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Association of Salivary HIF‐1α Level With Epithelial and Mesenchymal Markers in Smokers and Nonsmokers With Periodontitis: A Case‐Control Study
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Objectives

This case–control study aimed to investigate the relationship between the hypoxia‐related biomarker hypoxia‐inducible factor‐1α (HIF‐1α) and the epithelial‐mesenchymal transition (EMT)–associated markers E‐cadherin (E‐CAD) and N‐cadherin (N‐CAD) in saliva among smokers and nonsmokers with and without periodontitis and to assess their association with clinical periodontal parameters.

Methods

A case–control study was conducted, including 88 participants equally allocated into four groups ( n  = 22 each): healthy nonsmokers, healthy smokers, nonsmokers with periodontitis, and smokers with periodontitis. Unstimulated whole saliva samples were collected, and periodontal status was assessed using plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL). Subsequently, samples were analyzed for HIF‐1a, E‐CAD, and N‐CAD levels using enzyme‐linked immunosorbent assay (ELISA). Statistical analyses included intergroup comparisons, Spearman’s correlation analysis, diagnostic performance evaluation using receiver operating characteristic (ROC) curve analysis, and mixed‐effects model analysis.

Results

Salivary E‐CAD and N‐CAD levels were significantly higher in the periodontitis groups than in the healthy groups ( p   < 0.05), whereas HIF‐1α showed no significant differences among the study groups ( p   > 0.05). All clinical periodontal parameters were significantly elevated in participants with periodontitis. ROC analysis demonstrated acceptable discriminatory performance for E‐CAD and N‐CAD, whereas HIF‐1α showed variable performance. N‐CAD yielded the highest discrimination between periodontal health and periodontitis (area under the curve [AUC] = 84.5%), while E‐CAD showed the highest discrimination between healthy smokers and nonsmoking participants with periodontitis (AUC = 85.9%). Although salivary E‐CAD levels were descriptively lower in smokers with periodontitis than in nonsmokers with periodontitis, this difference was not statistically significant.

Conclusions

Salivary E‐CAD and N‐CAD were significantly altered in periodontitis and demonstrated greater potential than HIF‐1α for reflecting periodontal disease status. The absence of significant differences in salivary HIF‐1α levels among the study groups may indicate limited ability to reflect localized periodontal hypoxic changes. HIF‐1α also showed limited and inconsistent associations with EMT‐related biomarkers, with a significant positive correlation observed only between HIF‐1α and N‐CAD in the periodontitis group. Smoking was associated with alterations in biomarker profiles, particularly E‐CAD levels. Overall, salivary EMT–related biomarkers may serve as promising noninvasive indicators of periodontal disease, although further validation is required.

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Publication Date
Thu Mar 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of Salivary Total Antioxidants Capacity Levels of Patients with Chronic Periodontitis in Comparison to Healthy Control
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Background: Chronic periodontitis (CP) is greatly prevalent condition of inflammatory behavior. Salivary biomarker total antioxidants capacity (T-AOC) status, may be related to both periodontal condition and oral hygiene. Aims of the study: To assess the level of salivary T-AOC of patients with chronic periodontitis in comparison to healthy control and to correlate between the level of this marker with the clinical periodontal parameters (plaque index (PLI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL)). Materials and Methods: Ninety subjects of males and females with an age ranged between (35-55) years were participated in this study. Participants were divided into two grou

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Publication Date
Fri Oct 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Measurement of salivary Immunoglobulin A of participants with a healthy, gingivitis and chronic periodontitis conditions
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Background: Secretory Immunoglobulin A (SIgA) is a subclass of Immunoglobulin A (IgA), It is an antibody that plays an important role in mucosal immunity. It is the main immunoglobulin found in mucous secretions from mammary glands, tear glands and salivary glands, every pathologic process in the body involves the immune system, and periodontal inflammation is one of them and is not an exception. Material and methods: this study was consisted of 60 healthy male participants of an age ranged between (35-50) years old ; 25 of them with generalized moderate chronic periodontists(Clinical Attachment Loss equal to 3-4mm at ≥ 30% of the sites; 20 participants with plaque induced gingivitis and 15 participants had clinically healthy pe

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of the Salivary Level of Malondialdehyde in Localized Periodontitis Versus Generalized Periodontitis: An Analytical Cross-Sectional Study
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Publication Date
Fri Oct 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of Salivary Leptin and Resistin Levels in Type Two Diabetic Patients with Chronic Periodontitis (A Comparative Study)
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Background: Type 2 diabetes mellitusand chronic periodontitis hold a close relationship that has been the focus of many researches. Currently there is an appreciation to the role of adipose tissue-derived substances "the adipokines" in immune-inflammatory responses; also, there is an interest in using the simple non-invasive saliva in diagnosing and linking oral and general health problems. The current study aims to determine the periodontal health status in the chronic periodontitis patients with and without poorly or well controlled type 2 diabetes mellitus, measure the salivary levels of two adipokines "leptin and resistin", pH and flow rate and then correlate between these clinical periodontal, biochemical and physical parameters in eac

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Influence of Vitamin D Deficiency on the Level of Salivary cathelicidin LL-37 in relation to Dental Caries Experience: A Case-Control Study
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Background: Vitamin D improves innate immunity by enhancing the expression of antimicrobial peptides. The antimicrobial action of cathelicidin is widespread and effective against cariogenic bacteria. This research aimed to investigate the effect of vitamin D deficiency on the level of salivary cathelicidin concerning dental caries experience.

Subjects and Methods: A case-control study was carried out, and the sample was composed of 80 females; the study group involved 40 females with a serum vitamin D concentration of less than 10 ng/ml. In addition to the control group involving 40 females wh

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Publication Date
Tue Jul 01 2025
Journal Name
Journal Of Breast Diseases
Association Between Serum Interleukin-41 Levels and Breast Cancer Status: A Case–Control Study in Iraqi Women
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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Association between anti-CMV IgG and salivary levels of IL‐6 and TNF-α in chronic periodontitis
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Background: Periodontitis is an infection attributable to multiple infectious; it causes an interrelated cellular and humoral host immune responses. Recent reports have indicated that human cytomegalovirus (HCMV) may contribute to pathogenesis of periodontitis. The HCMV can stimulate the release of cytokines from inflammatory and non-inflammatory cells and weaken the periodontal immune defense. This study aimed to reveal the presence of anti-CMV IgG, and determine the levels of IL‐6 and TNF-α and to correlate the presence of cytomegalovirus (CMV) with cytokines levels. Materials and Methods: Forty patients with chronic periodontitis and 40 healthy control subjects (their age and sex were matched with the patients) were involved

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Life – Style of patients with peptic ulcer A case control study
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Abstract A descriptive (retrospective) (a case-control) study was carried out at Al-Karama Teaching Hospital, Baghdad Teaching Hospital and Surgical Specialties Hospital, and Gastro-Intestinal Tract and Liver (GIT) Hospital for the period of December 1st, 2001 To March 15th 2002. To identify aspects of life-style that may contribute to the occurrence of peptic ulcer (P.U)as risk factors. And to find out the relationship between the demographic characteristic of the group. Non-probability (Purposive) sample of (100) cases who were admitted to the endoscopy department who were later on diagnosed as having

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Publication Date
Fri Oct 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of some salivary enzymes levels in type 2 diabetic patients with chronic periodontitis (Clinical and biochemical study)
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Background: Diabetic patients have been reported to be more susceptible to gingivitis and periodontitis than healthy subjects. Many intracellular enzymes like (alkaline phosphatase- (ALP), aspartate aminotransferase- (AST) and alanine aminotransferase- (ALT) that are released outside cells into the gingival crevicular fluid (GCF) and saliva after destruction of periodontal tissue during periodontitis. This study was conducted to determine the periodontal health status and the levels of salivary enzymes (ALP, AST and ALT) of the study and control groups and to correlate the levels of these enzymes with clinical periodontal parameters in each study group. Subjects, Materials and Methods: One hundred subjects were enrolled in the study, with a

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Publication Date
Fri Oct 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Impairment of Salivary Gland Function in Rheumatoid Arthritis: Association with Change in Salivary Biomarkers and Disease Activity
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Background: Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by joint inflammation, involvement of exocrine salivary and lacrimal glands may occur as extra-articular mani¬festations in this disease. This study aimed to provide evidence of altered in function and composition of salivary gland in patients with rheumatoid arthritis by determine salivary flow rate and some biochemical parameters(total protein, amylase, peroxidase) and to investigate the relationship between disease activity and changes in function and composition of salivary gland. Materials and Methods: Fifty five patients with RA (7 males and 48 females) were enrolled in this study with age range (20-69) years. The patients were separated int

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