Periodontal status and serum antibody titers for Porphyromonas gingivalis fimbriae in a rural population in Japan

Correlation of salivary immunoglobulin A against lipopolysaccharide of Porphyromonas gingivalis with clinical periodontal parameters

BACKGROUND

A major challenge in clinical periodontics is to find a reliable molecular marker of periodontal tissue destruction.

AIM

The aim of the present study was to assess, whether any correlation exists between salivary immunoglobulin A (IgA) level against lipopolysaccharide of Porphyromonas gingivalis and clinical periodontal parameters (probing depth and clinical attachment loss).

MATERIALS AND METHODS

Totally, 30 patients with chronic periodontitis were included for the study based on clinical examination. Unstimulated saliva was collected from each study subject. Probing depth and clinical attachment loss were recorded in all selected subjects using University of North Carolina-15 periodontal probe. Extraction and purification of lipopolysaccharide were done from the standard strain of P. gingivalis (ATCC 33277). Enzyme linked immunosorbent assay (ELISA) was used to detect the level of IgA antibodies against lipopolysaccharide of P. gingivalis in the saliva of each subject by coating wells of ELISA kit with extracted lipopolysaccharide antigen.

STATISTICAL ANALYSIS

The correlation between salivary IgA and clinical periodontal parameters was checked using Karl Pearson's correlation coefficient method and regression analysis.

RESULTS

The significant correlation was observed between salivary IgA level and clinical periodontal parameters in chronic periodontitis patients.

CONCLUSION

A significant strong correlation was observed between salivary IgA against lipopolysaccharide of P. gingivalis and clinical periodontal parameters which suggest that salivary IgA level against lipopolysaccharide of P. gingivalis can be used to predict the severity of periodontal destruction in chronic periodontitis patients.

Gender-specific associations of serum antibody to Porphyromonas gingivalis and inflammatory markers

It remains unclear whether serum antibody titer against Porphyromonas gingivalis (Pg) and inflammatory components lead to periodontal deterioration in each gender, as periodontal and systemic status is influenced by gender. The present study investigates the gender-specific probable effects of titer against Pg and inflammatory markers on periodontal health status in a longitudinal study. A retrospective study design was used. At two time points over an 8-year period (in 2003 and 2011), 411 individuals (295 males with a mean age of 57.6 ± 11.2 years and 116 females with a mean age of 59.2 ± 10.3 years) were surveyed. Periodontal status, serum antibody titer against Pg, and high-sensitive C-reactive protein (hsCRP) were evaluated. Poisson regression analyses revealed that the elevated titer against Pg and hsCRP significantly predicted the persistence of periodontal disease 8 years later in females with periodontal disease in 2003. Elevated hsCRP was significantly associated with the incidence of periodontal disease 8 years later in females who were periodontally healthy in 2003. Males had a weaker association among titer against Pg, inflammatory markers, and periodontal disease. These findings suggest that immune response to Pg infection in addition to inflammatory components affects periodontal deterioration in females.

N-acetylcysteine and the human serum components that inhibit bacterial invasion of gingival epithelial cells prevent experimental periodontitis in mice

PURPOSE

We previously reported that human serum significantly reduces the invasion of various oral bacterial species into gingival epithelial cells in vitro. The aims of the present study were to characterize the serum component(s) responsible for the inhibition of bacterial invasion of epithelial cells and to examine their effect on periodontitis induced in mice.

METHODS

Immortalized human gingival epithelial (HOK-16B) cells were infected with various 5- (and 6-) carboxy-fluorescein diacetate succinimidyl ester-labeled oral bacteria, including Fusobacterium nucleatum, Provetella intermedia, Porphyromonas gingivalis, and Treponiema denticola, in the absence or presence of three major serum components (human serum albumin [HSA], pooled human IgG [phIgG] and α1-antitrypsin). Bacterial adhesion and invasion were determined by flow cytometry. The levels of intracellular reactive oxygen species (ROS) and activation of small GTPases were examined. Experimental periodontitis was induced by oral inoculation of P. gingivalis and T. denticola in Balb/c mice.

RESULTS

HSA and phIgG, but not α1-antitrypsin, efficiently inhibited the invasion of various oral bacterial species into HOK-16B cells. HSA but not phIgG decreased the adhesion of F. nucleatum onto host cells and the levels of intracellular ROS in HOK-16B cells. N-acetylcysteine (NAC), a ROS scavenger, decreased both the levels of intracellular ROS and invasion of F. nucleatum into HOK-16B cells, confirming the role of ROS in bacterial invasion. Infection with F. nucleatum activated Rac1, a regulator of actin cytoskeleton dynamics. Not only HSA and NAC but also phIgG decreased the F. nucleatum-induced activation of Rac1. Furthermore, both HSA plus phIgG and NAC significantly reduced the alveolar bone loss in the experimental periodontitis induced by P. gingivalis and T. denticola in mice.

CONCLUSIONS

NAC and the serum components HSA and phIgG, which inhibit bacterial invasion of oral epithelial cells in vitro, can successfully prevent experimental periodontitis.

Determinants of serum IgG responses to periodontal bacteria in a nationally representative sample of US adults

AIM

To assess the distribution of elevated antibody titres to multiple periodontal bacteria, including established/putative pathogens and health-related species, by selected demographic, behavioural, and oral- and general health-related characteristics.

METHODS

Data from 8153 >or=40-year-old participants from the third National Health and Nutrition Examination Survey were used, including 1588 edentulous individuals. We used checkerboard immunoblotting to assess serum IgG levels to 19 periodontal species. Thresholds for elevated antibody responses were defined for each species using the 90th percentile titre in periodontal healthy participants, using two alternative definitions of periodontitis.

RESULTS

Edentulous individuals showed lower antibody responses than dentate participants, notably for titres to "red complex" species and Actinobacillus actinomycetemcomitans. Elevated titres to Porphyromonas gingivalis were twice as prevalent in participants with periodontitis than in periodontal healthy individuals. Non-Hispanic blacks and Mexican-Americans were more likely to display elevated titres for P. gingivalis compared with non-Hispanic whites (22.9%versus 19.4%versus 9.5%). Current smokers were significantly less likely to exhibit high titres to multiple bacteria than never smokers.

CONCLUSION

Demographic, behavioural, and oral- and general health-related characteristics were strong determinants of systemic antibody responses to periodontal bacteria in a nationally representative sample of US adults.

Significant association between score of periodontal disease and coronary artery disease

Recently, several researchers have demonstrated the association between periodontal disease and coronary artery disease (CAD). Therefore, we herein investigate the association between periodontal diseases and the existence of CAD among the study population who received both coronary angiography and dental examination. A total of 174 consecutive patients with dental examination including radiography and coronary angiography in the same hospitalization were recruited (64.5 +/- 10.3 years, M/F: 94/80). A dentist assessed severity of periodontal status markers (bleeding on probing, probing depth >or=6 mm, teeth lost, alveolar bone resorption >half of root length by radiography and smoking status). We divided these patients into two groups according to whether they had CAD (CAD group, n = 99) or not (non-CAD group, n = 75) according to the results of coronary angiography. The composite periodontal risk scores calculated from periodontal status markers were higher in the CAD group than in the non-CAD group (P = 0.02). The composite periodontal scores were higher in the CAD group of age <60 years old population (P = 0.03) and in the CAD group of patients with normal glucose tolerance (P = 0.04). However, the difference was not significant in the age >or=60 years old population or those with diabetes mellitus or impaired glucose tolerance. In all populations, hypertension, glucose tolerance, statin therapy, and composite of periodontal risk scores were associated with CAD. Multivariate analyses revealed statin therapy, glucose tolerance, and periodontal risk scores were independent and significant risk factors for CAD. Composite periodontal risk scores were independent and significant predictive factors for CAD.

Markers of systemic bacterial exposure in periodontal disease and cardiovascular disease risk: a systematic review and meta-analysis

BACKGROUND

Recent meta-analyses reported a weak association between periodontal disease (PD) on clinical examination and cardiovascular disease (CVD). Systemic bacterial exposure from periodontitis, which correlates poorly with the clinical examination, has been proposed as the more biologically pertinent risk factor. The purpose of this study was to review and analyze the association between PD with elevated systemic bacterial exposure and CVD.

METHODS

We searched in the PubMed, Cochrane Controlled Trials Register, EMBASE, and SCOPUS databases for all literature examining PD and CVD. From 10 selected publications, we extracted 12 cohort (N = 5) and cross-sectional (N = 7) studies and included 11 of these in a meta-analysis. With stratified analyses, this resulted in 14 analyses of coronary heart disease (CHD; N = 7), stroke (N = 4), and carotid intima-medial thickening (CIMT; N = 3) as a measure of early atherosclerosis. Systemic bacterial exposure was measured by periodontal bacterial burden (N = 1), periodontitis-specific serology (N = 12), or C-reactive protein (N = 1).

RESULTS

Periodontal disease with elevated markers of systemic bacterial exposure was associated strongly with CHD compared to subjects without PD, with a summary odds ratio of 1.75 (95% confidence interval (CI): 1.32 to 2.34; P <0.001). This group was not associated with CVD events or with stroke but was associated with a significant increase in mean CIMT (0.03 mm; 95% CI: 0.02 to 0.04).

CONCLUSION

Periodontal disease with elevated bacterial exposure is associated with CHD events and early atherogenesis (CIMT), suggesting that the level of systemic bacterial exposure from periodontitis is the biologically pertinent exposure with regard to atherosclerotic risk.

Associations of Periodontal Status with General Health Conditions and Serum Antibody Titers forPorphyromonas gingivalisandActinobacillus actinomycetemcomitans

BACKGROUND

The purpose of the present study was to evaluate associations of periodontal status with general health conditions and with serum antibody titers for Porphyromonas gingivalis (Pg) and Actinobacillus actinomycetemcomitans (Aa) in a Japanese population.

METHODS

Subjects (1,314) aged 40 years or older were recruited for the study. Their periodontal status was evaluated using the community periodontal index of treatment needs (CPITN). Records from general health examinations were used for the present analyses, including data on age, gender, body mass index, systolic and diastolic blood pressure (SBP/DBP); levels of serum alkaline phosphatase, total cholesterol, high-density lipoprotein cholesterol, triglyceride, fasting blood glucose, and C-reactive protein (CRP); counts of white blood cells (WBC) and platelets; smoking habit; and electrocardiogram recordings. Serum IgG antibody titers for Pg fimbrial antigens (IgG.Pg.Fim.), Pg whole-cell antigens (IgG.Pg.whol.), and Aa whole-cell antigens (IgG.Aa.whol.) were determined using enzyme-linked immunosorbent assay. The subjects were divided, according to their maximum CPITN codes, into four periodontal groups: max.CPITN-0/1/2, -3, -4, or -MS (missing sextant).

RESULTS

Multivariable logistic regression analyses revealed significant associations of the max.CPITN-4 subjects who were males (odds ratio, OR: 2.03) or smokers (OR: 1.73), or who had high diastolic blood pressure (OR: 1.27), high WBC (OR: 1.24), high serum CRP level (OR: 2.39) and high serum IgG.Pg.Fim. (OR: 1.17), IgG.Pg.whol. (OR:1.54), and IgG.Aa.whol. (OR: 1.19) titers.

CONCLUSION

Significant associations between periodontal status and several health conditions were found in the adult population examined, including gender, smoking habit, diastolic blood pressure, white blood cell counts, C-reactive protein, and serum IgG antibodies to P. gingivalis fimbriae, IgG P. gingivalis whole cell, and IgG A. actinomycetemcomitans whole cell titers.

Antibodies to periodontal pathogens are associated with coronary heart disease

OBJECTIVE

We analyzed the association of coronary heart disease (CHD) and serology of periodontitis in a random sample (n=1163) of men (aged 45 to 74 years) by determining serum IgG-antibodies to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis.

METHODS AND RESULTS

CHD (n=159) was more prevalent among edentulous than dentate subjects (19.8% and 12.1%, P=0.003). In the dentate population, CHD was more common among subjects seropositive for P. gingivalis compared with those seronegative (14.0% and 9.7%, P=0.029). Accordingly, CHD was more prevalent in subjects with a high combined antibody response than those with a low response (17.4% and 11.1%, P=0.026). When adjusted for age and several CHD risk factors, the subjects with a high combined antibody response had an odds ratio of 1.5 (95% CI, 0.95 to 2.50, P=0.077) for prevalent CHD. In a linear regression model, the combined antibody response was directly associated with prevalent CHD (P=0.046) and inversely with serum HDL cholesterol concentration (P=0.050).

CONCLUSIONS

In conclusion, edentulousness and serum antibodies to major periodontal pathogens were associated with CHD. This suggests that periodontal infection or response of the host against the infection may play a role in the pathogenesis of CHD.