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Zhou Y, Meyle J, Groeger S. Periodontal pathogens and cancer development. Periodontol 2000 2024. [PMID: 38965193 DOI: 10.1111/prd.12590] [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: 01/23/2024] [Revised: 05/03/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
Increasing evidence suggests a significant association between periodontal disease and the occurrence of various cancers. The carcinogenic potential of several periodontal pathogens has been substantiated in vitro and in vivo. This review provides a comprehensive overview of the diverse mechanisms employed by different periodontal pathogens in the development of cancer. These mechanisms induce chronic inflammation, inhibit the host's immune system, activate cell invasion and proliferation, possess anti-apoptotic activity, and produce carcinogenic substances. Elucidating these mechanisms might provide new insights for developing novel approaches for tumor prevention, therapeutic purposes, and survival improvement.
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Affiliation(s)
- Yuxi Zhou
- Department of Periodontology, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Joerg Meyle
- Department of Periodontology, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Sabine Groeger
- Department of Periodontology, Justus-Liebig-University of Giessen, Giessen, Germany
- Department of Orthodontics, Justus-Liebig-University of Giessen, Giessen, Germany
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2
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Chepchumba B, Asudi GO, Katana J, Ngayo MO, Khayeli JA. Isolation of phages against Streptococcus species in the oral cavity for potential control of dental diseases and associated systemic complications. Arch Microbiol 2024; 206:175. [PMID: 38493441 DOI: 10.1007/s00203-024-03897-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/19/2024]
Abstract
Dental infections and systemic complications caused by Streptococcus species in the oral cavity are increasingly exhibiting resistance to commonly used antibiotics, posing a potential threat to global public health. Phage therapy may offer a superior alternative, given that bacteriophages can be easily isolated and rapidly replicate in large numbers. In this study, six Streptococcus species from the oral cavity were characterized. Bacteriophages isolated from wastewater using five of these species as hosts produced plaques ranging from 0.2 to 2.4 mm in size. The phages demonstrated stability within a temperature range of 4 ℃ to 37 ℃. However, at temperatures exceeding 45 ℃, a noticeable reduction in bacteriophage titer was observed. Similarly, the phages showed greater stability within a pH range of 5 to 10. The isolated phages exhibited latency periods ranging from 15 to 20 min and had burst sizes varying from 10 to 200 viral particles. This study supports the potential use of bacteriophages in controlling infections caused by Streptococcus species.
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Affiliation(s)
- Beatrice Chepchumba
- Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, Kenya.
| | - George O Asudi
- Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, Kenya
| | - Japhet Katana
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Musa O Ngayo
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
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3
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Serón C, Olivero P, Flores N, Cruzat B, Ahumada F, Gueyffier F, Marchant I. Diabetes, periodontitis, and cardiovascular disease: towards equity in diabetes care. Front Public Health 2023; 11:1270557. [PMID: 38192555 PMCID: PMC10771979 DOI: 10.3389/fpubh.2023.1270557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
Type 2 diabetes and its associated cardiovascular risk is an escalating epidemic that represents a significant public health burden due to increased morbidity and mortality, disproportionately affecting disadvantaged communities. Poor glycaemic control exacerbates this burden by increasing retinal, renal, and cardiac damage and raising healthcare costs. This predicament underscores the urgent need for research into cost-effective approaches to preventing diabetes complications. An important but often overlooked strategy to improve metabolic control in diabetic patients is the treatment of periodontitis. Our aim is to assess whether the inclusion of periodontitis treatment in diabetes management strategies can effectively improve metabolic control, and to advocate for its inclusion from an equity perspective. We conducted a comprehensive review of the literature from 2000 to 2023. We analyzed the pathophysiological links between periodontitis, diabetes, and atherosclerotic cardiovascular disease, all of which have inflammation as a central component. We also examined the inequalities in health care spending in this context. Our findings suggest that incorporating routine screening and treatment of periodontitis into national health programs, with coordinated efforts between physicians and dentists, is a cost-effective measure to improve metabolic control, reduce complications and improve the overall quality of life of people with diabetes.
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Affiliation(s)
- Constanza Serón
- Laboratorio de Modelamiento en Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
- Clinical Studies Unit, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Pablo Olivero
- Clinical Studies Unit, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
- Laboratorio de Estructura y Función Celular, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Nicolás Flores
- Laboratorio de Modelamiento en Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
- Clinical Studies Unit, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Benjamín Cruzat
- Laboratorio de Modelamiento en Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
- Clinical Studies Unit, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Francisca Ahumada
- Laboratorio de Modelamiento en Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
- Clinical Studies Unit, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - François Gueyffier
- Laboratoire de biologie et biométrie évolutive – équipe modélisation des effets thérapeutiques, Université Claude Bernard Lyon, Lyon, France
| | - Ivanny Marchant
- Laboratorio de Modelamiento en Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
- Clinical Studies Unit, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
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4
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Integrative analysis of gene and protein expression in atherosclerosis-related pathways modulated by periodontal pathogens. Systematic review. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:8-22. [PMID: 36654677 PMCID: PMC9841036 DOI: 10.1016/j.jdsr.2022.12.001] [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: 01/19/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
The mechanisms modulated by periodontal pathogens in atherosclerosis are not fully understood. Aim: to perform an integrative analysis of gene and protein expression modulated by periodontal pathogens in cells and animal models for atherosclerosis. Methods Cochrane, PRISMA and AMSTAR2 guidelines for systematic reviews were followed. Data search was conducted in Pub-med, LILACS and Science Direct databases. Gene and protein expression data were collected from the included papers to perform an overrepresentation analysis using the Reactome Pathway Analysis tool and the KEGG database. Results Thirty-two papers were included in the review, they analyzed the effect of Fusobacterium nucleatum, Porphyromonas gingivalis, Streptococcus anginosus, Streptococcus sanguinis, Tannerella forsythia, and Treponema denticola or/and their virulent factors on gene and protein expression in human cells and animal models of atherosclerosis. Some of the modulated pathways include the immune system, programmed cell death, cellular responses to external stimuli, transport of small molecules, and signal transduction (p < 0.05). Those pathways are known to be involved in different stages of atherosclerosis progression. Conclusion Based on the performed analysis, it is possible to state that periodontal pathogens have the potential to be a contributing factor for atherosclerosis even in absence of a high-fat diet or high shear stress.
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Motoc GV, Juncar RI, Moca AE, Motoc O, Moca RT, Țig IA, Vaida LL, Juncar M. The Relationship between Dietary Habits and Periodontal Pathogens in a Sample of Romanian Children and Adolescents: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1779. [PMID: 38002870 PMCID: PMC10670252 DOI: 10.3390/children10111779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
The role of diet in shaping oral microbiota and its potential contribution to the development of periodontal pathogens cannot be understated. This study aimed to explore the correlation between dietary habits and the prevalence of 11 periodontal pathogens among children and adolescents in Oradea, Romania. The identification of these pathogens was performed using the micro-IDent test kit, capable of detecting 11 specific periodontal pathogens. Bacterial sampling was conducted from the crevicular fluid in the morning, prior to brushing, followed by the completion of a brief questionnaire by parents. The questionnaire captured various aspects of the children's eating habits, including meal frequency, consumption of sweets, and hydration levels. The collected samples were dispatched to the laboratory for analysis, which provided insights into the abundance of microorganisms. The study encompassed 60 participants aged between 2 and 18 years, with the majority reported by their parents to have regulated meal timings, frequent sugar intake, and adequate hydration. The findings revealed significant associations between certain dietary factors and the presence of specific periodontal pathogens. Notably, the absence of breastfeeding was linked with the detection of Tannerella forsythia and Campylobacter rectus. Furthermore, frequent consumption of sweets corresponded with the presence of Capnocytophaga spp., which was particularly observed in individuals consuming sweets 2-3 times a day. Insufficient age-appropriate hydration showed an association with the prevalence of T. forsythia, Peptostreptococcus micros, and Capnocytophaga spp. In this sample, it became evident that eating habits and diet influenced the presence of several periodontal pathogens. The lack of breastfeeding was predominantly associated with positive results for T. forsythia and C. rectus, while inadequate hydration correlated more frequently with the presence of T. forsythia and P. micros. Moreover, frequent consumption of sweets was linked to the presence of Capnocytophaga spp.
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Affiliation(s)
- Georgiana Veronica Motoc
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania; (G.V.M.); (R.T.M.)
| | - Raluca Iulia Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Ovidiu Motoc
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Rahela Tabita Moca
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania; (G.V.M.); (R.T.M.)
| | - Ioan Andrei Țig
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Mihai Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
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Xuan Y, Yu C, Ni K, Congcong L, Lixin Q, Qingxian L. Protective effects of tanshinone IIA on Porphyromonas gingivalis-induced atherosclerosis via the downregulation of the NOX2/NOX4-ROS mediation of NF-κB signaling pathway. Microbes Infect 2023; 25:105177. [PMID: 37392987 DOI: 10.1016/j.micinf.2023.105177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/07/2023] [Accepted: 06/25/2023] [Indexed: 07/03/2023]
Abstract
Tanshinone IIA (TSA), an active component isolated from Danshen, possess high medicinal values against atherosclerosis by reducing vascular oxidative stress, inhibiting platelet aggregation, and protecting the endothelium from damage. The periodontal pathogen Porphyromonas gingivalis (P. gingivalis) has been proven to accelerate the development of atherosclerosis. We aim to determine the effects of TSA on P. gingivalis-induced atherosclerosis in ApoE-knockout (ApoE-/-) mice. After feeding with a high-lipid diet and infected with P. gingivalis three times per week for four weeks, TSA-treated (60 mg/kg/d) mice greatly inhibited atherosclerotic lesions both morphologically and biochemically and exhibited significantly reduction ROS, 8-OHdG, and ox-LDL levels in serum compared with P. gingivalis-infected mice. Additionally, TSA-treated mice were observed a marked reduction of ROS, 8-OHdG and ox-LDL in the serum, mRNA levels of COX-2, LOX-1, NOX2 and NOX4 in the aorta, as well as the levels of NOX2, NOX4, and NF-κB. These results suggest that TSA attenuates oxidative stress by decreasing NOX2 and NOX4 and downregulating NF-κB signaling pathway, which might be contributed to the amelioration of atherosclerosis.
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Affiliation(s)
- Yan Xuan
- Department of the Fourth Division, Peking University, School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Cai Yu
- Department of Periodontology, Peking University, School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Kang Ni
- Department of Periodontology, Peking University, School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Lou Congcong
- Department of Periodontology, Peking University, School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Qiu Lixin
- Department of the Fourth Division, Peking University, School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
| | - Luan Qingxian
- Department of Periodontology, Peking University, School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
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7
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Etta I, Kambham S, Girigosavi KB, Panjiyar BK. Mouth-Heart Connection: A Systematic Review on the Impact of Periodontal Disease on Cardiovascular Health. Cureus 2023; 15:e46585. [PMID: 37933364 PMCID: PMC10625740 DOI: 10.7759/cureus.46585] [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] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Periodontal diseases (PDs) and cardiovascular diseases (CVDs) are highly prevalent global diseases with increasing percentages of morbidity and mortality. Both PD and CVDs independently have multifactorial causation, and emerging evidence shows an association between PD and CVDs. Periodontal diseases like gingivitis and periodontitis are chronic inflammatory conditions that eventually cause systemic inflammation, leading to many systemic diseases like rheumatoid arthritis, cardiovascular diseases, and others. In this study, we followed a systematic review approach to give an overview of the current evidence on the association between PD and CVDs. We used a relevant search strategy to retrieve articles from databases such as PubMed and Google Scholar from 2013 to July 2023. Upon applying filters and screening through titles and abstracts, we could narrow down articles to 21. On full-text screening, we selected 10 articles for in-depth analysis. This study showed a significant correlation between PD and CVDs. Poor oral hygiene, infection, and inflammation in the oral cavity lead to systemic inflammation, causing endothelial dysfunction. There are controversial views about PD acting as an independent risk factor for CVD development, as there are other risk factors such as age, gender, smoking, etc. acting as confounding factors while establishing the link between PD and CVDs. Knowledge about oral health, maintaining good oral hygiene, and proper treatment for PD could reduce the incidence of CVDs. Further research is needed to prove that PD is an independent risk factor for CVDs.
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Affiliation(s)
- Indu Etta
- Internal Medicine, Kakatiya Medical College, Warangal, IND
| | - Saisravika Kambham
- Internal Medicine, Dr. Bhim Rao Ambedkar Medical College and Hospital, Bangalore, IND
| | - Khushal B Girigosavi
- Neurology, Dr. Vasantrao Pawar Medical College, Hospital and Research Center, Nashik, IND
| | - Binay K Panjiyar
- Internal Medicine, Harvard Medical School, Boston, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Gualtero DF, Lafaurie GI, Buitrago DM, Castillo Y, Vargas-Sanchez PK, Castillo DM. Oral microbiome mediated inflammation, a potential inductor of vascular diseases: a comprehensive review. Front Cardiovasc Med 2023; 10:1250263. [PMID: 37711554 PMCID: PMC10498784 DOI: 10.3389/fcvm.2023.1250263] [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: 06/30/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
The dysbiosis of the oral microbiome and vascular translocation of the periodontopathic microorganism to peripheral blood can cause local and systemic extra-oral inflammation. Microorganisms associated with the subgingival biofilm are readily translocated to the peripheral circulation, generating bacteremia and endotoxemia, increasing the inflammation in the vascular endothelium and resulting in endothelial dysfunction. This review aimed to demonstrate how the dysbiosis of the oral microbiome and the translocation of oral pathogen-induced inflammation to peripheral blood may be linked to cardiovascular diseases (CVDs). The dysbiosis of the oral microbiome can regulate blood pressure and activate endothelial dysfunction. Similarly, the passage of periodontal microorganisms into the peripheral circulation and their virulence factors have been associated with a vascular compartment with a great capacity to activate endothelial cells, monocytes, macrophages, and plaquettes and increase interleukin and chemokine secretion, as well as oxidative stress. This inflammatory process is related to atherosclerosis, hypertension, thrombosis, and stroke. Therefore, oral diseases could be involved in CVDs via inflammation. The preclinic and clinical evidence suggests that periodontal disease increases the proinflammatory markers associated with endothelial dysfunction. Likewise, the evidence from clinical studies of periodontal treatment in the long term evidenced the reduction of these markers and improved overall health in patients with CVDs.
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Alwithanani N. Periodontal Diseases and Heart Diseases: A Systemic Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S72-S78. [PMID: 37654288 PMCID: PMC10466634 DOI: 10.4103/jpbs.jpbs_517_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/07/2023] [Accepted: 03/03/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction Up to 50% of people worldwide are affected by periodontal disease (PD); cardiovascular diseases are a serious concern for the major portion of the world's population. Observational data have shown a connection between PD and CVD. The current systemic review investigates the incidence of the CVD in individuals with PD through various designs of the previous research. Materials and Methods An extensive online search in the various databanks of EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were: "PD, CVD, myocardial infarction, coronary heart disease (CHD), and stroke; technique of diagnosis and the degree of PD were assessed clinically or by self-report." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of mortality due to cardiac issues in periodontal diseases, meta-analysis, and meta-regression were carried out. The diagnosis techniques for periodontal diseases, severity, and impact of gender, were also examined. Results After full-text screening, 32 longitudinal cohort studies were included. PD patients had a significantly greater risk of CVD than non-PD patients (RR: 1.20). Clinical and self-reported PD diagnoses did not differ in CVD risk (RR = 0.97). Men were at increased risk for both severe PD (RR: 1.25), and CVD (RR: 1.16). The risk of stroke was the highest among all forms of CVD (RR = 1.24), and the risk of CHD was significantly elevated (RR = 1.14). Conclusion Current review showed that populations with PD consistently and modestly have an elevated risk of CVD. Men and those with severe PD are at higher CVD risk, which suggests population-targeted therapies may be helpful.
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Affiliation(s)
- Naif Alwithanani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, Taif University, Taif, Saudi Arabia
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10
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Mewborn EK, Wright DB, Wicks MN. Clinical utility of inflammatory and genetic biomarkers for cardiovascular disease prevention, categorization, and treatment. J Am Assoc Nurse Pract 2023; 35:404-412. [PMID: 37260280 DOI: 10.1097/jxx.0000000000000901] [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: 01/03/2023] [Accepted: 05/09/2023] [Indexed: 06/02/2023]
Abstract
ABSTRACT The complex interplay of increased atherogenic lipoproteins, inflammation, and immune activation hallmarks the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). Atherosclerotic cardiovascular disease remains a leading cause of death, yet risk estimator tools lack comprehensiveness for genetic/inflammatory biomarkers associated with ASCVD. Unexplained ASCVD risk necessitates a better understanding of primary, secondary, and tertiary prevention variables. This article discusses the clinical utility of genetic and inflammatory biomarkers for ASCVD risk prediction, management, treatment, and recategorization into primary, secondary, and tertiary prevention. Furthermore, nurse practitioners (NPs) should use a ternary prevention classification system instead of the current binary system to mitigate risk in the large group of patients with subclinical ASCVD. High-sensitivity C-reactive protein (hs-CRP)-linearly associated with ASCVD-and lipoprotein-associated phospholipase-A 2 (Lp-PLA 2 ) and myeloperoxidase (MPO), both associated with plaque vulnerability/rupture, are inflammatory biomarkers. Elevated hs-CRP, MPO, and Lp-PLA 2 treatment requires addressing root causes of elevation (e.g., obesity, insulin resistance, tobacco use, gingival disease, and chronic autoimmune/infectious conditions). In addition, haptoglobin (Hp) phenotype determines the antioxidant potential of Hp. Haptoglobin phenotype, a root cause of ASCVD, is a one-time test. Individuals with Hp 2-2 should adopt a gluten-free diet to reduce endothelial and intestinal inflammation. Nurse practitioners should use stricter glycemic goals (hemoglobin A1c ≤6.5%) and add daily vitamin E if this group has type 2 diabetes. Genetic/inflammatory biomarkers should be used to better predict ASCVD risk and tailor primary, secondary, and tertiary prevention treatment. Clinical use of these biomarkers reaches beyond the standard of care to reduce residual ASCVD risk.
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Affiliation(s)
- Emily K Mewborn
- Baptist Medical Group, Collierville, Tennessee
- The University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Mona N Wicks
- Health Promotion and Disease Prevention, The University of Tennessee Health Science Center, Memphis, Tennessee
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11
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Ellett F, Kacamak NI, Alvarez CR, Oliveira EH, Hasturk H, Paster BJ, Kantarci A, Irimia D. Fusobacterium nucleatum dissemination by neutrophils. J Oral Microbiol 2023; 15:2217067. [PMID: 37283724 PMCID: PMC10240972 DOI: 10.1080/20002297.2023.2217067] [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: 02/01/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023] Open
Abstract
Recent studies uncovered that Fusobacterium nucleatum (Fn), a common, opportunistic bacterium in the oral cavity, is associated with a growing number of systemic diseases, ranging from colon cancer to Alzheimer's disease. However, the pathological mechanisms responsible for this association are still poorly understood. Here, we leverage recent technological advances to study the interactions between Fn and neutrophils. We show that Fn survives within human neutrophils after phagocytosis. Using in vitro microfluidic devices, we determine that human neutrophils can protect and transport Fn over large distances. Moreover, we validate these observations in vivo by showing that neutrophils disseminate Fn using a zebrafish model. Our data support the emerging hypothesis that bacterial dissemination by neutrophils is a mechanistic link between oral and systemic diseases. Furthermore, our results may ultimately lead to therapeutic approaches that target specific host-bacteria interactions, including the dissemination process.
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Affiliation(s)
- Felix Ellett
- Department of Surgery, Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, MA, USA
- Shriners Hospital for Children, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Nazli I. Kacamak
- The Forsyth Institute, Cambridge, MA, USA
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Carla R. Alvarez
- The Forsyth Institute, Cambridge, MA, USA
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Eduardo H.S. Oliveira
- The Forsyth Institute, Cambridge, MA, USA
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Hatice Hasturk
- The Forsyth Institute, Cambridge, MA, USA
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Bruce J. Paster
- The Forsyth Institute, Cambridge, MA, USA
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Alpdogan Kantarci
- The Forsyth Institute, Cambridge, MA, USA
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Daniel Irimia
- Department of Surgery, Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Boston, MA, USA
- Shriners Hospital for Children, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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12
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Ruan Q, Guan P, Qi W, Li J, Xi M, Xiao L, Zhong S, Ma D, Ni J. Porphyromonas gingivalis regulates atherosclerosis through an immune pathway. Front Immunol 2023; 14:1103592. [PMID: 36999040 PMCID: PMC10043234 DOI: 10.3389/fimmu.2023.1103592] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/01/2023] [Indexed: 03/15/2023] Open
Abstract
Atherosclerosis (AS) is a chronic inflammatory disease, involving a pathological process of endothelial dysfunction, lipid deposition, plaque rupture, and arterial occlusion, and is one of the leading causes of death in the world population. The progression of AS is closely associated with several inflammatory diseases, among which periodontitis has been shown to increase the risk of AS. Porphyromonas gingivalis (P. gingivalis), presenting in large numbers in subgingival plaque biofilms, is the “dominant flora” in periodontitis, and its multiple virulence factors are important in stimulating host immunity. Therefore, it is significant to elucidate the potential mechanism and association between P. gingivalis and AS to prevent and treat AS. By summarizing the existing studies, we found that P. gingivalis promotes the progression of AS through multiple immune pathways. P. gingivalis can escape host immune clearance and, in various forms, circulate with blood and lymph and colonize arterial vessel walls, directly inducing local inflammation in blood vessels. It also induces the production of systemic inflammatory mediators and autoimmune antibodies, disrupts the serum lipid profile, and thus promotes the progression of AS. In this paper, we summarize the recent evidence (including clinical studies and animal studies) on the correlation between P. gingivalis and AS, and describe the specific immune mechanisms by which P. gingivalis promotes AS progression from three aspects (immune escape, blood circulation, and lymphatic circulation), providing new insights into the prevention and treatment of AS by suppressing periodontal pathogenic bacteria.
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Affiliation(s)
- Qijun Ruan
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Peng Guan
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Weijuan Qi
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Jiatong Li
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Mengying Xi
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Limin Xiao
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Sulan Zhong
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Dandan Ma
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- *Correspondence: Dandan Ma, ; Jia Ni,
| | - Jia Ni
- Department of Periodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- *Correspondence: Dandan Ma, ; Jia Ni,
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13
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Mewborn E, Stanfill A. Oxidative Stress Underpins Clinical, Social, and Genetic Risk Factors for Atherosclerotic Cardiovascular Disease. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2023; 17:11795468231170779. [PMID: 37153696 PMCID: PMC10155032 DOI: 10.1177/11795468231170779] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/31/2023] [Indexed: 05/10/2023]
Abstract
Background Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and is poorly predicted with current risk estimation tools. The biological mechanisms relating ASCVD risk factors to oxidative stress (OS) and how this accumulates ASCVD risk are misunderstood. Purpose To develop a comprehensive conceptual model explaining how expanded clinical, social, and genetic ASCVD risk factors accumulate ASCVD risk through OS. Conclusions OS (primarily from excess reactive oxygen species) and inflammation are present along the entire ASCVD pathophysiologic continuum. An expanded list of clinical and social ASCVD risk factors (including hypertension, obesity, diabetes, kidney disease, inflammatory diseases, substance use, poor nutrition, psychosocial stress, air pollution, race, and genetic ancestry) influence ASCVD largely through increased OS. Many risk factors exert a positive feedback mechanism to increase OS. One genetic risk factor, haptoglobin (Hp) genotype, is associated with higher ASCVD risk in diabetes and hypothesized to do the same in those with insulin resistance due to the Hp 2-2 genotype increasing OS. Implications Understanding the biological mechanisms of OS informs how these ASCVD risk factors relate to each other and compound ASCVD risk. Individualized ASCVD risk estimation should include a comprehensive, holistic perspective of risk factors to better address the clinical, social, and genetic influences of OS. Preventing and reducing OS is key to preventing ASCVD development or progression.
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Affiliation(s)
- Emily Mewborn
- University of Tennessee Health Science
Center, Memphis, TN, USA
- Emily Mewborn, University of Tennessee
Health Science Center, 874 Union Avenue, Suite G022B, Memphis, TN 38163, USA.
| | - Ansley Stanfill
- University of Tennessee Health Science
Center, Memphis, TN, USA
- Department of Acute and Tertiary Care,
College of Nursing, University of Tennessee Health Science Center, Memphis, TN,
USA
- Department of Genetics, Genomics, and
Informatics, College of Medicine, University of Tennessee Health Science Center,
Memphis, TN, USA
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14
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Abstract
Periodontitis, being a multifactorial disorder is found to be the most common oral disease denoted by the inflammation of gingiva and resorption of tooth supporting alveolar bone. The disease being closely linked with fast life style and determined by unhygienic behavioural factors, the internal milieu of oral cavity and formation of plaque biofilm on the dental and gingival surfaces. Porphyromonas gingivalis, being the major keystone pathogen of the periodontal biofilm evokes host immune responses that causes damage of gingival tissues and resorption of bones. The biofilm associated microbial community progressively aggravates the condition resulting in chronic inflammation and finally tooth loss. The disease often maintains bidirectional relationship with different systemic, genetic, autoimmune, immunodeficiency diseases and even psychological disorders. The disease can be diagnosed and predicted by various genetic, radiographic and computer-aided design (CAD) & computer-aided engineering (CAE) and artificial neural network (ANN). The elucidation of genetic background explains the inheritance of the disease. The therapeutic approaches commonly followed include mechanical removal of dental plaque with the use of systemic antibiotics. Awareness generation amongst local people, adoption of good practice of timely tooth brushing preferably with fluoride paste or with nanoconjugate pastes will reduce the chance of periodontal plaque formation. Modern tissue engineering technology like 3D bioprinting of periodontal tissue may help in patient specific flawless regeneration of tooth structures and associated bones.
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Affiliation(s)
- Rina Rani Ray
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, West Bengal, Haringhata, Nadia, India.
- Department of Biotechnology and Bioinformatics, Sambalpur University, FVHM+9QP, Jyoti Vihar, Burla, Odisha, 768019, India.
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15
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Bale BF, Doneen AL, Leimgruber PP, Vigerust DJ. The critical issue linking lipids and inflammation: Clinical utility of stopping oxidative stress. Front Cardiovasc Med 2022; 9:1042729. [PMID: 36439997 PMCID: PMC9682196 DOI: 10.3389/fcvm.2022.1042729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/24/2022] [Indexed: 07/30/2023] Open
Abstract
The formation of an atheroma begins when lipoproteins become trapped in the intima. Entrapped lipoproteins become oxidized and activate the innate immune system. This immunity represents the primary association between lipids and inflammation. When the trapping continues, the link between lipids and inflammation becomes chronic and detrimental, resulting in atherosclerosis. When entrapment ceases, the association between lipids and inflammation is temporary and healthy, and the atherogenic process halts. Therefore, the link between lipids and inflammation depends upon lipoprotein retention in the intima. The entrapment is due to electrostatic forces uniting apolipoprotein B to polysaccharide chains on intimal proteoglycans. The genetic transformation of contractile smooth muscle cells in the media into migratory secretory smooth muscle cells produces the intimal proteoglycans. The protein, platelet-derived growth factor produced by activated platelets, is the primary stimulus for this genetic change. Oxidative stress is the main stimulus to activate platelets. Therefore, minimizing oxidative stress would significantly reduce the retention of lipoproteins. Less entrapment decreases the association between lipids and inflammation. More importantly, it would halt atherogenesis. This review will analyze oxidative stress as the critical link between lipids, inflammation, and the pathogenesis of atherosclerosis. Through this perspective, we will discuss stopping oxidative stress to disrupt a harmful association between lipids and inflammation. Numerous therapeutic options will be discussed to mitigate oxidative stress. This paper will add a new meaning to the Morse code distress signal SOS-stopping oxidative stress.
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Affiliation(s)
- Bradley Field Bale
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Spokane, WA, United States
| | - Amy Lynn Doneen
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Spokane, WA, United States
| | - Pierre P. Leimgruber
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Spokane, WA, United States
- Department of Medical Education and Clinical Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - David John Vigerust
- Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, TN, United States
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16
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Aleksijević LH, Aleksijević M, Škrlec I, Šram M, Šram M, Talapko J. Porphyromonas gingivalis Virulence Factors and Clinical Significance in Periodontal Disease and Coronary Artery Diseases. Pathogens 2022; 11:pathogens11101173. [PMID: 36297228 PMCID: PMC9609396 DOI: 10.3390/pathogens11101173] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/27/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Porphyromonas gingivalis is a gram-negative, anaerobic bacterium that lives in the oral cavity. It is an integral part of the oral microbiome, which includes more than 500 types of bacteria. Under certain circumstances, as a consequence of virulence factors, it can become very destructive and proliferate to many cells in periodontal lesions. It is one of the causative agents present extremely often in dental plaque and is the main etiological factor in the development of periodontal disease. During various therapeutic procedures, P. gingivalis can enter the blood and disseminate through it to distant organs. This primarily refers to the influence of periodontal agents on the development of subacute endocarditis and can facilitate the development of coronary heart disease, atherosclerosis, and ischemic infarction. The action of P. gingivalis is facilitated by numerous factors of virulence and pathogenicity such as fimbriae, hemolysin, hemagglutinin, capsules, outer membrane vesicles, lipopolysaccharides, and gingipains. A special problem is the possibility of biofilm formation. P. gingivalis in a biofilm is 500 to 1000 times less sensitive to antimicrobial drugs than planktonic cells, which represents a significant problem in the treatment of infections caused by this pathogen.
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Affiliation(s)
- Lorena Horvat Aleksijević
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Correspondence: (L.H.A.); (J.T.)
| | - Marko Aleksijević
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marko Šram
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Miroslav Šram
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Cardiology, Clinical Hospital Center Osijek, 31000 Osijek, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Correspondence: (L.H.A.); (J.T.)
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17
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Kanagasingam S, von Ruhland C, Welbury R, Chukkapalli SS, Singhrao SK. Porphyromonas gingivalis Conditioned Medium Induces Amyloidogenic Processing of the Amyloid-β Protein Precursor upon in vitro Infection of SH-SY5Y Cells. J Alzheimers Dis Rep 2022; 6:577-587. [PMID: 36275415 PMCID: PMC9535609 DOI: 10.3233/adr-220029] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/23/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Cleavage of the amyloid-β protein precursor (AβPP) mediated by host secretase enzymes, releases several fragments including amyloid-β (Aβ40 and Aβ42). Objective: To determine if Porphyromonas gingivalis conditioned medium cleaved AβPP to release Aβ40 and Aβ42. Methods: The SH-SY5Y cell line was challenged, in vitro, with P. gingivalis (Pg381) conditioned medium in the presence/absence of cytokines. The cells and their supernatants were assessed for AβPP cleavage fragments by immunoblotting and transmission electron microscopy. Results: Western blotting of the cell lysates with the anti-AβPP C-terminal antibody demonstrated variable molecular weight bands corresponding to full length and fragmented AβPP in lanes treated with the following factors: Tryptic soy broth (TSB), Pg381, IL-6, Pg381 + IL-1β, and Pg381 + TNF-α. The low molecular weight bands corresponding to the C99 dimerized fragment were observed in the Pg381 and interlukin-6 (IL-6) treated groups and were significantly more intense in the presence of Pg381 with either IL-6 or TNF-α. Bands corresponding to the dimerized C83 fragment were observed with cells treated with TNF-α alone and with Pg381 combined with IL-1β or IL-6 or TNF-α. The anti-Aβ antibody detected statistically significant Aβ40 and Aβ42, levels when these two Aβ species were pooled across test samples and compared to the untreated group. Electron microscopic examination of the supernatants demonstrated insoluble Aβ40 and Aβ42. Conclusion: These observations strongly imply that AβPP is an infection responsive protein cleaved via the amyloidogenic pathway on exposure to conditioned medium and in the presence of pro-inflammatory mediators.
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Affiliation(s)
- Shalini Kanagasingam
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Christopher von Ruhland
- Electron and Light Microscopy Facility, College of Biomedical and Life Sciences, Cardiff University, Wales, UK
| | - Richard Welbury
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | | | - Sim K. Singhrao
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
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18
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Curia MC, Pignatelli P, D’Antonio DL, D’Ardes D, Olmastroni E, Scorpiglione L, Cipollone F, Catapano AL, Piattelli A, Bucci M, Magni P. Oral Porphyromonas gingivalis and Fusobacterium nucleatum Abundance in Subjects in Primary and Secondary Cardiovascular Prevention, with or without Heterozygous Familial Hypercholesterolemia. Biomedicines 2022; 10:biomedicines10092144. [PMID: 36140246 PMCID: PMC9496065 DOI: 10.3390/biomedicines10092144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Low-grade chronic inflammation, promoted by dysbiosis of the gut and oral microbiota, has been shown to contribute to individual susceptibility to atherosclerotic cardiovascular disease (ASCVD). High oral Porphyromonas gingivalis (Pg) and lower Fusobacterium nucleatum (Fn) concentrations have been associated with clinical and experimental atherosclerosis. We assessed oral Pg and Fn abundance in very high-risk patients with previously diagnosed ASCVD, with or without heterozygous familial hypercholesterolemia (HeFH), in subjects with HeFH in primary prevention and in healthy subjects. Methods: In this cross-sectional study, 40 patients with previously diagnosed ASCVD (10 with genetically proven HeFH, and 30 without FH), 26 subjects with HeFH in primary prevention, and 31 healthy subjects were selected to quantify oral Pg and Fn abundance by qPCR and assess oral health status. Results: Compared to healthy subjects, patients with previously diagnosed ASCVD showed greater Pg abundance (1101.3 vs. 192.4, p = 0.03), but similar Fn abundance. HeFH patients with ASCVD had an even greater Pg abundance than did non-HeFH patients and healthy subjects (1770.6 vs. 758.4 vs. 192.4, respectively; p = 0.048). No differences were found in the levels of Pg and Fn abundance in HeFH subjects in primary prevention, as compared to healthy subjects. Conclusions: Greater oral Pg abundance is present in very high-risk patients with previously diagnosed ASCVD, with or without FH, suggesting a potential relationship with CV events. Future studies will assess the predictive value of Pg abundance measurement in ASCVD risk stratification.
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Affiliation(s)
- Maria Cristina Curia
- Department of Medical, Oral and Biotechnological Sciences, Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: (M.C.C.); (M.B.); (P.M.)
| | - Pamela Pignatelli
- Department of Medical, Oral and Biotechnological Sciences, Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Domenica Lucia D’Antonio
- Department of Medical, Oral and Biotechnological Sciences, Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Damiano D’Ardes
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Elena Olmastroni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | - Luca Scorpiglione
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Cipollone
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Alberico Luigi Catapano
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy
| | - Adriano Piattelli
- Master Course in Microsurgery in Odontostomatology, Saint Camillus International University for Health Sciences (Unicamillus), 00131 Rome, Italy
- Fondazione Villaserena per la Ricerca, 65013 Città Sant’Angelo, Pescara, Italy
- Casa di Cura Villa Serena, 65013 Città Sant’Angelo, Pescara, Italy
| | - Marco Bucci
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: (M.C.C.); (M.B.); (P.M.)
| | - Paolo Magni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy
- Correspondence: (M.C.C.); (M.B.); (P.M.)
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19
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Schulz S, Hofmann B, Grollmitz J, Friebe L, Kohnert M, Schaller HG, Reichert S. Campylobacter Species of the Oral Microbiota as Prognostic Factor for Cardiovascular Outcome after Coronary Artery Bypass Grafting Surgery. Biomedicines 2022; 10:biomedicines10081801. [PMID: 35892701 PMCID: PMC9332846 DOI: 10.3390/biomedicines10081801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The oral microbiota has been implicated in a variety of systemic diseases, including cardiovascular (CV) disease. The main objective of this study (DRKS-ID: DRKS00015776) was to evaluate the prognostic importance of the oral microbiota for further CV events in patients undergoing coronary artery bypass grafting surgery (3-year follow-up). Methods: In this longitudinal cohort study, 102 CV patients were enrolled, of whom 95 completed the 3-year follow-up. The CV outcome was assessed using the major adverse cardiac and cerebrovascular events criteria. To evaluate subgingival colonization, 16S rRNA genes were amplified, targeting the V3/V4 region (Illumina MiSeq). Results: Regarding the specific number of operational taxonomic units (OTUs), no significant differences in CV outcome were determined (alpha diversity, Shannon index). In linear discriminant analyses and t-tests, the disease-specific differences in the beta diversity of the microbiota composition were evaluated. It was evident that bacteria species of the genus Campylobacter were significantly more prevalent in patients with a secondary CV event (p = 0.015). This hierarchical order also includes Campylobacter rectus, which is considered to be of comprehensive importance in both periodontal and CV diseases. Conclusions: Here, we proved that subgingival occurrence of Campylobacter species has prognostic relevance for cardiovascular outcomes in CV patients undergoing coronary artery bypass grafting.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
- Correspondence:
| | - Britt Hofmann
- Department of Cardiothoracic Surgery, Heart Centre of the University Clinics Halle (Saale), Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany;
| | - Julia Grollmitz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
| | - Lisa Friebe
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
| | - Michael Kohnert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
- Department of Cardiothoracic Surgery, Heart Centre of the University Clinics Halle (Saale), Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany;
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (J.G.); (L.F.); (M.K.); (H.-G.S.); (S.R.)
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20
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Kajihara R, Sakai H, Han Y, Amari K, Kawamoto M, Hakoyama Y, Nagashio S, Yamada SI, Sanjo H, Kurita H. Presence of periodontitis may synergistically contribute to cancer progression via Treg and IL-6. Sci Rep 2022; 12:11584. [PMID: 35804048 PMCID: PMC9270385 DOI: 10.1038/s41598-022-15690-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/28/2022] [Indexed: 11/09/2022] Open
Abstract
A close causal relationship has been suggested to exist between cancer and periodontitis. We hypothesized that the immune surveillance system is impaired in patients with periodontitis, which contributes to cancer development and growth. Therefore, the present study investigated the relationship between immune surveillance mechanisms and periodontitis in cancer patients. The presence or absence of periodontitis was assessed and the peripheral blood (PB) concentrations of IL-6, immunosuppressive cytokines (VEGF, TGF-β1, and CCL22) and proportion of T regulatory cells (Treg, CD3 + CD4 + CD25 + Foxp3 +) were measured. Subjects were classified into the following four groups: non-cancer patients without periodontitis (C − P −), non-cancer patients with periodontitis (C − P +), cancer patients without periodontitis (C + P −), and cancer patients with periodontitis (C + P +). The results of a multivariate analysis showed that the PB concentration of IL-6 was significantly higher in C + than in C- and higher in C + P + than in C + P −. The PB proportion of Treg was significantly higher in C + P + than in C + P −, C − P + , and C − P −. The results of this study suggested that the presence of periodontitis and cancer synergistically increased Treg in PB, which may be one of the underlying causes of immunosuppression and immune evasion in cancer. It was also suggested that the presence of periodontal disease and/or cancer also increases IL-6 in PB, which would be associated with cancer progression. These results suggest the possibility that the presence of periodontitis might synergistically contribute to cancer progression.
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Affiliation(s)
- Ryo Kajihara
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Hironori Sakai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan.
| | - Yibing Han
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Kei Amari
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Makiko Kawamoto
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Yusuke Hakoyama
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Sachiho Nagashio
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Hideki Sanjo
- Department of Molecular and Cellular Immunology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
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21
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Liu Y, Huang W, Dai K, Liu N, Wang J, Lu X, Ma J, Zhang M, Xu M, Long X, Liu J, Kou Y. Inflammatory response of gut, spleen, and liver in mice induced by orally administered Porphyromonas gingivalis. J Oral Microbiol 2022; 14:2088936. [PMID: 35756539 PMCID: PMC9225697 DOI: 10.1080/20002297.2022.2088936] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Periodontitis is a chronic multifactorial inflammatory disease. Porphyromonas gingivalis is a primary periopathogen in the initiation and development of periodontal disease. Evidence has shown that P. gingivalis is associated with systemic diseases, including IBD and fatty liver disease. Inflammatory response is a key feature of diseases related to this species. Methods C57BL/6 mice were administered either PBS, or P. gingivalis. After 9 weeks, the inflammatory response in gut, spleen, and liver was analyzed. Results The findings revealed significant disturbance of the intestinal microbiota and increased inflammatory factors in the gut of P. gingivalis-administered mice. Administrated P. gingivalis remarkably promoted the secretion of IRF-1 and activated the inflammatory pathway IFN-γ/STAT1 in the spleen. Histologically, mice treated with P. gingivalis exhibited hepatocyte damage and lipid deposition. The inflammatory factors IL-17a, IL-6, and ROR-γt were also upregulated in the liver of mice fed with P. gingivalis. Lee’s index, spleen index, and liver index were also increased. Conclusion These results suggest that administrated P. gingivalis evokes inflammation in gut, spleen, and liver, which might promote the progression of various systemic diseases.
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Affiliation(s)
- Yingman Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Wenkai Huang
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Ke Dai
- Department of Stomatology, Lishui University School of Medicine, Lishui, Zhejing, China
| | - Ni Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Jiaqi Wang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Xiaoying Lu
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Jiaojiao Ma
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Manman Zhang
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Mengqi Xu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Xu Long
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Jie Liu
- Department of Stomatology, Science Experiment Center, China Medical University, Shenyang, Liaoning, China
| | - Yurong Kou
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China.,Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
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22
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Harding A, Kanagasingam S, Welbury R, Singhrao SK. Periodontitis as a Risk Factor for Alzheimer's Disease: The Experimental Journey So Far, with Hope of Therapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:241-260. [PMID: 35612802 DOI: 10.1007/978-3-030-96881-6_13] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis and Alzheimer's disease (AD) exist globally within the adult population. Given that the risk of AD incidence doubles within 10 years from the time of periodontal disease diagnosis, there is a window of opportunity for slowing down or preventing AD by risk-reduction-based intervention. Literature appraisal on the shared risk factors of these diseases suggests a shift to a healthy lifestyle would be beneficial. Generalised (chronic) periodontitis with an established dysbiotic polymicrobial aetiology affects the tooth supporting tissues with eventual tooth loss. The cause of AD remains unknown, however two neurohistopathological lesions - amyloid-beta plaques and neurofibrillary tangles, together with the clinical history, provide AD diagnosis at autopsy. Historically, prominence was given to the two hallmark lesions but now emphasis is placed on cerebral inflammation and what triggers it. Low socioeconomic status promotes poor lifestyles that compromise oral and personal hygiene along with reliance on poor dietary intake. Taken together with advancing age and a declining immune protection, these risk factors may negatively impact on periodontitis and AD. These factors also provide a tangible solution to controlling pathogenic bacteria indigenous to the oral and gastrointestinal tract microbioes in vulnerable subjects. The focus here is on Porphyromonas gingivalis, one of several important bacterial pathogens associated with both periodontitis and AD. Recent research has enabled advances in our knowledge of the armoury of P. gingivalis via reproduction of all clinical and neuropathological hallmark lesions of AD and chronic periodontal disease in vitro and in vivo experimental models, thus paving the way for better future management.
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Affiliation(s)
- Alice Harding
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Shalini Kanagasingam
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Richard Welbury
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Sim K Singhrao
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK.
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23
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Lu F, Qi GG, Fang W, Zhang X, Zhou J, Yu XF, Li XJ. Causes of Emergency Bleeding after Nonsurgical Periodontal Therapy in Adult Periodontitis Patients: A Retrospective Analysis. Appl Bionics Biomech 2022; 2022:1579574. [PMID: 35392359 PMCID: PMC8983271 DOI: 10.1155/2022/1579574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background Emergency gingival uncontrollable bleeding after nonsurgical periodontal therapy (NSPT) could be caused by a variety of factors; local oral factors are the main cause of gingival bleeding in most patients. Because the doctor will do a good job of evaluating the patient's physical condition before nonsurgical periodontal therapy. This study is subjected to evaluate the possible factors associated with emergency uncontrollable bleeding within 24-48 hours after NSPT. Material and Methods. A total of fifty-eight patients with emergency bleeding after NSPT in the past four years were enrolled. The related factors in patients, such as age, gender, clotting function, systemic diseases, and baseline periodontitis severity, were analyzed. The site-related factors, such as tooth type, tooth distribution, and alveolar bone resorption at the bleeding site, were compared. The possible relationship of the parameters to the causes of emergency bleeding with NSPT was also evaluated. Results Gingival bleeding after NSPT was registered. In this retrospective study, a total of 58 patients were selected. There were 29 males and 29 females, aged from 20 to 67 years old, with an average age of 35.21 ± 10.09 years. Among them, 8.6% were over 50 years old, and 91.4% were under 50 years old. Completed evaluations were performed in 15.5% gingivitis and 84.5% periodontitis. The causes of emergency bleeding after nonsurgical periodontal therapy in this study were residual subgingival calculus or granulation tissue in 63.79% of cases: severe gingival inflammation, 29.32%; gum trauma, 3.45%; and poor compliance, 3.45%. The therapy method before bleeding includes supragingival scaling accounted for 72.4% and subgingival scaling accounted for 27.6%. 23 cases of horizontal absorption at the bleeding site accounted for 39.66%, and 35 cases of angular absorption accounted for 60.34%. Bleeding of maxillary posterior teeth accounted for 34.48%; mandibular anterior teeth accounted for 15.52%; mandibular anterior teeth accounted for 8.62%; and mandibular posterior teeth accounted for 18.97%; multiple sites accounted for 22.41%; eliminating residual subgingival calculus and granulation tissue were the main and most effective hemostatic methods, 86.21%. Conclusion Residual subgingival calculus or granulation tissue and severe gingival inflammation were the main causes of emergency gingival bleeding after nonsurgical periodontal therapy. Severe gingival inflammation causing emergency bleeding was more common in maxillary posterior teeth areas. Angular alveolar bone resorption was more likely to cause bleeding than horizontal resorption. Careful debridement of residual subgingival calculus and granulation tissue was the main hemostatic method.
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Affiliation(s)
- Fei Lu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Gang-Gang Qi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Wen Fang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Xin Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Jing Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Xue-Fen Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Xiao-Jun Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
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24
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Kowalski J, Górska R, Cieślik M, Górski A, Jończyk-Matysiak E. What Are the Potential Benefits of Using Bacteriophages in Periodontal Therapy? Antibiotics (Basel) 2022; 11:antibiotics11040446. [PMID: 35453197 PMCID: PMC9027636 DOI: 10.3390/antibiotics11040446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 01/16/2023] Open
Abstract
Periodontitis, which may result in tooth loss, constitutes both a serious medical and social problem. This pathology, if not treated, can contribute to the development of, among others, pancreatic cancer, cardiovascular diseases or Alzheimer’s disease. The available treatment methods are expensive but not always fully effective. For this reason, the search for and isolation of bacteriophages specific to bacterial strains causing periodontitis seems to be a great opportunity to target persistent colonization by bacterial pathogens and lower the use of antibiotics consequently limiting further development of antibiotic resistance. Furthermore, antimicrobial resistance (AMR) constitutes a growing challenge in periodontal therapy as resistant pathogens may be isolated from more than 70% of patients with periodontitis. The aim of this review is to present the perspective of phage application in the prevention and/or treatment of periodontitis alongside its complicated multifactorial aetiology and emphasize the challenges connecting composition and application of effective phage preparation.
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Affiliation(s)
- Jan Kowalski
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.K.); (R.G.)
| | - Renata Górska
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland; (J.K.); (R.G.)
| | - Martyna Cieślik
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (M.C.); (A.G.)
| | - Andrzej Górski
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (M.C.); (A.G.)
- Phage Therapy Unit, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland
- Infant Jesus Hospital, The Medical University of Warsaw, 02-006 Warsaw, Poland
| | - Ewa Jończyk-Matysiak
- Bacteriophage Laboratory, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (M.C.); (A.G.)
- Correspondence:
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25
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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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26
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Teles F, Collman RG, Mominkhan D, Wang Y. Viruses, periodontitis, and comorbidities. Periodontol 2000 2022; 89:190-206. [PMID: 35244970 DOI: 10.1111/prd.12435] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Seminal studies published in the 1990s and 2000s explored connections between periodontal diseases and systemic conditions, revealing potential contributions of periodontal diseases in the initiation or worsening of systemic conditions. The resulting field of periodontal medicine led to the publication of studies indicating that periodontal diseases can influence the risk of systemic conditions, including adverse pregnancy outcomes, cardiovascular and respiratory diseases, as well as Alzheimer disease and cancers. In general, these studies hypothesized that the periodontal bacterial insult and/or the associated proinflammatory cascade could contribute to the pathogenesis of these systemic diseases. While investigations of the biological basis of the connections between periodontal diseases and systemic conditions generally emphasized the bacteriome, it is also biologically plausible, under an analogous hypothesis, that other types of organisms may have a similar role. Human viruses would be logical "suspects" in this role, given their ubiquity in the oral cavity, association with periodontal diseases, and ability to elicit strong inflammatory response, compromise immune responses, and synergize with bacteria in favor of a more pathogenic microbial consortium. In this review, the current knowledge of the role of viruses in connecting periodontal diseases and systemic conditions is examined. We will also delve into the mechanistic basis for such connections and highlight the importance of those relationships in the management and treatment of patients.
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Affiliation(s)
- Flavia Teles
- Department of Basic and Translational Sciences, School of Dental Medicine, Center for Innovation & Precision Dentistry, School of Dental Medicine & School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ronald G Collman
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Dana Mominkhan
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yu Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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27
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Lucchese A, Cenciarelli S, Manuelli M, Marcolina M, Barzaghi F, Calbi V, Migliavacca M, Bernardo ME, Tucci F, Gallo V, Fraschetta F, Darin S, Casiraghi M, Aiuti A, Ferrua F, Cicalese MP. Wiskott-Aldrich syndrome: Oral findings and microbiota in children and review of the literature. Clin Exp Dent Res 2022; 8:28-36. [PMID: 35199474 PMCID: PMC8874040 DOI: 10.1002/cre2.503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/20/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Wiskott–Aldrich syndrome (WAS) is a rare X‐linked primary immunodeficiency, characterized by micro‐thrombocytopenia, recurrent infections, and eczema. This study aims to describe common oral manifestations and evaluate oral microbioma of WAS patients. Material and methods In this cohort study, 11 male WAS patients and 16 male healthy controls were evaluated in our Center between 2010 and 2018. Data about clinical history, oral examination, Gingival Index (GI) and Plaque Index (PI) were collected from both groups. Periodontal microbiological flora was evaluated on samples of the gingival sulcus. Results WAS subjects presented with premature loss of deciduous and permanent teeth, inclusions, eruption disturbance, and significantly worse GI and PI. They also showed a trend toward a higher total bacterial load. Fusobacterium nucleatum, reported to contribute to periodontitis onset, was the most prevalent bacteria, together with Porphyromonas gingivalis and Tannerella forsythia. Conclusions Our data suggest that WAS patients are at greater risk of alterations in the oral cavity. The statistically higher incidence of periodontitis and the trend to higher prevalence of potentially pathological bacterial species in our small cohort, that should be confirmed in future in a larger population, underline the importance of dentistry monitoring as part of the multidisciplinary management of WAS patients.
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Affiliation(s)
- Alessandra Lucchese
- Unit of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, Milan, Italy.,Unit of Orthodontics, Division of Dentistry, IRCSS Ospedale San Raffaele Scientific Institute, Milan, Italy.,Unit of Dentistry, Research Center for Oral Pathology and Implantology, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Sabina Cenciarelli
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Maurizio Manuelli
- Unit of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, Milan, Italy.,Unit of Orthodontics, Division of Dentistry, IRCSS Ospedale San Raffaele Scientific Institute, Milan, Italy.,Private Practice, Milan, Bologna, Pavia, Italy
| | - Marta Marcolina
- Unit of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, Milan, Italy.,Unit of Orthodontics, Division of Dentistry, IRCSS Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Federica Barzaghi
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Calbi
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Maddalena Migliavacca
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Maria Ester Bernardo
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Tucci
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Vera Gallo
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Federico Fraschetta
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Darin
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Miriam Casiraghi
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Aiuti
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Ferrua
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | - Maria Pia Cicalese
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
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28
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Tryptophanyl tRNA Synthetase from Human Macrophages Infected by Porphyromonas gingivalis Induces a Proinflammatory Response Associated with Atherosclerosis. Pathogens 2021; 10:pathogens10121648. [PMID: 34959604 PMCID: PMC8708850 DOI: 10.3390/pathogens10121648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 11/16/2022] Open
Abstract
Porphyromonas gingivalis is the most common microorganism associated with adult periodontal disease, causing inflammation around the subgingival lesion. In this study, we investigated tryptophanyl tRNA synthase (WRS) production by THP-1 cells infected with P. gingivalis. Cytokine production, leukocyte adhesion molecules, and low-density lipoprotein receptor (LDLR) expressions in cultured cells were examined. WRS was detected in THP-1 cell culture supernatants stimulated with P. gingivalis from 1 to 24 h, and apparent production was observed after 4 h. No change in WRS mRNA expression was observed from 1 to 6 h in THP-1 cells, whereas its expression was significantly increased 12 h after stimulation with P. gingivalis. Lactate dehydrogenase (LDH) activity was observed from 4 to 24 h. The TNF-α, IL-6, IL-8, and CXCL2 levels of THP-1 cells were upregulated after treatment with recombinant WRS (rWRS) and were significantly reduced when THP-1 cells were treated with C29. The MCP-1, ICAM-1, and VCAM-1 levels in human umbilical vein endothelial cells were upregulated following treatment with rWRS, and TAK242 suppressed these effects. Additionally, unmodified LDLR, macrophage scavenger receptor A, and lectin-like oxidized LDLRs were upregulated in THP-1 cells treated with rWRS. These results suggest that WRS from macrophages infected with P. gingivalis is associated with atherosclerosis.
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29
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Sansores-España LD, Melgar-Rodríguez S, Olivares-Sagredo K, Cafferata EA, Martínez-Aguilar VM, Vernal R, Paula-Lima AC, Díaz-Zúñiga J. Oral-Gut-Brain Axis in Experimental Models of Periodontitis: Associating Gut Dysbiosis With Neurodegenerative Diseases. FRONTIERS IN AGING 2021; 2:781582. [PMID: 35822001 PMCID: PMC9261337 DOI: 10.3389/fragi.2021.781582] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Abstract
Periodontitis is considered a non-communicable chronic disease caused by a dysbiotic microbiota, which generates a low-grade systemic inflammation that chronically damages the organism. Several studies have associated periodontitis with other chronic non-communicable diseases, such as cardiovascular or neurodegenerative diseases. Besides, the oral bacteria considered a keystone pathogen, Porphyromonas gingivalis, has been detected in the hippocampus and brain cortex. Likewise, gut microbiota dysbiosis triggers a low-grade systemic inflammation, which also favors the risk for both cardiovascular and neurodegenerative diseases. Recently, the existence of an axis of Oral-Gut communication has been proposed, whose possible involvement in the development of neurodegenerative diseases has not been uncovered yet. The present review aims to compile evidence that the dysbiosis of the oral microbiota triggers changes in the gut microbiota, which creates a higher predisposition for the development of neuroinflammatory or neurodegenerative diseases.The Oral-Gut-Brain axis could be defined based on anatomical communications, where the mouth and the intestine are in constant communication. The oral-brain axis is mainly established from the trigeminal nerve and the gut-brain axis from the vagus nerve. The oral-gut communication is defined from an anatomical relation and the constant swallowing of oral bacteria. The gut-brain communication is more complex and due to bacteria-cells, immune and nervous system interactions. Thus, the gut-brain and oral-brain axis are in a bi-directional relationship. Through the qualitative analysis of the selected papers, we conclude that experimental periodontitis could produce both neurodegenerative pathologies and intestinal dysbiosis, and that periodontitis is likely to induce both conditions simultaneously. The severity of the neurodegenerative disease could depend, at least in part, on the effects of periodontitis in the gut microbiota, which could strengthen the immune response and create an injurious inflammatory and dysbiotic cycle. Thus, dementias would have their onset in dysbiotic phenomena that affect the oral cavity or the intestine. The selected studies allow us to speculate that oral-gut-brain communication exists, and bacteria probably get to the brain via trigeminal and vagus nerves.
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Affiliation(s)
- Luis Daniel Sansores-España
- Periodontal Biology Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
- Faculty of Dentistry, Autonomous University of Yucatán, Mérida, México
| | | | | | - Emilio A. Cafferata
- Department of Periodontology, School of Dentistry, Universidad Científica Del Sur, Lima, Perú
| | | | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Andrea Cristina Paula-Lima
- Biomedical Neuroscience Institute, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Jaime Díaz-Zúñiga
- Periodontal Biology Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Medicine, Faculty of Medicine, University of Atacama, Copiapó, Chile
- *Correspondence: Jaime Díaz-Zúñiga, ,
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30
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miR-30a-5p inhibits osteogenesis and promotes periodontitis by targeting Runx2. BMC Oral Health 2021; 21:513. [PMID: 34635105 PMCID: PMC8504121 DOI: 10.1186/s12903-021-01882-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/29/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Periodontitis is the most extensive chronic inflammatory bone resorption disease. MiRNAs offer a potential way for potential therapy. Indeed, miR-30a-5p had an increasing expression in periodontitis gingivae, but whether it promotes osteogenesis and inhibits inflammation remains unknown. METHODS Periodontitis model was exhibited by wire ligation and verified by micro-CT and HE staining; qPCR was used to detect the expression of miR-30a-5p; miR-30a-5p inhibitors and mimics were transfected into MC3T3-E1 cell line by lipofectamine 3000; The dual luciferase reporter gene experiment and RIP experiment were used to detect the relationship between miR-30a-5p and Runx2; Rescue experiment was used to verify the relationship between miR-30a-5p and Runx2. RESULTS Periodontitis model was exhibited successfully and miR-30a-5p was overexpressed at the bone and gingival tissues of this model. miR-30a-5p inhibitors not only promoted the osteogenesis but also relieved inflammation. Runx2 is a target of miR-30a-5p by dual luciferase reporter gene experiment and RIP experiment. Rescue experiments revealed that miR-30a-5p inhibitors would promote osteogenesis and relieve inflammation by targeting Runx2 in inflammation of MC3T3-E1 cell line. CONCLUSIONS That all suggested that miR-30a-5p-mediated-Runx2 provided a novel understanding of mechanism of periodontitis.
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Gianos E, Jackson EA, Tejpal A, Aspry K, O'Keefe J, Aggarwal M, Jain A, Itchhaporia D, Williams K, Batts T, Allen KE, Yarber C, Ostfeld RJ, Miller M, Reddy K, Freeman AM, Fleisher KE. Oral health and atherosclerotic cardiovascular disease: A review. Am J Prev Cardiol 2021; 7:100179. [PMID: 34611631 PMCID: PMC8387275 DOI: 10.1016/j.ajpc.2021.100179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Periodontal disease (PD) is common in the US and globally. Evidence suggests that poor oral health is associated with atherosclerotic cardiovascular disease (ASCVD); however, this relationship has not been a major focus in clinical cardiology. This manuscript will review the growing evidence linking PD to ASCVD, including pathophysiologic mechanisms and coexistent risk factors. Public health considerations with a focus on disparities, social determinants, preventive strategies, and a call to action to reduce the burden of coincident ASCVD and PD are also reviewed.
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Affiliation(s)
- Eugenia Gianos
- Division of Cardiology, Lenox Hill Hospital, Northwell Health, New York, NY, United States
| | - Elizabeth A Jackson
- Division of Cardiovascular Disease, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Astha Tejpal
- Division of Cardiology, Lenox Hill Hospital, Northwell Health, New York, NY, United States
| | - Karen Aspry
- Lifespan Cardiovascular Institute, and Division of Cardiology, Brown University, Alpert Medical School, Providence, RI, United States
| | - James O'Keefe
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine, Kansas City, MI, United States
| | - Monica Aggarwal
- Division of Cardiology, University of Florida, Gainesville, FL, United States
| | - Ankur Jain
- Division of Cardiology, University of Florida, Gainesville, FL, United States
| | - Dipti Itchhaporia
- Jeffrey M. Carlton Heart & Vascular Institute, Hoag Memorial Hospital, Newport Beach, CA, United States
| | - Kim Williams
- Department of Medicine, Division of Cardiology, Rush University Medical Center, Chicago, IL, United States
| | - Travis Batts
- Division of Cardiology, Department of Medicine, Wilford Hall Ambulatory Surgical Center, San Antonio, TX, United States
| | - Kathleen E Allen
- Geisel School of Medicine at Dartmouth, Hanover, NY, United States
| | - Clark Yarber
- Department of Internal Medicine, Montefiore Health System, Bronx, NY, United States
| | - Robert J Ostfeld
- Division of Cardiology, Department of Medicine, Montefiore Health System, Bronx, NY, United States
| | - Michael Miller
- Department of Cardiovascular Medicine, Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Koushik Reddy
- Division of Cardiology, James A. Haley VA Medical Center, University of South Florida, Tampa, FL, United States
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, CO, United States
| | - Kenneth E Fleisher
- Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, New York, NY, United States
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32
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Kennedy EN, Niessen LC. Integrating Oral Health into Primary Care. MISSOURI MEDICINE 2021; 118:446-449. [PMID: 34658438 PMCID: PMC8504515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This article provides data on oral diseases as they relate to systemic health conditions. Research continues to identify biologic mechanisms that link oral diseases to systemic disease and vice versa. The Smiles for Life curriculum, developed for physicians, provides a systematic approach for incorporating an oral exam into your physical evaluation. Guidelines for the use of antibiotics for tooth pain and swelling, to prevent infective endocarditis, and for patients for total joint replacements are provided.
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Affiliation(s)
- Erinne N Kennedy
- Kansas City University College of Dental Medicine (KCU-CDM), Joplin Campus, Joplin, Missouri
| | - Linda C Niessen
- Vice Provost for Oral Health Affairs, Professor and Dean, KCU-CDM, Joplin Campus, Joplin, Missouri
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33
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Murphy K, O'Donovan AN, Caplice NM, Ross RP, Stanton C. Exploring the Gut Microbiota and Cardiovascular Disease. Metabolites 2021; 11:metabo11080493. [PMID: 34436434 PMCID: PMC8401482 DOI: 10.3390/metabo11080493] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular disease (CVD) has been classified as one of the leading causes of morbidity and mortality worldwide. CVD risk factors include smoking, hypertension, dyslipidaemia, obesity, inflammation and diabetes. The gut microbiota can influence human health through multiple interactions and community changes are associated with the development and progression of numerous disease states, including CVD. The gut microbiota are involved in the production of several metabolites, such as short-chain fatty acids (SCFAs), bile acids and trimethylamine-N-oxide (TMAO). These products of microbial metabolism are important modulatory factors and have been associated with an increased risk of CVD. Due to its association with CVD development, the gut microbiota has emerged as a target for therapeutic approaches. In this review, we summarise the current knowledge on the role of the gut microbiome in CVD development, and associated microbial communities, functions, and metabolic profiles. We also discuss CVD therapeutic interventions that target the gut microbiota such as probiotics and faecal microbiota transplantation.
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Affiliation(s)
- Kiera Murphy
- Teagasc Food Research Centre, Moorepark, Co. Cork P61 C996, Ireland
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland
| | - Aoife N O'Donovan
- Teagasc Food Research Centre, Moorepark, Co. Cork P61 C996, Ireland
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland
- VistaMilk SFI Research Centre, Teagasc, Moorepark, Co. Cork P61 C996, Ireland
| | - Noel M Caplice
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland
- Centre for Research in Vascular Biology, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland
| | - R Paul Ross
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland
| | - Catherine Stanton
- Teagasc Food Research Centre, Moorepark, Co. Cork P61 C996, Ireland
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland
- VistaMilk SFI Research Centre, Teagasc, Moorepark, Co. Cork P61 C996, Ireland
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Sia SK, Jan MS, Wang YH, Huang YF, Wei JCC. Periodontitis is associated with incidental valvular heart disease: A nationwide population-based cohort study. J Clin Periodontol 2021; 48:1085-1092. [PMID: 34060116 DOI: 10.1111/jcpe.13478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/18/2021] [Accepted: 04/10/2021] [Indexed: 12/15/2022]
Abstract
AIM Periodontitis and valvular heart disease (VHD) are common diseases. Both diseases are related to chronic inflammation and share many common risk factors. Previous periodontal studies had focused mainly on atherosclerotic cardiovascular disease. This study aimed to determine whether periodontitis is associated with the development of VHD. MATERIALS AND METHODS This was a retrospective nationwide cohort study using Taiwan's Longitudinal Health Insurance Database. Using ICD-9-CM coding, both the periodontitis and non-periodontitis groups were matched. RESULTS There were 8483 cases and 4919 cases of VHD diagnosed in the periodontitis group and non-periodontitis group, respectively. The cumulative incidence of VHD was significantly higher in the periodontitis group (log-rank test, p < .001), with the incidence density of 6.44 (95% CI, 6.31-6.58) per 1000 person-years in the periodontitis group compared to 4.65 (95% CI, 4.52-4.78) in the non-periodontitis group. The relative risk for VHD was 1.39 (95% CI, 1.34-1.44). After multivariate analysis, periodontitis was independently associated with a risk for VHD (HR, 1.38; 95% CI, 1.33-1.42, p < .001). Intensive treatment of periodontitis significantly lowered the risk for VHD (HR, 0.68; 95% CI, 0.60-0.77, p < .001). CONCLUSIONS Periodontitis was significantly associated with the development of VHD. Treatment of periodontitis reduced the risk for VHD.
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Affiliation(s)
- Sung-Kien Sia
- Division of cardiology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Shiou Jan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Feng Huang
- Department of stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,College of oral medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Division of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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35
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Ma L, Cao Z. Membrane vesicles from periodontal pathogens and their potential roles in periodontal disease and systemic illnesses. J Periodontal Res 2021; 56:646-655. [PMID: 33826135 DOI: 10.1111/jre.12884] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/18/2021] [Accepted: 03/24/2021] [Indexed: 12/13/2022]
Abstract
Periodontium is an ordered ecological system where a dynamic equilibrium exists between oral microorganisms and the host defense system, and periodontal disease occurs whenever the balance is broken. Periodontal pathogens mainly include gram-negative anaerobic bacteria and emerging gram-positive microbes, which have a large variety of virulence factors and influence disease initiation and progression. Recently, different types of bacterial membrane vesicles (MVs), formed by bubbling of membrane materials from living cells or in conditions of endolysin-triggered cell death, have gained interests as a novel virulence factor for periodontopathogens. MVs load multiple sorted cargo molecules, such as proteins, lipids, and genetic materials, and actively participate in toxin transport, signal delivery, and periodontal disease pathogenesis. Since periodontitis is recognized as a risk factor for many systemic diseases, periodontal MVs could work as a bridge for periodontal diseases and systemic illnesses. Furthermore, MVs with unique nature and advantages are promising candidates as vaccines and drug delivery vehicles. In this review, we provided an overview of different types and compositions of periodontal MVs, described their involvements in the pathogenesis of periodontitis and several general diseases, and discussed potential applications of periodontal MVs in vaccination and drug delivery.
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Affiliation(s)
- Li Ma
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhengguo Cao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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36
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Chen Y, Sun H, Sun M, Shi C, Sun H, Shi X, Ji B, Cui J. Finding Colon Cancer- and Colorectal Cancer-Related Microbes Based on Microbe-Disease Association Prediction. Front Microbiol 2021; 12:650056. [PMID: 33796094 PMCID: PMC8007907 DOI: 10.3389/fmicb.2021.650056] [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: 01/06/2021] [Accepted: 02/09/2021] [Indexed: 12/02/2022] Open
Abstract
Microbes are closely associated with the formation and development of diseases. The identification of the potential associations between microbes and diseases can boost the understanding of various complex diseases. Wet experiments applied to microbe-disease association (MDA) identification are costly and time-consuming. In this manuscript, we developed a novel computational model, NLLMDA, to find unobserved MDAs, especially for colon cancer and colorectal carcinoma. NLLMDA integrated negative MDA selection, linear neighborhood similarity, label propagation, information integration, and known biological data. The Gaussian association profile (GAP) similarity of microbes and GAPs similarity and symptom similarity of diseases were firstly computed. Secondly, linear neighborhood method was then applied to the above computed similarity matrices to obtain more stable performance. Thirdly, negative MDA samples were selected, and the label propagation algorithm was used to score for microbe-disease pairs. The final association probabilities can be computed based on the information integration method. NLLMDA was compared with the other five classical MDA methods and obtained the highest area under the curve (AUC) value of 0.9031 and 0.9335 on cross-validations of diseases and microbe-disease pairs. The results suggest that NLLMDA was an effective prediction method. More importantly, we found that Acidobacteriaceae may have a close link with colon cancer and Tannerella may densely associate with colorectal carcinoma.
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Affiliation(s)
- Yu Chen
- The Cancer Hospital of Jia Mu Si, Jiamusi, China
| | - Hongjian Sun
- Oncological Surgery, The Central Hospital of Jia Mu Si, Jiamusi, China
| | - Mengzhe Sun
- Oncological Surgery, The Central Hospital of Jia Mu Si, Jiamusi, China
| | - Changguo Shi
- Department of Thoracic Surgery, The Cancer Hospital of Jia Mu Si, Jiamusi, China
| | - Hongmei Sun
- Medical Oncology, The Cancer Hospital of Jia Mu Si, Jiamusi, China
| | - Xiaoli Shi
- Geneis Beijing Co., Ltd., Beijing, China
- Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Binbin Ji
- Geneis Beijing Co., Ltd., Beijing, China
- Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Jinpeng Cui
- Department of Laboratory Medicine, Yantaishan Hospital of Yantai City, Yantai, China
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37
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Önal MA, Fentoğlu Ö, Aksoy F, Calapoğlu M, Varol E, Orhan H. Salivary levels of last generation specific pro-resolving lipid mediators (SPMs) (protectin and maresin) in patients with cardiovascular and periodontal disease: A case-control study. J Periodontal Res 2021; 56:606-615. [PMID: 33650687 DOI: 10.1111/jre.12861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/15/2021] [Accepted: 01/27/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontal disease and cardiovascular disease (CVD), which are both deemed to be triggered by inflammation, are recognized as public health problems. Evidence of host modulation via pro-resolving lipid shown in previous studies supports a two-way relationship between periodontitis and CVD. Last generation endogenous specific pro-resolution lipid mediators (SPMs) such as protectins (PDs) and maresins (MaRs) may have potential effects on inflammatory pathogenesis via activation and resolution mechanisms. Currently, there are no data on SPM levels in patients with CVD and periodontal disease. We aimed to evaluate salivary levels of PD and MaR in patients with CVD and periodontal disease. MATERIALS AND METHODS At total of 181 individuals comprising of 79 healthy controls (C) and 102 patients with diagnosed CVD were included cross-sectionally. Unstimulated total salivary samples were obtained, and clinical periodontal parameters were determined. Salivary levels of PD and MaR were evaluated by ELISA. The periodontal status of the study population was classified as gingivitis (g) or periodontitis (p). RESULTS Patients with CVD showed lower sociodemographic characteristics, increased clinical periodontal parameters (p < .05), decreased salivary PD (p < .001), and increased salivary MaR levels (p > .05). In the CVDg group, leukocyte, hemoglobin, hematocrit, and high-density lipoprotein values were higher (p < .05). The CVDp group had a higher neutrophil-to-lymphocyte ratio (p < .05). While the PD level was highest in the Cg group, MaR was highest in the CVDp group. The salivary levels of PD and MaR were independent of other confounders in CVD and periodontal disease (p > .05). CONCLUSION(S) PDs and MaRs may play effective roles in pathogenesis associated with worsening cardiometabolic and periodontal status. These SPMs could also be predictors for conversion from a healthy (systemically and periodontally) to diseased state (CVD and/or periodontitis). Elucidation of the role of SPMs in the relationship between periodontal disease and CVD will enable the development of new host modulation strategies in the prevention and treatment of both diseases, and may also constitute an important public health step by increasing the quality of life of patients with CVD and periodontal disease.
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Affiliation(s)
- Mehmet Artuğ Önal
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Özlem Fentoğlu
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Fatih Aksoy
- Department of Cardiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Mustafa Calapoğlu
- Department of Biochemistry, Faculty of Science, Süleyman Demirel University, Isparta, Turkey
| | - Ercan Varol
- Department of Cardiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Hikmet Orhan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
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Schulz S, Reichert S, Grollmitz J, Friebe L, Kohnert M, Hofmann B, Schaller HG, Klawonn F, Shi R. The role of Saccharibacteria (TM7) in the subginival microbiome as a predictor for secondary cardiovascular events. Int J Cardiol 2021; 331:255-261. [PMID: 33529661 DOI: 10.1016/j.ijcard.2021.01.054] [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] [Received: 08/11/2020] [Revised: 11/27/2020] [Accepted: 01/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The composition of the subgingival microbiota is of great importance in both oral and systemic diseases. However, a possible association of the oral microbiome and cardiovascular (CV) outcome has not yet been considered in a complex model. The primary objective of the study (DRKS-ID: DRKS00015776) was to assess differences in complex subgingival bacterial composition, depending on the CV outcome in patients undergoing Coronary Artery Bypass Grafting Surgery (CABG). MATERIAL AND METHODS We conducted a longitudinal cohort study enrolling 102 CV patients. After a one-year follow-up, the postoperative outcome was evaluated applying MACCE (Major Adverse Cardiac and Cerebrovascular Events) criteria. The complex oral microbiome was evaluated depending on CV outcome. The mathematical data processing included Qiime 2 software workflow and DADA2 pipeline as well as Human Oral Microbiome Database (HOMD) and Greengenes database classification. For identifying biomarkers distinguishing patients suffering from secondary CV events, the Cox Proportional Hazard Model for survival analysis was applied. RESULTS In total, 19,418 Operational Taxonomic Units (OTU) were mapped according to the HOMD and Greengenes database. No significant differences in alpha and beta diversity were linked to CV outcomes (Shannon index; Principal Coordinates Analysis). No biomarker predicting secondary CV events were identified applying the area under the receiver operating characteristic curve (AUC) model. However, in survival analysis, one biomarker of Saccharibacteria phylum (class: TM7-3, order: CW040, family: F16) was associated with the incidence of a secondary CV event (p = 0.016). CONCLUSIONS For the first time, a subgingival biomarker has been identified that supports a cardiovascular prognosis in CV patients undergoing coronary artery bypass grafting.
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Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany.
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Julia Grollmitz
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Lisa Friebe
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Michael Kohnert
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Britt Hofmann
- Department of Cardiothoracic Surgery, Heart Centre of the University Clinics Halle (Saale), Martin-Luther-University Halle-Wittenberg, Germany
| | - Hans-Günter Schaller
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Germany
| | - Frank Klawonn
- Biostatistics, Helmholtz Centre for Infection Research, Braunschweig, Germany; Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbüttel, Germany
| | - Ruibing Shi
- Biostatistics, Helmholtz Centre for Infection Research, Braunschweig, Germany
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Emery DC, Cerajewska TL, Seong J, Davies M, Paterson A, Allen-Birt SJ, West NX. Comparison of Blood Bacterial Communities in Periodontal Health and Periodontal Disease. Front Cell Infect Microbiol 2021; 10:577485. [PMID: 33469518 PMCID: PMC7813997 DOI: 10.3389/fcimb.2020.577485] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022] Open
Abstract
The use of Next Generation Sequencing (NGS) techniques has generated a wide variety of blood microbiome data. Due to the large variation in bacterial DNA profiles between studies and the likely high concentrations of cell-free bacterial DNA in the blood, it is still not clear how such microbiome data relates to viable microbiota. For these reasons much remains to be understood about the true nature of any possible healthy blood microbiota and of bacteraemic events associated with disease. The gut, reproductive tracts, skin, and oral cavity are all likely sources of blood-borne bacteria. Oral bacteria, especially those associated with periodontal diseases, are also commonly associated with cardiovascular diseases such as infective endocarditis, and also have been linked to rheumatoid arthritis and Alzheimer’s disease. Periodontal treatment, dental probing, and toothbrushing have been shown to cause transient bacteraemia and oral bacteria from the phyla Firmicutes (e.g. Streptococci) and Bacteroidetes (e.g. Porphyromonas) are found in cardiovascular lesions (CVD). Many studies of blood bacterial DNA content however, find Proteobacteria DNA to be the dominant microbiome component, suggesting a gut origin. Most studies of this type use total DNA extracted from either whole blood or blood fractions, such as buffy coat. Here, using a method that purifies DNA from intact bacterial cells only, we examined blood donated by those with active, severe periodontitis and periodontally healthy controls and show that 43–52% of bacterial species in blood are classified as oral. Firmicutes, consisting largely of members of the Streptococcus mitis group and Staphylococcus epidermidis, were predominant at 63.5% of all bacterial sequences detected in periodontal health and, little changed at 66.7% in periodontitis. Compared to studies using total DNA Proteobacteria were found here at relatively low levels in blood at 13.3% in periodontitis and 17.6% in health. This study reveals significant phylogenetic differences in blood bacterial population profiles when comparing periodontal health to periodontal disease cohorts.
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Affiliation(s)
- David C Emery
- Bristol Medical School, Translational Health Sciences, Learning & Research, Southmead Hospital, Bristol, United Kingdom
| | - Tanya L Cerajewska
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Joon Seong
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Maria Davies
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Alex Paterson
- University of Bristol Genomics Facility, School of Biological Sciences, Bristol, United Kingdom
| | - Shelley J Allen-Birt
- Bristol Medical School, Translational Health Sciences, Learning & Research, Southmead Hospital, Bristol, United Kingdom
| | - Nicola X West
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
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40
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Torres MA, Gualtero DF, Lafaurie GI, Fontanilla MR. Aggregatibacter actinomycetemcomitans
induces a proatherosclerotic response in human endothelial cells in a three‐dimensional collagen scaffold model. Mol Oral Microbiol 2020. [DOI: 10.1111/omi.12326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Maria A. Torres
- Tissue Engineering Group Department of Pharmacy Universidad Nacional de Colombia Bogotá Colombia
- Biotechnology Laboratory, Basic Oral Research Unit (UIBO) School of Odontology Universidad El Bosque Bogotá Colombia
| | - Diego F. Gualtero
- Tissue Engineering Group Department of Pharmacy Universidad Nacional de Colombia Bogotá Colombia
- Biotechnology Laboratory, Basic Oral Research Unit (UIBO) School of Odontology Universidad El Bosque Bogotá Colombia
| | - Gloria I. Lafaurie
- Biotechnology Laboratory, Basic Oral Research Unit (UIBO) School of Odontology Universidad El Bosque Bogotá Colombia
| | - Marta R. Fontanilla
- Tissue Engineering Group Department of Pharmacy Universidad Nacional de Colombia Bogotá Colombia
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Díaz-Zúñiga J, More J, Melgar-Rodríguez S, Jiménez-Unión M, Villalobos-Orchard F, Muñoz-Manríquez C, Monasterio G, Valdés JL, Vernal R, Paula-Lima A. Alzheimer's Disease-Like Pathology Triggered by Porphyromonas gingivalis in Wild Type Rats Is Serotype Dependent. Front Immunol 2020; 11:588036. [PMID: 33240277 PMCID: PMC7680957 DOI: 10.3389/fimmu.2020.588036] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/14/2020] [Indexed: 01/18/2023] Open
Abstract
Periodontal disease is a disease of tooth-supporting tissues. It is a chronic disease with inflammatory nature and infectious etiology produced by a dysbiotic subgingival microbiota that colonizes the gingivodental sulcus. Among several periodontal bacteria, Porphyromonas gingivalis (P. gingivalis) highlights as a keystone pathogen. Previous reports have implied that chronic inflammatory response and measurable bone resorption are observed in young mice, even after a short period of periodontal infection with P. gingivalis, which has been considered as a suitable model of experimental periodontitis. Also, encapsulated P. gingivalis strains are more virulent than capsular-defective mutants, causing an increased immune response, augmented osteoclastic activity, and accrued alveolar bone resorption in these rodent experimental models of periodontitis. Recently, P. gingivalis has been associated with Alzheimer’s disease (AD) pathogenesis, either by worsening brain pathology in AD-transgenic mice or by inducing memory impairment and age-dependent neuroinflammation middle-aged wild type animals. We hypothesized here that the more virulent encapsulated P. gingivalis strains could trigger the appearance of brain AD-markers, neuroinflammation, and cognitive decline even in young rats subjected to a short periodontal infection exposure, due to their higher capacity of activating brain inflammatory responses. To test this hypothesis, we periodontally inoculated 4-week-old male Sprague-Dawley rats with K1, K2, or K4 P. gingivalis serotypes and the K1-isogenic non-encapsulated mutant (GPA), used as a control. 45-days after periodontal inoculations with P. gingivalis serotypes, rat´s spatial memory was evaluated for six consecutive days in the Oasis maze task. Following functional testing, the animals were sacrificed, and various tissues were removed to analyze alveolar bone resorption, cytokine production, and detect AD-specific biomarkers. Strikingly, only K1 or K2 P. gingivalis-infected rats displayed memory deficits, increased alveolar bone resorption, pro-inflammatory cytokine production, changes in astrocytic morphology, increased Aβ1-42 levels, and Tau hyperphosphorylation in the hippocampus. None of these effects were observed in rats infected with the non-encapsulated bacterial strains. Based on these results, we propose that the bacterial virulence factors constituted by capsular polysaccharides play a central role in activating innate immunity and inflammation in the AD-like pathology triggered by P. gingivalis in young rats subjected to an acute experimental infection episode.
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Affiliation(s)
- Jaime Díaz-Zúñiga
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Jamileth More
- Centro de Investigación Clínica Avanzada (CICA), Hospital Clínico Universidad de Chile, Santiago, Chile
| | | | - Matías Jiménez-Unión
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | | | | | - Gustavo Monasterio
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - José Luis Valdés
- Biomedical Neuroscience Institute, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Andrea Paula-Lima
- Biomedical Neuroscience Institute, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Institute for Research in Dental Sciences, Universidad de Chile, Santiago, Chile
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Sadiq N, Probst JC, Merchant AT, Martin AB, Shrestha D, Khan MM. The role of dental insurance in mitigating mortality among working-age U.S. adults with periodontitis. J Clin Periodontol 2020; 47:1294-1303. [PMID: 32939782 DOI: 10.1111/jcpe.13366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 07/28/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
AIM To assess the relationship of dental insurance with all-cause mortality and mortality due to cardiovascular diseases (CVD), diabetes mellitus (DM), and cerebrovascular diseases (CBD) among those with periodontitis. MATERIALS AND METHODS NHANES III and its associated mortality data set were used in this study. The outcome variables were "all-cause mortality" and "combined mortality" due to CVD, DM, and CBD. The independent variable was dental insurance stratified over periodontitis status. Unweighted frequencies with weighted column percentages were used for descriptive statistics, and chi-square test was applied for significance. Cox proportional hazard models were used for stratified multivariable analyses. All analyses were performed in SAS v9.4 accounting for survey data complexities. Significance level was kept at 5%. RESULTS The mortality was 14.58% for all-cause mortality and 4.06% for combined mortality among those with periodontitis in this study. Dental insurance significantly reduced the hazard of all-cause mortality among those with periodontitis (HR: 0.75; 95% CI: 0.61 - 0.93), adjusted for covariates. However, no association of dental insurance with combined mortality was observed among periodontitis group. CONCLUSIONS Dental insurance reduces hazard of all-cause mortality among those with periodontitis. Dental insurance ensures access to dentists and improves oral and dental health. Longitudinal study is needed to establish causality.
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Affiliation(s)
- Naveed Sadiq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan.,Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Janice C Probst
- Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Amy B Martin
- College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Deepika Shrestha
- Data Management and Analysis Division, Center for Policy, Planning and Evaluation, DC Department of Health, Washington, DC, USA
| | - M Mahmud Khan
- Department of Health Policy & Management, University of Georgia, Athens, GA, USA
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Risk of incident cardiovascular disease in people with periodontal disease: A systematic review and meta-analysis. Clin Exp Dent Res 2020; 7:109-122. [PMID: 33124761 PMCID: PMC7853902 DOI: 10.1002/cre2.336] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/02/2020] [Accepted: 09/27/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Cardiovascular disease (CVD) is a major cause of mortality; periodontal disease (PD) affects up to 50% of the world's population. Observational evidence has demonstrated association between CVD and PD. Absent from the literature is a systematic review and meta-analysis of longitudinal cohort studies quantifying CVD risk in PD populations compared to non-PD populations. To examine the risk of incident CVD in people with PD in randomised controlled trials and longitudinal cohort studies. MATERIAL AND METHODS We searched Medline, EMBASE and Cochrane databases up to 9th Oct 2019 using keywords and MeSH headings using the following concepts: PD, CVD, longitudinal and RCT study design. CVD outcomes included but were not restricted to any CVD, myocardial infarction, coronary heart disease (CHD) and stroke. Diagnosis method and severity of PD were measured either clinically or by self-report. Studies comparing incident CVD in PD and non-PD populations were included. Meta-analysis and meta-regression was performed to determine risk of CVD in PD populations and examine the effects of PD diagnosis method, PD severity, gender and study region. RESULTS Thirty-two longitudinal cohort studies were included after full text screening; 30 were eligible for meta-analysis. The risk of CVD was significantly higher in PD compared to non-PD (relative risk [RR]: 1.20, 95% CI: 1.14-1.26). CVD risk did not differ between clinical or self-reported PD diagnosis (RR = 0.97, 95% CI: 0.87-1.07,). CVD risk was higher in men (RR: 1.16, 95% CI: 1.08-1.25) and severe PD (RR: 1.25, 95% CI: 1.15-1.35). Among all types of CVD, the risk of stroke was highest (RR = 1.24; 95% CI:1.12-1.38), the risk of CHD was also increased (RR = 1.14; 95% CI:1.08-1.21). CONCLUSION This study demonstrated modest but consistently increased risk of CVD in PD populations. Higher CVD risk in men and people with severe PD suggests population-targeted interventions could be beneficial.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
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Jamieson LM, Sajiv C, Cass A, Maple-Brown LJ, Skilton MR, Kapellas K, Pawar B, Arrow P, Askie LM, Hoy W, Harris D, Brown A, Hughes JT. Lessons learned from a periodontal intervention to reduce progression of chronic kidney disease among Aboriginal Australians. BMC Res Notes 2020; 13:483. [PMID: 33059735 PMCID: PMC7566020 DOI: 10.1186/s13104-020-05317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
Objective Periodontal disease is associated with chronic kidney disease (CKD), with both conditions being highly prevalent among Australia’s Aboriginal population. This paper reflects on the lessons learned following implementation of a periodontal intervention in the Central Australian region of the Northern Territory among Aboriginal adults with CKD. Results Between Oct 2016 and May 2019, research staff recruited 102 eligible participants. This was far below the anticipated recruitment rate. The challenges faced, and lessons learned, were conceptualised into five specific domains. These included: (1) insufficient engagement with the Aboriginal community and Aboriginal community-controlled organisations; (2) an under-appreciation of the existing and competing patient commitments with respect to general health and wellbeing, and medical treatment to enable all study commitments; (3) most study staff employed from outside the region; (4) potential participants not having the required number of teeth; (5) invasive intervention that involved travel to, and time at, a dental clinic. A more feasible research model, which addresses the divergent needs of participants, communities and service partners is required. This type of approach, with sufficient time and resourcing to ensure ongoing engagement, partnership and collaboration in co-design throughout the conduct of research, challenges current models of competitive, national research funding.
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Affiliation(s)
- Lisa M Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia.
| | - Cherian Sajiv
- Central Australian Renal Services, Northern Territory Department of Health, Darwin, NT, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Louise J Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Michael R Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, University of Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia
| | - Basant Pawar
- Central Australian Renal Services, Northern Territory Department of Health, Darwin, NT, Australia
| | - Peter Arrow
- Western Australian Dental Services, Western Australian Government, Perth, WA, Australia
| | - Lisa M Askie
- NHMRC Clinical, Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Wendy Hoy
- Centre for Chronic Disease, University of Queensland, Brisbane, QLD, Australia
| | - David Harris
- Westmead Centre for Medical Research, University of Sydney & Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia
| | - Alex Brown
- Aboriginal Research Unit, South Australian Health & Medical Research Institute, Adelaide, SA, Australia
| | - Jaquelyne T Hughes
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.,Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
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Doneen AL, Bale BF, Vigerust DJ, Leimgruber PP. Cardiovascular Prevention: Migrating From a Binary to a Ternary Classification. Front Cardiovasc Med 2020; 7:92. [PMID: 32528979 PMCID: PMC7256212 DOI: 10.3389/fcvm.2020.00092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/29/2020] [Indexed: 12/21/2022] Open
Abstract
Migrating from a binary approach to risk assessment to a ternary model of disease identification allows for individualized, optimal disease management. Redefining the disease/inflammatory approach has been proven to identify, stabilize, and regress atherosclerosis while adding understanding to the progression of vascular disease. Our previously published results show the beneficial effect of comprehensive, evidence-based management on subclinical atherosclerosis and vulnerable plaque. We argue that this approach does not mitigate the value of utilizing standard risk factor identification, but rather augments it for the benefit of the individual patient.
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Affiliation(s)
- Amy Lynn Doneen
- College of Medicine, Washington State University, Spokane, WA, United States
| | - Bradley Field Bale
- College of Medicine, Washington State University, Spokane, WA, United States
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Merkler A, Sertić J, Bazina Martinović A, Križ T, Miličić I, Šimić M, Caban D, Ljubić H, Markeljević J, Šimičević L, Kaštelan S, Pećin I, Reiner Ž. Haptoglobin genotype 2-2 associated with atherosclerosis in patients with ischemic stroke. Gene 2020; 752:144786. [PMID: 32439379 DOI: 10.1016/j.gene.2020.144786] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 01/08/2023]
Abstract
AIM Ischemic stroke (IS) is multifactorial disease and therefore different genes and proteins play a role in its development. Haptoglobin (Hp) removes free hemoglobin and protects from iron-induced oxidative damage, inflammatory response, atherosclerosis and cerebrovascular diseases. The aim of this study was to investigate Hp genetic variants in patients with carotid atherosclerotic lesions and IS. MATERIAL AND METHODS A total of 121 subjects with IS participated in the study, 81 male and 40 female. RESULTS Among 121 patients with IS, 79 had diffuse atherosclerotic plaques and stenosis. Hp genotype was statistically significantly associated with CDFI neck carotid artery stenosis findings (p = 0.006). Patients with Hp1-2 genotype had statistically significantly larger odds for atherosclerotic changes compared to those with Hp1-1 genotype, as well as those with Hp2-2 genotype. CONCLUSION This study has shown an association of the Hp2-2 genotype and atherosclerosis in patients with IS, indicating Hp2-2 genotype as a genetic biomarker for precision medicine and personalized healthcare.
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Affiliation(s)
- A Merkler
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Sertić
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia; University of Zagreb, School of Medicine, Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Zagreb, Croatia.
| | | | - T Križ
- Department of Ophthalmology, University Hospital Centre 'Sestre milosrdnice', Zagreb, Croatia
| | - I Miličić
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - M Šimić
- Department of Clinical Microbiology, Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia
| | - D Caban
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - H Ljubić
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Markeljević
- Department of Immunology, Pulmology and Rheumatology, University Hospital Centre 'Sestre milosrdnice', Zagreb, Croatia
| | - L Šimičević
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - S Kaštelan
- Department of Ophthalmology, Clinical Hospital Dubrava, Zagreb, Croatia
| | - I Pećin
- University of Zagreb, School of Medicine, Zagreb, Croatia; Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ž Reiner
- University of Zagreb, School of Medicine, Zagreb, Croatia; Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
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Lee JS, Spooner R, Chowdhury N, Pandey V, Wellslager B, Atanasova KR, Evans Z, Yilmaz Ö. In Situ Intraepithelial Localizations of Opportunistic Pathogens, Porphyromonas gingivalis and Filifactor alocis, in Human Gingiva. CURRENT RESEARCH IN MICROBIAL SCIENCES 2020; 1:7-17. [PMID: 34308393 PMCID: PMC8294339 DOI: 10.1016/j.crmicr.2020.05.001] [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: 02/08/2023] Open
Abstract
The gingival epithelium serves as a growth reservoir for opportunistic bacteria. Intraepithelial P. gingivalis and F. alocis colonies are detected together in dysbiotic mucosa. Increased metabolically active dual species can lead to higher microvasculature. Invasion of intraepithelial microvessels leads to systemic pathogen dissemination.
Porphyromonas gingivalis and Filifactor alocis are fastidious oral pathogens and etiological agents associated with chronic periodontitis. Although previous studies showed increased levels of the two obligate anaerobic species in periodontitis patients, methodologies for this knowledge were primarily limited to sampling subgingival plaque, saliva, or gingival crevicular fluid. To evaluate the extent to which P. gingivalis and F. alocis may invade the periodontal tissues, an in situ cross-sectional study was comparatively conducted on the gingival biopsy specimens of patients diagnosed with periodontal health or chronic periodontitis. Immunostained tissue sections for each organism were imaged by Super-Resolution Confocal Scanning Microscopy to determine the relative presence and localization of target bacterial species. Fluorescence-in-situ-hybridization (FISH) coupled with species specific 16S rRNA method was utilized to confirm whether detected bacteria were live within the tissue. In periodontitis, P. gingivalis and F. alocis revealed similarly concentrated localization near the basement membrane or external basal lamina of the gingival epithelium. The presence of both bacteria was significantly increased in periodontitis vs. healthy tissue. However, P. gingivalis was still detected to an extent in health tissue, while only minimal levels of F. alocis were spotted in health. Additionally, the micrographic analyses displayed heightened formation of epithelial microvasculature containing significantly co-localized and metabolically active dual species within periodontitis tissue. Thus, this study demonstrates, for the first-time, spatial arrangements of P. gingivalis and F. alocis in both single and co-localized forms within the complex fabric of human gingiva during health and disease. It also exhibits critical visualizations of co-invaded microvascularized epithelial layer of the tissue by metabolically active P. gingivalis and F. alocis from patients with severe periodontitis. These findings collectively uncover novel visual evidence of a potential starting point for systemic spread of opportunistic bacteria during their chronic colonization in gingival epithelium.
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Affiliation(s)
- Jaden S Lee
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina, 29425, USA
| | - Ralee Spooner
- Department of Stomatology, Division of Periodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina, 29425, USA.,Lieutenant, Dental Corps, United States Navy, Marine Corps Air Ground Combat Center, Twentynine Palms, California, 92278, USA
| | - Nityananda Chowdhury
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina, 29425, USA
| | - Vivek Pandey
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina, 29425, USA
| | - Bridgette Wellslager
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina, 29425, USA
| | - Kalina R Atanasova
- Department of Periodontology, University of Florida, Gainesville, Florida, 32611, USA
| | - Zachary Evans
- Department of Stomatology, Division of Periodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina, 29425, USA
| | - Özlem Yilmaz
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina, 29425, USA.,Department of Microbiology & Immunology, Medical University of South Carolina, Charleston, South Carolina, 29425, USA
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Lindholm M, Metsäniitty M, Granström E, Oscarsson J. Outer membrane vesicle-mediated serum protection in Aggregatibacter actinomycetemcomitans. J Oral Microbiol 2020; 12:1747857. [PMID: 32363008 PMCID: PMC7178816 DOI: 10.1080/20002297.2020.1747857] [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] [Received: 12/19/2019] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 01/23/2023] Open
Abstract
Aggregatibacter actinomycetemcomitans belongs to the HACEK group of fastidious Gram-negative organisms, a recognized cause of infective endocarditis. A. actinomycetemcomitans is also implicated in periodontitis, with rapid progress in adolescents. We recently demonstrated that the major outer membrane protein, OmpA1 was critical for serum survival of the A. actinomycetemcomitans serotype a model strain, D7SS, and that the paralogue, OmpA2 could operate as a functional homologue to OmpA1 in mediating serum resistance. In the present work, an essentially serum-sensitive ompA1 ompA2 double mutant A. actinomycetemcomitans strain derivative was exploited to elucidate if A. actinomycetemcomitans OMVs can contribute to bacterial serum resistance. Indeed, supplementation of OMVs resulted in a dose-dependent increase of the survival of the serum-sensitive strain in incubations in 50% normal human serum (NHS). Whereas neither OmpA1 nor OmpA2 was required for the OMV-mediated serum protection, OMVs and LPS from an A. actinomycetemcomitans strain lacking the LPS O-antigen polysaccharide part were significantly impaired in protecting D7SS ompA1 ompA2. Our results using a complement system screen assay support a model where A. actinomycetemcomitans OMVs can act as a decoy, which can trigger complement activation in an LPS-dependent manner, and consume complement components to protect serum-susceptible bacterial cells.
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Affiliation(s)
- Mark Lindholm
- Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Marjut Metsäniitty
- Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
| | | | - Jan Oscarsson
- Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
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Leite FRM, Nascimento GG, Peres KG, Demarco FF, Horta BL, Peres MA. Collider bias in the association of periodontitis and carotid intima‐media thickness. Community Dent Oral Epidemiol 2020; 48:264-270. [DOI: 10.1111/cdoe.12525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Fábio R. M. Leite
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
| | - Gustavo G. Nascimento
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
| | - Karen G. Peres
- School of Dentistry and Oral Health Griffith University, Gold Coast Campus Southport QLD Australia
| | - Flávio F. Demarco
- Graduate Program in Dentistry Federal University of Pelotas Pelotas Brazil
- Graduate Program in Epidemiology Federal University of Pelotas Pelotas Brazil
| | - Bernardo L. Horta
- Graduate Program in Epidemiology Federal University of Pelotas Pelotas Brazil
| | - Marco A. Peres
- School of Dentistry and Oral Health Griffith University, Gold Coast Campus Southport QLD Australia
- Menzies Health Institute Queensland Griffith University, Gold Coast Campus Southport QLD Australia
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