BAX Gene Overexpression in the Tongue Could Warn of Infection Risk due to Periodontal Pathogens

Germano Orrù1, *, Francesca Muggironi1, Antonello Mameli1, 2, Cristina Demontis1, 2, Bastiana Arcadu1, Alessandra Scano1, Gloria Denotti2, Vincenzo Piras2, Carolina Girometta3, Blerina Zeza4, Andrea Pilloni4
1 Department of Surgical Sciences, Oral Biotechnology Laboratory (OBL), University of Cagliari, Cagliari, Italy
2 Department of Surgical Sciences, School of Dentistry, University of Cagliari, Cagliari, Italy
3 Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, Pavia, Italy
4 Department of Dentistry and Maxillofacial Surgery, Section of Periodontics, Sapienza University of Rome, Rome, Italy

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© 2018 Orrù et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Surgical Sciences, Oral Biotechnology Laboratory (OBL), University of Cagliari, Via Ospedale 54, 09121 Cagliari, Italy; Tel: +39 070 537413; Fax: +39 070 537437; E-mail:



Different host proteins play a central role in cell response during bacterial infections, the Bcl-2-Associated X protein (BAX) and Vascular Cell Adhesion Protein 1 (VCAM-1) are often reported in infective primary events during cell injury.


The aim of this study is to evaluate the predictive value of these two proteins as biomarkers of oral bacterial infection, with particular emphasis on the tongue, which plays an important role in microbial homeostasis in the mouth.


Twenty-nine patients were recruited and divided according to the Periodontal Index (CPI), 4 of them were severely compromised periodontal patients. Oral hygiene, gingival tissues and plaque presence were evaluated clinically. The laboratory analysis carried out on tongue tissue included: total bacterial genomes, proportion of specific periopathogens and BAX -VCAM-1 expression rate, while Reactive Oxygen Species (ROS) were measured in saliva.


Neither tongue microbiological status nor salivary ROS level corresponded with the state of disease. VCAM-1 mRNA expression rate was comparable in all patients but, on the contrary, BAX expression resulted high in periodontally-compromised patients and appears related to periodontal status in the analyzed subjects.


This preliminary work suggests that the BAX protein is a possible candidate in a prognostic marker study for oral diseases started by periodontal bacteria. For example, none of the evaluated clinical and microbiological parameters could predict the presence, prognosis or recurrence of periodontal diseases. This biomarker could be a valuable tool in determining the risk, diagnosis and prognosis of this human illness.

Keywords: VCAM-1 and BAX proteins, Tongue biofilm, Periodontitis and incipient diagnosis, Periodontal pathogens, Reactive Oxygen Species (ROS), Microbial homeostasis.