Decreased Salivary Gremlin-1 Levels in Periodontitis Patients

INTRODUCTION: Gremlin-1, a member of the Transforming Growth Factor-Beta protein superfamily, is an antagonist of Bone Morphogenetic Proteins involved in processes such as angiogenesis, inflammation, fibrosis, and osteogenesis.The aim of this study is to compare salivary Gremlin-1 levels in individuals with periodontitis to those in periodontally healthy individuals and to evaluate the relationship of these levels with clinical parameters. METHODS: A total of 40 systemically healthy individuals were included, comprising 20 stage III/grade B periodontitis and 20 periodontal healthy individuals. Clinical periodontal parameters (plaque index (PI), probing depth (PD), clinical attachment loss (CAL)and bleeding on probing (BOP)) were recorded.Salivary Gremlin-1 levels were analyzed using an ELISA.RESULTS: All periodontal measurements were significantly higher in the periodontitis group rather than controls (p<0.0001).Salivary Gremlin-1 levels were significantly lower in the periodontitis compared to the control group (p<0.0001).Negative correlations were found between Gremlin-1 levels and PI (r=-0.592,p=0.011),PD (r=-0.452,p=0.003), and CAL (r=-0.453,p=0.003).No significant correlation was observed between Gremlin-1 levels and BOP (p>0.05).CONCLUSION: Decreased saliva Gremlin-1 levels in periodontitis patients and their negative correlation with clinical periodontal parameters suggest that saliva Gremlin-1 might modulate the inflammation and limit tissue remodeling as a systemic compensation mechanism in periodontitis.