Trypsin-like Peptidase Activity, but Not Gingival Crevicular Fluid C-Reactive Protein, Reflects Local Clinical and Microbiological Periodontal Conditions

Trypsin-like peptidase (TLP) activity has emerged as a promising chairside biomarker for periodontal disease, but its relationship with local inflammatory biomarkers has not been fully elucidated. This study aimed to compare the associations of TLP activity and gingival crevicular fluid (GCF) C-reactive protein (CRP) concentration with local periodontal conditions. Sixty patients with untreated periodontitis were enrolled, and GCF and subgingival plaque samples were collected from the deepest periodontal pocket of each participant. TLP activity was measured using a chairside assay, GCF CRP concentration by enzyme-linked immunosorbent assay, and Porphyromonas gingivalis (P. gingivalis), Treponema denticola, and Tannerella forsythia by real-time PCR. GCF CRP concentration was not associated with clinical periodontal parameters or microbiological findings, whereas TLP activity was significantly associated with probing pocket depth and P. gingivalis counts. In multivariable analysis including age, probing pocket depth, bleeding on probing, GCF CRP concentration, and P. gingivalis counts, age, probing pocket depth, and P. gingivalis counts were independently associated with TLP activity. These findings suggest that TLP activity better reflects local clinical and microbiological periodontal conditions than GCF CRP concentration and may provide complementary information to conventional periodontal assessment.