Comparison of cathelicidine, alpha 1 defensin, histatin 1, and statherin levels in saliva between children with early childhood caries and caries-free children (case–control study)

Background Early childhood caries (ECC) is a chronic, microbial, carbohydrate-driven multifactorial disease. The composition of saliva, quantity, pH buffering capacity, presence of microorganisms, and amounts of peptides and proteins play important roles in the development and progression of dental caries. Salivary peptides and proteins are crucial for the formation of acquired enamel pellicles, protection against infections, and maintenance of calcium homeostasis. This study aimed to investigate the salivary levels of antimicrobial peptides (cathelicidine, alpha 1 defensin, histatin 1, and statherin) in children with early childhood caries and caries-free children. Methods This case‒control study involved 82 children (mean age 5.18 years) from the Pediatric Dentistry Department in Pilsen, Czech Republic. Children were enrolled on the basis of medical history and clinical examination and then divided into a case group (children with ECC) and a control group (caries-free children). Dental caries was recorded according to the WHO criteria, and the dmf index was calculated. Stimulated saliva was collected, and selected antimicrobial peptides were assessed via magnetic bead-based fluorescence assay kits following the manufacturer's instructions (Cloud-Clone Corp.). The data were statistically analyzed via a version without a multivariate regression model and a version with a multivariate regression model adjusted for age and sex. Graphical comparisons of antimicrobial peptide levels between groups were performed via box plots, with all tests performed at a significance level of 5%. Results Significant differences in age were found between the case group (mean 5.5 years) and the control group (mean 4.56 years), with no significant differences in sex. Compared with caries-free children, children with ECC (mean dmf index of 7.2) had higher levels of cathelicidin and statherin and lower levels of alpha defensin and histatin 1 in stimulated saliva. However, these differences were not statistically significant. Conclusions The results of the present study did not confirm statistically significant differences in the levels of selected antimicrobial peptides in the saliva, yet this issue deserves further attention.