{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:13:13Z","timestamp":1747195993574,"version":"3.40.5"},"reference-count":35,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOS"],"abstract":"<jats:p>Objective: Periodontitis is a condition characterised by inflammation. Neopterin and kynurenine-to-tryptophan ratio (KTR) are markers of immune system activation in response to inflammation whose elevated levels are linked to higher incidence and poorer prognosis of various systemic diseases. Their potential association with oral health remains underexplored. The aim of this study was to prospectively investigate the associations between these biomarkers and periodontal health status among community-dwelling adults in Hordaland County, Norway.\nMaterials and methods: Neopterin and KTR were measured in 1,298 participants of the Hordaland Health Study, 1997\u20131999. Information on oral health indicators was obtained from the \u2018Hordaland-Oral Health Survey\u2019, 2020\u20132022. Ordinal logistic regression and negative binomial regression were used to explore the association between biomarkers and periodontitis, tooth loss, and current inflammation (extend of sites with pocket depth \u22654mm and bleeding on probing) and odds ratios (OR) and incidence rate ratios (IRR), along with respective 95% confidence intervals (CI) were reported.\nResults: No association was found between biomarker levels and periodontitis [neopterin: OR = 0.96, 95% CI: 0.69\u20131.33 for fourth (Q4) vs. first quartile (Q1); KTR: OR = 0.85, 95% CI: 0.61\u20131.18 for Q4 vs. Q1], tooth loss [neopterin: IRR = 1.00, 95% CI: 0.94\u20131.06 for Q4 vs. Q1; KTR: IRR = 0.97, 95% CI: 0.91\u20131.03 for Q4 vs. Q1) or extend of inflammation [neopterin: OR = 0.87, 95% CI: 0.70\u20131.09 for Q4 vs. Q1; KTR: OR = 0.98, 95% CI: 0.78\u20131.23 for Q4 vs. Q1].\nConclusion: Plasma levels of neopterin and KTR were not prospectively associated with periodontal health and number of missing teeth.<\/jats:p>","DOI":"10.2340\/aos.v84.43535","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T07:08:00Z","timestamp":1747120080000},"page":"218-225","source":"Crossref","is-referenced-by-count":0,"title":["Plasma levels of immune system activation markers Neopterin and Kynurenine-to-Tryptophan Ratio, and oral health among community-dwelling adults in Norway: a population-based, cohort study"],"prefix":"10.2340","volume":"84","author":[{"given":"Sarala","family":"Banjara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Berggreen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannicke","family":"Igland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Kristine","family":"\u00c5str\u00f8m","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d8ivind","family":"Midttun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"Bun\u00e6s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1247-1577","authenticated-orcid":false,"given":"Gerhard","family":"Sulo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"110898","doi-asserted-by":"crossref","unstructured":"Bernabe E, Marcenes W, Hernandez CR, Bailey J, Abreu LG, Alipour V, et al. Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study. J Dent Res. 2020;99:362\u201373.","DOI":"10.1177\/0022034520908533"},{"key":"110899","doi-asserted-by":"crossref","unstructured":"Trindade D, Carvalho R, Machado V, Chambrone L, Mendes JJ, Botelho J. Prevalence of periodontitis in dentate people between 2011 and 2020: a systematic review and meta-analysis of epidemiological studies. J Clin Periodontol. 2023;50:604\u201326. https:\/\/doi.org\/10.1111\/jcpe.13769","DOI":"10.1111\/jcpe.13769"},{"key":"110900","doi-asserted-by":"crossref","unstructured":"Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol. 2017;44:456\u201362. https:\/\/doi.org\/10.1111\/jcpe.12732","DOI":"10.1111\/jcpe.12732"},{"key":"110901","doi-asserted-by":"crossref","unstructured":"Herrero ER, Fernandes S, Verspecht T, Ugarte-Berzal E, Boon N, Proost P, et al. Dysbiotic biofilms deregulate the periodontal inflammatory response. J Dent Res. 2018;97:547\u201355. https:\/\/doi.org\/10.1177\/0022034517752675","DOI":"10.1177\/0022034517752675"},{"key":"110902","doi-asserted-by":"crossref","unstructured":"Cecoro G, Annunziata M, Iuorio MT, Nastri L, Guida L. Periodontitis, low-grade inflammation and systemic health: a scoping review. Medicina (Kaunas). 2020;56(6):272. https:\/\/doi.org\/10.3390\/medicina56060272","DOI":"10.3390\/medicina56060272"},{"key":"110903","doi-asserted-by":"crossref","unstructured":"Page RC, Kornman KS. The pathogenesis of human periodontitis: an introduction. 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Level of neopterin, a marker of immune cell activation in gingival crevicular fluid, saliva, and urine in patients with aggressive periodontitis. J Periodontol. 2002;73:720\u20135. https:\/\/doi.org\/10.1902\/jop.2002.73.7.720","DOI":"10.1902\/jop.2002.73.7.720"},{"key":"110917","doi-asserted-by":"crossref","unstructured":"Nisapakultorn K, Makrudthong J, Sa-Ard-Iam N, Rerkyen P, Mahanonda R, Takikawa O. Indoleamine 2,3-dioxygenase expression and regulation in chronic periodontitis. J Periodontol. 2009;80:\u200b114\u201321. https:\/\/doi.org\/10.1902\/jop.2009.080315","DOI":"10.1902\/jop.2009.080315"},{"key":"110918","doi-asserted-by":"crossref","unstructured":"Kurgan S, Onder C, Balci N, Akdogan N, Altingoz SM, Serdar MA, et al. Influence of periodontal inflammation on tryptophan-kynurenine metabolism: a cross-sectional study. 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Biomedicines. 2022;10(32):3200. https:\/\/doi.org\/10.3390\/biomedicines10123200","DOI":"10.3390\/biomedicines10123200"},{"key":"110921","doi-asserted-by":"crossref","unstructured":"Prasanna JS, Sumadhura C. Biochemical analysis of three biological fluids and its response to non-surgical periodontal therapy in pre and postmenopausal women with periodontitis. J Menopausal Med. 2019;25:149\u201357. https:\/\/doi.org\/10.6118\/jmm.18179","DOI":"10.6118\/jmm.18179"},{"key":"110922","doi-asserted-by":"crossref","unstructured":"Ren J, Chen YB, Zhang YY, Zhou QB, Chen S, Yang JY, et al. Decreased circulating neopterin is associated with increased arterial elasticity: a beneficial role of periodontal treatment. Aust Dent J. 2016;61:76\u201383. https:\/\/doi.org\/10.1111\/adj.12303","DOI":"10.1111\/adj.12303"},{"key":"110923","doi-asserted-by":"crossref","unstructured":"Fratini A, Izzetti R, Riccetti N, Gennai S, Graziani F, Marchetti E. Diagnostic accuracy of urinary biomarkers in periodontitis: a systematic review and meta-analysis. Int J Dent. 2024;2024:9769772. https:\/\/doi.org\/10.1155\/2024\/9769772","DOI":"10.1155\/2024\/9769772"},{"key":"110924","doi-asserted-by":"crossref","unstructured":"Midttun \u00d8, Hustad S, Ueland PM. Quantitative profiling of biomarkers related to B-vitamin status, tryptophan metabolism and inflammation in human plasma by liquid chromatography\/tandem mass spectrometry. Rapid Commun Mass Spectrometry. 2009;23:1371\u20139. https:\/\/doi.org\/10.1002\/rcm.4013","DOI":"10.1002\/rcm.4013"},{"key":"110925","doi-asserted-by":"crossref","unstructured":"Sulo G, Vollset SE, Nygard O, Midttun O, Ueland PM, Eussen SJ, et al. Neopterin and kynurenine-tryptophan ratio as predictors of coronary events in older adults, the Hordaland Health Study. 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J Appl Oral Sci. 2018;26:e20170199. https:\/\/doi.org\/10.1590\/1678-7757-2017-0199","DOI":"10.1590\/1678-7757-2017-0199"},{"key":"110931","doi-asserted-by":"crossref","unstructured":"Pink C, Kocher T, Meisel P, Dorr M, Markus MR, Jablonowski L, et al. Longitudinal effects of systemic inflammation markers on periodontitis. J Clin Periodontol. 2015;42:988\u201397. https:\/\/doi.org\/10.1111\/jcpe.12473","DOI":"10.1111\/jcpe.12473"},{"key":"110932","doi-asserted-by":"crossref","unstructured":"Fejerskov O, Escobar G, Jossing M, Baelum V. A functional natural dentition for all--and for life? The oral healthcare system needs revision. 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