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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
Fri Jun 14 2024
Journal Name
The Ukrainian Biochemical Journal
PREX proteins level correlation with insulin resistance markers and lipid profile in obese and overweight non-diabetic patients
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Metabolic dysregulation and obesity are associated with many metabolic alterations, including impairment of insulin sensitivity and dyslipidemia. Recent studies highlight the key role of phosphatidylinositol 3,4,5-triphosphate-dependent Rac exchange proteins (PREX proteins) in the pathogenesis of obesity, advocating further elucidation of their potential therapeutic implications. The present study aimed to estimate the serum level of PREX proteins and its potential association with insulin resistance markers and plasma lipids level in obese and overweight non-diabetic patients. The study included 30 persons classified as obese, 30 as overweight, and 30 healthy individuals of similar age and gender. The levels of PREX1 and PREX2 were

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Publication Date
Thu Mar 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of Salivary Lactoferrin and pH Levels and Their Correlation with Gingivitis and Severity of Chronic Periodontitis (Part: 2)
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Background: Periodontal diseases are bacterial infections of the gingiva, bone and attachment fibers that support the teeth and hold them in the jaw. Lactoferrin is a multifunctional glycoprotein and it is the main component of neutrophil polymorphonuclear leukocytes that activated during inflammatory processes such as Periodontal diseases Aims of the study: Determine the salivary levels of Lactoferrin and pH and their correlations with clinical periodontal parameters(Plaque Index , Gingival Index , Bleeding on Probing , Probing Pocket Depth , and Clinical Attachment Level ) and the correlation between Lactoferrin with potential of hydrogen ion (PH) ,flow rate and α-amylase of study groups that consisted of patients had gingivitis and pa

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Publication Date
Sun Sep 01 2024
Journal Name
International Immunopharmacology
Evaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study
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Evaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study

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Publication Date
Sun Jan 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
Association of Interleukin-12B Polymorphism and Serum Level of Interleukin-12 in a Sample of Iraqi Patients with Rheumatoid Arthritis
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Background In rheumatoid arthritis, your immune system attacks the tissue lining the joints on both sides of your body. Other parts of the body may also be affected. Unsure of the exact cause. Two separate genes termed IL12A (p35) and IL12 encode the heterodimeric cytokine known as IL12 (p40). Several different hematopoietic cell types can have several different hematopoietic cell types that can generate antigen-presenting cells (APCs), including DCs and macrophages. Objectives This study aimed to investigate if the interleukin IL-12B gene's common polymorphisms in an Iraqi population were associated with RA. Material and methods Blood samples were taken from 70 Iraqi patients with RA illnesses and 30 Iraqi controls during the periods from

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of Salivary Levels of the RANKL and RANK in Patients with Healthy Gingiva on Reduced Periodontium Versus Periodontitis: An Analytical Cross-Sectional Study
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Publication Date
Fri Nov 21 2025
Journal Name
Plos Global Public Health
Association of socioeconomic and demographic determinants with clinical outcomes in Iraqi patients with diabetes: A cross-sectional study
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Social determinants of health (SDH) profoundly influence diabetes outcomes; nevertheless, their impact on the Iraqi diabetic population remains under researched. The objectives of this study were To investigate the relationship between particular social determinants of health (SDH) variables namely food and housing insecurity, social support, income, and education and clinical outcomes, including HbA1c levels, medication adherence, and patient satisfaction among Iraqi diabetic patients. A cross-sectional study involving 212 diabetic patients in Iraq was conducted. Participants attending a healthcare facility in Iraq filled out validated questionnaires regarding social determinants of health, medication adherence, and satisfaction. HbA1c rea

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Publication Date
Sat Oct 03 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary α-Amylase and Albumin Levels in Patients with Chronic Periodontitis and Poorly or Well Controlled Type II Diabetes Mellitus
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Background: Recent studies suggest that chronic periodontitis (CP) and type2 diabetes mellitus (T2DM) are bidirectionally associated. Analysis of saliva as a mirror of oral and systemic health could allow identification of α amylase (α-Am) and albumin (A1) antioxidant system markers to assist in the diagnosis and monitoring of both diseases. The present study aims at comparing the clinical periodontal parameters in chronic periodontitis patients with poorly or well controlled Type 2Diabetes Mellitus, salivary α-Am, A1, flow rate (FR) and pH then correlate between biochemical, physical and clinical periodontal parameters of each study and control groups. Materials and Methods: 80 males, with an age range of (35-50) years were divide

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Publication Date
Sat Oct 03 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Dental Caries and Some Salivary Constituents among a Group of Ten Years Iraqi Passive Smokers
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Background: Passive smoking and dental caries affect the integrity of the health of individuals and both of them affected by sociodemographic characteristics of those individuals. This research aimed to investigate the severity of dental caries in relation to salivary magnesium and zinc of stimulated whole saliva of a group of 10 years passive smokers in comparison with normal subjects. Materials and methods: the study group included 40 subjects (20boys and 20 girls), with an age of 10 years of passive smokers determined by a questionnaire. The control group included 40 normal subjects of the same gender and age of the study group. The diagnosis and recording of dental caries was measured by (D1-4MFS & d1-4mfs) index according to the criter

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Publication Date
Fri Jan 01 2021
Journal Name
Clinical Epidemiology And Global Health
Association of overweight/obesity with the severity of periodontitis using BPE code in an iraqi population
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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of Salivary α-amylase and Flow Rate Levels and Their Correlation with Gingivitis and Severity of Chronic Periodontitis (Part: 1)
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Background: Periodontal diseases are bacterial infections of the gingiva, bone and attachment fibers that support the teeth and hold them in the jaw. α-amylase is an enzyme, produced mainly by parotid gland and it seems to play a role in maintaining mucosal immunity. Aims of the study: Determine the salivary levels of α-Amylase and flow rate and their correlations with clinical periodontal parameters(Plaque Index , Gingival Index , Bleeding on Probing , Probing Pocket Depth , and Clinical Attachment Level ) and the correlation between α-Amylase with flow rate of study groups that consist of ( patients had gingivitis and patients had chronic periodontitis with different severities(mild ,moderate ,severe) and control group . Ma

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