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Thomas C, Minty M, Vinel A, Canceill T, Loubières P, Burcelin R, Kaddech M, Blasco-Baque V, Laurencin-Dalicieux S. Oral Microbiota: A Major Player in the Diagnosis of Systemic Diseases. Diagnostics (Basel) 2021; 11:1376. [PMID: 34441309 PMCID: PMC8391932 DOI: 10.3390/diagnostics11081376] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
The oral cavity is host to a complex and diverse microbiota community which plays an important role in health and disease. Major oral infections, i.e., caries and periodontal diseases, are both responsible for and induced by oral microbiota dysbiosis. This dysbiosis is known to have an impact on other chronic systemic diseases, whether triggering or aggravating them, making the oral microbiota a novel target in diagnosing, following, and treating systemic diseases. In this review, we summarize the major roles that oral microbiota can play in systemic disease development and aggravation and also how novel tools can help investigate this complex ecosystem. Finally, we describe new therapeutic approaches based on oral bacterial recolonization or host modulation therapies. Collaboration in diagnosis and treatment between oral specialists and general health specialists is of key importance in bridging oral and systemic health and disease and improving patients' wellbeing.
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Affiliation(s)
- Charlotte Thomas
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Matthieu Minty
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Alexia Vinel
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Thibault Canceill
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR CNRS 5085, Centre Interuniversitaire de Recherche et d’Ingénierie des Matériaux (CIRIMAT), Université Paul Sabatier, 35 Chemin des Maraichers, CEDEX 9, 31062 Toulouse, France
| | - Pascale Loubières
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
| | - Remy Burcelin
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
| | - Myriam Kaddech
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Vincent Blasco-Baque
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Sara Laurencin-Dalicieux
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- INSERM UMR 1295, Centre d’Epidémiologie et de Recherche en Santé des Populations de Toulouse (CERPOP), Epidémiologie et Analyse en Santé Publique, Risques, Maladies Chroniques et Handicaps, 37 Allées Jules Guesdes, 31000 Toulouse, France
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Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000 2020; 83:90-106. [PMID: 32385879 DOI: 10.1111/prd.12304] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerosis is central to the pathology of cardiovascular diseases, a group of diseases in which arteries become occluded with atheromas that may rupture, leading to different cardiovascular events, such as myocardial infarction or ischemic stroke. There is a large body of epidemiologic and animal model evidence associating periodontitis with atherosclerotic disease, and many potential mechanisms linking these diseases have been elucidated. This chapter will update knowledge on these mechanisms, which generally fall into 2 categories: microbial invasion and infection of atheromas; and inflammatory and immunologic. With respect to the invasion and infection of atheromas, it is well established that organisms from the subgingival biofilm can enter the circulation and lodge in most distant tissues. Bacteremias resulting from oral interventions, and even oral hygiene activities, are well documented. More recently, indirect routes of entry of oral organisms (via phagocytes or dendritic cells) have been described for many oral organisms, into many tissues. Such organisms include the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum. Intracellular survival of these organisms with dissemination to distant sites (The Trojan Horse approach) has been described. Their relative contribution to atheroma formation and progression has been studied mainly in experimental research, with results demonstrating that these organisms can invade endothelial cells and phagocytic cells within the atheroma, leading to pathogenic changes and progression of the atheroma lesion. The second category of mechanisms potentially linking periodontitis to atherosclerosis includes the dumping of inflammatory mediators originating from periodontal lesions into the systemic circulation. These inflammatory mediators, such as C-reactive protein, matrix metalloproteinases, fibrinogen, and other hemostatic factors, would further accelerate atheroma formation and progression, mainly through oxidative stress and inflammatory dysfunction. Moreover, direct effects on lipid oxidation have also been described. In summary, the evidence supports the concept that periodontitis enhances the levels of systemic mediators of inflammation that are risk factors for atherosclerotic diseases.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, NewYork, New York, USA
| | - Robert Genco
- Departments of Oral Biology, and Microbiology and Immunology, Center for Microbiome Research, University at Buffalo, Buffalo, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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Choi YH, Kosaka T, Ojima M, Sekine S, Kokubo Y, Watanabe M, Miyamoto Y, Ono T, Amano A. Relationship between the burden of major periodontal bacteria and serum lipid profile in a cross-sectional Japanese study. BMC Oral Health 2018; 18:77. [PMID: 29728099 PMCID: PMC5935931 DOI: 10.1186/s12903-018-0536-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/23/2018] [Indexed: 12/16/2022] Open
Abstract
Background The association of periodontal bacteria with lipid profile alteration remains largely unknown, although it has been suggested that chronic periodontitis increases the atherosclerotic risk. This cross-sectional study investigated the relationship between the prevalence and total burden of periodontal bacteria and serum lipid profile. Methods Saliva from enrolled participants was collected to detect 4 major periodontal bacteria (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Prevotella intermedia) using Polymerase Chain Reaction method. High-density lipoprotein (HDL) cholesterol, triglycerides (TG), and low-density lipoprotein cholesterol were assessed using blood samples. We compared the averages of each lipid in association with the prevalence of each bacterial species, their burden (low, moderate, and high), and the combination of bacterial burden and periodontal status, defined as periodontitis, using the Community Periodontal Index, after adjustment for other potential confounding factors, by employing general linear models with least square means. Results A total of 385 Japanese individuals (176 men, 209 women; mean age 69.2 years) were enrolled. The number of bacterial species and their co-existence with periodontitis were significantly related to a decrease in HDL (p for trend < 0.01) and increase in TG (p for trend = 0.04). The adjusted mean HDL levels (mg/dL) in individuals with low, moderate, and high levels of bacterial species were 66.1, 63.0, and 58.9, respectively, and those in the 6 groups defined by combination of the two factors were 67.9, 64.6, 64.3, 65.4, 61.5, and 54.7, respectively. Conclusion Periodontal bacterial burden is suggested to be independently involved in lowering serum HDL level. Our findings suggest that bacterial tests in a clinical setting could be a useful approach for predicting the risk of HDL metabolism dysregulation.
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Affiliation(s)
- Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Takayuki Kosaka
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
| | - Miki Ojima
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita-Osaka, 565-0871, Japan
| | - Shinichi Sekine
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita-Osaka, 565-0871, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita-Osaka, Japan
| | - Makoto Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita-Osaka, Japan
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita-Osaka, Japan
| | - Takahiro Ono
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan.,Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita-Osaka, 565-0871, Japan.
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Gunpinar S, Alptekin NO, Dundar N. Gingival crevicular fluid levels of monocyte chemoattractant protein-1 in patients with aggressive periodontitis. Oral Dis 2017; 23:763-769. [PMID: 28231622 DOI: 10.1111/odi.12658] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 02/13/2017] [Accepted: 02/19/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the gingival crevicular fluid (GCF) levels of monocyte chemoattractant protein (MCP)-1 in aggressive periodontitis (AgP) and whether GCF MCP-1 levels differ among localized (L) AgP and generalized (G) AgP. MATERIAL AND METHODS A total of 160 subjects including 80 AgP and 80 age- and gender-matched periodontally healthy (H) controls were recruited in this cross-sectional study (NCT02927704). GCF samples were collected from 160 patients including 50 LAgP, 30 GAgP, and 80 H. Volume of GCF was measured by Periotron 8000® , and enzyme-linked immunosorbent assay was used to assess MCP-1 levels. RESULTS Compared to H controls, all clinical parameters and total amounts (pg 30 s-1 ) of MCP-1 were significantly higher in subjects with LAgP and GAgP (P < 0.05). Although concentrations of GCF MCP-1 did not differ between LAgP and GAgP (P > 0.05), total amounts of MCP-1 were higher in GAgP than LAgP (P < 0.05). CONCLUSION It can be concluded that the total amount of MCP-1 level in GCF may be a potential determinant in AgP subjects. Increased MCP-1 levels in line with the degree of periodontal destruction in GAgP patients reveal that MCP-1 can be used to understand the disease pathogenesis of LAgP and GAgP.
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Affiliation(s)
- S Gunpinar
- Department of Periodontology, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey
| | - N O Alptekin
- Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - N Dundar
- Research Center of Dental Faculty, Selcuk University, Konya, Turkey
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Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Clin Periodontol 2016; 40 Suppl 14:S51-69. [PMID: 23627334 DOI: 10.1111/jcpe.12060] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/17/2022]
Abstract
AIMS In this article, inflammatory mechanisms that link periodontal diseases to cardiovascular diseases are reviewed. METHODS This article is a literature review. RESULTS Studies in the literature implicate a number of possible mechanisms that could be responsible for increased inflammatory responses in atheromatous lesions due to periodontal infections. These include increased systemic levels of inflammatory mediators stimulated by bacteria and their products at sites distant from the oral cavity, elevated thrombotic and hemostatic markers that promote a prothrombotic state and inflammation, cross-reactive systemic antibodies that promote inflammation and interact with the atheroma, promotion of dyslipidemia with consequent increases in pro-inflammatory lipid classes and subclasses, and common genetic susceptibility factors present in both disease leading to increased inflammatory responses. CONCLUSIONS Such mechanisms may be thought to act in concert to increase systemic inflammation in periodontal disease and to promote or exacerbate atherogenesis. However, proof that the increase in systemic inflammation attributable to periodontitis impacts inflammatory responses during atheroma development, thrombotic events or myocardial infarction or stroke is lacking.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, Virginia Commonwealth University, Richmond, VA 23298-0566, USA.
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Links between atherosclerotic and periodontal disease. Exp Mol Pathol 2016; 100:220-35. [DOI: 10.1016/j.yexmp.2016.01.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/08/2016] [Indexed: 02/06/2023]
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Gao H, Tian Y, Meng H, Hou J, Xu L, Zhang L, Shi D, Lu R, Feng X, Wang X, Chen Z. Associations of apolipoprotein E and low-density lipoprotein receptor-related protein 5 polymorphisms with dyslipidemia and generalized aggressive periodontitis in a Chinese population. J Periodontal Res 2014; 50:509-18. [PMID: 25329009 DOI: 10.1111/jre.12237] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2014] [Indexed: 12/23/2022]
Affiliation(s)
- H. Gao
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Y. Tian
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - H. Meng
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - J. Hou
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - L. Xu
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - L. Zhang
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - D. Shi
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - R. Lu
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - X. Feng
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - X. Wang
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Z. Chen
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
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Liberopoulos EN, Apostolou F, Gazi IF, Kostara C, Bairaktari ET, Tselepis AD, Elisaf M. Visceral leishmaniasis is associated with marked changes in serum lipid profile. Eur J Clin Invest 2014; 44:719-27. [PMID: 24920396 DOI: 10.1111/eci.12288] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/06/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infection is often accompanied by lipid profile alterations. The aim of this study was to evaluate the lipid profile changes in patients with visceral leishmaniasis (VL). MATERIALS AND METHODS We included 15 patients [10 men, aged 50 (24-82) years old] with VL and 15 age- and sex-matched controls. The parameters estimated at diagnosis and 4 months after VL resolution were total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), apolipoproteins (apo) A-Ι, B, E, C-II, C-III, lipoprotein (a) [Lp(a)], activities of lipoprotein-associated phospholipase A2 (Lp-PLA2), HDL-Lp-PLA2, PON1 (paraoxonase 1) and cholesterol ester transfer protein (CETP), cytokines (interleukins 1β and 6 and tumour necrosis factor α), as well as LDL subfraction profile. RESULTS Patients with VL at diagnosis had lower levels of TC, LDL-C, apoΒ and Lp(a), and higher TG and apoE concentrations compared with 4 months after VL resolution. The activities of Lp-PLA2, HDL-Lp-PLA2 and ΡΟΝ1 were reduced at diagnosis compared with post-treatment values. VL patients had decreased levels of both large and sdLDL-C at diagnosis; no effect on mean LDL particle size was observed. Patients with VL at diagnosis had decreased HDL-C and apoA-I concentrations; these increased 4 months after VL resolution, but remained lower compared with controls. The activities of HDL-Lp-PLA2 and PON1 remained lower in patients after VL resolution compared with controls. CONCLUSIONS Patients with VL exhibit increased TG levels and decreased cholesterol subclasses at diagnosis. HDL-C, apoA-I and associated enzymes remain lower 4 months after VL resolution compared with controls.
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Macri E, Lifshitz F, Ramos C, Orzuza R, Costa O, Zago V, Boyer P, Friedman S. Atherogenic cholesterol-rich diet and periodontal disease. Arch Oral Biol 2014; 59:679-86. [DOI: 10.1016/j.archoralbio.2014.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 01/22/2014] [Accepted: 03/12/2014] [Indexed: 01/20/2023]
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Biochemical and C-reactive protein alterations in myocardial infarction periodontitis patients. Am J Med Sci 2014; 348:181-5. [PMID: 24670724 DOI: 10.1097/maj.0000000000000253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Periodontitis (PD) is a risk factor for acute myocardial infarction (AMI). C-reactive protein (CRP) is elevated in PD. The aim of this study was to investigate biochemical alterations among AMI with PD. Thirty non-AMI (25 non-PD and only 5 PD) and 30 AMI (13 PD and 17 non-PD) patients were participated. Serum CRP, tumor necrosis factor alpha (TNF-α), total cholesterol, low-density lipoprotein cholesterol, protein carbonyl (PC) contents, soluble vascular cell adhesion molecule-1 (sVCAM-1), adiponectin, creatine kinase, resistin, catalase and superoxide dismutase (SOD) levels were measured. AMI-PD elicited significant differences in percentage hypertension, diabetes, serum creatine kinase, cholesterol and low-density lipoprotein cholesterol. CRP among AMI-PD and non-AMI-PD was increased by 73.4% and 31.3%, respectively. The level of PC contents was increased significantly among AMI-PD and non-AMI-PD by 47.62% and 33.3%, respectively. Catalase and SOD levels were significantly decreased in AMI-PD by 33.7% and 34.1%, respectively; however, their levels among non-AMI-PD were significantly increased by 35.7% and 28%, respectively. TNF-α, sVCAM-1 and resistin levels among AMI-PD were increased by 134.3%, 68.8% and 25.5%, respectively; however, TNF-α and sVCAM-1 levels among non-AMI-PD were increased significantly by 21.4% and 29.4%, respectively. Adiponectin level produced insignificant changes. PD prevalence among AMI associated with elevated serum CRP, PC contents, sVCAM-1, TNF-α and resistin levels concurrent with declines in SOD and catalase enzymes. In conclusion, among nondiabetic, nonsmoking patients suffering from AMI, PD is highly prevalent and associated with elevated serum CRP, PC contents, sVCAM-1, TNF-α and resistin levels, associated with significant declines in antioxidant enzymes with insignificant change in serum adiponectin level.
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Bartova J, Sommerova P, Lyuya-Mi Y, Mysak J, Prochazkova J, Duskova J, Janatova T, Podzimek S. Periodontitis as a risk factor of atherosclerosis. J Immunol Res 2014; 2014:636893. [PMID: 24741613 PMCID: PMC3987959 DOI: 10.1155/2014/636893] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/29/2014] [Accepted: 02/17/2014] [Indexed: 11/24/2022] Open
Abstract
Over the last two decades, the amount of evidence corroborating an association between dental plaque bacteria and coronary diseases that develop as a result of atherosclerosis has increased. These findings have brought a new aspect to the etiology of the disease. There are several mechanisms by which dental plaque bacteria may initiate or worsen atherosclerotic processes: activation of innate immunity, bacteremia related to dental treatment, and direct involvement of mediators activated by dental plaque and involvement of cytokines and heat shock proteins from dental plaque bacteria. There are common predisposing factors which influence both periodontitis and atherosclerosis. Both diseases can be initiated in early childhood, although the first symptoms may not appear until adulthood. The formation of lipid stripes has been reported in 10-year-old children and the increased prevalence of obesity in children and adolescents is a risk factor contributing to lipid stripes development. Endothelium damage caused by the formation of lipid stripes in early childhood may lead to bacteria penetrating into blood circulation after oral cavity procedures for children as well as for patients with aggressive and chronic periodontitis.
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Affiliation(s)
- Jirina Bartova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Pavla Sommerova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Yelena Lyuya-Mi
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jaroslav Mysak
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jarmila Prochazkova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jana Duskova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Tatjana Janatova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Stepan Podzimek
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
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Kizildag A, Arabaci T, Dogan GE. Relationship between periodontitis and cardiovascular diseases: A literature review. World J Stomatol 2014; 3:1-9. [DOI: 10.5321/wjs.v3.i1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 08/14/2013] [Accepted: 11/16/2013] [Indexed: 02/06/2023] Open
Abstract
Periodontitis and cardiovascular disease have a complex etiology and genetics and share some common risk factors (i.e., smoking, age, diabetes, etc.). In recent years, the relationship between periodontal disease and cardiovascular disease has been investigated extensively. This research mostly focused on the fact that periodontitis is an independent risk factor for cardiovascular disease. Our aim in this article is to investigate the etiological relationship between periodontal disease and cardiovascular disease and the mechanisms involved in this association. According to the current literature, it is concluded that there is a strong relationship between these chronic disorders.
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Sharifov OF, Nayyar G, Ternovoy VV, Palgunachari MN, Garber DW, Anantharamaiah G, Gupta H. Comparison of anti-endotoxin activity of apoE and apoA mimetic derivatives of a model amphipathic peptide 18A. Innate Immun 2013; 20:867-80. [PMID: 24323453 DOI: 10.1177/1753425913514621] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Endotoxemia is a major cause of chronic inflammation, and is an important pathogenic factor in the development of metabolic syndrome and atherosclerosis. Human apolipoprotein E (apoE) and apoA-I are protein components of high-density lipoprotein, which have strong anti-endotoxin activity. Here, we compared anti-endotoxin activity of Ac-hE18A-NH2 and 4F peptides, modified from model amphipathic helical 18A peptide, to mimic, respectively, apoE and apoA-I properties. Ac-hE18A-NH2, stronger than 4F, inhibited endotoxin activity and disaggregated Escherichia coli 055:B5 (wild smooth serotype). Ac-hE18A-NH2 and 4F inhibited endotoxin activity of E. coli 026:B6 (rough-like serotype) to a similar degree. This suggests that Ac-hE18A-NH2 as a dual-domain molecule might interact with both the lipid A and headgroup of smooth LPS, whereas 4F binds lipid A. In C57BL/6 mice, Ac-hE18A-NH2 was superior to 4F in inhibiting the inflammatory responses mediated by E. coli 055:B5, but not E. coli 026:B6. However, in THP-1 cells, isolated human primary leukocytes, and whole human blood, Ac-hE18A-NH2 reduced responses more strongly than 4F to both E. coli serotypes either when peptides were pre-incubated or co-incubated with LPS, indicating that Ac-hE18A-NH2 also has strong anti-inflammatory effects independent of endotoxin-neutralizing properties. In conclusion, Ac-hE18A-NH2 is more effective than 4F in inhibiting LPS-mediated inflammation, which opens prospective clinical applications for Ac-hE18A-NH2.
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Affiliation(s)
- Oleg F Sharifov
- Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - Gaurav Nayyar
- Department of Medicine, University of Alabama at Birmingham, AL, USA
| | | | | | - David W Garber
- Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - Gm Anantharamaiah
- Department of Medicine, University of Alabama at Birmingham, AL, USA Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, AL, USA
| | - Himanshu Gupta
- Department of Medicine, University of Alabama at Birmingham, AL, USA VA Medical Center, Birmingham, AL, USA
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Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Periodontol 2013; 84:S51-69. [DOI: 10.1902/jop.2013.134006] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Miyazawa H, Honda T, Miyauchi S, Domon H, Okui T, Nakajima T, Tabeta K, Yamazaki K. Increased serum PCSK9 concentrations are associated with periodontal infection but do not correlate with LDL cholesterol concentration. Clin Chim Acta 2012; 413:154-9. [DOI: 10.1016/j.cca.2011.09.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 09/08/2011] [Accepted: 09/09/2011] [Indexed: 11/25/2022]
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Davies RC, Jaedicke KM, Barksby HE, Jitprasertwong P, Al-Shahwani RM, Taylor JJ, Preshaw PM. Do patients with aggressive periodontitis have evidence of diabetes? A pilot study. J Periodontal Res 2011; 46:663-72. [DOI: 10.1111/j.1600-0765.2011.01388.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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18
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Maekawa T, Takahashi N, Tabeta K, Aoki Y, Miyashita H, Miyauchi S, Miyazawa H, Nakajima T, Yamazaki K. Chronic oral infection with Porphyromonas gingivalis accelerates atheroma formation by shifting the lipid profile. PLoS One 2011; 6:e20240. [PMID: 21625524 PMCID: PMC3098290 DOI: 10.1371/journal.pone.0020240] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 04/28/2011] [Indexed: 11/19/2022] Open
Abstract
Background Recent studies have suggested that periodontal disease increases the risk of atherothrombotic disease. Atherosclerosis has been characterized as a chronic inflammatory response to cholesterol deposition in the arteries. Although several studies have suggested that certain periodontopathic bacteria accelerate atherogenesis in apolipoprotein E-deficient mice, the mechanistic link between cholesterol accumulation and periodontal infection-induced inflammation is largely unknown. Methodology/Principal Findings We orally infected C57BL/6 and C57BL/6.KOR-Apoeshl (B6.Apoeshl) mice with Porphyromonas gingivalis, which is a representative periodontopathic bacterium, and evaluated atherogenesis, gene expression in the aorta and liver and systemic inflammatory and lipid profiles in the blood. Furthermore, the effect of lipopolysaccharide (LPS) from P. gingivalis on cholesterol transport and the related gene expression was examined in peritoneal macrophages. Alveolar bone resorption and elevation of systemic inflammatory responses were induced in both strains. Despite early changes in the expression of key genes involved in cholesterol turnover, such as liver X receptor and ATP-binding cassette A1, serum lipid profiles did not change with short-term infection. Long-term infection was associated with a reduction in serum high-density lipoprotein (HDL) cholesterol but not with the development of atherosclerotic lesions in wild-type mice. In B6.Apoeshl mice, long-term infection resulted in the elevation of very low-density lipoprotein (VLDL), LDL and total cholesterols in addition to the reduction of HDL cholesterol. This shift in the lipid profile was concomitant with a significant increase in atherosclerotic lesions. Stimulation with P. gingivalis LPS induced the change of cholesterol transport via targeting the expression of LDL receptor-related genes and resulted in the disturbance of regulatory mechanisms of the cholesterol level in macrophages. Conclusions/Significance Periodontal infection itself does not cause atherosclerosis, but it accelerates it by inducing systemic inflammation and deteriorating lipid metabolism, particularly when underlying hyperlidemia or susceptibility to hyperlipidemia exists, and it may contribute to the development of coronary heart disease.
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Affiliation(s)
- Tomoki Maekawa
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- Laboratory of Periodontology and Immunology, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Takahashi
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- Laboratory of Periodontology and Immunology, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichi Tabeta
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
| | - Yukari Aoki
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- Laboratory of Periodontology and Immunology, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hirotaka Miyashita
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- Laboratory of Periodontology and Immunology, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sayuri Miyauchi
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- Laboratory of Periodontology and Immunology, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruna Miyazawa
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- Laboratory of Periodontology and Immunology, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takako Nakajima
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kazuhisa Yamazaki
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
- Laboratory of Periodontology and Immunology, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- * E-mail:
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Ying Ouyang X, Mei Xiao W, Chu Y, Ying Zhou S. Influence of periodontal intervention therapy on risk of cardiovascular disease. Periodontol 2000 2011; 56:227-57. [DOI: 10.1111/j.1600-0757.2010.00368.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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20
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Griffiths R, Barbour S. Lipoproteins and lipoprotein metabolism in periodontal disease. CLINICAL LIPIDOLOGY 2010; 5:397-411. [PMID: 20835400 PMCID: PMC2933935 DOI: 10.2217/clp.10.27] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A growing body of evidence indicates that the incidence of atherosclerosis is increased in subjects with periodontitis - a chronic infection of the oral cavity. This article summarizes the evidence that suggests periodontitis shifts the lipoprotein profile to be more proatherogenic. LDL-C is elevated in periodontitis and most studies indicate that triglyceride levels are also increased. By contrast, antiatherogenic HDL tends to be low in periodontitis. Periodontal therapy tends to shift lipoprotein levels to a healthier profile and also reduces subclinical indices of atherosclerosis. In summary, periodontal disease alters lipoprotein metabolism in ways that could promote atherosclerosis and cardiovascular disease.
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Affiliation(s)
- Rachel Griffiths
- Department of Biochemistry & Molecular Biology, Virginia Commonwealth University School of Medicine, Box 980614, Richmond, VA 23298-0614, USA
| | - Suzanne Barbour
- Department of Biochemistry & Molecular Biology, Virginia Commonwealth University School of Medicine, Box 980614, Richmond, VA 23298-0614, USA
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Ramirez-Tortosa MC, Quiles JL, Battino M, Granados S, Morillo JM, Bompadre S, Newman HN, Bullon P. Periodontitis is associated with altered plasma fatty acids and cardiovascular risk markers. Nutr Metab Cardiovasc Dis 2010; 20:133-139. [PMID: 19500957 DOI: 10.1016/j.numecd.2009.03.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 02/27/2009] [Accepted: 03/02/2009] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS In periodontitis it has been found that some perturbation exists in lipid biomarkers, such as increased serum total cholesterol and low-density lipoprotein cholesterol. Nevertheless, the relationship between fatty acids and periodontitis has been demonstrated only in a few studies and remains controversial. The aim of this investigation was to explore the effects of periodontitis on a cluster of traditional and novel cardiovascular risk factors such as plasma-lipids profile, types of plasma fatty acids, adhesion molecules and systemic inflammatory markers. METHODS AND RESULTS At a university dental school, 56 patients all over 35 years old were enrolled and invited to participate in the study. Total plasma fatty acids, saturated, n-6 polyunsaturated and monounsaturated fatty acids, peroxidability index, soluble VCAM, TNF-alpha, cholesterol, triacylglycerols, and VLDL-c were significantly higher in the periodontitis group compared to the non-periodontitis group. CONCLUSIONS This close association found between plasma triacylglycerols, LDL-c, saturated fatty acids, polyunsaturated fatty acids, total amount of fatty acids and coenzyme Q(10) with some periodontal data such as periodontal probing depth, recession of the gingival margin and clinical attachment level (Pearson correlation between 0.3 and 0.6), leads to the conclusion that there is an inter-relationship between periodontitis, plasma fatty acids profile and the increase in metabolic risk factors for cardiovascular diseases.
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Affiliation(s)
- M C Ramirez-Tortosa
- Institute of Nutrition and Food Technology, Department of Biochemistry and Molecular Biology II, University of Granada, Granada, Spain.
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Periodontal disease and risk of atherosclerotic coronary heart disease. Odontology 2009; 97:84-91. [PMID: 19639450 DOI: 10.1007/s10266-009-0104-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2009] [Accepted: 05/11/2009] [Indexed: 12/22/2022]
Abstract
Atherosclerosis is an important component of coronary heart disease (CHD), which is the leading cause of death worldwide, including in Japan. Because atherosclerotic processes are typified by chronic inflammatory responses, which are similar to those elicited by chronic infection, the role of infection in promoting or accelerating atherosclerosis has received considerable focus. Increasing evidence supports the notion that periodontitis is associated with increased risk of atherosclerosis through dysfunction of endothelial cells induced by either periodontopathic bacteria or their products, or inflammatory mediators derived from infected periodontal tissue. Here we review whether periodontitis represents a risk factor for CHD or atherosclerosis, particularly in a Japanese population.
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24
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Bibliography. Current world literature. Atherosclerosis: cell biology and lipoproteins. Curr Opin Lipidol 2008; 19:525-35. [PMID: 18769235 DOI: 10.1097/mol.0b013e328312bffc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Boutouyrie P, Bouchard P, Mattout C, Bourgeois D. Periodontitis and Calculated Risk of Cardiovascular Mortality. Clin Med Cardiol 2008. [DOI: 10.4137/cmc.s573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- P. Boutouyrie
- Service de Pharmacologié, Universite Paris 5 René Descartes Faculté de Médecine et INSERM U652, Assistance publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France
| | - P. Bouchard
- Service d'Odontologie, Université Paris 7 Denis Diderot, Hôtel Dieu, Assistance Publique Hôpitaux de Paris, Paris, France
| | - C. Mattout
- Periodontal Private Practice, Marseille, France
| | - D. Bourgeois
- LIRIS UMR CNRS 5205, University Lyon I, France
- Global Oral Health Program, Department for Chronic Disease and Health Promotion, World Health Organization, Geneva, Switzerland
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