{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:23:01Z","timestamp":1783426981030,"version":"3.54.6"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intrinsic apoptosis plays a critical role in immune defense and inflammation. Its dysregulation is involved in various chronic diseases. The B\u2010cell lymphoma 2 (Bcl\u20102) family primarily mediates this mitochondrial pathway. This study aimed to investigate the proapoptotic Bcl\u20102\u2010associated X protein (Bax) and antiapoptotic B\u2010cell lymphoma\u2010extra large (Bcl\u2010xl) levels and their association with interleukin\u201022 (IL\u201022) and transforming growth factor beta 1 (TGF\u2010\u03b21) in the gingival crevicular fluid (GCF) of patients with periodontitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 75 systemically healthy nonsmokers were enrolled, of whom 23 had stage III periodontitis, 26 had gingivitis, and 26 were periodontally healthy. Whole\u2010mouth clinical periodontal measurements were recorded. Bax, Bcl\u2010xl, IL\u201022, and TGF\u2010\u03b21 levels in the GCF were determined by enzyme\u2010linked immunosorbent assay (ELISA). Data were analyzed using nonparametric statistical tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The periodontitis group had significantly lower GCF Bax levels than the gingivitis group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). The periodontitis and gingivitis groups had higher GCF Bcl\u2010xl levels than the periodontally healthy group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). GCF IL\u201022 levels were similar in all groups (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.05). The periodontitis group had lower GCF TGF\u2010\u03b21 levels than the gingivitis and periodontally healthy groups (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). The diseased groups had a lower GCF Bax\/Bcl\u2010xl ratio than the healthy controls (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). IL\u201022 was positively correlated with Bax (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first study investigating GCF Bax and Bcl\u2010xl levels in periodontal health and disease. Increased GCF Bcl\u2010xl levels and a decreased Bax\/Bcl\u2010xl ratio in stage III periodontitis implicate that those apoptotic proteins may be involved in the pathogenesis of periodontal disease. Further studies are needed to enlighten the possible role of Bax and Bcl\u2010xl and their association with IL\u201022 and TGF\u2010\u03b21 in periodontal diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>A type of cell death called intrinsic apoptosis plays an important role in the body's defense system, and its dysregulation is linked to different human diseases. The B\u2010cell lymphoma 2\u2010associated X protein (Bax) and B\u2010cell lymphoma\u2010extra large (Bcl\u2010xl) are apoptosis\u2010related proteins, which promote and inhibit cell death, respectively. This study aimed to investigate Bax and Bcl\u2010xl levels and their association with the signaling proteins interleukin\u201022 (IL\u201022) and transforming growth factor beta 1 (TGF\u2010\u03b21) in the gingival crevicular fluid (GCF), which accumulates around the necks of the teeth of patients suffering from gum diseases such as gingivitis and periodontitis. Clinical parameters were recorded and GCF was collected. Bax, Bcl\u2010xl, IL\u201022, and TGF\u2010\u03b21 levels were measured by biochemical assay in periodontally healthy individuals who had healthy gums (<jats:italic>n<\/jats:italic>\u00a0=\u00a026) and patients with periodontitis (<jats:italic>n<\/jats:italic>\u00a0=\u00a023) and gingivitis (<jats:italic>n<\/jats:italic>\u00a0=\u00a026). Periodontitis patients had lower Bax levels than gingivitis patients. Periodontitis and gingivitis patients had higher Bcl\u2010xl levels and a lower Bax\/Bcl\u2010xl ratio than periodontally healthy individuals. IL\u201022 was positively correlated with Bax. The present findings suggest that the apoptotic regulatory molecules may be involved in the development of gum diseases, highlighting the need for further research in this area.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.24-0356","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T08:50:12Z","timestamp":1734511812000},"page":"974-983","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gingival crevicular fluid Bax, Bcl\u2010xl, interleukin\u201022, and transforming growth factor beta 1 levels in stage III periodontitis"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2581-1400","authenticated-orcid":false,"given":"Beral","family":"Afacan","sequence":"first","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry Ayd\u0131n Adnan Menderes University Ayd\u0131n 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