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Jaago M, Pupina N, Rähni A, Pihlak A, Sadam H, Vrana NE, Sinisalo J, Pussinen P, Palm K. Antibody response to oral biofilm is a biomarker for acute coronary syndrome in periodontal disease. Commun Biol 2022; 5:205. [PMID: 35246599 PMCID: PMC8897497 DOI: 10.1038/s42003-022-03122-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/08/2022] [Indexed: 12/15/2022] Open
Abstract
Cumulative evidence over the last decades have supported the role of gum infections as a risk for future major cardiovascular events. The precise mechanism connecting coronary artery disease (CAD) with periodontal findings has remained elusive. Here, we employ next generation phage display mimotope-variation analysis (MVA) to identify the features of dysfunctional immune system that associate CAD with periodontitis. We identify a fine molecular description of the antigenic epitope repertoires of CAD and its most severe form - acute coronary syndrome (ACS) by profiling the antibody reactivity in a patient cohort with invasive heart examination and complete clinical oral assessment. Specifically, we identify a strong immune response to an EBV VP26 epitope mimicking multiple antigens of oral biofilm as a biomarker for the no-CAD group. With a 2-step biomarker test, we stratify subjects with periodontitis from healthy controls (balanced accuracy 84%), and then assess the risk for ACS with sensitivity 71-89% and specificity 67-100%, depending on the oral health status. Our findings highlight the importance of resolving the immune mechanisms related to severe heart conditions such as ACS in the background of oral health. Prospective validation of these findings will support incorporation of these non-invasive biomarkers into clinical practice.
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Affiliation(s)
- Mariliis Jaago
- Protobios Llc, Mäealuse 4, 12618, Tallinn, Estonia.,Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia tee 15, 12618, Tallinn, Estonia
| | | | - Annika Rähni
- Protobios Llc, Mäealuse 4, 12618, Tallinn, Estonia.,Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia tee 15, 12618, Tallinn, Estonia
| | - Arno Pihlak
- Protobios Llc, Mäealuse 4, 12618, Tallinn, Estonia
| | - Helle Sadam
- Protobios Llc, Mäealuse 4, 12618, Tallinn, Estonia.,Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia tee 15, 12618, Tallinn, Estonia
| | - Nihal Engin Vrana
- Spartha Medical, 14B Rue de la Canardiere, 67100, Strasbourg, France
| | - Juha Sinisalo
- Heart and Lung Center, Helsinki University Hospital, and Helsinki University, Helsinki, Finland
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, FI-00014, Helsinki, Finland
| | - Kaia Palm
- Protobios Llc, Mäealuse 4, 12618, Tallinn, Estonia. .,Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia tee 15, 12618, Tallinn, Estonia.
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