Defensin-4 as a proposed diagnostic marker for gingivitis and periodontitis

PURPOSE: This study aimed to provide evidence supporting defensin-4 (DEFA4) as a potential diagnostic marker for periodontal diseases. METHODS: Proteomic analysis of gingival crevicular fluid (GCF) collected from patients with gingivitis and periodontitis was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, immortalized gingival fibroblasts (IGFs) were stimulated with Porphyromonas gingivalis lipopolysaccharide (PG-LPS) and co-cultured with oral bacteria isolated from periodontitis patients. RESULTS: LC-MS/MS analysis of GCF from patients with periodontal disease revealed markedly elevated levels of DEFA4. The expression of DEFA4 in immortalized gingival fibroblasts (IGFs) was significantly increased following stimulation with Porphyromonas gingivalis lipopolysaccharide (PG-LPS) and co-culture with oral bacteria isolated from periodontitis patients. Furthermore, the culture supernatant of IGFs co-cultured with periodontitis-associated oral bacteria showed increased levels of GRO, GRO-α (CXCL1), IL-1α, IL-6, IL-8, and angiogenin. CONCLUSION: DEFA4 expression is strongly enhanced by the inflammatory environment of gingival cells influenced by oral bacteria, supporting its potential utility as a diagnostic marker for monitoring periodontal diseases.