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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
Low salivary thioredoxin-1 levels in periodontitis
Leonardo Lorente, Esther Hernández Marrero, Pedro Abreu-Gonzalez, Angel Daniel Lorente Martín, Marina Lorente Martín, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Alejandro Jiménez, Cándido Manuel Hernández Padilla
Leonardo Lorente, Intensive Care Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain
Esther Hernández Marrero, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Cándido Manuel Hernández Padilla, Department of Periodontal, Clínica Dental Cándido, La Laguna 38204, Spain
Pedro Abreu-Gonzalez, Department of Basic Medical Sciences, University of La Laguna, La Laguna 38320, Spain
Angel Daniel Lorente Martín, Department of Odontology, CEU San Pablo University, Madrid 28660, Spain
Marina Lorente Martín, Department of Nursing, Salus Infirmorum-Universidad Pontificia de Salamanca, Madrid 28015, Spain
Alejandro Jiménez, Research Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain
Author contributions: Lorente L conceived, designed and coordinated the study, participated in acquisition and interpretation of data, and drafted the manuscript; Hernández Marrero E, Lorente Martín AD, Lorente Martín M, Marrero González MJ, Marrero CH, Hernández Marrero, and Hernández Padilla CM participated in acquisition of data; Abreu-Gonzalez P participated in salivary levels determinations; Jiménez A participated in the interpretation of data; all authors revised the manuscript critically for important intellectual content and made the final approval of the version to be published.
Institutional review board statement: This study was initiated after obtaining approval from the Clinical Research Ethics Committee of the Hospital Universitario de Canarias, No. CHUC_2023_138.
Informed consent statement: Prior to inclusion, all participants provided written informed consent.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: The datasets generated during the current study are available from the corresponding author on reasonable request.
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: Leonardo Lorente, MD, PhD, Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n, La Laguna 38320, Spain.
lorentemartin@msn.com
Received: January 4, 2026
Revised: January 18, 2026
Accepted: January 26, 2026
Published online: February 26, 2026
Processing time: 42 Days and 7.9 Hours
BACKGROUND
The protein thioredoxin-1 (TRX-1) has anti-oxidative, anti-inflammatory and anti-apoptotic effects, and it has been related to the regulation of ageing and different diseases. TRX-1 in periodontitis has been scarcely studied, and the results in humans and in mice are contradictory. In three small studies with humans (the highest with 96 subjects), it was found that patients with periodontitis, compared to periodontally healthy subjects, showed a higher expression of TRX-1 or of the TRX-1 gene in saliva. However, in one study with mice, it was found that mice with periodontitis, compared to periodontally healthy mice, showed a lower expression of TRX-1 in the periodontal tissues.
AIM
To explore the possible association of salivary TRX-1 concentrations with periodontitis and its severity, and of determining the capability of salivary TRX-1 concentrations to predict the diagnosis of periodontitis in a larger sample size study.
METHODS
Salivary TRX-1 concentrations were measured in subjects with and without periodontitis in this observational and prospective study. Criteria to establish periodontal health were the nonexistence, or existence in less than 10% of sites, of bleeding on probing, and the nonexistence of interproximal attachment and bone loss. Criteria to establish localized gingivitis were the existence of bleeding between 10%-30% of sites, and the nonexistence of interproximal attachment and bone loss. Criteria to establish periodontitis were the existence of interproximal attachment or bone loss. We carried out a multivariate logistic regression analysis to determine the variables associated with periodontitis, a correlation analysis to determine the possible association between salivary TRX-1 concentrations and periodontitis severity, and a receiver operating characteristic (ROC) analysis to determine the capability of salivary TRX-1 concentrations to predict the diagnosis of periodontitis.
RESULTS
A total of 144 subjects (58 with periodontitis and 86 without periodontitis) were included. Low salivary TRX-1 concentrations showed an association with periodontitis (P = 0.04) according to regression analysis, an association with periodontitis severity (rho = -0.47; P < 0.001) according to correlation analysis, and an area under curve of 75% (95%CI: 67%-82%; P < 0.001) for periodontitis diagnosis according to ROC analysis.
CONCLUSION
Novel findings of this study were the association of low salivary TRX-1 concentrations with periodontitis and its severity, and the capacity of salivary TRX-1 concentrations to help in the periodontitis diagnosis.
Core Tip: The protein thioredoxin-1 (TRX-1) has anti-oxidative effects and is involved in senescence, aging and different diseases. Salivary levels of TRX-1 in patients with periodontitis have not been explored. Novel findings of this study were the association of low salivary TRX-1 concentrations with periodontitis and its severity, and the capacity of salivary TRX-1 concentrations to help in the diagnosis of periodontitis.
