the relation between MMP-2 assay and Chronic periodontitis.

• Exclusion criteria; some studies which don’t support the relation between periodontal problem with MMP-2 strongly are excluded. Also the outline wasn’t showed the gelatinase specifically was excluded.

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Discussion

• MMP-2 is correlated with chronic periodontitis, because as a gelatinase, thus, it can hydrolyze cartilage tissue and make tooth ligament decrease. Tooth mobility are cause because of the decrease of tooth ligament. Therefore in Chronic periodontitis treatment, dentists use antibiotics e.g. Tetracycline and Doxycycline.

• In cosmetic market there are a lot of natural compounds developed for decrease MMP-2 on the skin or soft tissue of face. e.g. Q10 co-factor, 3’, 4’, 7-Trihydroxyflavone. It will avoid collagen fiber breakdown on the skin and then Anti-wrinkle.

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Alternative periodontitis therapy of antibiotics

• To develop another alternative way for chronic periodontitis therapy, to discover another natural compound with less or without side effect will make chronic periodontitis patient have a good life quality and according to MMP-2 values examination to make the treatment plan with the compound which can make inhibition of MMP-2 after usual periodontal treatment will decrease the antibiotics use. e.g. Tetracycline , doxycycline. For example , tetraxcycline will make fluorosis or some severe fugal infection patients who can’t prescribe antibiotics.

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Tetracycline, MMPs and Gingival cervical fluid

• Tetracycline are effective in suppressing the Gram-negative periodontopathic organisms in the subgingival plaque and tetracycline have the ability among antibiotics to concentrate in the gingival crevicular fluid (GCF) of the periodontal pocket at levels 5-10 times greater than those found in serum.

• In present study, there are a lot of method to analyze MMPs with Zymography combined specific western blotting and ELISA. It’s more precise and sensible than only zymography or ELISA.

• Therefore to detect MMPs values in GCF with Zymography combined specific ELIZA is more precise than only use Zymography way.

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Conclusion

• MMP-2 values would be quantified for ELISA reader and to be a reference of chronic periodontitis with periodontitis classification.

• Because MMP-2 is a kind of gelatinase, MMP-2 may make the connective tissue destruction in periodontitis.

• MMP-2 values may be associated with chronic periodontitis.

• GCF can be the indicator of MMP-2 value for periodontitis patients.

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Conclusion • MMPs have a marked role also in tissue destructive oral diseases.

• The role of collagenases, especially MMP-8, in periodontitis and peri-implantitis is the best-known example of the unwanted tissue destruction related to increased presence and activity of MMPs at the site of disease, but evidence has been brought forward to indicate that MMPs may be involved also in other oral diseases, such as dental caries and oral cancer.

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Conclusion

• According to characteristics of MMP-2 in chronic periodontitis, we tend to be looking for new diagnosis and treatment for oral surgery and post-surgery care.

• There are variable natural compounds which have the inhibition of MMPs. • It may facilitate the development of new means of diagnosis and treatment of

oral diseases. • People spend billions of money every year for anti-aging products to stay

young. The key component is anti-aging active ingredients. It promises to diminish fine lines and wrinkles, abolish sun damage, and lift sagging part on the face. Hya-Heal+/MMpH+ can inhibit the activity of certain proteinase therefore reduce degradation of natural collagen. (ITRI ,Taiwan, 2016)

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Thank you very much!!!

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Photo by Skaja Lee Photo Studio