Synergistic Effect of Biphasic Calcium Phosphate and Platelet-Rich Fibrin Attenuate Markers for Inflammation and Osteoclast Differentiation by Suppressing <i>NF-κB</i>/<i>MAPK</i> Signaling Pathway in Chronic Periodontitis
Anil Kumar,
Jaideep Mahendra,
Little Mahendra,
Hesham H. Abdulkarim,
Mohammed Sayed,
Maryam H. Mugri,
Zeeshan Heera Ahmad,
Ashok Kumar Bhati,
Hadeel Hussain Faqehi,
Waleed Omar Algregri,
Saranya Varadarajan,
Thodur Madapusi Balaji,
Hosam Ali Baeshen,
Shankargouda Patil
Affiliations
Anil Kumar
Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai 600095, India
Jaideep Mahendra
Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai 600095, India
Little Mahendra
Maktoum Bin Hamdan Dental University College, Dubai 213620, United Arab Emirates
Hesham H. Abdulkarim
Advanced Periodontal and Dental Implant Care, Missouri School of Dentistry and Oral Health, A. T. Still University, St. Louis, MO 63104, USA
Mohammed Sayed
Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
Maryam H. Mugri
Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
Zeeshan Heera Ahmad
Dental College Hospital, King Saud University Medical City, Riyadh 12372, Saudi Arabia
Ashok Kumar Bhati
Division of Periodontics Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
Hadeel Hussain Faqehi
Dental School, Jazan University, Jazan 45412, Saudi Arabia
Waleed Omar Algregri
King Fahad Armed Forces Hospital, Jeddah 23311, Saudi Arabia
Saranya Varadarajan
Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India
Thodur Madapusi Balaji
Department of Periodontology, Tagore Dental College and Hospital, Chennai 600127, India
Hosam Ali Baeshen
Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah 22254, Saudi Arabia
Shankargouda Patil
Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
Background: Periodontitis is characterized by excessive osteoclastic activity, which is closely associated with inflammation. It is well established that MAPK/NF-kB axis is a key signaling pathway engaged in osteoclast differentiation. It is stated that that biphasic calcium phosphate (BCP) and platelet-rich fibrin (PRF) have significant antiostoeclastogenic effects in chronic periodontitis. Objective: We aimed to elucidate the synergetic effect of PRF/BCP involvement of the nuclear factor kappa–light–chain–enhancer of activated B cells (NF-kB) and the mitogen-activated protein kinase (MAPK) signaling pathway in osteoclast differentiation in chronic periodontitis. Methods: We induced osteoclast differentiation in vitro using peripheral blood mononuclear cells (PBMCs) derived from patients with chronic periodontitis. We assessed osteoclast generation by tartrate-resistant acid phosphatase (TRAP) activity, proinflammatory cytokines were investigated by ELISA and NF-κB, and IKB by immunoblot, respectively. MAPK proteins and osteoclast transcription factors were studied by Western blot analysis and osteoclast transcriptional genes were assessed by RT-PCR. Results: The results showed that the potent inhibitory effect of PRF/BCP on osteoclastogenesis was evidenced by decreased TRAP activity and the expression of transcription factors, NFATc1, c-Fos, and the osteoclast marker genes, TRAP, MMP-9, and cathepsin-K were found to be reduced. Further, the protective effect of PRF/BCP on inflammation-mediated osteoclastogenesis in chronic periodontitis was shown by decreased levels of proinflammatory cytokines, NF-kB, IKB, and MAPK proteins. Conclusions: PRF/BCP may promote a synergetic combination that could be used as a strong inhibitor of inflammation-induced osteoclastogenesis in chronic periodontitis.
