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Sato A, Arai S, Sumi K, Fukamachi H, Miyake S, Ozawa M, Myers M, Maruoka Y, Shimizu K, Mizutani T, Kuwata H. Metagenomic Analysis of Bacterial Microflora in Dental and Atherosclerotic Plaques of Patients With Internal Carotid Artery Stenosis. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2024; 18:11795468231225852. [PMID: 38328472 PMCID: PMC10848802 DOI: 10.1177/11795468231225852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/22/2023] [Indexed: 02/09/2024]
Abstract
Background Internal carotid artery stenosis is primarily attributed to atherosclerosis in the carotid artery bifurcation. Previous studies have detected oral bacteria in atherosclerotic lesions, suggesting an association between oral bacteria and atherosclerosis. In this study, we compared the bacterial flora of the atherosclerotic plaque in the carotid artery and dental plaque of patients with internal carotid artery stenosis using 16S ribosomal RNA (16S rRNA) metagenomic sequencing. Methods Fifty-four patients who underwent internal carotid endarterectomy for internal carotid artery stenosis at the Showa University Hospital between April 2016 and February 2018 were included. Polymerase chain reaction targeting the 16S rRNA gene detected bacterial DNA in the carotid plaques of 11 cases, of which only 5 could be further analyzed. Thereafter, DNA extracted from the carotid and oral plaques of these 5 cases were analyzed using metagenomic sequencing targeting 16S rRNA. In addition, their general condition and oral conditions were evaluated. The patients were classified into symptomatic and asymptomatic groups based on the presence or absence of symptoms of transient ischemic attack, and their bacterial flora was evaluated. Results The results demonstrated that the microflora of carotid plaques (n = 5) contained bacterial species from 55 families and 78 genera. In addition, 86.5% of the bacteria detected in the carotid plaques were also detected in oral plaques. Cariogenic and periodontopathic bacteria accounted for 27.7% and 4.7% of the bacteria in the carotid plaques, respectively. Conclusions These results suggest that oral bacteria are directly or indirectly involved in the pathogenesis of atherosclerosis. More extensive studies of oral commensal bacteria detected in extra-oral lesions are warranted to comprehensively investigate the role of oral bacteria in the pathogenesis of systemic diseases.
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Affiliation(s)
- Ayako Sato
- Department of Special Needs Dentistry, Division of Community-Based Comprehensive Dentistry, Showa University, Ohta-ku, Tokyo, Japan
- Department of Oral Microbiology and Immunology, School of Dentistry, Showa University, Shinagawa-Ku, Tokyo, Japan
| | - Shintaro Arai
- Department of Neurosurgery, School of Medicine, Showa University, Shinagawa-Ku, Tokyo, Japan
| | - Kenji Sumi
- Department of Neurosurgery, School of Medicine, Showa University, Shinagawa-Ku, Tokyo, Japan
| | - Haruka Fukamachi
- Department of Oral Microbiology and Immunology, School of Dentistry, Showa University, Shinagawa-Ku, Tokyo, Japan
| | - Satoko Miyake
- Department of Special Needs Dentistry, Division of Community-Based Comprehensive Dentistry, Showa University, Ohta-ku, Tokyo, Japan
| | - Manami Ozawa
- Department of Advanced Oral Surgery, Yokohama Clinic, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Mie Myers
- Department of Special Needs Dentistry, Division of Community-Based Comprehensive Dentistry, Showa University, Ohta-ku, Tokyo, Japan
| | - Yasubumi Maruoka
- Department of Special Needs Dentistry, Division of Community-Based Comprehensive Dentistry, Showa University, Ohta-ku, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, Totsuka Kyouritsu Daini Hospital, Yokohama-shi, Kanagawa, Japan
| | - Katsuyoshi Shimizu
- Department of Neurosurgery, School of Medicine, Showa University, Shinagawa-Ku, Tokyo, Japan
| | - Tohru Mizutani
- Department of Neurosurgery, School of Medicine, Showa University, Shinagawa-Ku, Tokyo, Japan
| | - Hirotaka Kuwata
- Department of Oral Microbiology and Immunology, School of Dentistry, Showa University, Shinagawa-Ku, Tokyo, Japan
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Moon MG, Kang SH, Kim SH, Park SY, Seol YJ, Yoon CH, Lee HJ, Youn TJ, Chae IH, Leira Y, Munoz-Aguilera E, D'Aiuto F. Association between toothbrushing and cardiovascular risk factors: a cross-sectional study using Korean National Health and Nutrition Examination Survey 2015-2017. BMC Oral Health 2024; 24:4. [PMID: 38167045 PMCID: PMC10763411 DOI: 10.1186/s12903-023-03775-5] [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: 06/12/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Previous studies have suggested that frequent toothbrushing is associated with a lower risk of future cardiovascular events. We sought to investigate further the relationship between toothbrushing, cardiovascular risk factors, and lifestyle behaviours. METHODS We analysed a cross-sectional survey including 13,761 adults aged 30 years or older without a history of cardiovascular diseases from the Korean National Health and Nutritional Examination Survey. Conventional cardiovascular risk factors (blood pressure, lipid profiles, and fasting glucose), and inflammatory markers (high-sensitivity C-reactive protein [hsCRP], and white blood cell counts [WBC]) were investigated in relation to the frequency of toothbrushing. RESULTS The estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk, calculated using the pooled cohort equations was 13.7%, 9.1%, and 7.3% for participants who reported toothbrushing 0-1, 2, and ≥ 3 times a day, respectively. Both conventional risk factors and inflammatory markers were significantly associated with frequent toothbrushing. However, after adjusting potential confounding factors such as age, sex, comorbidities, and lifestyle behaviours, only inflammatory markers were remained as significant factors. CONCLUSIONS Oral hygiene behaviours are closely linked to cardiovascular risk factors. This study suggests that reduced systemic inflammatory burden may explain the benefit of improved oral hygiene in terms of cardiovascular risk.
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Affiliation(s)
- Mi-Gil Moon
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Korea
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Si-Hyuck Kang
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Korea
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Sun-Hwa Kim
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Korea
| | - Shin-Young Park
- Program of Clinical Dental Education and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
- Pre-doctoral treatment center, Seoul National University Dental Hospital, Seoul, Korea.
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Chang-Hwan Yoon
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Korea
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, Korea
| | - Tae-Jin Youn
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Korea
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - In-Ho Chae
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Korea
- Department of Internal Medicine, Seoul National University, Seoul, Korea
| | - Yago Leira
- UCL Eastman Dental Institute, Periodontology Unit, University College London, London, UK
| | - Eva Munoz-Aguilera
- UCL Eastman Dental Institute, Periodontology Unit, University College London, London, UK
| | - Francesco D'Aiuto
- UCL Eastman Dental Institute, Periodontology Unit, University College London, London, UK
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Brun A, Petit C, Huck O, Bouchard P, Carra MC, Gosset M. [Periodontitis : An underestimated risk of cardiovascular diseases]. Med Sci (Paris) 2024; 40:35-41. [PMID: 38299901 DOI: 10.1051/medsci/2023193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Epidemiological studies have identified periodontitis as a contributing factor to cardiovascular risk. Periodontitis is a chronic inflammatory disease that affects the tissues supporting the teeth. Although the nature of the association between periodontitis and cardiovascular disease (CVD) remains to be defined, the low-grade systemic inflammation and chronic bacteremia associated with periodontitis appear to be involved in the development of atherosclerosis and associated cardiovascular pathologies. Periodontal treatment has been shown to improve cardiovascular health parameters. A bidirectional preventive approach, involving the management of both periodontitis and cardiovascular risk factors, could lead to a reduction in morbidity and mortality related to cardiovascular disease.
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Affiliation(s)
- Adrian Brun
- Unité de recherche URP2496, Biomedical Research In Odontology (BRIO), France - Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Henri Mondor (AP-HP), service de médecine bucco-dentaire, Créteil, France
| | - Catherine Petit
- Laboratoire de nanomédecine régénérative, Inserm UMR 1260, CRBS, 1 rue Eugène Boeckel, 67000 Strasbourg, France - Département de parodontologie, faculté de chirurgie dentaire Robert Frank, Strasbourg, France - Hôpitaux universitaires de Strasbourg, pôle de médecine et chirurgie bucco-dentaire, Strasbourg, France
| | - Olivier Huck
- Laboratoire de nanomédecine régénérative, Inserm UMR 1260, CRBS, 1 rue Eugène Boeckel, 67000 Strasbourg, France - Département de parodontologie, faculté de chirurgie dentaire Robert Frank, Strasbourg, France - Hôpitaux universitaires de Strasbourg, pôle de médecine et chirurgie bucco-dentaire, Strasbourg, France
| | - Philippe Bouchard
- Unité de recherche URP2496, Biomedical Research In Odontology (BRIO), France - Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Rothschild (AP-HP), service d'odontologie, 5 rue Santerre 75012 Paris
| | - Maria Clotilde Carra
- Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Rothschild (AP-HP), service d'odontologie, 5 rue Santerre 75012 Paris - Epidemiology and Statistics Research Centre, Inserm UMR1153, Paris, France
| | - Marjolaine Gosset
- Unité de recherche URP2496, Biomedical Research In Odontology (BRIO), France - Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Charles Foix (AP-HP), service de médecine bucco-dentaire, Ivry/Seine, France
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Park S, Kim I, Han SJ, Kwon S, Min EJ, Cho W, Koh H, Koo BN, Lee JS, Kwon JS, Seo KY, Ha JW, Park YM. Oral Porphyromonas gingivalis infection affects intestinal microbiota and promotes atherosclerosis. J Clin Periodontol 2023; 50:1553-1567. [PMID: 37621247 DOI: 10.1111/jcpe.13864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 06/19/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
AIM The link between periodontitis and intestinal dysbiosis, two factors that contribute to atherosclerosis, has not been clearly defined. We investigated the integrative effects of oral infection with Porphyromonas gingivalis (PG), the major pathogen for periodontitis, on intestinal microbiota and atherosclerosis. MATERIALS AND METHODS ApoE-/- mice were fed a normal chow diet (NC), a Western diet (WD) or a WD with oral PG infection (PG). The PG infection was investigated by placing a total of 109 CFUs of live PG into the oral cavity of each mouse using a feeding needle five times a week for 3 weeks. Atherosclerotic lesions of the aortae were measured, and blood lipoproteins and the expression of molecules related to lipid metabolism in the liver were analysed. We also performed 16S RNA sequencing and a microbiome analysis using faeces. RESULTS En face bloc preparation of the aortae showed that the PG group had a 1.7-fold increase in atherosclerotic lesions compared with the WD group (p < .01). Serum analyses showed that oral PG infection induced a significant decrease in high-density lipoprotein (HDL) and triglyceride. Western blots of hepatic tissue lysates revealed that PG infection reduced the expression of scavenger receptor class B type 1 (SR-B1) in the liver by 50%. Faecal microbiota analysis revealed that species richness estimates (Chao1, ACE) decreased immediately after PG infection. PG infection also induced a significant decrease in Shannon diversity and an increase in Simpson's indices in the WD-fed mice. PG infection significantly increased the phyla Actinobacteria and Deferribacteres, along with the species Mucispirillum schaedleri and Lactobacillus gasseri, in the mice. The functional study showed that PG infection increased the expression of proteins that function in carbohydrate and glucose metabolism, including phosphotransferase system (PTS) proteins and the GntR family transcriptional regulator. CONCLUSIONS Oral PG infection promotes atherosclerosis and induces significant metabolic changes, including reduced serum HDL and reduced hepatic SR-B1 and ABCA1 expression, as well as changes in intestinal microbiota. Our study suggests that intestinal dysbiosis accompanies periodontitis and could play a role in atherosclerosis.
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Affiliation(s)
- Sowon Park
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Inyoung Kim
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Soo Jung Han
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Soyeon Kwon
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Eun-Ji Min
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Wonkyoung Cho
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Hong Koh
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Bon-Nyeo Koo
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Seok Lee
- Department of Periodontics, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Sung Kwon
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong-Won Ha
- Cardiology Division, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Mi Park
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, South Korea
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Yang X, Shi Z, Wang X, Yang Y, Sun D, Zhu B, Song F, Zhu X, Ding S, Zou Y, Xiao C, Yang X. Disruption of Histamine-H 1R signaling exacerbates cardiac microthrombosis after periodontal disease via TLR4/NFκB-p65 pathway. Int Immunopharmacol 2023; 123:110774. [PMID: 37567012 DOI: 10.1016/j.intimp.2023.110774] [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: 06/10/2023] [Revised: 07/29/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
Periodontal disease is a chronic inflammatory disease that is highly correlated with cardiovascular disease(CVD). Histamine has been proven to participate in the pathophysiological processes of cardiovascular disease and oral inflammation. However, the role of histamine in the development of cardiac microthrombosis caused by periodontal disease has not been fully elucidated. We established a murine periodontal inflammation model by injecting lipopolysaccharide (LPS) or Porphyromonas gingivalis (P. gingivalis). In order to examine the effect of histamine/H1R signaling on cardiac injury after periodontal disease, we used histidine decarboxylase- knockout (HDC-/-) mice and histamine 1 receptor (H1R) antagonist. Our results demonstrated that LPS-induced periodontal inflammation significantly increased CD11b+Gr-1+ neutrophils in the peripheral blood and myocardial interstitium. Histamine deficiency resulted in further increases in P. gingivalis, neutrophils, inflammatory cytokines, and cardiac microthrombosis in the myocardium of HDC-/- mice compared to wild-type (WT) mice. Mechanistic analysis showed that blocking H1R could synergistically interact with LPS, further increasing the phosphorylation of p65, exacerbating the inflammatory response of neutrophils and endothelial cell damage. Conclusively, the disruption of histamine-H1R signaling exacerbates cardiac microthrombosis after periodontal disease via TLR4/NFκB-p65 pathway. Our findings not only reveal a link between periodontal inflammation and myocardial injury but also provided some thoughts for the use of H1R antagonist in clinical practice.
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Affiliation(s)
- Xiyang Yang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital & Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhaocheng Shi
- Department of Oral Mucosa and Periodontal Clinic, Shanghai Stomatological Hospital& School of Stomatology & Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai 200433, China
| | - Xiangfei Wang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital & Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yi Yang
- Department of Medical Laboratory, College of Medical Technology, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China
| | - Dili Sun
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital & Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Baoling Zhu
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China
| | - Fujie Song
- Department of First Dental Clinic, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Xiaowei Zhu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital & Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Suling Ding
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital & Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yunzeng Zou
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital & Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China
| | - Chun Xiao
- Department of Cardiology, Third People's Hospital of Huizhou, Guangzhou Medical University, Guangdong 516002, China.
| | - Xiangdong Yang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital & Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; Department of Cardiology, Third People's Hospital of Huizhou, Guangzhou Medical University, Guangdong 516002, China.
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Huang X, Xie M, Lu X, Mei F, Song W, Liu Y, Chen L. The Roles of Periodontal Bacteria in Atherosclerosis. Int J Mol Sci 2023; 24:12861. [PMID: 37629042 PMCID: PMC10454115 DOI: 10.3390/ijms241612861] [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: 05/31/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Atherosclerosis (AS) is an inflammatory vascular disease that constitutes a major underlying cause of cardiovascular diseases (CVD) and stroke. Infection is a contributing risk factor for AS. Epidemiological evidence has implicated individuals afflicted by periodontitis displaying an increased susceptibility to AS and CVD. This review concisely outlines several prevalent periodontal pathogens identified within atherosclerotic plaques, including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum. We review the existing epidemiological evidence elucidating the association between these pathogens and AS-related diseases, and the diverse mechanisms for which these pathogens may engage in AS, such as endothelial barrier disruption, immune system activation, facilitation of monocyte adhesion and aggregation, and promotion of foam cell formation, all of which contribute to the progression and destabilization of atherosclerotic plaques. Notably, the intricate interplay among bacteria underscores the complex impact of periodontitis on AS. In conclusion, advancing our understanding of the relationship between periodontal pathogens and AS will undoubtedly offer invaluable insights and potential therapeutic avenues for the prevention and management of AS.
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Affiliation(s)
- Xiaofei Huang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Mengru Xie
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Xiaofeng Lu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Feng Mei
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Yang Liu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
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A Systematic Review and Meta-Analysis of the Relationship between Receiving the Flu Vaccine with Acute Cerebrovascular Accident and Its Hospitalization in the Elderly. BIOMED RESEARCH INTERNATIONAL 2023; 2023:2606854. [PMID: 36814798 PMCID: PMC9940958 DOI: 10.1155/2023/2606854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 12/15/2022] [Accepted: 01/21/2023] [Indexed: 02/15/2023]
Abstract
Background and Aims In recent years, various studies have been conducted worldwide to investigate the relationship between receiving the flu vaccine with acute cerebrovascular accident or stroke and its hospitalization in the elderly; however, the results of these studies are contradictory. Therefore, this study was aimed at investigating the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly. Methods This study is a systematic review and meta-analysis of studies examining the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly during the years 1980 to 2021 which have been published in ISI Web of Science, Scopus PubMed, Cochrane, Science Direct, Google Scholar, and Embase. All analyses were performed by Stata 15, and the significance level in this study was considered <0.05. Results In the systematic search, 3088 articles were retrieved, considering the study criteria; finally, 14 studies were included in the meta-analysis. Based on the results of the meta-analysis, the odds ratio (OR) of occurrence and hospitalization of stroke compared to the nonvaccinated group in vaccine recipients is equal to 0.84 (95% confidence interval (CI): 0.78-0.90, P value ≤ 0.001). Publication bias was not observed in this study (P value = 0.101). Conclusion Getting the flu vaccine can reduce the risk of occurrence and hospitalization of stroke in the elderly by 16% (10%-22%). Therefore, receiving this vaccine as a preventive intervention for stroke in the elderly may be promising.
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Liu L, Geng Y, Xiong C. Impact of Porphyromonas gingivalis-odontogenic infection on the pathogenesis of non-alcoholic fatty liver disease. Ann Med 2023; 55:2255825. [PMID: 37708866 PMCID: PMC10503456 DOI: 10.1080/07853890.2023.2255825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/15/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023] Open
Abstract
Aim: Non-alcoholic fatty liver disease is characterized by diffuse hepatic steatosis and has quickly risen to become the most prevalent chronic liver disease. Its incidence is increasing yearly, but the pathogenesis is still not fully understood. Porphyromonas gingivalis (P. gingivalis) is a major pathogen widely prevalent in periodontitis patients. Its infection has been reported to be a risk factor for developing insulin resistance, non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), and metabolic syndrome. The aim of this review is to evaluate the association between P. gingivalis infection and NAFLD, identify the possible etiopathogenetic mechanisms, and raise public awareness of oral health to prevent and improve NAFLD.Methods: After searching in PubMed and Web of Science databases using 'Porphyromonas gingivalis', 'non-alcoholic fatty liver disease', and 'hepatic steatosis' as keywords, studies related were compiled and examined.Results: P. gingivalis infection is a direct risk factor for NAFLD based on clinical and basic research. Moreover, it induces systematic changes and systemic abnormalities by disrupting metabolic, inflammatory, and immunologic homeostasis.Conclusion: P. gingivalis-odontogenic infection promotes the occurrence and development of NAFLD. Further concerns are needed to emphasize oral health and maintain good oral hygiene for the prevention and treatment of NAFLD.
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Affiliation(s)
- Linbo Liu
- Department of Clinical Laboratory, Yulin No.2 Hospital, Yulin, Shaanxi, China
| | - Yan Geng
- Department of Clinical Laboratory, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Chaoliang Xiong
- Department of Clinical Laboratory, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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9
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Bacterial Infections and Atherosclerosis – A Mini Review. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Atherosclerosis is the most challenging subsets of coronary artery disease in humans, in which risk factors emerge from childhood, and its prevalence increases with age. Experimental research demonstrates that infections due to bacteria stimulate atherogenic events. Atherosclerosis has complex pathophysiology that is linked with several bacterial infections by damaging the inner arterial wall and heart muscles directly and indirectly by provoking a systemic pro-inflammation and acute-phase protein. Repeated bacterial infections trigger an inflammatory cascade that triggers immunological responses that negatively impact cardiovascular biomarkers includes triglycerides, high-density lipoprotein, C-reactive protein, heat shock proteins, cytokines, fibrinogen, and leukocyte count. Herein, we intended to share the role of bacterial infection in atherosclerosis and evaluate existing evidence of animal and human trials on the association between bacterial infections and atherosclerosis on update.
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Cardiovascular Diseases and Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:261-280. [PMID: 35612803 DOI: 10.1007/978-3-030-96881-6_14] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is a chronic inflammatory disease of the tooth-supporting connective tissue and alveolar bone that is initiated by a bacterial biofilm in periodontal pockets. It affects about half of adults in the Western world, and is associated with a range of systemic comorbidities, e.g., cardiovascular disease (CVD), diabetes and rheumatoid arthritis, and these diseases share overlapping systemic and target tissue inflammatory mechanisms. Indeed, mounting evidence has indicated that their association is causal and built on the presence of systemic low-grade inflammation (LGI). Prior research linking periodontitis to CVD has mainly been derived from experimental studies, observational data, and small interventional trials with surrogate markers of CVD, e.g., endothelial dysfunction. However, recent data from randomised studies have demonstrated that intensive treatment of periodontitis can reduce blood pressure in patients with hypertension in conjunction with reduction of systemic inflammatory markers. Furthermore, targeted anti-inflammatory therapy has been shown to reduce recurrent events in patients with established CVD and LGI. Along this line, the concept of residual inflammatory risk has emerged as an independent new risk factor for atherothrombotic CVD. The present review summarizes translational evidence indicating that periodontitis is a risk factor for CVD dependent on LGI, and we conclude that treatment of periodontitis is likely to contribute importantly to reduction of residual inflammatory risk.
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11
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Oral microbiota in human systematic diseases. Int J Oral Sci 2022; 14:14. [PMID: 35236828 PMCID: PMC8891310 DOI: 10.1038/s41368-022-00163-7] [Citation(s) in RCA: 142] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 02/07/2023] Open
Abstract
Oral bacteria directly affect the disease status of dental caries and periodontal diseases. The dynamic oral microbiota cooperates with the host to reflect the information and status of immunity and metabolism through two-way communication along the oral cavity and the systemic organs. The oral cavity is one of the most important interaction windows between the human body and the environment. The microenvironment at different sites in the oral cavity has different microbial compositions and is regulated by complex signaling, hosts, and external environmental factors. These processes may affect or reflect human health because certain health states seem to be related to the composition of oral bacteria, and the destruction of the microbial community is related to systemic diseases. In this review, we discussed emerging and exciting evidence of complex and important connections between the oral microbes and multiple human systemic diseases, and the possible contribution of the oral microorganisms to systemic diseases. This review aims to enhance the interest to oral microbes on the whole human body, and also improve clinician’s understanding of the role of oral microbes in systemic diseases. Microbial research in dentistry potentially enhances our knowledge of the pathogenic mechanisms of oral diseases, and at the same time, continuous advances in this frontier field may lead to a tangible impact on human health.
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12
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Zhu X, Huang H, Zhao L. PAMPs and DAMPs as the Bridge Between Periodontitis and Atherosclerosis: The Potential Therapeutic Targets. Front Cell Dev Biol 2022; 10:856118. [PMID: 35281098 PMCID: PMC8915442 DOI: 10.3389/fcell.2022.856118] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/11/2022] [Indexed: 12/31/2022] Open
Abstract
Atherosclerosis is a chronic artery disease characterized by plaque formation and vascular inflammation, eventually leading to myocardial infarction and stroke. Innate immunity plays an irreplaceable role in the vascular inflammatory response triggered by chronic infection. Periodontitis is a common chronic disorder that involves oral microbe-related inflammatory bone loss and local destruction of the periodontal ligament and is a risk factor for atherosclerosis. Periodontal pathogens contain numerous pathogen-associated molecular patterns (PAMPs) such as lipopolysaccharide, CpG DNA, and Peptidoglycan, that initiate the inflammatory response of the innate immunity depending on the recognition of pattern-recognition receptors (PRRs) of host cells. The immune-inflammatory response and destruction of the periodontal tissue will produce a large number of damage-associated molecular patterns (DAMPs) such as neutrophil extracellular traps (NETs), high mobility group box 1 (HMGB1), alarmins (S100 protein), and which can further affect the progression of atherosclerosis. Molecular patterns have recently become the therapeutic targets for inflammatory disease, including blocking the interaction between molecular patterns and PRRs and controlling the related signal transduction pathway. This review summarized the research progress of some representative PAMPs and DAMPs as the molecular pathological mechanism bridging periodontitis and atherosclerosis. We also discussed possible ways to prevent serious cardiovascular events in patients with periodontitis and atherosclerosis by targeting molecular patterns.
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Affiliation(s)
- Xuanzhi Zhu
- State Key Laboratory of Oral Diseases, Department of Periodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hanyao Huang
- State Key Laboratory of Oral Diseases, Department of Oral and Maxillofacial Surgery, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- *Correspondence: Hanyao Huang, ; Lei Zhao,
| | - Lei Zhao
- State Key Laboratory of Oral Diseases, Department of Periodontics, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- *Correspondence: Hanyao Huang, ; Lei Zhao,
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Zhang J, Xie M, Huang X, Chen G, Yin Y, Lu X, Feng G, Yu R, Chen L. The Effects of Porphyromonas gingivalis on Atherosclerosis-Related Cells. Front Immunol 2022; 12:766560. [PMID: 35003080 PMCID: PMC8734595 DOI: 10.3389/fimmu.2021.766560] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/30/2021] [Indexed: 12/21/2022] Open
Abstract
Atherosclerosis (AS), one of the most common types of cardiovascular disease, has initially been attributed to the accumulation of fats and fibrous materials. However, more and more researchers regarded it as a chronic inflammatory disease nowadays. Infective disease, such as periodontitis, is related to the risk of atherosclerosis. Porphyromonas gingivalis (P. gingivalis), one of the most common bacteria in stomatology, is usually discovered in atherosclerotic plaque in patients. Furthermore, it was reported that P. gingivalis can promote the progression of atherosclerosis. Elucidating the underlying mechanisms of P. gingivalis in atherosclerosis attracted attention, which is thought to be crucial to the therapy of atherosclerosis. Nevertheless, the pathogenesis of atherosclerosis is much complicated, and many kinds of cells participate in it. By summarizing existing studies, we find that P. gingivalis can influence the function of many cells in atherosclerosis. It can induce the dysfunction of endothelium, promote the formation of foam cells as well as the proliferation and calcification of vascular smooth muscle cells, and lead to the imbalance of regulatory T cells (Tregs) and T helper (Th) cells, ultimately promoting the occurrence and development of atherosclerosis. This article summarizes the specific mechanism of atherosclerosis caused by P. gingivalis. It sorts out the interaction between P. gingivalis and AS-related cells, which provides a new perspective for us to prevent or slow down the occurrence and development of AS by inhibiting periodontal pathogens.
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Affiliation(s)
- Jiaqi Zhang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Mengru Xie
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Xiaofei Huang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Guangjin Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Ying Yin
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Xiaofeng Lu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Guangxia Feng
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Ran Yu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
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14
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Jin M, Zheng L, Wei Y, Cheng J, Zhang D, Yan S, Qin H, Wang Q, Ci X, Feng H. Enterobacter cloacae aggravates metabolic disease by inducing inflammation and lipid accumulation. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 90:103819. [PMID: 35077907 DOI: 10.1016/j.etap.2022.103819] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/03/2022] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
It is well known that gut microbiota imbalance can promote the development of metabolic disease. Enterobacter cloacae (E. cloacae) is a kind of opportunistic pathogen in the intestine. Therefore, we hypothesized that E. cloacae accelerated the development of metabolic disease. To answer this question, we used E. cloacae to induce disease in guinea pigs. We used H&E staining to detect the pathological changes of liver and aorta and used Oil Red O staining to evaluate the lipid accumulation in the liver. And that we used a kit to detect AST content and used Western blot to detect protein levels in the liver. We found that E. cloacae could induce liver pathological changes and lipid accumulation as well as aortic wall pathological changes in guinea pigs. And E. cloacae increased the liver index to 5.94% and the serum AST level to 41.93 U/L. Importantly, E. cloacae activated liver high mobility group protein (HMGB1)/toll-like receptor 4 (TLR4)/myeloiddifferentiationfactor88 (MYD88)/nuclear factor-kappa B (NF-κB) signal and sterol regulatory element-binding protein 1c (SREBP-1c) and inhibited AMP-activated protein kinase (AMPK). We conclude that E. cloacae promote nonalcoholic fatty liver disease (NAFLD) by inducing inflammation and lipid accumulation, and E. cloacae also promote atherosclerosis. These findings are important for study on the pathogenesis and drug screening of NAFLD and atherosclerosis.
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Affiliation(s)
- Meiyu Jin
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China
| | - Lianwen Zheng
- Reproductive Medical Center, the Second Hospital of Jilin University, Changchun, PR China
| | - Yunfei Wei
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China
| | - Jiaqi Cheng
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China
| | - Di Zhang
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China
| | - Siru Yan
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China
| | - Haiyan Qin
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China
| | - Qi Wang
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China
| | - Xinxin Ci
- Institute of Translational Medicine, The First Hospital, Jilin University, Changchun 130001, PR China
| | - Haihua Feng
- Key Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, PR China.
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15
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Agnello F, Capodanno D. Anti-inflammatory strategies for atherosclerotic artery disease. Expert Opin Drug Saf 2022; 21:661-672. [DOI: 10.1080/14740338.2022.2036717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Federica Agnello
- Division of Cardiology, A.O.U. Policlinico “G. Rodolico-San Marco”, University of Catania, Catania, Italy
| | - Davide Capodanno
- Division of Cardiology, A.O.U. Policlinico “G. Rodolico-San Marco”, University of Catania, Catania, Italy
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16
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Alshareef GH, Mohammed AE, Abumaree M, Basmaeil YS. Phenotypic and Functional Responses of Human Decidua Basalis Mesenchymal Stem/Stromal Cells to Lipopolysaccharide of Gram-Negative Bacteria. STEM CELLS AND CLONING-ADVANCES AND APPLICATIONS 2021; 14:51-69. [PMID: 34754198 PMCID: PMC8572118 DOI: 10.2147/sccaa.s332952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022]
Abstract
Introduction Human decidua basalis mesenchymal stem cells (DBMSCs) are potential therapeutics for the medication to cure inflammatory diseases, like atherosclerosis. The current study investigates the capacity of DBMSCs to stay alive and function in a harmful inflammatory environment induced by high levels of lipopolysaccharide (LPS). Methods DBMSCs were exposed to different levels of LPS, and their viability and functional responses (proliferation, adhesion, and migration) were examined. Furthermore, DBMSCs’ expression of 84 genes associated with their functional activities in the presence of LPS was investigated. Results Results indicated that LPS had no significant effect on DBMSCs’ adhesion, migration, and proliferation (24 h and 72 h) (p > 0.05). However, DBMSCs’ proliferation was significantly reduced at 10 µg/mL of LPS at 48 h (p < 0.05). In addition, inflammatory cytokines and receptors related to adhesion, proliferation, migration, and differentiation were significantly overexpressed when DBMSCs were treated with 10 µg/mL of LPS (p < 0.05). Conclusion These results indicated that DBMSCs maintained their functional activities (proliferation, adhesion, and migration) in the presence of LPS as there was no variation between the treated DBMSCs and the control group. This study will lay the foundation for future preclinical and clinical studies to confirm the appropriateness of DBMSCs as a potential medication to cure inflammatory diseases, like atherosclerosis.
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Affiliation(s)
- Ghofran Hasan Alshareef
- Biology Department, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, 84428, Saudi Arabia
| | - Afrah E Mohammed
- Biology Department, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, 84428, Saudi Arabia
| | - Mohammed Abumaree
- Stem Cell & Regenerative Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, 11481, Saudi Arabia
| | - Yasser S Basmaeil
- Stem Cell & Regenerative Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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17
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Iwai T, Matsui Y, Homma K, Takemura T, Fujiwara M, Aoyama N, Furukawa A, Sato H, Izumi Y. Pathological and immunological differences of arterial thrombi and wall caused by three different periodontal bacterial injections in rat models and proposals on the pathogeneses of vascular diseases. Clin Exp Dent Res 2021; 7:637-646. [PMID: 33463085 PMCID: PMC8543461 DOI: 10.1002/cre2.391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Periodontal bacteria that have been studied show a strong connection to various vascular diseases. Among the many kinds of periodontal bacteria, Porphyromonas gingivalis (Pg) is well examined in the general aspects and in a rat model. However, whether other periodontal bacteria work or react differently is not studied well. MATERIAL AND METHODS We chose Aggregatibacter actinomycetemcomitans (Aa) and Prevotella intermedia (Pi) as different types of periodontal bacteria. Low-density and high-density bacterial solutions were injected in the small artery of rats' groins using our rat model. Eighteen limbs of 9 SD male rats (500-650 g) were used. After 7 days, 14-18 days, and 28 days, the rats were sacrificed. A pathological and an immuno-histochemical study was conducted and reported on the low-density group with 12 limbs because the Pi group lacked a high-density study. Immuno-histochemical staining of live Pg was performed on three limbs of three rats at 1 h, 3 h, and 1 week after injection. RESULTS The appearances from the acute, at 7 days, to chronic phases, at 28 days, were observed. The differences of the species were certainly observed in the internal elastic lamina (IEL), and immuno-histochemical reactions. The inflammatory reactions, such as cellular distribution or intra-thrombus materials, were similar in all. One week later, we could not see any living bacteria in the specimen or immunological observation. CONCLUSIONS The three species were essentially the same, except for Aa's stronger disruption of IEL, and more CD3 (Pan T cell) in Pi and more CD79a (Pan B cell) in Pg. We propose a new concept of a possible mechanism of vascular diseases, in which the work of LPS (lipopolysaccharides) and a toll-like receptor (TLR) is emphasized.
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Affiliation(s)
- Takehisa Iwai
- Division of Vascular Surgery and Collagen Disease MedicineTsukuba Vascular CenterMoriyaJapan
| | - Yoshiki Matsui
- Division of Vascular Surgery and Collagen Disease MedicineTsukuba Vascular CenterMoriyaJapan
| | - Kaori Homma
- Division of Vascular Surgery and Collagen Disease MedicineTsukuba Vascular CenterMoriyaJapan
| | - Tamiko Takemura
- Section of PathologyJapanese Red‐Cross Medical CenterTokyoJapan
| | | | - Norio Aoyama
- Kanagawa Dental University HospitalYokosukaJapan
| | - Asuka Furukawa
- Department of Human PathologyTokyo Medical and Dental UniversityTokyoJapan
| | - Hiroki Sato
- Department of PeriodontologyTokyo Medical and Dental UniversityTokyoJapan
| | - Yuichi Izumi
- Department of PeriodontologyTokyo Medical and Dental UniversityTokyoJapan
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18
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Association between Periodontitis and Carotid Artery Calcification: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:3278351. [PMID: 34532500 PMCID: PMC8438587 DOI: 10.1155/2021/3278351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 02/05/2023]
Abstract
Recent studies have supported the relationship between periodontitis and carotid artery calcification (CAC), but still uncertain. This systematic review is aimed at evaluating the association between periodontitis and CAC. The search was conducted in four electronic databases: PubMed, EMBASE, Web of Science, and The Cochrane Library, supplemented by checking references of included articles and related review articles. Eligibility assessment and data extraction were conducted independently. The quality assessment and publication bias analysis were performed. The association between periodontitis and CAC was presented in odd ratio (OR) with 95% confidence interval (CI). Additional outcomes included the percentage of alveolar bone loss in CAC versus non-CAC. Twelve studies were included, and 10 were performed quantity analysis. Periodontitis with secure definition (OR = 2.02, 95%CI = 1.18 − 3.45) and insecure definition (OR = 10.78, 95%CI = 4.41 − 26.34) was associated with CAC. And a higher average percentage of alveolar bone loss (weighted mean difference = 10.84%; 95%CI = 6.40 − 15.48) was also observed in CAC patients compared to non-CAC patients. No significant publication bias was found. The results of this systematic review and meta-analysis revealed a significant relationship between periodontitis and CAC.
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Gorabi AM, Kiaie N, Khosrojerdi A, Jamialahmadi T, Al-Rasadi K, Johnston TP, Sahebkar A. Implications for the role of lipopolysaccharide in the development of atherosclerosis. Trends Cardiovasc Med 2021; 32:525-533. [PMID: 34492295 DOI: 10.1016/j.tcm.2021.08.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/16/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
Mounting scientific evidence over decades has established that atherosclerosis is a chronic inflammatory disorder. Among the potentially critical sources of vascular inflammation during atherosclerosis are the components of pathogenic bacteria, especially lipopolysaccharide (LPS). Toll-like receptor (TLR)-4, expressed on different inflammatory cells involved with the recognition of bacterial LPS, has been recognized to have mutations that are prevalent in a number of ethnic groups. Such mutations have been associated with a decreased risk of atherosclerosis. In addition, epidemiological investigations have proposed that LPS confers a risk factor for the development of atherosclerosis. Gram-negative bacteria are the major source of LPS in an individual's serum, which may be generated during subclinical infections. The major cell receptors on inflammatory cells involved in the pathogenesis of atherosclerosis, like macrophages, monocytes, and dendritic cells (DCs), are CD14, MD-2, and LPS binding protein (LBP). These receptors have been blamed for the development of atherosclerosis through dysregulated activation following LPS recognition. Lipoproteins may also play a role in modulating the LPS-induced inflammatory events during atherosclerosis development. In this review article, we attempt to clarify the role of LPS in the initiation and progression of atherosclerotic lesion development.
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Affiliation(s)
- Armita Mahdavi Gorabi
- Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Kiaie
- Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezou Khosrojerdi
- Department of Medical Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Thomas P Johnston
- Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri, 64108, USA.
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Medicine, The University of Western Australia, Perth, Australia; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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Porphyromonas gingivalis infection promotes mitochondrial dysfunction through Drp1-dependent mitochondrial fission in endothelial cells. Int J Oral Sci 2021; 13:28. [PMID: 34475379 PMCID: PMC8413291 DOI: 10.1038/s41368-021-00134-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/24/2021] [Accepted: 07/04/2021] [Indexed: 02/07/2023] Open
Abstract
Porphyromonas gingivalis (P. gingivalis), a key pathogen in periodontitis, has been shown to accelerate the progression of atherosclerosis (AS). However, the definite mechanisms remain elusive. Emerging evidence supports an association between mitochondrial dysfunction and AS. In our study, the impact of P. gingivalis on mitochondrial dysfunction and the potential mechanism were investigated. The mitochondrial morphology of EA.hy926 cells infected with P. gingivalis was assessed by transmission electron microscopy, mitochondrial staining, and quantitative analysis of the mitochondrial network. Fluorescence staining and flow cytometry analysis were performed to determine mitochondrial reactive oxygen species (mtROS) and mitochondrial membrane potential (MMP) levels. Cellular ATP production was examined by a luminescence assay kit. The expression of key fusion and fission proteins was evaluated by western blot and immunofluorescence. Mdivi-1, a specific Drp1 inhibitor, was used to elucidate the role of Drp1 in mitochondrial dysfunction. Our findings showed that P. gingivalis infection induced mitochondrial fragmentation, increased the mtROS levels, and decreased the MMP and ATP concentration in vascular endothelial cells. We observed upregulation of Drp1 (Ser616) phosphorylation and translocation of Drp1 to mitochondria. Mdivi-1 blocked the mitochondrial fragmentation and dysfunction induced by P. gingivalis. Collectively, these results revealed that P. gingivalis infection promoted mitochondrial fragmentation and dysfunction, which was dependent on Drp1. Mitochondrial dysfunction may represent the mechanism by which P. gingivalis exacerbates atherosclerotic lesions.
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Pardo A, Signoriello A, Signoretto C, Messina E, Carelli M, Tessari M, De Manna ND, Rossetti C, Albanese M, Lombardo G, Luciani GB. Detection of Periodontal Pathogens in Oral Samples and Cardiac Specimens in Patients Undergoing Aortic Valve Replacement: A Pilot Study. J Clin Med 2021; 10:jcm10173874. [PMID: 34501320 PMCID: PMC8432007 DOI: 10.3390/jcm10173874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/16/2021] [Accepted: 08/26/2021] [Indexed: 11/29/2022] Open
Abstract
This observational study aimed to: (i) assess the presence of periodontal disease among patients requiring aortic valve replacement; (ii) investigate the presence of oral pathogens in aortic valve specimens and compare them with the microorganisms detected in the oral cavity. Twenty-six patients (15 men and 11 women) were scheduled to be visited the day before the cardiac surgery: periodontal conditions were accurately registered through clinical and radiographic examinations; dental plaque or salivary samples were collected. Valve specimens were collected during surgical aortic valve replacement and analyzed for pathogens detection through microbiological 16SrRna gene sequencing. Bacteria found in plaque samples and valve specimens were assessed according to oral and periodontal conditions. A qualitative comparison between oral and cardiac profiles of the microorganisms detected was performed. The overall number of patients examined for soft tissues conditions was 19, as 7 patients were edentulous. Twelve and three individuals, respectively, presented moderate and severe periodontitis. Nine valves were found to be positive for the presence of oral and periodontopathic bacterial DNA. The microbial species found in valve samples of patients with periodontitis suggest that the presence of these microorganisms in valvular tissue seems to be not coincidental.
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Affiliation(s)
- Alessia Pardo
- Dentistry and Maxillo-Facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.P.); (A.S.); (E.M.); (M.A.)
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.P.); (A.S.); (E.M.); (M.A.)
| | - Caterina Signoretto
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy; (C.S.); (M.C.)
| | - Elena Messina
- Dentistry and Maxillo-Facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.P.); (A.S.); (E.M.); (M.A.)
| | - Maria Carelli
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy; (C.S.); (M.C.)
| | - Maddalena Tessari
- Division of Cardiac Surgery, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale Stefani 1, 37134 Verona, Italy; (M.T.); (N.D.D.M.); (C.R.); (G.B.L.)
| | - Nunzio Davide De Manna
- Division of Cardiac Surgery, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale Stefani 1, 37134 Verona, Italy; (M.T.); (N.D.D.M.); (C.R.); (G.B.L.)
| | - Cecilia Rossetti
- Division of Cardiac Surgery, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale Stefani 1, 37134 Verona, Italy; (M.T.); (N.D.D.M.); (C.R.); (G.B.L.)
| | - Massimo Albanese
- Dentistry and Maxillo-Facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.P.); (A.S.); (E.M.); (M.A.)
| | - Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (A.P.); (A.S.); (E.M.); (M.A.)
- Correspondence: ; Tel.: +39-0458124867
| | - Giovanni Battista Luciani
- Division of Cardiac Surgery, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale Stefani 1, 37134 Verona, Italy; (M.T.); (N.D.D.M.); (C.R.); (G.B.L.)
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22
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Kajiwara K, Sawa Y. Overexpression of SGLT2 in the kidney of a P. gingivalis LPS-induced diabetic nephropathy mouse model. BMC Nephrol 2021; 22:287. [PMID: 34425759 PMCID: PMC8383391 DOI: 10.1186/s12882-021-02506-8] [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: 11/04/2020] [Accepted: 08/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background The overexpression of sodium-glucose cotransporter 2 (SGLT2) in diabetic kidneys has been reported. It has also been established that the diabetic glomerular endothelium expresses the toll-like receptors TLR2 and TLR4. The present study aims to examine the renal SGLT2 induction by the TLR2/4 ligand Porphyromonas (P.) gingivalis lipopolysaccharide (Pg-LPS) in mouse diabetic nephropathy. Methods Immunohistochemical study and tissue RT-PCR analyses were performed on mouse kidneys in streptozotocin (STZ)-induced diabetic ICR mice (STZ-ICR), in healthy ICR mice administered Pg-LPS (LPS-ICR), and in diabetic ICR mouse kidneys with Pg-LPS-induced nephropathy (LPS-STZ). Results In the quantitative analysis of blood sugar levels, the mean time to reach 600 mg/dl was shorter in the LPS-STZ than in the STZ-ICR kidneys. The rise in blood glucose levels was significantly steeper in the LPS-STZ than in the STZ-ICR kidneys. According to these data the LPS-STZ model suggests a marked glucose intolerance. The expression of SGLT2 was significantly stronger in the whole of the renal parenchyma of the LPS-STZ than in the LPS-ICR or in the STZ-ICR. The expression of SGLT2 was observed both in the renal tubules and around the renal tubules, and in the glomeruli of the LPS-STZ kidneys. In the analysis by tissue real-time PCR and cell ELISA, the expression of the SGLT2 gene and protein was significantly stronger in the LPS-STZ than in the LPS-ICR or in the STZ-ICR. There were no differences in the renal SGLT2 production in the LPS-ICR and the STZ-ICR kidneys. Conclusions Abnormally high renal expression of SGLT2 occurs in diabetic kidneys with P. gingivalis LPS. Periodontitis may be an exacerbating factor in diabetic nephropathy as well as in diabetes.
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Affiliation(s)
- Koichiro Kajiwara
- Department of Oral Growth & Development, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Yoshihiko Sawa
- Department of Oral Function & Anatomy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, Kita-ku, 700-0914, Japan.
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23
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Bregaint S, Boyer E, Fong SB, Meuric V, Bonnaure-Mallet M, Jolivet-Gougeon A. Porphyromonas gingivalis outside the oral cavity. Odontology 2021; 110:1-19. [PMID: 34410562 DOI: 10.1007/s10266-021-00647-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 07/31/2021] [Indexed: 12/14/2022]
Abstract
Porphyromonas gingivalis, a Gram-negative anaerobic bacillus present in periodontal disease, is considered one of the major pathogens in periodontitis. A literature search for English original studies, case series and review articles published up to December 2019 was performed using the MEDLINE, PubMed and GoogleScholar databases, with the search terms "Porphyromonas gingivalis" AND the potentially associated condition or systemic disease Abstracts and full text articles were used to make a review of published research literature on P. gingivalis outside the oral cavity. The main points of interest of this narrative review were: (i) a potential direct action of the bacterium and not the systemic effects of the inflammatory acute-phase response induced by the periodontitis, (ii) the presence of the bacterium (viable or not) in the organ, or (iii) the presence of its virulence factors. Virulence factors (gingipains, capsule, fimbriae, hemagglutinins, lipopolysaccharide, hemolysin, iron uptake transporters, toxic outer membrane blebs/vesicles, and DNA) associated with P. gingivalis can deregulate certain functions in humans, particularly host immune systems, and cause various local and systemic pathologies. The most recent studies linking P. gingivalis to systemic diseases were discussed, remembering particularly the molecular mechanisms involved in different infections, including cerebral, cardiovascular, pulmonary, bone, digestive and peri-natal infections. Recent involvement of P. gingivalis in neurological diseases has been demonstrated. P. gingivalis modulates cellular homeostasis and increases markers of inflammation. It is also a factor in the oxidative stress involved in beta-amyloid production.
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Affiliation(s)
- Steeve Bregaint
- Microbiology, INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Université de Rennes, U1241, 2, avenue du Professeur Léon Bernard, 35043, Rennes, France
| | - Emile Boyer
- Microbiology, INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Université de Rennes, U1241, 2, avenue du Professeur Léon Bernard, 35043, Rennes, France.,Teaching Hospital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes, France
| | - Shao Bing Fong
- Microbiology, INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Université de Rennes, U1241, 2, avenue du Professeur Léon Bernard, 35043, Rennes, France
| | - Vincent Meuric
- Microbiology, INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Université de Rennes, U1241, 2, avenue du Professeur Léon Bernard, 35043, Rennes, France.,Teaching Hospital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes, France
| | - Martine Bonnaure-Mallet
- Microbiology, INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Université de Rennes, U1241, 2, avenue du Professeur Léon Bernard, 35043, Rennes, France.,Teaching Hospital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes, France
| | - Anne Jolivet-Gougeon
- Microbiology, INSERM, INRAE, CHU Rennes, Institut NUMECAN (Nutrition Metabolisms and Cancer), Université de Rennes, U1241, 2, avenue du Professeur Léon Bernard, 35043, Rennes, France. .,Teaching Hospital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes, France.
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24
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Noreen M, Imran M, Safi SZ, Bashir MA, Gul S, Alkhuriji AF, Aloma SY, Alharbi HM, Arshad M. Protective role of TIRAP functional variant against development of coronary artery disease. Saudi J Biol Sci 2021; 28:3548-3552. [PMID: 34121897 PMCID: PMC8176052 DOI: 10.1016/j.sjbs.2021.03.028] [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] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 11/17/2022] Open
Abstract
Coronary artery disease (CAD) is the leading cause of sudden death worldwide. Inflammation is proved to be an important player in development of the CAD. Inflammation is directly regulated by the Toll like receptors (TLRs). Susceptibility of CAD is influenced by genetic variations within TLRs and the proteins involved in its signaling cascade. The TIRAP/MAL {TIR domain containing adaptor protein / MyD88 (myeloid differentiation primary response gene 88) adaptor-like} exhibits maximum genetic variations of all adaptor proteins involved in TLR signaling cascade. Susceptibility to a number of diseases can be influenced due to presence of S180L single nucleotide polymorphism (SNP) of TIRAP/MAL. This study was conducted to investigate the functional role of this well characterized S180L polymorphism on susceptibility to CAD among Pakistani patients. A total of 146 Pakistani CAD patients and 147 controls were genotyped by Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS-PCR) and the data was analyzed by using 2-tailed Chi square (x2 ) test. The p value ≤ 0.05 was considered to be significant. Significantly high frequency of homozygous L180L genotype was observed among healthy subjects as compared to the CAD patients [24 (16%) vs 7 (5%); x2 11.85; p = 0.003]. Moreover, the allele frequency of the minor allele; 180L was observed to be significantly higher among controls than the CAD patients, having same direction of association [156 (53%) vs 131 (45%); OR (95% CI) = 0.7198 (0.520-0.996); p < 0.05). Our results indicate that protective effect of L180L; a coding variant of TIRAP/MAL against CAD is discernible.
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Affiliation(s)
- Mamoona Noreen
- Atta ur Rehman School of Applied Biosciences (ASAB), National University of Sciences & Technology (NUST), H-12 sector, Islamabad, Pakistan
- Department of Zoology, The Women University Multan, Multan, Pakistan
| | - Muhammad Imran
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Sher Zaman Safi
- Interdisciplinary Research Center in Biomedical Materials (IRCBM), COMSATS Institute of Information Technology, Lahore, Pakistan
| | - Muhammad Amjad Bashir
- Department of Plant Protection Faculty of Agricultural Sciences, Ghazi University, Dera Ghazi Khan, Pakistan
| | - Sana Gul
- Department of Biological Sciences National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
| | - Afrah Fahad Alkhuriji
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Suliman Yousef Aloma
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Hanan Mualla Alharbi
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Arshad
- Atta ur Rehman School of Applied Biosciences (ASAB), National University of Sciences & Technology (NUST), H-12 sector, Islamabad, Pakistan
- University of Education, Lahore, Pakistan
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25
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Li A, Yang Y, Qin S, Lv S, Jin T, Li K, Han Z, Li Y. Microbiome analysis reveals gut microbiota alteration of early-weaned Yimeng black goats with the effect of milk replacer and age. Microb Cell Fact 2021; 20:78. [PMID: 33789672 PMCID: PMC8010993 DOI: 10.1186/s12934-021-01568-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background Colonization of intestinal microbiota in ruminant during the early life is important to host health, metabolism and immunity. Accumulating evidence revealed the ameliorative effect of milk replacer administration in the gut microbial development of early-weaned ruminants. Yimeng black goats (YBGs) inhabiting Shandong, China show a complex intestinal microbial ecosystem, but studies of their gut microbiota are still insufficient to report. Here, this study was performed to investigate how the gut microbiota develops in weaned YBGs with the effect of age and milk replacer. Results Results indicated that both age and milk replacer were important factors to change the gut microbiota of YBGs. Although the alpha diversity of gut microbiota did not change with the age of YBGs, the taxonomic compositions significantly changed. The relative abundance of some beneficial bacteria such as Lachnospiraceae, Ruminococcaceae, Ruminiclostridium, Eubacterium and Barnesiella significantly decreased and subsequently increase with age, which contributes to maintain the stability of intestinal environment and realize the diversity of intestinal functions. The relative abundance of Porphyromonas, Brevundimonas, Flavobacterium, Stenotrophomonas, Propionibacterium, Acinetobacter, Enterococcus and Clostridium belong to pathogenic bacteria in milk replacer-treated YBGs was significantly decreased. Additionally, some beneficial bacteria such as Ruminococcus, Ruminococcaceae, Christensenellaceae and Ruminiclostridium also display a trend of decreasing first followed by gradually increasing. Conclusions This study first revealed the gut bacterial community alterations in YBGs with the effect of age and milk replacer. This study also characterized the gut microbial distribution in YBGs with different ages and provided better insight into microbial population structure and diversity of YBGs. Moreover, milk replacer may serve as a good applicant for improving gut microbial development in early-weaned YBGs.
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Affiliation(s)
- Aoyun Li
- College of Agriculture and Forestry Science, Linyi University, Linyi, China.,College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, China
| | - Yan Yang
- Linyi Academy of Agricultural Sciences, Linyi, 276012, China
| | - Songkang Qin
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, 430070, China
| | - Shenjin Lv
- College of Agriculture and Forestry Science, Linyi University, Linyi, China
| | - Taihua Jin
- College of Agriculture and Forestry Science, Linyi University, Linyi, China
| | - Kun Li
- Institute of Traditional Chinese Veterinary Medicine, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, China.
| | - Zhaoqing Han
- College of Agriculture and Forestry Science, Linyi University, Linyi, China.
| | - Yongzhu Li
- College of Agriculture and Forestry Science, Linyi University, Linyi, China.
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26
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Bunte K, Kuhn C, Walther C, Peters U, Aarabi G, Smeets R, Beikler T. Clinical significance of ragA, ragB, and PG0982 genes in Porphyromonas gingivalis isolates from periodontitis patients. Eur J Oral Sci 2021; 129:e12776. [PMID: 33667038 DOI: 10.1111/eos.12776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/14/2022]
Abstract
Consistent detection of ragA, ragB, and PG0982 in the genome of Porphyromonas gingivalis (P. gingivalis) isolates from periodontitis patients suggests that genotypes containing these genes may influence virulence and P. gingivalis-associated periodontitis progression. This study evaluated the prevalence of these genes in P. gingivalis isolates from periodontitis patients (n = 28) and in isolates from periodontally healthy P. gingivalis carriers (n = 34). The association of these genes with progression of periodontitis, in vitro cell invasiveness, and bacterial survival following periodontal therapy was also assessed. Periodontal charting and microbiological sampling were done at baseline, and at 6, 12, and 24 months following subgingival debridement of the periodontitis patients. Healthy controls were assessed at baseline for comparison. P. gingivalis isolates were analysed by ragA, ragB, and PG0982 specific polymerase chain reaction (PCR) and Sanger sequencing. Primary human gingival fibroblasts were used for invasion experiments. Results showed that 25% of the tested isolates from the periodontitis group had ragB detected, whereas this gene was undetected in isolates from healthy participants. However, none of the selected genes was associated with an increased cell invasiveness in vitro, with bacterial survival, or with significant clinical periodontal parameter changes. Identification of genes that influence P.gingivalis virulence and therapeutic outcome may have a diagnostic or prognostic value.
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Affiliation(s)
- Kübra Bunte
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Carolin Walther
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Division of Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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27
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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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28
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Kato-Kogoe N, Sakaguchi S, Kamiya K, Omori M, Gu YH, Ito Y, Nakamura S, Nakano T, Tamaki J, Ueno T, Hoshiga M. Characterization of Salivary Microbiota in Patients with Atherosclerotic Cardiovascular Disease: A Case-Control Study. J Atheroscler Thromb 2021; 29:403-421. [PMID: 33612553 PMCID: PMC8894113 DOI: 10.5551/jat.60608] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims:
Oral bacteria have been reported to be associated with the pathogenesis of atherosclerosis; however, the relationship between the oral microbiota and atherosclerosis remains unclear. The present study aimed to investigate whether or not salivary microbiota of patients with atherosclerotic cardiovascular disease (ACVD) differs from that of subjects without ACVD, and to characterize the salivary microbiota of patients with ACVD.
Methods:
This study included 43 patients with ACVD and 86 age- and sex-matched non-ACVD individuals. 16S rRNA metagenomic analysis were performed using DNA isolated from the saliva samples of the participants. To select unique operational taxonomic unit (OTU) sets of ACVD, we conducted the random forest algorithm in machine learning, followed by confirmation via 10-fold cross-validation
Results:
There was no difference in richness or evenness between the ACVD and non-ACVD groups (alpha diversity; observed OTU index,
p
=0.503; Shannon’s index,
p
=0.478). However, significant differences were found in the overall salivary microbiota structure (beta diversity; unweighted UniFrac distances,
p
=0.001; weighted UniFrac distances,
p
=0.001). The Actinobacteria phylum was highly abundant in patients with ACVD, while the Bacteroidetes phylum was less abundant. The random forest classifier identified 43 OTUs as an optimal marker set of ACVD. In a 10-fold cross validation using the validation data, an area under the curve (AUC) of 0.933 (95% CI, 0.855–1.000) was obtained.
Conclusions:
The salivary microbiota in patients with ACVD was distinct from that of non-ACVD individuals, indicating that the salivary microbiota may be related to ACVD.
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Affiliation(s)
| | - Shoichi Sakaguchi
- Department of Microbiology and Infection Control, Osaka Medical College
| | - Kuniyasu Kamiya
- Department of Hygiene and Public Health, Osaka Medical College
| | - Michi Omori
- Department of Dentistry and Oral Surgery, Osaka Medical College
| | - Yan-Hong Gu
- Department of Hygiene and Public Health, Osaka Medical College
| | - Yuri Ito
- Research and Development Center, Osaka Medical College
| | - Shota Nakamura
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University
| | - Takashi Nakano
- Department of Microbiology and Infection Control, Osaka Medical College
| | - Junko Tamaki
- Department of Hygiene and Public Health, Osaka Medical College
| | - Takaaki Ueno
- Department of Dentistry and Oral Surgery, Osaka Medical College
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29
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Kajiwara K, Sawa Y, Fujita T, Tamaoki S. Immunohistochemical study for the expression of leukocyte adhesion molecules, and FGF23 and ACE2 in P. gingivalis LPS-induced diabetic nephropathy. BMC Nephrol 2021; 22:3. [PMID: 33407253 PMCID: PMC7786162 DOI: 10.1186/s12882-020-02203-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022] Open
Abstract
Objective The present study aims to examine the expression of leukocyte adhesion molecules and renal metabolic factors in diabetic mouse kidneys with periodontal pathogen Pg-LPS-induced nephropathy. Background We recently reported that the glomerular endothelium expresses toll-like receptor (TLR)2 and TLR4 in diabetic environments and TLR2/4 ligand Porphyromonas (P.) gingivalis lipopolysaccharides (Pg-LPS) induce nephropathy in diabetic mice. It is thought that Pg-LPS promotes the chronic inflammation with the overexpression of leukocyte adhesion molecules and renal-specific metabolic enzymes by the recognition of Pg-LPS via TLR in the diabetic kidneys. There have been no reports of the effects of periodontopathic bacteria on the expression of leukocyte adhesion molecules and the accumulation of physiologically active substances in the kidney. Methods The immunohistochemical investigation was performed on diabetic mouse kidney with Pg-LPS-induced nephropathy with glomerulosclerosis in glomeruli. Results There were no vessels which expressed vascular cell adhesion molecule-1 (VCAM-1), E-selectin, or fibroblast growth factor (FGF) 23 in streptozotocin (STZ)-induced diabetic ICR mice (STZ-ICR), or in healthy ICR mice administered Pg-LPS (LPS-ICR). However, in diabetic ICR mouse kidneys with Pg-LPS-induced nephropathy (LPS-STZ) the expression of VCAM-1 and the accumulation of FGF23 were observed in renal tubules and glomeruli, and the expression of E-selectin was observed in renal parenchyma and glomeruli. The angiotensin-converting enzyme 2 (ACE2) was detected in the proximal tubules but not in other regions of ICR, STZ-ICR, or LPS-ICR. In LPS-STZ ACE2 was detected both in renal tubules as well as in glomeruli. The Mac-1 and podoplanin-positive cells increased in the renal parenchyma with diabetic condition and there was the distribution of a large number of Mac-1-positive cells in LPS-STZ. Conclusions The Pg-LPS may induce diabetic renal inflammation such as glomerulosclerosis and tubulitis with infiltration of Mac-1/podoplanin positive macrophages via glomerular overexpression of VCAM-1 and E-selectin, resulting in accumulation of both ACE2 and FGF23 which were unmetabolized with the inflammation-induced kidney damage under the diabetic condition. Periodontitis may be a critical factor in the progress of nephropathy in diabetic patients.
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Affiliation(s)
- Koichiro Kajiwara
- Department of Oral Growth & Development, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Yoshihiko Sawa
- Department of Oral Function & Anatomy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-0914, Japan.
| | - Takahiro Fujita
- Department of Oral Growth & Development, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Sachio Tamaoki
- Department of Oral Growth & Development, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
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30
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Iwasaki M, Kimura Y, Yamaga T, Yamamoto N, Ishikawa M, Wada T, Sakamoto R, Ishimoto Y, Fujisawa M, Okumiya K, Otsuka K, Matsubayashi K, Ogawa H. A population-based cross-sectional study of the association between periodontitis and arterial stiffness among the older Japanese population. J Periodontal Res 2020; 56:423-431. [PMID: 33368318 DOI: 10.1111/jre.12835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/06/2020] [Accepted: 12/06/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the potential association between periodontitis and arterial stiffness among the older Japanese population. BACKGROUND The prevalence of periodontitis is increasing in Japanese older adults. Arterial stiffness increases the risks of cardiovascular events and death, morbidity, and dementia. METHODS This secondary analysis of data from a cross-sectional study evaluated the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue that was estimated by a full-mouth periodontal examination. Severe periodontitis was defined per the parameters provided by the Centers for Disease Control/American Academy of Periodontology. The Cardio-Ankle Vascular Index (CAVI) was used for measuring the overall stiffness of the artery, and higher CAVI indicated increased arterial stiffness. An ordinal logistic regression model was used to evaluate the association between periodontitis and arterial stiffness. RESULTS The analysis included 185 Japanese adults [35% men; age, mean (standard deviation) 80.2 (4.4) years]. The average PISA and the prevalence of severe periodontitis were 64.4 mm2 and 27.6%, respectively; 54 (29.2%), 56 (30.3%), and 75 (40.5%) participants were stratified to the CAVI < 9, 9 ≤ CAVI <10, and CAVI ≥ 10 groups, respectively. After adjusting for potential confounders, the odds ratio of the prevalence and severity of arterial stiffness evaluated using CAVI was 1.06 [95% confidence interval (CI) 1.01 to 1.10] for PISA per 10 mm2 and 2.12 (95% CI 1.09 to 4.11) for severe periodontitis. CONCLUSION Periodontitis was associated with arterial stiffness among Japanese older adults. Further studies are needed to investigate whether arterial stiffness is an intermediate factor in the pathway between periodontitis and systemic diseases, including cardiovascular disease and dementia.
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Affiliation(s)
| | - Yumi Kimura
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Takayuki Yamaga
- Department of Oral Health, Matsumoto Dental University, Shiojiri, Japan
| | - Naomune Yamamoto
- Department of Health Innovation, Aino University Junior College, Ibaraki, Japan
| | | | - Taizo Wada
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Ryota Sakamoto
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Yasuko Ishimoto
- Department of Health and Sports Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Michiko Fujisawa
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Kiyohito Okumiya
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | | | | | - Hiroshi Ogawa
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Mei F, Xie M, Huang X, Long Y, Lu X, Wang X, Chen L. Porphyromonas gingivalis and Its Systemic Impact: Current Status. Pathogens 2020; 9:pathogens9110944. [PMID: 33202751 PMCID: PMC7696708 DOI: 10.3390/pathogens9110944] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/24/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023] Open
Abstract
The relationship between periodontitis and systemic diseases, notably including atherosclerosis and diabetes, has been studied for several years. Porphyromonas gingivalis, a prominent component of oral microorganism communities, is the main pathogen that causes periodontitis. As a result of the extensive analysis of this organism, the evidence of its connection to systemic diseases has become more apparent over the last decade. A significant amount of research has explored the role of Porphyromonas gingivalis in atherosclerosis, Alzheimer's disease, rheumatoid arthritis, diabetes, and adverse pregnancy outcomes, while relatively few studies have examined its contribution to respiratory diseases, nonalcoholic fatty liver disease, and depression. Here, we provide an overview of the current state of knowledge about Porphyromonas gingivalis and its systemic impact in an aim to inform readers of the existing epidemiological evidence and the most recent preclinical studies. Additionally, the possible mechanisms by which Porphyromonas gingivalis is involved in the onset or exacerbation of diseases, together with its effects on systemic health, are covered. Although a few results remain controversial, it is now evident that Porphyromonas gingivalis should be regarded as a modifiable factor for several diseases.
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Affiliation(s)
- Feng Mei
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (F.M.); (M.X.); (X.H.); (Y.L.); (X.L.)
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Mengru Xie
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (F.M.); (M.X.); (X.H.); (Y.L.); (X.L.)
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Xiaofei Huang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (F.M.); (M.X.); (X.H.); (Y.L.); (X.L.)
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Yanlin Long
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (F.M.); (M.X.); (X.H.); (Y.L.); (X.L.)
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Xiaofeng Lu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (F.M.); (M.X.); (X.H.); (Y.L.); (X.L.)
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Xiaoli Wang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Correspondence: (X.W.); (L.C.)
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (F.M.); (M.X.); (X.H.); (Y.L.); (X.L.)
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
- Correspondence: (X.W.); (L.C.)
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Porphyromonas gingivalis disrupts vascular endothelial homeostasis in a TLR-NF-κB axis dependent manner. Int J Oral Sci 2020; 12:28. [PMID: 32999278 PMCID: PMC7527479 DOI: 10.1038/s41368-020-00096-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 08/15/2020] [Accepted: 08/23/2020] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular disease is still the leading cause of mortality worldwide. Vascular endothelial dysfunction is viewed as the initial step of most cardiovascular diseases. Many studies have indicated that periodontal pathogens, especially Porphyromonas gingivalis, are closely correlated with vascular endothelial homeostasis, but the function of P. gingivalis and the underlying mechanisms are still elusive. To illuminate the effects and elucidate the mechanisms of P. gingivalis on endothelial structural integrity, we developed P. gingivalis infection models in vivo and in vitro. Endothelial cell proliferation, differentiation and apoptosis were detected. Here, we showed that P. gingivalis can impair endothelial integrity by inhibiting cell proliferation and inducing endothelial mesenchymal transformation and apoptosis of endothelial cells, which reduce the cell levels and cause the endothelium to lose its ability to repair itself. A mechanistic analysis showed that TLR antagonist or NF-κB signalling inhibitor can largely rescue the damaged integrity of the endothelium caused by P. gingivalis, suggesting that TLR-NF-κB signalling plays a vital role in vascular endothelial homeostasis destroyed by P. gingivalis. These results suggest a potential intervention method for the prevention and treatment of cardiovascular disease.
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Fu E, Cheng CM, Chung CH, Lee WC, Chen WL, Sun GH, Chien WC. Association of chronic periodontitis with prostatic hyperplasia and prostatitis: A population-based cohort study in Taiwan. J Periodontol 2020; 92:72-86. [PMID: 32627845 DOI: 10.1002/jper.19-0706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/30/2020] [Accepted: 05/05/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Association between periodontitis and prostate diseases of benign prostatic hyperplasia (BPH) and prostatitis is uncertain. METHODS From the National Health Insurance Research Database of Taiwan, 5,510 patients with newly diagnosed chronic periodontitis and participated in therapies were selected from 2000 to 2015 as cohort 1. Matched with age and index year, 5,510 patients with periodontitis diagnosis without therapy were selected as cohort 2, and 5,510 participants without diagnosis were used as control. Cox proportional hazard and survival analysis were performed to compare the risks and the survival probabilities among cohorts. RESULTS In two periodontitis cohorts, 636 and 638 participants compared with 550 in control (1,174 and 1,187 versus 989 per 100,000 person-years) had prostate disorder. Difference was identified for prostatitis (n = 68, 70 versus 34; rate = 125, 130 versus 61 /100,000 person-years; P <0.001) but not for BPH (n = 577, 575, versus 529; rate = 1,065, 1,070 versus 951 /100,000 person-years, respectively). Different survival probabilities for prostate disorder and prostatitis, but not for BPH, were observed among cohorts. Periodontitis patients were more likely to develop prostate disorder after adjustment (adjusted hazard ratio [aHR] of 2.590 to 2.641 by competing model). With stratification, risks between two periodontitis cohorts exhibited no difference. When BPH cases were excluded, the aHRs for prostatitis were 4.611 to 4.798. CONCLUSIONS Despite treatment, the patients with periodontitis had higher risk of developing prostatitis than patients without periodontitis.
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Affiliation(s)
- Earl Fu
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Xindian, Taiwan, ROC.,Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chia-Mao Cheng
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Xindian, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, ROC
| | - Wei-Cheng Lee
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wei-Liang Chen
- Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC.,School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Guang-Huan Sun
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, ROC.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
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Fujitani T, Aoyama N, Hirata F, Minabe M. Association between periodontitis and vascular endothelial function using noninvasive medical device-A pilot study. Clin Exp Dent Res 2020; 6:576-582. [PMID: 32737946 PMCID: PMC7545230 DOI: 10.1002/cre2.312] [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: 04/15/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
The present study aimed to assess the relationship between periodontal condition and endothelial function using a noninvasive device. Many recent studies have reported associations between periodontitis and cardiovascular diseases. Endothelial dysfunction is the first step of atherosclerosis, but information on the association between periodontal disease and endothelial dysfunction remains limited. Thirty‐three subjects were recruited from among patients at a private medical clinic. We examined vascular endothelial function using a noninvasive medical device and periodontal measurements including probing pocket depth, attachment level, tooth mobility, and oral cleaning condition. Subjects were divided into two groups according to endothelial function score. Tooth mobility and number of lost teeth were increased in the group with endothelial dysfunction. A greater frequency of elderly subjects and altered hemoglobin A1c levels were seen in the endothelial dysfunction group. On multiple logistic regression analysis, increased tooth mobility was independently associated with endothelial dysfunction. Increased tooth mobility, a major periodontal parameter, appears related to endothelial dysfunction.
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Affiliation(s)
- Takahito Fujitani
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Norio Aoyama
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | | | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
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Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000 2020; 83:90-106. [PMID: 32385879 DOI: 10.1111/prd.12304] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerosis is central to the pathology of cardiovascular diseases, a group of diseases in which arteries become occluded with atheromas that may rupture, leading to different cardiovascular events, such as myocardial infarction or ischemic stroke. There is a large body of epidemiologic and animal model evidence associating periodontitis with atherosclerotic disease, and many potential mechanisms linking these diseases have been elucidated. This chapter will update knowledge on these mechanisms, which generally fall into 2 categories: microbial invasion and infection of atheromas; and inflammatory and immunologic. With respect to the invasion and infection of atheromas, it is well established that organisms from the subgingival biofilm can enter the circulation and lodge in most distant tissues. Bacteremias resulting from oral interventions, and even oral hygiene activities, are well documented. More recently, indirect routes of entry of oral organisms (via phagocytes or dendritic cells) have been described for many oral organisms, into many tissues. Such organisms include the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum. Intracellular survival of these organisms with dissemination to distant sites (The Trojan Horse approach) has been described. Their relative contribution to atheroma formation and progression has been studied mainly in experimental research, with results demonstrating that these organisms can invade endothelial cells and phagocytic cells within the atheroma, leading to pathogenic changes and progression of the atheroma lesion. The second category of mechanisms potentially linking periodontitis to atherosclerosis includes the dumping of inflammatory mediators originating from periodontal lesions into the systemic circulation. These inflammatory mediators, such as C-reactive protein, matrix metalloproteinases, fibrinogen, and other hemostatic factors, would further accelerate atheroma formation and progression, mainly through oxidative stress and inflammatory dysfunction. Moreover, direct effects on lipid oxidation have also been described. In summary, the evidence supports the concept that periodontitis enhances the levels of systemic mediators of inflammation that are risk factors for atherosclerotic diseases.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, NewYork, New York, USA
| | - Robert Genco
- Departments of Oral Biology, and Microbiology and Immunology, Center for Microbiome Research, University at Buffalo, Buffalo, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Hassan MO, Dix-Peek T, Duarte R, Dickens C, Naidoo S, Vachiat A, Grinter S, Manga P, Naicker S. Association of chronic inflammation and accelerated atherosclerosis among an indigenous black population with chronic kidney disease. PLoS One 2020; 15:e0232741. [PMID: 32649699 PMCID: PMC7351182 DOI: 10.1371/journal.pone.0232741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 04/03/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction Inflammation plays a major role in the development of atherosclerosis and cardiovascular morbidity and mortality in chronic kidney disease (CKD) patients. Toll-like receptor-4 (TLR4) is a major receptor for lipopolysaccharides (endotoxin) and other ligands involved in the pathogenesis of inflammation. We determined whether endotoxin levels and the presence of TLR4 polymorphisms are associated with markers of inflammation and atherosclerosis among South African CKD patients. Materials and methods Endotoxin, lipopolysaccharide binding protein (LBP), serum CD14 (sCD14), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1) and carotid intima media thickness (CIMT) were measured in 160 participants (120 CKD patients and 40 controls). Associations between endotoxins and CIMT in the presence of sCD14, IL-8 and MCP-1, were assessed using odds ratios. Participants were screened for the presence of Asp299Gly and Thr399Ile TLR4 polymorphisms, and CIMT and inflammatory markers were compared between subjects with and without TLR4 polymorphisms. Results Endotoxin levels correlated with sCD14 (r = 0.441, p<0.001) and MCP-1 (r = 0.388, p<0.001) levels while increased CIMT was associated with MCP-1 (r = 0.448, p<0.001), sCD14 levels (r = 0.476, p<0.001), LBP (r = 0.340, p<0.001), and IL-8 (r = 0.395, p<0.001). Atherosclerosis was associated with endotoxin levels (odds ratio: 4.95; 95% confidence interval: 2.52–9.73; p<0.001), and was predicted by higher serum levels of inflammatory markers. Analysis of patients with TLR4 polymorphisms showed reduced serum levels of inflammatory markers and CIMT values compared with the patients carrying the wild type TLR4 alleles. Conclusion The study demonstrated associations between circulating endotoxaemia, systemic inflammation and accelerated atherosclerosis among South African CKD patients, and showed that the atherogenic predictive power of endotoxaemia was significantly increased by the presence of elevated levels of inflammatory markers. Additional findings, which must be confirmed, suggest that TLR4 polymorphisms are associated with low levels of inflammatory markers and CIMT values.
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Affiliation(s)
- Muzamil Olamide Hassan
- Divisions of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Therese Dix-Peek
- Internal Medicine Research Laboratory, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Raquel Duarte
- Internal Medicine Research Laboratory, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Caroline Dickens
- Internal Medicine Research Laboratory, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sagren Naidoo
- Divisions of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ahmed Vachiat
- Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sacha Grinter
- Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pravin Manga
- Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Saraladevi Naicker
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Oral Microbiota and Immune System Crosstalk: A Translational Research. BIOLOGY 2020; 9:biology9060131. [PMID: 32560235 PMCID: PMC7344575 DOI: 10.3390/biology9060131] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Oral pathogens may exert the ability to trigger differently the activation of local macrophage immune responses, for instance Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans induce predominantly pro-inflammatory (M1-like phenotypes) responses, while oral commensal microbiota primarily elicits macrophage functions consistent with the anti-inflammatory (M2-like phenotypes). METHODS In healthy individuals vs. periodontal disease patients' blood samples, the differentiation process from monocyte to M1 and M2 was conducted using two typical growth factors, the granulocyte/macrophage colony stimulating factor (GM-CSF) and the macrophage colony stimulating factor (M-CSF). RESULTS In contrast with the current literature our outcomes showed a noticeable increase of macrophage polarization from healthy individuals vs. periodontal patients. The biological and clinical significance of these data was discussed. CONCLUSIONS Our translational findings showed a significant variance between control versus periodontal disease groups in M1 and M2 marker expression within the second group significantly lower skews differentiation of M2-like macrophages towards an M1-like phenotype. Macrophage polarization in periodontal tissue may be responsible for the development and progression of inflammation-induced periodontal tissue damage, including alveolar bone loss, and modulating macrophage function may be a potential strategy for periodontal disease management.
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Porphyromonas gingivalis, a Long-Range Pathogen: Systemic Impact and Therapeutic Implications. Microorganisms 2020; 8:microorganisms8060869. [PMID: 32526864 PMCID: PMC7357039 DOI: 10.3390/microorganisms8060869] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is an inflammatory disease associated with a dysbiosis of the oral flora characterized by a chronic sustained inflammation leading to destruction of tooth-supporting tissues. Over the last decade, an association between periodontitis and systemic disorders such as cardiovascular diseases, rheumatoid arthritis and obesity has been demonstrated. The role of periodontal pathogens, notably Porphyromonas gingivalis (P. gingivalis), in the onset or exacerbation of systemic diseases has been proposed. P. gingivalis expresses several virulence factors that promote its survival, spreading, and sustaining systemic inflammation. Recently, the impact of periodontitis on gut dysbiosis has also been suggested as a potential mechanism underlying the systemic influence of periodontitis. New therapeutic strategies for periodontitis and other dysbiotic conditions, including the use of beneficial microbes to restore healthy microbial flora, may pave the way to improved therapeutic outcomes and more thorough patient management.
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Microbiome composition comparison in oral and atherosclerotic plaque from patients with and without periodontitis. Odontology 2020; 109:239-249. [PMID: 32430725 DOI: 10.1007/s10266-020-00524-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/07/2020] [Indexed: 12/13/2022]
Abstract
There is no conclusive evidence regarding a causal relationship between periodontitis and atherosclerosis. In this study, we examined the microbiome in the oral cavity and atheromatous plaques from atherosclerosis patients with or without periodontitis to investigate the role of oral bacteria in the formation of atheromatous plaques. We chose four patients with and without periodontitis, who had undergone carotid endarterectomy. Bacterial samples were extracted from the tongue surface, from periodontal pocket (during the oral examination), and from the atheromatous plaques (APs). We investigated the general and oral conditions from each patient and performed next-generation sequencing (NGS) analysis for all bacterial samples. There were no significant differences between both groups concerning general conditions. However, the microbiome patterns of the gingival pocket showed differences depending on the absence or presence of periodontitis, while those of the tongue surface were relatively similar. The microbiome pattern of the atheromatous plaques was entirely different from that on the tongue surface and gingival pocket, and oral bacteria were seldom detected. However, the microbiome pattern in atheromatous plaques was different in the presence or absence of periodontitis. These results suggested that oral bacteria did not affect the formation of atheromatous plaques directly.
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Xie M, Tang Q, Nie J, Zhang C, Zhou X, Yu S, Sun J, Cheng X, Dong N, Hu Y, Chen L. BMAL1-Downregulation Aggravates Porphyromonas Gingivalis-Induced Atherosclerosis by Encouraging Oxidative Stress. Circ Res 2020; 126:e15-e29. [PMID: 32078488 DOI: 10.1161/circresaha.119.315502] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
RATIONALE Atherosclerotic cardiovascular diseases are the leading cause of mortality worldwide. Atherosclerotic cardiovascular diseases are considered as chronic inflammation processes. In addition to risk factors associated with the cardiovascular system itself, pathogenic bacteria such as the periodontitis-associated Porphyromonas gingivalis (P gingivalis) are also closely correlated with the development of atherosclerosis, but the underlying mechanisms are still elusive. OBJECTIVE To elucidate the mechanisms of P gingivalis-accelerated atherosclerosis and explore novel therapeutic strategies of atherosclerotic cardiovascular diseases. METHODS AND RESULTS Bmal1-/- (brain and muscle Arnt-like protein 1) mice, ApoE-/- mice, Bmal1-/-ApoE-/- mice, conditional endothelial cell Bmal1 knockout mice (Bmal1fl/fl; Tek-Cre mice), and the corresponding jet-legged mouse model were used. Pgingivalis accelerates atherosclerosis progression by triggering arterial oxidative stress and inflammatory responses in ApoE-/- mice, accompanied by the perturbed circadian clock. Circadian clock disruption boosts P gingivalis-induced atherosclerosis progression. The mechanistic dissection shows that P gingivalis infection activates the TLRs-NF-κB signaling axis, which subsequently recruits DNMT-1 to methylate the BMAL1 promoter and thus suppresses BMAL1 transcription. The downregulation of BMAL1 releases CLOCK, which phosphorylates p65 and further enhances NF-κB signaling, elevating oxidative stress and inflammatory response in human aortic endothelial cells. Besides, the mouse model exhibits that joint administration of metronidazole and melatonin serves as an effective strategy for treating atherosclerotic cardiovascular diseases. CONCLUSIONS P gingivalis accelerates atherosclerosis via the NF-κB-BMAL1-NF-κB signaling loop. Melatonin and metronidazole are promising auxiliary medications toward atherosclerotic cardiovascular diseases.
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Affiliation(s)
- Mengru Xie
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Qingming Tang
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Jiaming Nie
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Chao Zhang
- Department of Cardiovascular Surgery (C.Z., N.D.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Zhou
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Shaoling Yu
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Jiwei Sun
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
| | - Xiang Cheng
- Department of Cardiology (X.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nianguo Dong
- Department of Cardiovascular Surgery (C.Z., N.D.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Hu
- Institute of Hematology (Y.H.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lili Chen
- From the Department of Stomatology (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China (M.X., Q.T., J.N., X.Z., S.Y., J.S., L.C.)
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Berlin‐Broner Y, Alexiou M, Levin L, Febbraio M. Characterization of a mouse model to study the relationship between apical periodontitis and atherosclerosis. Int Endod J 2020; 53:812-823. [DOI: 10.1111/iej.13279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/10/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Y. Berlin‐Broner
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - M. Alexiou
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - L. Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - M. Febbraio
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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Role of oral pathogens in the pathogenesis of intracranial aneurysm: review of existing evidence and potential mechanisms. Neurosurg Rev 2020; 44:239-247. [PMID: 32034564 PMCID: PMC7850994 DOI: 10.1007/s10143-020-01253-y] [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: 11/24/2019] [Revised: 01/12/2020] [Accepted: 01/27/2020] [Indexed: 12/13/2022]
Abstract
Degeneration of intracranial aneurysm wall is under active research and recent studies indicate an increased risk of rupture of intracranial aneurysm among patients with periodontal diseases. In addition, oral bacterial DNA has been identified from wall samples of ruptured and unruptured aneurysms. These novel findings led us to evaluate if oral diseases could predispose to pathological changes seen on intracranial aneurysm walls eventually leading to subarachnoid hemorrhage. The aim of this review is to consider mechanisms on the relationship between periodontitis and aneurysm rupture, focusing on recent evidence.
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Porphyromonas gingivalis triggers the shedding of inflammatory endothelial microvesicles that act as autocrine effectors of endothelial dysfunction. Sci Rep 2020; 10:1778. [PMID: 32019950 PMCID: PMC7000667 DOI: 10.1038/s41598-020-58374-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022] Open
Abstract
A link between periodontitis and atherothrombosis has been highlighted. The aim of this study was to determine the influence of Porphyromonas gingivalis on endothelial microvesicles (EMVPg) shedding and their contribution to endothelial inflammation. Endothelial cells (EC) were infected with P. gingivalis (MOI = 100) for 24 h. EMVPg were isolated and their concentration was evaluated by prothrombinase assay. EMVPg were significantly increased in comparison with EMVCtrl shedded by unstimulated cells. While EMVCtrl from untreated EC had no effect, whereas, the proportion of apoptotic EC was increased by 30 nM EMVPg and viability was decreased down to 25%, a value elicited by P. gingivalis alone. Moreover, high concentration of EMVPg (30 nM) induced a pro-inflammatory and pro-oxidative cell response including up-regulation of TNF-α, IL-6 and IL-8 as well as an altered expression of iNOS and eNOS at both mRNA and protein level. An increase of VCAM-1 and ICAM-1 mRNA expression (4.5 folds and 3 folds respectively (p < 0.05 vs untreated) was also observed after EMVPg (30 nM) stimulation whereas P. gingivalis infection was less effective, suggesting a specific triggering by EMVPg. Kinasome analysis demonstrated the specific effect induced by EMVPg on main pro-inflammatory pathways including JNK/AKT and STAT. EMVPg are effective pro-inflammatory effectors that may have detrimental effect on vascular homeostasis and should be considered as potential autocrine and paracrine effectors involved in the link between periodontitis and atherothrombosis.
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Liu X, Wang Z, Song W, Sun W, Hong R, Pothukuchi A, Xu Q. Systematically transplanted human gingiva-derived mesenchymal stem cells regulate lipid metabolism and inflammation in hyperlipidemic mice with periodontitis. Exp Ther Med 2019; 19:672-682. [PMID: 31885706 PMCID: PMC6913381 DOI: 10.3892/etm.2019.8256] [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: 10/21/2018] [Accepted: 11/07/2019] [Indexed: 12/21/2022] Open
Abstract
Gingiva-derived mesenchymal stem cells (GMSCs) have been the focus of extensive research due to their numerous distinct properties, including their homing to injury sites and their contribution to tissue regeneration. However, the role of transplanted GMSCs in the regulation of lipid metabolism and inflammation in hyperlipidemic mice with periodontitis has not been demonstrated. In the present study, apolipoprotein E-deficient (ApoE−/−) mice were used to establish a hyperlipidemia model with periodontitis and divided into two groups: Group B and Group C (n=20 per group), and wild-type C57BL/6J mice without any treatment were assigned to Group A (n=20). Animals in Group C were then injected with human GMSCs through the tail vein and animals in Group B were injected with α-MEM as control. Animals were sacrificed at indicated time points. Serum was collected to determine the lipids and inflammatory cytokines. Liver samples were collected to estimate lipid-associated gene expression. Morphometric and histological analyses were performed to maxillaries. The results demonstrated that the delivery of GMSCs led to a significant decrease in triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL), interleukin (IL)-6, tumor necrosis factor (TNF)-α, alveolar bone loss (ABL), and sterol regulatory element binding protein-1c (SREBP-1c) mRNA, and a significant increase in high density lipoprotein cholesterol (HDL), IL-10 and peroxisome proliferator-activated receptor α (PPARα) mRNA in Group C compared to Group B. Histological examination showed increased formation of new bone and higher alveolar bone height in Group C. Systematically transplanted GFP-positive cells were detected through both fluorescence microscope observation and immunohistochemical staining in the periodontal tissues. Overall, systematically transplanted GMSCs attenuated the hyperlipidemia and inflammatory responses in hyperlipidemic mice with periodontitis, and improved periodontal tissue regeneration.
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Affiliation(s)
- Xiaoxuan Liu
- Department of Stomatology, Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China.,Department of Stomatology, Yidu Central Hospital of Weifang, Weifang, Shandong 262500, P.R. China
| | - Zhiguo Wang
- Department of Burn and Plastic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Wenbin Song
- Department of Stomatology, Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Wendong Sun
- Department of Stomatology, Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Rundan Hong
- Department of Stomatology, Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Anita Pothukuchi
- Department of Physical and Biological Sciences, University of California, Santa Cruz, CA 95064, USA
| | - Quanchen Xu
- Department of Stomatology, Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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45
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Iwai T, Matsui Y, Homma K, Takemura T, Fujiwara M, Aoyama N, Sato H, Izumi Y. Oral-bacterial-induced arterial and venous thrombus in rats: Pathological and immunological studies. Clin Exp Dent Res 2019; 5:497-504. [PMID: 31687183 PMCID: PMC6820577 DOI: 10.1002/cre2.215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 11/06/2022] Open
Abstract
Objectives Our study investigated the pathological outcome of experimental thrombi that incorporate oral bacteria. Material and methods A small artery and vein in the rats' groins were injected with a solution containing periodontal bacteria Porphyromonas gingivalis and followed up for 28 days. In all, 18 limbs of nine male rats (500-650 g) were used for the arterial study, and eight limbs of four rats were used for the veins. Two densities of the bacterial solution and two arterial thicknesses sizes were used in the arterial study. Both proximal and distal arteries and veins were ligated loosely using a monofilament nylon suture before bacterial suspensions or control solutions were injected into the ligated vessels. Results After 7, 14-18, and 28 days, the rats were sacrificed. Pathology and immunohistochemistry were performed. All specimens exhibited thrombus formation and an acute inflammation reaction with granulocytes at 7 days and then settled down to chronic fibrous change with plasma cells or macrophages at 28 days in the arterial thrombus. CD3 (Pan T-cells), CD79a (Pan B cells in the rats), and IgG were observed in the process of the healing of the arterial thrombus. Venous changes showed relatively clear recanalization that appeared at 7 days, which is slightly different from the artery. Granulocytes were present from 7 to 28 days. Conclusions Periodontal bacteria act as an inflammatory core in the vessels, but not as an infectious agent, in our experiments, because of their low ability to invade tissues.
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Affiliation(s)
- Takehisa Iwai
- Division of Vascular Surgery and Collagen Disease Medicine Tsukuba Vascular Center Ibaraki Japan
| | - Yoshiki Matsui
- Division of Vascular Surgery and Collagen Disease Medicine Tsukuba Vascular Center Ibaraki Japan
| | - Kaori Homma
- Division of Vascular Surgery and Collagen Disease Medicine Tsukuba Vascular Center Ibaraki Japan
| | - Tamiko Takemura
- Section of Pathology Japanese Red-Cross Medical Center Tokyo Japan
| | | | - Norio Aoyama
- Department of Periodontology Kanagawa Dental University Kanagawa Japan
| | - Hiroki Sato
- Department of Periodontology Tokyo Medical and Dental University Tokyo Japan
| | - Yuichi Izumi
- Department of Periodontology Tokyo Medical and Dental University Tokyo Japan
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46
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Aoyama N, Kure K, Minabe M, Izumi Y. Increased Heart Failure Prevalence in Patients with a High Antibody Level Against Periodontal Pathogen. Int Heart J 2019; 60:1142-1146. [PMID: 31447467 DOI: 10.1536/ihj.19-010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to assess whether a specific cardiovascular disease was related to an increased antibody level against a periodontal pathogen.A strong association between cardiovascular disease and periodontitis was shown, however, the causal relationship was not proven. Increased inflammatory reaction of patients with periodontitis was a possible factor, which connected periodontal infection and vascular diseases.We assessed medical history, blood data, and periodontal conditions in patients with cardiovascular diseases. Serum IgG antibody titers against major periodontal pathogens and existence of salivary periodontal bacteria were analyzed.In total, 348 subjects were enrolled in this study. The patients who exhibited 10,000 counts/mL or more of salivary Porphyromonas gingivalis were divided into two groups according to the antibody level of the pathogen. Patients with a high antibody level against Porphyromonas gingivalis exhibited a high rate of heart failure compared to the low antibody group. Mean probing pocket depth and clinical attachment level significantly increased in the high antibody group. We found that the high anti-Porphyromonas gingivalis antibody group also experienced enhanced antibody levels against other periodontal bacteria.An increased heart failure prevalence was found in patients with a high antibody level against a major periodontal pathogen, Porphyromonas gingivalis.
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Affiliation(s)
- Norio Aoyama
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University
| | - Keitetsu Kure
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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47
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Xia MY, Xie Y, Yu CH, Chen GY, Li YH, Zhang T, Peng Q. Graphene-based nanomaterials: the promising active agents for antibiotics-independent antibacterial applications. J Control Release 2019; 307:16-31. [PMID: 31185232 DOI: 10.1016/j.jconrel.2019.06.011] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 02/05/2023]
Abstract
Graphene-based nanomaterials, such as graphene oxide (GO) and reduced graphene oxide (rGO), have shown great potentials in drug delivery and photodynamic/photothermal therapy due to their featured structure and physicochemical properties. In recent years, their antibacterial potentials have also been exploited. The commonly recognized antibacterial mechanisms include sharp edge-mediated cutting effect, oxidative stress and cell entrapment. This antibacterial activity is very important for human health. As we know, infection with the pathogenic bacteria, especially the drug-resistant ones, is a great threat to human lives. Thus, the development of the antibiotics-independent and drug-free antibacterial agents is of great importance and significance. Graphene-based nanomaterials are a kind of such antibacterial agents. An insight into their properties and antibacterial mechanisms is necessary before they are developed into real products. Herein, we provide a comprehensive understanding of the antibacterial application of graphene-based nanomaterials via summarizing their antibacterial activities against some typical microbial species and discussing their unique mechanisms. In addition, the side-effects and problems in using these nanomaterials are also discussed.
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Affiliation(s)
- Meng-Ying Xia
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yu Xie
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chen-Hao Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ge-Yun Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yuan-Hong Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ting Zhang
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiang Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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48
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O'Boyle C, Haley MJ, Lemarchand E, Smith CJ, Allan SM, Konkel JE, Lawrence CB. Ligature-induced periodontitis induces systemic inflammation but does not alter acute outcome after stroke in mice. Int J Stroke 2019; 15:175-187. [PMID: 30794103 PMCID: PMC7045281 DOI: 10.1177/1747493019834191] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Stroke is a major cause of disability and mortality. Poorer outcome after stroke is associated with concomitant inflammatory and infectious disease. Periodontitis is a chronic inflammatory disease of the dental supporting structures and is a prominent risk factor for many systemic disorders, including cardiovascular disease and stroke. While epidemiological studies suggest that periodontitis increases the likelihood of stroke, its impact on stroke severity is poorly understood. Here, we sought to determine the contribution of periodontitis to acute stroke pathology. Methods We characterized a murine ligature model of periodontitis for inflammatory responses that could potentially impact stroke outcome. We applied this model and then subjected mice to either transient or permanent middle cerebral artery occlusion. We also enhanced the periodontitis model with repeated intravenous administration of a periodontal-specific lipopolysaccharide to better mimic the clinical condition. Results Ligature-induced periodontitis caused bone loss, bacterial growth, and increased local inflammatory cell trafficking. Systemically, periodontitis increased circulating levels of pro-inflammatory cytokines, and primed bone marrow monocytes to produce elevated tumour necrosis factor-alpha (TNFα). Despite these changes, periodontitis alone or in tandem with repeated lipopolysaccharide challenge did not alter infarct volume, blood–brain barrier breakdown, or systemic inflammation after experimental stroke. Conclusions Our data show that despite elevated systemic inflammation in periodontitis, oral inflammatory disease does not impact acute stroke pathology in terms of severity, determined primarily by infarct volume. This indicates that, at least in this experimental paradigm, periodontitis alone does not alter acute outcome after cerebral ischemia.
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Affiliation(s)
- Conor O'Boyle
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Michael J Haley
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Eloise Lemarchand
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Craig J Smith
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,Greater Manchester Comprehensive Stroke Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK
| | - Stuart M Allan
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Joanne E Konkel
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,Manchester Collaborative Centre for Inflammation Research (MCCIR), Core Technology Facility, The University of Manchester, Manchester, UK
| | - Catherine B Lawrence
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
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49
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Pereira LC, Nascimento JCR, Rêgo JMC, Canuto KM, Crespo-Lopez ME, Alvarez-Leite JI, Baysan A, Oriá RB. Apolipoprotein E, periodontal disease and the risk for atherosclerosis: a review. Arch Oral Biol 2018; 98:204-212. [PMID: 30503976 DOI: 10.1016/j.archoralbio.2018.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/25/2018] [Accepted: 11/10/2018] [Indexed: 12/26/2022]
Abstract
The association between cardiovascular and periodontal diseases is characterized by chronic inflammatory processes, with a high prevalence worldwide and complex genetic-environment interactions. Although apolipoprotein E4 (ApoE4), one of the isoforms coded by a polymorphic APOE gene, has been widely recognized as a risk factor for cardiovascular diseases and as an immunoinflammatory factor, less is known regarding how ApoE4 affects atherosclerosis in periodontitis patients. The aim of this review was to investigate the potential underlying mechanisms related to APOE4 that could increase the risk of periodontal disease and, ultimately, of atherosclerosis. There have only been a few studies addressing apoE polymorphisms in patients with chronic periodontitis. To date, no studies have been performed that have assessed how ApoE4 affects atherosclerotic disease in chronic periodontitis patients. Although clinical studies are warranted, experimental studies have consistently documented the presence of periodontal pathogens, which are usually found in the oral cavity and saliva, in the atherosclerotic plaques of ApoE-deficient mice. In addition, in this review, the potential role of the APOE4 allele as an example of antagonistic pleiotropy during human evolution and its relation to oral health is discussed.
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Affiliation(s)
- L C Pereira
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - J C R Nascimento
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - J M C Rêgo
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - K M Canuto
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - M E Crespo-Lopez
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Para, Belém, PA, Brazil
| | - J I Alvarez-Leite
- Institute of Biological Sciences, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - A Baysan
- Institute of Dentistry, Barts and the London, School of Medicine and Dentistry, Queen Mary University, London, UK
| | - R B Oriá
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil.
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50
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Aoyama N, Kobayashi N, Hanatani T, Ashigaki N, Yoshida A, Shiheido Y, Sato H, Takamura C, Yoshikawa S, Matsuo K, Izumi Y, Isobe M. Periodontal condition in Japanese coronary heart disease patients: A comparison between coronary and non‐coronary heart diseases. J Periodontal Res 2018; 54:259-265. [DOI: 10.1111/jre.12626] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 09/22/2018] [Accepted: 10/11/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Norio Aoyama
- Division of PeriodontologyDepartment of Oral Interdisciplinary MedicineGraduate School of DentistryKanagawa Dental University Yokosuka Kanagawa Japan
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Tokyo Japan
| | - Naho Kobayashi
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Tokyo Japan
| | - Tomoya Hanatani
- Division of PeriodontologyKyushu Dental University Kitakyushu Fukuoka Japan
| | - Norihiko Ashigaki
- Department of Oral MicrobiologyTsurumi University Yokohama Kanagawa Japan
| | - Asuka Yoshida
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Tokyo Japan
| | - Yuka Shiheido
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Tokyo Japan
| | - Hiroki Sato
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Tokyo Japan
| | - Chisato Takamura
- Department of Cardiovascular MedicineTokyo Medical and Dental University Tokyo Japan
| | - Shunji Yoshikawa
- Department of Cardiovascular MedicineTokyo Medical and Dental University Tokyo Japan
| | | | - Yuichi Izumi
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Tokyo Japan
| | - Mitsuaki Isobe
- Department of Cardiovascular MedicineTokyo Medical and Dental University Tokyo Japan
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