Estimation and comparison of salivary VEGF-A expression in healthy patients who were non-smokers vs chronic periodontitis patients who were smokers

Introduction: Change in vasculature is the initial response observed in chronic inflammatory diseases including periodontal disease. The cascade of vascular events determines the progression of inflammation which is also regulated by host immuno-inflammatory response. Morphological changes in vasculature observed in periodontal disease are a result of angiogenesis which is regulated by angiogenic activators and inhibitors. Vascular Endothelial Growth Factor (VEGF) is a potent angiogen and endothelial mitogen regulating angiogenesis. The vascular events of periodontal disease are influenced by cigarettes and smokeless tobacco products. Smokeless tobacco (ST) constituents such as nicotine and aryl- choline increase inflammatory mediator levels in gingiva which is already exposed to oral biofilm, subjecting it to further destructive changes. Salivary VEGF system plays an important role in establishing homeostasis in oral mucosa. Thus, estimating the expression of VEGF in saliva of chronic periodontitis patients who consume smokeless tobacco could provide a better understanding of this interrelationship. Materials and Methods: The study comprised of 52 subjects (34 males and 18 females). Of these 25 periodontally healthy patients who were Non-smokers were recruited in group A and 27 chronic periodontitis patients who were Smokers were recruited in group B. VEGF-A levels were estimated in unstimulated whole saliva using sandwich ELISA technique. The data obtained were statistically analyzed using Mann-Whitney U test. Results: The salivary VEGF-A levels in periodontally healthy subjects was 252.07pg/ml and in chronic periodontitis patients was 880.16 pg/ml. The salivary VEGF-A levels in Group B (chronic periodontitis) was significantly higher than Group A (Periodontally Healthy) with p value of 0.000 (p value