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Ilievski V, Zuchowska PK, Green SJ, Toth PT, Ragozzino ME, Le K, Aljewari HW, O’Brien-Simpson NM, Reynolds EC, Watanabe K. Chronic oral application of a periodontal pathogen results in brain inflammation, neurodegeneration and amyloid beta production in wild type mice. PLoS One 2018; 13:e0204941. [PMID: 30281647 PMCID: PMC6169940 DOI: 10.1371/journal.pone.0204941] [Citation(s) in RCA: 214] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/16/2018] [Indexed: 01/08/2023] Open
Abstract
Background The results from cross sectional and longitudinal studies show that periodontitis is closely associated with cognitive impairment (CI) and Alzhemer’s Disease (AD). Further, studies using animal model of periodontitis and human post-mortem brain tissues from subjects with AD strongly suggest that a gram-negative periodontal pathogen, Porphyromonas gingivalis (Pg) and/or its product gingipain is/are translocated to the brain. However, neuropathology resulting from Pg oral application is not known. In this work, we tested the hypothesis that repeated exposure of wild type C57BL/6 mice to orally administered Pg results in neuroinflammation, neurodegeneration, microgliosis, astrogliosis and formation of intra- and extracellular amyloid plaque and neurofibrillary tangles (NFTs) which are pathognomonic signs of AD. Methods Experimental chronic periodontitis was induced in ten wild type 8-week old C57BL/6 WT mice by repeated oral application (MWF/week) of Pg/gingipain for 22 weeks (experimental group). Another 10 wild type 8-week old C57BL/6 mice received vehicle alone (control group) MWF per week for 22 weeks. Brain tissues were collected and the presence of Pg/gingipain was determined by immunofluorescence (IF) microscopy, confocal microscopy, and quantitative PCR (qPCR). The hippocampi were examined for the signs of neuropathology related to AD: TNFα, IL1β, and IL6 expression (neuroinflammation), NeuN and Fluoro Jade C staining (neurodegeneration) and amyloid beta1-42 (Aβ42) production and phosphorylation of tau protein at Ser396 were assessed by IF and confocal microscopy. Further, gene expression of amyloid precursor protein (APP), beta-site APP cleaving enzyme 1 (BACE1), a disintegrin and metalloproteinase domain-containing protein10 (ADAM10) for α-secretase and presenilin1 (PSEN1) for ɣ-secretase, and NeuN (rbFox3) were determined by RT-qPCR. Microgliosis and astrogliosis were also determined by IF microscopy. Results Pg/gingipain was detected in the hippocampi of mice in the experimental group by immunohistochemistry, confocal microscopy, and qPCR confirming the translocation of orally applied Pg to the brain. Pg/gingipain was localized intra-nuclearly and peri-nuclearly in microglia (Iba1+), astrocytes (GFAP+), neurons (NeuN+) and was evident extracellularly. Significantly greater levels of expression of IL6, TNFα and IL1β were evident in experimental as compared to control group (p<0.01, p<0.00001, p<0.00001 respectively). In addition, microgliosis and astrogliosis were evident in the experimental but not in control group (p <0.01, p<0.0001 respectively). Neurodegeneration was evident in the experimental group based on a fewer number of intact neuronal cells assessed by NeuN positivity and rbFOX3 gene expression, and there was a greater number of degenerating neurons in the hippocampi of experimental mice assessed by Fluoro Jade C positivity. APP and BACE1 gene expression were increased in experimental group compared with control group (p<0.05, p<0.001 respectively). PSEN1 gene expression was higher in experimental than control group but the difference was not statistically significant (p = 0.07). ADAM10 gene expression was significantly decreased in experimental group compared with control group (p<0.01). Extracellular Aβ42 was detected in the parenchyma in the experimental but not in the control group (p< 0.00001). Finally, phospho-Tau (Ser396) protein was detected and NFTs were evident in experimental but not in the control group (p<0.00001). Conclusions This study is the first to show neurodegeneration and the formation of extracellular Aβ42 in young adult WT mice after repeated oral application of Pg. The neuropathological features observed in this study strongly suggest that low grade chronic periodontal pathogen infection can result in the development of neuropathology that is consistent with that of AD.
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Affiliation(s)
- Vladimir Ilievski
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Paulina K. Zuchowska
- Undergraduate Program, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Stefan J. Green
- Department of Biological Sciences University of Illinois at Chicago, Chicago, Illinois, Unites States of America
| | - Peter T. Toth
- Department of Pharmacology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Michael E. Ragozzino
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Khuong Le
- Undergraduate Program, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Haider W. Aljewari
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | | | - Eric C. Reynolds
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - Keiko Watanabe
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois, United States of America
- * E-mail:
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Naiff P, Carneiro V, Guimarães MDC. Importance of Mechanical Periodontal Therapy in Patients with Diabetes Type 2 and Periodontitis. Int J Dent 2018; 2018:6924631. [PMID: 30356347 PMCID: PMC6176290 DOI: 10.1155/2018/6924631] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/29/2018] [Indexed: 11/17/2022] Open
Abstract
Periodontitis is an infectious and inflammatory disease of high prevalence worldwide and constitutes a significant oral health problem. It can lead to tooth loss. In addition, the local inflammatory process can cause the release of inflammatory mediators in the bloodstream and, consequently, contribute to the emergence of systemic effects as cardiovascular and diabetic complications. The purpose of this mini review is to alert health professionals about the risk that periodontitis represents for the onset or exacerbation of complications in individuals with type 2 diabetes mellitus and to emphasize that the mechanical treatment of periodontal disease and reestablishment of oral health are essential for the metabolic control of these patients. The periodontal therapy may help to reduce the risk of systemic complications in diabetes patients. Proper dental management should be suggested by health professionals, mainly from physicians to their patients, in order to improve the health conditions in these individuals.
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Affiliation(s)
- Priscilla Naiff
- Ph.D. Student, Faculty of Health Sciences, University of Brasilia, Distrito Federal, Brazil
| | - Valéria Carneiro
- Ph.D. Professor at Periodontics Division, University of Brasilia, Distrito Federal, Brazil
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Laky M, Anscheringer I, Wolschner L, Heber S, Haririan H, Schrottmaier WC, Kral-Pointner JB, Salzmann M, Volf I, Moritz A, Assinger A. Periodontal treatment limits platelet activation in patients with periodontitis-a controlled-randomized intervention trial. J Clin Periodontol 2018; 45:1090-1097. [PMID: 29972709 DOI: 10.1111/jcpe.12980] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/08/2018] [Accepted: 07/02/2018] [Indexed: 12/20/2022]
Abstract
AIM Periodontitis results in platelet activation and enhanced risk for cardiovascular disease. As it is currently unknown whether periodontal treatment reverses platelet hyper-reactivity, we aimed to investigate the role of periodontal treatment on platelet activation. MATERIALS AND METHODS In a prospective controlled therapeutic trial, 52 patients were enrolled and randomly selected for periodontal treatment or monitored without treatment for 3 months. Patient blood was analysed by flow cytometry for platelet activation markers and by light transmission aggregometry for platelet aggregation in response to pro-thrombotic stimuli. RESULTS In this study, platelet activation in the control group aggravated over the observation period of 3 months, whereas patients that underwent periodontal treatment showed unchanged levels of platelet activation, measured by surface expression of CD62P, CD40L, generation of reactive oxygen production, activation of GPIIb/IIIa and fibrinogen binding. Moreover, platelet turnover, measured by platelet RNA content and platelet aggregation in response to collagen, differed significantly between patients that were treated and those who were untreated. CONCLUSIONS Subgingival debridement reduces the risk of aggravated platelet activation and therefore might potentially diminish subsequent diseases such as cardiovascular disease in periodontal patients.
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Affiliation(s)
- Markus Laky
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Isabella Anscheringer
- Department for Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Lukas Wolschner
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Stefan Heber
- Institute of Physiology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Hady Haririan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Waltraud C Schrottmaier
- Department for Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Julia B Kral-Pointner
- Department for Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Manuel Salzmann
- Department for Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Ivo Volf
- Institute of Physiology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Alice Assinger
- Department for Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
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54
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Wallet SM, Puri V, Gibson FC. Linkage of Infection to Adverse Systemic Complications: Periodontal Disease, Toll-Like Receptors, and Other Pattern Recognition Systems. Vaccines (Basel) 2018; 6:E21. [PMID: 29621153 PMCID: PMC6027258 DOI: 10.3390/vaccines6020021] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/25/2018] [Accepted: 03/30/2018] [Indexed: 12/13/2022] Open
Abstract
Toll-like receptors (TLRs) are a group of pattern recognition receptors (PRRs) that provide innate immune sensing of conserved pathogen-associated molecular patterns (PAMPs) to engage early immune recognition of bacteria, viruses, and protozoa. Furthermore, TLRs provide a conduit for initiation of non-infectious inflammation following the sensing of danger-associated molecular patterns (DAMPs) generated as a consequence of cellular injury. Due to their essential role as DAMP and PAMP sensors, TLR signaling also contributes importantly to several systemic diseases including cardiovascular disease, diabetes, and others. The overlapping participation of TLRs in the control of infection, and pathogenesis of systemic diseases, has served as a starting point for research delving into the poorly defined area of infection leading to increased risk of various systemic diseases. Although conflicting studies exist, cardiovascular disease, diabetes, cancer, rheumatoid arthritis, and obesity/metabolic dysfunction have been associated with differing degrees of strength to infectious diseases. Here we will discuss elements of these connections focusing on the contributions of TLR signaling as a consequence of bacterial exposure in the context of the oral infections leading to periodontal disease, and associations with metabolic diseases including atherosclerosis and type 2 diabetes.
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Affiliation(s)
- Shannon M Wallet
- Department of Oral Biology, College of Dental Medicine, University of Florida, Gainesville, FL 32610, USA.
| | - Vishwajeet Puri
- Department of Biomedical Sciences and Diabetes Institute, Ohio University, Athens, OH 45701, USA.
| | - Frank C Gibson
- Department of Oral Biology, College of Dental Medicine, University of Florida, Gainesville, FL 32610, USA.
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Abstract
The hydrophobicity of vitamin E poses transport and metabolic challenges to regulate its bioavailability and to prevent its accumulation in lipid-rich tissues such as adipose tissue, brain, and liver. Water-soluble precursors of vitamin E (α-tocopherol, αT), such as its esters with acetate (αTA), succinate (αTS), or phosphate (αTP), have increased solubility in water and stability against reaction with free radicals, but they are rapidly converted during their uptake into the lipid-soluble vitamin E. Therefore, the bioavailability of these precursors as intact molecules is low; nevertheless, at least for αTS and αTP, the recent research has revealed unique regulatory effects on signal transduction and gene expression and the modulation of cellular events ranging from proliferation, survival/apoptosis, lipid uptake and metabolism, phagocytosis, long term potentiation, cell migration, telomere maintenance, and angiogenesis. Moreover, water-soluble derivatives of vitamin E including some based on αTP are increasingly used as components of nanocarriers for enhanced and targeted delivery of drugs and other molecules (vitamins, including αT and αTP itself, vitamin D3, carnosine, caffeine, docosahexaenoic acid (DHA), insulin) and cofactors such as coenzyme Q10. In this review, the chemical characteristics, transport, metabolic pathways, and molecular mechanisms of action of αTP in cells and tissues are summarized and put into perspective with its possible role in the prevention of a number of diseases.
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Affiliation(s)
- Jean-Marc Zingg
- Miller School of Medicine, University of Miami, Miami, FL, United States.
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Abstract
Although diet has long been known to contribute to the pathogenesis of cardiovascular disease (CVD), research over the past decade has revealed an unexpected interplay between nutrient intake, gut microbial metabolism and the host to modify the risk of developing CVD. Microbial-associated molecular patterns are sensed by host pattern recognition receptors and have been suggested to drive CVD pathogenesis. In addition, the host microbiota produces various metabolites, such as trimethylamine-N-oxide, short-chain fatty acids and secondary bile acids, that affect CVD pathogenesis. These recent advances support the notion that targeting the interactions between the host and microorganisms may hold promise for the prevention or treatment of CVD. In this Review, we summarize our current knowledge of the gut microbial mechanisms that drive CVD, with special emphasis on therapeutic interventions, and we highlight the need to establish causal links between microbial pathways and CVD pathogenesis.
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Affiliation(s)
- J Mark Brown
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, 9500 Euclid Avenue, NC-10, Cleveland, Ohio 44195, USA
| | - Stanley L Hazen
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, 9500 Euclid Avenue, NC-10, Cleveland, Ohio 44195, USA
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Odermarsky M, Pesonen E, Sorsa T, Lernmark Å, Pussinen PJ, Liuba P. HLA, infections and inflammation in early stages of atherosclerosis in children with type 1 diabetes. Acta Diabetol 2018; 55:41-47. [PMID: 29064046 PMCID: PMC5794827 DOI: 10.1007/s00592-017-1063-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/26/2017] [Indexed: 01/30/2023]
Abstract
AIMS This prospective study focuses on risk factors for arterial damage in children with type 1 diabetes (T1D). METHODS Eighty children and adolescents with T1D were investigated twice, approximately 2 years apart, for carotid artery intima-media thickness (cIMT) and compliance (CAC), flow-mediated dilatation (FMD) of the brachial artery, and plasma levels of matrix metalloproteinase (MMP)-8. All subjects were genotyped for HLA. The number of respiratory tract infections (RTI) during the past year was obtained by a questionnaire in 56 patients. RESULTS cIMT progression, defined as percentage (%) change of cIMT from baseline, correlated inversely with the % changes of both CAC (p = 0.04, r = - 0.3; n = 62) and FMD (p = 0.03, r = - 0.3; n = 47). In multivariate analysis, RTI frequency correlated significantly with cIMT progression irrespective of age, diabetes duration, BMI, and HbA1c (p = 0.03, r = 0.3). When patients were divided in relation to RTI, the association of DQ2/8 with cIMT progression remained significant in patients with over three infections/year (p = 0.04, r = 0.3). During follow-up, the group of DQ2/8 patients with hsCRP > 1 mg/l showed significantly higher levels of plasma MMP-8 than the non-DQ2/8 group. CONCLUSIONS The diabetes-risk genotype DQ2/8 and systemic inflammation contribute to pro-atherosclerotic vascular changes in children and adolescents with T1D.
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Affiliation(s)
- Michal Odermarsky
- Department of Paediatric Cardiology, Paediatric Heart Center, Lund University and Skåne University Hospital, 22185, Lund, Sweden
| | - Erkki Pesonen
- Department of Paediatric Cardiology, Paediatric Heart Center, Lund University and Skåne University Hospital, 22185, Lund, Sweden
| | - Timo Sorsa
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Åke Lernmark
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Petru Liuba
- Department of Paediatric Cardiology, Paediatric Heart Center, Lund University and Skåne University Hospital, 22185, Lund, Sweden.
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Kramer CD, Genco CA. Microbiota, Immune Subversion, and Chronic Inflammation. Front Immunol 2017; 8:255. [PMID: 28348558 PMCID: PMC5346547 DOI: 10.3389/fimmu.2017.00255] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/21/2017] [Indexed: 12/12/2022] Open
Abstract
Several host-adapted pathogens and commensals have evolved mechanisms to evade the host innate immune system inducing a state of low-grade inflammation. Epidemiological studies have also documented the association of a subset of these microorganisms with chronic inflammatory disorders. In this review, we summarize recent studies demonstrating the role of the microbiota in chronic inflammatory diseases and discuss how specific microorganisms subvert or inhibit protective signaling normally induced by toll-like receptors (TLRs). We highlight our work on the oral pathogen Porphyromonas gingivalis and discuss the role of microbial modulation of lipid A structures in evasion of TLR4 signaling and resulting systemic immunopathology associated with atherosclerosis. P. gingivalis intrinsically expresses underacylated lipid A moieties and can modify the phosphorylation of lipid A, leading to altered TLR4 signaling. Using P. gingivalis mutant strains expressing distinct lipid A moieties, we demonstrated that expression of antagonist lipid A was associated with P. gingivalis-mediated systemic inflammation and immunopathology, whereas strains expressing agonist lipid A exhibited modest systemic inflammation. Likewise, mice deficient in TLR4 were more susceptible to vascular inflammation after oral infection with P. gingivalis wild-type strain compared to mice possessing functional TLR4. Collectively, our studies support a role for P. gingivalis-mediated dysregulation of innate and adaptive responses resulting in immunopathology and systemic inflammation. We propose that anti-TLR4 interventions must be designed with caution, given the balance between the protective and destructive roles of TLR signaling in response to microbiota and associated immunopathologies.
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Affiliation(s)
- Carolyn D Kramer
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine , Boston, MA , USA
| | - Caroline Attardo Genco
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine , Boston, MA , USA
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von Scheidt M, Zhao Y, Kurt Z, Pan C, Zeng L, Yang X, Schunkert H, Lusis AJ. Applications and Limitations of Mouse Models for Understanding Human Atherosclerosis. Cell Metab 2017; 25:248-261. [PMID: 27916529 PMCID: PMC5484632 DOI: 10.1016/j.cmet.2016.11.001] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/26/2016] [Accepted: 11/03/2016] [Indexed: 12/13/2022]
Abstract
Most of the biological understanding of mechanisms underlying coronary artery disease (CAD) derives from studies of mouse models. The identification of multiple CAD loci and strong candidate genes in large human genome-wide association studies (GWASs) presented an opportunity to examine the relevance of mouse models for the human disease. We comprehensively reviewed the mouse literature, including 827 literature-derived genes, and compared it to human data. First, we observed striking concordance of risk factors for atherosclerosis in mice and humans. Second, there was highly significant overlap of mouse genes with human genes identified by GWASs. In particular, of the 46 genes with strong association signals in CAD GWASs that were studied in mouse models, all but one exhibited consistent effects on atherosclerosis-related phenotypes. Third, we compared 178 CAD-associated pathways derived from human GWASs with 263 from mouse studies and observed that the majority were consistent between the species.
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Affiliation(s)
- Moritz von Scheidt
- Deutsches Herzzentrum München, Technische Universität München, 80333 Munich, Germany
| | - Yuqi Zhao
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Zeyneb Kurt
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Calvin Pan
- Departments of Medicine, Microbiology, and Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Lingyao Zeng
- Deutsches Herzzentrum München, Technische Universität München, 80333 Munich, Germany
| | - Xia Yang
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Heribert Schunkert
- Deutsches Herzzentrum München, Technische Universität München, 80333 Munich, Germany; Deutsches Zentrum für Herz- und Kreislauferkrankungen (DZHK), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Aldons J Lusis
- Departments of Medicine, Microbiology, and Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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Rokad F, Moseley R, Hardy RS, Chukkapalli S, Crean S, Kesavalu L, Singhrao SK. Cerebral Oxidative Stress and Microvasculature Defects in TNF-α Expressing Transgenic and Porphyromonas gingivalis-Infected ApoE-/- Mice. J Alzheimers Dis 2017; 60:359-369. [PMID: 28800332 DOI: 10.3233/jad-170304] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The polymicrobial dysbiotic subgingival biofilm microbes associated with periodontal disease appear to contribute to developing pathologies in distal body sites, including the brain. This study examined oxidative stress, in the form of increased protein carbonylation and oxidative protein damage, in the tumor necrosis factor-α (TNF-α) transgenic mouse that models inflammatory TNF-α excess during bacterial infection; and in the apolipoprotein knockout (ApoE-/-) mouse brains, following Porphyromonas gingivalis gingival monoinfection. Following 2,4-dinitrophenylhydrazine derivatization, carbonyl groups were detected in frontal lobe brain tissue lysates by immunoblotting and immunohistochemical analysis of fixed tissue sections from the frontotemporal lobe and the hippocampus. Immunoblot analysis confirmed the presence of variable carbonyl content and oxidative protein damage in all lysates, with TNF-α transgenic blots exhibiting increased protein carbonyl content, with consistently prominent bands at 25 kDa (p = 0.0001), 43 kDa, and 68 kDa, over wild-type mice. Compared to sham-infected ApoE-/- mouse blots, P. gingivalis-infected brain tissue blots demonstrated the greatest detectable protein carbonyl content overall, with numerous prominent bands at 25 kDa (p = 0.001) and 43 kDa (p = 0.0001) and an exclusive band to this group between 30-43 kDa* (p = 0.0001). In addition, marked immunostaining was detected exclusively in the microvasculature in P. gingivalis-infected hippocampal tissue sections, compared to sham-infected, wild-type, and TNF-α transgenic mice. This study revealed that the hippocampal microvascular structure of P. gingivalis-infected ApoE-/- mice possesses elevated oxidative stress levels, resulting in the associated tight junction proteins being susceptible to increased oxidative/proteolytic degradation, leading to a loss of functional integrity.
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Affiliation(s)
- Farheen Rokad
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Ryan Moseley
- Stem Cells, Wound Repair and Regeneration, School of Dentistry, Cardiff University, Cardiff, UK
| | - Rowan S Hardy
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Sasanka Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - StJohn Crean
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Sim K Singhrao
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
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Haro A, Saxlin T, Suominen AL, Jula A, Knuuttila M, Ylöstalo P. Serum lipids modify periodontal infection - interleukin-6 association. J Clin Periodontol 2016; 44:275-282. [PMID: 28032903 DOI: 10.1111/jcpe.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2016] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to investigate whether the systemic response against a local inflammatory process in periodontium is dependent on the individual's serum lipid composition. MATERIAL AND METHODS This study was based on a subpopulation of the Health 2000 Survey that included 878 subjects who were aged between 45 and 64 years, dentate, non-diabetic and non-rheumatic. The inflammatory condition of periodontium was measured by means of the number of teeth with deepened (4 mm or deeper) periodontal pockets. Systemic inflammation was assessed by means of the serum levels of interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α). The association between an inflammatory condition in the periodontium and the systemic inflammatory response was analysed using linear regression models. RESULTS The number of teeth with deepened periodontal pockets was associated with elevated serum IL-6 levels among subjects with an unfavourable lipid composition (low-density lipoprotein cholesterol ≥3.7 mmol/l or high-density lipoprotein cholesterol <1.3 mmol/l). There was no association between serum TNF-α levels and the number of teeth with deepened periodontal pockets in these data. CONCLUSION The systemic response against the inflammatory condition of periodontium varied between individuals. The variation appeared to be dependent on the serum lipid composition or related factors.
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Affiliation(s)
- Anniina Haro
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,City of Äänekoski, Public Health Centre, Oral Health Care Services, Äänekoski, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,Institute of Dentistry, University of Oulu, Oulu, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,The Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.,The Health Monitoring Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Antti Jula
- National Institute for Health and Welfare (THL), Turku, Finland
| | - Matti Knuuttila
- Institute of Dentistry, University of Oulu, Oulu, Finland.,Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and Oulu University, Oulu, Finland
| | - Pekka Ylöstalo
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and Oulu University, Oulu, Finland
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Singhrao SK, Harding A, Chukkapalli S, Olsen I, Kesavalu L, Crean S. Apolipoprotein E Related Co-Morbidities and Alzheimer's Disease. J Alzheimers Dis 2016; 51:935-48. [PMID: 26923007 DOI: 10.3233/jad150690] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The primary goal of advancement in clinical services is to provide a health care system that enhances an individual's quality of life. Incidence of diabetes mellitus, cardiovascular disease, and associated dementia coupled with the advancing age of the population, have led to an increase in the worldwide challenge to the healthcare system. In order to overcome these challenges, prior knowledge of common, reliable risk factors and their effectors is essential. Oral health constitutes one such relatively unexplored but indispensable risk factor for aforementioned co-morbidities, in the form of poor oral hygiene and tooth loss during aging. Behavioral traits such as low education, smoking, poor diet, neglect of oral health, lack of exercise, and hypertension are few of the risk factors that are shared commonly among these conditions. In addition, common genetic susceptibility traits such as the apolipoprotein E gene, together with an individual's lifestyle can also influence the development of co-morbidities such as periodontitis, atherosclerosis/stroke, diabetes, and Alzheimer's disease. This review specifically addresses the susceptibility of apolipoprotein E gene allele 4 as the plausible commonality for the etiology of co-morbidities that eventually result from periodontal diseases and ultimately progress to dementia.
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Affiliation(s)
- Sim K Singhrao
- Oral & Dental Sciences Research Group, College of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Alice Harding
- Oral & Dental Sciences Research Group, College of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Sasanka Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - StJohn Crean
- Oral & Dental Sciences Research Group, College of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
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Porphyromonas gingivalis oral infection promote T helper 17/Treg imbalance in the development of atherosclerosis. J Dent Sci 2016; 12:60-69. [PMID: 30895025 PMCID: PMC6395245 DOI: 10.1016/j.jds.2016.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 10/13/2016] [Indexed: 02/08/2023] Open
Abstract
Background/purpose Increasing studies have indicated the involvement of Porphyromonas gingivalis in atherosclerosis. T helper 17 (Th17)/Treg balance is critical during atherosclerosis. However, whether P. gingivalis oral infection is associated with Th17/Treg imbalance is unclear. The aim of the present study was to investigate the effect of P. gingivalis on Th17/Treg balance during atherosclerosis. Materials and methods ApoE–/– and C57BL/6 mice were inoculated orally with P. gingivalis ATCC 33277 for 9 weeks. The alveolar bone loss was assessed by microcomputerized tomography. The area of atherosclerosis plaque was identified by oil red O staining. Plaque stability was analyzed by CD68 and αSMA immunohistochemistry staining and Masson staining. The frequency of Th17 and Treg in spleen was detected by flow cytometry. The mRNA expression of Th17- and Treg-related factors was determined by quantitative polymerase chain reaction. Interleukin (IL)-6, a critical factor in modulating T-cell differentiation, was determined from spleen cells and mouse dendritic cells by enzyme-linked immunosorbent assay. Results Long-term P. gingivalis oral infection induced alveolar bone resorption. In ApoE–/– mice, P. gingivalis enhanced atherosclerotic lesion formation and plaque instability accompanied with a decreased Treg frequency and an increased Th17 cell frequency. In addition, mRNA expression of retinoic acid receptor-related orphan receptor γt and IL-17 was increased, and that of transforming growth factor (TGF) β and IL-10 was decreased in P. gingivalis-infected ApoE–/– mice. Furthermore, secretion of IL-6 was elevated in the spleen of P. gingivalis-infected ApoE–/– mice, as well as in mouse dendritic cells after P. gingivalis infection. Conclusion P. gingivalis oral infection may promote Th17/Treg imbalance by influencing T-cell differentiation during the process of atherosclerosis, with a larger lesion area and decreasing plaque instability.
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Hand TW, Vujkovic-Cvijin I, Ridaura VK, Belkaid Y. Linking the Microbiota, Chronic Disease, and the Immune System. Trends Endocrinol Metab 2016; 27:831-843. [PMID: 27623245 PMCID: PMC5116263 DOI: 10.1016/j.tem.2016.08.003] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/08/2016] [Accepted: 08/09/2016] [Indexed: 12/11/2022]
Abstract
Chronic inflammatory diseases (CIDs) are the most important causes of mortality in the world today and are on the rise. We now know that immune-driven inflammation is critical in the etiology of these diseases, though the environmental triggers and cellular mechanisms that lead to their development are still mysterious. Many CIDs are associated with significant shifts in the microbiota toward inflammatory configurations, which can affect the host both by inducing local and systemic inflammation and by alterations in microbiota-derived metabolites. This review discusses recent findings suggesting that shifts in the microbiota may contribute to chronic disease via effects on the immune system.
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Affiliation(s)
- Timothy W. Hand
- R.K. Mellon Institute for Pediatric Research, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, 15224
- Correspondence addressed to: Timothy Hand () or Yasmine Belkaid ()
| | - Ivan Vujkovic-Cvijin
- Mucosal Immunology Section, Laboratory of Parasitic Diseases, NIAID/NIH, Bethesda, Maryland 20892, USA
| | - Vanessa K. Ridaura
- Mucosal Immunology Section, Laboratory of Parasitic Diseases, NIAID/NIH, Bethesda, Maryland 20892, USA
| | - Yasmine Belkaid
- Mucosal Immunology Section, Laboratory of Parasitic Diseases, NIAID/NIH, Bethesda, Maryland 20892, USA
- National Institute of Allergy and Infectious diseases (NIAID) Microbiome Program, National Institutes of Health (NIH), Bethesda, Maryland 20892, USA
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Cho YJ, Song HY, Ben Amara H, Choi BK, Eunju R, Cho YA, Seol Y, Lee Y, Ku Y, Rhyu IC, Koo KT. In Vivo Inhibition ofPorphyromonas gingivalisGrowth and Prevention of Periodontitis With Quorum-Sensing Inhibitors. J Periodontol 2016; 87:1075-82. [DOI: 10.1902/jop.2016.160070] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Weishan L, Dechao L, Rongrong Q. [Effects of Porphyromonas gingivalis on interleukin-33 expression in rabbit vascular endothelium tissues]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2016; 34:354-357. [PMID: 28317351 DOI: 10.7518/hxkq.2016.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate interleukin-33 (IL-33) in the arterial vascular endothelium of rabbits infected with Porphyromonas gingivalis (P. gingivalis), and to explore the relationship between P. gingivalis and atherosclerosis. METHODS A total of 24 rabbits were randomly divided into control and experimental groups. The experimental group received intravenous injection of P. gingivalis once a week for 12 weeks to establish a coronary atherosclerosis model. The rabbits in the control group were injected with equal volume of physiological saline. All the rabbits were killed after 13 weeks. The IL-33 expression levels in the arterial vascular endothelium of the rabbits were detected through immunohistochemistry, reverse transcription polymerase chain reaction, and Western blot analysis. The effects of P. gingivalis on the IL-33 expression in the arterial vascular endothelium of the rabbits were analyzed. RESULTS The relative expression levels of IL-33 mRNA in the vascular endothelium cells were 58.244±2.407, and the relative expression levels of IL-33 protein were 1.863±0.171 in the experimental group. The relative expression levels of IL-33 mRNA were 3.143±0.805, and the relative expression levels of IL-33 protein were 0.537±
0.028 in the control group. The expression levels of IL-33 mRNA and protein of vascular endothelium cells in the experimental group were significantly higher than those of the control group (P<0.01). CONCLUSIONS P. gingivalis infection promotes IL-33 expression levels in vascular endothelial cells and may regulate the occurrence and development of atherosclerosis.
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Affiliation(s)
- Li Weishan
- Dept. of Periodontal and Mucosal Diseases, The Affiliated Stomatology Hospital of Jiamusi University, Jiamusi 154007, China
| | - Li Dechao
- Dept. of Periodontal and Mucosal Diseases, The Affiliated Stomatology Hospital of Jiamusi University, Jiamusi 154007, China
| | - Qiu Rongrong
- Dept. of Periodontal and Mucosal Diseases, The Affiliated Stomatology Hospital of Jiamusi University, Jiamusi 154007, China
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Abstract
The connection between oral and systemic health is becoming more obvious. Oral infections, specifically periodontitis, have been associated with diseases such as diabetes, cardiovascular disease, respiratory infection, erectile dysfunction, metabolic syndrome, and rheumatoid arthritis, to name a few. As people age, they become more susceptible for developing both oral and systemic diseases. This article discusses the oral-systemic relationship as well as sheds light on preventive measures that can be taken.
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Cui D, Li H, Lei L, Chen C, Yan F. Nonsurgical periodontal treatment reduced aortic inflammation in ApoE(-/-) mice with periodontitis. SPRINGERPLUS 2016; 5:940. [PMID: 27386384 PMCID: PMC4929118 DOI: 10.1186/s40064-016-2637-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 06/21/2016] [Indexed: 01/07/2023]
Abstract
Background Although the correlation between periodontal infection and atherosclerotic lesions has been well recognized, whether and how the nonsurgical periodontal treatment (NSPT) can improve the vascular inflammation has not been investigated clearly. Methods Thirty-two apolipoprotein E−/− (apoE−/−) mice were randomly divided into four groups: (1) Con group: no treatment, blank control group; (2) Lig group: ligature-induced-periodontitis group; (3) Lig-N group: ligatures were removed on the 7th day; (4) Lig-SRP group: ligatures were removed on the 7th day, and scaling and root planing (SRP) were performed on the 9th day. All the animals were euthanized on the 30th day. Alveolar bone loss (ABL) was assessed under microcomputed tomography. Systemic inflammatory status and lipid contents in the plasma were detected. Expression of several surrogate markers for vascular inflammation was evaluated by immunohistology and quantitative real time PCR. Results NSPT reduced ABL, improved lipid profile, and inhibited systemic inflammation with reduced plasma interleukin-6 (IL-6) level in apoE−/− mice; in addition, reduced inflammation in arterial wall was observed in NSPT treated mice, showing less vascular cell adhesion molecule-1 expression and less macrophage adhesion; furthermore, NSPT improved elastic fiber fragmentation disorder in the aortic wall, thus preserved elasticity of aortic artery. Conclusion Ligature-induced periodontitis can lead to inflammatory response in the vascular wall and NSPT has beneficial effect on the early stage of atherosclerosis process in the articular wall by reducing systemic inflammation and improving lipid profile.
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Affiliation(s)
- Di Cui
- Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhong Yang Road, Nanjing, 210008 Jiangsu People's Republic of China
| | - Houxuan Li
- Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhong Yang Road, Nanjing, 210008 Jiangsu People's Republic of China
| | - Lang Lei
- Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhong Yang Road, Nanjing, 210008 Jiangsu People's Republic of China
| | - Changxing Chen
- Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhong Yang Road, Nanjing, 210008 Jiangsu People's Republic of China
| | - Fuhua Yan
- Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhong Yang Road, Nanjing, 210008 Jiangsu People's Republic of China
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Ilievski V, Kinchen JM, Prabhu R, Rim F, Leoni L, Unterman TG, Watanabe K. Experimental Periodontitis Results in Prediabetes and Metabolic Alterations in Brain, Liver and Heart: Global Untargeted Metabolomic Analyses. ACTA ACUST UNITED AC 2016; 3. [PMID: 27390783 DOI: 10.13188/2377-987x.1000020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Results from epidemiological studies suggest that there is an association between periodontitis and prediabetes, however, causality is not known. The results from our previous studies suggest that induction of periodontitis leads to hyperinsulinemia glucose intolerance and insulin resistance, all hallmarks of prediabetes. However, global effects of periodontitis on critical organs in terms of metabolic alterations are unknown. We determined the metabolic effects of periodontitis on brain, liver, heart and plasma resulting from Porphyromonas gingivalis induced periodontitis in mice. Periodontitis was induced by oral application of the periodontal pathogen, Porphyromonas gingivalis for 22 weeks. Global untargeted biochemical profiles in samples from these organs/plasma were determined by liquid and gas chromatography/mass spectrometry and compared between controls and animals with periodontitis. Oral application of Porphyromonas gingivalis induced chronic periodontitis and hallmarks of prediabetes. The results of sample analyses indicated a number of changes in metabolic readouts, including changes in metabolites related to glucose and arginine metabolism, inflammation and redox homeostasis. Changes in biochemicals suggested subtle systemic effects related to periodontal disease, with increases in markers of inflammation and oxidative stress most prominent in the liver. Signs of changes in redox homeostasis were also seen in the brain and heart. Elevated bile acids in liver were suggestive of increased biosynthesis, which may reflect changes in liver function. Interestingly, signs of decreasing glucose availability were seen in the brain. In all three organs and plasma, there was a significant increase in the microbiome-derived bioactive metabolite 4-ethylphenylsulfate sulfate in animals with periodontitis. The results of metabolic profiling suggest that periodontitis/bacterial products alter metabolomic signatures of brain, heart, liver, and plasma in the prediabetic state. These data provide scientific community valuable metabolic signatures that become the basis for understanding the impact of periodontitis on a systemic disease and potentially targets for therapeutic intervention.
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Affiliation(s)
- Vladimir Ilievski
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Ramya Prabhu
- Undergraduate Program, University of Illinois at Chicago, Chicago, IL, USA
| | - Fadi Rim
- Undergraduate Program, University of Illinois at Chicago, Chicago, IL, USA
| | - Lara Leoni
- Department of Radiology, University of Chicago, Chicago, IL, USA
| | - Terry G Unterman
- Departments of Medicine and Physiology and Biophysics, College of Medicine, University of Illinois at Chicago, and Jesse Brown VA Medical Center, Chicago, IL, USA
| | - Keiko Watanabe
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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Reyes L, Herrera D, Kozarov E, Roldán S, Progulske-Fox A. Periodontal bacterial invasion and infection: contribution to atherosclerotic pathology. J Clin Periodontol 2016; 40 Suppl 14:S30-50. [PMID: 23627333 DOI: 10.1111/jcpe.12079] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this review was to perform a systematic evaluation of the literature reporting current scientific evidence for periodontal bacteria as contributors to atherosclerosis. METHODS Literature from epidemiological, clinical and experimental studies concerning periodontal bacteria and atherosclerosis were reviewed. Gathered data were categorized into seven "proofs" of evidence that periodontal bacteria: 1) disseminate from the oral cavity and reach systemic vascular tissues; 2) can be found in the affected tissues; 3) live within the affected site; 4) invade affected cell types in vitro; 5) induce atherosclerosis in animal models of disease; 6) non-invasive mutants of periodontal bacteria cause significantly reduced pathology in vitro and in vivo; and 7) periodontal isolates from human atheromas can cause disease in animal models of infection. RESULTS Substantial evidence for proofs 1 to 6 was found. However, proof 7 has not yet been fulfilled. CONCLUSIONS Despite the lack of evidence that periodontal bacteria obtained from human atheromas can cause atherosclerosis in animal models of infection, attainment of proofs 1 to 6 provides support that periodontal pathogens can contribute to atherosclerosis.
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Affiliation(s)
- Leticia Reyes
- Department of Oral Biology, College of Dentistry and Center for Molecular Microbiology, University of Florida, Gainesville, FL 32610-0424, USA
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Reyes L, Herrera D, Kozarov E, Roldá S, Progulske-Fox A. Periodontal bacterial invasion and infection: contribution to atherosclerotic pathology. J Periodontol 2016; 84:S30-50. [PMID: 23631583 DOI: 10.1902/jop.2013.1340012] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this review was to perform a systematic evaluation of the literature reporting current scientific evidence for periodontal bacteria as contributors to atherosclerosis. METHODS Literature from epidemiological, clinical and experimental studies concerning periodontal bacteria and atherosclerosis were reviewed. Gathered data were categorized into seven "proofs" of evidence that periodontal bacteria: 1) disseminate from the oral cavity and reach systemic vascular tissues; 2) can be found in the affected tissues; 3) live within the affected site; 4) invade affected cell types in vitro; 5) induce atherosclerosis in animal models of disease; 6) non-invasive mutants of periodontal bacteria cause significantly reduced pathology in vitro and in vivo; and 7) periodontal isolates from human atheromas can cause disease in animal models of infection. RESULTS Substantial evidence for proofs 1 to 6 was found. However, proof 7 has not yet been fulfilled. CONCLUSIONS Despite the lack of evidence that periodontal bacteria obtained from human atheromas can cause atherosclerosis in animal models of infection, attainment proofs 1 to 6 provides support that periodontal pathogens can contribute to atherosclerosis.
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Affiliation(s)
- Leticia Reyes
- Department of Oral Biology, College of Dentistry and Center for Molecular Microbiology, University of Florida, Gainesville, FL, USA
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Abstract
PURPOSE OF REVIEW We have summarized available evidence for and against the presence of a vascular microbiome. Studies that have attempted to detect bacteria and viruses in blood vessels in both health and disease are critiqued in an attempt to explain contrary results that may be due to variations in methodology. RECENT FINDINGS Many studies have demonstrated the presence of both bacteria and viruses within diseased blood vessels. Evidence is most compelling in atherosclerosis; however, recent reports have raised questions about the potential role of microbes in nonatherosclerotic aortic aneurysms and vasculitis. Preliminary evidence also suggests that apparently normal vessels may harbor microbes. With the exception of certain viral infections (e.g. hepatitis C virus, HIV, Epstein-Barr virus, and cytomegalovirus) and infectious endocarditis, systemic vasculitides have not been convincingly associated with infectious agents. However, emerging data suggest that different communities of microbes may be present in noninflammatory and inflammatory large-vessel diseases. Whether variations in vascular microbial communities are the cause or a secondary result (epiphenomena) of vessel injury remains to be determined. SUMMARY Blood vessels may not be sterile. Future studies of microbes in vessel health and disease may provide important insights into disease pathogenesis and suggest new therapies for diseases now considered to be idiopathic and refractory.
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73
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Links between atherosclerotic and periodontal disease. Exp Mol Pathol 2016; 100:220-35. [DOI: 10.1016/j.yexmp.2016.01.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/08/2016] [Indexed: 02/06/2023]
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Alfakry H, Malle E, Koyani CN, Pussinen PJ, Sorsa T. Neutrophil proteolytic activation cascades: a possible mechanistic link between chronic periodontitis and coronary heart disease. Innate Immun 2016; 22:85-99. [PMID: 26608308 DOI: 10.1177/1753425915617521] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/13/2015] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular diseases are chronic inflammatory diseases that affect a large segment of society. Coronary heart disease (CHD), the most common cardiovascular disease, progresses over several years and affects millions of people worldwide. Chronic infections may contribute to the systemic inflammation and enhance the risk for CHD. Periodontitis is one of the most common chronic infections that affects up to 50% of the adult population. Under inflammatory conditions the activation of endogenous degradation pathways mediated by immune responses leads to the release of destructive cellular molecules from both resident and immigrant cells. Matrix metalloproteinases (MMPs) and their regulators can activate each other and play an important role in immune response via degrading extracellular matrix components and modulating cytokines and chemokines. The action of MMPs is required for immigrant cell recruitment at the site of inflammation. Stimulated neutrophils represent the major pathogen-fighting immune cells that upregulate expression of several proteinases and oxidative enzymes, which can degrade extracellular matrix components (e.g. MMP-8, MMP-9 and neutrophil elastase). The activity of MMPs is regulated by endogenous inhibitors and/or candidate MMPs (e.g. MMP-7). The balance between MMPs and their inhibitors is thought to mirror the proteolytic burden. Thus, neutrophil-derived biomarkers, including myeloperoxidase, may activate proteolytic destructive cascades that are involved in subsequent immune-pathological events associated with both periodontitis and CHD. Here, we review the existing studies on the contribution of MMPs and their regulators to the infection-related pathology. Also, we discuss the possible proteolytic involvement and role of neutrophil-derived enzymes as an etiological link between chronic periodontitis and CHD.
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Affiliation(s)
- Hatem Alfakry
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ernst Malle
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Chintan N Koyani
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Steinmetz O, Hoch S, Avniel-Polak S, Gavish K, Eli-Berchoer L, Wilensky A, Nussbaum G. CX3CR1hi Monocyte/Macrophages Support Bacterial Survival and Experimental Infection-Driven Bone Resorption. J Infect Dis 2015; 213:1505-15. [PMID: 26704610 DOI: 10.1093/infdis/jiv763] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/17/2015] [Indexed: 12/13/2022] Open
Abstract
Porphyromonas gingivalis,an anaerobic bacterium strongly linked to infection-driven inflammatory bone erosion, thrives within a highly inflamed milieu and disseminates to distant sites, such as atherosclerotic plaque. We examined the role of monocyte/macrophages in determining the outcome of infection with P. gingivalis. Surprisingly, transient monocyte/macrophage depletion led to greatly improved clearance of P. gingivalis. The chemokine receptors CCR2 and CX3CR1 play a major role in monocyte recruitment and differentiation to Ly6C(hi) vs CX3CR1(hi) subsets, respectively. To determine the contribution of particular monocyte/macrophage subsets to bacterial survival, we challenged chemokine receptor knockout mice and found that P. gingivalis clearance is significantly improved in the absence of CX3CR1. CX3CR1(hi) monocyte/macrophages promote P. gingivalis survival by downregulating neutrophil phagocytosis. Furthermore, CX3CR1 knockout mice resist bone resorption in the oral cavity following challenge with P. gingivalis Our findings provide an explanation for bacterial coexistence alongside an activate neutrophil infiltrate.
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Affiliation(s)
- Orit Steinmetz
- Institute of Dental Sciences, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Shifra Hoch
- Institute of Dental Sciences, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Shani Avniel-Polak
- Institute of Dental Sciences, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Keren Gavish
- Institute of Dental Sciences, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Luba Eli-Berchoer
- Institute of Dental Sciences, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Asaf Wilensky
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Gabriel Nussbaum
- Institute of Dental Sciences, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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Chukkapalli SS, Velsko IM, Rivera-Kweh MF, Zheng D, Lucas AR, Kesavalu L. Polymicrobial Oral Infection with Four Periodontal Bacteria Orchestrates a Distinct Inflammatory Response and Atherosclerosis in ApoE null Mice. PLoS One 2015; 10:e0143291. [PMID: 26619277 PMCID: PMC4664240 DOI: 10.1371/journal.pone.0143291] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/02/2015] [Indexed: 12/17/2022] Open
Abstract
Periodontal disease (PD) develops from a synergy of complex subgingival oral microbiome, and is linked to systemic inflammatory atherosclerotic vascular disease (ASVD). To investigate how a polybacterial microbiome infection influences atherosclerotic plaque progression, we infected the oral cavity of ApoEnull mice with a polybacterial consortium of 4 well-characterized periodontal pathogens, Porphyromonas gingivalis, Treponema denticola, Tannerealla forsythia and Fusobacterium nucleatum, that have been identified in human atherosclerotic plaque by DNA screening. We assessed periodontal disease characteristics, hematogenous dissemination of bacteria, peripheral T cell response, serum inflammatory cytokines, atherosclerosis risk factors, atherosclerotic plaque development, and alteration of aortic gene expression. Polybacterial infections have established gingival colonization in ApoEnull hyperlipidemic mice and displayed invasive characteristics with hematogenous dissemination into cardiovascular tissues such as the heart and aorta. Polybacterial infection induced significantly higher levels of serum risk factors oxidized LDL (p < 0.05), nitric oxide (p < 0.01), altered lipid profiles (cholesterol, triglycerides, Chylomicrons, VLDL) (p < 0.05) as well as accelerated aortic plaque formation in ApoEnull mice (p < 0.05). Periodontal microbiome infection is associated with significant decreases in Apoa1, Apob, Birc3, Fga, FgB genes that are associated with atherosclerosis. Periodontal infection for 12 weeks had modified levels of inflammatory molecules, with decreased Fas ligand, IL-13, SDF-1 and increased chemokine RANTES. In contrast, 24 weeks of infection induced new changes in other inflammatory molecules with reduced KC, MCSF, enhancing GM-CSF, IFNγ, IL-1β, IL-13, IL-4, IL-13, lymphotactin, RANTES, and also an increase in select inflammatory molecules. This study demonstrates unique differences in the host immune response to a polybacterial periodontal infection with atherosclerotic lesion progression in a mouse model.
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Affiliation(s)
- Sasanka S. Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Irina M. Velsko
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Mercedes F. Rivera-Kweh
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Donghang Zheng
- Division of Cardiovascular Medicine, Department of Medicine, Gainesville, Florida, United States of America
| | - Alexandra R. Lucas
- Division of Cardiovascular Medicine, Department of Medicine, Gainesville, Florida, United States of America
- Department of Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Dratva J, Caviezel S, Schaffner E, Bettschart R, Kuenzli N, Schindler C, Schmidt-Trucksäss A, Stolz D, Zemp E, Probst-Hensch N. Infectious diseases are associated with carotid intima media thickness in adolescence. Atherosclerosis 2015; 243:609-15. [PMID: 26545015 DOI: 10.1016/j.atherosclerosis.2015.10.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/04/2015] [Accepted: 10/17/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Inflammatory risk factors in childhood, e.g. obesity, impact on carotid artery intima media thickness (CIMT), an early indicator of atherosclerosis. Little is known on potential infectious origins in childhood. We investigated the association between number of reported different childhood infectious diseases and CIMT in adolescence. STUDY DESIGN 288 SAPALDIA offspring (8-21years) underwent a clinical examination in 2010-2011: anthropometry, blood pressure, CIMT, blood draw (cardiovascular biomarkers, cotinine). Offspring and parents gave information on individuals' and family health, child's vaccination status, infectious diseases and other early life factors. Life-time prevalence of bronchitis, pneumonia, tonsillitis, otitis, mononucleosis, meningitis, appendicitis, and scarlet fever were investigated, separately, and as cumulative infectious disease score. Multilevel adjusted linear regression analysis on the association between subjects' CIMT average and infectious diseases score was performed, stratifying by sex. RESULTS Youth (mean age 14.8 yrs; 53% female) reported on average 1.3 of the listed infectious diseases; 22% boys and 15% girls reported ≥3 infectious diseases (p = 0.136). Two-thirds were vaccinated according to recommendations (boys 56%, girls 61.5%, p = 0.567). Sex-stratified analyses yielded significantly increased CIMT in boys with ≥3 infectious diseases vs. none (0.046 mm, 95%CI 0.024; 0.068). In girls, the effect was of same direction but statistically non-significant (0.011 mm, 95%CI -0.015; 0.036). CONCLUSION The SAPALDIA Youth study complements current evidence on infectious origins of atherosclerosis in adults. The larger effects observed in boys may relate to a higher vulnerability of the vasculature and/or to infectious pathogens. Our data are suggestive of an early impact of childhood infectious diseases on vascular health.
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Affiliation(s)
- Julia Dratva
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland.
| | - Seraina Caviezel
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland; Department for Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Robert Bettschart
- Lungenpraxis Hirslanden Klinik Aarau, Schanzweg 7, CH-5000 Aarau, Switzerland
| | - Nino Kuenzli
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department for Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland
| | - Daiana Stolz
- Universitätsspital, Pneumologie, Basel CH, Petersgraben 4, CH-4031 Basel, Switzerland
| | - Elisabeth Zemp
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland
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Presence of Periodontopathic Bacteria DNA in Atheromatous Plaques from Coronary and Carotid Arteries. BIOMED RESEARCH INTERNATIONAL 2015; 2015:825397. [PMID: 26504835 PMCID: PMC4609377 DOI: 10.1155/2015/825397] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/16/2015] [Accepted: 05/18/2015] [Indexed: 01/19/2023]
Abstract
Objectives. Interest in periodontitis as a potential risk factor for atherosclerosis and its complications resulted from the fact that the global prevalence of periodontal diseases is significant and periodontitis may induce a chronic inflammatory response. Many studies have analyzed the potential impact of the Porphyromonas gingivalis, major pathogen of periodontitis, on general health. The purpose of this study was to find the presence of the Porphyromonas gingivalis DNA in the atherosclerotic plaques of coronary and carotid arteries and in the periodontal pockets in patients with chronic periodontitis, who underwent surgery because of vascular diseases. Methods and Results. The study population consisted of 91 patients with coronary artery disease or scheduled for carotid endarterectomy. The presence of Porphyromonas gingivalis DNA in atheromatous plaques and in subgingival samples was determined by PCR. Bacterial DNA was found in 21 of 91 (23%) samples taken from vessels and in 47 of 63 (74.6%) samples from periodontal pockets. Conclusions. Porphyromonas gingivalis DNA is frequently found in atheromatous plaques of patients with periodontitis. That is why more research should be conducted to prove if this periopathogen may have an impact on endothelium of patients at risk of atherosclerosis.
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Papapanou PN. Systemic effects of periodontitis: lessons learned from research on atherosclerotic vascular disease and adverse pregnancy outcomes. Int Dent J 2015; 65:283-91. [PMID: 26388299 DOI: 10.1111/idj.12185] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Studies conducted over the past 25 years have focussed on the role of periodontitis, an inflammatory condition of microbial aetiology that destroys the tooth-supporting tissues, as a systemic inflammatory stressor that can act as an independent risk factor of atherosclerotic vascular disease (AVSD) and adverse pregnancy outcomes (APOs). It has been suggested that periodontitis-associated bacteraemias and systemic dissemination of inflammatory mediators produced in the periodontal tissues may result in systemic inflammation and endothelial dysfunction, and that bacteria of oral origin may translocate into the feto-placental unit. Epidemiological studies largely support an association between periodontitis and ASVD/APOs, independently of known confounders; indeed, periodontitis has been shown to confer statistically significantly elevated risk for clinical events associated with ASVD and APOs in multivariable adjustments. On the other hand, intervention studies demonstrate that although periodontal therapy reduces systemic inflammation and improves endothelial function, it has no positive effect on the incidence of APOs. Studies of the effects of periodontal interventions on ASVD-related clinical events are lacking. This review summarises key findings from mechanistic, association and intervention studies and attempts to reconcile the seemingly contradictory evidence that originates from different lines of investigation.
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Affiliation(s)
- Panos N Papapanou
- Section of Oral and Diagnostic Sciences, Division of Periodontics, Columbia University College of Dental Medicine, New York, NY, USA
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80
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Stallmann-Jorgensen I, Ogbi S, Szasz T, Webb RC. A Toll-Like Receptor 1/2 Agonist Augments Contractility in Rat Corpus Cavernosum. J Sex Med 2015; 12:1722-31. [PMID: 26234560 DOI: 10.1111/jsm.12960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Activation of the innate immune Toll-like receptor 2 (TLR2) initiates inflammation and has been implicated in vascular dysfunction. Increased contraction and decreased relaxation responses in the penile vasculature lead to erectile dysfunction, a condition associated with inflammation. However, whether TLR2 activation plays a role in penile vascular function has not been established. AIM We hypothesized that activation of the TLR 1/2 heterodimer (TLR1/2) augments contractile and impairs relaxation responses of corpus cavernosum and that these perturbations of vascular function are mediated by low nitric oxide (NO) availability and enhanced activity of the RhoA/Rho-kinase pathway. METHODS Contraction and relaxation responses were measured in rat cavernosal strips using a myograph after incubation with a TLR1/2-activating ligand Pam3 CSK4 (Pam3), the TLR1/2 inhibitor CuCPT 22 (CuCPT), and inhibitors of NO synthase (LNAME) and Rho-kinase (Y27632). TLR2 protein expression was assessed by immunohistochemistry. MAIN OUTCOME MEASURES Cumulative concentration response curves, sensitivity (pEC50), and maximal response (Emax ) of cavernosal strips to vasodilatory and vasocontractile agonists were compared between treatments. RESULTS Pam3-treated cavernosal strips exhibited greater pEC50 and higher Emax to phenylephrine (PE) than control tissues. Inhibition of NO synthase increased Emax to PE in Pam3-treated cavernosal strips. Pam3 treatment reduced relaxation to Y27632 compared with control tissues. Inhibition of TLR1/2 activation with CuCPT returned the augmented contraction to PE and the decreased relaxation to Y27632 of Pam3-treated cavernosal strips to control values. CONCLUSIONS The TLR1/2 heterodimer mediates augmented contraction and reduced relaxation in rat cavernosal strips. Thus, TLR1/2 activation antagonizes vascular responses crucial for normal erectile function and implicates immune activation in vasculogenic erectile dysfunction. Immune signaling via TLR2 may offer novel targets for treating inflammation-mediated vascular dysfunction in the penis.
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Affiliation(s)
| | - Safia Ogbi
- Department of Physiology, Georgia Regents University, Augusta, GA, USA
| | - Theodora Szasz
- Department of Physiology, Georgia Regents University, Augusta, GA, USA
| | - R Clinton Webb
- Department of Physiology, Georgia Regents University, Augusta, GA, USA
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81
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Rosiglitazone impedes Porphyromonas gingivalis-accelerated atherosclerosis by downregulating the TLR/NF-κB signaling pathway in atherosclerotic mice. Int Immunopharmacol 2015; 23:701-8. [PMID: 25445963 DOI: 10.1016/j.intimp.2014.10.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 10/22/2014] [Accepted: 10/22/2014] [Indexed: 11/20/2022]
Abstract
Porphyromonas gingivalis,a predominant periodontal pathogen, is known to accelerate atherosclerosis in hyperlipidemic animals via aberrant inflammatory responses. Peroxisome proliferator-activated receptor gamma (PPARγ) agonists have been reported to exert anti-inflammatory effects in vitro. The purpose of the present study was to investigate the potential protective role of the PPARγ agonist rosiglitazone in pathogen accelerated atherosclerosis in an apolipoprotein E-deficient (ApoE-/-) mouse model. ApoE-/- mice were inoculated intravenously with live P. gingivalis (strain 33277) or the buffer vehicle and treated with rosiglitazone or saline over a 10-week period. Their atherosclerotic status in aortic artery was assessed through histomorphometric analysis, inflammatory agent and lipid profiles in blood was determined by ELISA, and levels of relevant cytokines and Toll-like receptors (TLRs) in aortic tissues were evaluated using immunohistochemistry and quantitative PCR. P. gingivalis inoculation was associated with increased atherosclerotic plaque formation in the aorta and higher levels of serum pro-inflammatory cytokines (tumor necrosis factor-α, monocyte chemotactic protein-1 and interleukin-1β), but the serum lipid profile was not affected by P. gingivalis infection. Levels of tumor necrosis factor-α, monocyte chemotactic protein-1 intercellular cell adhesion molecule-1 and TLRs were higher in the aortic tissues of mice exposed to P. gingivalis, and activation of nuclear factor-κB was also observed. In both P. gingivalis-treated and -untreated ApoE-/- mice, rosiglitazone treatment was associated with less atherosclerotic plaque formation; lower serum inflammatory cytokines, total cholesterol, and low density lipoprotein cholesterol; higher levels of PPARγ, lower amounts of TLR2/4 and downregulated nuclear factor-κB activity in aortic tissues. These findings suggest that rosiglitazone mitigates or prevents P. gingivalis-accelerated atherosclerosis by inhibiting the inflammatory response via downregulation of the TLR/ nuclear factor-κB signaling pathway.
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82
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Campbell LA, Rosenfeld ME. Infection and Atherosclerosis Development. Arch Med Res 2015; 46:339-50. [PMID: 26004263 PMCID: PMC4524506 DOI: 10.1016/j.arcmed.2015.05.006] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 05/12/2015] [Indexed: 01/19/2023]
Abstract
Atherosclerosis is a chronic disease hallmarked by chronic inflammation, endothelial dysfunction and lipid accumulation in the vasculature. Although lipid modification and deposition are thought to be a major source of the continuous inflammatory stimulus, a large body of evidence suggests that infectious agents may contribute to atherosclerotic processes. This could occur by either direct effects through infection of vascular cells and/or through indirect effects by induction of cytokine and acute phase reactant proteins by infection at other sites. Multiple bacterial and viral pathogens have been associated with atherosclerosis by seroepidemiological studies, identification of the infectious agent in human atherosclerotic tissue, and experimental studies demonstrating an acceleration of atherosclerosis following infection in animal models of atherosclerosis. This review will focus on those infectious agents for which biological plausibility has been demonstrated in animal models and on the challenges of proving a role of infection in human atherosclerotic disease.
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Affiliation(s)
- Lee Ann Campbell
- Department of Epidemiology, School of Public Health, Seattle, Washington, USA.
| | - Michael E Rosenfeld
- Departments of Environmental, Health and Occupational Sciences and Pathology, University of Washington, Seattle, Washington, USA
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83
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Velsko IM, Chukkapalli SS, Rivera-Kweh MF, Chen H, Zheng D, Bhattacharyya I, Gangula PR, Lucas AR, Kesavalu L. Fusobacterium nucleatum Alters Atherosclerosis Risk Factors and Enhances Inflammatory Markers with an Atheroprotective Immune Response in ApoE(null) Mice. PLoS One 2015; 10:e0129795. [PMID: 26079509 PMCID: PMC4469693 DOI: 10.1371/journal.pone.0129795] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/13/2015] [Indexed: 12/20/2022] Open
Abstract
The American Heart Association supports an association between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) but does not as of yet support a causal relationship. Recently, we have shown that major periodontal pathogens Porphyromonas gingivalis and Treponema denticola are causally associated with acceleration of aortic atherosclerosis in ApoEnull hyperlipidemic mice. The aim of this study was to determine if oral infection with another significant periodontal pathogen Fusobacterium nucleatum can accelerate aortic inflammation and atherosclerosis in the aortic artery of ApoEnull mice. ApoEnull mice (n = 23) were orally infected with F. nucleatum ATCC 49256 and euthanized at 12 and 24 weeks. Periodontal disease assessments including F. nucleatum oral colonization, gingival inflammation, immune response, intrabony defects, and alveolar bone resorption were evaluated. Systemic organs were evaluated for infection, aortic sections were examined for atherosclerosis, and inflammatory markers were measured. Chronic oral infection established F. nucleatum colonization in the oral cavity, induced significant humoral IgG (P=0.0001) and IgM (P=0.001) antibody response (12 and 24 weeks), and resulted in significant (P=0.0001) alveolar bone resorption and intrabony defects. F. nucleatum genomic DNA was detected in systemic organs (heart, aorta, liver, kidney, lung) indicating bacteremia. Aortic atherosclerotic plaque area was measured and showed a local inflammatory infiltrate revealed the presence of F4/80+ macrophages and CD3+ T cells. Vascular inflammation was detected by enhanced systemic cytokines (CD30L, IL-4, IL-12), oxidized LDL and serum amyloid A, as well as altered serum lipid profile (cholesterol, triglycerides, chylomicrons, VLDL, LDL, HDL), in infected mice and altered aortic gene expression in infected mice. Despite evidence for systemic infection in several organs and modulation of known atherosclerosis risk factors, aortic atherosclerotic lesions were significantly reduced after F. nucleatum infection suggesting a potential protective function for this member of the oral microbiota.
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Affiliation(s)
- Irina M. Velsko
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Sasanka S. Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Mercedes. F. Rivera-Kweh
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Hao Chen
- Cardiovascular Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Donghang Zheng
- Cardiovascular Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Indraneel Bhattacharyya
- Oral Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Pandu R. Gangula
- Department of Oral Biology and Research, CWHR Meharry Medical College, Nashville, Tennessee, United States of America
- Department of Physiology, CWHR Meharry Medical College, Nashville, Tennessee, United States of America
| | - Alexandra R. Lucas
- Cardiovascular Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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84
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Huang N, Shaik-Dasthagirisaheb YB, LaValley MP, Gibson FC. Liver X receptors contribute to periodontal pathogen-elicited inflammation and oral bone loss. Mol Oral Microbiol 2015; 30:438-50. [PMID: 25946408 DOI: 10.1111/omi.12103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 12/29/2022]
Abstract
Periodontal diseases are chronic oral inflammatory diseases that are polymicrobial in nature. The presence of specific bacteria in subgingival plaque such as Porphyromonas gingivalis is associated with microbial dysbiosis and the modulation of host immune response. Bacterially elicited innate immune activation and inflammation are key elements implicated in the destruction of soft and hard tissues supporting the teeth. Liver X receptors (LXRs) are nuclear hormone receptors with important function in lipid homeostasis, inflammation, and host response to infection; however, their contribution to chronic inflammatory diseases such as periodontal disease is not understood. The aim of this study was to define the contribution of LXRs in the development of immune response to P. gingivalis and to assess the roles that LXRs play in infection-elicited oral bone loss. Employing macrophages, we observed that P. gingivalis challenge led to reduced LXRα and LXRβ gene expression compared with that observed with unchallenged wild-type cells. Myeloid differentiation primary response gene 88 (MyD88)-independent, Toll/interleukin-1 receptor-domain-containing adapter-inducing interferon-β (TRIF)-dependent signaling affected P. gingivalis-mediated reduction in LXRα expression, whereas neither pathway influenced the P. gingivalis effect on LXRβ expression. Employing LXR agonist and mice deficient in LXRs, we observed functional effects of LXRs in the development of a P. gingivalis-elicited cytokine response at the level of the macrophage, and participation of LXRs in P. gingivalis-elicited oral bone loss. These findings identify novel importance for LXRs in the pathogenesis of P. gingivalis infection-elicited inflammation and oral bone loss.
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Affiliation(s)
- N Huang
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Y B Shaik-Dasthagirisaheb
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - M P LaValley
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - F C Gibson
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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85
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Aarabi G, Eberhard J, Reissmann DR, Heydecke G, Seedorf U. Interaction between periodontal disease and atherosclerotic vascular disease--Fact or fiction? Atherosclerosis 2015; 241:555-60. [PMID: 26100678 DOI: 10.1016/j.atherosclerosis.2015.04.819] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/22/2015] [Accepted: 04/30/2015] [Indexed: 12/23/2022]
Abstract
C-reactive protein (CRP) level is associated with the 10-year risk of an atherosclerotic vascular disease (ASVD), suggesting presence of systemic inflammation probably long before ASVD is present. Where, however, does this systemic inflammation come from? One active area of research has been the study of dental infection and various forms of periodontal disease (PD), both of which are highly prevalent in populations at risk for ASVD. Recent data show that ASVD and PD interact with each other via systemic release of specific pro- and anti-inflammatory cytokines, small signal molecules and enzymes which modulate initiation and progression of the chronic inflammatory reaction involved in both diseases. In addition, periodontal pathogens were identified within atherosclerotic lesions and thrombi isolated from myocardial infarction patients. LDL cholesterol, a strong risk factor for ASVD, is also associated with PD; and statins, used to treat ASVD, are also active to prevent or reduce PD. Finally, there is growing evidence for common genetic susceptibility factors involved in both diseases. These findings support commonalities with respect to the pathogenic mechanisms involved in both inflammatory diseases. Conversely, a causative relationship cannot yet be concluded in the absence of data from large longitudinal cohort and randomized controlled intervention trials.
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Affiliation(s)
- Ghazal Aarabi
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Jörg Eberhard
- Periimplant and Oral Infections, Department of Prosthetic Dentistry and Biomaterial Sciences, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Udo Seedorf
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
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CD36/SR-B2-TLR2 Dependent Pathways Enhance Porphyromonas gingivalis Mediated Atherosclerosis in the Ldlr KO Mouse Model. PLoS One 2015; 10:e0125126. [PMID: 25938460 PMCID: PMC4418723 DOI: 10.1371/journal.pone.0125126] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 02/25/2015] [Indexed: 12/11/2022] Open
Abstract
There is strong epidemiological association between periodontal disease and cardiovascular disease but underlying mechanisms remain ill-defined. Because the human periodontal disease pathogen, Porphyromonas gingivalis (Pg), interacts with innate immune receptors Toll-like Receptor (TLR) 2 and CD36/scavenger receptor-B2 (SR-B2), we studied how CD36/SR-B2 and TLR pathways promote Pg-mediated atherosclerosis. Western diet fed low density lipoprotein receptor knockout (Ldlr°) mice infected orally with Pg had a significant increase in lesion burden compared with uninfected controls. This increase was entirely CD36/SR-B2-dependent, as there was no significant change in lesion burden between infected and uninfected Ldlr° mice. Western diet feeding promoted enhanced CD36/SR-B2-dependent IL1β generation and foam cell formation as a result of Pg lipopolysaccharide (PgLPS) exposure. CD36/SR-B2 and TLR2 were necessary for inflammasome activation and optimal IL1ß generation, but also resulted in LPS induced lethality (pyroptosis). Modified forms of LDL inhibited Pg-mediated IL1ß generation in a CD36/SR-B2-dependent manner and prevented pyroptosis, but promoted foam cell formation. Our data show that Pg infection in the oral cavity can lead to significant TLR2-CD36/SR-B2 dependent IL1ß release. In the vessel wall, macrophages encountering systemic release of IL1ß, PgLPS and modified LDL have increased lipid uptake, foam cell formation, and release of IL1ß, but because pyroptosis is inhibited, this enables macrophage survival and promotes increased plaque development. These studies may explain increased lesion burden as a result of periodontal disease, and suggest strategies for development of therapeutics.
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87
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Lee SJ, Seo KW, Kim CD. LPS Increases 5-LO Expression on Monocytes via an Activation of Akt-Sp1/NF-κB Pathways. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2015; 19:263-8. [PMID: 25954132 PMCID: PMC4422967 DOI: 10.4196/kjpp.2015.19.3.263] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/26/2015] [Accepted: 03/21/2015] [Indexed: 01/01/2023]
Abstract
5-Lipoxygenase (5-LO) plays a pivotal role in the progression of atherosclerosis. Therefore, this study investigated the molecular mechanisms involved in 5-LO expression on monocytes induced by LPS. Stimulation of THP-1 monocytes with LPS (0~3 µg/ml) increased 5-LO promoter activity and 5-LO protein expression in a concentration-dependent manner. LPS-induced 5-LO expression was blocked by pharmacological inhibition of the Akt pathway, but not by inhibitors of MAPK pathways including the ERK, JNK, and p38 MAPK pathways. In line with these results, LPS increased the phosphorylation of Akt, suggesting a role for the Akt pathway in LPS-induced 5-LO expression. In a promoter activity assay conducted to identify transcription factors, both Sp1 and NF-κB were found to play central roles in 5-LO expression in LPS-treated monocytes. The LPS-enhanced activities of Sp1 and NF-κB were attenuated by an Akt inhibitor. Moreover, the LPS-enhanced phosphorylation of Akt was significantly attenuated in cells pretreated with an anti-TLR4 antibody. Taken together, 5-LO expression in LPS-stimulated monocytes is regulated at the transcriptional level via TLR4/Akt-mediated activations of Sp1 and NF-κB pathways in monocytes.
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Affiliation(s)
- Seung Jin Lee
- Department of Pharmacology and BK21 Medical Science Education Center, School of Medicine, Pusan National University, Yangsan 626-870, Korea
| | - Kyo Won Seo
- Department of Pharmacology and BK21 Medical Science Education Center, School of Medicine, Pusan National University, Yangsan 626-870, Korea
| | - Chi Dae Kim
- Department of Pharmacology and BK21 Medical Science Education Center, School of Medicine, Pusan National University, Yangsan 626-870, Korea
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Deficiency of cathepsin K prevents inflammation and bone erosion in rheumatoid arthritis and periodontitis and reveals its shared osteoimmune role. FEBS Lett 2015; 589:1331-1339. [PMID: 25896020 DOI: 10.1016/j.febslet.2015.04.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/06/2015] [Accepted: 04/08/2015] [Indexed: 12/22/2022]
Abstract
Using rheumatoid arthritis (RA) and periodontitis mouse models, we demonstrate that RA and periodontitis share many pathological features, such as deregulated cytokine production, increased immune-cell infiltration, increased expression of Toll-like receptors (TLRs), and enhanced osteoclast activity and bone erosion. We reveal that genetic deletion of cathepsin K (Ctsk) caused a radical reduction in inflammation and bone erosion within RA joint capsules and periodontal lesions, a drastic decrease in immune-cell infiltration, and a significant reduction in osteoclasts, macrophages, dendritic and T-cells. Deficiency of Ctsk greatly decreased the expression of TLR-4, 5, and 9 and their downstream cytokines in periodontal gingival epithelial lesions and synovial RA lesions. Hence, Ctsk may be targeted to treat RA and periodontitis simultaneously due to its shared osteoimmune role.
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Hao L, Chen J, Zhu Z, Reddy MS, Mountz JD, Chen W, Li YP. Odanacatib, A Cathepsin K-Specific Inhibitor, Inhibits Inflammation and Bone Loss Caused by Periodontal Diseases. J Periodontol 2015; 86:972-83. [PMID: 25879791 DOI: 10.1902/jop.2015.140643] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Periodontitis is a bacteria-induced inflammatory disease mainly affecting periodontal tissues, leading to periodontal inflammation, bone breakdown, and loss of the tooth. The main obstacle for treating periodontitis effectively is the difficulty in finding a target that can inhibit bone loss and inflammation simultaneously. Recent studies showed that cathepsin K (CTSK) might have functions in the immune system besides its role in osteoclasts. Thus, targeting CTSK would have a potential therapeutic effect in both the bone system and the immune system during the progression of periodontitis. METHODS In the current study, a small molecular inhibitor (odanacatib [ODN]) is explored to inhibit the function of CTSK in a bacteria-induced periodontitis mouse model. RESULTS The application of ODN decreased the number of osteoclasts, macrophages, and T cells, as well as the expression of Toll-like receptors (TLRs) in the periodontitis lesion area. Furthermore, lack of CTSK inhibited the expression of TLR4, TLR5, and TLR9 and their downstream cytokine signaling in the gingival epithelial cells in periodontitis lesions, demonstrating that the innate immune response was inhibited in periodontitis. CONCLUSION The present results show that inhibition of CTSK can prevent bone loss and the immune response during the progression of periodontitis, indicating that CTSK is a promising target for treating inflammatory diseases such as periodontitis by affecting both osteoclasts and the immune system.
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Affiliation(s)
- Liang Hao
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Jianwei Chen
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Zheng Zhu
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Michael S Reddy
- Department of Periodontology, University of Alabama at Birmingham School of Dentistry, Birmingham, AL
| | - John D Mountz
- Department of Medicine, University of Alabama at Birmingham
| | - Wei Chen
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL.,Department of Periodontology, University of Alabama at Birmingham School of Dentistry, Birmingham, AL
| | - Yi-Ping Li
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL.,Department of Periodontology, University of Alabama at Birmingham School of Dentistry, Birmingham, AL
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90
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Zhang X, Tang Q, Xu L. Herpes simplex virus 2 infects human endothelial ECV304 cells and induces cell apoptosis synergistically with ox-LDL. J Toxicol Sci 2015; 39:909-17. [PMID: 25421969 DOI: 10.2131/jts.39.909] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Virus infection has been shown to accelerate atherosclerosis. Serological studies indicate a link between the Herpes simplex virus (HSV) infection and atherosclerosis, which is initiated and progression of which is promoted by such factors as oxidized low-density lipoprotein (ox-LDL)-induced endothelial dysfunction. In order to recognize the direct role of HSV-2 in endothelial dysfunction, the present study investigated the infection of HSV-2 in endothelial ECV304 cells and the induction of cell apoptosis in the presence of ox-LDL. We firstly examined the HSV-2 infection by immunohistochemical assay for viral gB protein, quantitative PCR for viral ICP4 mRNA, or via virus growth determination. Then we investigated the regulation of HSV-2 infection on the cell viability and apoptosis, in the absence or presence of ox-LDL. In addition, we analyzed the apoptosis-associated molecules in the HSV-2-infected ECV304 cells. The results demonstrated that HSV-2 infected endothelial ECV304 cells and replicated efficiently, and the virus infection significantly reduced the cell viability and significantly induced cell apoptosis; particularly, cell viability reduction and cell apoptosis induction were aggravated by the ox-LDL presence. Moreover, the western blot assay confirmed the apoptosis induction; there was a significantly high level of released cytochrome c, activated caspase 3 and lyzed Poly (ADP-ribose) polymerase (PARP) by the activated caspase 3 in the HSV-2-infected ECV304 cells, particularly the cells subject to ox-LDL. Thus, we confirmed that HSV-2 infected endothelial ECV304 cells, induced cell apoptosis, which was aggravated by ox-LDL.
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Affiliation(s)
- Xiaoyun Zhang
- Health wards, The Affiliated Hospital of Inner Mongolia Medical University
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91
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Suo J, Zhao L, Wang J, Zhu Z, Zhang H, Gao R. Influenza virus aggravates the ox-LDL-induced apoptosis of human endothelial cells via promoting p53 signaling. J Med Virol 2015; 87:1113-23. [PMID: 25777161 DOI: 10.1002/jmv.24166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2015] [Indexed: 12/13/2022]
Abstract
Oxidized low-density lipoprotein (ox-LDL) is well recognized to play a key role in the development of atherosclerosis. And influenza virus infection has been also recognized to promote the atherosclerosis onset and progressing. However, little is known about the mechanism into it. In present study, we investigated the infection of A/Porto Rico/8/1934 (H1N1) (PR8) influenza virus in human endothelial Eahy926 cells, and determined the induction of apoptosis by the virus infection in the cell. Then we investigated the apoptosis induced by ox-LDL in Eahy926 cells, determined the influence of influenza virus infection on the ox-LDL-induced apoptosis in Eahy926 cells. Results demonstrated that PR8 virus infected human endothelial Eahy926 cells, forming plaques and replicated efficiently in the cell. And the virus infection promoted apoptosis in the cell, upregulated cytchrome c release, activated caspase 3. And what's more, we found that combined PR8 virus infection and ox-LDL treatment promoted higher level of apoptosis and higher level of the activation of apoptosis-associated molecules. Further examination indicated that the p53 signaling was more significantly promoted by both treatments. Therefore, present study confirmed that influenza virus aggravated the ox-LDL-induced apoptosis of human endothelial Eahy926 cells via promoting p53 signaling.
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Affiliation(s)
- Jing Suo
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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92
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Chukkapalli SS, Rivera-Kweh MF, Velsko IM, Chen H, Zheng D, Bhattacharyya I, Gangula PR, Lucas AR, Kesavalu L. Chronic oral infection with major periodontal bacteria Tannerella forsythia modulates systemic atherosclerosis risk factors and inflammatory markers. Pathog Dis 2015; 73:ftv009. [PMID: 25663343 DOI: 10.1093/femspd/ftv009] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Tannerella forsythia is a Gram-negative anaerobic organism that inhabits the subgingival cavity and initiates connective tissue destruction and alveolar bone resorption in periodontal disease (PD). PD is a chronic immunoinflammatory disease and has been linked to several systemic diseases including atherosclerosis. This study evaluated the effects of a chronic oral infection with T. forsythia ATCC 43037 on the induction of PD, inflammatory markers and atherosclerosis risk factors in hyperlipidemic ApoE(null) mice. Mice were orally infected for 12 and 24 weeks prior to euthanasia. Bacterial colonization of the oral cavity and bacteremia was confirmed via isolation of genomic DNA from oral plaque and tissues. Oral infection elicited significantly elevated levels of serum IgG and IgM antibodies and alveolar bone resorption compared to control mice. Tannerella forsythia-infected mice had increased serum amyloid A, and significantly reduced serum nitric oxide when compared to controls. Tannerella forsythia chronic infection also significantly increased serum lipoproteins suggesting altered cholesterol metabolism and potential for aortic inflammation. Despite enhanced acute phase reactants and altered lipid profiles, T. forsythia infection was associated with decreased aortic plaque. This study investigates the potential of a known periodontal bacterial pathogen found in atherosclerotic plaque in humans to accelerate atherosclerosis in hyperlipdemic mice.
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Affiliation(s)
- Sasanka S Chukkapalli
- Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | | | - Irina M Velsko
- Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Hao Chen
- Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Donghang Zheng
- Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Indraneel Bhattacharyya
- Oral Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Pandu R Gangula
- Department of Physiology, Department of Oral Biology and Research, School of Medicine and School of Dentistry, CWHR Nashville, TN 37208, USA
| | - Alexandra R Lucas
- Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Lakshmyya Kesavalu
- Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA Dept. of Periodontology and Oral Biology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
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93
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Noble JM, Scarmeas N, Celenti RS, Elkind MSV, Wright CB, Schupf N, Papapanou PN. Serum IgG antibody levels to periodontal microbiota are associated with incident Alzheimer disease. PLoS One 2014; 9:e114959. [PMID: 25522313 PMCID: PMC4270775 DOI: 10.1371/journal.pone.0114959] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/07/2014] [Indexed: 02/07/2023] Open
Abstract
Background Periodontitis and Alzheimer disease (AD) are associated with systemic inflammation. This research studied serum IgG to periodontal microbiota as possible predictors of incident AD. Methods Using a case-cohort study design, 219 subjects (110 incident AD cases and 109 controls without incident cognitive impairment at last follow-up), matched on race-ethnicity, were drawn from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a cohort of longitudinally followed northern Manhattan residents aged >65 years. Mean follow-up was five years (SD 2.6). In baseline sera, serum IgG levels were determined for bacteria known to be positively or negatively associated with periodontitis (Porphyromonas gingivalis, Tannerella forsythia, Actinobacillus actinomycetemcomitans Y4, Treponema denticola, Campylobacter rectus, Eubacterium nodatum, and Actinomyces naeslundii genospecies-2). In all analyses, we used antibody threshold levels shown to correlate with presence of moderate-severe periodontitis. Results Mean age was 72 years (SD 6.9) for controls, and 79 years (SD 4.6) for cases (p<0.001). Non-Hispanic Whites comprised 26%, non-Hispanic Blacks 27%, and Hispanics 48% of the sample. In a model adjusting for baseline age, sex, education, diabetes mellitus, hypertension, smoking, prior history of stroke, and apolipoprotein E genotype, high anti-A. naeslundii titer (>640 ng/ml, present in 10% of subjects) was associated with increased risk of AD (HR = 2.0, 95%CI: 1.1–3.8). This association was stronger after adjusting for other significant titers (HR = 3.1, 95%CI: 1.5–6.4). In this model, high anti-E. nodatum IgG (>1755 ng/ml; 19% of subjects) was associated with lower risk of AD (HR = 0.5, 95%CI: 0.2–0.9). Conclusions Serum IgG levels to common periodontal microbiota are associated with risk for developing incident AD.
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Affiliation(s)
- James M. Noble
- Taub Institute for Alzheimer Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Nikolaos Scarmeas
- Taub Institute for Alzheimer Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
- Department of Social Medicine, Psychiatry, and Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Romanita S. Celenti
- Division of Periodontics, Section of Oral and Diagnostic Sciences, Columbia University College of Dental Medicine, New York, New York, United States of America
| | - Mitchell S. V. Elkind
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Clinton B. Wright
- Evelyn F. McKnight Brain Institute, Departments of Neurology and Epidemiology & Public Health Sciences, and the Neuroscience Program, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Nicole Schupf
- Taub Institute for Alzheimer Disease and the Aging Brain, Columbia University, New York, New York, United States of America
| | - Panos N. Papapanou
- Division of Periodontics, Section of Oral and Diagnostic Sciences, Columbia University College of Dental Medicine, New York, New York, United States of America
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94
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Ndip A, Wilkinson FL, Jude EB, Boulton AJM, Alexander MY. RANKL-OPG and RAGE modulation in vascular calcification and diabetes: novel targets for therapy. Diabetologia 2014; 57:2251-60. [PMID: 25112376 DOI: 10.1007/s00125-014-3348-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/17/2014] [Indexed: 12/18/2022]
Abstract
Type 2 diabetes is associated with increased cardiovascular morbidity and mortality and early vascular ageing. This takes the form of atherosclerosis, with progressive vascular calcification being a major complication in the pathogenesis of this disease. Current research and drug targets in diabetes have hitherto focused on atherosclerosis, but vascular calcification is now recognised as an independent predictor of cardiovascular morbidity and mortality. An emerging regulatory pathway for vascular calcification in diabetes involves the receptor activator for nuclear factor κB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG). Important novel biomarkers of calcification are related to levels of glycation and inflammation in diabetes. Several therapeutic strategies could have advantageous effects on the vasculature in patients with diabetes, including targeting the RANKL and receptor for AGE (RAGE) signalling pathways, since there has been little success-at least in macrovascular outcomes-with conventional glucose-lowering therapy. There is substantial and relevant clinical and basic science evidence to suggest that modulating RANKL-RANK-OPG signalling, RAGE signalling and the associated proinflammatory milieu alters the natural course of cardiovascular complications and outcomes in people with diabetes. However, further research is critically needed to understand the precise mechanisms underpinning these pathways, in order to translate the anti-calcification strategies into patient benefit.
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Affiliation(s)
- Agbor Ndip
- Department of Medicine and Diabetes, Manchester Royal Infirmary, Manchester, UK,
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95
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Gurav AN. The implication of periodontitis in vascular endothelial dysfunction. Eur J Clin Invest 2014; 44:1000-9. [PMID: 25104241 DOI: 10.1111/eci.12322] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 08/04/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Periodontitis is the most common oral infection seen in humans worldwide. It is characterized by gradual destruction of tooth supporting tissues, eventually leading to loss of tooth. The periodontal biofilm associated with periodontitis comprises of gram-positive and gram-negative bacteria, instrumental for the initiation and progression of periodontitis. Evidence-based literature has identified the nature of periodontal infection as a possible causative condition in the inducement of 'low-grade systemic inflammation and infection'. The periodontal pathogens exert systemic effects via the haematogenous route. AIM The present review provides an insight into the pathophysiology of the endothelial dysfunction with reference to periodontal infection and highlights the association between periodontitis and endothelial dysfunction. Various studies addressing the implication of periodontitis on endothelial dysfunction will be described, with a focus of periodontal treatment on improvement of endothelial function. MATERIALS AND METHODS Studies examining the effects of periodontitis on vascular endothelial function were segregated. Studies conducted on both animal and human models were identified using MEDLINE database search with key search terms such as 'Periodontitis', 'vascular endothelium', 'endothelial dysfunction', 'periodontal bacteria' and 'periodontal therapy'. Systematic reviews and meta-analysis were also screened. Only studies published in English language were considered. The review has been prepared by screening MEDLINE database from 1989 to 2012. RESULTS AND CONCLUSIONS Chronic periodontitis results in altered vascular response, increased expression of pro-inflammatory cytokines and adhesion molecules inducing vascular endothelial dysfunction. Periodontal therapy may ameliorate the perturbed vascular endothelial function.
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Affiliation(s)
- Abhijit N Gurav
- Department of Periodontics, Tatyasaheb Kore Dental College & Research Centre, Kolhapur, India
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96
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Turunen SP, Kummu O, Wang C, Harila K, Mattila R, Sahlman M, Pussinen PJ, Hörkkö S. Immunization with malondialdehyde-modified low-density lipoprotein (LDL) reduces atherosclerosis in LDL receptor-deficient mice challenged with Porphyromonas gingivalis. Innate Immun 2014; 21:370-85. [PMID: 25134521 DOI: 10.1177/1753425914542444] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 06/06/2014] [Indexed: 01/31/2023] Open
Abstract
Periodontal infections increase the risk of atherosclerotic vascular disease via partly unresolved mechanisms. Of the natural IgM Abs that recognize molecular mimicry on bacterial epitopes and modified lipid and protein structures, IgM directed against oxidized low-density lipoprotein (LDL) is associated with atheroprotective properties. Here, the effect of natural immune responses to malondialdehyde-modified LDL (MDA-LDL) in conferring protection against atherosclerosis, which was accelerated by the major periodontopathogen Porphyromonas gingivalis, was investigated. LDL receptor-deficient (LDLR(-/-)) mice were immunized with mouse MDA-LDL without adjuvant before topical application challenge with live P. gingivalis. Atherosclerosis was analyzed after a high-fat diet, and plasma IgG and IgM Ab levels were measured throughout the study, and the secretion of IL-5, IL-10 and IFN-γ in splenocytes stimulated with MDA-LDL was determined. LDLR(-/-) mice immunized with MDA-LDL had elevated IgM and IgG levels to MDA-LDL compared with saline-treated controls. MDA-LDL immunization diminished aortic lipid depositions after challenge with P. gingivalis compared with mice receiving only P. gingivalis challenge. Immunization of LDLR(-/-) mice with homologous MDA-LDL stimulated the production of IL-5, implicating general activation of B-1 cells. Immune responses to MDA-LDL protected from the P. gingivalis-accelerated atherosclerosis. Thus, the linkage between bacterial infectious burden and atherogenesis is suggested to be modulated via natural IgM directed against cross-reactive epitopes on bacteria and modified LDL.
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Affiliation(s)
- S Pauliina Turunen
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Finland and Medical Research Center Oulu, Oulu, Finland NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Outi Kummu
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Finland and Medical Research Center Oulu, Oulu, Finland NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Chunguang Wang
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Finland and Medical Research Center Oulu, Oulu, Finland
| | - Kirsi Harila
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Finland and Medical Research Center Oulu, Oulu, Finland
| | - Riikka Mattila
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Finland and Medical Research Center Oulu, Oulu, Finland
| | - Marjo Sahlman
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Finland and Medical Research Center Oulu, Oulu, Finland
| | | | - Sohvi Hörkkö
- Department of Medical Microbiology and Immunology, Institute of Diagnostics, University of Oulu, Finland and Medical Research Center Oulu, Oulu, Finland NordLab Oulu, Oulu University Hospital, Oulu, Finland
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97
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Tabeta K, Yoshie H, Yamazaki K. Current evidence and biological plausibility linking periodontitis to atherosclerotic cardiovascular disease. JAPANESE DENTAL SCIENCE REVIEW 2014. [DOI: 10.1016/j.jdsr.2014.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Azevedo A, Prado AF, Antonio RC, Issa JP, Gerlach RF. Matrix metalloproteinases are involved in cardiovascular diseases. Basic Clin Pharmacol Toxicol 2014; 115:301-14. [PMID: 24974977 DOI: 10.1111/bcpt.12282] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 06/26/2014] [Indexed: 12/18/2022]
Abstract
This MiniReview describes the essential biochemical and molecular aspects of matrix metalloproteinases (MMPs) and briefly discusses how they engage in different diseases, with particular emphasis on cardiovascular diseases. There is compelling scientific evidence that many MMPs, especially MMP-2, play important roles in the development of cardiovascular diseases; inhibition of these enzymes is beneficial to many cardiovascular conditions, sometimes precluding or postponing end-organ damage and fatal outcomes. Conducting comprehensive discussions and further studies on how MMPs participate in cardiovascular diseases is important, because inhibition of these enzymes may be an alternative or an adjuvant for current cardiovascular disease therapy.
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Affiliation(s)
- Aline Azevedo
- Department of Pharmacology, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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Miyajima SI, Naruse K, Kobayashi Y, Nakamura N, Nishikawa T, Adachi K, Suzuki Y, Kikuchi T, Mitani A, Mizutani M, Ohno N, Noguchi T, Matsubara T. Periodontitis-activated monocytes/macrophages cause aortic inflammation. Sci Rep 2014; 4:5171. [PMID: 24893991 PMCID: PMC4044620 DOI: 10.1038/srep05171] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/15/2014] [Indexed: 01/20/2023] Open
Abstract
A relationship between periodontal disease and atherosclerosis has been suggested by epidemiological studies. Ligature-induced experimental periodontitis is an adequate model for clinical periodontitis, which starts from plaque accumulation, followed by inflammation in the periodontal tissue. Here we have demonstrated using a ligature-induced periodontitis model that periodontitis activates monocytes/macrophages, which subsequently circulate in the blood and adhere to vascular endothelial cells without altering the serum TNF-α concentration. Adherent monocytes/macrophages induced NF-κB activation and VCAM-1 expression in the endothelium and increased the expression of the TNF-α signaling cascade in the aorta. Peripheral blood-derived mononuclear cells from rats with experimental periodontitis showed enhanced adhesion and increased NF-κB/VCAM-1 in cultured vascular endothelial cells. Our results suggest that periodontitis triggers the initial pathogenesis of atherosclerosis, inflammation of the vasculature, through activating monocytes/macrophages.
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Affiliation(s)
- Shin-ichi Miyajima
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Keiko Naruse
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Yasuko Kobayashi
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Nobuhisa Nakamura
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Toru Nishikawa
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Kei Adachi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Yuki Suzuki
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Takeshi Kikuchi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Akio Mitani
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Makoto Mizutani
- Department of Oral Anatomy, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya, Aichi, 464-8650, Japan
| | - Norikazu Ohno
- Department of Oral Anatomy, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya, Aichi, 464-8650, Japan
| | - Toshihide Noguchi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
| | - Tatsuaki Matsubara
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi, 464-8651, Japan
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100
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Periodontal pathogens and atherosclerosis: implications of inflammation and oxidative modification of LDL. BIOMED RESEARCH INTERNATIONAL 2014; 2014:595981. [PMID: 24949459 PMCID: PMC4052162 DOI: 10.1155/2014/595981] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/07/2014] [Accepted: 04/28/2014] [Indexed: 12/29/2022]
Abstract
Inflammation is well accepted to play a crucial role in the development of atherosclerotic lesions, and recent studies have demonstrated an association between periodontal disease and cardiovascular disease. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, causative agents of destructive chronic inflammation in the periodontium, can accelerate atheroma deposition in animal models. Emerging evidence suggests that vaccination against virulence factors of these pathogens and anti-inflammatory therapy may confer disease resistance. In this review, we focus on the role of inflammatory mechanisms and oxidative modification in the formation and activation of atherosclerotic plaques accelerated by P. gingivalis or A. actinomycetemcomitans in an ApoE-deficient mouse model and high-fat-diet-fed mice. Furthermore, we examine whether mucosal vaccination with a periodontal pathogen or the anti-inflammatory activity of catechins can reduce periodontal pathogen-accelerated atherosclerosis.
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