The role of azurocidin and its implications in periodontal and peri-implant disease: A systematic review

• Published in: Archives of oral biology Vol. 175; p. 106256
• Main Authors: Alarcón-Sánchez, Mario Alberto, Lomelí-Martínez, Sarah Monserrat, Rodríguez-Montaño, Ruth, Becerra-Ruiz, Julieta Sarai, Martínez-Bugarin, Cristina Hermila, Mosaddad, Seyed Ali, Heboyan, Artak
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2025
• Subjects: Azurocidin; Biomarkers; Biomarkers - metabolism; Dental Implants - adverse effects; Gingival Crevicular Fluid; Humans; Peri-Implantitis - metabolism; Periodontal disease; Periodontal Diseases - metabolism; Periodontitis - metabolism; Saliva; Biomarkers; Gingival Crevicular Fluid; Periodontal disease; Azurocidin; Saliva
• ISSN: 0003-9969; 1879-1506; 1879-1506
• DOI: 10.1016/j.archoralbio.2025.106256

This systematic review aimed to explore the role of Azurocidin (Azu) in the pathogenesis of periodontal and peri-implant disease and its potential use as an inflammatory biomarker. Four electronic databases were used for study identification: PubMed, Google Scholar, ScienceDirect, and Scopus from Oct 10, 1991 to Jul 15, 2024. Study selection and data extraction were performed in a blinded and independent manner. The Joanna Briggs Institute (JBI) tool was used to assess the quality of cross-sectional articles, and the Newcastle-Ottawa scale was used to assess cohort studies. Out of 222 identified articles, nine studies met the inclusion criteria. These studies included 462 participants: 156 with healthy teeth and implants and 306 with periodontal conditions such as gingivitis, periodontitis, apical periodontitis, peri-implant mucositis, and peri-implantitis. A total of 1313 samples were analyzed (163 saliva, 118 PICF, 1003 GCF, 11 gingival tissue, and 18 infected root canals). ELISA was the most common method for azurocidin analysis (66.6 %), followed by LC-MS/MS (33.3 %), nLC-MS/MS (11.1 %), and Western Blot (11.1 %). Azu levels were consistently elevated in individuals with periodontitis compared to periodontally healthy subjects. Azu may contribute to the inflammatory processes in periodontal and peri-implant diseases. Although elevated levels are observed in periodontitis, its diagnostic value remains unclear due to limited and heterogeneous data. •First systematic review studying the role of Azurocidin in periodontal and peri-implant disease.•Azurocidin induces vascular leakage, facilitating immune cell extravasation. In addition, it induces the expression of of other proinflammatory mediators contributing to alveolar bone loss.•Azurocidin levels are elevated in periodontal diseasesubjects.