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Lee SY. Association between gingivitis, tooth loss and cardiovascular risk: Insights from a 10-year nationwide cohort study of 3.7 million Koreans. PLoS One 2024; 19:e0308250. [PMID: 39093905 PMCID: PMC11296644 DOI: 10.1371/journal.pone.0308250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 07/20/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND While studies have suggested an association between periodontal disease and an increased risk of cardiovascular disease, the strength of this association and its specific links to various types of cardiovascular disease have not been thoroughly investigated. This study aimed to examine how gingivitis and tooth loss affect cardiovascular diseases, probing their individual impacts. METHODS A retrospective cohort study was conducted, encompassing 3,779,490 individuals with no history of cardiovascular disease, utilizing data from the National Health Examination and the Korean National Health Insurance database from 2006 to 2019. Cox proportional hazards models were applied to estimate the association between tooth loss, gingivitis, and cardiovascular disease. RESULTS Following a median follow-up of 10.38 years, 17,942 new cardiovascular disease cases were identified, comprising 10,224 cases of angina pectoris, 6,182 cases of acute myocardial infarction, and 9,536 cases of stroke. It was observed that the risk of stroke was significantly higher in the tooth loss group compared to the control group (adjusted hazard ratio [aHR]: 1.09, 95% confidence interval [CI]: 1.04-1.15). In the group with gingivitis and tooth loss, the risk of stroke and cardiovascular disease was significantly higher than in the control group (aHR: 1.12, 95% CI: 1.04-1.20; aHR: 1.08, 95% CI: 1.03-1.14). The gingivitis group exhibited a higher risk associated with stroke (aHR: 1.05, 95% CI: 1.01-1.10) among individuals aged 50 and above. However, statistically significant associations between periodontal disease and angina pectoris were not observed, nor between periodontal disease and acute myocardial infarction except among those aged above 50. Furthermore, the association between periodontal disease and cardiovascular disease was found to be stronger among individuals over the age of 50, males, those with obesity, and smokers compared to the control group. CONCLUSIONS Our results emphasize the association of tooth loss and gingivitis with cardiovascular disease, specifically stroke, underlining the critical need for preventive oral healthcare. Tailored interventions are necessary to reduce the heightened risk of cardiovascular disease events, especially stroke, among older, obese individuals and smokers.
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Affiliation(s)
- Seung Yeon Lee
- Seoul National University Hospital, Seoul, Republic of Korea
- Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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2
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He Y, Liu C, Zheng Z, Gao R, Lin H, Zhou H. Identification and validation of new fatty acid metabolism-related mechanisms and biomarkers for erectile dysfunction. Sex Med 2024; 12:qfae011. [PMID: 38529412 PMCID: PMC10960936 DOI: 10.1093/sexmed/qfae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 03/27/2024] Open
Abstract
Background Erectile dysfunction (ED) is a common condition affecting middle-aged and elderly men. Aim The study sought to investigate differentially expressed fatty acid metabolism-related genes and the molecular mechanisms of ED. Methods The expression profiles of GSE2457 and GSE31247 were downloaded from the Gene Expression Omnibus database and merged. Differentially expressed genes (DEGs) between ED and normal samples were obtained using the R package limma. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses of DEGs were conducted using the R package clusterProfiler. Fatty acid metabolism-related DEGs (FAMDEGs) were further identified and analyzed. Machine learning algorithms, including Lasso (least absolute shrinkage and selection operator), support vector machine, and random forest algorithms, were utilized to identify hub FAMDEGs with the ability to predict ED occurrence. Coexpression analysis and gene set enrichment analysis of hub FAMDEGs were performed. Outcome Fatty acid metabolism-related functions (such as fatty acid metabolism and degradation) may play a vital role in ED. Results In total, 5 hub FAMDEGs (Aldh2, Eci2, Acat1, Acadl, and Hadha) were identified and found to be differentially expressed between ED and normal samples. Gene set enrichment analysis identified key pathways associated with these genes. The area under the curve values of the 5 hub FAMDEGs for predicting ED occurrence were all >0.8. Clinical Translation Our results suggest that these 5 key FAMDEGs may serve as biomarkers for the diagnosis and treatment of ED. Strengths and Limitations The strengths of our study include the use of multiple datasets and machine learning algorithms to identify key FAMDEGs. However, limitations include the lack of validation in animal models and human tissues, as well as research on the mechanisms of these FAMDEGs. Conclusion Five hub FAMDEGs were identified as potential biomarkers for ED progression. Our work may prove that fatty acid metabolism-related genes are worth further investigation in ED.
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Affiliation(s)
- Yanfeng He
- Department of Urology, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Department of Urology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Andrology and Sexual Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Changyi Liu
- Department of Urology, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Department of Urology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Zhongjie Zheng
- Department of Urology, Peking University Third Hospital, Peking University, Beijing 100191, China
| | - Rui Gao
- Department of Urology, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Department of Urology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Peking University, Beijing 100191, China
| | - Huiliang Zhou
- Department of Andrology and Sexual Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
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Barbosa De Accioly Mattos M, Bernardo Peixoto C, Geraldo de Castro Amino J, Cortes L, Tura B, Nunn M, Giambiagi-deMarval M, Sansone C. Coronary atherosclerosis and periodontitis have similarities in their clinical presentation. FRONTIERS IN ORAL HEALTH 2024; 4:1324528. [PMID: 38292927 PMCID: PMC10825671 DOI: 10.3389/froh.2023.1324528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background Periodontitis (PE) and coronary heart disease (CHD) possess multiple mechanisms for a putative association. This case-control study compared the periodontal status among CHD subjects to controls without CHD, while also investigating atheroma invasion by known periodontal pathogens. Methods 161 subjects participated in this study were divided into three CHD groups: No CHD, chronic CHD, acute CHD. Additional analysis involved grouping subjects according to number of atheromas: no atheroma, 1-4 atheromas, 5-18 atheromas. Data were collected from medical records, periodontal examinations, and questionnaires that included demographic, behavioral, and oral health variables. Angiographic catheterizations were analyzed according to the number of atheroma lesions, lesion size, lesion location, and atheroma lesion stability. Lipoprotein profile, inflammatory markers and cells were analyzed. The microbiological branch added 30 individuals who had their atheroma lesion and subgingival plaque analyzed using polymerase chain reaction probes against the 16 s region, red complex and Aggregatibacter actinomycetemcomitans' DNA. Results Subjects with CHD had high levels of systemic inflammatory markers and low levels of high-density lipoproteins compared to subjects without CHD. Subjects without CHD and clear coronaries had a prevalence of mild CAL, while individuals with more atheroma lesions had advanced CAL and more active PE. Subjects with more advanced CAL were 4 times more likely to have CHD compared to subjects with less, which is comparable to smoking. Only 4 subjects had the screened pathogens detected in atheroma, although these subjects also have the screened pathogens in subgingival plaque. However, 80% of atheromas had bacteria. Conclusions CHD and PE showed similarities in progression while active PE led to more atheroma lesions that also tended to be larger in size.
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Affiliation(s)
- Marcelo Barbosa De Accioly Mattos
- School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Division of Periodontics, University of Kentucky College of Dentistry, Lexington, KY, United States
| | | | | | - Leandro Cortes
- Department of Cardiology, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Bernardo Tura
- Department of Cardiology, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Martha Nunn
- Department of Biostatistic, Nunn Biostatistical Solutions, Omaha, NE, United States
| | - Marcia Giambiagi-deMarval
- Instituto de Microbiologia Professor Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carmelo Sansone
- Departamento de Periodontia, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Huh Y, Yoo JE, Park S, Han K, Kim SM, Park HS, Cho KH, Ahn J, Jun SH, Nam GE. Association of Dental Diseases and Oral Hygiene Care With the Risk of Heart Failure in Patients With Type 2 Diabetes: A Nationwide Cohort Study. J Am Heart Assoc 2023; 12:e029207. [PMID: 37548156 PMCID: PMC10492939 DOI: 10.1161/jaha.122.029207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/27/2023] [Indexed: 08/08/2023]
Abstract
Background To evaluate the association of dental diseases and oral hygiene care with incidence of heart failure (HF) among patients with type 2 diabetes. Methods and Results This study included 173 927 patients with type 2 diabetes aged ≥40 years, who underwent Korean National Health Insurance Service health examinations in 2008 and were followed up until the end of 2017. Hazard ratios (HRs) and 95% CIs for HF were estimated using multivariable Cox proportional hazards regression analysis. During a median follow-up of 9.3 years, 1.94% of participants developed HF. An increased number of missing teeth was associated with a higher risk of HF (P<0.001). HRs of HF increased among individuals with ≥15 missing teeth (HR, 1.37 [95% CI, 1.14-1.64]) compared with those without missing teeth. Decreased risk of HF was observed in individuals with ≥1 time/year of professional dental cleaning (HR, 0.93 [95% CI, 0.87-0.99]) and in those with ≥2 times/d of toothbrushing (HR, 0.90 [95% CI, 0.82-0.98]) compared with those without these practices. While combined presence of missing teeth and periodontal disease (P=0.004) or dental caries (P=0.007) increased HF risk, combined oral hygiene care was associated with further HF risk reduction (P=0.024). Better oral hygiene care was associated with decreased HF risk, even as the number of missing teeth increased (P<0.001). Conclusions Among patients with type 2 diabetes, dental diseases and oral hygiene care are important determinants of HF development. Dental disease management and good oral care may prevent HF in patients with type 2 diabetes.
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Affiliation(s)
- Youn Huh
- Department of Family MedicineUijeongbu Eulji Medical CenterEulji UniversityUijeongbuGyeonggi‐doRepublic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam CenterSeoul National University HospitalSeoulRepublic of Korea
| | - Sang‐Hyun Park
- Department of Medical StatisticsCollege of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulRepublic of Korea
| | - Seon Mee Kim
- Department of Family MedicineKorea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea
| | - Hye Soon Park
- Department of Family MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Kyung Hwan Cho
- Department of Family MedicineKorea University Anam HospitalKorea University College of MedicineSeoulRepublic of Korea
| | - Jin‐Soo Ahn
- Department of Dental Biomaterials Science and Dental Research InstituteSchool of DentistrySeoul National UniversitySeoulRepublic of Korea
| | - Sang Ho Jun
- Department of Oral & Maxillofacial SurgeryKorea University Anam HospitalSeoulRepublic of Korea
| | - Ga Eun Nam
- Department of Family MedicineKorea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea
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Xie H, Qin Z, Ling Z, Ge X, Zhang H, Guo S, Liu L, Zheng K, Jiang H, Xu R. Oral pathogen aggravates atherosclerosis by inducing smooth muscle cell apoptosis and repressing macrophage efferocytosis. Int J Oral Sci 2023; 15:26. [PMID: 37380627 DOI: 10.1038/s41368-023-00232-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023] Open
Abstract
Periodontitis imparting the increased risk of atherosclerotic cardiovascular diseases is partially due to the immune subversion of the oral pathogen, particularly the Porphyromonas gingivalis (P. gingivalis), by inducing apoptosis. However, it remains obscure whether accumulated apoptotic cells in P. gingivalis-accelerated plaque formation are associated with impaired macrophage clearance. Here, we show that smooth muscle cells (SMCs) have a greater susceptibility to P. gingivalis-induced apoptosis than endothelial cells through TLR2 pathway activation. Meanwhile, large amounts of miR-143/145 in P.gingivalis-infected SMCs are extracellularly released and captured by macrophages. Then, these miR-143/145 are translocated into the nucleus to promote Siglec-G transcription, which represses macrophage efferocytosis. By constructing three genetic mouse models, we further confirm the in vivo roles of TLR2 and miR-143/145 in P. gingivalis-accelerated atherosclerosis. Therapeutically, we develop P.gingivalis-pretreated macrophage membranes to coat metronidazole and anti-Siglec-G antibodies for treating atherosclerosis and periodontitis simultaneously. Our findings extend the knowledge of the mechanism and therapeutic strategy in oral pathogen-associated systemic diseases.
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Affiliation(s)
- Hanyu Xie
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Ziyue Qin
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Periodontology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Ziji Ling
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Xiao Ge
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Hang Zhang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Shuyu Guo
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Laikui Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Kai Zheng
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China
| | - Hongbing Jiang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China.
| | - Rongyao Xu
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, China.
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LaValley EA, Sen S, Mason E, Logue M, Trivedi T, Moss K, Beck J, Rosamond WD, Gottesman RF. Dental Caries a Risk Factor for Intracerebral Hemorrhage. Cerebrovasc Dis 2023; 53:98-104. [PMID: 37231788 PMCID: PMC10988391 DOI: 10.1159/000530568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/23/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Streptococcus mutans is a known cause of dental caries that contains a collagen-binding protein, Cnm, and exhibits inhibition of platelet aggregation and matrix metalloproteinase-9 activation. This strain has been linked to aggravation of experimental intracerebral hemorrhage (ICH) and may be a risk factor for ICH. The purpose of this study was to test the association between dental caries and incident ICH. METHODS The presence of dental caries and periodontal disease was assessed in subjects from the Dental Atherosclerosis Risk in Communities (DARIC) study without prior stroke or ICH. This cohort was followed for incident ICH over a period of 10 years. Cox regression was used to compute crude and adjusted hazards ratio from the dental assessment. RESULTS Among 6,315 subjects, dental surface caries and/or root caries were recorded in 1,338 (27%) subjects. Of those, 7 (0.5%) had incident ICH over a period of 10 years following the visit 4 assessment. Of the remaining 4,977 subjects, 10 (0.2%) had incident ICH. Those with dental caries versus those without dental caries were slightly younger (mean age 62.0 ± 5.7 vs. 62.4 ± 5.6, p = 0.012), had a greater proportion of males (51 vs. 44%, p < 0.001), African Americans (44 vs. 10%, p < 0.001), and were hypertensive (42 vs. 31%, p < 0.001). The association between caries and ICH was significant (crude HR 2.69, 95% CI 1.02-7.06) and strengthened after adjustment for age, gender, race, education level, hypertension, and periodontal disease (adjusted HR 3.88, 95% CI 1.34-11.24). CONCLUSION Dental caries is a potential risk for incident ICH after caries detection. Future studies are needed to determine if treatment of dental caries can reduce the risk of ICH.
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Affiliation(s)
- Elizabeth A LaValley
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, South Carolina, USA
| | - Souvik Sen
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, South Carolina, USA
| | - Emma Mason
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, South Carolina, USA
| | - Makenzie Logue
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, South Carolina, USA
| | - Tushar Trivedi
- Department of Neurology, Regional Medical Center, Orangeburg, South Carolina, USA
| | - Kevin Moss
- Division of Comprehensive Oral Health/Periodontology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - James Beck
- Division of Comprehensive Oral Health/Periodontology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Wayne D Rosamond
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland, USA
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Gurr A, Henneberg M, Kumaratilake J, Lerche D, Richards L, Brook AH. The Oral Health of a Group of 19th Century South Australian Settlers in Relation to Their General Health and Compared with That of Contemporaneous Samples. Dent J (Basel) 2023; 11:dj11040099. [PMID: 37185476 PMCID: PMC10136771 DOI: 10.3390/dj11040099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
The aims of this study are to determine the oral health status of a rare sample of 19th-century migrant settlers to South Australia, how oral conditions may have influenced their general health, and how the oral health of this group compares with contemporaneous samples in Australia, New Zealand, and Britain. Dentitions of 18 adults and 22 subadults were investigated using non-destructive methods (micro-CT, macroscopic, radiographic). Extensive carious lesions were identified in seventeen adults and four subadults, and from this group one subadult and sixteen adults had antemortem tooth loss. Sixteen adults showed evidence of periodontal disease. Enamel hypoplastic (EH) defects were identified in fourteen adults and nine subadults. Many individuals with dental defects also had skeletal signs of comorbidities. South Australian individuals had the same percentage of carious lesions as the British sample (53%), more than other historic Australian samples, but less than a contemporary New Zealand sample. Over 50% of individuals from all the historic cemeteries had EH defects, suggesting systemic health insults during dental development were common during the 19th century. The overall oral health of the South Australian settlers was poor but, in some categories, (tooth wear, periapical abscess, periodontal disease), better than the other historic samples.
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Affiliation(s)
- Angela Gurr
- Discipline of Anatomy and Pathology, School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia
- Biological Anthropology and Comparative Anatomy Research Unit, School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - Maciej Henneberg
- Discipline of Anatomy and Pathology, School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia
- Biological Anthropology and Comparative Anatomy Research Unit, School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia
- Institute of Evolutionary Medicine, University of Zurich, 8006 Zurich, Switzerland
| | - Jaliya Kumaratilake
- Discipline of Anatomy and Pathology, School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia
- Biological Anthropology and Comparative Anatomy Research Unit, School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - Derek Lerche
- School of Dentistry, University of Adelaide, Adelaide, SA 5005, Australia
| | - Lindsay Richards
- School of Dentistry, University of Adelaide, Adelaide, SA 5005, Australia
| | - Alan Henry Brook
- School of Dentistry, University of Adelaide, Adelaide, SA 5005, Australia
- Institute of Dentistry, Queen Mary, University of London, London WC1E 7HU, UK
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Chu K, Zhang Z, Chu Y, Xu Y, Yang W, Guo L. Ginsenoside Rg1 alleviates lipopolysaccharide-induced pyroptosis in human periodontal ligament cells via inhibiting Drp1-mediated mitochondrial fission. Arch Oral Biol 2023; 147:105632. [PMID: 36736069 DOI: 10.1016/j.archoralbio.2023.105632] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/29/2022] [Accepted: 01/25/2023] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The present study aimed to investigate whether Ginsenoside Rg1 alleviated lipopolysaccharide (LPS) - induced pyroptosis of human periodontal ligament cells (HPDLCs) and further explore the underlying mechanism. DESIGN Cell viability was detected using the CCK-8 assay. Proinflammatory cytokine secretion and lactate dehydrogenase release were examined by ELISA. Flow cytometry analysis was conducted to determine the pyroptosis ratio, and ATP production was estimated using the ATP assay kit. Fluorescence staining was utilized to visualize mitochondrial morphology and analyze mitochondrial reactive oxygen species (mtROS), and the mitochondrial membrane potential level. Western blot and qRT-PCR were used to determine the expression of signaling pathway-related proteins and mRNA, respectively. RESULTS The results discovered that Ginsenoside Rg1 treatment enhanced cell viability in comparison to LPS stimulation, attenuated pyroptosis in HPDLCs, and reduced the release of lactate dehydrogenase, IL-1β, and IL-18 significantly. Additionally, we found that Ginsenoside Rg1 upregulated ATP content and mitochondrial membrane potential level while reducing aberrant mitochondrial fission and mtROS production. Mechanistically, we found that Ginsenoside Rg1 upregulated dynamin-related protein 1 (Drp1) phosphorylation at Ser 637 in an AMP-activated protein kinase (AMPK)-dependent manner, and reduced pyroptosis-related proteins expression, including NLRP3, ASC, Caspase-1, and GSDMD-NT. CONCLUSIONS These findings demonstrate that Ginsenoside Rg1 treatment attenuates LPS-induced pyroptosis and inflammation damage in HPDLCs, which may connect to the activation of the AMPK/Drp1/NLRP3 signaling pathway. Moreover, the results offer a potential theoretical foundation for applying Ginsenoside Rg1 in inflammatory diseases such as periodontitis.
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Affiliation(s)
- Kefei Chu
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China; Department of Oral prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China
| | - Zhenghao Zhang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China; Department of Oral prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China
| | - Yi Chu
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China; Department of Oral prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China
| | - Yao Xu
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China; Department of Oral prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China
| | - Wanrong Yang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China; Department of Oral prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China
| | - Ling Guo
- Department of Oral prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan, PR China.
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Gain a Baby Lose a Tooth-Is There an Association between Periodontitis and Preterm Birth? J Clin Med 2022; 11:jcm11237183. [PMID: 36498757 PMCID: PMC9739114 DOI: 10.3390/jcm11237183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/22/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
Preterm birth serves as one of the leading causes of neonatal mortality worldwide. The underlying mechanisms that contribute to preterm birth are not yet fully understood. However, an association between periodontitis and preterm birth has been proposed. The periodontal status and presence of periodontal pathogens in women with different birth outcomes have been previously examined. However, varying definitions of periodontitis and different microbiological methods make their interpretation challenging. The aim of this case-control study on women with and without preterm birth was to investigate their periodontal status using the current classification system for periodontal diseases. Moreover, differences in the periodontal microbiome of the study participants were investigated. Therefore, we collected data on oral and periodontal parameters in 77 puerperal women divided into two groups based on gestational age at delivery: 33 patients with preterm birth (PTB, <37 weeks) and 44 patients with term birth (TB, >37 weeks). These data included pocket probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), gingival-bleeding index, DMFT index, and gynecologic and dental history. In addition, their oral microbiome was explored. Median CAL and percentage PPD ≥ 4 mm were significantly higher in the PTB group than in the TB group (p = 0.0128 and p = 0.047, respectively). Birth weight was significantly higher in periodontally healthy women than in those with gingivitis (p = 0.0078) or periodontitis (p = 0.0127). The periodontal microbiome differed significantly between groups. Our results are underlining the possible association between periodontitis and preterm delivery. Women with periodontitis had babies with significantly lower birth weights. The microbiome varied between the groups.
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Farrugia C, Stafford GP, Gains AF, Cutts AR, Murdoch C. Fusobacterium nucleatum mediates endothelial damage and increased permeability following single species and polymicrobial infection. J Periodontol 2022; 93:1421-1433. [PMID: 35644006 PMCID: PMC9796848 DOI: 10.1002/jper.21-0671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/04/2022] [Accepted: 05/20/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Numerous lines of evidence link periodontal pathobionts and their virulence factors with endothelial damage. Most research has been conducted using single species infections at the exclusion of other periodontal microorganisms that have been identified in vascular tissue. Here, we assessed endothelial infection with either single or mixed periodontal species infection and examined their effect on endothelial damage and permeability. METHODS Cell surface abundance of platelet endothelial cell adhesion molecule-1 (PECAM-1) or endothelial permeability following infection with Porphyromonas gingivalis, Fusobacterium nucleatum subspecies (ssp) nucleatum, ssp polymorphum or Tannerella forsythia as single or mixed species infection was determined by flow cytometry and a fluorescent dextran permeability assay. Zebrafish embryos were infected systemically with either single or mixed species with mortality and disease measured over time. RESULTS F. nucleatum ssp nucleatum, ssp polymorphum and P. gingivalis significantly reduced PECAM-1 abundance in single species infection, whereas T. forsythia had no effect. F. nucleatum ssp polymorphum caused considerable mortality and morbidity in a zebrafish systemic infection model. Polymicrobial infection underscored the virulence of F. nucleatum ssp polymorphum in particular with increased endothelial cell death and reduced PECAM-1 abundance in co-infection studies with this organism. When injected systemically into zebrafish in polymicrobial infection, fluorescently labeled bacteria were distributed throughout the vasculature and cardiac region where, in some instances, they co-localized with each other. CONCLUSIONS These data provide further evidence on the effects of F. nucleatum on endothelium adhesion molecule abundance and permeability while also highlighting the importance of performing polymicrobial infection to study the molecular mechanisms associated with periodontal pathogen-induced vascular damage.
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Affiliation(s)
- Cher Farrugia
- School of Clinical DentistryUniversity of SheffieldSheffieldUK,Bristol Dental SchoolUniversity of BristolBristolUK
| | | | - Ashley F. Gains
- School of Clinical DentistryUniversity of SheffieldSheffieldUK
| | | | - Craig Murdoch
- School of Clinical DentistryUniversity of SheffieldSheffieldUK
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11
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Sao P, Chand Y, Al-Keridis LA, Saeed M, Alshammari N, Singh S. Classifying Integrated Signature Molecules in Macrophages of Rheumatoid Arthritis, Osteoarthritis, and Periodontal Disease: An Omics-Based Study. Curr Issues Mol Biol 2022; 44:3496-3517. [PMID: 36005137 PMCID: PMC9406916 DOI: 10.3390/cimb44080241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/15/2022] [Accepted: 07/23/2022] [Indexed: 12/02/2022] Open
Abstract
Rheumatoid arthritis (RA), osteoarthritis (OA), and periodontal disease (PD) are chronic inflammatory diseases that are globally prevalent, and pose a public health concern. The search for a potential mechanism linking PD to RA and OA continues, as it could play a significant role in disease prevention and treatment. Recent studies have linked RA, OA, and PD to Porphyromonas gingivalis (PG), a periodontal bacterium, through a similar dysregulation in an inflammatory mechanism. This study aimed to identify potential gene signatures that could assist in early diagnosis as well as gain insight into the molecular mechanisms of these diseases. The expression data sets with the series IDs GSE97779, GSE123492, and GSE24897 for macrophages of RA, OA synovium, and PG stimulated macrophages (PG-SM), respectively, were retrieved and screened for differentially expressed genes (DEGs). The 72 common DEGs among RA, OA, and PG-SM were further subjected to gene–gene correlation analysis. A GeneMANIA interaction network of the 47 highly correlated DEGs comprises 53 nodes and 271 edges. Network centrality analysis identified 15 hub genes, 6 of which are DEGs (API5, ATE1, CCNG1, EHD1, RIN2, and STK39). Additionally, two significantly up-regulated non-hub genes (IER3 and RGS16) showed interactions with hub genes. Functional enrichment analysis of the genes showed that “apoptotic regulation” and “inflammasomes” were among the major pathways. These eight genes can serve as important signatures/targets, and provide new insights into the molecular mechanism of PG-induced RA, OA, and PD.
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Affiliation(s)
- Prachi Sao
- Faculty of Biotechnology, Institute of Biosciences and Technology, Shri Ramswaroop Memorial University, Barabanki 225003, Uttar Pradesh, India
| | - Yamini Chand
- Faculty of Biotechnology, Institute of Biosciences and Technology, Shri Ramswaroop Memorial University, Barabanki 225003, Uttar Pradesh, India
| | - Lamya Ahmed Al-Keridis
- Department of Biology, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
- Correspondence: (L.A.A.-K.); (S.S.)
| | - Mohd Saeed
- Department of Biology, College of Science, University of Hail, Hail 55476, Saudi Arabia
| | - Nawaf Alshammari
- Department of Biology, College of Science, University of Hail, Hail 55476, Saudi Arabia
| | - Sachidanand Singh
- Faculty of Biotechnology, Institute of Biosciences and Technology, Shri Ramswaroop Memorial University, Barabanki 225003, Uttar Pradesh, India
- Department of Biotechnology, Vignan’s Foundation for Science, Technology, and Research (Deemed to be University), Vadlamudi, Guntur 522213, Andhra Pradesh, India
- Department of Biotechnology, Smt. S. S. Patel Nootan Science & Commerce College, Sankalchand Patel University, Visnagar 384315, Gujarat, India
- Correspondence: (L.A.A.-K.); (S.S.)
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12
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Dewake N, Iwasaki Y, Taguchi A, Udagawa N, Yoshinari N. Association between Type 2 Diabetes and Classification of Periodontal Disease Severity in Japanese Men and Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138134. [PMID: 35805792 PMCID: PMC9266002 DOI: 10.3390/ijerph19138134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022]
Abstract
Background: to evaluate the association between type 2 diabetes and periodontal disease severity using the rate of alveolar bone loss (ABL) and high-sensitivity C-reactive protein (hs-CRP) value as indices. Methods: In this cross-sectional study of 372 patients (mean age ± SD, 53.2 ± 11.8 years) from a Japanese hospital, we measured ABL and number of teeth on either panoramic radiographs or intraoral dental radiographs of all teeth. Periodontal disease severity was classified into nine groups by combining ABL and hs-CRP. Results: 48 subjects had type 2 diabetes; 324 did not. Univariate analysis showed that type 2 diabetes was significantly associated with age, sex, body mass index, number of teeth, ABL, hs-CRP, and periodontal disease severity. Multivariate analysis showed significant associations between type 2 diabetes and the groups with high severity of periodontal disease. In receiver operating characteristic (ROC) curve analysis, predicting the presence of diabetes, area under the ROC curve was 0.762 (95%CI = 0.688–0.835) for ABL, and 0.709 (95%CI = 0.635–0.784) for hs-CRP, which was significant. Conclusions: this study showed that diabetes can be associated with a periodontal disease severity classification using the combination of ABL and hs-CRP.
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Affiliation(s)
- Nanae Dewake
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan;
- Correspondence:
| | - Yukiko Iwasaki
- Department of Oral Sciences, Matsumoto Dental University Hospital, Shiojiri 399-0781, Japan;
| | - Akira Taguchi
- Department of Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri 399-0781, Japan; (A.T.); (N.U.)
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan
| | - Nobuyuki Udagawa
- Department of Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri 399-0781, Japan; (A.T.); (N.U.)
- Department of Biochemistry, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan
| | - Nobuo Yoshinari
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan;
- Department of Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri 399-0781, Japan; (A.T.); (N.U.)
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13
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Sugi N, Eguchi E, Tsuboi A, Hatanaka K, Takashiba S, Kira Y, Miura M, Ogino K, Hirano K, Nakagawa T, Doi K. Periodontal diseases assessed by average bone resorption are associated with microvascular complications in patients with type 2 diabetes. Diabetol Int 2022; 14:32-39. [PMID: 36636165 PMCID: PMC9829934 DOI: 10.1007/s13340-022-00591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 06/07/2022] [Indexed: 01/16/2023]
Abstract
Periodontal disease often develops in patients with diabetes, and further exacerbated with diabetic complications. It would be clinically important to clarify the relationship between diabetic microvascular diseases and periodontal disease. This study aimed to evaluate the association between periodontal disease and diabetic complications in patients with type 2 diabetes with poor glycemic control. A total of 447 patients with type 2 diabetes hospitalized at Rakuwakai Otowa Hospital, Japan, were initially recruited in this study. After excluding 134 patients who lacked clinical data or were edentulous, 312 were included in our study. The severity of periodontal disease was evaluated based on the average bone resorption rate. Patients with diabetic nephropathy developed severe periodontal disease (multivariate-adjusted odds ratio, 3.00 [95% CI 1.41-5.19]). Diabetic neuropathy was positively associated with the severity of periodontal disease; the multivariate-adjusted odds ratio (95% CI) was 1.62 (0.87‒2.99) for moderate and 4.26 (2.21‒8.20) for severe periodontal disease. In contrast, diabetic retinopathy was linked with moderate periodontal disease (multivariate-adjusted odds ratio 2.23 [95% CI 1.10-4.10]), but not with severe conditions (multivariate-adjusted odds ratio 0.92 [95% CI 0.67-3.07]). In conclusion, periodontal disease, evaluated by average bone resorption rate, was associated with diabetic nephropathy and neuropathy. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-022-00591-0.
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Affiliation(s)
- Noriko Sugi
- Kyoto Oral Health Center, Rakuwakai Otowa Hospital, 2 Otowachinjicho, Yamashina-ku, Kyoto, Japan
| | - Eri Eguchi
- Department of Public Health, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Okayama, Japan
| | - Ayaka Tsuboi
- Department of Pathophysiology-Periodontal Science, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Okayama, Japan
| | - Kazu Hatanaka
- Department of Pathophysiology-Periodontal Science, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Okayama, Japan
| | - Shogo Takashiba
- Department of Pathophysiology-Periodontal Science, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama University, Okayama, Japan
| | - Yuri Kira
- Diabetes and Endocrinology Lifestyle-Related Disease Center, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Masako Miura
- Diabetes and Endocrinology Lifestyle-Related Disease Center, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Keiki Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kochi, Japan
| | - Keita Hirano
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Kentaro Doi
- Diabetes and Endocrinology Lifestyle-Related Disease Center, Rakuwakai Otowa Hospital, Kyoto, Japan ,Takashima Municipal Hospital, Shiga, Japan
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Beukers NGFM, Heijden GJMG, Su N, Galiën O, Gerdes VEA, Loos BG. An examination of the risk of periodontitis for nonfatal cardiovascular diseases on the basis of a large insurance claims database. Community Dent Oral Epidemiol 2022; 51:408-417. [DOI: 10.1111/cdoe.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 04/11/2022] [Accepted: 04/24/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Nicky G. F. M. Beukers
- Department of Periodontology, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Geert J. M. G. Heijden
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Onno Galiën
- Knowledge Center Achmea Health Insurance Company Leusden The Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands
- Department of Internal Medicine Spaarne Gasthuis Hoofddorp The Netherlands
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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15
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Periodontopathic Microbiota and Atherosclerosis: Roles of TLR-Mediated Inflammation Response. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9611362. [PMID: 35295717 PMCID: PMC8920700 DOI: 10.1155/2022/9611362] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
Atherosclerosis is a chronic inflammatory disease with a high prevalence worldwide, contributing to a series of adverse cardiovascular and cerebrovascular diseases. Periodontal disease induced by pathogenic periodontal microbiota has been well established as an independent factor of atherosclerosis. Periodontal microorganisms have been detected in atherosclerotic plaques. The high-risk microbiota dwelling in the subgingival pocket can stimulate local and systematic host immune responses and inflammatory cascade reactions through various signaling pathways, resulting in the development and progression of atherosclerosis. One often-discussed pathway is the Toll-like receptor-nuclear factor-κB (TLR-NF-κB) signaling pathway that plays a central role in the transduction of inflammatory mediators and the release of proinflammatory cytokines. This narrative review is aimed at summarizing and updating the latest literature on the association between periodontopathic microbiota and atherosclerosis and providing possible therapeutic ideas for clinicians regarding atherosclerosis prevention and treatment.
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16
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Wzatek M, Bahammam S, Buiga P, Haddad K, Sima C. Oral Neutrophil Free Fatty Acid Receptors Expression May Link Oral Host and Microbiome Lipid Metabolism. FRONTIERS IN ORAL HEALTH 2022; 3:821326. [PMID: 35320973 PMCID: PMC8937037 DOI: 10.3389/froh.2022.821326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/18/2022] [Indexed: 11/29/2022] Open
Abstract
In health, commensal bacteria from oral biofilms stimulate polymorphonuclear neutrophil (PMN) recruitment in gingival sulci and the oral cavity. Oral PMN (oPMN) is short-lived cells with low prosurvival gene expression. In periodontitis, oPMN accumulates in higher numbers, has extended lifespan, and sustains nonresolving inflammation. We hypothesize that short- and long-chain free fatty acids (SCFAs and LCFAs) and lipid mediator resolvin E1 (RvE1) modulate host ability to control biofilms and resolve inflammation. Our objective was to measure oPMN surface expression of receptors FFAR2 (binds bacteria-derived SCFA), FFAR4 (binds LCFA, EPA, and DHA), and ERV1 (binds RvE1) in health and to assess sex differences. We included 20 periodontally healthy individuals aged 20–80 years (10 males, 10 females), who were asked to (1) answer a targeted health nutritional questionnaire and (2) provide an oral saline rinse. oPMN isolated by sequential filtration was labeled with fluorophore-conjugated antibodies against CD11b, CD14, CD16, CD66b, ERV1, FFAR2, and FFAR4 and analyzed by flow cytometry. Statistical analyses were the following: two-way ANOVA, Tukey's test, and Pearson's correlation. Oral rinses contained 80% oPMN of which 60% were ERV1+ and FFAR2+, and 10% FFAR4+, with no sex differences. Females had more oPMN ERV1 compared to males. Both sexes had higher ERV1 compared to FFAR2 and FFAR4. CD66b+CD16high oPMN expressed less ERV1 and FFAR2 compared to CD66b+CD16low. There were positive correlations between oPMN ERV1 and FFAR2 expression and between ERV1+ and FFAR2+ oPMN and fish intake. These findings will help to better understand how oral host and microbiome interactions maintain periodontal health.
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Affiliation(s)
- Martin Wzatek
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
- Department of Dentistry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Shaima Bahammam
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
- Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Petronela Buiga
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Kendal Haddad
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Corneliu Sima
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
- *Correspondence: Corneliu Sima
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17
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Hajishengallis G, Li X, Divaris K, Chavakis T. Maladaptive trained immunity and clonal hematopoiesis as potential mechanistic links between periodontitis and inflammatory comorbidities. Periodontol 2000 2022; 89:215-230. [PMID: 35244943 DOI: 10.1111/prd.12421] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is bidirectionally associated with systemic inflammatory disorders. The prevalence and severity of this oral disease and linked comorbidities increases with aging. Here, we review two newly emerged concepts, trained innate immunity (TII) and clonal hematopoiesis of indeterminate potential (CHIP), which together support a potential hypothesis on how periodontitis affects and is affected by comorbidities and why the susceptibility to periodontitis and comorbidities increases with aging. Given that chronic diseases are largely triggered by the action of inflammatory immune cells, modulation of their bone marrow precursors, the hematopoietic stem and progenitor cells (HSPCs), may affect multiple disorders that emerge as comorbidities. Such alterations in HSPCs can be mediated by TII and/or CHIP, two non-mutually exclusive processes sharing a bias for enhanced myelopoiesis and production of innate immune cells with heightened proinflammatory potential. TII is a state of elevated immune responsiveness based on innate immune (epigenetic) memory. Systemic inflammation can initiate TII in the bone marrow via sustained rewiring of HSPCs, which thereby display a skewing toward the myeloid lineage, resulting in generation of hyper-reactive or "trained" myeloid cells. CHIP arises from aging-related somatic mutations in HSPCs, which confer a survival and proliferation advantage to the mutant HSPCs and give rise to an outsized fraction of hyper-inflammatory mutant myeloid cells in the circulation and tissues. This review discusses emerging evidence that supports the notion that TII and CHIP may underlie a causal and age-related association between periodontitis and comorbidities. A holistic mechanistic understanding of the periodontitis-systemic disease connection may offer novel diagnostic and therapeutic targets for treating inflammatory comorbidities.
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Affiliation(s)
- George Hajishengallis
- Department of Basic and Translational Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xiaofei Li
- Department of Basic and Translational Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kimon Divaris
- Division of Pediatrics and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Triantafyllos Chavakis
- Institute for Clinical Chemistry and Laboratory Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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18
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Fukushima T, Yonetsu T, Aoyama N, Tashiro A, Niida T, Shiheido-Watanabe Y, Maejima Y, Isobe M, Iwata T, Sasano T. Effect of Periodontal Disease on Long-Term Outcomes After Percutaneous Coronary Intervention for De Novo Coronary Lesions in Non-Smokers. Circ J 2021; 86:811-818. [PMID: 34789614 DOI: 10.1253/circj.cj-21-0720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study aimed to investigate the effect of periodontal disease (PD) on the outcomes of patients with coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI).Methods and Results:The study included 77 consecutive non-smoking patients with de novo coronary lesions treated with a drug-eluting stent (DES). Periodontal measurements, including the community periodontal index (CPI), were performed by independent periodontists. A CPI score of ≥3 was used to define PD. The occurrence of major adverse cardiac events (MACEs), which were defined as a composite of cardiovascular death, non-fatal myocardial infarction, target lesion revascularization, or non-target lesion revascularization, was compared between patients with and without PD. Of the 77 patients, 49 (63.6%) exhibited a CPI score of 3 or 4 and were assigned to the PD group. The remaining 28 patients (36.4%) were assigned to the non-PD group. Baseline clinical characteristics and angiographic findings were comparable between the 2 groups. MACEs occurred in 13 (26.5%) of the PD patients and 2 (7.1%) of the non-PD patients. Kaplan-Meier analysis showed a significantly lower MACE-free survival rate in the PD group than for the non-PD group (P=0.034). CONCLUSIONS PD at baseline was associated with an increased risk of MACEs in CAD patients who were treated with a DES for de novocoronary lesions.
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Affiliation(s)
- Taku Fukushima
- Department of Cardiovascular Medicine, Shin-Yurigaoka General Hospital.,Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Taishi Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University
| | - Akira Tashiro
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Takayuki Niida
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | | | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University.,Sakakibara Heart Institute
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
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Periodontal Disease and Vitamin D Deficiency in Pregnant Women: Which Correlation with Preterm and Low-Weight Birth? J Clin Med 2021; 10:jcm10194578. [PMID: 34640596 PMCID: PMC8509337 DOI: 10.3390/jcm10194578] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 01/13/2023] Open
Abstract
Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital “Maggiore della Carità”, Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI > 3 (p = 0.033), and between LBW and OHI > 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) < 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p < 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p < 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women.
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20
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Dain CP, Ganapathi S, Geevar Z, Harikrishnan S, Ammu JV, Chacko M. The traditional and modifiable risk factors of coronary artery disease - a community-based cross-sectional study among 2 populations. Medicine (Baltimore) 2021; 100:e27350. [PMID: 34596141 PMCID: PMC8483818 DOI: 10.1097/md.0000000000027350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT A community-based cross-sectional study was undertaken by the Cardiology Society of India (Kerala Chapter) to determine the prevalence of coronary artery disease (CAD) and its risk factors. The periodontal health status of the rural and urban participants in the Thiruvananthapuram district of Kerala was evaluated to document any association between periodontal disease (PD) and CAD and to describe any shared risk factors.The participants were selected using a multistage cluster random sampling method. Socio-demographic data and personal histories were collected using a structured interview schedule and validated tools. Body mass index, blood pressure, electrocardiogram, and biochemical investigations were recorded and analyzed using standard protocols. A modification of the Ramfjord periodontal disease index was used to assess periodontal health.PD was more frequent among rural (61.4%) than in the urban population (35.5%). The frequencies of CAD associated with PD in the rural and urban populations were 82.6% and 40.5%, respectively. PD was not found to be a significant risk factor for CAD in the univariate regression analysis of urban populations. In the rural population, the odds of PD as a risk factor for CAD were found to be 3.08 (95% CI [1.38-8.38]) and significant (P = .043) in univariate regression analysis and 1.54 (95% CI: 0.44-5.4) and non-significant (P = .503) in the multivariate regression analysis.In rural areas, male sex and dyslipidemia demonstrated borderline significance as risk factors for CAD. PD was not found to be an independent risk factor after adjusting for age, sex, tobacco use, hypertension, sedentary lifestyle, and dyslipidemia. Male sex and dyslipidemia were identified as shared risk factors between PD and CAD, which could have confounded the significant association between the latter. In urban areas, age, male sex, and dyslipidemia demonstrated an independent association with CAD. This study could not establish an independent association between PD and CAD in either community. Future epidemiological studies should identify and recruit novel environmental factors to understand the interrelationships between PD and CAD and focus on the role of effect modifiers that may have a protective role against PD colluding with CAD.
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Affiliation(s)
- Chacko Pearl Dain
- Department of Oral and Maxillofacial Surgery, Government Dental College, Medical College, Thiruvananthapuram, Kerala, India
| | - Sanjay Ganapathi
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, (Institute of National Importance under the Government of India) www.sctimst.ac.in, Thiruvananthapuram, Kerala, India
| | | | - Sivadasanpillai Harikrishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, (Institute of National Importance under the Government of India) www.sctimst.ac.in, Thiruvananthapuram, Kerala, India
| | - Jayanthi Viswanathan Ammu
- Division of Biostatistics and Cancer Epidemiology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Manas Chacko
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, (Institute of National Importance under the Government of India) www.sctimst.ac.in, Thiruvananthapuram, Kerala, India
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21
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Sari A, Davutoglu V, Bozkurt E, Taner IL, Erciyas K. Effect of periodontal disease on oxidative stress markers in patients with atherosclerosis. Clin Oral Investig 2021; 26:1713-1724. [PMID: 34415433 DOI: 10.1007/s00784-021-04144-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 08/11/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effect of periodontal inflammation on oxidative stress in patients with atherosclerosis by considering serum and saliva total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI). MATERIALS AND METHODS In the study, there were 4 groups, with 20 individuals in each group. These groups consisted of individuals who had periodontitis with atherosclerosis (group A-P), were periodontally healthy with atherosclerosis (group A-C), were systemically healthy with periodontitis (group P), and were systemically and periodontally healthy (group C). Clinical periodontal parameters were recorded. PISA values were calculated. Atherosclerosis severity was determined by the Gensini score. The ratio of TAS/TOS resulting in the OSI levels of the serum and saliva samples was examined biochemically. RESULTS Group A-P serum TAS and group C saliva OSI values were lower than those of the other groups (p < 0.05). Group A-P serum TOS and OSI values were higher than those of the other groups (p < 0.05). Groups A-C and P serum TOS and OSI values were higher than those of group C (p < 0.05). In the multivariate linear regression analysis, group A-P and PISA values were independently associated with serum TOS and OSI values (p < 0.05). Group A-P, group P, and PISA values were independently associated with saliva OSI values (p < 0.05). CONCLUSIONS Periodontitis and atherosclerosis may have systemic oxidative stress-increasing effects. The coexistence of periodontitis and atherosclerosis increases oxidative stress beyond that seen in either condition alone. Periodontitis can be associated with increased systemic TOS and OSI values in patients with atherosclerosis. STATEMENT OF CLINICAL RELEVANCE Oxidative status is affected more severely when periodontitis and atherosclerosis coexist rather than when either exists alone. Periodontitis can cause increasing effect on serum TOS and OSI and decreasing effect on TAS in patients with atherosclerosis. The increase in oxidative stress markers with the presence of periodontal disease in patients with atherosclerosis emphasizes that controlling periodontal diseases, a treatable disease, may contribute to the prognosis of atherosclerosis.
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Affiliation(s)
- Aysegul Sari
- Department of Periodontology, Faculty of Dentistry, Mustafa Kemal University, 31040, Hatay, Turkey.
| | - Vedat Davutoglu
- Department of Cardiology, NCR International Hospital, Gaziantep, Turkey
| | - Emrullah Bozkurt
- Department of Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ibrahim Levent Taner
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Kamile Erciyas
- Department of Periodontology, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
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22
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Choi H, Dey AK, Priyamvara A, Aksentijevich M, Bandyopadhya D, Dey D, Dani S, Guha A, Nambiar P, Nasir K, Jneid H, Mehta NN, Lavie C, Amar S. Role of Periodontal Infection, Inflammation and Immunity in Atherosclerosis. Curr Probl Cardiol 2021; 46:100638. [PMID: 32646544 PMCID: PMC8761259 DOI: 10.1016/j.cpcardiol.2020.100638] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Inflammation plays a major role in the development and progression of cardiovascular disease (CVD) morbidity and mortality. The well-established relationship between periodontal disease (PD) and CVD may be causal. Left untreated, PD can lead to high systemic inflammation, thus contributing to inflammatory CVD, such as atherosclerosis. Multiple mechanisms have been proposed to elucidate the causal relationship between PD and its contribution to CVD. OBJECTIVE This review article highlights the current evidence supporting the role of PD in the development and progression of atherosclerosis. METHODS After creating a list of relevant medical subject heading (MeSH) terms, a systematic search within PubMed in English for each MeSH term between 2000 and 2019 was used to generate evidence for this review article. CONCLUSION There is overwhelming evidence in the current literature that supports an association between PD and CVD that is independent of known CVD risk factors. However, the supporting evidence that PD directly causes CVD in humans continues to remain elusive. Multiple biologically plausible mechanisms have been proposed and investigated, yet most studies are limited to mouse models and in vitro cell cultures. Additional studies testing the various proposed mechanisms in longitudinal human studies are required to provide deeper insight into the mechanistic link between these 2 related diseases.
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Affiliation(s)
- Harry Choi
- National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Amit K. Dey
- National Heart Lung and Blood Institute, Bethesda, MD, USA
| | | | | | | | | | | | | | | | | | | | - Nehal N. Mehta
- National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Carl Lavie
- Ochsner Clinical School-UQ School of Medicine, New Orleans, LA, USA
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23
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Farrugia C, Stafford GP, Potempa J, Wilkinson RN, Chen Y, Murdoch C, Widziolek M. Mechanisms of vascular damage by systemic dissemination of the oral pathogen Porphyromonas gingivalis. FEBS J 2021; 288:1479-1495. [PMID: 32681704 PMCID: PMC9994420 DOI: 10.1111/febs.15486] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/15/2020] [Accepted: 07/14/2020] [Indexed: 01/04/2023]
Abstract
Several studies have shown a clear association between periodontal disease and increased risk of cardiovascular disease. Porphyromonas gingivalis (Pg), a key oral pathogen, and its cell surface-expressed gingipains, induce oedema in a zebrafish larvae infection model although the mechanism of these vascular effects is unknown. Here, we aimed to determine whether Pg-induced vascular damage is mediated by gingipains. In vitro, human endothelial cells from different vascular beds were invaded by wild-type (W83) but not gingipain-deficient (ΔK/R-ab) Pg. W83 infection resulted in increased endothelial permeability as well as decreased cell surface abundance of endothelial adhesion molecules PECAM-1 and VE-cadherin compared to infection with ΔK/R-ab. In agreement, when transgenic zebrafish larvae expressing fluorescently labelled PECAM-1 or VE-cadherin were systemically infected with W83 or ΔK/R-ab, a significant reduction in adhesion molecule fluorescence was observed specifically in endothelium proximal to W83 bacteria through a gingipain-dependent mechanism. Furthermore, this was associated with increased vascular permeability in vivo when assessed by dextran leakage microangiography. These data are the first to show that Pg directly mediates vascular damage in vivo by degrading PECAM-1 and VE-cadherin. Our data provide a molecular mechanism by which Pg might contribute to cardiovascular disease.
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Affiliation(s)
- Cher Farrugia
- School of Clinical Dentistry, University of Sheffield, UK
| | | | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.,Department of Oral Immunity and Infectious Diseases, University of Louisville School of Dentistry, KY, USA
| | | | - Yan Chen
- Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, UK
| | - Craig Murdoch
- School of Clinical Dentistry, University of Sheffield, UK
| | - Magdalena Widziolek
- School of Clinical Dentistry, University of Sheffield, UK.,Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.,Department of Evolutionary Immunology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University, Kraków, Poland
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24
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Kyrklund M, Kaski H, Akhi R, Nissinen AE, Kummu O, Bergmann U, Pussinen P, Hörkkö S, Wang C. Existence of natural mouse IgG mAbs recognising epitopes shared by malondialdehyde acetaldehyde adducts and Porphyromonas gingivalis. Innate Immun 2021; 27:158-169. [PMID: 33445998 PMCID: PMC7882809 DOI: 10.1177/1753425920981133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Natural Abs are produced by B lymphocytes in the absence of external Ag stimulation. They recognise self, altered self and foreign Ags, comprising an important first-line defence against invading pathogens and serving as innate recognition receptors for tissue homeostasis. Natural IgG Abs have been found in newborns and uninfected individuals. Yet, their physiological role remains unclear. Previously, no natural IgG Abs to oxidation-specific epitopes have been reported. Here, we show the cloning and characterisation of mouse IgG mAbs against malondialdehyde acetaldehyde (MAA)-modified low-density lipoprotein. Sequence analysis reveals high homology with germline genes, suggesting that they are natural. Further investigation shows that the MAA-specific natural IgG Abs cross-react with the major periodontal pathogen Porphyromonas gingivalis and recognise its principle virulence factors gingipain Kgp and long fimbriae. The study provides evidence that natural IgGs may play an important role in innate immune defence and in regulation of tissue homeostasis by recognising and removing invading pathogens and/or modified self-Ags, thus being involved in the development of periodontitis and atherosclerosis.
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MESH Headings
- Acetaldehyde/chemistry
- Acetaldehyde/metabolism
- Animals
- Antibodies, Monoclonal/isolation & purification
- Antibodies, Monoclonal/metabolism
- Clone Cells
- Epitopes, B-Lymphocyte/metabolism
- Fimbriae Proteins/metabolism
- Gingipain Cysteine Endopeptidases/metabolism
- Immunity, Innate
- Immunoglobulin G/isolation & purification
- Immunoglobulin G/metabolism
- Lipoproteins, LDL/chemistry
- Lipoproteins, LDL/metabolism
- Malondialdehyde/chemistry
- Malondialdehyde/metabolism
- Mice
- Mice, Knockout
- Oxidation-Reduction
- Periodontitis/immunology
- Porphyromonas gingivalis/physiology
- Receptors, LDL/genetics
- Receptors, Pattern Recognition/isolation & purification
- Receptors, Pattern Recognition/metabolism
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Affiliation(s)
- Mikael Kyrklund
- Medical Microbiology and Immunology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Finland
- Medical Research Centre and Nordlab Oulu, University Hospital and University of Oulu, Finland
| | - Heidi Kaski
- Medical Microbiology and Immunology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Finland
| | - Ramin Akhi
- Medical Microbiology and Immunology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Finland
- Medical Research Centre and Nordlab Oulu, University Hospital and University of Oulu, Finland
| | - Antti E Nissinen
- Medical Microbiology and Immunology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Finland
- Medical Research Centre and Nordlab Oulu, University Hospital and University of Oulu, Finland
| | - Outi Kummu
- Medical Microbiology and Immunology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Finland
- Medical Research Centre and Nordlab Oulu, University Hospital and University of Oulu, Finland
| | - Ulrich Bergmann
- Protein Analysis Core Facility, Biocentre Oulu and Faculty of Biochemistry and Molecular Medicine, University of Oulu, Finland
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Sohvi Hörkkö
- Medical Microbiology and Immunology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Finland
- Medical Research Centre and Nordlab Oulu, University Hospital and University of Oulu, Finland
| | - Chunguang Wang
- Medical Microbiology and Immunology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Finland
- Medical Research Centre and Nordlab Oulu, University Hospital and University of Oulu, Finland
- Minerva Foundation Institute for Medical Research, Biomedicum Helsinki 2U, Finland
- Chunguang Wang, Cardiovascular Research Unit, Minerva Foundation Institute for Medical Research, Biomedicum Helsinki 2U, Tukholmankatu 8, Helsinki 00290, Finland.
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25
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Miya C, Cueno ME, Suzuki R, Maruoka S, Gon Y, Kaneko T, Yonehara Y, Imai K. Porphyromonas gingivalis gingipains potentially affect MUC5AC gene expression and protein levels in respiratory epithelial cells. FEBS Open Bio 2020; 11:446-455. [PMID: 33332733 PMCID: PMC7876492 DOI: 10.1002/2211-5463.13066] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/02/2020] [Accepted: 12/15/2020] [Indexed: 01/08/2023] Open
Abstract
Porphyromonas gingivalis (Pg) is a periodontopathic pathogen that may affect MUC5AC‐related mucus hypersecretion along airway epithelial cells. Here, we attempted to establish whether Pg virulence factors (lipopolysaccharide, FimA fimbriae, gingipains) affect MUC5AC in immortalized and primary bronchial cells. We report that MUC5AC gene expression and protein levels are affected by Pg culture supernatant, but not by lipopolysaccharide or FimA fimbriae. Cells treated with either Pg single (Kgp or Rgp) or double (Kgp/Rgp) mutants had altered levels of MUC5AC gene expression and protein levels, and MUC5AC staining of double mutant‐treated mouse lung cells showed that MUC5AC protein levels were unaffected. Taken together, we propose that Pg gingipains may be the primary virulence factor that influences both MUC5AC gene expression and protein levels.
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Affiliation(s)
- Chihiro Miya
- Department of Oral and Maxillofacial Surgery II, Nihon University School of Dentistry, Tokyo, Japan.,Department of Microbiology, Nihon University School of Dentistry, Tokyo, Japan
| | - Marni E Cueno
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, Japan
| | - Ryuta Suzuki
- Department of Oral and Maxillofacial Surgery II, Nihon University School of Dentistry, Tokyo, Japan.,Department of Microbiology, Nihon University School of Dentistry, Tokyo, Japan
| | - Shuichiro Maruoka
- Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuhiro Gon
- Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Tadayoshi Kaneko
- Department of Oral and Maxillofacial Surgery II, Nihon University School of Dentistry, Tokyo, Japan
| | - Yoshiyuki Yonehara
- Department of Oral and Maxillofacial Surgery II, Nihon University School of Dentistry, Tokyo, Japan
| | - Kenichi Imai
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, Japan
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26
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Abstract
Periodontitis is increasingly associated with increased risk of cardiovascular and other systemic diseases. The Gram-negative anaerobe, Porphyromonas gingivalis, is a key periodontal pathogen, and several lines of evidence link the presence of this bacterium in the circulation with vascular disease. The outer membrane vesicles (OMVs) produced by P. gingivalis have been shown to play a role in periodontitis, although, to date, little is known about their interaction with the vasculature; therefore, this study assessed the effects of P. gingivalis OMVs on the endothelium. OMVs were isolated from wild-type strain W83 and the gingipain-deficient strain ΔK/R-ab. Immunoblotting along with cryo-EM showed gingipain expression in W83 but not ΔK/R-ab-derived OMVs, where gingipains were localized to the cell wall surface. Confluent endothelial cell monolayers infected with either W83 or W83-derived OMV displayed significantly increased dextran permeability over those infected with ΔK/R-ab or its OMV. Moreover, W83-derived OMVs induced significantly more vascular disease in a zebrafish larvae systemic infection model over 72 h compared to those injected with gingipain-deficient OMVs or controls. In line with these data, human microvascular endothelial cells (HMEC-1) displayed an OMV-associated, gingipain-dependent decrease in cell surface levels of the intercellular adhesion molecule PECAM-1 (CD31) when examined by flow cytometry. These data show, for the first time, that OMVs from P. gingivalis mediate increased vascular permeability, leading to a diseased phenotype both in vitro and in vivo. Moreover, these data strongly implicate gingipains present on the OMV surface in mediating these vascular events, most likely via a mechanism that involves proteolytic cleavage of endothelial cell-cell adhesins such as PECAM-1. These data provide important evidence for the role of bacterial-derived OMVs in mediating systemic disease.
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Affiliation(s)
- C. Farrugia
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - G.P. Stafford
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - C. Murdoch
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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27
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Sari A, Davutoglu V, Bozkurt E, Tarakcioglu M, Erciyas K. Effect of periodontitis on oxidative stress parameters in patients with rheumatic heart valve disease. Arch Oral Biol 2020; 121:104961. [PMID: 33197805 DOI: 10.1016/j.archoralbio.2020.104961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of periodontitis on oxidative stress parameters by investigating serum and gingival crevicular fluid (GCF) total antioxidant capacity (TAOC), total oxidant status (TOS), and oxidative stress index (OSI) values in patients with rheumatic heart valve disease (RHVD). MATERIALS AND METHODS The study population comprised 76 patients, who were divided into four groups: chronic periodontitis with RVHD (RV-CP), periodontally healthy with RVHD (RV-C), systemically healthy with chronic periodontitis (CP), and systemically and periodontally healthy (C). Demographic, periodontal, and echocardiographic parameters were measured. Serum and GCF oxidative stress parameters were evaluated based on the OSI. RESULTS Similar serum oxidative stress parameters were found in all study groups (P ≥ 0.05). The GCF TAOC values of the C group were significantly higher than those of the other groups (P = 0.001). The GCF OSI values of the C group were significantly lower than those of the other groups (P = 0.001). The GCF TOS and OSI values of the RV-CP group were significantly higher than those of the CP and C groups (P = 0.001). The GCF TOS value of the RV-C group was significantly higher than those of the CP and C groups (P = 0.001). CONCLUSIONS Altered local oxidative stress profile was associated with the presence of periodontitis. Rheumatic heart valve disease may increase oxidative stress in individuals with chronic periodontitis.
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Affiliation(s)
- Aysegul Sari
- Mustafa Kemal University, Faculty of Dentistry, Department of Periodontology, Hatay, Turkey.
| | - Vedat Davutoglu
- NCR International Hospital, Department of Cardiology, Gaziantep, Turkey
| | - Emrullah Bozkurt
- Gaziantep University, Faculty of Medicine, Department of Cardiology, Gaziantep, Turkey
| | - Mehmet Tarakcioglu
- Gaziantep University, Faculty of Medicine, Department of Biochemistry, Gaziantep, Turkey
| | - Kamile Erciyas
- Gaziantep University, Faculty of Dentistry, Department of Periodontology, Gaziantep, Turkey
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28
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Abstract
PURPOSE OF THE REVIEW The purpose of this review is to provide an update on the data regarding periodontitis and its association with cardiovascular disease (CVD), as well as a closer look at the connection between periodontitis and valvular heart disease. RECENT FINDINGS The body of literature that demonstrates an association between periodontitis and CVD is growing, and there is increasing evidence that periodontal disease (PD) can have negative cardiovascular effects. Far less data is available for the management of periodontitis specifically in those with valvular heart disease. However, recent studies suggest that routine preoperative dental evaluation practices may not be necessary in all patients and, similar to changes in antibiotic prophylaxis, may only be indicated for a select group of individuals. There is a strong association between PD and CVD, although a causal relationship is yet to be elucidated. Further data is needed in this regard, as well as in determining the appropriate management of PD in those with valvular heart disease.
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Affiliation(s)
- Sahar Naderi
- Division of Cardiology, Kaiser Permanente, 2238 Geary Boulevard 8th Floor, San Francisco, CA, 94115, USA.
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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29
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Cui K, Luan Y, Tang Z, Li CC, Wang T, Wang SG, Chen Z, Liu JH. Human tissue kallikrein-1 protects against the development of erectile dysfunction in a rat model of hyperhomocysteinemia. Asian J Androl 2020; 21:508-515. [PMID: 30618416 PMCID: PMC6732897 DOI: 10.4103/aja.aja_111_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to investigate the mechanism by which a diet inducing high hyperhomocysteinemia (HHcy) leads to the deterioration of erectile function in rats and whether this is inhibited by expression of the human tissue kallikrein-1 (hKLK1) gene. We established a rat model of HHcy by feeding methionine (Met)-rich diets to male Sprague-Dawley (SD) rats. Male wild-type SD rats (WTRs) and transgenic rats harboring the hKLK1 gene (TGRs) were fed a normal diet until 10 weeks of age. Then, 30 WTRs were randomly divided into three groups as follows: the control (n = 10) group, the low-dose (4% Met, n = 10) group, and the high-dose (7% Met, n = 10) group. Another 10 age-matched TGRs were fed the high-dose diet and designated as the TGR+7% Met group. After 30 days, in all four groups, erectile function was measured and penile tissues were harvested to determine oxidative stress, endothelial cell content, and penis fibrosis. Compared with the 7% Met group, the TGR+7% Met group showed diminished HHcy-induced erectile dysfunction (ED), indicating the improvement caused by hKLK1. Regarding corpus cavernosum endothelial cells, hKLK1 preserved endothelial cell-cell junctions and endothelial cell content, and activated protein kinase B/endothelial nitric oxide synthase (Akt/eNOS) signaling. Fibrosis assessment indicated that hKLK1 preserved normal penis structure by inhibiting apoptosis in the corpus cavernosum smooth muscle cells. Taken together, these findings showed that oxidative stress, impaired corpus cavernosum endothelial cells, and severe penis fibrosis were involved in the induction of ED by HHcy in rats, whereas hKLK1 preserved erectile function by inhibiting these pathophysiological changes.
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Affiliation(s)
- Kai Cui
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yang Luan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhe Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chuan-Chang Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shao-Gang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhong Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ji-Hong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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30
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Abstract
Periodontitis is a complex disease: (a) various causative factors play a role simultaneously and interact with each other; and (b) the disease is episodic in nature, and bursts of disease activity can be recognized, ie, the disease develops and cycles in a nonlinear fashion. We recognize that various causative factors determine the immune blueprint and, consequently, the immune fitness of a subject. Normally, the host lives in a state of homeostasis or symbiosis with the oral microbiome; however, disturbances in homeostatic balance can occur, because of an aberrant host response (inherited and/or acquired during life). This imbalance results from hyper- or hyporesponsiveness and/or lack of sufficient resolution of inflammation, which in turn is responsible for much of the disease destruction seen in periodontitis. The control of this destruction by anti-inflammatory processes and proresolution processes limits the destruction to the tissues surrounding the teeth. The local inflammatory processes can also become systemic, which in turn affect organs such as the heart. Gingival inflammation also elicits changes in the ecology of the subgingival environment providing optimal conditions for the outgrowth of gram-negative, anaerobic species, which become pathobionts and can propagate periodontal inflammation and can further negatively impact immune fitness. The factors that determine immune fitness are often the same factors that determine the response to the resident biofilm, and are clustered as follows: (a) genetic and epigenetic factors; (b) lifestyle factors, such as smoking, diet, and psychosocial conditions; (c) comorbidities, such as diabetes; and (d) local and dental factors, as well as randomly determined factors (stochasticity). Of critical importance are the pathobionts in a dysbiotic biofilm that drive the viscious cycle. Focusing on genetic factors, currently variants in at least 65 genes have been suggested as being associated with periodontitis based on genome-wide association studies and candidate gene case control studies. These studies have found pleiotropy between periodontitis and cardiovascular diseases. Most of these studies point to potential pathways in the pathogenesis of periodontal disease. Also, most contribute to a small portion of the total risk profile of periodontitis, often limited to specific racial and ethnic groups. To date, 4 genetic loci are shared between atherosclerotic cardiovascular diseases and periodontitis, ie, CDKN2B-AS1(ANRIL), a conserved noncoding element within CAMTA1 upstream of VAMP3, PLG, and a haplotype block at the VAMP8 locus. The shared genes suggest that periodontitis is not causally related to atherosclerotic diseases, but rather both conditions are sequelae of similar (the same?) aberrant inflammatory pathways. In addition to variations in genomic sequences, epigenetic modifications of DNA can affect the genetic blueprint of the host responses. This emerging field will yield new valuable information about susceptibility to periodontitis and subsequent persisting inflammatory reactions in periodontitis. Further studies are required to verify and expand our knowledge base before final cause and effect conclusions about the role of inflammation and genetic factors in periodontitis can be made.
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Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts, USA
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31
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Byun SH, Lee S, Kang SH, Choi HG, Hong SJ. Cross-Sectional Analysis of the Association between Periodontitis and Cardiovascular Disease Using the Korean Genome and Epidemiology Study Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145237. [PMID: 32698486 PMCID: PMC7400444 DOI: 10.3390/ijerph17145237] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 12/16/2022]
Abstract
This cross-sectional study aimed to evaluate the association between periodontitis and cardiovascular disease (CVD) by reviewing and discussing the role of the oral microbiome in periodontitis and CVD. This prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study from 2004 to 2016. We selected 9973 patients with periodontitis and 125,304 controls (non-periodontitis) from 173,209 participants and analyzed their medical histories to determine the relationship between cerebral stroke/ischemic heart disease and periodontitis. The participants were questioned about any previous history of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke (hemorrhagic or ischemic), ischemic heart disease (angina or myocardial infarction), and periodontitis. Their body mass index, smoking habit, alcohol intake, nutritional intake, and income were recorded. The Chi-square test, independent t-test, and two-tailed analyses were used for statistical analysis. The adjusted OR (aOR) of periodontitis for stroke was 1.35 (95% confidence interval (CI) = 1.16–1.57, p < 0.001). The aOR of periodontitis for ischemic heart disease was 1.34 (95% CI = 1.22–1.48, p < 0.001). We concluded that periodontitis was associated with CVD and may be a risk factor for CVD. However, further studies are required to determine the association between periodontal treatment and CVD.
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Affiliation(s)
- Soo Hwan Byun
- Department of Oral & Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea;
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon 24252, Korea
| | - Sunki Lee
- Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Dongtan 18450, Korea;
| | - Sung Hun Kang
- Department of Biomedical Sciences, College of Medicine, Hallym University, Chuncheon 24252, Korea;
| | - Hyo Geun Choi
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon 24252, Korea
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea
- Department of Otorhinolaryngology-Head & Neck Surgery, Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (H.G.C.); (S.J.H.)
| | - Seok Jin Hong
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon 24252, Korea
- Department of Otorhinolaryngology-Head & Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Dongtan 18450, Korea
- Correspondence: (H.G.C.); (S.J.H.)
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Analyzing the Association between Hyperuricemia and Periodontitis: A Cross-Sectional Study Using KoGES HEXA Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134777. [PMID: 32630802 PMCID: PMC7370102 DOI: 10.3390/ijerph17134777] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/18/2020] [Accepted: 06/27/2020] [Indexed: 01/05/2023]
Abstract
Hyperuricemia arises from the buildup of excessive uric acid in the blood, and it is implicated in the development of periodontitis. The objective of this study was to investigate the association between hyperuricemia and periodontitis using a cross-sectional study design and Korean Genome and Epidemiology Study Health Examinee (KoGES HEXA) data. This prospective cohort study used epidemiological data from the KoGES from 2004 to 2016. Among 173,209 participants, 8809 with hyperuricemia and 126,465 controls (non-hyperuricemia) were selected. This study defined hyperuricemia as >7.0 mg/dL of uric acid in men and >6.0 mg/dL in women. This study analyzed the history of periodontitis among hyperuricemia and control participants. Participants’ age, gender, income, obesity, smoking, alcohol consumption, and nutritional intake were all examined. Chi-square tests, independent t-tests, and two-tailed analyses were used for statistical analysis. The adjusted OR (aOR) of hyperuricemia for periodontitis was 0.89 (95% confidence interval (CI) = 0.81–0.96, p = 0.005). This study demonstrated that hyperuricemia was associated with periodontitis. This finding meant that elevated uric acid levels could have a positive effect on periodontitis. However, further studies should be performed to determine the range of uric acid levels beneficial to periodontal health.
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Willink A, Reed NS, Swenor B, Leinbach L, DuGoff EH, Davis K. Dental, Vision, And Hearing Services: Access, Spending, And Coverage For Medicare Beneficiaries. Health Aff (Millwood) 2020; 39:297-304. [PMID: 32011933 PMCID: PMC7652597 DOI: 10.1377/hlthaff.2019.00451] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Among Medicare beneficiaries, dental, vision, and hearing services could be characterized as high need, high cost, and low use. While Medicare does not cover most of these services, coverage has increased recently as a result of changes in state Medicaid programs and increased enrollment in Medicare Advantage (MA) plans, many of which offer these services as supplemental benefits. Using data from the 2016 Medicare Current Beneficiary Survey, this analysis shows that MA plans are filling an important gap in dental, vision, and hearing coverage, particularly among low- and middle-income beneficiaries. In 2016 only 21 percent of beneficiaries in traditional Medicare had purchased a stand-alone dental plan, whereas 62 percent of MA enrollees were in plans with a dental benefit. Among Medicare beneficiaries with coverage overall, out-of-pocket expenses still made up 70 percent of dental spending, 62 percent of vision spending, and 79 percent of hearing spending. While Medicare beneficiaries are enrolling in private coverage options, they are not getting adequate financial protection. This article examines these findings in the context of recent proposals in Congress to expand Medicare coverage of dental, vision, and hearing services.
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Affiliation(s)
- Amber Willink
- Amber Willink ( awillin2@jhu. edu ) is an assistant scientist in the Department of Health Policy and Management and in the Cochlear Center for Hearing and Public Health, both at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland
| | - Nicholas S Reed
- Nicholas S. Reed is an assistant professor in the Department of Epidemiology and in the Cochlear Center for Hearing and Public Health, both at the Johns Hopkins Bloomberg School of Public Health
| | - Bonnielin Swenor
- Bonnielin Swenor is an associate professor in the Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine
| | - Leah Leinbach
- Leah Leinbach an assistant professor in the Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine
| | - Eva H DuGoff
- Eva H. DuGoff is an assistant professor in the Department of Health Services Administration, School of Public Health, University of Maryland, in College Park
| | - Karen Davis
- Karen Davis is a professor emerita in the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
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Gobin R, Tian D, Liu Q, Wang J. Periodontal Diseases and the Risk of Metabolic Syndrome: An Updated Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:336. [PMID: 32582028 PMCID: PMC7296056 DOI: 10.3389/fendo.2020.00336] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Periodontitis and metabolic syndrome (MetS) are two major global health problems that are widely prevalent in the world, although the former is a common infection in developing countries and the latter is a non-infectious but prevalent disease in developed countries. This study aims to provide an updated review on the existence and magnitude of the relationship between periodontal disease and the risk of MetS. Methods: We searched the PubMed, Web of Science, ScienceDirect, Chinese National Knowledge Infrastructure, and Wanfang databases for original studies assessing the association between periodontitis and MetS published before August 2019. We calculated the pooled crude and adjusted odds ratios (ORs) together with the 95% confidence intervals (95% CIs) to estimate the strength of this association. Subgroup analysis was performed by considering the diagnostic method or the country where the studies were performed. Results: We identified 43 potentially eligible articles for this systematic review, including 32 cross-sectional studies, eight case-control studies, and three cohort studies. Among them, 39 articles presented enough information to be included in the meta-analysis. The pooled crude and adjusted ORs were 1.99 (95% CI: 1.75-2.25) and 1.46 (95% CI: 1.31-1.61), respectively. Subgroup analysis showed a consistent relation stratified by either the diagnostic method or the country where the studies were performed. The pooled OR was 1.68 (95% CI: 1.41-2.00) for Japan, 1.75 (95% CI: 1.31-2.34) for the USA, 1.81 (95% CI: 1.35-2.42) for Korea, and 2.29 (95% CI: 1.53-3.41) for China. Conclusion: Our results provide compelling evidence for the association between periodontitis and MetS. Patients with periodontal disease are a critical screening population for MetS. We also recommend that people exhibiting components of MetS should receive a periodontal check-up and pay attention to their oral health.
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Affiliation(s)
- Romila Gobin
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dan Tian
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qiao Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, China
| | - Jianming Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- *Correspondence: Jianming Wang
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Analytical Strategies in Lipidomics for Discovery of Functional Biomarkers from Human Saliva. DISEASE MARKERS 2019; 2019:6741518. [PMID: 31885741 PMCID: PMC6914909 DOI: 10.1155/2019/6741518] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/29/2019] [Accepted: 11/13/2019] [Indexed: 01/24/2023]
Abstract
Human saliva is increasingly being used and validated as a biofluid for diagnosing, monitoring systemic disease status, and predicting disease progression. The discovery of biomarkers in saliva biofluid offers unique opportunities to bypass the invasive procedure of blood sampling by using oral fluids to evaluate the health condition of a patient. Saliva biofluid is clinically relevant since its components can be found in plasma. As salivary lipids are among the most essential cellular components of human saliva, there is great potential for their use as biomarkers. Lipid composition in cells and tissues change in response to physiological changes and normal tissues have a different lipid composition than tissues affected by diseases. Lipid imbalance is closely associated with a number of human lifestyle-related diseases, such as atherosclerosis, diabetes, metabolic syndromes, systemic cancers, neurodegenerative diseases, and infectious diseases. Thus, identification of lipidomic biomarkers or key lipids in different diseases can be used to diagnose diseases and disease state and evaluate response to treatments. However, further research is needed to determine if saliva can be used as a surrogate to serum lipid profiles, given that highly sensitive methods with low limits of detection are needed to discover salivary biomarkers in order to develop reliable diagnostic and disease monitoring salivary tests. Lipidomic methods have greatly advanced in recent years with a constant advance in mass spectrometry (MS) and development of MS detectors with high accuracy and high resolution that are able to determine the elemental composition of many lipids.
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Jafari A, Rezapour A, Hajahmadi M. Cost-effectiveness of B-type natriuretic peptide-guided care in patients with heart failure: a systematic review. Heart Fail Rev 2019; 23:693-700. [PMID: 29744629 DOI: 10.1007/s10741-018-9710-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Measuring the level of B-type natriuretic peptide (BNP), as a guide to pharmacotherapy, can increase the survival of patients with heart failure. This study is aimed at systematically reviewing the studies conducted on the cost-effectiveness of BNP-guided care in patients with heart failure. Using the systematic review method, we reviewed the published studies on the cost-effectiveness of BNP-guided care in patients with heart failure during the years 2004 to 2017. The results showed that all studies clearly stated the time horizon of the study and included direct medical costs in their analysis. In addition, most of the studies used the Markov model. The quality-adjusted life years (QALYs) were the main outcome used for measuring the effectiveness. The studies reported various ranges of the incremental cost-effectiveness ratio (ICER); accordingly, the highest ratio was observed in the USA ($32,748) and the lowest ratio was observed in Canada ($6251). Although the results of the studies were different in terms of a number of aspects, such as the viewpoint of the study, the study horizons, and the costs of expenditure items, they reached similar results. Based on the results of the present study, it seems that the use of BNP or N-terminal pro-BNP (NT-pro-BNP) in patients with heart failure may reduce cost compared to the symptom-based clinical care and increase QALY. In this regard, these studies were designed and conducted in high-income countries; thus, the application of these results in low- and middle-income countries will be limited.
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Affiliation(s)
- Abdosaleh Jafari
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Marjan Hajahmadi
- Cardiovascular Department, Rasoul Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran
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Bizzarro S, Loos BG. The link between periodontitis and erectile dysfunction: a review. Br Dent J 2019; 227:599-603. [DOI: 10.1038/s41415-019-0724-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Periodontal Pathogens as Risk Factors of Cardiovascular Diseases, Diabetes, Rheumatoid Arthritis, Cancer, and Chronic Obstructive Pulmonary Disease-Is There Cause for Consideration? Microorganisms 2019; 7:microorganisms7100424. [PMID: 31600905 PMCID: PMC6843669 DOI: 10.3390/microorganisms7100424] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 09/29/2019] [Accepted: 10/01/2019] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular diseases, chronic obstructive pulmonary diseases, diabetes, rheumatoid arthritis, and cancer are the most common noncommunicable diseases (NCDs). These NCDs share risk factors with periodontal disease (PD), a preventable risk factor linked to lifestyle. The discussion regarding the association between these chronic diseases is more complex. There is still a significant knowledge gap particularly of the causal relationship between PD and NCDs. In this paper, we present fundamental knowledge of the mechanisms and roles of putative periodontal bacteria to gather several hypotheses, evidence that clinical studies thus far have not produced. Although the causal hypotheses are not yet clearly established on a biological basis, prevention and prophylactic measures are recommended to prevent even the possibility of such potential risk factors.
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Santos-Paul MA, Neves RS, Gowdak LHW, de Paula FJ, David-Neto E, Bortolotto LA, Ramires JAF, De Lima JJG. Cardiovascular risk reduction with periodontal treatment in patients on the waiting list for renal transplantation. Clin Transplant 2019; 33:e13658. [PMID: 31271675 DOI: 10.1111/ctr.13658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/13/2019] [Accepted: 06/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiovascular mortality is increased in chronic kidney disease, a condition with a high prevalence of periodontal disease. Whether periodontitis treatment improves prognosis is unknown. METHODS The effect of periodontal treatment on the incidence of cardiovascular events and death in 206 waitlist hemodialysis subjects was compared with that in 203 historical controls who did not undergo treatment. Patients were followed up for 24 months or until death or transplantation. RESULTS The prevalence of moderate/severe periodontitis was 74%. Coronary artery disease correlated with the severity of periodontal disease (P = .02). Survival free of cardiovascular events (94% vs 83%, log-rank 0.009), coronary events (97% vs 89%, log-rank = 0.009), and cardiovascular death (96% vs 87%, log-rank = 0.037) was higher in the evaluated group. Death by any cause did not differ between groups. Multivariate analysis showed that treatment was associated with reduction in cardiovascular events (HR 0.43; 95% CI 0.22-0.87), coronary events (HR 0.31; 95% CI 0.12-0.83), and cardiovascular deaths (HR 0.43; 95% CI 0.19-0.98). CONCLUSION Periodontal treatment reduced the 24-month incidence of cardiovascular events and cardiovascular death, suggesting that periodontal treatment may improve cardiovascular outcomes. We suggest that periodontal screening and eventual treatment may be considered in patients with advanced renal disease.
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Affiliation(s)
- Marcela A Santos-Paul
- Hospital das Clínicas, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Ricardo Simões Neves
- Hospital das Clínicas, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Luis Henrique W Gowdak
- Hospital das Clínicas, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Flávio J de Paula
- Urology, Renal Transplant Unit, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Elias David-Neto
- Urology, Renal Transplant Unit, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Luiz A Bortolotto
- Hospital das Clínicas, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - José Antonio F Ramires
- Hospital das Clínicas, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Jose Jayme G De Lima
- Hospital das Clínicas, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
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Willink A. The High Coverage of Dental, Vision, and Hearing Benefits Among Medicare Advantage Enrollees. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 56:46958019861554. [PMID: 31271082 PMCID: PMC6611012 DOI: 10.1177/0046958019861554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While the traditional Medicare program does not cover dental, vision, and hearing services, Medicare Advantage (MA) plans have been given the flexibility to do so. However, it is not known how many MA enrollees are in plans that cover these services. The 2016 Medicare Current Beneficiary Survey linked to MA plan benefit data is used to examine enrollment levels in plans that cover dental, vision, and/or hearing services in MA. Medicaid beneficiaries are excluded from this analysis as coverage of supplemental benefits is largely determined by the state. The highest coverage of supplemental services is vision, followed by hearing and dental (71%, 56%, and 41%, respectively). Across all supplemental services, coverage for supplemental benefits is highest among low-income beneficiaries and those who have not completed high school. Hispanic Medicare beneficiaries had the highest enrollment in plans that offered a supplemental benefit, and white Medicare beneficiaries tended to have the lowest enrollment in these plans. Unlike in traditional Medicare, MA enrollees have access to health plans that offer supplemental benefits, including dental, vision, and/or hearing services. This analysis shows that enrollment in these plans is highest among low-income MA enrollees who may not have the means to purchase stand-alone insurance for these services in traditional Medicare. More analysis is warranted to examine the generosity of the coverage of these services in MA plans. However, for federal policy makers to consider offering supplemental coverage in traditional Medicare, the MA experience suggests this type of benefit would be valuable.
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Affiliation(s)
- Amber Willink
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Zhang LN, Wang XX, Wang Z, Li KY, Xu BH, Zhang J. Berberine improves advanced glycation end products‑induced osteogenic differentiation responses in human periodontal ligament stem cells through the canonical Wnt/β‑catenin pathway. Mol Med Rep 2019; 19:5440-5452. [PMID: 31059099 PMCID: PMC6522873 DOI: 10.3892/mmr.2019.10193] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 04/02/2019] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to investigate the effects of advanced glycation end products (AGEs) and berberine hydrochloride (BBR) on the osteogenic differentiation ability of human periodontal ligament stem cells (hPDLSCs) in vitro, and their underlying mechanisms. hPDLSCs were subjected to osteogenic induction and were treated with AGEs or AGEs + BBR. Following varying numbers of days in culture, alkaline phosphatase (ALP) activity assays, ALP staining, alizarin red staining, ELISAs, and reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) and western blot analyses were performed to determine the osteogenic differentiation ability of hPDLSCs; RT‑qPCR, western blot analysis, and immunofluorescence staining were conducted to investigate the underlying mechanisms. The canonical Wnt/β‑catenin pathway inhibitor XAV‑939 and agonist CHIR‑99021 were used to determine the contribution of the canonical Wnt/β‑catenin pathway to differentiation. Treatment with AGEs resulted in reduced ALP activity and Collagen I protein levels, decreased ALP staining, fewer mineralized nodules, and downregulated expression of osteogenic‑specific genes [Runt‑related transcription factor 2 (Runx2), Osterix, ALP, osteopontin (OPN), Collagen I and osteocalcin (OCN)] and proteins (Runx2, OPN, BSP and OCN); however, BBR partially rescued the AGE‑induced decrease in the osteogenic potential of hPDLSCs. Furthermore, AGEs activated the canonical Wnt/β‑catenin signaling pathway and promoted the nuclear translocation of β‑catenin; BBR partially attenuated this effect. In addition, XAV‑939 partially rescued the AGE‑induced reduction in the osteogenic potential of hPDLSCs, whereas CHIR‑99021 suppressed the BBR‑induced increase in the osteogenic potential of hPDLSCs. The present study indicated that AGEs attenuated the osteogenic differentiation ability of hPDLSCs, in part by activating the canonical Wnt/β‑catenin pathway; however, BBR attenuated these effects by inhibiting the canonical Wnt/β‑catenin pathway. These findings suggest a role for BBR in periodontal regeneration induced by hPDLSCs in patients with diabetes mellitus.
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Affiliation(s)
- Li-Na Zhang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
- Department of Orthodontics, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
- Department of Orthodontics, Faculty of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Xu-Xia Wang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Zhi Wang
- Department of Orthodontics, Faculty of Stomatology, Linyi People's Hospital of Shandong, Linyi, Shandong 276000, P.R. China
| | - Ke-Yi Li
- Department of Oral and Maxillofacial Surgery, Faculty of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Bao-Hua Xu
- Dental Medical Center, China-Japan Friendship Hospital, Ministry of Health, Chaoyang, Beijing 100029, P.R. China
| | - Jun Zhang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
- Department of Orthodontics, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
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Eshraghi VT, Malloy KA, Tahmasbi M. Role of Cone-Beam Computed Tomography in the Management of Periodontal Disease. Dent J (Basel) 2019; 7:dj7020057. [PMID: 31159356 PMCID: PMC6631177 DOI: 10.3390/dj7020057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 12/20/2022] Open
Abstract
The goal of this paper was to review the current literature surrounding the use of cone beam computed tomography (CBCT) related to the diagnosis, prognostic determination, and treatment of periodontal diseases. A literature review was completed to identify peer-reviewed articles related to CBCT and periodontics. The results were filtered to pool only articles specific to CBCT and periodontal diagnosis, prognosis, and treatment/outcomes. The articles were reviewed and findings summarized. Author’s commentary on technological advances and additional potential uses of CBCT in the field of periodontics were included. There is evidence to suggest that CBCT imaging can be more accurate in diagnosing specific periodontal defects (intrabony and furcation defects), and therefore be helpful in the prognostic determination and treatment planning. However, at this time, CBCT cannot be recommended as the standard of care. It is up to the individual clinician to use one’s own judgment as to when the additional information provided by CBCT may be beneficial, while applying the As Low As Reasonably Achievable (ALARA) principle. With continued technological advances in CBCT imaging (higher resolution, reduced imaging artifacts, lower exposure, etc.) the author’s believe that CBCT usage will become more prominent in diagnosis and treatment of periodontal diseases.
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Affiliation(s)
- V Thomas Eshraghi
- Private Practice, Tualatin, OR 97062, USA.
- Private Practice, Beaverton, OR 97006, USA.
- Department of Periodontology, Oregon Health & Science University, Portland, OR 97201, USA.
| | | | - Mehrnaz Tahmasbi
- Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, TX 75246, USA.
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Petrukhina NB, Zorina OA, Abaev ZM, Kartysheva EV, Saltovets MV. [Influence of gender, age and metabolic factors on the course of chronic generalized periodontitis in patients with metabolic syndrome]. STOMATOLOGII︠A︡ 2019; 98:31-36. [PMID: 31089117 DOI: 10.17116/stomat20199802131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In a study of 537 patients with chronic generalized periodontitis and metabolic syndrome, depending on gender, age and metabolic factors, it was found that with increasing of body mass index (BMI) symptoms of chronic generalized periodontitis is becoming more unfavorable, there is a close positive relationship between the severity of chronic generalized periodontitis and BMI. Patients' with BMI ≥40 kg/m2 in 80% of cases, periodontitis was characterized by severe course. It was found that the gender of the patient becomes relevant only with correlation of age and BMI. It was proved that for the most accurate prognosis of chronic generalized periodontitis, patient's sex, age and BMI should be taken into consideration. The developed model for predicting the course of chronic generalized periodontitis depending on the sex, age and metabolic factors of a particular patient, allows to monitor the dynamics of the disease in time.
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Affiliation(s)
- N B Petrukhina
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O A Zorina
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - Z M Abaev
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - E V Kartysheva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - M V Saltovets
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Wang X, Li W, Song W, Xu L, Zhang L, Feng X, Lu R, Meng H. Association of CYP1A1 rs1048943 variant with aggressive periodontitis and its interaction with hyperlipidemia on the periodontal status. J Periodontal Res 2019; 54:546-554. [PMID: 31032950 DOI: 10.1111/jre.12658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/12/2019] [Accepted: 03/18/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVE CYP1A1 rs1048943 polymorphism was reported to be correlated with periodontitis; however, its association with aggressive periodontitis (AgP) has not yet been investigated. The aim of the study was to investigate the association between the CYP1A1 gene rs1048943 variant with generalized aggressive periodontitis (GAgP) and platelet activation and analyse whether its interaction with hyperlipidemia affects periodontal status in a Chinese population. METHODS A case-control study of 224 GAgP patients and 139 healthy controls was conducted. The clinical parameters of probing depth (PD), attachment loss (AL) and bleeding index (BI) were recorded. Platelet count (PLT), platelet distribution width (PDW), platelet large cell ratio (PLCR), mean platelet volume (MPV), serum total cholesterol (TC), triacylglycerol (TG), high and low-density lipoprotein (HDL and LDL) were also measured. The CYP1A1 rs1048943 SNP was genotyped by time-of-flight mass spectrometry. Logistic and linear regression models were used to measure correlation. RESULTS The CYP1A1 rs1048943 AG/GG genotype was associated with GAgP (OR = 1.56, 95%CI: 1.01, 2.42), PD, AL and decreased PDW, PLCR and MPV after adjustment for covariates. Gene-lipid interactions were found between CYP1A1 rs1048943 and HDL for PD (Pinteraction = 0.0033), BI (Pinteraction = 0.0311) and AL (Pinteraction = 0.0141) and between CYP1A1 rs1048943 and LDL for PD (Pinteraction = 0.013) among patients with GAgP. CONCLUSION The G allele of the CYP1A1 rs1048943 gene was associated with GAgP, periodontal status and platelet-related inflammation status in a Chinese population. Hyperlipidemia could modulate the effect of CYP1A1 rs1048943 on the periodontal status of GAgP.
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Affiliation(s)
- Xian'e Wang
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wenjing Li
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wenli Song
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.,Third Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Xu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Zhang
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ruifang Lu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.,Third Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China
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Bloch S, Tomek MB, Friedrich V, Messner P, Schäffer C. Nonulosonic acids contribute to the pathogenicity of the oral bacterium Tannerella forsythia. Interface Focus 2019; 9:20180064. [PMID: 30842870 PMCID: PMC6388019 DOI: 10.1098/rsfs.2018.0064] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2018] [Indexed: 12/15/2022] Open
Abstract
Periodontitis is a polymicrobial, biofilm-caused, inflammatory disease affecting the tooth-supporting tissues. It is not only the leading cause of tooth loss worldwide, but can also impact systemic health. The development of effective treatment strategies is hampered by the complicated disease pathogenesis which is best described by a polymicrobial synergy and dysbiosis model. This model classifies the Gram-negative anaerobe Tannerella forsythia as a periodontal pathogen, making it a prime candidate for interference with the disease. Tannerella forsythia employs a protein O-glycosylation system that enables high-density display of nonulosonic acids via the bacterium's two-dimensional crystalline cell surface layer. Nonulosonic acids are sialic acid-like sugars which are well known for their pivotal biological roles. This review summarizes the current knowledge of T. forsythia's unique cell envelope with a focus on composition, biosynthesis and functional implications of the cell surface O-glycan. We have obtained evidence that glycobiology affects the bacterium's immunogenicity and capability to establish itself in the polymicrobial oral biofilm. Analysis of the genomes of different T. forsythia isolates revealed that complex protein O-glycosylation involving nonulosonic acids is a hallmark of pathogenic T. forsythia strains and, thus, constitutes a valuable target for the design of novel anti-infective strategies to combat periodontitis.
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Faden AA, Alsalhani AB, Idrees MM, Alshehri MA, Nassani MZ, Kujan OB. Knowledge, attitudes, and practice behavior of dental hygienists regarding the impact of systemic diseases on oral health. Saudi Med J 2019; 39:1139-1147. [PMID: 30397714 PMCID: PMC6274662 DOI: 10.15537/smj.2018.11.23267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To assess the knowledge levels of dental hygienists in Saudi Arabia regarding the association between systemic and oral disease in addition to evaluating their attitude about integrating this knowledge into clinical practice. Methods: This was a cross-sectional survey using a questionnaire of 102 items among 192 randomly selected dental hygienists practicing in Riyadh, Saudi Arabia by individual interview. The research tool was pilot tested among 12 dental hygienists (8 females and 4 males) to obtain feedback about clarity and objectivity. Results: The response rate was 83%, and the majority of respondents were female (77.5%). The respondents' knowledge about the risk factors of cardiovascular diseases was better than other conditions. The level of education was considered to be a significant predictor in many items related to risk factors. More than the half, rated the evidence linking periodontal disease and diabetes mellitus as strong; however, the knowledge level of oral-systemic evidence was less than expected. A high percentage of the respondents were confident and comfortable managing patients with systemic conditions. Most agreed that dental hygienists must be prepared efficiently to manage medically compromised patients. Conclusion: Dental hygienists in Riyadh, Saudi Arabia have low level of knowledge about the oral-systemic disease relationship. This study suggests that greater emphasis should be placed on this association in current and continuing education programs.
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Affiliation(s)
- Asma'a A Faden
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Mizutani S, Aoki H, Haresaku S, Shimada K, Ueno M, Kubota K, Naito T. Association between subjective well-being and presence of primary care dentists in community-dwelling elderly people: A cross-sectional study. Gerodontology 2019; 36:134-141. [PMID: 30698302 DOI: 10.1111/ger.12390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 01/01/2019] [Accepted: 01/03/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim was to investigate the relationships between subjective well-being and the existence of primary care dentists in community-dwelling elderly people. BACKGROUND Some studies have reported subjective well-being focusing on oral health, but no studies have examined the relationship between subjective well-being and primary care dentists. METHODS This cross-sectional study used data from community-dwelling elderly people aged ≥70 years (n = 624). The Philadelphia Geriatric Center Morale Scale (PGCMS; range = 0 [low morale]-17) was used to assess subjective well-being. Additional information regarding age group, sex, medical consulting situation (ambulatory care/home care), primary care dentists, family structure, economic status, health status was collected via questionnaire. RESULTS The average PGCMS score in ambulatory care patients (ACP) group who have primary care dentists was highest among community-dwelling elderly people. In a logistic regression model, a low PGCMS score (0-11) was independently correlated to 80-89 age group (OR = 1.70; 95% CI, 1.13-2.54; P = 0.008), ≥90 age group (OR = 3.86; 95% CI, 1.83-8.18; P < 0.001), unsatisfied for economic status (OR = 2.68; 95% CI, 1.59-4.53; P < 0.001), unsatisfied for health status (OR = 3.94; 95% CI, 2.60-5.98; P < 0.001) and having no primary care dentists (OR = 1.81; 95% CI, 1.09-3.01; P = 0.021) in ACP group. CONCLUSIONS The subjective well-being of ACP who have primary care dentists was higher than in other people. Primary dentists contributed to the subjective well-being of elderly people.
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Affiliation(s)
- Shinsuke Mizutani
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Kaoru Shimada
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Michio Ueno
- National Hospital Organization Fukuoka-higashi Medical Center, Fukuoka, Japan
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
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Donley TG. Time to put periodontal disease on the list of chronic inflammatory diseases contributing to premature atherosclerosis. CMAJ 2019; 191:E52. [PMID: 30642827 DOI: 10.1503/cmaj.71062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Timothy G Donley
- Periodontist, Bowling Green, Ky.; member of the Cardiovascular Research Foundation, New York, NY
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Petrukhina NB, Zorina OA, Shikh EV, Kartysheva EV, Kudryavtsev AV, Berkutova IS. [Changes in proinflammatory cytokines in patients with chronic periodontitis and metabolic syndrome, depending on gender and age]. STOMATOLOGII︠A︡ 2018; 97:38-44. [PMID: 30589423 DOI: 10.17116/stomat20189706138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In a study of 537 patients with chronic generalized periodontitis and metabolic syndrome (MS) depending on age and gender, it was found that the increase of TNF-α and IL-6 in the content of periodontal pockets correlated with the severity of chronic generalized periodontitis and MS. For these cytokines, there was a clear gender relationship: women had higher levels in periodontal pocket content than men. For IL-1β and IL-4 cytokines, there is no coupling between the severity of the damage and the level of cytokines in the periodontal pocket. The developed model for calculating the risk of chronic generalized periodontitis depending on the level of TNF-α in the patient's periodontal pockets allows predicting and monitoring the dynamics of the disease.
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Affiliation(s)
- N B Petrukhina
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O A Zorina
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - E V Shikh
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - E V Kartysheva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A V Kudryavtsev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - I S Berkutova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Liu L, Liu K, Yan Y, Chu Z, Tang Y, Tang C. Two Transcripts of FBXO5 Promote Migration and Osteogenic Differentiation of Human Periodontal Ligament Mesenchymal Stem Cells. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7849294. [PMID: 29850565 PMCID: PMC5933072 DOI: 10.1155/2018/7849294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/03/2018] [Accepted: 03/13/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Enhanced migration and osteogenic differentiation of mesenchymal stem cells (MSCs) are beneficial for MSC-mediated periodontal tissue regeneration, a promising method for periodontitis treatment. FBXO5, a member of the F-box protein family, is involved in the osteogenic differentiation of MSCs. Here, we investigated the effect of FBXO5 on human periodontal ligament stem cells (hPDLSCs). MATERIALS AND METHODS hPDLSCs were isolated from periodontal ligament tissue. Lentivirus FBXO5 shRNA was used to silence FBXO5 expression. Two transcripts of FBXO5 were overexpressed and transduced into hPDLSCs via retroviral infection. Migration and osteogenic differentiation of hPDLSCs were evaluated using the scratch migration assay, alkaline phosphatase (ALP) activity, ALP staining, alizarin red staining, western blotting, and real-time polymerase chain reaction. RESULTS The expression of FBXO5 was upregulated after osteogenic induction in hPDLSCs. FBXO5 knockdown attenuated migration, inhibited ALP activity and mineralization, and decreased RUNX2, OSX, and OCN expression, while the overexpression of two transcript isoforms significantly accelerated migration, enhanced ALP activity and mineralization, and increased RUNX2, OSX, and OCN expression in hPDLSCs. CONCLUSIONS Both isoforms of FBXO5 promoted the migration and osteogenic differentiation potential of hPDLSCs, which identified a potential target for improving periodontal tissue regeneration.
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Affiliation(s)
- Lin Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kun Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yanzhe Yan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhuangzhuang Chu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yi Tang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chunbo Tang
- Department of Dental Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
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