Reinforcement of Oral Epithelial Barrier Function by Vitamin D Induction of the Antimicrobial Peptide Cathelicidin. A Novel Therapeutic Approach in Chronic Periodontitis

Oral epithelium forms a physical, chemical and immunological barrier against the invading microorganisms. The chemical barrier mainly comprises of anti-microbial peptides (AMPs) like cathelicidins which are endogenously produced antibiotics. Transcription of the cathelicidin anti-microbial peptide (CAMP) gene is induced by binding of the bioactive form of vitamin D to the vitamin D receptor. Thus, an increase in vitamin D should significantly improve the chemical barrier function by increasing AMPs. Through a randomized controlled trial we tend to explore a well accepted molecule like vitamin D in primary prevention of chronic periodontitis by reinforcing the oral epithelial barrier by increased action of cathelicidin. Aim of the Study: The aim of this study was to assess the effect of vitamin D administration systemically on levels of cathelicidin LL-37 in gingival crevicular fluid of chronic periodontitis patients. Methodology: 40 vitamin D insufficient subjects with chronic periodontitis were divided into 2 groups. Gingival crevicular fluid (GCF) sampling was carried out a day after the periodontal examination. Next all patients were subjected to scaling and root planning (SRP). Test group patients were prescribed oral dose of 2000IU Vitamin D daily for a period of 3months whereas control group was devoid of any medication. GCF sampling was repeated for both the groups after three months. Cathelicidin LL-37 level was estimated using Enzyme Linked Immunosorbent Assay (ELISA)method for both the groups. Results: Vitamin D administration increases the levels of cathelicidin in periodontal diseases. Cathelicidin levels in GCF increase after Vitamin D intake. Conclusion: Periodontal diseases might be prevented by reinforcing the oral epithelial barrier (chemical barrier) by vitamin D induced production of AMPs.