IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 7 Ver. VII (July. 2016), PP 92-99 www.iosrjournals.org DOI: 10.9790/0853-150779299 www.iosrjournals.org 92 | Page Acute Phase Proteins: Journey of Pivotal Marker in Periodontal Disease Surbhi Khaparde 1 , Vishnudas Bhandari 2 , Gauri Ugale 3 , Rashmi Jawade 4 , Mukesh Ardale 5 , Kailash Mundada 6 . 1 (Department Of Periodontics, MIDSR Dental College And Hospital, Latur, Maharashtra, India) 2 (Department Of Periodontics, MIDSR Dental College And Hospital, Latur, Maharashtra, India) 3 (Department Of Periodontics, MIDSR Dental College And Hospital, Latur, Maharashtra, India) 4 (Department Of Periodontics, MIDSR Dental College And Hospital, Latur, Maharashtra, India) 5 (Department Of Periodontics, MIDSR Dental College And Hospital, Latur, Maharashtra, India) 6 (Department Of Periodontics, Darshan Dental College And Hospital, Udaipur, Rajasthan, India) Abstract: Periodontal disease is a chronic and concealed infection. It has become progressively clearer in recent years that periodontal disease can cause remarkable increase as well as decrease in the levels of markers of systemic inflammation. These markers include chiefly plasma proteins such as acute phase proteins. The acute phase proteins are an evolutionarily conserved family of proteins produced mainly in the liver in response to infection and inflammation. Acute phase proteins are generated in the host by a process called as acute phase reaction which is mediated by cytokines like Interleukin-1, 6, 8 and tumor necrosis factor- α. The rise in the plasma concentration of acute phase proteins can assist host defense by aiding recognition of invading microbes, mobilization of leukocytes into the circulation, and increasing blood flow to injured or infected sites. This review reiterates on the structure, synthesis, classification, functions of acute phase proteins and their interrelationship with periodontal disease. Keywords: Acute phase proteins, acute phase response, inflammation and periodontitis. I. Introduction Periodontitis is a polymicrobial infectious disease of multifactorial origin involving supporting structures of the teeth. It triggers an array of events which involves innate & adaptive immunity as well as inflammatory response in the host.[1] The characteristic of this response is infiltration of the periodontal tissue with multiple inflammatory cells which include polymorphonuclear neutrophils, macrophages, lymphocytes & plasma cells.[2] Even though periodontitis is localized to periodontal tissue, this disease appears to be sufficient to influence the acute phase response systemically. One of the most interesting features of the acute-phase is the change in the concentrations of many plasma proteins, known as the acute-phase proteins. An acute-phase protein (APP) has been defined as one whose plasma concentration increases (positive acute-phase proteins) or decreases (negative acute-phase proteins) by at least 25 percent during inflammatory disorders.[3] The systematic search of literature was carried out to identify relevant studies by using key words like acute phase proteins, acute phase response, inflammation and periodontitis in PUBMED, MEDLINE, COCHRANE and Google databases. Out of 587 searched articles, 47 articles describing acute phase proteins and its relation to periodontitis were used to prepare a concise review. This review will focus on the knowledge acquired on acute phase reactants in particular to role of acute phase proteins in systemic and periodontal disease. II. Acute Phase Reaction The acute-phase response is critical to the body's ability to successfully respond to injury. It normally lasts only few days; however, if continuously unchecked, the acute phase response may contribute to the development of chronic inflammatory states, tissue damage and disease. (Fig. 1) The acute phase response is typically characterized by fever and changes in vascular permeability, along with profound changes in the biosynthetic profile of various acute phase proteins (APPs).[4] APPs are an evolutionarily conserved family of proteins produced mainly in the liver in response to infection and inflammation. The rise in the plasma concentration of APPs assist host defense by aiding recognition of invading microbes, mobilization of leukocytes into the circulation, and increasing blood flow to injured or infected sites.[5]