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Leskelä J, Putaala J, Martinez-Majander N, Tulkki L, Manzoor M, Zaric S, Ylikotila P, Lautamäki R, Saraste A, Suihko S, Könönen E, Sinisalo J, Pussinen P, Paju S. Periodontitis, Dental Procedures, and Young-Onset Cryptogenic Stroke. J Dent Res 2024; 103:494-501. [PMID: 38623924 PMCID: PMC11047014 DOI: 10.1177/00220345241232406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Periodontitis is associated with an increased risk of ischemic stroke, and the risk may be particularly high among young people with unexplained stroke etiology. Thus, we investigated in a case-control study whether periodontitis or recent invasive dental treatments are associated with young-onset cryptogenic ischemic stroke (CIS). We enrolled participants from a multicenter case-control SECRETO study including adults aged 18 to 49 y presenting with an imaging-positive first-ever CIS and stroke-free age- and sex-matched controls. Thorough clinical and radiographic oral examination was performed. Furthermore, we measured serum lipopolysaccharide (LPS) and lipotechoic acid (LTA) levels. Multivariate conditional regression models were adjusted for stroke risk factors, regular dentist visits, and patent foramen ovale (PFO) status. We enrolled 146 case-control pairs (median age 41.9 y; 58.2% males). Periodontitis was diagnosed in 27.5% of CIS patients and 20.1% of controls (P < 0.001). In the fully adjusted models, CIS was associated with high periodontal inflammation burden (odds ratio [OR], 95% confidence interval) with an OR of 10.48 (3.18-34.5) and severe periodontitis with an OR of 7.48 (1.24-44.9). Stroke severity increased with the severity of periodontitis, having an OR of 6.43 (1.87-23.0) in stage III to IV, grade C. Invasive dental treatments performed within 3 mo prestroke were associated with CIS, with an OR of 2.54 (1.01-6.39). Association between CIS and invasive dental treatments was especially strong among those with PFO showing an OR of 6.26 (1.72-40.2). LPS/LTA did not differ between CIS patients and controls but displayed an increasing trend with periodontitis severity. Periodontitis and recent invasive dental procedures were associated with CIS after controlling for multiple confounders. However, the role of bacteremia as a mediator of this risk was not confirmed.
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Affiliation(s)
- J. Leskelä
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J. Putaala
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - N. Martinez-Majander
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - L. Tulkki
- Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - M. Manzoor
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - S. Zaric
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - P. Ylikotila
- Neurocenter, Turku University Hospital, University of Turku, Turku, Finland
| | - R. Lautamäki
- Heart Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - A. Saraste
- Heart Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - S. Suihko
- Department of Medicine, Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
| | - E. Könönen
- Institute of Dentistry, University of Turku, Turku, Finland
| | - J. Sinisalo
- Department of Medicine, Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
| | - P.J. Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - S. Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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2
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Schmalz G, Hennecke A, Haak R, Kottmann T, Garbade J, Binner C, Ziebolz D. Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure-results of a German cohort. BMC Cardiovasc Disord 2023; 23:573. [PMID: 37990175 PMCID: PMC10664670 DOI: 10.1186/s12872-023-03612-1] [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: 02/27/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES Aim of this retrospective cohort study was to evaluate whether oral health parameters would be associated with infection-related parameters and overall survival of patients with severe heart failure (HF). METHODS Patients with severe HF, heart transplantation (HTx) and left-ventricular assist device (LVAD), which underwent a full oral examination between 2017 and 2018 were included. Infection-related and survival data were assessed from the patient´s medical records. The oral examination included: remaining teeth, caries and periodontal condition, including periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and diagnosis (staging/grading). In addition, the periodontal inflamed surface area (PISA) was determined. Statistical analysis included Chi-square, Fisher´s exact and Mann-Whitney-U test, as well as a logistic regression, considering age, gender, body-mass-index (BMI), diabetes and several oral health parameters with regard to overall survival and infections at heart/driveline. RESULTS 329 patients (HTx: 34%, LVAD: 38.9%, HF: 27.1%), were included. Patients had on average 18.96 ± 8.90 remaining teeth, whereby the majority had a periodontitis stage III or IV (88.7%) and a grade B (80.5%). Higher BOP was associated with infections at heart/driveline (p = 0.04) and outside the heart (p < 0.01) during follow-up. Increased PISA was significantly associated with bacterial infections outside the heart (p < 0.01) and sepsis (p = 0.02). Only BMI of 25 or higher correlated with an increased risk of infections at heart/driveline in regression analysis (OR 3.063, CI95 1.158-8.101, p = 0.02), while no associations between oral health parameters and infections at heart/driveline or overall survival were confirmed. CONCLUSIONS In patients with severe HF, periodontal inflammation might be associated with infection-related parameters. Improved dental care, especially including periodontal therapy and maintenance might be favourable to support prevention of infections in patients with severe HF.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany.
| | - Alina Hennecke
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | | | - Jens Garbade
- Department of Cardiac Surgery, Klinikum Links der Weser, 28277, Bremen, Germany
| | - Christian Binner
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
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3
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Zhou X, Kumar P, Bhuyan DJ, Jensen SO, Roberts TL, Münch GW. Neuroinflammation in Alzheimer's Disease: A Potential Role of Nose-Picking in Pathogen Entry via the Olfactory System? Biomolecules 2023; 13:1568. [PMID: 38002250 PMCID: PMC10669446 DOI: 10.3390/biom13111568] [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: 09/13/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Alzheimer's disease (AD) is a complex neurodegenerative disorder characterized by progressive cognitive decline and memory impairment. Many possible factors might contribute to the development of AD, including amyloid peptide and tau deposition, but more recent evidence suggests that neuroinflammation may also play an-at least partial-role in its pathogenesis. In recent years, emerging research has explored the possible involvement of external, invading pathogens in starting or accelerating the neuroinflammatory processes in AD. In this narrative review, we advance the hypothesis that neuroinflammation in AD might be partially caused by viral, bacterial, and fungal pathogens entering the brain through the nose and the olfactory system. The olfactory system represents a plausible route for pathogen entry, given its direct anatomical connection to the brain and its involvement in the early stages of AD. We discuss the potential mechanisms through which pathogens may exploit the olfactory pathway to initiate neuroinflammation, one of them being accidental exposure of the olfactory mucosa to hands contaminated with soil and feces when picking one's nose.
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Affiliation(s)
- Xian Zhou
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia; (X.Z.); (D.J.B.)
| | - Paayal Kumar
- Pharmacology Unit, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia;
| | - Deep J. Bhuyan
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia; (X.Z.); (D.J.B.)
| | - Slade O. Jensen
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; (S.O.J.); (T.L.R.)
- Microbiology and Infectious Diseases Unit, School of Medicine, Western Sydney University, Liverpool, NSW 2170, Australia
| | - Tara L. Roberts
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; (S.O.J.); (T.L.R.)
- Oncology Unit, School of Medicine, Western Sydney University, Liverpool, NSW 2170, Australia
| | - Gerald W. Münch
- NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia; (X.Z.); (D.J.B.)
- Pharmacology Unit, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia;
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4
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Chen SH, Chen JF, Hung YT, Hsu TJ, Chiu CC, Kuo SJ. Exploring the Relationship between Periodontitis, Anti-Periodontitis Therapy, and Extra-Oral Cancer Risk: Findings from a Nationwide Population-Based Study. Biomedicines 2023; 11:1949. [PMID: 37509588 PMCID: PMC10377021 DOI: 10.3390/biomedicines11071949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to evaluate the systemic impact of periodontitis, previously considered a local disease, on cancer occurrence. We enrolled 683,854 participants, comparing cancer incidence among those with and without periodontitis and assessing the impact of periodontal treatment on cancer risk. Regardless of gender, age, Charlson comorbidity index, or the use of non-steroidal anti-inflammatory drugs, periodontitis patients had a lower overall cancer risk than controls. However, men with periodontitis had a higher risk of prostate cancer (adjusted hazard ratio [aHR] = 1.22; 95% confidence interval [CI] = 1.10-1.35), and both men and women had a higher risk of thyroid cancer (women: aHR = 1.20, 95%CI = 1.04-1.38; men: aHR = 1.51, 95% CI = 1.15-1.99). Patients with periodontitis who received treatment showed a reduced cancer risk (aHR = 0.41; 95% CI = 0.38-0.44) compared to untreated patients. Proper treatment for periodontitis may lower an individual's cancer risk more than if they did not have the disease at all, suggesting that periodontitis is a modifiable risk factor for cancer.
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Affiliation(s)
- Sung-Hsiung Chen
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan
| | - Jui-Feng Chen
- Department of Education, China Medical University Hospital, Taichung 404327, Taiwan
| | - Yu-Tung Hung
- Management Office for Health Data, China Medical University Hospital, Taichung 404327, Taiwan
| | - Tzu-Ju Hsu
- Management Office for Health Data, China Medical University Hospital, Taichung 404327, Taiwan
| | - Ching-Chih Chiu
- Department of Education, China Medical University Hospital, Taichung 404327, Taiwan
| | - Shu-Jui Kuo
- School of Medicine, China Medical University, Taichung 404328, Taiwan
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung 404327, Taiwan
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5
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Secondary Cardiovascular Prevention after Acute Coronary Syndrome: Emerging Risk Factors and Novel Therapeutic Targets. J Clin Med 2023; 12:jcm12062161. [PMID: 36983163 PMCID: PMC10056379 DOI: 10.3390/jcm12062161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The control of cardiovascular risk factors, the promotion of a healthy lifestyle, and antithrombotic therapy are the cornerstones of secondary prevention after acute coronary syndrome (ACS). However, many patients have recurrent ischemic events despite the optimal control of traditional modifiable risk factors and the use of tailored pharmacological therapy, including new-generation antiplatelet and lipid-lowering agents. This evidence emphasizes the importance of identifying novel risk factors and targets to optimize secondary preventive strategies. Lipoprotein(a) (Lp(a)) has emerged as an independent predictor of adverse events after ACS. New molecules such as anti-PCSK9 monoclonal antibodies, small interfering RNAs, and antisense oligonucleotides can reduce plasma Lp(a) levels and are associated with a long-term outcome benefit after the index event. The inflammatory stimulus and the inflammasome, pivotal elements in the development and progression of atherosclerosis, have been widely investigated in patients with coronary artery disease. More recently, randomized clinical trials including post-ACS patients treated with colchicine and monoclonal antibodies targeting cytokines yielded promising results in the reduction in major cardiovascular events after an ACS. Gut dysbiosis has also raised great interest for its potential pathophysiological role in cardiovascular disease. This evidence, albeit preliminary and needing confirmation by larger population-based studies, suggests the possibility of targeting the gut microbiome in particularly high-risk populations. The risk of recurrent ischemic events after ACS is related to the complex interaction between intrinsic predisposing factors and environmental triggers. The identification of novel risk factors and targets is fundamental to customizing patient clinical management with a precision medicine perspective.
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6
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Yuzefpolskaya M, Bohn B, Ladanyi A, Khoruts A, Colombo PC, Demmer RT. Oral and gut microbiome alterations in heart failure: Epidemiology, pathogenesis and response to advanced heart failure therapies. J Heart Lung Transplant 2023; 42:291-300. [PMID: 36586790 DOI: 10.1016/j.healun.2022.12.009] [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: 09/27/2022] [Revised: 11/18/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Despite significant advances in therapies, heart failure (HF) remains a progressive disease that, once advanced, is associated with significant death and disability. Cardiac replacement therapies with left ventricular assist device (LVAD) and heart transplantation (HT) are the only treatment options for advanced HF, while lifesaving they can also be lifespan limiting due to the associated complications. Systemic inflammation is mechanistically important in HF pathophysiology and progression. However, directly targeting inflammation in HF has not been beneficial thus far. These failed attempts at therapeutics might be related to our limited understanding of the factors that cause inflammation in HF, and, therefore, to our inability to investigate these triggers in interventional studies. Observational studies have consistently demonstrated associations between alterations in the digestive (gut and oral) microbiome, inflammation and HF risk and progression. Additionally, recent data indicate that these microbial perturbations persist following LVAD and HT, along with residual inflammation and oxidative stress. Furthermore, there is rising recognition of the critical contribution of the microbiome to the metabolism of immunosuppressive drugs after HT. Cumulatively, these findings might posit a mechanistic link between microbiome alterations, systemic inflammation, and adverse outcomes in HF patients before and after cardiac replacement therapies. This review (1) provides an update on available data linking changes in digestive tract microbiota, inflammation, and oxidative stress, to HF pathogenesis and progression; (2) describes evolution of these relationships following LVAD and HT; and (3) outlines present and future intervention strategies that can manipulate the microbiome and possibly modify HF disease trajectory.
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Affiliation(s)
- Melana Yuzefpolskaya
- Division of Cardiovascular Medicine, Columbia University Irving Medical Center, New York City, New York.
| | - Bruno Bohn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Annamaria Ladanyi
- Division of Cardiovascular Medicine, Columbia University Irving Medical Center, New York City, New York
| | - Alexander Khoruts
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine University of Minnesota, Minneapolis, Minnesota
| | - Paolo C Colombo
- Division of Cardiovascular Medicine, Columbia University Irving Medical Center, New York City, New York
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
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7
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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: 26] [Impact Index Per Article: 26.0] [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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8
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Abstract
Systemic inflammation has been suggested to have a pivotal role in atherothrombosis, but the factors that trigger systemic inflammation have not been fully elucidated. Lipopolysaccharide (LPS) is a component of the membrane of Gram-negative bacteria present in the gut that can translocate into the systemic circulation, causing non-septic, low-grade endotoxaemia. Gut dysbiosis is a major determinant of low-grade endotoxaemia via dysfunction of the intestinal barrier scaffold, which is a prerequisite for LPS translocation into the systemic circulation. Experimental studies have demonstrated that LPS is present in atherosclerotic arteries but not in normal arteries. In atherosclerotic plaques, LPS promotes a pro-inflammatory status that can lead to plaque instability and thrombus formation. Low-grade endotoxaemia affects several cell types, including leukocytes, platelets and endothelial cells, leading to inflammation and clot formation. Low-grade endotoxaemia has been described in patients at risk of or with overt cardiovascular disease, in whom low-grade endotoxaemia was associated with atherosclerotic burden and its clinical sequelae. In this Review, we describe the mechanisms favouring the development of low-grade endotoxaemia, focusing on gut dysbiosis and changes in gut permeability; the plausible biological mechanisms linking low-grade endotoxaemia and atherothrombosis; the clinical studies suggesting that low-grade endotoxaemia is a risk factor for cardiovascular events; and the potential therapeutic tools to improve gut permeability and eventually eliminate low-grade endotoxaemia.
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9
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Lipopolysaccharides and Cellular Senescence: Involvement in Atherosclerosis. Int J Mol Sci 2022; 23:ijms231911148. [PMID: 36232471 PMCID: PMC9569556 DOI: 10.3390/ijms231911148] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Atherosclerosis is a chronic inflammatory disease of the vascular walls related to aging. Thus far, the roles of cellular senescence and bacterial infection in the pathogenesis of atherosclerosis have been speculated to be independent of each other. Some types of macrophages, vascular endothelial cells, and vascular smooth muscle cells are in a senescent state at the sites of atherosclerotic lesions. Likewise, bacterial infections and accumulations of lipopolysaccharide (LPS), an outer-membrane component of Gram-negative bacteria, have also been observed in the atherosclerotic lesions of patients. This review introduces the integration of these two potential pathways in atherosclerosis. Previous studies have suggested that LPS directly induces cellular senescence in cultured monocytes/macrophages and vascular cells. In addition, LPS enhances the inflammatory properties (senescence-associated secretory phenotype [SASP]) of senescent endothelial cells. Thus, LPS derived from Gram-negative bacteria could exaggerate the pathogenesis of atherosclerosis by inducing and enhancing cellular senescence and the SASP-associated inflammatory properties of specific vascular cells in atherosclerotic lesions. This proposed mechanism can provide novel approaches to preventing and treating this common age-related disease.
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10
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Owen A, Patel JM, Parekh D, Bangash MN. Mechanisms of Post-critical Illness Cardiovascular Disease. Front Cardiovasc Med 2022; 9:854421. [PMID: 35911546 PMCID: PMC9334745 DOI: 10.3389/fcvm.2022.854421] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Prolonged critical care stays commonly follow trauma, severe burn injury, sepsis, ARDS, and complications of major surgery. Although patients leave critical care following homeostatic recovery, significant additional diseases affect these patients during and beyond the convalescent phase. New cardiovascular and renal disease is commonly seen and roughly one third of all deaths in the year following discharge from critical care may come from this cluster of diseases. During prolonged critical care stays, the immunometabolic, inflammatory and neurohumoral response to severe illness in conjunction with resuscitative treatments primes the immune system and parenchymal tissues to develop a long-lived pro-inflammatory and immunosenescent state. This state is perpetuated by persistent Toll-like receptor signaling, free radical mediated isolevuglandin protein adduct formation and presentation by antigen presenting cells, abnormal circulating HDL and LDL isoforms, redox and metabolite mediated epigenetic reprogramming of the innate immune arm (trained immunity), and the development of immunosenescence through T-cell exhaustion/anergy through epigenetic modification of the T-cell genome. Under this state, tissue remodeling in the vascular, cardiac, and renal parenchymal beds occurs through the activation of pro-fibrotic cellular signaling pathways, causing vascular dysfunction and atherosclerosis, adverse cardiac remodeling and dysfunction, and proteinuria and accelerated chronic kidney disease.
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Affiliation(s)
- Andrew Owen
- Department of Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, United Kingdom
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Jaimin M. Patel
- Department of Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, United Kingdom
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Dhruv Parekh
- Department of Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, United Kingdom
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Mansoor N. Bangash
- Department of Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, United Kingdom
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Mansoor N. Bangash
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11
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Zheng Q, Chen Y, Zhai Y, Meng L, Liu H, Tian H, Feng R, Wang J, Zhang R, Sun K, Gao L, Wang Y, Wang X, Wu E, Teng J, Ding X. Gut Dysbiosis Is Associated With the Severity of Cryptogenic Stroke and Enhanced Systemic Inflammatory Response. Front Immunol 2022; 13:836820. [PMID: 35603160 PMCID: PMC9120915 DOI: 10.3389/fimmu.2022.836820] [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: 12/15/2021] [Accepted: 03/22/2022] [Indexed: 01/14/2023] Open
Abstract
Studies implicate that gut dysbiosis is related with many neurological diseases. However, the potential role of gut dysbiosis in cryptogenic stroke (CS) has not been elucidated yet. In this study, a high prevalence of gastrointestinal (GI) dysfunction and gut inflammation with increased intestinal permeability have been found in CS patients compared with normal controls (NCs). The systemic inflammation in CS patients was also identified by measuring the levels of plasma C-reactive protein (CRP), lipopolysaccharide (LPS), LPS-binding protein (LBP), and white blood cells (WBC) count. Using 16S rRNA sequencing, we found increased alpha diversity, accompanied by a higher abundance of Enterobacteriaceae, Streptococcaceae, and Lactobacillaceae at the family level and Escherichia–Shigella, Streptococcus, Lactobacillus, and Klebsilla at the genus level in the intestinal microbiota of CS patients compared to NCs. Our results showed that the abundance of Klebsilla was positively correlated with the systemic inflammation, the National Institutes of Health Stroke Scale (NIHSS) scores, and the infarct volumes. In conclusion, gut dysbiosis in CS patients was associated with the severity of CS and the systemic inflammation. Maintaining the intestinal homeostasis may be a potential strategy for the treatment of CS.
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Affiliation(s)
- Qianyi Zheng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Yongkang Chen
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Yanping Zhai
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Lin Meng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Han Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Haiyan Tian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Renyi Feng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Jiuqi Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Rui Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Kedi Sun
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Lina Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Yijing Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Xuejing Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Erxi Wu
- Neuroscience Institute and Department of Neurosurgery, Baylor Scott & White Health, Temple, TX, United States.,College of Medicine, Texas A&M University, College Station, TX, United States.,Irma Lerma Rangel College of Pharmacy, Texas A&M University, College Station, TX, United States.,LIVESTRONG Cancer Institutes and Department of Oncology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Junfang Teng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
| | - Xuebing Ding
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Institute of Parkinson and Movement Disorder, Zhengzhou University, Zhengzhou, China
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12
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5,2′-Dibromo-2,4′,5′-trihydroxydiphenylmethanone Inhibits LPS-Induced Vascular Inflammation by Targeting the Cav1 Protein. Molecules 2022; 27:molecules27092884. [PMID: 35566232 PMCID: PMC9101869 DOI: 10.3390/molecules27092884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/18/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022] Open
Abstract
Vascular inflammation is directly responsible for atherosclerosis. 5,2′-Dibromo-2,4′,5′-trihydroxydiphenylmethanone (TDD), a synthetic bromophenol derivative, exhibits anti-atherosclerosis and anti-inflammatory effects. However, the underlying pathways are not yet clear. In this study, we first examined the effects of TDD on toll-like receptor-4 (TLR4) activity, the signaling receptor for lipopolysaccharide (LPS), and found that TDD does not inhibit LPS-induced TLR4 expression in EA.hy926 cells and the vascular wall in vivo. Next, we investigated the global protein alterations and the mechanisms underlying the action of TDD in LPS-treated EA.hy926 cells using an isobaric tag for the relative and absolute quantification technique. Western blot analysis revealed that TDD inhibited NF-κB activation by regulating the phosphorylation and subsequent degradation IκBα. Among the differentially expressed proteins, TDD concentration-dependently inhibited Caveolin 1(Cav1) expression. The interaction between Cav1 and TDD was determined by using biolayer interference assay, UV-vis absorption spectra, fluorescence spectrum, and molecular docking. We found that TDD can directly bind to Cav1 through hydrogen bonds and van der Waals forces. In conclusion, our results showed that TDD inhibited LPS-induced vascular inflammation and the NF-κB signaling pathway by specifically targeting the Cav1 protein. TDD may be a novel anti-inflammatory compound, especially for the treatment of atherosclerosis.
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13
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Pussinen PJ, Kopra E, Pietiäinen M, Lehto M, Zaric S, Paju S, Salminen A. Periodontitis and cardiometabolic disorders: The role of lipopolysaccharide and endotoxemia. Periodontol 2000 2022; 89:19-40. [PMID: 35244966 PMCID: PMC9314839 DOI: 10.1111/prd.12433] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lipopolysaccharide is a virulence factor of gram-negative bacteria with a crucial importance to the bacterial surface integrity. From the host's perspective, lipopolysaccharide plays a role in both local and systemic inflammation, activates both innate and adaptive immunity, and can trigger inflammation either directly (as a microbe-associated molecular pattern) or indirectly (by inducing the generation of nonmicrobial, danger-associated molecular patterns). Translocation of lipopolysaccharide into the circulation causes endotoxemia, which is typically measured as the biological activity of lipopolysaccharide to induce coagulation of an aqueous extract of blood cells of the assay. Apparently healthy subjects have a low circulating lipopolysaccharide activity, since it is neutralized and cleared rapidly. However, chronic endotoxemia is involved in the pathogenesis of many inflammation-driven conditions, especially cardiometabolic disorders. These include atherosclerotic cardiovascular diseases, obesity, liver diseases, diabetes, and metabolic syndrome, where endotoxemia has been recognized as a risk factor. The main source of endotoxemia is thought to be the gut microbiota. However, the oral dysbiosis in periodontitis, which is typically enriched with gram-negative bacterial species, may also contribute to endotoxemia. As endotoxemia is associated with an increased risk of cardiometabolic disorders, lipopolysaccharide could be considered as a molecular link between periodontal microbiota and cardiometabolic diseases.
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Affiliation(s)
- Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elisa Kopra
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Markku Lehto
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Clinical and Molecular Metabolism, Faculty of Medicine Research Programs, University of Helsinki, Helsinki, Finland
| | - Svetislav Zaric
- Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| | - Susanna Paju
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aino Salminen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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14
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Keeter WC, Ma S, Stahr N, Moriarty AK, Galkina EV. Atherosclerosis and multi-organ-associated pathologies. Semin Immunopathol 2022; 44:363-374. [PMID: 35238952 PMCID: PMC9069968 DOI: 10.1007/s00281-022-00914-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/13/2022] [Indexed: 12/31/2022]
Abstract
Atherosclerosis is a chronic inflammatory disease of the vascular system that is characterized by the deposition of modified lipoproteins, accumulation of immune cells, and formation of fibrous tissue within the vessel wall. The disease occurs in vessels throughout the body and affects the functions of almost all organs including the lymphoid system, bone marrow, heart, brain, pancreas, adipose tissue, liver, kidneys, and gastrointestinal tract. Atherosclerosis and associated factors influence these tissues via the modulation of local vascular functions, induction of cholesterol-associated pathologies, and regulation of local immune responses. In this review, we discuss how atherosclerosis interferers with functions of different organs via several common pathways and how the disturbance of immunity in atherosclerosis can result in disease-provoking dysfunctions in multiple tissues. Our growing appreciation of the implication of atherosclerosis and associated microenvironmental conditions in the multi-organ pathology promises to influence our understanding of CVD-associated disease pathologies and to provide new therapeutic opportunities.
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Affiliation(s)
- W Coles Keeter
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, 700 West Olney Rd, Norfolk, VA, 23507, USA
| | - Shelby Ma
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, 700 West Olney Rd, Norfolk, VA, 23507, USA
| | - Natalie Stahr
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, 700 West Olney Rd, Norfolk, VA, 23507, USA
| | - Alina K Moriarty
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, 700 West Olney Rd, Norfolk, VA, 23507, USA
| | - Elena V Galkina
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, 700 West Olney Rd, Norfolk, VA, 23507, USA.
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15
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Al-hadlaq SM, Balto HA, Hassan WM, Marraiki NA, El-Ansary AK. Biomarkers of non-communicable chronic disease: an update on contemporary methods. PeerJ 2022; 10:e12977. [PMID: 35233297 PMCID: PMC8882335 DOI: 10.7717/peerj.12977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/31/2022] [Indexed: 01/11/2023] Open
Abstract
Chronic diseases constitute a major global burden with significant impact on health systems, economies, and quality of life. Chronic diseases include a broad range of diseases that can be communicable or non-communicable. Chronic diseases are often associated with modifications of normal physiological levels of various analytes that are routinely measured in serum and other body fluids, as well as pathological findings, such as chronic inflammation, oxidative stress, and mitochondrial dysfunction. Identification of at-risk populations, early diagnosis, and prediction of prognosis play a major role in preventing or reducing the burden of chronic diseases. Biomarkers are tools that are used by health professionals to aid in the identification and management of chronic diseases. Biomarkers can be diagnostic, predictive, or prognostic. Several individual or grouped biomarkers have been used successfully in the diagnosis and prediction of certain chronic diseases, however, it is generally accepted that a more sophisticated approach to link and interpret various biomarkers involved in chronic disease is necessary to improve our current procedures. In order to ensure a comprehensive and unbiased coverage of the literature, first a primary frame of the manuscript (title, headings and subheadings) was drafted by the authors working on this paper. Second, based on the components drafted in the preliminary skeleton a comprehensive search of the literature was performed using the PubMed and Google Scholar search engines. Multiple keywords related to the topic were used. Out of screened papers, only 190 papers, which are the most relevant, and recent articles were selected to cover the topic in relation to etiological mechanisms of different chronic diseases, the most recently used biomarkers of chronic diseases and finally the advances in the applications of multivariate biomarkers of chronic diseases as statistical and clinically applied tool for the early diagnosis of chronic diseases was discussed. Recently, multivariate biomarkers analysis approach has been employed with promising prospect. A brief discussion of the multivariate approach for the early diagnosis of the most common chronic diseases was highlighted in this review. The use of diagnostic algorithms might show the way for novel criteria and enhanced diagnostic effectiveness inpatients with one or numerous non-communicable chronic diseases. The search for new relevant biomarkers for the better diagnosis of patients with non-communicable chronic diseases according to the risk of progression, sickness, and fatality is ongoing. It is important to determine whether the newly identified biomarkers are purely associations or real biomarkers of underlying pathophysiological processes. Use of multivariate analysis could be of great importance in this regard.
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Affiliation(s)
- Solaiman M. Al-hadlaq
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hanan A. Balto
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia,Central Research Laboratory, Female Campus, King Saud University, Riyadh, Saudi Arabia
| | - Wail M. Hassan
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, KS, United States of America
| | - Najat A. Marraiki
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Afaf K. El-Ansary
- Central Research Laboratory, Female Campus, King Saud University, Riyadh, Saudi Arabia
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16
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Zerumbone suppresses high glucose and LPS-induced inflammation in THP-1-derived macrophages by inhibiting the NF-κB/TLR signaling pathway. Nutr Res 2022; 100:58-69. [DOI: 10.1016/j.nutres.2022.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 12/28/2021] [Accepted: 01/16/2022] [Indexed: 02/06/2023]
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17
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Influence of Diet and Levels of Zonulin, Lipopolysaccharide and C-Reactive Protein on Cardiometabolic Risk Factors in Young Subjects. Nutrients 2021; 13:nu13124472. [PMID: 34960024 PMCID: PMC8706658 DOI: 10.3390/nu13124472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/17/2022] Open
Abstract
A western diet and increased intestinal permeability may contribute to systemic inflammation and the development of cardio-metabolic alterations. The aim of this study was to assess the relationship between diet, biomarkers of intestinal permeability, and chronic low-grade inflammation on the cardiometabolic profile. A cross-sectional study was carried out in 238 young subjects aged 18–29 years, divided into two groups: with <3 cardiometabolic risk factors (CRF) and ≥3 risk factors. Anthropometric parameters, biochemical profile, and serum levels of zonulin, lipopolysaccharide (LPS), and high-sensitivity C-reactive protein (hs-CRP) were measured, and the macronutrient intake was evaluated. Interaction models showed elevated glucose levels in the presence of high biomarker levels: zonulin ≥51.6 ng/mL plus LPS ≥ 1.35 EU/mL (β = 1.1, p = 0.006), and LPS ≥1.35 EU/mL plus hs-CRP ≥ 4.3 mg/L (β = 1.2, p = 0.007). In addition, triglyceride levels increased in the presence of LPS ≥ 1.35 EU/mL and hs-CRP ≥ 4.3 mg/L (β = 3.9, p = 0.01). Despite having increased biomarker levels, a higher consumption of water (≥2100 mL), polyunsaturated fatty acids (≥6.0 g), or fiber (≥30 g) decreased triglyceride (β = −9.6, p = 0.03), total cholesterol (β = −5.1, p = 0.01), and LDL-C levels (β = −7.7, p = 0.01). These findings suggest that the increased consumption of water, PUFA and fiber may improve lipid profile in subjects with intestinal permeability dysfunction or low-grade systemic inflammation.
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18
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Leskelä J, Toppila I, Härma MA, Palviainen T, Salminen A, Sandholm N, Pietiäinen M, Kopra E, Pais de Barros JP, Lassenius MI, Kumar A, Harjutsalo V, Roslund K, Forsblom C, Loukola A, Havulinna AS, Lagrost L, Salomaa V, Groop PH, Perola M, Kaprio J, Lehto M, Pussinen PJ. Genetic Profile of Endotoxemia Reveals an Association With Thromboembolism and Stroke. J Am Heart Assoc 2021; 10:e022482. [PMID: 34668383 PMCID: PMC8751832 DOI: 10.1161/jaha.121.022482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Translocation of lipopolysaccharide from gram-negative bacteria into the systemic circulation results in endotoxemia. In addition to acute infections, endotoxemia is detected in cardiometabolic disorders, such as cardiovascular diseases and obesity. Methods and Results We performed a genome-wide association study of serum lipopolysaccharide activity in 11 296 individuals from 6 different Finnish study cohorts. Endotoxemia was measured by limulus amebocyte lysate assay in the whole population and by 2 other techniques (Endolisa and high-performance liquid chromatography/tandem mass spectrometry) in subpopulations. The associations of the composed genetic risk score of endotoxemia and thrombosis-related clinical end points for 195 170 participants were analyzed in FinnGen. Lipopolysaccharide activity had a genome-wide significant association with 741 single-nucleotide polymorphisms in 5 independent loci, which were mainly located at genes affecting the contact activation of the coagulation cascade and lipoprotein metabolism and explained 1.5% to 9.2% of the variability in lipopolysaccharide activity levels. The closest genes included KNG1, KLKB1, F12, SLC34A1, YPEL4, CLP1, ZDHHC5, SERPING1, CBX5, and LIPC. The genetic risk score of endotoxemia was associated with deep vein thrombosis, pulmonary embolism, pulmonary heart disease, and venous thromboembolism. Conclusions The biological activity of lipopolysaccharide in the circulation (ie, endotoxemia) has a small but highly significant genetic component. Endotoxemia is associated with genetic variation in the contact activation pathway, vasoactivity, and lipoprotein metabolism, which play important roles in host defense, lipopolysaccharide neutralization, and thrombosis, and thereby thromboembolism and stroke.
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Affiliation(s)
- Jaakko Leskelä
- Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Iiro Toppila
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Mari-Anne Härma
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland University of Helsinki Finland
| | - Aino Salminen
- Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Niina Sandholm
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Elisa Kopra
- Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Jean-Paul Pais de Barros
- INSERM UMR1231 Dijon France.,Lipidomic Analytical Platform, University Bourgogne Franche-Comté Dijon France.,LipSTIC LabEx Dijon France
| | | | - Mariann I Lassenius
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Anmol Kumar
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Kajsa Roslund
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Carol Forsblom
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Anu Loukola
- Institute for Molecular Medicine Finland University of Helsinki Finland.,Department of Public Health Solutions Finnish Institute for Health and Welfare Helsinki Finland.,Department of Public Health University of Helsinki Finland
| | - Aki S Havulinna
- Institute for Molecular Medicine Finland University of Helsinki Finland.,Department of Public Health Solutions Finnish Institute for Health and Welfare Helsinki Finland
| | - Laurent Lagrost
- INSERM UMR1231 Dijon France.,LipSTIC LabEx Dijon France.,University Bourgogne Franche-Comté Dijon France.,University Hospital, Hôpital du Bocage Dijon France
| | - Veikko Salomaa
- Department of Public Health Solutions Finnish Institute for Health and Welfare Helsinki Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland.,Department of Diabetes Central Clinical School Monash University Melbourne Victoria Australia
| | - Markus Perola
- Genomics and Biomarkers Unit Department of Health Finnish Institute for Health and Welfare Helsinki Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland University of Helsinki Finland.,Department of Public Health University of Helsinki Finland
| | - Markku Lehto
- Folkhälsan Institute of GeneticsFolkhälsan Research Center Helsinki Finland.,Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland.,Diabetes and Obesity Research Program Research Programs Unit University of Helsinki Finland
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
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19
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Raju K, Taylor GW, Tahir P, Hyde S. Association of tooth loss with morbidity and mortality by diabetes status in older adults: a systematic review. BMC Endocr Disord 2021; 21:205. [PMID: 34663281 PMCID: PMC8524900 DOI: 10.1186/s12902-021-00830-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This systematic review assesses the association of tooth loss (TL), as the exposure, with morbidity and mortality by diabetes mellitus (DM) status, as the outcome, in older adults. BACKGROUND Individuals with DM have higher prevalence of severe TL and increased risk of developing morbidities and mortality. No systematic review has evaluated the association between TL with morbidity and mortality by DM status. MATERIAL AND METHODS Comprehensive searches used multiple publication databases containing reports published between 01/01/2000 and 04/21/2021. Two authors independently evaluated included studies for quality and risk of bias using the Critical Appraisal Skills Programme (CASP) checklist for cohort and Center for Evidence-Based Medicine (CEBM) critical appraisal sheet for cross-sectional studies, while a third author arbitrated decisions to resolve disagreements. RESULTS Thirteen studies met the inclusion criteria: eight cross-sectional and five cohort. Qualitative review of the included studies indicated TL is associated with increased incidence and prevalence of DM. TL is also associated with DM-related morbidities including greater prevalence of heart disease, diabetic retinopathy, metabolic syndrome; poorer health-related quality of life; poorer survival of participants with chronic kidney disease; and increased medical expenditure. Overall, the quality of the evidence reviewed was medium, as per the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. CONCLUSIONS/PRACTICAL IMPLICATIONS This review found significant associations of TL with prevalence and incidence of DM and adverse DM-related outcomes. An interprofessional team-care approach that includes an oral health component could benefit the prevention and management of DM.
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Affiliation(s)
- Karen Raju
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - George W. Taylor
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - Peggy Tahir
- University of California, UCSF Library, 530 Parnassus Ave, San Francisco, CA 94143-0840 USA
| | - Susan Hyde
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
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20
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Mussalo F, Karaharju-Suvanto T, Mäntylä P, Pyörälä E. Biomedical Courses Should Also Be Designed for Dental Students: The Perceptions of Dental Students. Dent J (Basel) 2021; 9:dj9080096. [PMID: 34436008 PMCID: PMC8394652 DOI: 10.3390/dj9080096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/31/2021] [Accepted: 08/12/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION It can be challenging integrating biomedical sciences into dentistry programs. The aim was to examine students' perceptions of how joint biomedical courses with medical students and courses tailored for dental students supported their clinical studies. MATERIALS AND METHODS The target group was clinical phase dental students. Cross-sectional survey data were collected using a questionnaire, which consisted of questions covering biomedical and clinical study content and learning methods. RESULTS A total of 110 (82%) students completed the survey. Students had difficulty recognising the relevance of joint biomedical courses for clinical work, but when the link was clear, their interest in the content increased. The closer the respondents were to graduation, the less relevance they expressed the biomedical sciences had. Almost all students (95%) wanted more dental content for the early study years. DISCUSSION The student perspective provides valuable information for the development of biomedical courses. Students should be offered customised courses that include dental content and perspectives on clinical work, whenever suitable to the didactic content of the basic science course. Our study shows that the dental perspective needs greater integration with the biomedical content. This also supports interprofessional learning and appreciation for the other field's contribution to human health.
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Affiliation(s)
- Fanny Mussalo
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland;
- Correspondence:
| | - Terhi Karaharju-Suvanto
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland;
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, 70211 Kuopio, Finland;
- Oral and Maxillofacial Clinic, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Eeva Pyörälä
- Center for University Teaching and Learning, University of Helsinki, 00014 Helsinki, Finland;
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21
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Jiménez C, Garrido M, Pussinen P, Bordagaray MJ, Fernández A, Vega C, Chaparro A, Hoare A, Hernández M. Systemic burden and cardiovascular risk to Porphyromonas species in apical periodontitis. Clin Oral Investig 2021; 26:993-1001. [PMID: 34313848 DOI: 10.1007/s00784-021-04083-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Porphyromonas (P.) species (spp.) are a major etiological agent of apical periodontitis (AP), which in turn represents a risk factor for cardiovascular diseases. This study explored the associations between endodontic infection with Porphyromonas species, the systemic bacterial burden, and cardiovascular risk, based on high-sensitivity C-reactive protein (hsCRP), in young adults with AP. MATERIALS AND METHODS Cross-sectional study. Otherwise, healthy individuals with AP and controls (n = 80, ≤ 40 years) were recruited at the University Dental Clinic. Oral parameters and classic cardiovascular risk factors were registered. Endodontic Porphyromonas endodontalis and Porphyromonas gingivalis were identified using conventional PCR. Serum concentrations of anti-P. endodontalis and anti-P. gingivalis antibodies, and endotoxins were determined through ELISA and Limulus-amebocyte assays. Serum hsCRP was determined for cardiovascular risk stratification. RESULTS Intracanal detection of P. endodontalis and P. gingivalis in AP were 33.3% and 22.9%, respectively. Serum anti-P. endodontalis and anti-P. gingivalis IgG was higher in AP than controls (p < 0.05 and p = 0.057, respectively). Intracanal P. endodontalis associated with higher endotoxemia (p < 0.05). Among endodontic factors, the presence (OR 4.2-5.5, p < 0.05) and the number of apical lesions (OR 2.3, p < 0.05) associated with moderate-severe cardiovascular risk, whereas anti-P. endodontalis IgG were protective (OR 0.3, p > 0.05). CONCLUSIONS AP and infection with P. endodontalis positively associated with cardiovascular risk based on hsCRP levels and endotoxemia, respectively, whereas anti-P. endodontalis IgG response seems to be protective against low-grade systemic inflammation. CLINICAL RELEVANCE Apical periodontitis and endodontic P. endodontalis can influence the systemic burden with impact on the surrogate cardiovascular risk marker hsCRP, providing mechanistic links.
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Affiliation(s)
- Constanza Jiménez
- Department of Oral Pathology, Faculty of Dentistry, Universidad Andrés Bello, Santiago, Chile.,Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Mauricio Garrido
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Pirkko Pussinen
- Department of Oral and Maxillofacial Diseases, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland
| | - María José Bordagaray
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Alejandra Fernández
- Department of Oral Pathology, Faculty of Dentistry, Universidad Andrés Bello, Santiago, Chile.,Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Claudia Vega
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Alejandra Chaparro
- Department of Periodontology, Centro de Investigación E Innovación Biomédica (CIIB), Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Anilei Hoare
- Laboratory of Oral Microbiology, Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Olivos 943, Box 8380492, Independencia , Santiago, Chile.
| | - Marcela Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile. .,Department of Pathology and Oral Medicine, Faculty of Dentistry, Universidad de Chile, Olivos 943, Box 8380492, Independencia , Santiago, Chile.
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22
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Progress in Oral Microbiome Related to Oral and Systemic Diseases: An Update. Diagnostics (Basel) 2021; 11:diagnostics11071283. [PMID: 34359364 PMCID: PMC8306157 DOI: 10.3390/diagnostics11071283] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
The human oral microbiome refers to an ecological community of symbiotic and pathogenic microorganisms found in the oral cavity. The oral cavity is an environment that provides various biological niches, such as the teeth, tongue, and oral mucosa. The oral cavity is the gateway between the external environment and the human body, maintaining oral homeostasis, protecting the mouth, and preventing disease. On the flip side, the oral microbiome also plays an important role in the triggering, development, and progression of oral and systemic diseases. In recent years, disease diagnosis through the analysis of the human oral microbiome has been realized with the recent development of innovative detection technology and is overwhelmingly promising compared to the previous era. It has been found that patients with oral and systemic diseases have variations in their oral microbiome compared to normal subjects. This narrative review provides insight into the pathophysiological role that the oral microbiome plays in influencing oral and systemic diseases and furthers the knowledge related to the oral microbiome produced over the past 30 years. A wide range of updates were provided with the latest knowledge of the oral microbiome to help researchers and clinicians in both academic and clinical aspects. The microbial community information can be utilized in non-invasive diagnosis and can help to develop a new paradigm in precision medicine, which will benefit human health in the era of post-metagenomics.
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23
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Brinkworth JF, Valizadegan N. Sepsis and the evolution of human increased sensitivity to lipopolysaccharide. Evol Anthropol 2021; 30:141-157. [PMID: 33689211 DOI: 10.1002/evan.21887] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 04/29/2020] [Accepted: 01/30/2021] [Indexed: 01/03/2023]
Abstract
Among mammals, humans are exquisitely sensitive to lipopolysaccharide (LPS), an environmentally pervasive bacterial cell membrane component. Very small doses of LPS trigger powerful immune responses in humans and can even initiate symptoms of sepsis. Close evolutionary relatives such as African and Asian monkeys require doses that are an order of magnitude higher to do the same. Why humans have evolved such an energetically expensive antimicrobial strategy is a question that biological anthropologists are positioned to help address. Here we compare LPS sensitivity in primate/mammalian models and propose that human high sensitivity to LPS is adaptive, linked to multiple immune tactics against pathogens, and part of multi-faceted anti-microbial strategy that strongly overlaps with that of other mammals. We support a notion that LPS sensitivity in humans has been driven by microorganisms that constitutively live on us, and has been informed by human behavioral changes over our species' evolution (e.g., meat eating, agricultural practices, and smoking).
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Affiliation(s)
- Jessica F Brinkworth
- Evolutionary Immunology and Genomics Laboratory, Department of Anthropology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.,Carl R Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,Department of Animal Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Negin Valizadegan
- Evolutionary Immunology and Genomics Laboratory, Department of Anthropology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA.,Carl R Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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24
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Choi H, Dey AK, Priyamvara A, Aksentijevich M, Bandyopadhya D, Dey D, Dani S, Guha A, Nambiar P, Nasir K, Jneid H, Mehta NN, Lavie C, Amar S. Role of Periodontal Infection, Inflammation and Immunity in Atherosclerosis. Curr Probl Cardiol 2021; 46:100638. [PMID: 32646544 PMCID: PMC8761259 DOI: 10.1016/j.cpcardiol.2020.100638] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Inflammation plays a major role in the development and progression of cardiovascular disease (CVD) morbidity and mortality. The well-established relationship between periodontal disease (PD) and CVD may be causal. Left untreated, PD can lead to high systemic inflammation, thus contributing to inflammatory CVD, such as atherosclerosis. Multiple mechanisms have been proposed to elucidate the causal relationship between PD and its contribution to CVD. OBJECTIVE This review article highlights the current evidence supporting the role of PD in the development and progression of atherosclerosis. METHODS After creating a list of relevant medical subject heading (MeSH) terms, a systematic search within PubMed in English for each MeSH term between 2000 and 2019 was used to generate evidence for this review article. CONCLUSION There is overwhelming evidence in the current literature that supports an association between PD and CVD that is independent of known CVD risk factors. However, the supporting evidence that PD directly causes CVD in humans continues to remain elusive. Multiple biologically plausible mechanisms have been proposed and investigated, yet most studies are limited to mouse models and in vitro cell cultures. Additional studies testing the various proposed mechanisms in longitudinal human studies are required to provide deeper insight into the mechanistic link between these 2 related diseases.
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Affiliation(s)
- Harry Choi
- National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Amit K. Dey
- National Heart Lung and Blood Institute, Bethesda, MD, USA
| | | | | | | | | | | | | | | | | | | | - Nehal N. Mehta
- National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Carl Lavie
- Ochsner Clinical School-UQ School of Medicine, New Orleans, LA, USA
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25
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Isola G, Lo Giudice A, Polizzi A, Alibrandi A, Murabito P, Indelicato F. Identification of the different salivary Interleukin-6 profiles in patients with periodontitis: A cross-sectional study. Arch Oral Biol 2021; 122:104997. [PMID: 33291049 DOI: 10.1016/j.archoralbio.2020.104997] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study was to analyze and identify the association among salivary interleukin-6 (IL-6) levels and periodontitis (PT) and to determine the significant trend of this association in PT patients. STUDY DESIGN For the present study, 49 patients with PT and 47 healthy subjects (HS) were enrolled and assessed for clinical parameters, blood samples and salivary IL-6 analyses. Clinical differences among groups were recorded and evaluated. The Spearman Correlation and the Jonckheere-Terpstra Test were applied in order to assess the interdependence between salivary IL-6 and PT. RESULTS Patients in the PT group had significantly higher median salivary IL-6 levels [195.4 (184.6-205.9 pg/mL)] compared to the HS group [101.9 (89.5-115.4 pg/mL) (p < 0.001). Salivary IL-6 levels were negatively correlated with C-reactive protein, with the number of teeth and with clinical attachment loss (CAL), probing pocket depth (PPD), and bleeding sites (FMBS) (p < 0.001). Furthermore, in patients with PT, salivary IL-6 levels were inversely associated (P-trend) with the number of teeth (p < 0.001), and directly associated with the proportional extent of PT (CAL, p = 0.006; PPD, p = 0.009; FMBS, p < 0.001). CONCLUSIONS The results of this study showed that PT patients presented significant higher salivary IL-6 levels compared to HS. Moreover, in the analyzed sample a significant p-trend among PT, tooth loss and increased salivary IL-6 levels was found.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy.
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy.
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy.
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, Messina, Italy.
| | - Paolo Murabito
- Department of General Surgery and Surgical-Medical Specialties, Unit of Anaesthesia and Intensive Care, University of Catania, Catania, Italy.
| | - Francesco Indelicato
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy.
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26
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Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010326. [PMID: 33466271 PMCID: PMC7795256 DOI: 10.3390/ijerph18010326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022]
Abstract
Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.
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27
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Simonsen JR, Järvinen A, Harjutsalo V, Forsblom C, Groop PH, Lehto M. The association between bacterial infections and the risk of coronary heart disease in type 1 diabetes. J Intern Med 2020; 288:711-724. [PMID: 32754939 DOI: 10.1111/joim.13138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/07/2020] [Accepted: 05/27/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Diabetes increases the risk of infections and coronary heart disease (CHD). Whether infections increase the risk of CHD and how this applies to individuals with diabetes is unclear. OBJECTIVES To investigate the association between bacterial infections and the risk of CHD in type 1 diabetes. METHODS Individuals with type 1 diabetes (n = 3781) were recruited from the Finnish Diabetic Nephropathy Study (FinnDiane), a prospective follow-up study. CHD was defined as incident events: fatal or nonfatal myocardial infarction, coronary artery bypass surgery or percutaneous coronary intervention, identified through national hospital discharge register data. Infections were identified through national register data on all antibiotic purchases from outpatient care. Register data were available from 1 January 1995 to 31 December 2015. Bacterial lipopolysaccharide (LPS) activity was measured from serum samples at baseline. Data on traditional risk factors for CHD were collected during baseline and consecutive visits. RESULTS Individuals with an incident CHD event (n = 370) had a higher mean number of antibiotic purchases per follow-up year compared to those without incident CHD (1.34 [95% CI: 1.16-1.52], versus 0.79 [0.76-0.82], P < 0.001), as well as higher levels of LPS activity (0.64 [0.60-0.67], versus 0.58 EU mL-1 [0.57-0.59], P < 0.001). In multivariable-adjusted Cox proportional hazards models, the mean number of antibiotic purchases per follow-up year was an independent risk factor for incident CHD (HR 1.21, 95% CI: 1.14-1.29, P < 0.0001). High LPS activity was a risk factor for incident CHD (HR 1.93 [1.34-2.78], P < 0.001) after adjusting for static confounders. CONCLUSION Bacterial infections are associated with an increased risk of incident CHD in individuals with type 1 diabetes.
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Affiliation(s)
- J R Simonsen
- From the, Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - A Järvinen
- Division of Infectious Diseases, Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - V Harjutsalo
- From the, Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - C Forsblom
- From the, Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - P-H Groop
- From the, Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Diabetes, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - M Lehto
- From the, Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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28
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Määttä AM, Salminen A, Pietiäinen M, Leskelä J, Palviainen T, Sattler W, Sinisalo J, Salomaa V, Kaprio J, Pussinen PJ. Endotoxemia is associated with an adverse metabolic profile. Innate Immun 2020; 27:3-14. [PMID: 33243051 PMCID: PMC7780360 DOI: 10.1177/1753425920971702] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Our aim was to analyze whether endotoxemia, i.e. translocation of LPS to circulation, is reflected in the serum metabolic profile in a general population and in participants with cardiometabolic disorders. We investigated three Finnish cohorts separately and in a meta-analysis (n = 7178), namely population-based FINRISK97, FinnTwin16 consisting of young adult twins, and Parogene, a random cohort of cardiac patients. Endotoxemia was determined as serum LPS activity and metabolome by an NMR platform. Potential effects of body mass index (BMI), smoking, metabolic syndrome (MetS), and coronary heart disease (CHD) status were considered. Endotoxemia was directly associated with concentrations of VLDL, IDL, LDL, and small HDL lipoproteins, VLDL particle diameter, total fatty acids (FA), glycoprotein acetyls (GlycA), aromatic and branched-chain amino acids, and Glc, and inversely associated with concentration of large HDL, diameters of LDL and HDL, as well as unsaturation degree of FAs. Some of these disadvantageous associations were significantly stronger in smokers and subjects with high BMI, but did not differ between participants with different CHD status. In participants with MetS, however, the associations of endotoxemia with FA parameters and GlycA were particularly strong. The metabolic profile in endotoxemia appears highly adverse, involving several inflammatory characters and risk factors for cardiometabolic disorders.
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Affiliation(s)
- Anne-Mari Määttä
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aino Salminen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Leskelä
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Wolfgang Sattler
- Division of Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Juha Sinisalo
- Department of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Veikko Salomaa
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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29
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Sterpetti AV. Inflammatory Cytokines and Atherosclerotic Plaque Progression. Therapeutic Implications. Curr Atheroscler Rep 2020; 22:75. [PMID: 33025148 PMCID: PMC7538409 DOI: 10.1007/s11883-020-00891-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE OF THE REVIEW Inflammatory cytokines play a major role in atherosclerotic plaque progression. This review summarizes the rationale for personalized anti-inflammatory therapy. RECENT FINDINGS Systemic inflammatory parameters may be used to follow the clinical outcome in primary and secondary prevention. Medical therapy, both in patients with stable cardiovascular disease, or with acute events, may be tailored taking into consideration the level and course of systemic inflammatory mediators. There is significant space for improvement in primary prevention and in the treatment of patients who have suffered from severe cardiovascular events, paying attention to not only blood pressure and cholesterol levels but also including inflammatory parameters in our clinical analysis. The potential exists to alter the course of atherosclerosis with anti-inflammatory drugs. With increased understanding of the specific mechanisms that regulate the relationship between inflammation and atherosclerosis, new, more effective and specific anti-inflammatory treatment may become available.
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Affiliation(s)
- Antonio V Sterpetti
- University of Rome Sapienza, Rome, Italy.
- AV Sterpetti- Policlinico Umberto I, Viale del Policlinico, 00167, Rome, Italy.
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30
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Immunological and Microbiological Profiling of Cumulative Risk Score for Periodontitis. Diagnostics (Basel) 2020; 10:diagnostics10080560. [PMID: 32764360 PMCID: PMC7460115 DOI: 10.3390/diagnostics10080560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022] Open
Abstract
The cumulative risk score (CRS) is a mathematical salivary diagnostic model to define an individual's risk of having periodontitis. In order to further validate this salivary biomarker, we investigated how periodontal bacteria, lipopolysaccharide (LPS), and systemic and local host immune responses relate to CRS. Subgingival plaque, saliva, and serum samples collected from 445 individuals were used in the analyses. Plaque levels of 28 microbial species, especially those of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, and Tannerella forsythia, and serum and salivary levels of IgA and IgG against these five species were determined. Additionally, LPS activity was measured. High CRS associated strongly with all IgA/IgG antibody and LPS levels in saliva, whereas in serum the associations were not that obvious. In the final logistic regression model, the best predictors of high CRS were saliva IgA burden against the five species (OR 7.04, 95% CI 2.25-22.0), IgG burden (3.79, 1.78-8.08), LPS (2.19, 1.38-3.47), and the sum of 17 subgingival Gram-negative species (6.19, 2.10-18.3). CRS is strongly associated with microbial biomarker species of periodontitis and salivary humoral immune responses against them.
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31
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Nwizu N, Wactawski-Wende J, Genco RJ. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontol 2000 2020; 83:213-233. [PMID: 32385885 PMCID: PMC7328760 DOI: 10.1111/prd.12329] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Epidemiologic and cancer control studies on the association of periodontal disease and cancer risk mostly suggest a positive association with overall cancer risk and certain specific types of cancer. These findings are generally consistent among cross‐sectional and longitudinal studies. In this paper, we review epidemiologic studies and current knowledge on periodontal disease and cancer, with a focus on those studies conducted in the years following the Joint European Federation of Periodontology/American Academy of Periodontology Workshop on “Periodontitis and Systemic Diseases” in November 2012. This review also explores the role of chronic inflammation as a biologically plausible mechanistic link between periodontal disease and risk of cancer. Furthermore, it highlights studies that have examined the potential importance of certain periodontal pathogens in this association.
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Affiliation(s)
- Ngozi Nwizu
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, USA.,School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, USA.,Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, USA
| | - Jean Wactawski-Wende
- School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, USA
| | - Robert J Genco
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, USA
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32
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Rahtes A, Li L. Polarization of Low-Grade Inflammatory Monocytes Through TRAM-Mediated Up-Regulation of Keap1 by Super-Low Dose Endotoxin. Front Immunol 2020; 11:1478. [PMID: 32765513 PMCID: PMC7378438 DOI: 10.3389/fimmu.2020.01478] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/08/2020] [Indexed: 12/19/2022] Open
Abstract
Subclinical endotoxemia [low levels of bacterial endotoxin (LPS) in the blood stream] has been correlated with chronic inflammatory diseases, with less-understood mechanisms. We have previously shown that chronic exposure to super low doses of LPS polarizes monocytes/macrophages to a pro-inflammatory state characterized by up-regulation of pro-inflammatory regulators such as p62 and simultaneous down-regulation of anti-inflammatory/resolving regulators such as Nrf2. Building upon this observation, here we show that chronic exposure to super-low doses of LPS leads to accumulation of the Nrf2-inhibitory protein Keap1 in murine monocytes. This is accompanied by increases of p62 and MLKL, consistent with a disruption of autolysosome function in polarized monocytes challenged by super-low dose LPS. Monocytes subjected to persistent super-low dose LPS challenge also accumulate higher levels of IKKβ. As a consequence, SLD-LPS challenge leads to an inflammatory monocyte state represented by higher expression of the inflammatory marker Ly6C as well as lower expression of the anti-inflammatory marker CD200R. Further analysis revealed that Keap1 levels are significantly enriched in the Ly6Chi pro-inflammatory monocyte population. Finally, we show that the TLR4 signaling adaptor TRAM is essential for these effects. Together our study provides novel insight into signaling mechanisms behind low-grade inflammatory monocyte polarization unique to chronic super-low dose LPS exposure.
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Affiliation(s)
- Allison Rahtes
- Department of Biological Sciences, Virginia Tech, Blacksburg, VA, United States
| | - Liwu Li
- Department of Biological Sciences, Virginia Tech, Blacksburg, VA, United States
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33
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Shen CY, Wang TX, Jiang JG, Huang CL, Zhu W. Bergaptol from blossoms of Citrus aurantium L. var. amara Engl inhibits LPS-induced inflammatory responses and ox-LDL-induced lipid deposition. Food Funct 2020; 11:4915-4926. [PMID: 32432251 DOI: 10.1039/c9fo00255c] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aberrant activation of inflammation and excess accumulation of lipids play pivotal roles in atherosclerosis (AS) progression. Constituents from Citrus aurantium Linn variant amara Engl (CAVA) were effectively investigated for their various bioactivities, especially anti-inflammation. Bergaptol (BER) is particularly abundant in Citrus products. Accumulating studies have confirmed its predominant anti-cancer and antioxidant functions, whereas few studies focused on its antiatherogenic functions. In the current study, BER was isolated from CAVA for the first time. Macrophages were stimulated with lipopolysaccharides (LPSs) or oxidized low-density lipoproteins (ox-LDL) to mimic inflammatory responses and AS development. BER treatment significantly inhibited LPS-induced production of nitric oxide (NO), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and gene expression of inducible nitric oxide synthase (iNOS), IL-6, TNF-α, interleukin-1 beta (IL-1β) and cyclooxygenase-2 (COX-2). BER also potently blocked LPS-induced mitogen-activated protein kinase (MAPK) phosphorylation and nuclear factor-kappa B (NF-κB) activation, as evidenced by the inhibitory effects on c-Jun N-terminal kinase (JNK), P38, P65, IκBα and IκKα/β phosphorylation, and NF-κB nuclear translocation. Furthermore, BER treatment markedly mitigated ox-LDL-induced foam cell formation by inhibiting scavenger receptor class A type I (SRA1) and cluster of differentiation 36 (CD36)-dependent cholesterol uptake. In conclusion, BER might be a novel therapeutic agent for AS prevention through inhibiting inflammatory responses and cholesterol uptake.
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Affiliation(s)
- Chun-Yan Shen
- College of Food and Bioengineering, South China University of Technology, Guangzhou, 510640, China.
| | - Tian-Xing Wang
- College of Food and Bioengineering, South China University of Technology, Guangzhou, 510640, China.
| | - Jian-Guo Jiang
- College of Food and Bioengineering, South China University of Technology, Guangzhou, 510640, China.
| | - Chun-Ling Huang
- The second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
| | - Wei Zhu
- The second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
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34
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Leskelä J, Pietiäinen M, Safer A, Lehto M, Metso J, Malle E, Buggle F, Becher H, Sundvall J, Grau AJ, Pussinen PJ, Palm F. Serum lipopolysaccharide neutralizing capacity in ischemic stroke. PLoS One 2020; 15:e0228806. [PMID: 32084157 PMCID: PMC7034831 DOI: 10.1371/journal.pone.0228806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Periodontitis is associated with increased serum lipopolysaccharide (LPS) activity, which may be one mechanism linking periodontitis with the risk of cardiovascular diseases. As LPS-carrying proteins including lipoproteins modify LPS-activity, we investigated the determinants of serum LPS-neutralizing capacity (LPS-NC) in ischemic stroke. The association of LPS-NC and Aggregatibacter actinomycetemcomitans, a major microbial biomarker in periodontitis, was also investigated. Materials and methods The assay to measure LPS-NC was set up by spiking serum samples with E. coli LPS. The LPS-NC, LPS-binding protein (LBP), soluble CD14 (sCD14), lipoprotein profiles, apo(lipoprotein) A-I, apoB, and phospholipid transfer protein (PLTP) activity, were determined in 98 ischemic stroke patients and 100 age- and sex-matched controls. Serum and saliva immune response to A. actinomycetemcomitans, its concentration in saliva, and serotype-distribution were examined. Results LPS-NC values ranged between 51–83% in the whole population. Although several of the LPS-NC determinants differed significantly between cases and controls (PLTP, sCD14, apoA-I, HDL-cholesterol), the levels did not (p = 0.056). The main determinants of LPS-NC were i) triglycerides (β = -0.68, p<0.001), and ii) HDL cholesterol (0.260, <0.001), LDL cholesterol (-0.265, <0.001), PLTP (-0.196, 0.011), and IgG against A. actinomycetemcomitans (0.174, 0.011). Saliva A. actinomycetemcomitans concentration was higher [log mean (95% CI), 4.39 (2.35–8.19) vs. 10.7 (5.45–21) genomes/ml, p = 0.023) and serotype D more frequent (4 vs. 0%, p = 0.043) in cases than controls. Serotypeablity or serotypes did not, however, relate to the LPS-NC. Conclusion Serum LPS-NC comprised low PLTP-activity, triglyceride and LDL cholesterol concentrations, as well as high HDL cholesterol and IgG against A. actinomycetemcomitans. The present findings let us to conclude that LPS-NC did not associate with stroke.
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Affiliation(s)
- Jaakko Leskelä
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Anton Safer
- Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Markku Lehto
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
| | - Jari Metso
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Ernst Malle
- Division of Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Florian Buggle
- Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Heiko Becher
- University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg, Germany
- University Hospital Heidelberg, Institute of Global Health, Heidelberg, Germany
| | - Jouko Sundvall
- National Institute for Health and Welfare, Helsinki, Finland
| | - Armin J. Grau
- Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Pirkko J. Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Frederick Palm
- Department of Neurology, Helios Klinikum Schleswig, Schleswig, Germany
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Hashimoto R, Kakigi R, Miyamoto Y, Nakamura K, Itoh S, Daida H, Okada T, Katoh Y. JAK-STAT-dependent regulation of scavenger receptors in LPS-activated murine macrophages. Eur J Pharmacol 2020; 871:172940. [PMID: 31968212 DOI: 10.1016/j.ejphar.2020.172940] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/23/2019] [Accepted: 01/17/2020] [Indexed: 12/17/2022]
Abstract
In atherosclerosis progression, atherosclerotic plaques develop upon accumulated foam cells derived from macrophages that take up modified low-density lipoprotein (LDL). CD36 and CD204 are the principal scavenger receptors responsible for the uptake of modified LDL. Lipopolysaccharide (LPS) exacerbates atherosclerosis by enhancing the expression of scavenger receptors and thus increasing the uptake of modified LDL into macrophages. However, the signaling pathways that mediate LPS and scavenger receptor expression have not been fully elucidated. We used mouse bone marrow-derived macrophages and investigated the effects of LPS in vitro. LPS enhanced the phosphorylation of extracellular signal-regulated kinase (ERK) and signal transducer and activator of transcription-1 (STAT-1). Inhibitors of the mitogen-activated protein kinase (MAPK)/ERK kinase (MEK) pathway (U0126 and PD0325901) suppressed the uptake of acetylated-LDL (Ac-LDL) and the expression of CD204 but not CD36 in LPS-activated macrophages. Inhibitors of the Janus tyrosine kinase (JAK)-STAT pathway (ruxolitinib and tofacitinib) suppressed the uptake of Ac-LDL and the expression of both CD36 and CD204 in LPS-activated macrophages. We next injected LPS into the peritoneal cavity of mice and analyzed the effects of LPS. MEK inhibitor U0126 suppressed the uptake of Ac-LDL and the expression of CD204 but not CD36 in LPS-activated macrophages. JAK inhibitor ruxolitinib suppressed the uptake of Ac-LDL and the expression of both CD36 and CD204 in LPS-activated macrophages. These results suggest that scavenger receptors in LPS-activated mouse macrophages are regulated through a JAK-STAT-dependent pathway. Although further evaluation is necessary, JAK-STAT inhibition could be useful in atherosclerosis therapy, at least for atherosclerosis exacerbated by LPS.
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Affiliation(s)
- Ryota Hashimoto
- Laboratory of Molecular and Biochemical Research, Research Support Center, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan; Department of Physiology, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Ryo Kakigi
- Department of Management Science, Josai International University, 1 Gumyo, Togane, Chiba, 283-8555, Japan
| | - Yuki Miyamoto
- Department of Cardiology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kyoko Nakamura
- Department of Physiology, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Seigo Itoh
- Department of Cardiology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroyuki Daida
- Department of Cardiology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takao Okada
- Department of Physiology, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Youichi Katoh
- Department of Cardiology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan; Juntendo University Faculty of International Liberal Arts, Hongo 2-1-1, Bunkyo-ku, Tokyo, 112-8421, Japan.
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Pejčić A, Obradović R, Bradić-Vasić M, Minić I, Kurtagić D. Periodontal health and detection of periodontal bacteria in patients with acute coronary syndrome. ACTA STOMATOLOGICA NAISSI 2020. [DOI: 10.5937/asn2082079p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Recent studies have found that patients with periodontitis have greater risk of incurring fatal cardiovascular disease than patients without periodontitis. Emerging research has identified inflammation caused by periodontitis as significantly increasing the risk for ACS. Aim: The aim of this study was to investigate a periodontal status in the patients with ACS, and to assess the association of different periodontal parameters with ACS. Material and methods: In the first group, patients both with ACS and periodontitis were enrolled as cases. Patients were examined 3 days after ischemia. The second group consisted of patients who had only periodontitis. The control group consisted of healthy individuals. Periodontal parameters were measured and matched on the basis of demographic characteristics and assessed between the groups. The severity of periodontitis in both cases was analyzed. Results: Analysis of the periodontal parameters showed that median scores were higher in patients in the first and the second group compared to the third control group but significantly higher in group with ACS. Levels of inflammatory markers were highest in the first group, compared to the second group and the control group. Periodontal pathogens were more strongly present in patients with ACS than in the group with periodontitis, indicating that it was a serious illness in these patients. Conclusion: This study supports an association between periodontitis and ACS. Severe periodontitis is present in this patients indicating that periodontitis can further act on the development of ACS.
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Abstract
The last decade has been characterized by an intense research on the composition of the gut microbiome and the links with human health. While previous work was focused on the effects of prebiotics and probiotics, nowadays several laboratories are describing the gut microbiome and its metabolic functions. Gut microbiome interaction with nutrients allows the gut microbiome to survive and at the same time determines the production of metabolites that are either adsorbed by intestinal cell in a mutual relationship or promote detrimental effect. Metabolomics, a new method to approach identification of biomarkers has been used to identify small metabolites in blood and other biofluids. The study of metabolome revealed several microbial derived metabolites that are circulating in blood and potentially affect human health. In this review we describe the links between regulation of metabolism and microbial derived metabolites.
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Affiliation(s)
- Ben Arpad Kappel
- Department of Internal Medicine 1, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
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Huang D, Mao X, Peng J, Cheng M, Bai T, Du M, Huang K, Liu B, Yang L, Huang K, Zhang F. Role of adipokine zinc-α 2-glycoprotein in coronary heart disease. Am J Physiol Endocrinol Metab 2019; 317:E1055-E1062. [PMID: 31526290 DOI: 10.1152/ajpendo.00075.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Zinc-α2-glycoprotein (AZGP1) is a newly identified adipokine that is associated with lipid metabolism and vascular fibrosis. Although adipokines contribute to lipid dysfunction and its related diseases, including stroke and coronary heart disease (CHD), the role of AZGP1 remains unclear. In this study, the role of AZGP1 in atherosclerosis and CHD was investigated. Serum AZGP1 levels from control (n = 84) and CHD (n = 91) patients were examined by ELISA and its relationship with various clinical parameters was analyzed. Immunohistochemistry and immunofluorescence were used to detect the expression of AZGP1 and its receptor in coronary atherosclerotic arteries. THP-1 and human embryonic kidney 293 cells were used to verify its anti-inflammatory role in atherosclerosis. Serum AZGP1 levels in CHD patients were lower than controls (P < 0.01) and independently associated with CHD prevalence (P = 0.021). AZGP1 levels also inversely correlated with the Gensini score. Immunohistochemistry and immunofluorescence showed that AZGP1 and its receptor β3-adrenoceptor (β3-AR) colocalized in lipid-rich areas of atherosclerotic plaques, particularly around macrophages. In vitro, AZGP1 had no effect on foam cell formation but showed anti-inflammatory effects through its regulation of JNK/AP-1 signaling. In summary, AZGP1 is an anti-inflammatory agent that can be targeted for CHD treatment.
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Affiliation(s)
- Dandan Huang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxiang Mao
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiangtong Peng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Cheng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng Du
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Huang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bing Liu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Yang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Huang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengxiao Zhang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Halajzadeh J, Milajerdi A, Reiner Ž, Amirani E, Kolahdooz F, Barekat M, Mirzaei H, Mirhashemi SM, Asemi Z. Effects of resistant starch on glycemic control, serum lipoproteins and systemic inflammation in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled clinical trials. Crit Rev Food Sci Nutr 2019; 60:3172-3184. [PMID: 31661295 DOI: 10.1080/10408398.2019.1680950] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aim of this systematic review and meta-analysis was to evaluate the effects of resistant starch (RS) on glycemic status, serum lipoproteins and inflammatory markers in patients with metabolic syndrome (MetS) and related disorders. Two independent authors systematically searched online database including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science from inception until 30 April 2019. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. The heterogeneity among the included studies was assessed using Cochrane's Q test and I-square (I2) statistic. Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size. Nineteen trials were included in this meta-analysis. Administration of RS resulted in significant reduction in fasting plasma glucose (FPG) (14 studies) (WMD: -4.28; 95% CI: -7.01, -1.55), insulin (12 studies) (WMD: -1.95; 95% CI: -3.22, -0.68), and HbA1C (8 studies) (WMD: -0.60; 95% CI: -0.95, -0.24). When pooling data from 13 studies, a significant reduction in total cholesterol levels (WMD: -8.19; 95% CI: -15.38, -1.00) and LDL-cholesterol (WMD: -8.57; 95% CI: -13.48, -3.66) were found as well. Finally, RS administration was associated with a significant decrease in tumor necrosis factor alpha (TNF-α) (WMD: -2.02; 95% CI: -3.14, -0.90). This meta-analysis showed beneficial effects of RS on improving FPG, insulin, HbA1c, total cholesterol, LDL-cholesterol and TNF-α levels in patients with MetS and related disorders, but it did not affect HOMA-IR, triglycerides, HDL-cholesterol, CRP and IL-6 levels.
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Affiliation(s)
- Jamal Halajzadeh
- Department of Biochemistry and Nutrition, Research Center for Evidence-Based Health Management, Maraghe University of Medical Science, Maraghe, Iran
| | - Alireza Milajerdi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Željko Reiner
- Department of Internal Medicine, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Elaheh Amirani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Fariba Kolahdooz
- Indigenous and Global Health Research, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Maryam Barekat
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Seyyed Mehdi Mirhashemi
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Recent progress in experimental and human disease-associated multi-species biofilms. Comput Struct Biotechnol J 2019; 17:1234-1244. [PMID: 31921390 PMCID: PMC6944735 DOI: 10.1016/j.csbj.2019.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/18/2019] [Accepted: 09/21/2019] [Indexed: 12/16/2022] Open
Abstract
Human bodies are colonized by trillions of microorganisms, which are often referred to as human microbiota and play important roles in human health. Next generation sequencing studies have established links between the genetic content of human microbiota and various human diseases. However, it remains largely unknown about the spatial organizations and interspecies interactions of individual species within the human microbiota. Bacterial cells tend to form surface-attached biofilms in many natural environments, which enable intercellular communications and interactions in a microbial ecosystem. In this review, we summarize the recent progresses on the experimental and human disease-associated multi-species biofilm studies. We hypothesize that engineering biofilm structures and interspecies interactions might provide a tool for manipulating the composition and function of human microbiota.
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Emampanahi M, Masoudi Rad S, Saghaeian Jazi M, Mansour Samaei N, Behnampour N, Mohammadi S, Fakhari E. Association between interleukin-10 gene polymorphisms and severe chronic periodontitis. Oral Dis 2019; 25:1619-1626. [PMID: 31055876 DOI: 10.1111/odi.13114] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 04/09/2019] [Accepted: 04/27/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Periodontitis is an inflammatory disease that is a result of the interaction between pathogenic bacteria and host immune response. Genetic alterations in interleukin-10 (IL-10) gene may be associated with the increased risk of periodontitis. We investigated the association between genotype and haplotype frequencies of IL-10 gene polymorphisms and susceptibility to periodontitis in an Iranian population. METHODS In this case-control study, a total of 64 patients with periodontitis and 128 healthy subjects were recruited. The PCR-RFLP technique was used to detect IL-10 promoter genotypes at the positions of -1082 (G/A), -819 (C/T), and -592 (C/A) in association with the susceptibility to severe chronic periodontitis. RESULTS Regarding IL-10 -592 (C/A) and IL-10 -819 (C/T) alleles and genotypes, no significant association was observed between the risk of periodontitis and genotype frequencies. However, the frequency of GG genotype in IL-10 -1082 (G/A) polymorphic region was higher in normal subjects and was associated with the decreased risk of periodontitis under recessive model [OR = 2.89, 95% CI (0.99-8.43), p = 0.039]. Haplotype analysis revealed a significantly higher presence of H7 (AGC; -592/-1082/-819) [OR = 97.74, 95% CI (95.52-99.96), p < 0.0001]. CONCLUSION IL-10 -1082(G/A) polymorphism and AGC (-592/-1082/-819) haplotype could be associated with the susceptibility to chronic periodontitis.
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Affiliation(s)
- Mohaddeseh Emampanahi
- Department of Oral medicine, Dental faculty, Babol University of Medical Sciences, Babol, Iran
| | - Saba Masoudi Rad
- Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Marie Saghaeian Jazi
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nader Mansour Samaei
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nasser Behnampour
- Department of Biostatics, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Saeed Mohammadi
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Elham Fakhari
- Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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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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Suzuki K, Ohkuma M, Nagaoka I. Bacterial lipopolysaccharide and antimicrobial LL-37 enhance ICAM-1 expression and NF-κB p65 phosphorylation in senescent endothelial cells. Int J Mol Med 2019; 44:1187-1196. [PMID: 31364735 PMCID: PMC6713406 DOI: 10.3892/ijmm.2019.4294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/14/2019] [Indexed: 12/24/2022] Open
Abstract
Cellular senescence is associated with the induction of a proinflammatory phenotype. Notably, senescent endothelial cells are detected at the sites of atherosclerotic lesions, suggesting the involvement of senescent endothelial cells in atherogenesis. Moreover, bacterial infection has been speculated to contribute to the pathogenesis of atherosclerosis. The present study investigated the effects of Gram‑negative bacterial lipopolysaccharide (LPS) and LL‑37 (a human antimicrobial peptide of the cathelicidin family), on senescent endothelial cells, using serially passaged human endothelial cells. The results indicated that senescent endothelial cells exhibited the basal proinflammatory phenotype, as evidenced by higher intercellular adhesion molecule‑1 (ICAM‑1) expression and NF‑κB p65 phosphorylation, compared with non‑senescent cells. Additionally, exposure to LPS and LL‑37 further enhanced the expression of ICAM‑1 in senescent endothelial cells, compared with non‑senescent cells. Of note, the NF‑κB p65 pathway was more activated in senescent endothelial cells stimulated with LPS and LL‑37. Furthermore, the expression levels of the receptors for LPS and LL‑37 [toll‑like receptor 4 (TLR4) and purinergic receptor P2X 7 (P2X7), respectively] were upregulated in senescent endothelial cells. These observations indicated that LPS and LL‑37 enhanced the ICAM‑1 expression and NF‑κB p65 activation in senescent endothelial cells, potentially via the upregulated TLR4 and P2X7. Thus, senescent endothelial cells may contribute to the pathogenesis of atherosclerosis via the basal proinflammatory phenotype and the enhanced inflammatory responses against atherogenic factors, including LPS and LL‑37.
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Affiliation(s)
- Kaori Suzuki
- Department of Host Defense and Biochemical Research, Juntendo University Graduate School of Medicine, Tokyo 113‑8421, Japan
| | - Mari Ohkuma
- Department of Host Defense and Biochemical Research, Juntendo University Graduate School of Medicine, Tokyo 113‑8421, Japan
| | - Isao Nagaoka
- Department of Host Defense and Biochemical Research, Juntendo University Graduate School of Medicine, Tokyo 113‑8421, Japan
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Bakker GJ, Schnitzler JG, Bekkering S, de Clercq NC, Koopen AM, Hartstra AV, Meessen ECE, Scheithauer TP, Winkelmeijer M, Dallinga‐Thie GM, Cani PD, Kemper EM, Soeters MR, Kroon J, Groen AK, van Raalte DH, Herrema H, Nieuwdorp M. Oral vancomycin treatment does not alter markers of postprandial inflammation in lean and obese subjects. Physiol Rep 2019; 7:e14199. [PMID: 31423751 PMCID: PMC6698488 DOI: 10.14814/phy2.14199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 12/30/2022] Open
Abstract
Intake of a high-fat meal induces a systemic inflammatory response in the postprandial which is augmented in obese subjects. However, the underlying mechanisms of this response have not been fully elucidated. We aimed to assess the effect of gut microbiota modulation on postprandial inflammatory response in lean and obese subjects. Ten lean and ten obese subjects with metabolic syndrome received oral vancomycin 500 mg four times per day for 7 days. Oral high-fat meal tests (50 g fat/m2 body surface area) were performed before and after vancomycin intervention. Gut microbiota composition, leukocyte counts, plasma lipopolysaccharides (LPS), LPS-binding protein (LBP), IL-6 and MCP-1 concentrations and monocyte CCR2 and cytokine expression were determined before and after the high-fat meal. Oral vancomycin treatment resulted in profound changes in gut microbiota composition and significantly decreased bacterial diversity in both groups (phylogenetic diversity pre- versus post-intervention: lean, 56.9 ± 7.8 vs. 21.4 ± 6.6, P < 0.001; obese, 53.9 ± 7.8 vs. 21.0 ± 5.9, P < 0.001). After intervention, fasting plasma LPS significantly increased (lean, median [IQR] 0.81 [0.63-1.45] EU/mL vs. 2.23 [1.33-3.83] EU/mL, P = 0.017; obese, median [IQR] 0.76 [0.45-1.03] EU/mL vs. 1.44 [1.11-4.24], P = 0.014). However, postprandial increases in leukocytes and plasma LPS were unaffected by vancomycin in both groups. Moreover, we found no changes in plasma LBP, IL-6 and MCP-1 or in monocyte CCR2 expression. Despite major vancomycin-induced disruption of the gut microbiota and increased fasting plasma LPS, the postprandial inflammatory phenotype in lean and obese subjects was unaffected in this study.
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Affiliation(s)
- Guido J. Bakker
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Johan G. Schnitzler
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Siroon Bekkering
- Department of Experimental Internal MedicineRadboud University Medical CentreNijmegenThe Netherlands
| | - Nicolien C. de Clercq
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Annefleur M. Koopen
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Annick V. Hartstra
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Emma C. E. Meessen
- Department of Endocrinology and MetabolismAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Torsten P. Scheithauer
- Department of Internal Medicine, Diabetes CenterAmsterdam UMC, Location VUMC at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Maaike Winkelmeijer
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Geesje M. Dallinga‐Thie
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Patrice D. Cani
- WELBIO – Walloon Excellence in Life Sciences and Biotechnology, Metabolism and NutritionLouvain Drug Research Institute, Université Catholique de LouvainBrusselsBelgium
| | - Elles Marleen Kemper
- Department of Clinical PharmacyAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Maarten R. Soeters
- Department of Endocrinology and MetabolismAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Jeffrey Kroon
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Albert K. Groen
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Daniël H. van Raalte
- Department of Internal Medicine, Diabetes CenterAmsterdam UMC, Location VUMC at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam UMC, ICar at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Hilde Herrema
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
| | - Max Nieuwdorp
- Department of Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
- Department of Experimental Vascular MedicineAmsterdam UMC, Location AMC at University of AmsterdamAmsterdamThe Netherlands
- Department of Internal Medicine, Diabetes CenterAmsterdam UMC, Location VUMC at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam UMC, ICar at Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Molecular and Clinical Medicine, Wallenberg LaboratorySahlgrenska Academy, University of GothenburgGothenburgSweden
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Periodontitis: A Multifaceted Disease of Tooth-Supporting Tissues. J Clin Med 2019; 8:jcm8081135. [PMID: 31370168 PMCID: PMC6723779 DOI: 10.3390/jcm8081135] [Citation(s) in RCA: 320] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022] Open
Abstract
Periodontitis is an infection-driven inflammatory disease in which the composition of biofilms plays a significant role. Dental plaque accumulation at the gingival margin initiates an inflammatory response that, in turn, causes microbial alterations and may lead to drastic consequences in the periodontium of susceptible individuals. Chronic inflammation affects the gingiva and can proceed to periodontitis, which characteristically results in irreversible loss of attachment and alveolar bone. Periodontitis appears typically in adult-aged populations, but young individuals can also experience it and its harmful outcome. Advanced disease is the major cause of tooth loss in adults. In addition, periodontitis is associated with many chronic diseases and conditions affecting general health.
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Habbab KM, D'Aiuto F, Habbab MA, Porter SR. Molecular markers relevant to myocardial injury following dental extraction in patients with or without coronary artery disease. BDJ Open 2019; 5:9. [PMID: 31240112 PMCID: PMC6586777 DOI: 10.1038/s41405-019-0018-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 05/07/2019] [Accepted: 05/12/2019] [Indexed: 12/20/2022] Open
Abstract
Objectives The aim of this study was to characterize biological changes following dental extractions in patients with and without coronary artery disease (CAD). Materials and methods Forty-five patients (36 males and 9 females) referred for dental extraction underwent treatment and provided blood samples before, immediately after, and 24 h after the procedure. A broad array of biomarkers was employed to assess myocardial injury (highly sensitive troponin T, hs-TnT), bacterial burden (LPS endotoxin activity), and systemic inflammation (CRP, fibrinogen, IFN-γ, IL-1β, IL-6, IL-8, IL-10, IL-12, and TNF-α). Results Dental extraction in patients with and without CAD was associated with rises in hs-TnT (p = 0.013), hs-CRP (p < 0.001), fibrinogen (p = 0.005), endotoxin activity (p < 0.001), IFN-γ (p < 0.001), IL-6 (p < 0.001), IL-8 (p = 0.011), and IL-12 (p < 0.001) at 24 h compared with immediately post procedure. Changes in systemic inflammation and endotoxin activity were more evident in those with hs-TnT rise. Conclusions Simple dental extractions may cause mild increase in hs-TnT, indicating minor myocardial injury in both patients with and without CAD. Acute systemic inflammation and endotoxemia could represent a possible link between invasive dental treatment and increased risk of acute cardiovascular events. These findings indicate that invasive dental treatment (as simple as a single dental extraction) may impact negatively on clinical outcomes in dental patients, especially those with CAD.
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Affiliation(s)
- K M Habbab
- 1UCL Eastman Dental Institute, London, England UK.,2Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - F D'Aiuto
- 1UCL Eastman Dental Institute, London, England UK
| | - M A Habbab
- 2Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - S R Porter
- 1UCL Eastman Dental Institute, London, England UK
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47
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Lorenzo-Pouso AI, Castelo-Baz P, Pérez-Sayáns M, Lim J, Leira Y. Autophagy in periodontal disease: Evidence from a literature review. Arch Oral Biol 2019; 102:55-64. [DOI: 10.1016/j.archoralbio.2019.03.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 12/19/2022]
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48
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Pietiäinen M, Liljestrand JM, Kopra E, Pussinen PJ. Mediators between oral dysbiosis and cardiovascular diseases. Eur J Oral Sci 2019; 126 Suppl 1:26-36. [PMID: 30178551 DOI: 10.1111/eos.12423] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 12/11/2022]
Abstract
Clinical periodontitis is associated with an increased risk for cardiovascular diseases (CVDs) through systemic inflammation as the etiopathogenic link. Whether the oral microbiota, especially its quality, quantity, serology, and virulence factors, plays a role in atherogenesis is not clarified. Patients with periodontitis are exposed to bacteria and their products, which have access to the circulation directly through inflamed oral tissues and indirectly (via saliva) through the gastrointestinal tract, resulting in systemic inflammatory and immunologic responses. Periodontitis is associated with persistent endotoxemia, which has been identified as a notable cardiometabolic risk factor. The serology of bacterial biomarkers for oral dysbiosis is associated with an increased risk for subclinical atherosclerosis, prevalent and future coronary artery disease, and incident and recurrent stroke. In addition to species-specific antibodies, the immunologic response includes persistent, cross-reactive, proatherogenic antibodies against host-derived antigens. Periodontitis may affect lipoprotein metabolism at all levels, and all lipoprotein classes are affected. Periodontitis or its bacterial signatures may be involved not only in increased storage of proatherogenic lipids but also in attenuation of the anti-atherogenic processes, thereby putatively increasing the net risk of atherosclerosis. In this review we summarize possible molecular mediators between the dysbiotic oral microbiota and atherosclerotic processes.
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Affiliation(s)
- Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - John M Liljestrand
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elisa Kopra
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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49
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Kapellas K, Singh A, Bertotti M, Nascimento GG, Jamieson LM. Periodontal and chronic kidney disease association: A systematic review and meta-analysis. Nephrology (Carlton) 2019; 24:202-212. [PMID: 29359889 DOI: 10.1111/nep.13225] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2018] [Indexed: 12/19/2022]
Abstract
AIM Chronic kidney disease (CKD) and kidney failure is increasing globally and evidence from observational studies suggest periodontal disease may contribute to kidney functional decline. METHODS Electronic searches of the PubMed, EMBASE, Web of Science, Scopus and Cochrane Library databases were conducted for the purposes of conducting a systematic review. Hand searching of reference lists was also performed. Meta-analysis of observational studies involving periodontal disease and chronic kidney disease in adults was performed. RESULTS A total of 17 studies was selected from an initial 4055 abstracts. Pooled estimates indicated the odds of having CKD were 60% higher among patients with periodontitis: pooled OR 1.60 (95% CI 1.44-1.79, I2 35.2%, P = 0.11) compared to those without. Conversely, a similar magnitude but non-significant higher odds of having periodontal disease was found among people with CKD 1.69 (95% CI: 0.84, 3.40, I2 = 89.8%, P < 0.00) versus non-CKD. Meta-regression revealed study quality based on the Newcastle-Ottawa Scale and statistical adjustment for potential confounders explained almost 35% of the heterogeneity in the studies investigating the association between CKD and periodontitis. CONCLUSIONS Moderate evidence for a positive association between periodontitis and CKD exists. Evidence for the opposite direction is extremely weak based on significant heterogeneity between studies.
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Affiliation(s)
- Kostas Kapellas
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ankur Singh
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Maitê Bertotti
- School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo G Nascimento
- Department of Dentistry and Oral Health, Aarhus Universitet Institut for Odontologi, Aarhus, Denmark
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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50
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Cuadra GA, Smith MT, Nelson JM, Loh EK, Palazzolo DL. A Comparison of Flavorless Electronic Cigarette-Generated Aerosol and Conventional Cigarette Smoke on the Survival and Growth of Common Oral Commensal Streptococci. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1669. [PMID: 31091650 PMCID: PMC6572406 DOI: 10.3390/ijerph16101669] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/26/2019] [Accepted: 05/08/2019] [Indexed: 12/15/2022]
Abstract
Background: The use of electronic cigarettes (ECIG) has become very common. Consequently, critical analysis of the biological effects of ECIG aerosol deserves attention. Flavorless ECIG aerosol is known to comprise fewer harmful constituents than cigarette smoke. Therefore, we hypothesize that aerosol has less immediate effect on the viability of oral commensal streptococci than smoke. Methods: Survival and growth of four strains of commensal streptococci were measured after exposure to flavorless ECIG aerosol ± nicotine and smoke. Peristaltic pumps were used to transport aerosol or smoke into chambers containing recently seeded colony-forming units (CFUs) of the oral commensal streptococci on agar plates. Bacterial survival and growth, based on colony counts and sizes, were determined 24 h post-exposure. Additionally, aerosol or smoke were delivered into chambers containing pre-adhered streptococci to plastic coverslips and biofilm formation was determined 24 h post-exposure via scanning electron microscopy. Results: The results suggest that flavorless aerosol ± nicotine has a modest effect on bacterial growth both as colonies on agar and as biofilms. In contrast, smoke dramatically decreased bacterial survival and growth in all parameters measured. Conclusion: Unlike cigarette smoke, flavorless ECIG aerosol has only a small effect on the survival and growth of oral commensal streptococci.
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Affiliation(s)
| | - Maxwell T Smith
- Department of Medical Laboratory Science, School of Allied Health Sciences, Lincoln Memorial University, Harrogate, TN 37752, USA.
| | - John M Nelson
- Department of Biology, School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN 37752, USA.
| | - Emma K Loh
- Department of Biology, Muhlenberg College, Allentown, PA 18104, USA.
| | - Dominic L Palazzolo
- Department of Physiology, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA.
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