Association of thalassemia major and gingival inflammation: A pilot study

• We hypothesized that thalassemia major may affect levels of MMPs biofluids and thereby deteriorate clinical periodontal status.
• We examine changes in the level of MMPs in thalassemia major patients.
• Thalassemia major may exacerbate the local inflammatory response.
• Higher serum TIMP-1 levels in thalassemia major could be result of their systemic drug usage.

ObjectivesThis cross-sectional study aimed to investigate the relationship between thalassemia major (TM) and gingival inflammation through the salivary, serum, and gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP)-8, MMP-9 and tissue inhibitor of MMP (TIMP)-1.MethodsBiofluid samples and full-mouth clinical periodontal recordings were obtained from 29 otherwise healthy patients with TM and 25 systemically healthy (SH) individuals. Biofluid samples were evaluated by immunofluorometric assay (IFMA) and enzyme-linked immunoassays (ELISAs). Data were tested statistically by Kolmogorov Simirnov, Mann–Whitney U tests, Spearman correlation analysis.ResultsAge, smoking status, bleeding on probing, plaque index were similar in the study groups, but probing depth, gender data exhibited significant differences (p = 0.037 for both). Salivary MMP-8, MMP-9, TIMP-1 concentrations were significantly higher in the TM than SH group (p = 0.014; p < 0.001; p = 0.042, respectively). Serum TIMP-1 concentrations were significantly higher; MMP-8/TIMP-1, MMP-9/TIMP-1 molar ratios were significantly lower in the TM than SH group (p < 0.001; p = 0.005; p = 0.022, respectively). Very few GCF samples revealed biochemical data above the detection limits. Numerous correlations were found between clinical periodontal parameters and biochemical data.ConclusionsIt may be suggested that TM may exacerbate the local inflammatory response as manifested in salivary MMP-8, MMP-9, TIMP-1 levels.