Salivary levels of NLRP3 protein are significantly raised in chronic periodontitis: A systematic review and meta-analysis of clinical studies.

Abstract

Background: To date, there is no confirmatory diagnostic test that can identify the type of periodontal disease and the disease progress. With the advent of "molecular biomarkers," this systematic review and meta-analysis were designed with the sole purpose of identifying a novel biomarker, namely, nucleotide leucine rich repeat pyrin protein-3 (NLRP3) inflammasome which has already been extensively researched for chronic inflammatory and autoimmune diseases.

Types of studies reviewed: Only case observational studies that evaluated the presence of human NLRP3 inflammasome in the saliva of patients with chronic periodontitis with no overlying systemic disease and compared the same to healthy patients to obtain quantitative data that can be statistically analyzed were included. The confirmatory test used in all the studies was the enzyme-linked immunosorbent assay.

Results: The broad-based search led to a total of three articles that fulfilled the inclusion criteria so that a meta-analysis of the results could be carried out. Data reveal that NLRP3 levels are raised in chronic periodontitis cases (P = 0.05; relative risk = 1.05 [0.00-2.09]). The risk of bias assessment was carried out according to the Joanna Briggs Institute Critical Appraisal Checklist where ten-point criteria were outlined indicating a low risk of bias for three studies.

Clinical implications: NLPR3 inflammasome could be tested as a reliable biomarker in saliva to identify the type and progress of the periodontal disease.