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PeriodontitisNCT06984237

Evaluation of Salivary and Serum Levels of TNF-α, IL-17A, and YKL-40 in Individuals With Psoriasis

An observational study of Periodontitis and Psoriasis, run by Akdeniz University at 1 site in Turkey (Türkiye).

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Background: Periodontitis is a chronic inflammatory disease triggered by microbial infections that lead to the destruction of tissues supporting the teeth. Psoriasis is a chronic skin condition characterized by excessive proliferation and abnormal differentiation of keratinocytes. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Periodontitis, Psoriasis
What is being tested?
TNF-α Analysis in saliva, IL-17A analysis in saliva and YKL-40 Analysis in saliva
Type of treatment
Pill or oral medicine
How many people
100 participants
Where
1 siteTurkey (Türkiye)
Study dates
2 Dec 2024to May 2025
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: A total of 100 participants are included after providing informed consent and meeting inclusion criteria. Participants are divided into five equal groups (n=20 per group): 1. Systemically and periodontally healthy individuals (H), 2. Systemically healthy individuals with gingivitis (Control Gingivitis, CG), 3. Systemically healthy individuals with periodontitis (Control Periodontitis, CP), 4. Individuals with psoriasis and gingivitis (Psoriasis Gingivitis, PG), and 5. Individuals with psoriasis and periodontitis (Psoriasis Periodontitis, PP). Periodontal diagnoses are made based on the 2017 classification system of the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP).

Who may be able to join

  • Voluntary participation
  • No use of antibiotics within the past 6 months
  • No periodontal treatment within the past 6 months
  • Absence of systemic diseases known to affect periodontal health (e.g., diabetes, cardiovascular diseases)
  • No infectious diseases such as tuberculosis, hepatitis, or AIDS
  • Age 18 years or older
  • Not pregnant (for female participants)

Who cannot join

  • Pregnancy or ongoing lactation
  • History of gingival treatment within the past 6 months
  • History of any disease involving the oral mucosa (e.g., lichen planus, pemphigus vulgaris, chronic ulcerative stomatitis)
  • Current use of systemic corticosteroids, immunosuppressive agents, or biological drugs
  • History of systemic inflammatory diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus, irritable bowel syndrome, diabetes mellitus)
  • Fewer than 20 natural teeth (excluding third molars)
  • Current smokers
  • Age younger than 18 or older than 65 years

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Akdeniz University, Fculty of Dentistry, Akdeniz University Hospital

    Antalya, 07070

Other trials in Turkey (Türkiye)

About this study

Official title: Psoriasis and Periodontitis Are Chronic Inflammatory Diseases That May Share Common Immunopathogenic Pathways. TNF-α, IL-17A, and YKL-40 Are Inflammatory Biomarkers Associated With Both Conditions. This Study Aims to Evaluate the Levels of These Markers in Saliva and Serum of Individuals With Psoriasis, Considering Their Periodontal Status, to Investigate a Potential Link Between the Two Diseases

Background: Periodontitis is a chronic inflammatory disease triggered by microbial infections that lead to the destruction of tissues supporting the teeth. Psoriasis is a chronic skin condition characterized by excessive proliferation and abnormal differentiation of keratinocytes. Due to the presence of similar inflammatory mechanisms, an immunological relationship between psoriasis and periodontal disease has been hypothesized. To explore this relationship, the levels of TNF-α, IL-17A, and YKL-40 in saliva and serum will be examined in both systemically healthy individuals and individuals with psoriasis.

Methods: The study will include five distinct groups based on systemic and periodontal conditions:

Read more
  1. systemically and periodontally healthy individuals (H),
  2. systemically healthy individuals with gingivitis (Control Gingivitis, CG),
  3. systemically healthy individuals with periodontitis (Control Periodontitis, CP),
  4. individuals with psoriasis and gingivitis (Psoriasis Gingivitis, PG), and
  5. individuals with psoriasis and periodontitis (Psoriasis Periodontitis, PP). Levels of TNF-α, IL-17A, and YKL-40 will be measured in both saliva and serum samples. Additionally, correlations among these cytokines and between cytokine levels and clinical periodontal parameters-including Plaque Index (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL)-will be analyzed.

Conclusion: The study is expected to provide insight into the immunological link between psoriasis and periodontal disease by evaluating TNF-α, IL-17A, and YKL-40 levels at both local (saliva) and systemic (serum) levels.

Read the detailed description

Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth, characterized by gingival inflammation, destruction of periodontal tissues, and alveolar bone loss. The disease primarily develops due to bacterial colonization at the tooth-gingival interface. Inflammatory mediators released in response to the interaction between a dysbiotic microbial biofilm and the host immune system play a critical role in tissue destruction and disease progression. Systemic conditions that affect the host immune system may exacerbate periodontal destruction in this multifactorial disease.

Psoriasis is a chronic inflammatory skin condition characterized by erythematous plaques or papules covered with silvery-white scales. The prevalence ranges between 1% and 3%, depending on the ethnic population, and it affects both genders equally. Although the exact etiopathogenesis of psoriasis remains unclear, several environmental and systemic factors-such as trauma, ultraviolet radiation, infections, medications, endocrine influences, psychological stress, alcohol consumption, and smoking-have been identified as potential triggers.

A possible association between psoriasis and periodontitis has been reported in multiple clinical studies and meta-analyses. Interleukin-17 (IL-17) is a pro-inflammatory cytokine that induces the expression of various inflammation-related mediators. It plays a central role in immune regulation and is implicated in inflammatory diseases, autoimmune disorders, and cancer. Elevated IL-17A levels have been detected in both psoriatic skin and serum samples of individuals with psoriasis when compared to healthy controls.

Tumor necrosis factor-alpha (TNF-α) is a polypeptide cytokine produced primarily by macrophages and monocytes. It functions as a multipotent regulator in immune responses by stimulating fibroblasts to release collagenase, increasing vascular permeability, promoting the release of other cytokines (such as IL-1α, IL-1β, IL-6, and IL-8), and enhancing the production of matrix metalloproteinases and adhesion molecules. TNF-α also synergizes with IL-1 to promote bone resorption. Elevated TNF-α levels in both serum and psoriatic lesions have been shown to decrease following effective treatment.

YKL-40 is a 40-kDa glycoprotein composed of tyrosine (Y), lysine (K), and leucine (L) at its N-terminal. It is secreted by neutrophils, macrophages, chondrocytes, synovial cells, osteoblasts, endothelial cells, and cancer cells. YKL-40 is associated with immune responses involving inflammation, tissue remodeling, and angiogenesis, and is considered an acute-phase protein.

A limited number of studies addressing the pathogenesis-related association between psoriasis and periodontal status have been identified in the literature, indicating a need for further investigation. To address this gap, a study is planned in which biomarkers associated with both periodontitis and psoriasis will be evaluated at both local and systemic levels.

The primary objective will be to comparatively assess TNF-α, IL-17A, and YKL-40 levels in saliva and serum samples of individuals with psoriasis, along with relevant clinical periodontal parameters.

Being tested
TNF-α Analysis in saliva, IL-17A analysis in saliva, YKL-40 Analysis in saliva, TNF-α analysis in serum, IL-17A analysis in serum
Keywords
TNF-α, IL-17A, YKL-40, salivary, serum
Medical subject headings
Periodontitis, Psoriasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TNF-α Analysis in salivaDiagnostic test

    Unstimulated whole saliva samples will be collected in the morning, at least one day after periodontal examination. Participants will be instructed to refrain from eating, drinking, brushing, or chewing gum for at least one hour before collection. The samples will be centrifuged at 1500 rpm for 10 minutes, and the supernatants will be stored at -80°C until analysis. TNF-α levels will be measured using ELISA.

  • IL-17A analysis in salivaDiagnostic test

    Unstimulated whole saliva samples will be collected in the morning, at least one day after periodontal examination. Participants will be asked to avoid eating, drinking, brushing their teeth, or chewing gum for at least one hour prior to sampling. The samples will be centrifuged at 1500 rpm for 10 minutes, and the supernatants will be stored at -80°C until analysis. IL-17A levels will be determined using ELISA.

  • YKL-40 Analysis in salivaDiagnostic test

    Unstimulated whole saliva samples will be obtained from participants in the morning, at least one day after the periodontal clinical assessment. They will be instructed not to eat, drink, chew gum, or brush their teeth for at least one hour before collection. Samples will be centrifuged at 1500 rpm for 10 minutes, and the clear supernatants will be stored at -80°C until the time of analysis. YKL-40 levels will be measured using ELISA.

  • TNF-α analysis in serumDiagnostic test

    A total of 8 mL of venous blood will be collected from the antecubital fossa of seated participants. Samples will be transferred into BD Vacutainer® SST™ II Advance serum separator tubes containing acrylic gel and will be allowed to clot for 30 minutes at room temperature. The samples will then be centrifuged at 1500 rpm for 10 minutes at 18-25°C. The resulting serum will be transferred into Eppendorf tubes using a Pasteur pipette and will be stored at -80°C until analysis. TNF-α levels will be measured using ELISA.

  • IL-17A analysis in serumDiagnostic test

    A total of 8 mL of venous blood will be obtained from the antecubital fossa of participants in a seated position. After collection, the blood will be placed into BD Vacutainer® SST™ II Advance tubes with acrylic gel and will rest for 30 minutes to allow clotting. The samples will be centrifuged at 1500 rpm for 10 minutes at 18-25°C. The serum will be extracted using a Pasteur pipette and stored in Eppendorf tubes at -80°C until analysis. IL-17A levels will be analyzed using ELISA.

  • YKL-40 analysis in serumDiagnostic test

    Venous blood (8 mL) will be drawn from the antecubital fossa of seated participants. The samples will be placed in BD Vacutainer® SST™ II Advance tubes containing acrylic gel and will be left to clot for 30 minutes at room temperature. Following this, the samples will be centrifuged at 1500 rpm for 10 minutes at 18-25°C. The supernatant serum will be separated with a Pasteur pipette and transferred into Eppendorf tubes. All samples will be stored at -80°C until analysis. YKL-40 levels will be measured using ELISA.

  • Clinical periodontal evaluationDiagnostic test

    Clinical periodontal parameters will be recorded from participants who meet the inclusion criteria. The following indices will be measured from all teeth present in the oral cavity: Plaque Index (PI; Silness \& Löe, 1964), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), and Bleeding on Probing (BOP). Radiographic evaluations will also be performed. All measurements will be conducted by the same calibrated clinician (HD) using a Williams periodontal probe (Hu-Friedy, Chicago, IL, USA).

Study groups in NCT06984237
Study groupRoleWhat they receive
1. Group: Healthy (H)1. Group: Healthy (H):Systemically and periodontally healthy individuals (H)
Receives: Diagnostic Test: TNF-α Analysis in saliva; Diagnostic Test: IL-17A analysis in saliva; Diagnostic Test: YKL-40 Analysis in saliva; Diagnostic Test: TNF-α analysis in serum; Diagnostic Test: IL-17A analysis in serum; Diagnostic Test: YKL-40 analysis in serum; Diagnostic Test: Clinical periodontal evaluation
2. Group: Control Gingivitis(CG)2. Group: Control Gingivitis(CG): Systemically healthy individuals with gingivitis
Receives: Diagnostic Test: TNF-α Analysis in saliva; Diagnostic Test: IL-17A analysis in saliva; Diagnostic Test: YKL-40 Analysis in saliva; Diagnostic Test: TNF-α analysis in serum; Diagnostic Test: IL-17A analysis in serum; Diagnostic Test: YKL-40 analysis in serum; Diagnostic Test: Clinical periodontal evaluation
3. Group: Control Periodontitis(CP)3. Group: Control Periodontitis(CP): Systemically healthy individuals with periodontitis
Receives: Diagnostic Test: TNF-α Analysis in saliva; Diagnostic Test: IL-17A analysis in saliva; Diagnostic Test: YKL-40 Analysis in saliva; Diagnostic Test: TNF-α analysis in serum; Diagnostic Test: IL-17A analysis in serum; Diagnostic Test: YKL-40 analysis in serum; Diagnostic Test: Clinical periodontal evaluation
4. Group: Psoriasis Gingivitis(PG)4. Group: Psoriasis Gingivitis(PG): Individuals with psoriasis and gingivitis
Receives: Diagnostic Test: TNF-α Analysis in saliva; Diagnostic Test: IL-17A analysis in saliva; Diagnostic Test: YKL-40 Analysis in saliva; Diagnostic Test: TNF-α analysis in serum; Diagnostic Test: IL-17A analysis in serum; Diagnostic Test: YKL-40 analysis in serum; Diagnostic Test: Clinical periodontal evaluation
5. Group: Psoriasis Periodontitis (PP)5. Group: Psoriasis Periodontitis (PP): Individuals with psoriasis and periodontitis
Receives: Diagnostic Test: TNF-α Analysis in saliva; Diagnostic Test: IL-17A analysis in saliva; Diagnostic Test: YKL-40 Analysis in saliva; Diagnostic Test: TNF-α analysis in serum; Diagnostic Test: IL-17A analysis in serum; Diagnostic Test: YKL-40 analysis in serum; Diagnostic Test: Clinical periodontal evaluation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. TNF-α levels in saliva

    The level of tumor necrosis factor-alpha (TNF-α) in saliva, measured in picograms per milliliter (pg/mL), will be recorded at the initial visit.

    Measured: at baseline (single visit)

  2. TNF-α levels in serum

    The level of tumor necrosis factor-alpha (TNF-α) in serum, measured in picograms per milliliter (pg/mL), will be recorded at the initial visit.

    Measured: at baseline (single visit)

  3. IL-17A levels in saliva

    The level of interleukin-17A (IL-17A) in saliva, measured in picograms per milliliter (pg/mL), will be recorded at the initial visit.

    Measured: at baseline (single visit)

  4. IL-17A levels in serum

    The level of interleukin-17A (IL-17A) in serum, measured in picograms per milliliter (pg/mL), will be recorded at the initial visit

    Measured: at baseline (single visit)

  5. YKL-40 levels in saliva

    The level of YKL-40 in saliva, measured in picograms per milliliter (pg/mL), will be recorded at the initial visit.

    Measured: at baseline (single visit)

  6. YKL-40 levels in serum

    The level of YKL-40 in serum, measured in nanograms per milliliter (ng/mL), will be recorded at the initial visit.

    Measured: at baseline (single visit)

Secondary outcomes (4)
  1. periodontal assesment

    probing pocket depth(PPD): Average probing pocket depth measured in millimeters at the initial visit.

    Measured: at baseline (single visit)

  2. Periodontal Assesment

    Bleeding on Probing (BOP): Percentage of sites with bleeding on probing measured at the initial visit

    Measured: Baseline (at single visit)

  3. Periodontal Assesment

    Plaque Index (PI): Plaque Index score measured at the initial visit

    Measured: Baseline (at single visit)

  4. Periodontal Assessment

    Clinical Attachment Level (CAL): Clinical Attachment Level measured in millimeters at the initial visit

    Measured: Baseline (at single visit)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 May 2025
  2. Study start2 Dec 2024
  3. Primary completion18 Apr 2025
  4. Study completionMay 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06984237
Sponsor's protocol ID
AkdenizU Psoriasis
Status last verified
May 2025
First submitted
8 May 2025
Last updated
22 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: The decision to share individual participant data (IPD) has not been finalized. Future data-sharing plans will depend on institutional policies, ethical considerations, and applicable regulatory requirements.

Publications

  • Kong Y, Zhang S, Su X, Peng D, Su Y. Serum levels of YKL-40 are increased in patients with psoriasis: a meta-analysis. Postgrad Med. 2019 Aug;131(6):405-412. doi: 10.1080/00325481.2019.1643634. Epub 2019 Jul 22.

    PubMed 31298974
  • Martinez-Garcia M, Hernandez-Lemus E. Periodontal Inflammation and Systemic Diseases: An Overview. Front Physiol. 2021 Oct 27;12:709438. doi: 10.3389/fphys.2021.709438. eCollection 2021.

    PubMed 34776994
  • de Oliveira PS, Cardoso PR, Lima EV, Pereira MC, Duarte AL, Pitta Ida R, Rego MJ, Pitta MG. IL-17A, IL-22, IL-6, and IL-21 Serum Levels in Plaque-Type Psoriasis in Brazilian Patients. Mediators Inflamm. 2015;2015:819149. doi: 10.1155/2015/819149. Epub 2015 Aug 13.

    PubMed 26351408
  • Jimenez C, Carvajal D, Hernandez M, Valenzuela F, Astorga J, Fernandez A. Levels of the interleukins 17A, 22, and 23 and the S100 protein family in the gingival crevicular fluid of psoriatic patients with or without periodontitis. An Bras Dermatol. 2021 Mar-Apr;96(2):163-170. doi: 10.1016/j.abd.2020.08.008. Epub 2021 Jan 25.

    PubMed 33531183
  • Marruganti C, Gaeta C, Falciani C, Cinotti E, Rubegni P, Alovisi M, Scotti N, Baldi A, Bellan C, Defraia C, Fiorino F, Valensin S, Bellini E, De Rosa A, D'Aiuto F, Grandini S. Are periodontitis and psoriasis associated? A pre-clinical murine model. J Clin Periodontol. 2024 Aug;51(8):1044-1053. doi: 10.1111/jcpe.13996. Epub 2024 May 3.

    PubMed 38699834

Questions about this trial

What is this clinical trial studying?

An observational study of Periodontitis and Psoriasis, run by Akdeniz University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 22 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

TNF-α levels in saliva (time frame: at baseline (single visit)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06984237, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2025.

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