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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
Tue May 05 2026
Journal Name
Journal Of Pioneering Medical Sciences
Clinical and Biochemical Indicators Associated with Impaired Kidney Function in Children with Type 1 Diabetes: A Case-Control Study.
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Background: Kidney failure is the leading cause of early death for diabetic patients and is regarded as the most dangerous consequence of the disease. This can only be reversed through early detection and intervention. The incidence of type 1 diabetes, which comprises 5-10 per cent of all diabetic diseases, is rising across the globe with a rate of 15 per 100,000 people per year. Methods: 90 samples were collected and used in this study. Thirty healthy children served as controls (aged 5-15 years), 30 patients with Type 1 Diabetes Mellitus (T1DM, aged 5-15 years) and 30 patients with type 1 diabetic nephropathy (DN), aged 5-20 years). Results: highly significant increase in Urea and Creatinine levels when compared control with DN al

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Publication Date
Fri Oct 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The association of crevicular albumin level with the severity of periodontal destruction in chronic periodontitis patients after initial periodontal treatment
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Background: Gingival crevice fluid (GCF) is a mixture of substances derived from serum, leukocytes, and structural cells of periodontium and oral bacteria. These substances possess a great potential for serving as indicators of periodontal disease and healing after therapy the main purpose of this study was to find if there is a difference in albumin concentration between healthy and diseased periodontal tissues and to compare between diseased group according to pocket depth Materials and methods: total sample composed of 60 pockets found in 35 patients all of them had no history of any systemic disease, The samples were divided in to three main group that include two diseased groups divided according to the depth of the periodontal pocket

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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of diabetes mellitus on periodontal health status, salivary flow rate and salivary pH in patients with chronic periodontitis
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Background: Diabetes and periodontitis are considered as chronic diseases with a bidirectional relationship between them. This study aimed to determine and compare the severity of periodontal health status and salivary parameters in diabetic and non-diabetic patients with chronic periodontitis. Materials and Methods: Seventy participants were enrolled in this study. The subjects were divided into three groups: Group I: 25 patients had type 2 diabetes mellitus with chronic periodontitis, Group 2: 25 patients had chronic periodontitis and with no history of any systemic diseases, Group 3: 20 subjects had healthy periodontium and were systemically healthy. Unstimulated whole saliva was collected for measurement of salivary flow rate and pH.

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Publication Date
Fri Jul 01 2022
Journal Name
Archives Of Razi Institute
Prognostic Value of Intracellular Transcription of Factors HIF-1α and p53 and Their Relation to Estradiol and TNM Parameters of Breast Cancer Tissues in Women with Invasive Ductal Carcinoma in Thi-Qar Province, Iraq
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Breast cancer is the most common malignancy affecting women's health, with an increasing incidence worldwide. This study aimed to measure the intracellular concentration of the hypoxia-inducible factor 1 α (HIF-1α), tumor suppression protein p53, and estradiol (E2) in tumor tissues of adult females with breast cancer and their relation to tumor grade, tumor size, and lymph node metastases (LNM). The study was conducted on 65 adult female participants with breast mass admitted to the operating theater in Al-Hussein Teaching Hospital and Al-Habboby Teaching Hospital in Nasiriyah, Iraq, from January to November 2021. Fresh breast tumor tissues were collated and homogenized for intracellular biochemical analysis using the enzyme-linked immuno

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Publication Date
Fri Apr 27 2018
Journal Name
Journal Of Periodontal Research
Potential role of periodontal pathogens in compromising epithelial barrier function by inducing epithelial‐mesenchymal transition
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Background and Objective

Epithelial‐mesenchymal transition (EMT) is a process by which epithelial cells acquire a mesenchymal‐like phenotype and this may be induced by exposure to gram‐negative bacteria. It has been proposed that EMT is responsible for compromising epithelial barrier function in the pathogenesis of several diseases. However, the possible role of EMT in the pathogenesis of periodontitis has not previously been investigated. The aim of this study therefore was to investigate whether gram‐negati

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Publication Date
Tue Jun 28 2022
Journal Name
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A Case-control Study to Determine Metalloproteinase-12 and Lysyl Oxidase Levels in Iraqi women with Osteoporosis
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The current study aimed to ascertain the levels of matrix metalloproteinase-12 (MMP-12) and Lysyl oxidase (LOX) in osteoporosis patients and their correlation with alkaline phosphatase (ALP), magnesium (Mg), vitamin D (Vit D), calcium (Ca), phosphorus (P), and T-score %. 110 participants recruited from Baghdad Teaching Hospital, Iraq, were enrolled in this study from November 2019 to March 2020). The participants were divided into two groups: Group 1 comprised 60 osteoporotic women and group 2 consisted of 50 healthy women. (MMP and LOX) were estimated using a quantitative enzyme-linked immunosorbent assay (ELISA. The results showed significant differences in serum LOX, age, ALP, Mg, and T-score %, while no significant differences i

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Publication Date
Fri Oct 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of serum and salivary ceruloplasmin level in patients with oral lichen planus
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Background: Oxidative stress is a deleterious process that can be an important mediator of damage to cell structures and consequently various disease states. Exposure to free radicals from a variety of sources has led organisms to produce a series of defense mechanisms. The antioxidant ceruloplasmin is a copper-containing ferroxidase that can oxidize ferrous iron (Fe2+) to its nontoxic ferric (Fe3+) form. Ferrous iron (Fe2+) is extremely damaging because of its ability to generate toxic free radicals. Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease of unknown etiology. Previous studies reported that reactive oxygen species may be involved in the pathogenesis of lichen planus. The aim of this study was to estimate the

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Publication Date
Fri Oct 02 2026
Journal Name
Journal Of The College Of Basic Education
A comparative study between students of smokers and non-smokers in endurance antenna
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Subjects took physical fitness for health imposed on the area of research that have become an important and clear answer to the many problems resulting from the nature of dealing with modern life current actions that were needed to be hours of manual work has become accomplished by modern technology circumstance minutes, and mediated equipment And machinery. The lack of traffic rights and further burdens the intellectual and psychological pressures and the typical method of work has led to the identification of kinetic activity, thereby threatening public health in many ways stands at the forefront of these threats the problem of smoking, which causes many types of cancers, notably lung cancer. The most important reasons that led to This dr

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Publication Date
Tue Oct 18 2022
Journal Name
Journal Of Research In Medical And Dental Science
Assessment of Salivary Macrophage Inflammatory Protein-1 Alpha Level in Different Stages of Periodontitis
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Assessment of Salivary Macrophage Inflammatory Protein-1 Alpha Level in Different Stages of Periodontitis, Riyam Muthanna Muhammed*, Hadeel Mazin Akram

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Publication Date
Thu Jul 04 2019
Journal Name
Journal Of Research In Medical And Dental Science
The Role of Epithelial Mesenchymal Transition Process in Inflammatory Gingival Hyperplasia
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