Gingival crevicular fluid and salivary HIF-1α, VEGF, and TNF-α levels in periodontal health and disease

Background Hypoxia-inducible factor-1 alpha (HIF-1 alpha) is expressed as an adaptive response to hypoxia, mediates angiogenesis through the expression of vascular endothelial growth factor (VEGF) and can be induced by tumor necrosis factor-alpha (TNF-alpha). This study aimed to investigate the gingival crevicular fluid (GCF) and salivary HIF-1 alpha, VEGF, and TNF-alpha levels in periodontal health and disease. Methods A total of 87 individuals, 20 generalized aggressive periodontitis (G-AgP), 20 chronic periodontitis (CP), 26 gingivitis patients, and 21 periodontally healthy individuals, were included. Clinical periodontal parameters were recorded; GCF and salivary samples were collected; and HIF-1 alpha, VEGF, and TNF-alpha levels were measured by enzyme-linked immunosorbent assay. Nonparametric tests were used for the statistical analyses. Results G-AgP and CP groups had significantly higher GCF HIF-1 alpha, VEGF, and TNF-alpha total amounts than gingivitis and healthy groups (P < 0.05). GCF HIF-1 alpha and TNF-alpha total amounts in gingivitis group were significantly higher than the healthy group (P < 0.05). GCF and salivary concentrations of biomarkers were similar in both periodontitis groups (P > 0.05). Salivary HIF-1 alpha concentrations in gingivitis group were significantly higher than G-AgP and healthy groups (P < 0.05). GCF HIF-1 alpha, VEGF, and TNF-alpha total amounts were positively correlated with the site-specific clinical periodontal parameters and with each other (P < 0.05). Conclusions HIF-1 alpha is detectable in GCF and saliva of periodontally diseased and healthy individuals, and the GCF levels of the biomarker can be affected by disease status. Increased GCF HIF-1 alpha, VEGF, and TNF-alpha levels in both chronic and aggressive form of periodontitis might suggest the role of TNF-alpha/HIF-1 alpha/VEGF pathway in the pathogenesis of periodontal diseases.