Subantimicrobial dose doxycycline efficacy as a matrix metalloproteinase inhibitor in chronic periodontitis patients is enhanced when combined with a non-steroidal anti-inflammatory drug

Lee H., Ciancio S., Tilter G., Ryan M., Komaroff E., Golub L.

JOURNAL OF PERIODONTOLOGY, vol.75, no.3, pp.453-463, 2004 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 75 Issue: 3
  • Publication Date: 2004
  • Doi Number: 10.1902/jop.2004.75.3.453
  • Journal Name: JOURNAL OF PERIODONTOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.453-463
  • Keywords: anti-inflammatory agents, non-steroidal, clinical studies, doxycycline/therapeutic use, flurbiprofen/therapeutic use, metalloproteinases, matrix, CHEMICALLY-MODIFIED TETRACYCLINES, FLUID COLLAGENASE ACTIVITY, CREVICULAR FLUID, ADULT PERIODONTITIS, BONE LOSS, GINGIVAL, FLURBIPROFEN, RATS, COMBINATION, NEUTROPHIL
  • Gazi University Affiliated: Yes

Abstract

Background: Administration of subantimicrobial dose doxycycline (SDD) to chronic periodontitis (CP) patients has repeatedly been found to reduce mammalian collagenase and other matrix metalloproteinase (MMP) activity in gingival tissues and crevicular fluid, in association with clinical efficacy, without the emergence of antibiotic-resistant bacteria either orally or extra-orally. More recently, SDD adjunctive to repeated mechanical debridement resulted in dramatic clinical improvement in patients (>50% smokers) with generalized aggressive periodontitis. As an additional pharmacologic approach, non-steroidal anti-inflammatory drugs (NSAIDs) can reduce gingival inflammation and alveolar bone resorption, at least under experimental conditions. In the current study, we determined the effect of administering a combination (combination) of these two host-modulating drugs (SDD plus low-dose NSAID) to CP patients, on selected neutral proteinases in gingiva, enzymes believed to mediate periodontal breakdown. Earlier preliminary studies in humans with bullous pemphigoid, which is also associated with excessive levels of host-derived proteinases including MMPs, indicated improved clinical efficacy of combination therapy.