Evaluation of the ability of the trypsin-like peptidase activity assay to detect severe periodontitis

• Published in: PloS one Vol. 16; no. 8; p. e0256538
• Main Authors: Iwasaki, Masanori, Usui, Michihiko, Ariyoshi, Wataru, Nakashima, Keisuke, Nagai-Yoshioka, Yoshie, Inoue, Maki, Kobayashi, Kaoru, Nishihara, Tatsuji
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20-08-2021; Public Library of Science (PLoS)
• Subjects: Adult; Biology and Life Sciences; Care and treatment; Diagnosis; Engineering and Technology; Female; Humans; Male; Medicine and Health Sciences; Middle Aged; Periodontitis; Periodontitis - diagnosis; Periodontitis - microbiology; ROC Curve; Sensitivity and Specificity; Testing; Trypsin; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0256538

N-benzoyl-DL-arginine peptidase (trypsin-like peptidase) is specifically produced by certain strains of periodontitis-associated bacteria. We aimed to examine the effectiveness of an objectively quantified trypsin-like peptidase activity assay (TLP-AA) for detecting severe periodontitis.
The study population included 347 adults (108 men and 239 women; average age, 43.3 years) who underwent a full-mouth periodontal examination. Specimens for the TLP-AA were obtained using tongue swabs. Using a color reader, the TLP-AA results were obtained as a* values, with higher positive a* values indicating an increased intense enzymatic activity. The predictive validity of the TLP-AA results for severe periodontitis was assessed using receiver operating characteristic curve analysis and the periodontitis case definition provided by the Centers for Disease Control and Prevention/American Academy of Periodontology as the gold standard. Furthermore, multivariable logistic regression analyses were performed to predict severe periodontitis using the TLP-AA results and health characteristics, as the exposure variables.
Severe periodontitis was observed in 5.2% of the participants. TLP-AA had high diagnostic accuracy for severe periodontitis, with an area under the curve of 0.83 (95% confidence interval [CI]: 0.75-0.92). The cut-off score for the a* value that best differentiated individuals with severe periodontitis was 0.09, with a sensitivity of 83% and specificity of 77%. Multivariable logistic regression analyses revealed that the TLP-AA results were significantly associated with severe periodontitis after adjusting for health characteristics (adjusted odds ratios: 1.90 [95% CI: 1.37-2.62] for the a* value).
Objectively quantified TLP-AA results are potentially useful for detecting severe periodontitis in epidemiological surveillance.