Biochemically, GCF contains both inorganic and organic components. Its composition is similar to plasma; however, it may be modified by the local environment and ecosystem. Inorganic constituents include sodium, potassium, calcium and magnesium. Calcium levels within the GCF are higher than those in saliva, which has important implications for pellicle protein interaction, enhancing salivary protein precipitation, attachment of bacteria and calculus formation. In health, the concentration of organic components of GCF are similar to those of plasma. In disease, there is an increase in components relating to the degradation of the underlying connective tissues and host response to invading pathogenic bacteria. The presence of such constituents highlights the potential of GCF for diagnostic/prognostic use. The serum-derived proteins found in the GCF include:
• Serum albumin, important in protein transport and as an antioxidant
• Immunoglobulins IgA, IgG and IgM
• Fibrinogen, essential for blood clot formation
• Complement components of both the classical and alternative pathways, which can cause release of lysosomal enzymes from leucocytes mediating cell lysis
• Protease inhibitors α1-antitrypsin, α2-macroglobulin and α1-antichymotrypsin. In addition to the above, GCF also contains components of bacterial origin, including urea, lactic acid, hydrogen sulphide, lipopolysaccharides and bacterial enzymes (acid phosphatase, lysozyme, hyaluronidase). These bacterial enzymes can be accompanied by the presence of enzymes derived from the host inflammatory cells and resident connective tissues. Such enzymes, with roles in the inflammatory response to periodontitis and inflammatory-mediated
tissue destruction, include cathepsin D, cathepsin G, alkaline phosphatase, elastase and collagenases.
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