Shi DD, Ding J, Tian J. Unraveling the enigma of salivary uric acid in periodontitis: Independent association, mechanistic insights, and future trajectories. World J Clin Cases 2025; 13(27): 108117 [DOI: 10.12998/wjcc.v13.i27.108117]
Corresponding Author of This Article
Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, Sunwen East Road, Zhongshan 528400, Guangdong Province, China. tian-ju@163.com
Research Domain of This Article
Dentistry, Oral Surgery & Medicine
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2025; 13(27): 108117 Published online Sep 26, 2025. doi: 10.12998/wjcc.v13.i27.108117
Unraveling the enigma of salivary uric acid in periodontitis: Independent association, mechanistic insights, and future trajectories
Dan-Dan Shi, Jing Ding, Ju Tian
Dan-Dan Shi, Jing Ding, Department of Plastic Surgery, Zhongshan City People’s Hospital, Zhongshan 528400, Guangdong Province, China
Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, Zhongshan 528400, Guangdong Province, China
Co-first authors: Dan-Dan Shi and Jing Ding.
Author contributions: Tian J served as the designer of the overall concept and outline of the manuscript; Shi DD and Ding J collaborated on the writing and editing of the manuscript, the creation of illustrations, and the review of the relevant literature.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, Sunwen East Road, Zhongshan 528400, Guangdong Province, China. tian-ju@163.com
Received: April 7, 2025 Revised: May 17, 2025 Accepted: June 17, 2025 Published online: September 26, 2025 Processing time: 122 Days and 5.5 Hours
Abstract
This article explores the association between salivary uric acid (UA) and periodontitis, systematically analyzing its dual roles and research progress. Studies indicate that UA acts as a primary antioxidant in saliva under physiological conditions (accounting for 70%), protecting periodontal tissues by scavenging reactive oxygen species. However, when gum disease becomes severe, UA can switch roles and fuel inflammation, worsening tissue damage. Lorente et al’s research found an independent inverse correlation between salivary UA levels and periodontitis severity (odds ratio = 6.14, P = 0.001), establishing 111 nmol/mL as a diagnostic threshold (area under the curve = 66%). Nevertheless, limitations include sample heterogeneity and failure to distinguish between gingivitis and periodontitis. Mechanistically, three hypotheses are proposed: The Antioxidant Depletion Hypothesis (UA oxidation consumption leading to feedback loops), the Microbial Metabolic Hijacking Hypothesis (pathogens utilizing UA as a carbon source to disrupt redox balance), and the Epithelial Barrier Dysfunction Hypothesis (UA deficiency causing downregulation of tight junction proteins). Future research should prioritize longitudinal cohorts to validate predictive value, integrate multi-omics to explore dysregulated signatures, and develop UA supplementation or targeted antioxidant therapies. This study provides novel insights into periodontitis diagnosis and mechanisms, advancing the application of salivary biomarkers in precision periodontics.
Core Tip: This article delves into salivary uric acid's (UA) dual role in periodontitis—antioxidant under normal conditions and pro-inflammatory under pathology. Studies show an inverse link between UA levels and periodontitis severity, with 111 nmol/mL as a diagnostic marker. Future research should prioritize longitudinal validation, multi-omics analysis, and therapeutic strategies.
