Levels of Pentraxin-3 in Gingival Crevicular Fluid and Plasma in Periodontal Health and Disease A.R. Pradeep,* Rahul Kathariya,* N.M. Raghavendra,* and Anuj Sharma* Background: Pentraxins are classic mediators of inflam- mation and markers of acute-phase reactions. Pentraxin-3 (PTX3) is the first-identified long pentraxin and is believed to be a true independent indicator of disease activity. Although a classic pentraxin, C-reactive protein, and its association with various systemic diseases is well documented in the peri- odontal literature, there is no data on PTX3 to our knowledge. Methods: Forty participants (20 males and 20 females; age range: 23 to 50 years) were involved in the study. Participants were divided into three groups based on gingival index, probing depth, and clinical attachment level: the healthy group (group 1; n = 10), gingivitis group (group 2; n = 15), and periodontitis group (group 3; n = 15). Gingival crevicular fluid (GCF) and plasma samples collected from each subject were quantified for PTX3 levels using an enzyme-linked immunosorbent assay. Results: In tandem with the disease progression from healthy to gingivitis to periodontitis, the mean PTX3 concentra- tions increased in GCF and plasma. However, GCF values were higher than plasma values. It was found that PTX3 concentra- tion was highest in group 3 and lowest in group 1. PTX3 concen- trations also correlated positively with periodontal parameters. Conclusions: GCF and plasma PTX3 concentrations corre- lated positively in all groups. However, within the limits of the present study, the differences in plasma PTX3 levels were not found to be statistically significant. Hence, GCF PTX3 values were considered a marker of inflammatory activity in periodon- tal disease. However, PTX3 deserves further consideration as a therapeutic target. Additional large-scale studies should be carried out to confirm positive correlations. J Periodontol 2011;82:734-741. KEY WORDS Acute-phase proteins; C-reactive protein; chronic periodontitis; gingival crevicular fluid; pentraxin-3; plasma. P eriodontal diseases are initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response with resultant osseous and soft tissue destruction. In response to endo- toxins derived from periodontal patho- gens, mediators target the destruction of alveolar bone and supporting connective tissues. 1 Mediators produced as part of the host response that contributes to tissue destruction include acute-phase (AP) proteins, cytokines, and prostaglan- dins. 2-4 A periodontal infection in its early stage may permit injurious agents derived from bacteria, or bacteria them- selves, to gain access to the connective tissue. 5-7 In response to bacteria or endotoxins derived from these periodon- tal pathogens, several AP proteins or- chestrate the inflammatory cascade to bring about a balance between host and inflammatory stimuli. One consequence of these inflammatory reactions has been the elevated levels of various AP proteins in gingival crevicular fluid (GCF) 8,9 and in plasma or serum. 2,10 It also appears that systemic manifesta- tions result because of many oral bacte- ria, which are significantly increased in periodontitis. 11,12 This potentially results from the transient access of oral bacteria to the circulation. 13 Thus, the ability to use AP reactants as a measure of in- flammation has substantial support. Pentraxins are classic AP proteins known to researchers for over a century. They are a super family of evolutionarily * Department of Periodontics, Government Dental College and Research Institute, Bangalore, India. doi: 10.1902/jop.2010.100526 Volume 82 • Number 5 734