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Kobsar A, Wiebecke S, Weber K, Koessler A, Kuhn S, Boeck M, Zeller-Hahn J, Koessler J. Effect of toxins from different periodontitis-associated bacteria on human platelet function. Mol Oral Microbiol 2024. [PMID: 39056428 DOI: 10.1111/omi.12480] [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: 10/18/2023] [Revised: 06/22/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Periodontitis is caused by a dysbiosis of oral bacteria resulting in alveolar bone destruction and teeth loss. The role of platelets in pathogenesis of periodontitis is a subject of research. The release of toxins from periodontitis-associated bacteria may influence platelet function and contribute to the modulation of hemostatic or inflammatory responses. Therefore, we explored platelet function upon exposure to defined toxins: leukotoxin A from Aggregatibacter actinomycetemcomitans (LtxA), a synthetic version of the C14-Tri-LAN-Gly peptide from Fusobacterium nucleatum (C14), and lipopolysaccharides from Porphyromonas gingivalis (LPS). METHODS Light transmission aggregometry was performed after the addition of toxins to platelet-rich plasma in different doses. Flow cytometry was used to identify inhibitory effects of toxins by measuring phosphorylation of the vaso-dilator-stimulated phosphoprotein or to identify activating effects by the detection of CD62P expression. The release of chemokines derived from washed platelets was determined by immunoassays. RESULTS Collagen-induced threshold aggregation values were diminished upon incubation with LtxA and C14, accompanied with an increase of vaso-dilator-stimulated phosphoprotein (VASP) phosphorylation, indicating platelet inhibition. In contrast, LPS did not affect aggregation but slightly enhanced CD62P expression under co-stimulation with low-dose thrombin pointing to slight platelet activation. The three toxins did not relevantly influence the secretion of chemokines. CONCLUSIONS Although weak, the investigated toxins differently influenced human platelet function. LtxA and C14 mediated inhibitory effects, whereas LPS contributed to a slight activation of platelets. Further analysis of specific cellular responses mediated by bacterial toxins may render novel targets and suggestions for the treatment of periodontitis.
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Affiliation(s)
- Anna Kobsar
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
| | - Sophie Wiebecke
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
| | - Katja Weber
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
| | - Angela Koessler
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
| | - Sabine Kuhn
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
| | - Markus Boeck
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
| | - Julia Zeller-Hahn
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
| | - Juergen Koessler
- Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wurzburg, Germany
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2
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Li X, Li Q, Wang L, Ding H, Wang Y, Liu Y, Gong T. The interaction between oral microbiota and gut microbiota in atherosclerosis. Front Cardiovasc Med 2024; 11:1406220. [PMID: 38932989 PMCID: PMC11199871 DOI: 10.3389/fcvm.2024.1406220] [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: 03/24/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024] Open
Abstract
Atherosclerosis (AS) is a complex disease caused by multiple pathological factors threatening human health-the pathogenesis is yet to be fully elucidated. In recent years, studies have exhibited that the onset of AS is closely involved with oral and gut microbiota, which may initiate or worsen atherosclerotic processes through several mechanisms. As for how the two microbiomes affect AS, existing mechanisms include invading plaque, producing active metabolites, releasing lipopolysaccharide (LPS), and inducing elevated levels of inflammatory mediators. Considering the possible profound connection between oral and gut microbiota, the effect of the interaction between the two microbiomes on the initiation and progression of AS has been investigated. Findings are oral microbiota can lead to gut dysbiosis, and exacerbate intestinal inflammation. Nevertheless, relevant research is not commendably refined and a concrete review is needed. Hence, in this review, we summarize the most recent mechanisms of the oral microbiota and gut microbiota on AS, illustrate an overview of the current clinical and epidemiological evidence to support the bidirectional connection between the two microbiomes and AS.
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Affiliation(s)
- Xinsi Li
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Qian Li
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Li Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Huifen Ding
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Yizhong Wang
- Department of Research & Development, Zhejiang Charioteer Pharmaceutical Co., Ltd, Taizhou, China
| | - Yunfei Liu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Gong
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
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3
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Zhang Y, He TC, Zhang H. The impact of metabolic disorders on management of periodontal health in children. PEDIATRIC DISCOVERY 2024; 2:e38. [PMID: 38784180 PMCID: PMC11115384 DOI: 10.1002/pdi3.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/10/2023] [Indexed: 05/25/2024]
Abstract
Periodontitis is a chronic inflammatory disease caused by plaque biofilm which shares risk factors with systemic chronic diseases such as diabetes, cardiovascular disease, and osteoporosis. Many studies have found increased prevalence and rate of progression of periodontal disease in children with common metabolic disorders. Although the causal relationship and specific mechanism between them has not been determined yet. The aim of this paper is to progress on the impact of metabolic disorders on periodontal health in children and the underlying mechanisms, which provides new evidences for the prevention and intervention of metabolic disorders and periodontitis in children.
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Affiliation(s)
- Yunyan Zhang
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
- Department of Pediatric Dentistry, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
| | - Tong-Chuan He
- Molecular Oncology Laboratory, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL, USA
| | - Hongmei Zhang
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
- Department of Pediatric Dentistry, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
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4
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Jagannathan R, Balaji TM, Rao SR, Alosaimi MS, Patil S, Siurkel Y, Cicciù M, Minervini G. Effect of non-surgical periodontal therapy on CD14 + CD16+ monocyte counts in peripheral blood samples: a clinical interventional study. BMC Oral Health 2024; 24:94. [PMID: 38229101 DOI: 10.1186/s12903-023-03793-3] [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: 10/23/2023] [Accepted: 12/17/2023] [Indexed: 01/18/2024] Open
Abstract
Monocytes and their macrophage progeny are thought to be involved in tissue and alveolar bone destruction in periodontal disease. It has been documented that the proportion of (CD14 + CD16+) non-classical monocytes in the blood are elevated in chronic periodontitis;A total of 20 chronic generalized periodontitis patients who were otherwise healthy, were recruited for this study. At baseline and 3 weeks after non-surgical periodontal treatment, peripheral blood was obtained to assess the levels of C-reactive protein (CRP) and the proportion of monocyte subsets. Monocyte subsets were assessed using flow cytometry;The mean percentage of CD14 + CD16+ non-classical monocytes in the peripheral blood sample at baseline was 13.95 + 2.09, that reduced to 8.94 + 1.23 3 weeks after non-surgical treatment. A distinct significant reduction in the percentage of non-classical monocytes and a concomitant increase in classical monocytes were observed following periodontal treatment compared to baseline. There was a significant reduction in the all the periodontal parameters and CRP levels 3 weeks post non-surgical periodontal treatment. A positive correlation between CRP and percentage of non-classical monocytes was also observed; Periodontal treatment potentially modulates the host response effectively.
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Affiliation(s)
- Raghunanthan Jagannathan
- Department of Periodontics and Implantology, Faculty of Dental Sciences, Sri Ramchandra University, Chennai, 600116, India
| | | | - Suresh Ranga Rao
- Department of Periodontics and Implantology, Faculty of Dental Sciences, Sri Ramchandra University, Chennai, 600116, India
| | | | - Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UTAH, 84095, USA.
| | - Yuliia Siurkel
- International European University School of Medicine, AkademikaHlushkova Ave, 42В, Kyiv, 03187, Ukraine.
| | - Marco Cicciù
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, 95124, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Caserta, 81100, Italy.
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5
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Sen S, Logue L, Logue M, Otersen E, Mason E, Moss K, Curtis J, Hicklin D, Nichols C, Rosamond WD, Gottesman RF, Beck J. Dental Caries, Race and Incident Ischemic Stroke, Coronary Heart Disease, and Death. Stroke 2024; 55:40-49. [PMID: 38018831 PMCID: PMC10841981 DOI: 10.1161/strokeaha.123.042528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/19/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Dental caries is a highly prevalent disease worldwide. In the United States, untreated dental caries is present in >1 in 5 adults. The objective of this study was to determine the relationship between dental caries and incident ischemic stroke, coronary heart disease (CHD) events, and death. METHODS The dental cohort (n=6351) of the ARIC study (Atherosclerosis Risk in Communities) was followed for incident ischemic stroke, CHD event, and all-cause mortality. Of all the participants at visit 4 (n=11 656), those who were unable to go through dental examination, or with prevalent ischemic stroke and CHD events, were excluded. The full-mouth dental examination was conducted at visit 4 (1996-1998), assessing dental caries. The dose response of decayed, missing, and filled surfaces due to caries was assessed and related to the outcome. Outcomes were assessed through the end of 2019. Additionally, the effect of regular dental care utilization on dental caries was evaluated. RESULTS Participants with ≥1 dental caries had an increased risk of stroke (adjusted hazard ratio [HR], 1.40 [95% CI, 1.10-1.79]) and death (adjusted HR, 1.13 [95% CI, 1.01-1.26]) but not for CHD events (adjusted HR, 1.13 [95% CI, 0.93-1.37]). The association of dental caries and ischemic incident stroke was significantly higher in the African American population compared with the White subgroup (interaction term P=0.0001). Increasing decayed, missing, and filled surfaces were significantly associated with stroke (adjusted HR, 1.006 [95% CI, 1.001-1.011]) and death (adjusted HR, 1.003 [95% CI, 1.001-1.005]) but not CHD (adjusted HR, 1.002 [95% CI, 1.000-1.005]). Regular dental care utilization lowered (adjusted odds ratio, 0.19 [95% CI, 0.16-0.22]; P<0.001) the chance of caries. CONCLUSIONS Among the cohort, dental caries was independently associated with the risk of ischemic stroke and death, with the effect higher in African American participants. Regular dental care utilization was associated with a lower chance of caries, emphasizing its relevance in the prevention of these events.
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Affiliation(s)
- Souvik Sen
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Lawson Logue
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Makenzie Logue
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Elizabeth Otersen
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Emma Mason
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Kevin Moss
- Division of Comprehensive Oral Health/Periodontology, University of North Carolina, Chapel Hill, NC
| | - James Curtis
- Department of Dentistry, Prisma Health Medical Group, Columbia, SC
| | - David Hicklin
- Department of Dentistry, Prisma Health Medical Group, Columbia, SC
| | - Cynthia Nichols
- Department of Dentistry, Prisma Health Medical Group, Columbia, SC
| | - Wayne D Rosamond
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC
| | - Rebecca F. Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, MD
| | - James Beck
- Division of Comprehensive Oral Health/Periodontology, University of North Carolina, Chapel Hill, NC
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Park S, Kim I, Han SJ, Kwon S, Min EJ, Cho W, Koh H, Koo BN, Lee JS, Kwon JS, Seo KY, Ha JW, Park YM. Oral Porphyromonas gingivalis infection affects intestinal microbiota and promotes atherosclerosis. J Clin Periodontol 2023; 50:1553-1567. [PMID: 37621247 DOI: 10.1111/jcpe.13864] [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: 07/22/2022] [Revised: 06/19/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
AIM The link between periodontitis and intestinal dysbiosis, two factors that contribute to atherosclerosis, has not been clearly defined. We investigated the integrative effects of oral infection with Porphyromonas gingivalis (PG), the major pathogen for periodontitis, on intestinal microbiota and atherosclerosis. MATERIALS AND METHODS ApoE-/- mice were fed a normal chow diet (NC), a Western diet (WD) or a WD with oral PG infection (PG). The PG infection was investigated by placing a total of 109 CFUs of live PG into the oral cavity of each mouse using a feeding needle five times a week for 3 weeks. Atherosclerotic lesions of the aortae were measured, and blood lipoproteins and the expression of molecules related to lipid metabolism in the liver were analysed. We also performed 16S RNA sequencing and a microbiome analysis using faeces. RESULTS En face bloc preparation of the aortae showed that the PG group had a 1.7-fold increase in atherosclerotic lesions compared with the WD group (p < .01). Serum analyses showed that oral PG infection induced a significant decrease in high-density lipoprotein (HDL) and triglyceride. Western blots of hepatic tissue lysates revealed that PG infection reduced the expression of scavenger receptor class B type 1 (SR-B1) in the liver by 50%. Faecal microbiota analysis revealed that species richness estimates (Chao1, ACE) decreased immediately after PG infection. PG infection also induced a significant decrease in Shannon diversity and an increase in Simpson's indices in the WD-fed mice. PG infection significantly increased the phyla Actinobacteria and Deferribacteres, along with the species Mucispirillum schaedleri and Lactobacillus gasseri, in the mice. The functional study showed that PG infection increased the expression of proteins that function in carbohydrate and glucose metabolism, including phosphotransferase system (PTS) proteins and the GntR family transcriptional regulator. CONCLUSIONS Oral PG infection promotes atherosclerosis and induces significant metabolic changes, including reduced serum HDL and reduced hepatic SR-B1 and ABCA1 expression, as well as changes in intestinal microbiota. Our study suggests that intestinal dysbiosis accompanies periodontitis and could play a role in atherosclerosis.
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Affiliation(s)
- Sowon Park
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Inyoung Kim
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Soo Jung Han
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Soyeon Kwon
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Eun-Ji Min
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Wonkyoung Cho
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Hong Koh
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Bon-Nyeo Koo
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Seok Lee
- Department of Periodontics, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Sung Kwon
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong-Won Ha
- Cardiology Division, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Mi Park
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
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7
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Sen S, Meyer J, Mascari R, Trivedi T, Suri F, Wasserman B, Rosamond W, Moss K, Beck J, Gottesman RF. Association of Dental Infections with Intracranial Atherosclerotic Stenosis. Cerebrovasc Dis 2023; 53:28-37. [PMID: 37121226 DOI: 10.1159/000530829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/24/2023] [Indexed: 05/02/2023] Open
Abstract
INTRODUCTION Periodontal disease (PD) and dental caries are oral infections leading to tooth loss that are associated with atherosclerosis and cerebrovascular disease. We assessed the hypothesis that PD and caries are associated with asymptomatic intracranial atherosclerosis (ICAS) in the Atherosclerosis Risk in Communities (ARIC) study. METHODS Full-mouth clinical periodontal measurements (7 indices) collected at 6 sites per tooth from 6,155 subjects from the Dental Atherosclerosis Risk in Communities Study (DARIC) without prior stroke were used to differentiate seven PD stages (Periodontal Profile Class [PPC]-I to -VII) and dental caries on coronal dental surface (DS) and dental root surface (DRS). A stratified subset underwent 3D time-of-flight MR angiogram and 3D high isotropic-resolution black blood MRI. ICAS was graded according to the criteria established by the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial. We evaluated the relationship between PD stage and dental caries with asymptomatic ICAS, graded as no ICAS, <50% ICAS, and ≥50% ICAS. RESULTS Among dentate subjects who underwent vascular imaging, 801 (70%) had no ICAS, 232 (20%) had <50% ICAS, and 112 (10%) had ≥50% ICAS. Compared to participants without gum disease (PPC-I), participants with mild-moderate tooth loss (PPC-VI), severe tooth loss (PPC-VII), and severe PD (PPC-IV) had higher odds of having <50% ICAS. Participants with extensive gingivitis (PPC-V) had significantly higher odds of having ≥50% ICAS. This association remained significant after adjusting for confounding variables: age, gender, race, hypertension, diabetes, dyslipidemia, 3-level education, and smoking status. There was no association between dental caries (DS and DRS) and ICAS <50% and ≥50%. CONCLUSION We report significant associations between mild-moderate tooth loss, severe tooth loss, and severe PD with <50% ICAS as well as an association between extensive gingivitis and ≥50% ICAS. We did not find an association between dental caries and ICAS.
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Affiliation(s)
- Souvik Sen
- Department of Neurology, University of South Carolina School of Medicine, Columbia, South Carolina, USA
| | - Jaclyn Meyer
- Department of Neurology, University of South Carolina School of Medicine, Columbia, South Carolina, USA
| | - Rachel Mascari
- Department of Neurology, University of South Carolina School of Medicine, Columbia, South Carolina, USA
| | - Tushar Trivedi
- Department of Neurology, University of South Carolina School of Medicine, Columbia, South Carolina, USA
| | - Fareed Suri
- Department of Neurology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Bruce Wasserman
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Wayne Rosamond
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - James Beck
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Comprehensive Oral Health/Periodontology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland, USA
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Baciu SF, Mesaroș AȘ, Kacso IM. Chronic Kidney Disease and Periodontitis Interplay-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1298. [PMID: 36674052 PMCID: PMC9859404 DOI: 10.3390/ijerph20021298] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Periodontitis (PO), a chronic microbially-induced inflammation of the supporting tissues of the tooth, is linked to various systemic diseases. We analyze its bidirectional relationship to chronic kidney disease (CKD), a major health-care problem with impressive excess mortality. Overwhelming associative relationship between CKD and PO are analyzed. Major pathophysiologic mechanisms that link CKD to PO are then presented: systemic inflammation, endothelial dysfunction, and imbalance of oxidative stress characteristic of CKD have a role in PO development and might influence escape mechanisms of oral microbiota. Subclinical local and systemic inflammation induced by PO might influence in turn CKD outcomes. Homeostatic changes induced by CKD such as mineral bone disorders, acidosis, uremic milieu, or poor salivary flow are also relevant for the occurrence of PO. There is insufficient evidence to recommend a standardized diagnostic and therapeutic approach regarding association of PO to CKD.
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Affiliation(s)
- Sorana Florica Baciu
- Department of Dental Propaedeutics and Esthetics, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Anca-Ștefania Mesaroș
- Department of Dental Propaedeutics and Esthetics, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Ina Maria Kacso
- Department of Nephrology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 2 Babes Street, 400012 Cluj-Napoca, Romania
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9
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Tonelli A, Lumngwena EN, Ntusi NAB. The oral microbiome in the pathophysiology of cardiovascular disease. Nat Rev Cardiol 2023; 20:386-403. [PMID: 36624275 DOI: 10.1038/s41569-022-00825-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 01/11/2023]
Abstract
Despite advances in our understanding of the pathophysiology of many cardiovascular diseases (CVDs) and expansion of available therapies, the global burden of CVD-associated morbidity and mortality remains unacceptably high. Important gaps remain in our understanding of the mechanisms of CVD and determinants of disease progression. In the past decade, much research has been conducted on the human microbiome and its potential role in modulating CVD. With the advent of high-throughput technologies and multiomics analyses, the complex and dynamic relationship between the microbiota, their 'theatre of activity' and the host is gradually being elucidated. The relationship between the gut microbiome and CVD is well established. Much less is known about the role of disruption (dysbiosis) of the oral microbiome; however, interest in the field is growing, as is the body of literature from basic science and animal and human investigations. In this Review, we examine the link between the oral microbiome and CVD, specifically coronary artery disease, stroke, peripheral artery disease, heart failure, infective endocarditis and rheumatic heart disease. We discuss the various mechanisms by which oral dysbiosis contributes to CVD pathogenesis and potential strategies for prevention and treatment.
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Affiliation(s)
- Andrea Tonelli
- Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.,Cardiovascular Research Unit, Christiaan Barnard Division of Cardiothoracic Surgery, Department of Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.,Cape Heart Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Extramural Research Unit on the Intersection of Noncommunicable Diseases and Infectious Disease, South African Medical Research Council, Cape Town, South Africa
| | - Evelyn N Lumngwena
- Cape Heart Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.,Centre for the Study of Emerging and Re-emerging Infections, Institute for Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
| | - Ntobeko A B Ntusi
- Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa. .,Cape Heart Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. .,Extramural Research Unit on the Intersection of Noncommunicable Diseases and Infectious Disease, South African Medical Research Council, Cape Town, South Africa. .,Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. .,Wellcome Centre for Infectious Disease Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
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10
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Hsu PW, Shen YW, Syam S, Liang WM, Wu TN, Hsu JT, Fuh LJ. Patients with periodontitis are at a higher risk of stroke: A Taiwanese cohort study. J Chin Med Assoc 2022; 85:1006-1010. [PMID: 36000972 DOI: 10.1097/jcma.0000000000000797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aimed to investigate the risk of stroke incidence in patients with periodontitis. METHODS Data on patients diagnosed with periodontitis were collected from Taiwan's National Health Insurance Research Database and were matched (1:1) with patients without periodontitis between 2001 and 2010. A multivariable Cox survival model was used to predict stroke between patients with and without periodontitis, and the possibility of confounders. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to explore the risk of stroke in the case and control groups. Diseases found during the follow-up period were analyzed to determine possible effects on the study. A total of 282 560 periodontitis and nonperiodontitis patients were enrolled, with most subjects aged 40 to 59 years. RESULTS The overall cumulative incidence of stroke was 2.14 times higher in periodontitis than in nonperiodontitis, and the highest HR was in the more than 80 years age group (HR = 9.30; 95% CI, 7.06-12.26). The multivariate Cox model indicated that the adjusted HR (aHR) between the case and control was 2.03 (95% CI, 1.99-2.08), and a higher aHR was associated with hypertension. Atherosclerosis, atrial fibrillation, obesity, kidney disease, anxiety, and gout discovered during follow-up also showed a potential risk of stroke in patients with periodontitis. CONCLUSION Therefore, this study suggests a high risk of stroke in patients with periodontitis.
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Affiliation(s)
- Pei-Wei Hsu
- School of Dentistry, China Medical University, Taichung, Taiwan, ROC
| | - Yen-Wen Shen
- School of Dentistry, China Medical University, Taichung, Taiwan, ROC
- Department of Dentistry, China Medical University and Hospital, Taichung, Taiwan, ROC
| | - Syamsiah Syam
- School of Dentistry, China Medical University, Taichung, Taiwan, ROC
- Faculty of Dentistry, Universitas Muslim Indonesia, Makassar, Indonesia
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC
| | - Trong-Neng Wu
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, Taiwan, ROC
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, ROC
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, Taiwan, ROC
- Department of Dentistry, China Medical University and Hospital, Taichung, Taiwan, ROC
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11
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Giacaman RA, Fernández CE, Muñoz-Sandoval C, León S, García-Manríquez N, Echeverría C, Valdés S, Castro RJ, Gambetta-Tessini K. Understanding dental caries as a non-communicable and behavioral disease: Management implications. FRONTIERS IN ORAL HEALTH 2022; 3:764479. [PMID: 36092137 PMCID: PMC9448953 DOI: 10.3389/froh.2022.764479] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
New paradigms in caries conceptualization have emerged during the last decades, leading to intense debate and discussion on how to approach the disease, both from a preventive and a therapeutic perspective. Among many new ideas, research discoveries and technologies, one major concept can be highlighted that created a deep frontier between the old and the new paradigm in caries conceptualization; the non-communicable nature of the disease, firmly associated with behaviors and lifestyles. This article synthetizes the conceptual construction of dental caries as a non-communicable disease (NCD) based on the current evidence and discusses the appropriate management of the disease in this context. Dental caries has shifted from being considered transmissible and infectious to an ecological and non-communicable disease. Environmental factors such as frequent sugars intake, disrupt the symbiosis of the dental biofilm leading to a dysbiosis, which favors caries lesion initiation and progression. As an NCD, dental caries shares characteristics with other NCDs such as cardiovascular and chronic respiratory diseases, cancer and diabetes, including long duration and slow progression, not being transmissible from person-to-person, being strongly related to modifiable behavioral risk factors, and affecting preferentially disadvantaged populations with a strong inequality gradient. Given the high prevalence of dental caries, and its consequences on people's health and quality of life, a recognizable conceptual view of caries as a NCD is required to target an effective management. Current understanding of dental caries supports prevention through acting on the modifiable risk factors (behaviors) and involves management based on an interdisciplinary approach. Communicating these modern concepts among researchers, clinicians and policymakers is needed to decrease the global high burden of the disease.
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Affiliation(s)
- Rodrigo A. Giacaman
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
- *Correspondence: Rodrigo A. Giacaman
| | - Constanza E. Fernández
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Cecilia Muñoz-Sandoval
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Soraya León
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
| | - Natalia García-Manríquez
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Constanza Echeverría
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Sebastián Valdés
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Ramiro J. Castro
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
| | - Karla Gambetta-Tessini
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
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12
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Giordano-Kelhoffer B, Lorca C, March Llanes J, Rábano A, del Ser T, Serra A, Gallart-Palau X. Oral Microbiota, Its Equilibrium and Implications in the Pathophysiology of Human Diseases: A Systematic Review. Biomedicines 2022; 10:biomedicines10081803. [PMID: 36009350 PMCID: PMC9405223 DOI: 10.3390/biomedicines10081803] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 02/06/2023] Open
Abstract
Imbalances of the oral microbiota and dysbiosis have traditionally been linked to the occurrence of teeth and oral diseases. However, recent findings indicate that this microbiota exerts relevant influence in systemic health. Dysbiosis of the oral microbiota is implicated in the apparition and progression of cardiovascular, neurodegenerative and other major human diseases. In fact, the oral microbiota are the second most diverse and largely populated microbiota of the human body and its relationships with systemic health, although widely explored, they still lack of proper integration. The purpose of this systematic review is thus to widely examine the implications of oral microbiota in oral, cardiovascular and neurodegenerative diseases to offer integrative and up-to-date interpretations. To achieve that aim, we identified a total of 121 studies curated in PUBMED from the time interval January 2003–April 2022, which after careful screening resulted in 79 studies included. The reviewed scientific literature provides plausible vias of implication of dysbiotic oral microbiota in systemic human diseases, and encourages further research to continue elucidating the highly relevant and still poorly understood implications of this niche microbiota in systemic health. PROSPERO Registration Number: CRD42022299692. This systematic review follows relevant PRISMA guidelines.
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Affiliation(s)
- Barbara Giordano-Kelhoffer
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain;
- Bioengineering Institute of Technology, Faculty of Health Sciences, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
| | - Cristina Lorca
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
- IMDEA—Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, 8 Crta. Canto Blanco, 28049 Madrid, Spain
| | - Jaume March Llanes
- NeuroPGA Research Group—Psychology Department, University of Lleida (UdL), 25001 Lleida, Spain;
| | - Alberto Rábano
- Alzheimer’s Centre Reina Sofia—CIEN Foundation, 28031 Madrid, Spain; (A.R.); (T.d.S.)
| | - Teodoro del Ser
- Alzheimer’s Centre Reina Sofia—CIEN Foundation, 28031 Madrid, Spain; (A.R.); (T.d.S.)
| | - Aida Serra
- IMDEA—Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, 8 Crta. Canto Blanco, 28049 Madrid, Spain
- Correspondence: (A.S.); (X.G.-P.); Tel.: +34-91-7278-100 (A.S.); +34-97-3702-224 (X.G.-P.)
| | - Xavier Gallart-Palau
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
- Psychology Department, University of Lleida (UdL), 25001 Lleida, Spain
- Correspondence: (A.S.); (X.G.-P.); Tel.: +34-91-7278-100 (A.S.); +34-97-3702-224 (X.G.-P.)
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13
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Feng Y, Chen Z, Tu SQ, Wei JM, Hou YL, Kuang ZL, Kang XN, Ai H. Role of Interleukin-17A in the Pathomechanisms of Periodontitis and Related Systemic Chronic Inflammatory Diseases. Front Immunol 2022; 13:862415. [PMID: 35371044 PMCID: PMC8968732 DOI: 10.3389/fimmu.2022.862415] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/28/2022] [Indexed: 01/02/2023] Open
Abstract
Periodontitis is a chronic inflammatory and destructive disease caused by periodontal microbial infection and mediated by host immune response. As the main cause of loosening and loss of teeth in adults, it is considered to be one of the most common and serious oral diseases in the world. The co-existence of periodontitis and systemic chronic inflammatory diseases such as rheumatoid arthritis, psoriasis, inflammatory bowel disease, diabetes and so on is very common. It has been found that interleukin-17A (IL-17A) secreted by various innate and adaptive immune cells can activate a series of inflammatory cascade reactions, which mediates the occurrence and development of periodontitis and related systemic chronic inflammatory diseases. In this work, we review the role of IL-17A in the pathomechanisms of periodontitis and related systemic chronic inflammatory diseases, and briefly discuss the therapeutic potential of cytokine targeted agents that modulate the IL-17A signaling. A deep understanding of the possible molecular mechanisms in the relationship between periodontitis and systemic diseases will help dentists and physicians update their clinical diagnosis and treatment ideas.
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14
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Oral microbiota in human systematic diseases. Int J Oral Sci 2022; 14:14. [PMID: 35236828 PMCID: PMC8891310 DOI: 10.1038/s41368-022-00163-7] [Citation(s) in RCA: 155] [Impact Index Per Article: 77.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 02/07/2023] Open
Abstract
Oral bacteria directly affect the disease status of dental caries and periodontal diseases. The dynamic oral microbiota cooperates with the host to reflect the information and status of immunity and metabolism through two-way communication along the oral cavity and the systemic organs. The oral cavity is one of the most important interaction windows between the human body and the environment. The microenvironment at different sites in the oral cavity has different microbial compositions and is regulated by complex signaling, hosts, and external environmental factors. These processes may affect or reflect human health because certain health states seem to be related to the composition of oral bacteria, and the destruction of the microbial community is related to systemic diseases. In this review, we discussed emerging and exciting evidence of complex and important connections between the oral microbes and multiple human systemic diseases, and the possible contribution of the oral microorganisms to systemic diseases. This review aims to enhance the interest to oral microbes on the whole human body, and also improve clinician’s understanding of the role of oral microbes in systemic diseases. Microbial research in dentistry potentially enhances our knowledge of the pathogenic mechanisms of oral diseases, and at the same time, continuous advances in this frontier field may lead to a tangible impact on human health.
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15
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Huang N, Li C, Sun W, Yang Y, Tang Q, Xiao F. Association Between Chronic Periodontal Disease and Erectile Dysfunction: A Case-Control Study. Am J Mens Health 2022; 16:15579883221084798. [PMID: 35319301 PMCID: PMC8949704 DOI: 10.1177/15579883221084798] [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] [Indexed: 11/16/2022] Open
Abstract
Erectile dysfunction (ED) and chronic periodontal disease (CPD) share mutual risk factors, and the incidence of ED is increasing among young adults. The relation of CPD and ED remains obscure due to inconsistent clinical evidence. This study aimed to further assess the relationship between CPD and ED using the Community Periodontal Index of Treatment Need (CPITN) and the International Index of Erectile Function (IIEF). Totally, 202 adult men were included, with 100 subjects with ED in the case group and 102 subjects without ED undergoing routine dental examinations in the control group. The IIEF questionnaire was used to assess the severity of ED, and CPD was assessed through the Community Periodontal Index (CPI) score. Periodontal assessments were performed by one single calibrated examiner. Logistic regression analysis was performed for the association between CPD and ED. After adjustment for age, smoking status, tooth brushing time, education level, monthly income, tooth brushing frequency, and gum bleeding, higher CPI score was identified to be associated with a greater risk of ED (odds ratio [OR] = 2.755, 95% confidence interval [CI] = [1.400, 5.423], p = .003), suggesting that CPD was positively associated with the odds of ED. CPD was getting more severe with the progress of ED (p < .05). Men with ED could be encouraged to receive routine dental examinations and appropriate preventive dental measures to maintain oral and periodontal health.
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Affiliation(s)
- Nannan Huang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Chanxiu Li
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Wenjuan Sun
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Yuhong Yang
- Department of Stomatology, Shenzhen University General Hospital, Shenzhen, Guangdong, P. R. China
| | - Qian Tang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Feng Xiao
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
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16
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Ning W, Ma Y, Li S, Wang X, Pan H, Wei C, Zhang S, Bai D, Liu X, Deng Y, Acharya A, Pelekos G, Savkovic V, Li H, Gaus S, Haak R, Schmalz G, Ziebolz D, Ma Y, Xu Y. Shared Molecular Mechanisms between Atherosclerosis and Periodontitis by Analyzing the Transcriptomic Alterations of Peripheral Blood Monocytes. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:1498431. [PMID: 34899963 PMCID: PMC8664523 DOI: 10.1155/2021/1498431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/12/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study investigated the nature of shared transcriptomic alterations in PBMs from periodontitis and atherosclerosis to unravel molecular mechanisms underpinning their association. METHODS Gene expression data from PBMs from patients with periodontitis and those with atherosclerosis were each downloaded from the GEO database. Differentially expressed genes (DEGs) in periodontitis and atherosclerosis were identified through differential gene expression analysis. The disease-related known genes related to periodontitis and atherosclerosis each were downloaded from the DisGeNET database. A Venn diagram was constructed to identify crosstalk genes from four categories: DEGs expressed in periodontitis, periodontitis-related known genes, DEGs expressed in atherosclerosis, and atherosclerosis-related known genes. A weighted gene coexpression network analysis (WGCNA) was performed to identify significant coexpression modules, and then, coexpressed gene interaction networks belonging to each significant module were constructed to identify the core crosstalk genes. RESULTS Functional enrichment analysis of significant modules obtained by WGCNA analysis showed that several pathways might play the critical crosstalk role in linking both diseases, including bacterial invasion of epithelial cells, platelet activation, and Mitogen-Activated Protein Kinases (MAPK) signaling. By constructing the gene interaction network of significant modules, the core crosstalk genes in each module were identified and included: for GSE23746 dataset, RASGRP2 in the blue module and VAMP7 and SNX3 in the green module, as well as HMGB1 and SUMO1 in the turquoise module were identified; for GSE61490 dataset, SEC61G, PSMB2, SELPLG, and FIBP in the turquoise module were identified. CONCLUSION Exploration of available transcriptomic datasets revealed core crosstalk genes (RASGRP2, VAMP7, SNX3, HMGB1, SUMO1, SEC61G, PSMB2, SELPLG, and FIBP) and significant pathways (bacterial invasion of epithelial cells, platelet activation, and MAPK signaling) as top candidate molecular linkage mechanisms between atherosclerosis and periodontitis.
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Affiliation(s)
- Wanchen Ning
- Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - Yihong Ma
- Department of Neurology, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - Xin Wang
- Department of Neurology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Hongying Pan
- School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI 48109, USA
| | - Chenxuan Wei
- School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI 48109, USA
| | - Shaochuan Zhang
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Dongying Bai
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471003, China
| | - Xiangqiong Liu
- Laboratory of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, 218 Anwaixiaoguanbeili Street, Chaoyang, Beijing 100029, China
| | - Yupei Deng
- Laboratory of Molecular Cell Biology, Beijing Tibetan Hospital, China Tibetology Research Center, 218 Anwaixiaoguanbeili Street, Chaoyang, Beijing 100029, China
| | - Aneesha Acharya
- Dr D Y Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pimpri, Pune, India
| | - George Pelekos
- Faculty of Dentistry, University of Hong Kong, Hong KongChina
| | - Vuk Savkovic
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - Hanluo Li
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - Sebastian Gaus
- Department of Cranio Maxillofacial Surgery, University Clinic Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Yanbo Ma
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471003, China
| | - Yuzhen Xu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province 271000, China
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Puzhankara L, Janakiram C. Common Risk Factor Approach to Limit Noncommunicable Diseases and Periodontal Disease-The Molecular and Cellular Basis: A Narrative Review. J Int Soc Prev Community Dent 2021; 11:490-502. [PMID: 34760792 PMCID: PMC8533044 DOI: 10.4103/jispcd.jispcd_109_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/16/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction The link between periodontal disease and noncommunicable diseases (NCDs) has been the subject of major research over the past several years. The primary objective of this review is to understand the cellular and molecular components that link common risk factors (exposure) in adult patients (population) with periodontal disease and other NCDs (outcome). The secondary objective is to interpret from existing literature the possibility of identifying the molecular plausibility of the Common Risk Factor Approach (CRFA). Materials and Methods A literature search was performed in PubMed/MEDLINE, CINAHL, Web of Science, and Google Scholar for all published articles pertaining to the molecular and cellular basis of the risk factors between periodontal diseases and major NCDs. Data from all randomized and nonrandomized clinical trials, cross-sectional studies, case-control, cohort studies, literature, and systematic reviews were included. Results Periodontal pathogens, stress, obesity, smoking, and dietary factors are some of the common risk factors between periodontal disease and NCDs. Conclusion Understanding the molecular and cellular link of common risk factors between NCDs and periodontal disease would ensure the application of CRFA. The CRFA implies that controlling the risk factors associated with NCDs can have an incredible positive impact on regulating many chronic conditions, which would extend to periodontal health also.
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Affiliation(s)
- Lakshmi Puzhankara
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Chandrashekar Janakiram
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Gonen T, Katz-Talmor D, Amital H, Comaneshter D, Cohen AD, Tiosano S. The Association between Sarcoidosis and Ischemic Heart Disease-A Healthcare Analysis of a Large Israeli Population. J Clin Med 2021; 10:jcm10215067. [PMID: 34768590 PMCID: PMC8584952 DOI: 10.3390/jcm10215067] [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: 09/04/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 12/24/2022] Open
Abstract
(1) Background: Inflammation plays a pivotal role in atherosclerosis, and the association between chronic inflammatory states and ischemic heart disease (IHD) has been shown in several rheumatic diseases. Persistent inflammation might also be a risk factor for IHD in sarcoidosis patients. (2) Methods: Demographic and clinical data of 3750 sarcoidosis patients and 18,139 age- and sex-matched controls were retrieved from the database of Clalit Health Services, Israel’s largest healthcare organization. Variables associated with IHD were assessed by a logistic regression model. To assess for variables that were related to increased risk of all-cause mortality, the Cox proportional hazards method was used, and a log-rank test was performed for survival analysis. (3) Results: Both groups were composed of 64% females with a median age of 56 years. An association between sarcoidosis and IHD was demonstrated by a multivariate analysis (adjusted odds ratio (OR) 1.5; 95% confidence interval (CI) 1.36–1.66). Long-term follow-up revealed increased mortality among sarcoidosis patients: 561 (15%) deaths compared to 1636 (9%) deaths among controls (p < 0.001). Survival analysis demonstrated that sarcoidosis patients were also at increased risk for all-cause mortality compared to controls (multivariate model, adjusted HR 1.93; 95% CI 1.76–2.13).
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Affiliation(s)
- Tal Gonen
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (T.G.); (H.A.)
- Sheba Medical Center, Department of Medicine ‘B’, Tel-Hashomer, Ramat-Gan 5266202, Israel
| | - Daphna Katz-Talmor
- Department of Medicine ‘A’, University Hospital Samason Assuta Ashdod, Ashdod 7747629, Israel;
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 5266202, Israel
| | - Howard Amital
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (T.G.); (H.A.)
- Sheba Medical Center, Department of Medicine ‘B’, Tel-Hashomer, Ramat-Gan 5266202, Israel
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 5266202, Israel
| | - Doron Comaneshter
- Chief Physician’s Office, Clalit Health Services Tel Aviv, Tel-Aviv 6209813, Israel; (D.C.); (A.D.C.)
| | - Arnon D. Cohen
- Chief Physician’s Office, Clalit Health Services Tel Aviv, Tel-Aviv 6209813, Israel; (D.C.); (A.D.C.)
- Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben Gurion University of the Negev, Beer Sheva 8410501, Israel
| | - Shmuel Tiosano
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (T.G.); (H.A.)
- Sheba Medical Center, Department of Medicine ‘B’, Tel-Hashomer, Ramat-Gan 5266202, Israel
- The Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 5266202, Israel
- Correspondence: ; Tel.: +972-3-530-2644
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Association Between Tooth Loss and Longitudinal Changes in B-Type Natriuretic Peptide Over 5 Years in Postmenopausal Women: The Nagahama Study. Curr Probl Cardiol 2021; 47:100997. [PMID: 34582901 DOI: 10.1016/j.cpcardiol.2021.100997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/14/2021] [Indexed: 11/20/2022]
Abstract
There is disparity between the sexes in cardiovascular diseases including heart failure (HF). This study aimed to investigate the effect of periodontal disease (PD) on plasma B-type natriuretic peptide (BNP) concentration across sex, age, and menopausal status, as well as the interaction effect of PD and diabetes mellitus (DM) on BNP. This large-scale prospective cohort study enrolled 7539 individuals with no myocardial infarctions or angina pectoris at baseline from the general Japanese population. The association between baseline number of missing teeth (MT) and the longitudinal changes in BNP over 5 years (ΔBNP) was evaluated according to sex and menopausal status. Among 7539 participants, 3190 were postmenopausal women with a mean age ± standard deviation of 61.1 ± 7.6 at baseline. Multivariate analysis revealed a positive association between MT and ΔBNP among postmenopausal women even after adjusting for covariates, including traditional HF risk factors (coefficient, 0.210; 95% confidence interval [CI], 0.107 to 0.312; P < 0.001), but not in men aged > 50. Including an interaction term (MT × DM) in the multivariate model revealed a positive interaction between MT and DM in ΔBNP among postmenopausal women (coefficient for interaction, 1.365; 95% CI, 0.902 to 1.827; P for interaction < 0.001). In conclusion, our study showed a positive association between MT and ΔBNP, as well as a positive effect of the interactive association between MT and DM, among postmenopausal women. Our results suggest a sex difference of an adverse effect of PD on initial myocardial wall stress in the ventricles.
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Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke. Stroke Res Treat 2021; 2021:5402764. [PMID: 34531969 PMCID: PMC8440111 DOI: 10.1155/2021/5402764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Methods Thrombus aspirates and control arterial blood were taken from 71 patients (70.4% male; mean age, 67.4 years) with acute ischemic stroke. Tooth pathology was registered using CT scans. Carotid stenosis was estimated with CTA and ultrasonography. The presence of bacterial DNA from aspirated thrombi was determined using quantitative PCR. We also analyzed the presence of these bacterial DNAs in carotid endarterectomies from patients with peripheral arterial disease. Results Bacterial DNA was found in 59 (83.1%) of the thrombus aspirates (median, 8.6-fold). Oral streptococcal DNA was found in 56 (78.9%) of the thrombus aspirates (median, 5.1-fold). DNA from A. actinomycetemcomitans and P. gingivalis was not found. Most patients suffered from poor oral health and had in median 19.0 teeth left. Paradoxically, patients with better oral health had more oral streptococcal DNA in their thrombus than the group with the worst pathology (p = 0.028). There was a trend (OR 7.122; p = 0.083) in the association of ≥50% carotid artery stenosis with more severe dental pathology. Oral streptococcal DNA was detected in 2/6 of carotid endarterectomies. Conclusions Stroke patients had poor oral health which tended to associate with their carotid artery stenosis. Although oral streptococcal DNA was found in thrombus aspirates and carotid endarterectomy samples, the amount of oral streptococcal DNA in thrombus aspirates was the lowest among those with the most severe oral pathology. These results suggest that the association between poor oral health and acute ischemic stroke is linked to carotid artery atherosclerosis.
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21
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Rahimi A, Afshari Z. Periodontitis and cardiovascular disease: A literature review. ARYA ATHEROSCLEROSIS 2021; 17:1-8. [PMID: 35686242 PMCID: PMC9137219 DOI: 10.22122/arya.v17i0.2362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/01/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are in charge of many deaths worldwide including myocardial infarction (MI), hypertension (HTN), coronary atherosclerosis (CAS), infective endocarditis (IE), heart failure (HF), arterial fibrillation (AF), and peripheral artery disease (PAD). Besides, periodontitis is the sixth prevalent disease among humans and it seems that there are common risk factors between these diseases which are creating communication between prevalence and treatment. The purpose of this study is to assess the articles that reviewed the relationship between heart diseases and periodontitis. METHODS Three databases, including PubMed, Scopus, and Web of Science were searched until November 2020. The search terms "periodontal disease, periodontitis, oral health, cardiovascular disease, atherosclerosis, myocardial infarction, hypertension, coronary heart disease, angina pectoris, arterial fibrillation, arrhythmia, and peripheral artery disease" were used in combination to identify the publications providing data. RESULTS MI, HTN, atherosclerosis diseases for coronary artery, IE, HF, AF, and PAD were associated with periodontitis. It seems that the treatment of periodontitis may help to improve the state of mentioned heart-related diseases. However, more studies are needed to prove this relationship. CONCLUSION The prevalence of heart diseases is more common in individuals with periodontitis.
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Affiliation(s)
- Alireza Rahimi
- Dentistry Student, Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohreh Afshari
- Postgraduate Student, Student Research Committee, Department of Periodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Zohreh Afshari; Postgraduate Student, Student Research Committee, Department of Periodontics, School
of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran;
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22
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Sari A, Davutoglu V, Bozkurt E, Taner IL, Erciyas K. Effect of periodontal disease on oxidative stress markers in patients with atherosclerosis. Clin Oral Investig 2021; 26:1713-1724. [PMID: 34415433 DOI: 10.1007/s00784-021-04144-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 08/11/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effect of periodontal inflammation on oxidative stress in patients with atherosclerosis by considering serum and saliva total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI). MATERIALS AND METHODS In the study, there were 4 groups, with 20 individuals in each group. These groups consisted of individuals who had periodontitis with atherosclerosis (group A-P), were periodontally healthy with atherosclerosis (group A-C), were systemically healthy with periodontitis (group P), and were systemically and periodontally healthy (group C). Clinical periodontal parameters were recorded. PISA values were calculated. Atherosclerosis severity was determined by the Gensini score. The ratio of TAS/TOS resulting in the OSI levels of the serum and saliva samples was examined biochemically. RESULTS Group A-P serum TAS and group C saliva OSI values were lower than those of the other groups (p < 0.05). Group A-P serum TOS and OSI values were higher than those of the other groups (p < 0.05). Groups A-C and P serum TOS and OSI values were higher than those of group C (p < 0.05). In the multivariate linear regression analysis, group A-P and PISA values were independently associated with serum TOS and OSI values (p < 0.05). Group A-P, group P, and PISA values were independently associated with saliva OSI values (p < 0.05). CONCLUSIONS Periodontitis and atherosclerosis may have systemic oxidative stress-increasing effects. The coexistence of periodontitis and atherosclerosis increases oxidative stress beyond that seen in either condition alone. Periodontitis can be associated with increased systemic TOS and OSI values in patients with atherosclerosis. STATEMENT OF CLINICAL RELEVANCE Oxidative status is affected more severely when periodontitis and atherosclerosis coexist rather than when either exists alone. Periodontitis can cause increasing effect on serum TOS and OSI and decreasing effect on TAS in patients with atherosclerosis. The increase in oxidative stress markers with the presence of periodontal disease in patients with atherosclerosis emphasizes that controlling periodontal diseases, a treatable disease, may contribute to the prognosis of atherosclerosis.
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Affiliation(s)
- Aysegul Sari
- Department of Periodontology, Faculty of Dentistry, Mustafa Kemal University, 31040, Hatay, Turkey.
| | - Vedat Davutoglu
- Department of Cardiology, NCR International Hospital, Gaziantep, Turkey
| | - Emrullah Bozkurt
- Department of Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ibrahim Levent Taner
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Kamile Erciyas
- Department of Periodontology, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
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Chen C, Zhu J, Deng X, Yang Z, Lin W, Ma Y, Huang S, Chen L, Liu Y, Zhu F. Severe periodontitis is associated with the serum levels of hypersensitive C reactive protein and lipoprotein-associated phospholipase A2 in the patients of acute ischemic stroke. J Clin Neurosci 2021; 88:232-236. [PMID: 33992190 DOI: 10.1016/j.jocn.2021.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/23/2021] [Accepted: 04/04/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Periodontitis is associated with the pathogenesis of atherosclerotic plaque, and hypersensitive C reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are the serum biomarkers of the stability of atherosclerotic plaque. Whether periodontitis is associated with the serum level of hs-CRP and Lp-PLA2 of acute ischemic stroke remains unclear. MATERIAL AND METHODS We recruited 103 cases with acute ischemic stroke within 7 days after stroke onset. Pocket depth and clinical attachment loss were assessed by oral examination to define the severe periodontitis. Demographic information including gender, age and body weight index, income level, education level, past medical history include smoking history, drinking history, ischemic stroke history, coronary heart disease, hypertension, diabetes and hyperlipidemia were collected, and serum biomarkers including white blood cell (WBC), fibrinogen, total cholesterol (TC), triglyceride (TG), lower density lipoprotein (LDL-C), high density lipoprotein (HDL-C), hs-CRP, HemoglobinA1c (HbAlc), Homocysteine (HCY) and Lp-PLA2 were tested. RESULTS 65 (63.1%) cases were diagnosed as severe periodontitis. Severe periodontitis group showed more male, age, drinking history, higher levels of hs-CRP and Lp-PLA2. Multivariate logistic regression showed that severe periodontitis was were significantly associated with hs-CRP (OR = 2.367, 95%CI: 1.182-4.738; P = .015) and Lp-PLA2 (OR = 2.577, 95% CI: 1.010-6.574; P = .048). CONCLUSIONS Severe periodontitis is independently associated with the serum Level of hs-CRP and Lp-PLA2 in patients with acute ischemic stroke. Whether the improvement of periodontitis could decrease the occurrence and re-occurrence of ischemic stroke by stablizating atherosclerotic plaque need be further studied in future.
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Affiliation(s)
- Chunchun Chen
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen City, Guangdong Province 518001, PR China; Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Jinhua Zhu
- Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Xuhui Deng
- Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Zhi Yang
- Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Weifeng Lin
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou City, Guangdong Province 510632, PR China
| | - Ying Ma
- Department of Cardiology, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen City, Guangdong Province 518001, PR China
| | - Shuxuan Huang
- Department of Neurology, People 's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, PR China
| | - Lue Chen
- Department of Neurology, Shunde Hospital of Southern Medical University, Shunde, Guangdong Province 528300, PR China
| | - Yuan Liu
- Department of Neurology, The Third People's Hospital of Hangzhou, Hangzhou, Zhejiang Province 310009, PR China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen City, Guangdong Province 518001, PR China; Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China.
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24
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Alvarenga MOP, Frazão DR, de Matos IG, Bittencourt LO, Fagundes NCF, Rösing CK, Maia LC, Lima RR. Is There Any Association Between Neurodegenerative Diseases and Periodontitis? A Systematic Review. Front Aging Neurosci 2021; 13:651437. [PMID: 34108875 PMCID: PMC8180549 DOI: 10.3389/fnagi.2021.651437] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Neurodegenerative diseases are a group of progressive disorders that affect the central nervous system (CNS) such as Alzheimer, Parkinson, and multiple sclerosis. Inflammation plays a critical role in the onset and progression of these injuries. Periodontitis is considered an inflammatory disease caused by oral biofilms around the tooth-supporting tissues, leading to a systemic and chronic inflammatory condition. Thus, this systematic review aimed to search for evidence in the association between neurodegenerative disorders and periodontitis. Methods: This systematic review was registered at International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD 42016038327. The search strategy was performed in three electronic databases and one gray literature source-PubMed, Scopus, Web of Science, and OpenGrey, based on the PECO acronym: observational studies in humans (P) in which a neurodegenerative disease was present (E) or absent (C) to observe an association with periodontitis (O). The Fowkes and Fulton checklist was used to critically appraise the methodological quality and the risk of bias of individual studies. The quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: From 534 articles found, 12 were included, of which eight were case-control, three were cross-sectional, and one was a cohort, giving a total of 3,460 participants. All the included studies reported an association between some neurodegenerative diseases and periodontitis and presented a low risk of bias. According to the GRADE approach, the level of evidence of probing pocket depth was considered very low due to the significant heterogeneity across the studies' upgrading imprecision and inconsistency. Conclusions: Although all the included studies in this review reported an association between neurodegenerative diseases and periodontitis, the level of evidence was classified to be very low, which suggests a cautious interpretation of the results.
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Affiliation(s)
- María Olimpia Paz Alvarenga
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Deborah Ribeiro Frazão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Isabella Gomes de Matos
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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25
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Zhu S, Xu K, Jiang Y, Zhu C, Suo C, Cui M, Wang Y, Yuan Z, Xue J, Wang J, Zhang T, Zhao G, Ye W, Huang T, Lu M, Tian W, Jin L, Chen X. The gut microbiome in subclinical atherosclerosis: a population-based multi-phenotype analysis. Rheumatology (Oxford) 2021; 61:258-269. [PMID: 33769467 DOI: 10.1093/rheumatology/keab309] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The altered microbiota, considered as quantitative traits, has also been identified to play pivotal roles in the host vascular physiology and might contribute to diseases. To understand the role of gut microbiota on vascular physiology in the sub-clinical elderly population and how lifestyles affect the composition of host gut microbiota to further impact the pathogenesis of vascular diseases. METHODS Performed a population-based fecal metagenomic study over 569 elderly asymptomatic sub-clinical individuals in rural China. An association network was built based on clinical measurements and detailed epidemiologic questionnaires, including blood chemistry, arterial stiffness, carotid ultrasonography, and metagenomic datasets. RESULTS Carotid arterial atherosclerosis indices, including intima-media thickness (IMT), were shown essentially in the network, and were significantly associated with living habits, socio-economic status, and diet. Using mediation analysis, we found that higher frequency of taking fresh fruits, fresh vegetables, and more exercise significantly reduces carotid arteries atherosclerosis in terms of IMT, PSV and EDV values the through the mediation of Alistepes, Oligella, and Prevotella. The gut microbes explained 16.5% of the mediation effect of lifestyles on the pathogenesis of carotid atherosclerosis. After adjusted, Faecalicatena (OR = 0.20∼0.30) was shown protective in the formation of carotid athersclerosis independently, while Libanicoccus (OR = 2.39∼2.43) were hazardous to carotid arterial IMTs. KEGG/KO analyses revealed a loss of anti-inflammation function in IMT subjects. CONCLUSIONS Our study provided a Chinese population-wide phenotype-metagenomic network, revealing association and mediation effect of gut microbiota on carotid artery atherosclerosis, hinting at a therapeutic and preventive potential of microbiota in vascular diseases.
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Affiliation(s)
- Sibo Zhu
- State Key Laboratory of Genetic Engineering and Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Kelin Xu
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Biostatistics, School of Public Health, Fudan University; Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering and Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Chengkai Zhu
- State Key Laboratory of Genetic Engineering and Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Chen Suo
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Mei Cui
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingzhe Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ziyu Yuan
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Jiangli Xue
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Jiucun Wang
- State Key Laboratory of Genetic Engineering and Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tingting Huang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ming Lu
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Weizhong Tian
- Department of Medical Imaging, Taizhou People's Hospital Affiliated to Nantong University, Taizhou, Jiangsu, China
| | - Li Jin
- State Key Laboratory of Genetic Engineering and Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering and Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
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26
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Dimitriu T, Bolfa P, Daradics Z, Suciu Ş, Armencea G, Cătoi C, Dinu C, Băciuţ G, Văcăraş S, Bran S, Băciuţ M. Ligature induced periodontitis causes atherosclerosis in rat descending aorta: an experimental study. Med Pharm Rep 2021; 94:106-111. [PMID: 33629057 PMCID: PMC7880073 DOI: 10.15386/mpr-2044] [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: 06/27/2019] [Revised: 09/11/2019] [Accepted: 09/28/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction In recent years a link between periodontitis and cardiovascular diseases has been proposed. Oxidative stress has been found to be involved in their pathophysiology. Objectives The aim of this study was to demonstrate that a wire ligature placed around the first mandibular molars of the rat causes inflammation in the periodontium and lipid deposits in the aorta, via oxidative stress. Methods Twenty male Wistar rats were divided randomly into two groups of 10: Control group and Periodontitis group. An orthodontic wire ligature was placed around the cervix of the first mandibular molar and was kept in place for 4 weeks. Clinical attachment loss was determined to assess the gingival recession. Aorta was harvested after 4 weeks and the malondialdehyde (MDA) levels in the aorta tissue homogenate were determined. Lipid deposits were evaluated using Oil Red staining and immunofluorescence under confocal microscopy. Total lipid deposits in the aorta were assessed using a computer morphometry system. Results Significant gingival recession was observed in the Periodontitis group in comparison with the Control group. Increased MDA levels were present in the aorta in the ligatured rats in comparison with the Control group. Significant lipid deposits were observed in the aorta of the Periodontitis group as opposed to the Control group. Conclusions The affixing of an orthodontic wire ligature produces gingival recession, increased oxidative stress and lipid deposits in the rat descending aorta.
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Affiliation(s)
- Tudor Dimitriu
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Pompei Bolfa
- Department of Pathology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania.,Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Zsofia Daradics
- Department of Pathology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Şoimiţa Suciu
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cornel Cătoi
- Department of Pathology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Băciuţ
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sergiu Văcăraş
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Roma
| | - Mihaela Băciuţ
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Paul O, Arora P, Mayer M, Chatterjee S. Inflammation in Periodontal Disease: Possible Link to Vascular Disease. Front Physiol 2021; 11:609614. [PMID: 33519515 PMCID: PMC7841426 DOI: 10.3389/fphys.2020.609614] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/21/2020] [Indexed: 12/12/2022] Open
Abstract
Inflammation is a well-organized protective response to pathogens and consists of immune cell recruitment into areas of infection. Inflammation either clears pathogens and gets resolved leading to tissue healing or remains predominantly unresolved triggering pathological processes in organs. Periodontal disease (PD) that is initiated by specific bacteria also triggers production of inflammatory mediators. These processes lead to loss of tissue structure and function. Reactive oxygen species and oxidative stress play a role in susceptibility to periodontal pathogenic bacterial infections. Periodontal inflammation is a risk factor for systemic inflammation and eventually cardiovascular disease (CVD). This review discusses the role of inflammation in PD and its two way association with other health conditions such as diabetes and CVD. Some of the mechanisms underpinning the links between inflammation, diabetes, CVD and PD are also discussed. Finally, we review available epidemiological data and other reports to assess possible links between oral health and CVD.
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Affiliation(s)
- Oindrila Paul
- Institute for Environmental Medicine, Department of Physiology, University of Pennsylvania School of Medicine, Philadelphia, PA, United States
| | - Payal Arora
- Early-Research Oral Care, Colgate-Palmolive Company, Piscataway, NJ, United States
| | - Michael Mayer
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, United States
| | - Shampa Chatterjee
- Institute for Environmental Medicine, Department of Physiology, University of Pennsylvania School of Medicine, Philadelphia, PA, United States
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28
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Karabulut A. The Role of Microbiologic Agents in the Progression of the Atherosclerosis: a Comprehensive Review. J Saudi Heart Assoc 2020; 32:440-450. [PMID: 33299789 PMCID: PMC7721457 DOI: 10.37616/2212-5043.1198] [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: 08/18/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/07/2022] Open
Abstract
Atherosclerosis is a leading cause of disability, morbidity and mortality in the world. Atherosclerosis is accepted as a chronic progressive inflammatory disease. The inflammatory cascade in the vascular wall is well-defined. However, the predictors and contributors of the inflammatory response in atherosclerosis are not completely understood. Systemic and local inflammation, which enhance the burden of inflammation in the vascular wall, have been proposed as risk factors for the progression of atherosclerosis. Infectious micro-organisms are one of the major triggering factors for local and systemic inflammation. In this review, we aimed to emphasize the linkage between micro-organisms and the progression of atherosclerosis. We briefly summarize the current medical literature and discuss the future perspectives of the linkage between microbial agents and atherosclerosis representing cause and effect.
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Affiliation(s)
- Ahmet Karabulut
- Department of Cardiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.,Department of Medical Biotechnology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
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29
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Conti LC, Segura-Egea JJ, Cardoso CBM, Benetti F, Azuma MM, Oliveira PHC, Bomfim SRM, Cintra LTA. Relationship between apical periodontitis and atherosclerosis in rats: lipid profile and histological study. Int Endod J 2020; 53:1387-1397. [PMID: 32573791 DOI: 10.1111/iej.13350] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022]
Abstract
AIM To investigate the relationship between apical periodontitis and atherosclerosis in rats by lipid profile and carotid artery intima tunic measurement, and histological and histometric evaluation of periapical lesions. METHODOLOGY Forty male Wistar rats were allocated into four groups: control (C), with apical periodontitis (AP), with atherosclerosis (AT) and with AP and AT (AP + AT). Atherosclerosis was induced using a high-lipid diet associated with a surgical ligature in the carotid artery and a super dosage of vitamin D3 . AP was induced via pulp exposure to the oral environment. At 45 and 75 days, serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured. The maxillary and mandibular jaws and carotid artery were collected and processed for histological analysis. The Kruskal-Wallis or Mann-Whitney test was performed for nonparametric data, and the Tukey's or Student's t-test was performed for parametric data (P < 0.05). RESULTS In nonatherosclerotic animals, the induction of apical periodontitis increased TG levels significantly, from 63.1 ± 11.4 mg dL-1 in group C to 88.2 ± 7.9 mg dL-1 in the AP group (P < 0.05). The induction of AP was associated with a trend for higher TC and LDL-C levels in atherosclerotic animals (P > 0.05); however, it only significantly increased TG levels, from 93.2 ± 18.0 mg dL-1 in AT group to 121.9 ± 14.5 mg dL-1 in the AP + AT group (P < 0.05). Animals in the AP + AT group had a 36.5% increase in the thickness of the carotid intima tunic when compared with the AT group (P < 0.05). The intensity of the inflammatory infiltrate was significantly larger in the AP + AT group when compared with AP group (P < 0.05). The AP + AT group exhibited significantly greater alveolar bone loss, with a periapical lesion size of 206.4 ± 56.3 × 104 μm2 , compared with 151.4 ± 49.1 × 104 μm2 in the AP group (P < 0.05). CONCLUSION Apical periodontitis influenced triglyceride levels, increasing them even in the absence of atherosclerosis, and influenced the increase in the thickness of the carotid artery intima tunic in the presence of atherosclerosis. Atherosclerosis intensified the inflammatory reaction and increased bone resorption in periapical lesions.
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Affiliation(s)
- L C Conti
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - J J Segura-Egea
- Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - C B M Cardoso
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - F Benetti
- Endodontic Section, Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - M M Azuma
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan, Ann Arbor, MI, USA
| | - P H C Oliveira
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - S R M Bomfim
- Department Clinic and Surgery and Animal Reproduction, Araçatuba Veterinary Medicine, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - L T A Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
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Cho MJ, Kim YS, Park EY, Kim EK. Association between Periodontal Health and Stroke: Results from the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHANES). J Dent Sci 2020; 16:268-274. [PMID: 33384808 PMCID: PMC7770241 DOI: 10.1016/j.jds.2020.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/08/2020] [Indexed: 11/17/2022] Open
Abstract
Background/purpose As the population ages, the prevalence of stroke increases, and as such there has been increasing interest in the risk factors associated with stroke. Although an association between periodontitis and stroke has been suggested, there has been no study of this association among the Korean population. Therefore, we investigated the association between periodontal health and stroke among Korean adults. Materials and methods A total of 9497 adults aged ≥40 years representing the Korean population were included in this cross-sectional study from the Korea National Health and Nutrition Examination Survey (KNHANES) VI (2013–2015). Periodontitis was diagnosed by dentists based on the Community Periodontal Index (CPI). Also, participants filled out a questionnaire regarding their experience of doctor-diagnosed stroke. Hypertension, diabetes, body mass index (BMI), and oral hygiene behavior covariates were adjusted in logistic regression analysis. Results The mean age of the study population was 55.71 ± 0.17 years and 52.7% of them were female. Also, 248 people had a history of having a stroke. Results of the logistic regression analysis after adjusting for age and sex showed a significant relationship between oral health behavior, periodontal health, and stroke even after adjusting for age, sex, education, household income, national health insurance, employment status, alcohol, smoking, diabetes, hypertension, BMI, and oral health behaviors (odds ratio [OR], 1.71; 95% confidence interval [CI] = 1.03–2.85). Conclusion Our findings suggest that periodontitis is associated with stroke in Korean adults.
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Affiliation(s)
- Min-Jeong Cho
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, South Korea
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Young-Seok Kim
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, South Korea
| | - Eun Young Park
- Department of Dentistry, Yeungnam University College of Medicine, Daegu, South Korea
| | - Eun-Kyong Kim
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, South Korea
- Corresponding author. Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, 2559, Gyeongsangde-ro, Sangju, Gyeongsangbuk-do, South Korea.
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31
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Rocha LO, Rocha E, Succi GDM, Brito Junior RBD. Association between Periodontitis, Genetic Polymorphisms and Presence of Coronary Artery Disease in Southern Brazil. Arq Bras Cardiol 2020; 114:268-272. [PMID: 32215496 PMCID: PMC7077581 DOI: 10.36660/abc.20180296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/10/2019] [Indexed: 12/17/2022] Open
Abstract
Background Periodontitis and coronary artery disease (CAD) share an inflammatory etiology; there is a recent concern regarding the investigation of an association between these two conditions. Current theories indicate that cytokines and proteins have an important role in this process. C-reactive protein and interleukin-6 are inflammatory derivatives produced in the presence of periodontitis and in the pathophysiology of coronary disease. The polymorphisms of CRP + 1444 C > T and IL6-174 G > C are recognized in the literature as being related to CAD. Objective This study investigates the association between periodontitis and coronary artery disease, through the presence of PCR and IL-6 polymorphisms. Methods We selected 80 patients who underwent diagnostic catheterization in the HU of UFSM. The presence of periodontitis was determined by the Community Periodontal Index, whereas the CAD was established by the medical report. DNA was collected from a saliva sample and the presence of polymorphism was determined by PCR and restriction enzymes. A significance level of 5% was adopted. Results The mean age of all participants (p = 0.035, OR 2.65; 95%CI: (1.02-6.87) male gender (p = 0.012, OR 3.37; 95% CI: (1.28- (p = 0.013, OR 3.66; 95% CI: (1.27-10.5)), PCR polymorphism + 1444C > T (p = 0.001, OR 6.37; 95% CI:, (2.25-17.9)) and IL6 -174 G > C polymorphism (p = 0.025, OR 2.87, 95% CI: (1.09-7.55)) were statistically associated with the presence of CAD. Age > 60 years and presence of the PCR +1444 C > T polymorphism remained independently associated with CAD after adjustment by logistic regression. Conclusions The presence of the PCR + 1444 C > T polymorphism in this study was independently associated with the presence of coronary artery disease.
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Affiliation(s)
| | - Eduarda Rocha
- Universidade Federal de Santa Maria, Santa Maria, RS - Brazil
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32
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A Diet Rich in Saturated Fat and Cholesterol Aggravates the Effect of Bacterial Lipopolysaccharide on Alveolar Bone Loss in a Rabbit Model of Periodontal Disease. Nutrients 2020; 12:nu12051405. [PMID: 32422858 PMCID: PMC7284766 DOI: 10.3390/nu12051405] [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: 03/25/2020] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 12/13/2022] Open
Abstract
Increasing evidence connects periodontitis with a variety of systemic diseases, including metabolic syndrome, atherosclerosis, and non-alcoholic fatty liver disease (NAFLD). The proposal of this study was to evaluate the role of diets rich in saturated fat and cholesterol in some aspects of periodontal diseases in a lipopolysaccharide (LPS)-induced model of periodontal disease in rabbits and to assess the influence of a periodontal intervention on hyperlipidemia, atherosclerosis, and NAFLD progression to non-alcoholic steatohepatitis. Male rabbits were maintained on a commercial standard diet or a diet rich in saturated fat (3% lard w/w) and cholesterol (1.3% w/w) (HFD) for 40 days. Half of the rabbits on each diet were treated 2 days per week with intragingival injections of LPS from Porphyromonas gingivalis. Morphometric analyses revealed that LPS induced higher alveolar bone loss (ABL) around the first premolar in animals receiving standard diets, which was exacerbated by the HFD diet. A higher score of acinar inflammation in the liver and higher blood levels of triglycerides and phospholipids were found in HFD-fed rabbits receiving LPS. These results suggest that certain dietary habits can exacerbate some aspects of periodontitis and that bad periodontal health can contribute to dyslipidemia and promote NAFLD progression, but only under certain conditions.
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Alushi B, Curini L, Christopher MR, Grubitzch H, Landmesser U, Amedei A, Lauten A. Calcific Aortic Valve Disease-Natural History and Future Therapeutic Strategies. Front Pharmacol 2020; 11:685. [PMID: 32477143 PMCID: PMC7237871 DOI: 10.3389/fphar.2020.00685] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/27/2020] [Indexed: 12/20/2022] Open
Abstract
Calcific aortic valve disease (CAVD) is the most frequent heart valve disorder. It is characterized by an active remodeling process accompanied with valve mineralization, that results in a progressive aortic valve narrowing, significant restriction of the valvular area, and impairment of blood flow.The pathophysiology of CAVD is a multifaceted process, involving genetic factors, chronic inflammation, lipid deposition, and valve mineralization. Mineralization is strictly related to the inflammatory process in which both, innate, and adaptive immunity are involved. The underlying pathophysiological pathways that go from inflammation to calcification and, finally lead to severe stenosis, remain, however, incompletely understood. Histopathological studies are limited to patients with severe CAVD and no samples are available for longitudinal studies of disease progression. Therefore, alternative routes should be explored to investigate the pathogenesis and progression of CAVD.Recently, increasing evidence suggests that epigenetic markers such as non-coding RNAs are implicated in the landscape of phenotypical changes occurring in CAVD. Furthermore, the microbiome, an essential player in several diseases, including the cardiovascular ones, has recently been linked to the inflammation process occurring in CAVD. In the present review, we analyze and discuss the CAVD pathophysiology and future therapeutic strategies, focusing on the real and putative role of inflammation, calcification, and microbiome.
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Affiliation(s)
- Brunilda Alushi
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Department of General and Interventional Cardiology, Helios Klinikum Erfurt, Erfurt, Germany
| | - Lavinia Curini
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Mary Roxana Christopher
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Herko Grubitzch
- Berlin Institute of Health, Berlin, Germany.,Department of Cardiology, German Heart Centre Berlin (DHZB), Berlin, Germany
| | - Ulf Landmesser
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.,Sod of Interdisciplinary Internal Medicine, Azienda Ospedaliera Universitaria Careggi (AOUC), Florence, Italy
| | - Alexander Lauten
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Department of General and Interventional Cardiology, Helios Klinikum Erfurt, Erfurt, Germany
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Lee HJ, Choi EK, Park JB, Han KD, Oh S. Tooth Loss Predicts Myocardial Infarction, Heart Failure, Stroke, and Death. J Dent Res 2020; 98:164-170. [PMID: 30782090 DOI: 10.1177/0022034518814829] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We investigated whether oral health, represented by missing teeth, was associated with an increased risk of cardiovascular disease, including myocardial infarction (MI), heart failure (HF), stroke, and all-cause mortality. Subjects who underwent routine dental examinations and health checkups provided by the Korean National Health Insurance from 2007 to 2008 ( n = 4,440,970) were followed up for incident MI, HF, stroke, and death until 2016. During follow-up of 7.56 y, 68,063 (1.5%) subjects died, and 31,868 (0.7%) were admitted for MI, 22,637 (0.5%) for HF, and 30,941 (0.7%) for stroke. Cardiovascular events and mortality increased in proportion to tooth loss. Tooth loss was an independent risk factor for cardiovascular events after multivariable analysis adjusted for cardiovascular risk, behavioral, and income factors. Each missing tooth was associated with an approximately 1% increase in MI (HR, 1.010; 95% CI, 1.007 to 1.014), 1.5% increase in HF (HR, 1.016; 95% CI, 1.013 to 1.019) and stroke (HR, 1.015; 95% CI, 1.012 to 1.018), and 2% increase in mortality (HR, 1.022; 95% CI, 1.020 to 1.023). Having ≥5 missing teeth substantially increased risk for cardiovascular outcomes, and even a small number of missing teeth (1 to 4) was associated with an increased risk for MI, stroke, and death. This association was consistent in subgroup analyses and especially strong among the younger subjects (age <65 y) and those with periodontitis. In this large Korean nationwide cohort study, we found that tooth loss showed a dose-dependent association with incident MI, HF, ischemic stroke, and all-cause death and was a good predictor of cardiovascular outcome. In clinical practice, the number of missing teeth can aid physicians in discriminating patients with a higher cardiovascular risk.
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Affiliation(s)
- H J Lee
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - E K Choi
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - J B Park
- 2 Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K D Han
- 3 Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S Oh
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Schulz S, Schlitt A, Hofmann B, Schaller H, Reichert S. Periodontal pathogens and their role in cardiovascular outcome. J Clin Periodontol 2019; 47:173-181. [DOI: 10.1111/jcpe.13224] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/07/2019] [Accepted: 11/20/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Susanne Schulz
- Department of Operative Dentistry and Periodontology Martin Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Axel Schlitt
- Department of Internal Medicine III Heart Centre of the University Clinics Halle (Saale) Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
- Department of Cardiology Paracelsus Harz‐Clinic Bad Suderode Quedlinburg Germany
| | - Britt Hofmann
- Department of Cardiothoracic Surgery Heart Centre of the University Clinics Halle (Saale) Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Hans‐Günter Schaller
- Department of Operative Dentistry and Periodontology Martin Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Stefan Reichert
- Department of Operative Dentistry and Periodontology Martin Luther‐University Halle‐Wittenberg Halle (Saale) Germany
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Dimitriu T, Daradics Z, Suciu Ş, Armencea G, Cătoi C, Dinu C, Băciuţ G, Văcăraş S, Bran S, Băciuţ M. Ligature induced periodontitis causes atherosclerosis in rat descending aorta: an experimental study. Med Pharm Rep 2019; 92:S39-S44. [PMID: 31989107 PMCID: PMC6978934 DOI: 10.15386/mpr-1514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/11/2019] [Accepted: 09/28/2019] [Indexed: 12/28/2022] Open
Abstract
Introduction In recent years a link between periodontitis and cardiovascular diseases has been proposed. Oxidative stress has been found to be involved in their pathophysiology. Objectives The aim of this study was to demonstrate that a wire ligature placed around the first mandibular molars of the rat causes inflammation in the periodontium and lipid deposits in the aorta, via oxidative stress. Methods Twenty male Wistar rats were divided randomly into two groups of 10: Control group and Periodontitis group. An orthodontic wire ligature was placed around the cervix of the first mandibular molar and was kept in place for 4 weeks. Clinical attachment loss was determined to assess the gingival recession. Aorta was harvested after 4 weeks and the malondialdehyde (MDA) levels in the aorta tissue homogenate were determined. Lipid deposits were evaluated using Oil Red staining and immunofluorescence under confocal microscopy. Total lipid deposits in the aorta were assessed using a computer morphometry system. Results Significant gingival recession was observed in the Periodontitis group in comparison with the Control group. Increased MDA levels were present in the aorta in the ligatured rats in comparison with the Control group. Significant lipid deposits were observed in the aorta of the Periodontitis group as opposed to the Control group. Conclusions The affixing of an orthodontic wire ligature produces gingival recession, increased oxidative stress and lipid deposits in the rat descending aorta.
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Affiliation(s)
- Tudor Dimitriu
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Zsofia Daradics
- Department of Pathology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Şoimiţa Suciu
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cornel Cătoi
- Department of Pathology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Băciuţ
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sergiu Văcăraş
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Băciuţ
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Binner C, Wagner J, Schmalz G, Eisner M, Rast J, Kottmann T, Haak R, Oberbach A, Borger MA, Garbade J, Ziebolz D. Insufficient Oral Behaviour and the High Need for Periodontal Treatment in Patients with Heart Insufficiency and after Heart Transplantation: A Need for Special Care Programs? J Clin Med 2019; 8:E1668. [PMID: 31614807 PMCID: PMC6832627 DOI: 10.3390/jcm8101668] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The aim of this cross-sectional study was the assessment of dental behaviour and oral health condition of heart transplant recipients (HTx) in comparison to patients with heart insufficiency (HI). METHODS Patients attending the Department for Cardiac Surgery, Leipzig Heart Center, Germany were recruited. Standardized questionnaires regarding dental behaviour and periodontal complaints were applied. A dental (decayed-, missing- and filled-teeth index) and periodontal examination (periodontal probing depth (PPD) and clinical attachment loss (CAL)) was performed. Based on the oral findings, dental and periodontal treatment need was determined. STATISTICS T-test, Mann-Whitney U test, Chi-square test, and Fisher-test (p < 0.05). RESULTS A total of 201 patients (HTx: 112, HI: 89) were included. HTx patients were significantly more often allocated to dentists (p < 0.01). Furthermore, the HTx patients rated feeling informed appropriately about oral health more often (p < 0.01). HTx patients used interdental cleaning (p < 0.01) and mouth rinse (p = 0.02) more often than HI patients. No differences between groups were present regarding dental status and periodontitis severity (p > 0.05). Periodontal treatment need was high, showing prevalence of 79.5% (HTx) and 87.6% (HI, p = 0.14), respectively. CONCLUSIONS Both groups show insufficient oral behaviour and a high need for periodontal treatment. Special care programs for HTx candidates and recipients appear recommendable.
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Affiliation(s)
- Christian Binner
- Department of Cardiac Surgery, Leipzig Heart Center, University of Leipzig, 04289 Leipzig, Germany.
| | - Justus Wagner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany.
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany.
| | - Mirjam Eisner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany.
| | - Josephine Rast
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany.
| | - Tanja Kottmann
- CRO Dr. med. Kottmann GmbH & Co. KG, 59077 Hamm, Germany.
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany.
| | - Andreas Oberbach
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology Leipzig, 04103 Leipzig, Germany.
| | - Michael A Borger
- Department of Cardiac Surgery, Leipzig Heart Center, University of Leipzig, 04289 Leipzig, Germany.
| | - Jens Garbade
- Department of Cardiac Surgery, Leipzig Heart Center, University of Leipzig, 04289 Leipzig, Germany.
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany.
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Gualtero DF, Lafaurie GI, Fontanilla MR. Differential responses of endothelial cells on three‐dimensional scaffolds to lipopolysaccharides from periodontopathogens. Mol Oral Microbiol 2019; 34:183-193. [DOI: 10.1111/omi.12263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 06/13/2019] [Accepted: 07/01/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Diego F. Gualtero
- Biotechnology Laboratory, Basic Oral Research Unit (UIBO), School of Odontology Universidad El Bosque Bogotá D.C. Colombia
- Tissue Engineering Group, Department of Pharmacy Universidad Nacional de Colombia Bogotá D.C. Colombia
| | - Gloria I. Lafaurie
- Biotechnology Laboratory, Basic Oral Research Unit (UIBO), School of Odontology Universidad El Bosque Bogotá D.C. Colombia
| | - Marta R. Fontanilla
- Tissue Engineering Group, Department of Pharmacy Universidad Nacional de Colombia Bogotá D.C. Colombia
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Kitamura M, Mochizuki Y, Miyata Y, Obata Y, Mitsunari K, Matsuo T, Ohba K, Mukae H, Yoshimura A, Nishino T, Sakai H. Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation. Int J Mol Sci 2019; 20:ijms20143413. [PMID: 31336777 PMCID: PMC6678374 DOI: 10.3390/ijms20143413] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 07/06/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.
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Affiliation(s)
- Mineaki Kitamura
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Yasushi Mochizuki
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Yasuyoshi Miyata
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan.
| | - Yoko Obata
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kensuke Mitsunari
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Kojiro Ohba
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Basic Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Atsutoshi Yoshimura
- Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Tomoya Nishino
- Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hideki Sakai
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
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40
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Márquez-Corona MDL, Tellez-Girón-Valdez A, Pontigo-Loyola AP, Islas-Zarazúa R, Robles-Bermeo NL, Gonzalez-López BS, Medina-Solís CE. Preterm birth associated with periodontal and dental indicators: a pilot case-control study in a developing country. J Matern Fetal Neonatal Med 2019; 34:690-695. [PMID: 31035800 DOI: 10.1080/14767058.2019.1613363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Preterm delivery is a multifactorial health problem that represents a serious public health problem around the world. In recent years, there has been an increase in scientific evidence suggesting associations between oral health status (mainly periodontal disease and tooth loss) and an increased risk of systemic diseases and various adverse pregnancy outcomes. This study explores the association between indicators of oral health and preterm delivery in a sample of Mexican pregnant women.Materials and methods: A case-control study was carried out with 111 pregnant (36 cases, 75 controls) who received prenatal care and delivered in an obstetric hospital in Pachuca, Mexico. Clinical files were reviewed to obtain the necessary information for the variables studied. The dependent variable was preterm delivery and the independent variables were gingivitis, periodontitis, DMFT index and its components, the number of decayed teeth with pulpal exposure or endodontic lesions, age of the mother, education, alcohol use, smoking status, number of gestations, and sex of the newborn.Results: The average ages were similar between the cases and the controls (24.29 ± 5.42 versus 24.89 ± 5.67, p = .5781). Significant differences were observed with gingivitis (p < .01) and periodontitis (p < .001). In addition, when the severity of gingivitis or periodontitis increased, the percentage of cases of preterm delivery increased (p < .01). The average number of teeth lost was higher among the cases than among the controls (1.33 ± 1.89 versus 0.81 ± 1.82, p < .05).Conclusions: It was found that gingivitis, periodontitis, and tooth loss were associated with preterm delivery. It is necessary to carry out actions aimed at the preservation of oral health in pregnant patients to avoid adverse results. These findings indicate a likely association, but it needs to be confirmed by large and well-designed studies.
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Affiliation(s)
| | - Aldo Tellez-Girón-Valdez
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | | | - Rosalina Islas-Zarazúa
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Norma Leticia Robles-Bermeo
- Advanced Studies and Research Center in Dentistry, "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University State of Mexico, Toluca, Mexico
| | - Blanca Silvia Gonzalez-López
- Advanced Studies and Research Center in Dentistry, "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University State of Mexico, Toluca, Mexico
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico.,Advanced Studies and Research Center in Dentistry, "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University State of Mexico, Toluca, Mexico
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41
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Anlu W, Dongcheng C, He Z, Qiuyi L, Yan Z, Yu Q, Hao X, Keji C. Using herbal medicine to target the “microbiota-metabolism-immunity” axis as possible therapy for cardiovascular disease. Pharmacol Res 2019; 142:205-222. [DOI: 10.1016/j.phrs.2019.02.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/18/2019] [Accepted: 02/18/2019] [Indexed: 02/08/2023]
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42
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Salhi L, Rompen E, Sakalihasan N, Laleman I, Teughels W, Michel JB, Lambert F. Can Periodontitis Influence the Progression of Abdominal Aortic Aneurysm? A Systematic Review. Angiology 2018; 70:479-491. [DOI: 10.1177/0003319718821243] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Leila Salhi
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Eric Rompen
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Natzi Sakalihasan
- Department of Cardiovascular and Thoracic Surgery, Surgical Research Centre, GIGA-Cardiovascular Science Unit, University of Liège, Liège, Belgium
| | - Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven & Dentistry University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Periodontology, Research Group for Microbial Adhesion, Catholic University Leuven, Leuven, Belgium
| | - Jean-Baptiste Michel
- DRE Laboratory for Translational Vascular Science, Inserm Denis Diderot University, Paris, France
| | - France Lambert
- Dental Biomaterials Research Unit, Head of Clinic, Department of Periodontology and Oral Surgery, University of Liège, Liège, Belgium
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43
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Zhou Y, Vatsalya V, Gobejishvili L, Lamont RJ, McClain CJ, Feng W. Porphyromonas gingivalis as a Possible Risk Factor in the Development/Severity of Acute Alcoholic Hepatitis. Hepatol Commun 2018; 3:293-304. [PMID: 30766965 PMCID: PMC6357836 DOI: 10.1002/hep4.1296] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/20/2018] [Indexed: 12/20/2022] Open
Abstract
Bacterial infection is frequently observed in patients with alcoholic liver disease (ALD). We examined a possible role of Porphyromonas gingivalis in the development/progression and severity of disease in patients with acute alcoholic hepatitis (AAH). Plasma specimens from 47 patients with AAH (16 moderate, Model for End‐Stage Liver Disease [MELD] score <20]; 31 severe, MELD score >20) and 22 healthy controls (HCs) were collected. Clinical, drinking history (lifetime drinking history [LTDH]), and demographic data were collected. Antibody tests for immunoglobulin (Ig) G, IgM, and IgA against two P. gingivalis strains were performed. Between‐group comparisons and within‐group association analyses were carried out. Patients with severe AAH showed significantly higher plasma levels of IgG, IgA, and IgM against two P. gingivalis strains (W83 and 33277) compared to HCs. Patients with moderate AAH also had significantly elevated anti‐P. gingivalis IgA concentrations for both strains compared to HCs. Male patients with moderate AAH showed a significant inverse association in LTDH and anti‐P. gingivalis IgM. The aspartate aminotransferase:alanine aminotransferase ratio was positively associated with IgM of both strains in male patients with moderate AAH. Female patients with severe AAH showed a significant association between MELD scores and W83 IgM. Conclusion: Antibody response to P. gingivalis in AAH is elevated. Significantly elevated plasma anti‐P. gingivalis IgG, IgA, and IgM in severe AAH provide preliminary data that P. gingivalis could be a novel risk factor in the development/severity of AAH.
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Affiliation(s)
- Yun Zhou
- Department of Medicine University of Louisville Louisville KY.,Alcohol Research Center University of Louisville Louisville KY
| | - Vatsalya Vatsalya
- Department of Medicine University of Louisville Louisville KY.,Alcohol Research Center University of Louisville Louisville KY.,Hepatobiology and Toxicology Center University of Louisville Louisville KY.,Robley Rex VA Medical Center Louisville KY
| | - Leila Gobejishvili
- Department of Medicine University of Louisville Louisville KY.,Alcohol Research Center University of Louisville Louisville KY.,Hepatobiology and Toxicology Center University of Louisville Louisville KY.,Department of Pharmacology and Toxicology University of Louisville Louisville KY
| | - Richard J Lamont
- Department of Oral Immunology and Infectious Diseases University of Louisville Louisville KY
| | - Craig J McClain
- Department of Medicine University of Louisville Louisville KY.,Alcohol Research Center University of Louisville Louisville KY.,Hepatobiology and Toxicology Center University of Louisville Louisville KY.,Robley Rex VA Medical Center Louisville KY.,Department of Pharmacology and Toxicology University of Louisville Louisville KY
| | - Wenke Feng
- Department of Medicine University of Louisville Louisville KY.,Alcohol Research Center University of Louisville Louisville KY.,Hepatobiology and Toxicology Center University of Louisville Louisville KY.,Department of Pharmacology and Toxicology University of Louisville Louisville KY
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44
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Mesa F, Magan-Fernandez A, Castellino G, Chianetta R, Nibali L, Rizzo M. Periodontitis and mechanisms of cardiometabolic risk: Novel insights and future perspectives. Biochim Biophys Acta Mol Basis Dis 2018; 1865:476-484. [PMID: 30529255 DOI: 10.1016/j.bbadis.2018.12.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 01/08/2023]
Abstract
Periodontitis is an infectious and inflammatory disease of the tooth-supporting tissues caused by the accumulation of subgingival plaque and the action of specific periodontopathogenic bacteria. Periodontitis has been associated with cardiovascular diseases and considered a cardiovascular risk factor. Several mechanisms have been proposed to explain this association, such as the infection of atherosclerotic plaques by periodontal pathogens, the pro-atherogenic effect on the lipid profile, the systemic dissemination of pro-inflammatory mediators or the contribution to type 2 diabetes mellitus. Periodontal treatment has also been related to improvement in cardiometabolic risk variables, and oral hygiene techniques may be useful in reducing cardiometabolic risk. The aim of this review is to provide new and recent insights on the relationship between periodontitis and cardiometabolic risk, focusing on recent evidence. Comments on shared potential therapeutic targets, such as the role of glucagon-like peptide 1, are also highlighted.
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Affiliation(s)
- Francisco Mesa
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
| | | | - Giuseppa Castellino
- Biomedical Department of Internal Medicine and Specialties, University of Palermo, Italy
| | - Roberta Chianetta
- Biomedical Department of Internal Medicine and Specialties, University of Palermo, Italy
| | - Luigi Nibali
- Centre for Oral Immunobiology & Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Specialties, University of Palermo, Italy
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45
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Temelli B, Yetkin Ay Z, Aksoy F, Büyükbayram Hİ, Kumbul Doğuç D, Uskun E, Varol E. Platelet indices (mean platelet volume and platelet distribution width) have correlations with periodontal inflamed surface area in coronary artery disease patients: A pilot study. J Periodontol 2018; 89:1203-1212. [DOI: 10.1002/jper.17-0684] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/01/2018] [Accepted: 04/02/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Başak Temelli
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - Zuhal Yetkin Ay
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - Fatih Aksoy
- Department of Cardiology; Faculty of Medicine; Süleyman Demirel University
| | | | - Duygu Kumbul Doğuç
- Department of Biochemistry; Faculty of Medicine; Süleyman Demirel University
| | - Ersin Uskun
- Department of Public Health; Faculty of Medicine; Süleyman Demirel University
| | - Ercan Varol
- Department of Cardiology; Faculty of Medicine; Süleyman Demirel University
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46
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Ding F, Wu D, Han X, Cheng LJ, Sun Z, Lv YL. Oral hygiene and periodontal conditions in the Chinese patients with aortic aneurysm. BMC Oral Health 2018; 18:136. [PMID: 30089493 PMCID: PMC6083576 DOI: 10.1186/s12903-018-0594-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 07/23/2018] [Indexed: 12/16/2022] Open
Abstract
Background This cross-sectional study aims to evaluate the association of periodontal conditions and oral hygiene habits in the Chinese patients with an aortic aneurysm (AA). Methods A questionnaire and periodontal examinations were carried out in the AA patients and non-AA volunteers recruited from the Center for Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University between August 2011 and June 2016. General information (e.g., height and weight), history of systemic diseases, and oral hygiene habits (e.g., brushing methods and regular oral examinations) were collected in the self-reported survey. Periodontal examinations, such as plaque index and bleeding index, were conducted in all the subjects. The correlation between periodontal indices and AA was further explored using univariate and multivariate analyses. Results Our analyses revealed that 87.6% of AA patients have chronic periodontitis, which is significantly higher than that of the non-AA patients (55.8%). In addition, AA patients demonstrated more severe periodontal damages with 69.3% moderate and severe periodontitis, compared to only 16.0% in the non-AA group. Using AA as the dependent variable and all the potential risk factors as covariates (e.g., gender, age, smoking, obesity, diabetes, hypertension, and hyperlipidemia), a logistic regression analysis was performed to show clinical attachment loss (CAL) being an independent risk factor for AA (OR = 2.309, 95% CI: 1.623–3.284, p = 0.000). In comparison with the non-AA patients, more AA patients have poor oral hygiene habits and don’t have regular dental appointments for supra-gingival cleaning. Conclusion Poor periodontal condition and dental hygiene were identified in the AA patients, suggesting that periodontitis-induced CAL may play a role in AA disease mechanisms.
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Affiliation(s)
- Fang Ding
- Department of Oral Medicine, Beijing Stomatology Hospital, Capital Medical University, No.4 Tiantan Xili, Dongcheng District, Beijing, 100050, China.,Department of Stomatology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Di Wu
- Department of Stomatology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Xiao Han
- Department of Stomatology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Li-Jian Cheng
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Aortic Disease Center, Beijing, China
| | - Zheng Sun
- Department of Oral Medicine, Beijing Stomatology Hospital, Capital Medical University, No.4 Tiantan Xili, Dongcheng District, Beijing, 100050, China.
| | - Ya-Lin Lv
- Department of Stomatology, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
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47
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Jayaprakash K, Demirel I, Khalaf H, Bengtsson T. Porphyromonas gingivalis-induced inflammatory responses in THP1 cells are altered by native and modified low-density lipoproteins in a strain-dependent manner. APMIS 2018; 126:667-677. [DOI: 10.1111/apm.12860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 05/19/2018] [Indexed: 01/08/2023]
Affiliation(s)
| | - Isak Demirel
- Department of Medical Sciences; Örebro University; Örebro Sweden
| | - Hazem Khalaf
- Department of Medical Sciences; Örebro University; Örebro Sweden
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48
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Temelli B, Yetkin Ay Z, Savaş HB, Aksoy F, Kumbul Doğuç D, Uskun E, Varol E. Circulation levels of acute phase proteins pentraxin 3 and serum amyloid A in atherosclerosis have correlations with periodontal inflamed surface area. J Appl Oral Sci 2018; 26:e20170322. [PMID: 29742255 PMCID: PMC5933826 DOI: 10.1590/1678-7757-2017-0322] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/04/2017] [Accepted: 10/09/2017] [Indexed: 12/31/2022] Open
Abstract
Objectives One of the plausible mechanisms in the relationship between periodontitis and coronary artery disease (CAD) is the systemic inflammatory burden comprised of circulating cytokines/mediators related to periodontitis. This study aims to test the hypothesis that periodontal inflamed surface area (PISA) is correlated with higher circulating levels of acute phase reactants (APR) and pro-inflammatory cytokines/mediators and lower anti-inflammatory cytokines/mediators in CAD patients. Material and Methods Patients aged from 30 to 75 years who underwent coronary angiography with CAD suspicion were included. Clinical periodontal parameters (probing depth - PD, clinical attachment loss, and bleeding on probing - BOP) were previously recorded and participants were divided into four groups after coronary angiography: Group 1: CAD (+) with periodontitis (n=20); Group 2: CAD (+) without periodontitis (n=20); Group 3: CAD (-) with periodontitis (n=21); Group 4: CAD (-) without periodontitis (n = 16). Serum interleukin (IL) -1, -6, -10, tumor necrosis factor (TNF)-α, serum amyloid A (SAA), pentraxin (PTX) 3, and high-sensitivity C-reactive protein (hs-CRP) levels were measured with ELISA. Results Groups 1 and 3 showed periodontal parameter values higher than Groups 2 and 4 (p<0.0125). None of the investigated serum parameters were statistically significantly different between the study groups (p>0.0125). In CAD (-) groups (Groups 3 and 4), PISA has shown positive correlations with PTX3 and SAA (p<0.05). Age was found to predict CAD significantly according to the results of the multivariate regression analysis (Odds Ratio: 1.17; 95% Confidence Interval: 1.08-1.27; p<0.001). Conclusions Although age was found to predict CAD significantly, the positive correlations between PISA and APR in CAD (-) groups deserve further attention, which might depend on the higher PISA values of periodontitis patients. In further studies conducted in a larger population, the stratification of age groups would provide us more accurate results.
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Affiliation(s)
- Başak Temelli
- Süleyman Demirel University, Faculty of Dentistry, Department of Periodontology, Isparta, Turkey
| | - Zuhal Yetkin Ay
- Süleyman Demirel University, Faculty of Dentistry, Department of Periodontology, Isparta, Turkey
| | - Hasan Basri Savaş
- Süleyman Demirel University, Faculty of Medicine, Department of Biochemistry, Isparta, Turkey
- Alanya Alaaddin Keykubat University, Faculty of Medicine, Department of Medical Biochemistry, Alanya, Antalya, Turkey
| | - Fatih Aksoy
- Süleyman Demirel University, Faculty of Medicine, Department of Cardiology, Isparta, Turkey
| | - Duygu Kumbul Doğuç
- Süleyman Demirel University, Faculty of Medicine, Department of Biochemistry, Isparta, Turkey
| | - Ersin Uskun
- Süleyman Demirel University, Faculty of Medicine, Department of Public Health, Isparta, Turkey
| | - Ercan Varol
- Süleyman Demirel University, Faculty of Medicine, Department of Cardiology, Isparta, Turkey
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Klimesova K, Jiraskova Zakostelska Z, Tlaskalova-Hogenova H. Oral Bacterial and Fungal Microbiome Impacts Colorectal Carcinogenesis. Front Microbiol 2018; 9:774. [PMID: 29731748 PMCID: PMC5920026 DOI: 10.3389/fmicb.2018.00774] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 04/05/2018] [Indexed: 12/31/2022] Open
Abstract
Host's physiology is significantly influenced by microbiota colonizing the epithelial surfaces. Complex microbial communities contribute to proper mucosal barrier function, immune response, and prevention of pathogen invasion and have many other crucial functions. The oral cavity and large intestine are distant parts of the digestive tract, both heavily colonized by commensal microbiota. Nevertheless, they feature different proportions of major bacterial and fungal phyla, mostly due to distinct epithelial layers organization and different oxygen levels. A few obligate anaerobic strains inhabiting the oral cavity are involved in the pathogenesis of oral diseases. Interestingly, these microbiota components are also enriched in gut inflammatory and tumor tissue. An altered microbiota composition - dysbiosis - and formation of polymicrobial biofilms seem to play important roles in the development of oral diseases and colorectal cancer. In this review, we describe the differences in composition of commensal microbiota in the oral cavity and large intestine and the mechanisms by which microbiota affect the inflammatory and carcinogenic response of the host.
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Affiliation(s)
- Klara Klimesova
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the CAS, Prague, Czechia
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50
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Arweiler NB, Auschill TM, Sculean A. Patient self-care of periodontal pocket infections. Periodontol 2000 2017; 76:164-179. [DOI: 10.1111/prd.12152] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 01/22/2023]
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