Çağla Varol1, Fatma Yeşim Kırzıoğlu2, Serpil Demirci3, Melike Dogan Ünlü3, Mustafa Calapoğlu4, Hikmet Orhan5

1Burdur Oral and Dental Health Center, Burdur, Türkiye
2Süleyman Demirel University Faculty of Dentistry, Department of Periodontology, Isparta, Türkiye
3Süleyman Demirel University Faculty of Medicine, Department of Neurology, Isparta, Türkiye
4Süleyman Demirel University Faculty of Arts and Sciences, Department of Biochemistry, Isparta, Türkiye
5Süleyman Demirel University Faculty of Medicine, Department of Biostatistic and Medical Informatics, Isparta, Türkiye

Keywords: Multiple sclerosis, myeloperoxidase, lactoferrin, oxidative stress, periodontitis


Objective: To compare the oxidative status in saliva between patients with multiple sclerosis (MS) and systemically healthy controls in the context of periodontal health and to evaluate whether salivary oxidative status correlates with the neutrophil/lymphocyte ratio (NLR).

Materials and Methods: A total of 184 volunteers, 92 with MS and 92 systemically healthy volunteers, participated in the study. Each person underwent medical, neurological, and oral examinations. Saliva samples were taken, and myeloperoxidase (MPO), lactoferrin (LF), total antioxidant capacity (TAOC), total oxidant status (TOS), and oxidative stress index (OSI) levels were determined.

Results: There were no differences in the periodontal parameters between the patients with MS and the healthy volunteers (P > 0.05). The NLR was higher in the patients with MS than in the controls (P = 0.000). However, patients with MS had non-significantly lower MPO levels and higher LF, TOS, and OSI levels than the controls (P > 0.050). There was a significant decrease in TAOC levels in the MS group (P = 0.016). There were higher TOS levels in the periodontally healthy patients with MS and higher OSI levels in the periodontitis - stage 2 patients with MS than those in the matched controls. There were also higher TAOC levels in the periodontitis - stage 3 MS group (P < 0.050). There were positive correlations between MPO, TAOC levels and the probing depths, the clinical attachment levels (CALs) in the MS and control groups. While higher periodontal parameters and MPO levels were associated with increased disability factors, the CALs and the TAOC and MPO levels were elevated in those with longer disease durations (P < 0.050).

Conclusion: The periodontal findings in the patients with MS are not different from those in healthy controls; however, increased MPO and decreased TAOC levels in saliva and higher NLRs in patients with MS indicate a prominent ongoing systemic inflammation despite altered immune surveillance.

Ethics Committee Approval

Ethics Committee of Süleyman Demirel University Faculty of Medicine (approval no: 12.13.2018/234).

Peer Review

Externally and internally peer-reviewed.

Author Contributions

Concept: Ç.V., F.Y.K., S.D., M.D.Ü., Design: Ç.V., F.Y.K., S.D., Data Collection or Processing: Ç.V., F.Y.K., S.D., M.D.Ü., Analysis or Interpretation: Ç.V., F.Y.K., S.D., M.C., H.O., Literature Search: Ç.V., F.Y.K., S.D., Writing: F.Y.K., S.D.

Conflict of Interest

No conflict of interest was declared by the authors.

Financial Disclosure

Süleyman Demirel University Scientific Research Unit (project number: TDH: 2019-7356).