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Article

Gingipain-Mediated Matrix Metalloproteinase-8 and -9 Activation in Oral Rinse Samples from Patients with Cancer: A Cross-Sectional Study

by
Nur Rahman Ahmad Seno Aji
1,2,*,
Sebastian K. Ahlstrand
3,
Vaibhav Sahni
4,
Kartika W. Taroeno-Hariadi
5,
Dyah Listyarifah
6,
Rezmelia Sari
2,
Iffah Mardhiyah
7,8,
Ahmad Syaify
2,
Asikin Nur
6,
Aditya Lia Ramadona
9,
Julie Toby Thomas
1,10,
Tommi Pätilä
11,
Antti A. Mäkitie
3,12,13,
Ismo T. Räisänen
1,
Pirjo Pärnänen
1,
Pietro Leone
14,
Sukumaran Anil
15,16 and
Timo Sorsa
1,17
1
Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, 00014 Helsinki, Finland
2
Department of Periodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
3
Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Kasarmikatu 11-23, 00029 Helsinki, Finland
4
All India Institute of Medical Sciences, New Delhi 110029, India
5
Divison of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Dr Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
6
Department of Dental Biomedical Sciences, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
7
Department of Conservative Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
8
Dental Hygiene Program, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
9
Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
10
Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
11
Department of Congenital Heart Surgery and Organ Transplantation, New Children’s Hospital, University of Helsinki, 00290 Helsinki, Finland
12
Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, 00014 Helsinki, Finland
13
Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, 171 76 Stockholm, Sweden
14
SmileLongevityCare360 Centre, 80122 Naples, Italy
15
Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand
16
Global Research Cell, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune 411018, India
17
Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
 
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Author to whom correspondence should be addressed.
Dent. J. 2026, 14(5), 272; https://doi.org/10.3390/dj14050272
Submission received: 27 February 2026 / Revised: 16 April 2026 / Accepted: 28 April 2026 / Published: 6 May 2026
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Abstract

Objectives: To investigate whether Porphyromonas gingivalis gingipains contribute to the activation of MMP-8 and MMP-9 in patients with cancer and to evaluate the potential of aMMP-8 chair-side test for early detection of active periodontal inflammation in cancer care. Methods: This cross-sectional study enrolled 89 of 119 initially assessed patients with cancer at Dr. Sardjito Hospital, Yogyakarta, Indonesia (2023–2024). Active MMP-8 was quantified using a chair-side test on oral rinse samples. Total MMP-8 was measured by ELISA, MMP-9 activation by gelatin zymography, and gingipain presence by Western immunoblotting. Associations with periodontal parameters (PPD, GI, OHI-S, and VPI) were analyzed using linear regression. Results: aMMP-8 chair-side test demonstrated 91% positive results in 89 patients with cancer. Western blotting revealed the co-localization of gingipains with fragmented MMP-8. aMMP-8 levels were significantly associated with MMP-9 activation (p = 0.003, R2 = 0.097), suggesting proteolytic cascade activation. Oral hygiene indices showed stronger associations (OHI-S: p = 0.003, R2 = 0.100; VPI: p = 0.014, R2 = 0.067) than deeper periodontal parameters (PPD: p = 0.094; GI: p = 0.358), suggesting early-stage inflammation detection. Conclusions: Gingipain presence may be associated with the activation of MMP-8 and MMP-9 in patients with cancer, which links bacterial virulence to amplified tissue destruction. aMMP-8 chair-side test enables rapid identification of active inflammation, facilitating timely periodontal intervention during cancer care.
Keywords: cancer screening; aMMP-8; MMP-9; gingipain; oral rinse biomarker cancer screening; aMMP-8; MMP-9; gingipain; oral rinse biomarker

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MDPI and ACS Style

Aji, N.R.A.S.; Ahlstrand, S.K.; Sahni, V.; Taroeno-Hariadi, K.W.; Listyarifah, D.; Sari, R.; Mardhiyah, I.; Syaify, A.; Nur, A.; Ramadona, A.L.; et al. Gingipain-Mediated Matrix Metalloproteinase-8 and -9 Activation in Oral Rinse Samples from Patients with Cancer: A Cross-Sectional Study. Dent. J. 2026, 14, 272. https://doi.org/10.3390/dj14050272

AMA Style

Aji NRAS, Ahlstrand SK, Sahni V, Taroeno-Hariadi KW, Listyarifah D, Sari R, Mardhiyah I, Syaify A, Nur A, Ramadona AL, et al. Gingipain-Mediated Matrix Metalloproteinase-8 and -9 Activation in Oral Rinse Samples from Patients with Cancer: A Cross-Sectional Study. Dentistry Journal. 2026; 14(5):272. https://doi.org/10.3390/dj14050272

Chicago/Turabian Style

Aji, Nur Rahman Ahmad Seno, Sebastian K. Ahlstrand, Vaibhav Sahni, Kartika W. Taroeno-Hariadi, Dyah Listyarifah, Rezmelia Sari, Iffah Mardhiyah, Ahmad Syaify, Asikin Nur, Aditya Lia Ramadona, and et al. 2026. "Gingipain-Mediated Matrix Metalloproteinase-8 and -9 Activation in Oral Rinse Samples from Patients with Cancer: A Cross-Sectional Study" Dentistry Journal 14, no. 5: 272. https://doi.org/10.3390/dj14050272

APA Style

Aji, N. R. A. S., Ahlstrand, S. K., Sahni, V., Taroeno-Hariadi, K. W., Listyarifah, D., Sari, R., Mardhiyah, I., Syaify, A., Nur, A., Ramadona, A. L., Thomas, J. T., Pätilä, T., Mäkitie, A. A., Räisänen, I. T., Pärnänen, P., Leone, P., Anil, S., & Sorsa, T. (2026). Gingipain-Mediated Matrix Metalloproteinase-8 and -9 Activation in Oral Rinse Samples from Patients with Cancer: A Cross-Sectional Study. Dentistry Journal, 14(5), 272. https://doi.org/10.3390/dj14050272

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