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Meng R, Xu J, Fan C, Liao H, Wu Z, Zeng Q. Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis. BMC Oral Health 2024; 24:692. [PMID: 38877442 PMCID: PMC11177403 DOI: 10.1186/s12903-024-04433-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of mortality in the world. Patients with periodontitis have a higher risk of CVD, although a causal relationship between these conditions remains unclear. Non-surgical periodontal therapy (NSPT) is able to control inflammation at local and systemic levels. This study aimed to analyze the effect of NSPT on CVD risk markers. METHODS Four electronic databases were searched from their inception to April 1, 2023, to identify and select articles without any language restrictions. Eleven CVD-related markers (e.g., C-reactive protein [CRP], Interleukin-6 [IL-6]) were selected. Meta-analyses were performed using random and fixed effect models. The differences were expressed as weighted mean differences (WMD) and 95% confidence interval (95% CI). RESULTS From 1353 studies, twenty-one randomized controlled clinical trials were included in the meta-analysis. Results showed a significant decrease in CRP, IL-6, and systolic blood pressure (SBP) after NSPT. CONCLUSION Moderate certainty evidence shows that NSPT has a positive effect on the reduction of IL-6 and SBP in patients with periodontitis, while low certainty evidence shows that NSPT is effective for reduction of CRP. Moderate certainty evidence showed that NSPT did not show a positive effect on low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglycerides (TG), and low certainty evidence showed that NSPT did not show a positive effect on Interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), diastolic blood pressure (DBP), and flow-mediated dilatation (FMD). PROTOCOL REGISTRATION The protocol was registered in the PROSPERO (International Prospective Register of Systematic Reviews), number CRD42022377565.
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Affiliation(s)
- Rijing Meng
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China
| | - Jialei Xu
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China
| | - Chenrui Fan
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China
| | - Haiqing Liao
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China.
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China.
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China.
| | - Zeni Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Qixin Zeng
- Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, No. 22, Shuangyong Road, Qingxiu District, Nanning, 530021, Guangxi, China.
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, China.
- Guangxi Health Commission Key laboratory of prevention and treatment for oral infectious diseases, Nanning, China.
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2
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Rajendran V, Uppoor A, Nayak SU, Rao SB, Dasson Bajaj P. Unraveling the cognitive implications among individuals with co-occurring chronic periodontitis and type 2 diabetes mellitus: a cross-sectional study. J Oral Biosci 2024:S1349-0079(24)00091-4. [PMID: 38815752 DOI: 10.1016/j.job.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES Chronic periodontitis and type 2 diabetes mellitus (T2DM) are associated with cognitive decline when examined individually. To gain deeper insight into the combined effects of these conditions on cognitive decline, the present study aimed to examine the cognitive status of individuals with co-occurring T2DM and chronic periodontitis. METHODS We recruited 220 participants categorized into four groups: Group I, healthy subjects; Group II, individuals with chronic periodontitis; Group III, individuals with T2DM; and Group IV, individuals with both T2DM and chronic periodontitis. Medical histories were recorded for all participants, followed by periodontal examination and evaluation of cognitive status using the Montreal Cognitive Assessment (MoCA) scale. Finger dexterity was assessed using the nine-hole peg test. RESULTS A statistically significant increase in the proportion of mild cognitive impairment (MCI) was observed between groups I and IV (p<0.001). Logistic regression analysis revealed that, among the parameters assessed in this study, the adjusted odds ratio (OR) was significant for age, finger dexterity scores, and co-occurrence of T2DM and periodontitis. CONCLUSIONS The findings of this study suggest that the co-occurrence of chronic periodontitis and T2DM can have a detrimental effect on the cognitive abilities of an individual. Subsequent research should include longitudinal monitoring of the cognitive status in patients with concurrent conditions during treatment to gain deeper prognostic insights into the relationship between these co-occurring conditions and cognitive decline.
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Affiliation(s)
- Valliammai Rajendran
- Department of Periodontology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Ashita Uppoor
- Department of Periodontology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Sangeeta Umesh Nayak
- Department of Periodontology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Satish B Rao
- Department of Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Parul Dasson Bajaj
- Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
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3
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Altamura S, Del Pinto R, Pietropaoli D, Ferri C. Oral health as a modifiable risk factor for cardiovascular diseases. Trends Cardiovasc Med 2024; 34:267-275. [PMID: 36963476 PMCID: PMC10517086 DOI: 10.1016/j.tcm.2023.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 03/26/2023]
Abstract
Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide with a high socioeconomic burden. Increasing evidence supports a convincing connection with increased cardiovascular risk of periodontal diseases (PD), a group of widespread, debilitating, and costly dysbiotic relapsing-remitting inflammatory diseases of the tissues supporting the teeth. Herein, we ensembled the best available evidence on the connection between CVDs and PD to review the recently emerging concept of the latter as a non-traditional risk factor for CVDs. We focused on oral dysbiosis, inflammation-associated molecular and cellular mechanisms, and epigenetic changes as potential causative links between PD and CVDs. The available evidence on the effects of periodontal treatment on cardiovascular risk factors and diseases was also described.
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Affiliation(s)
- Serena Altamura
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Center of Oral Diseases, Prevention and Translational Research - Dental Clinic, L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy; PhD School in Medicine and Public Health
| | - Rita Del Pinto
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy; Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
| | - Davide Pietropaoli
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Center of Oral Diseases, Prevention and Translational Research - Dental Clinic, L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy.
| | - Claudio Ferri
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Italy; Oral Diseases and Systemic Interactions Study Group (ODISSY Group), L'Aquila, Italy; Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, L'Aquila, Italy
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4
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Ali Daily Z, Al-Ghurabi BH, Al-Qarakhli AMA, Hussein HM. Association Between AIM2 and Pycard Genes Polymorphisms and Susceptibility to Periodontitis with Coronary Heart Disease. Clin Cosmet Investig Dent 2023; 15:307-320. [PMID: 38023488 PMCID: PMC10667083 DOI: 10.2147/ccide.s440577] [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] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Numerous genetic variations in inflammasome components are linked to prevalent disorders in the general population, including periodontitis and cardiovascular illness. Polymorphisms in the genes play a critical in the initiation and development of inflammatory diseases. The limited study on AIM2 gene variation associated with inflammatory disease and no study of PYCARD gene variation associated with inflammatory disease. Objective This case-control study was to examine the association between the single nucleotide polymorphism of AIM2 and Pycard genes with susceptibility to periodontitis with and without coronary heart disease, to determine interleuken-18 and gasdermin D levels in the saliva of periodontitis with and without coronary heart disease patients, as well as their correlation with salivary interleuken-18 and gasdermin D levels and clinical periodontal parameters. Methods The present study recruited 120 participants: 30 were healthy subjects (control, C), 30 had generalized periodontitis (P), 30 had atherosclerosis coronary heart disease with clinically healthy periodontium (AS-C), and 30 had atherosclerosis coronary heart disease with generalized periodontitis (AS-P). All individuals' demographic data recorded, saliva and blood samples collected, then periodontal characteristics were detailed. These parameters include plaque index, bleeding on probing, probing pocket depth, and clinical attachment loss. AIM2 and Pycard gene polymorphisms were analyzed by polymerase chain reaction assay, electrophoresis and sequencing. An enzyme-linked immunosorbent assay (ELISA) was conducted to determine the level of interleuken-18 and gasdermin D in their saliva. Results The study result of high frequency (T) in single-nucleotide polymorphisms. The high genotypes distribution of GT and TT genotypes in the AIM2 gene and the CT and TT genotypes in the Pycard gene were detected in the periodontitis, atherosclerosis coronary heart disease with healthy periodontium and atherosclerosis coronary heart disease with generalized periodontitis groups as compared to control group. Elevation of salivary interleuken-18 and gasdermin D levels in three patients' groups compared to healthy controls. Both these single-nucleotide polymorphisms also significantly correlated with higher salivary interleuken-18 and gasdermin D levels and worse clinical indices of periodontitis. Conclusion Single-nucleotide polymorphisms in the AIM2 and Pycard genes are associated with an increased risk of developing periodontitis with and/or without coronary heart disease. Elevation of salivary interleuken-18 and gasdermin D levels associated and impacted on periodontitis with and/or without coronary heart disease. These single-nucleotide polymorphisms may provide evidence for a genetic role in the pathogenesis of periodontitis with and without atherosclerosis coronary heart disease.
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Affiliation(s)
- Zina Ali Daily
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | | | | | - Hashim Mueen Hussein
- Department of Conservative Dentistry, College of Dentistry, University of Mustansiriyah, Baghdad, Iraq
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5
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Etta I, Kambham S, Girigosavi KB, Panjiyar BK. Mouth-Heart Connection: A Systematic Review on the Impact of Periodontal Disease on Cardiovascular Health. Cureus 2023; 15:e46585. [PMID: 37933364 PMCID: PMC10625740 DOI: 10.7759/cureus.46585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Periodontal diseases (PDs) and cardiovascular diseases (CVDs) are highly prevalent global diseases with increasing percentages of morbidity and mortality. Both PD and CVDs independently have multifactorial causation, and emerging evidence shows an association between PD and CVDs. Periodontal diseases like gingivitis and periodontitis are chronic inflammatory conditions that eventually cause systemic inflammation, leading to many systemic diseases like rheumatoid arthritis, cardiovascular diseases, and others. In this study, we followed a systematic review approach to give an overview of the current evidence on the association between PD and CVDs. We used a relevant search strategy to retrieve articles from databases such as PubMed and Google Scholar from 2013 to July 2023. Upon applying filters and screening through titles and abstracts, we could narrow down articles to 21. On full-text screening, we selected 10 articles for in-depth analysis. This study showed a significant correlation between PD and CVDs. Poor oral hygiene, infection, and inflammation in the oral cavity lead to systemic inflammation, causing endothelial dysfunction. There are controversial views about PD acting as an independent risk factor for CVD development, as there are other risk factors such as age, gender, smoking, etc. acting as confounding factors while establishing the link between PD and CVDs. Knowledge about oral health, maintaining good oral hygiene, and proper treatment for PD could reduce the incidence of CVDs. Further research is needed to prove that PD is an independent risk factor for CVDs.
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Affiliation(s)
- Indu Etta
- Internal Medicine, Kakatiya Medical College, Warangal, IND
| | - Saisravika Kambham
- Internal Medicine, Dr. Bhim Rao Ambedkar Medical College and Hospital, Bangalore, IND
| | - Khushal B Girigosavi
- Neurology, Dr. Vasantrao Pawar Medical College, Hospital and Research Center, Nashik, IND
| | - Binay K Panjiyar
- Internal Medicine, Harvard Medical School, Boston, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Gualtero DF, Lafaurie GI, Buitrago DM, Castillo Y, Vargas-Sanchez PK, Castillo DM. Oral microbiome mediated inflammation, a potential inductor of vascular diseases: a comprehensive review. Front Cardiovasc Med 2023; 10:1250263. [PMID: 37711554 PMCID: PMC10498784 DOI: 10.3389/fcvm.2023.1250263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
The dysbiosis of the oral microbiome and vascular translocation of the periodontopathic microorganism to peripheral blood can cause local and systemic extra-oral inflammation. Microorganisms associated with the subgingival biofilm are readily translocated to the peripheral circulation, generating bacteremia and endotoxemia, increasing the inflammation in the vascular endothelium and resulting in endothelial dysfunction. This review aimed to demonstrate how the dysbiosis of the oral microbiome and the translocation of oral pathogen-induced inflammation to peripheral blood may be linked to cardiovascular diseases (CVDs). The dysbiosis of the oral microbiome can regulate blood pressure and activate endothelial dysfunction. Similarly, the passage of periodontal microorganisms into the peripheral circulation and their virulence factors have been associated with a vascular compartment with a great capacity to activate endothelial cells, monocytes, macrophages, and plaquettes and increase interleukin and chemokine secretion, as well as oxidative stress. This inflammatory process is related to atherosclerosis, hypertension, thrombosis, and stroke. Therefore, oral diseases could be involved in CVDs via inflammation. The preclinic and clinical evidence suggests that periodontal disease increases the proinflammatory markers associated with endothelial dysfunction. Likewise, the evidence from clinical studies of periodontal treatment in the long term evidenced the reduction of these markers and improved overall health in patients with CVDs.
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7
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Fernandes D, Khambata RS, Massimo G, Ruivo E, Gee LC, Foster J, Goddard A, Curtis M, Barnes MR, Wade WG, Godec T, Orlandi M, D'Aiuto F, Ahluwalia A. Local delivery of nitric oxide prevents endothelial dysfunction in periodontitis. Pharmacol Res 2023; 188:106616. [PMID: 36566926 DOI: 10.1016/j.phrs.2022.106616] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/01/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
AIMS Increased cardiovascular disease risk underlies elevated rates of mortality in individuals with periodontitis. A key characteristic of those with increased cardiovascular risk is endothelial dysfunction, a phenomenon synonymous with deficiencies of bioavailable nitric oxide (NO), and prominently expressed in patients with periodontitis. Also, inorganic nitrate can be reduced to NO in vivo to restore NO levels, leading us to hypothesise that its use may be beneficial in reducing periodontitis-associated endothelial dysfunction. Herein we sought to determine whether inorganic nitrate improves endothelial function in the setting of periodontitis and if so to determine the mechanisms underpinning any responses seen. METHODS AND RESULTS Periodontitis was induced in mice by placement of a ligature for 14 days around the second molar. Treatment in vivo with potassium nitrate, either prior to or following establishment of experimental periodontitis, attenuated endothelial dysfunction, as determined by assessment of acetylcholine-induced relaxation of aortic rings, compared to control (potassium chloride treatment). These beneficial effects were associated with a suppression of vascular wall inflammatory pathways (assessed by quantitative-PCR), increases in the anti-inflammatory cytokine interleukin (IL)-10 and reduced tissue oxidative stress due to attenuation of xanthine oxidoreductase-dependent superoxide generation. In patients with periodontitis, plasma nitrite levels were not associated with endothelial function indicating dysfunction. CONCLUSION Our results suggest that inorganic nitrate protects against, and can partially reverse pre-existing, periodontitis-induced endothelial dysfunction through restoration of nitrite and thus NO levels. This research highlights the potential of dietary nitrate as adjunct therapy to target the associated negative cardiovascular outcomes in patients with periodontitis.
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Affiliation(s)
- Daniel Fernandes
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; Department of Pharmacology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Rayomand S Khambata
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Gianmichele Massimo
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Ernesto Ruivo
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Lorna C Gee
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Julie Foster
- Centre for Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Alison Goddard
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Mike Curtis
- Centre for Host-Microbiome Interactions, King's College London, London, UK
| | - Michael R Barnes
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - William G Wade
- Centre for Host-Microbiome Interactions, King's College London, London, UK; Forsyth Institute, Cambridge, MA 02142, USA
| | - Thomas Godec
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | | | - Amrita Ahluwalia
- William Harvey Research Institute, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
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Kato-Kogoe N, Kamiya K, Sakaguchi S, Omori M, Komori E, Kudo A, Nakamura S, Nakano T, Ueno T, Tamaki J, Hoshiga M. Salivary Microbiota Associated with Peripheral Microvascular Endothelial Dysfunction. J Atheroscler Thromb 2022. [PMID: 36130883 DOI: 10.5551/jat.63681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Oral health is associated with atherosclerotic cardiovascular disease (ACVD). We previously identified the salivary microbiota characteristics of patients with ACVD. However, whether salivary microbiota is characteristic under impaired vascular endothelial function before ACVD onset remains unclear. Therefore, we aimed to evaluate the characteristics of salivary microbiota associated with peripheral microvascular endothelial dysfunction. METHODS We collected saliva samples from 172 community-dwelling elderly individuals without a history of ACVD and performed 16S rRNA metagenomic analysis. We assessed the peripheral microvascular endothelial function using reactive hyperemia index (RHI) and compared the salivary microbiota in the groups with normal (RHI ≥ 2.10), borderline, and abnormal (RHI <1.67) peripheral endothelial function. Furthermore, we applied machine learning techniques to evaluate whether salivary microbiota could discriminate between individuals with normal and abnormal endothelial function. RESULTS The number of operational taxonomic units (OTUs) was higher in the abnormal group than in the normal group (p=0.037), and differences were found in the overall salivary microbiota structure (unweighted UniFrac distances, p=0.038). The linear discriminant analysis (LDA) effect size (LEfSe) algorithm revealed several significantly differentially abundant bacterial genera between the two groups. An Extra Trees classifier model was built to discriminate between groups with normal and abnormal vascular endothelial function based on the microbial composition at the genus level (AUC=0.810). CONCLUSIONS The salivary microbiota in individuals with endothelial dysfunction was distinct from that in individuals with normal endothelial function, indicating that the salivary microbiota may be related to endothelial function.
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Affiliation(s)
- Nahoko Kato-Kogoe
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Kuniyasu Kamiya
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Shoichi Sakaguchi
- Department of Microbiology and Infection Control, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Michi Omori
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Eri Komori
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Asako Kudo
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - 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, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Takaaki Ueno
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Junko Tamaki
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Masaoki Hoshiga
- Department of Cardiology, Faculty of Medicine, Osaka Medical and Pharmaceutical University
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9
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Li Q, Ouyang X, Lin J. The impact of periodontitis on vascular endothelial dysfunction. Front Cell Infect Microbiol 2022; 12:998313. [PMID: 36118034 PMCID: PMC9480849 DOI: 10.3389/fcimb.2022.998313] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022] Open
Abstract
Periodontitis, an oral inflammatory disease, originates from periodontal microbiota dysbiosis which is associated with the dysregulation of host immunoinflammatory response. This chronic infection is not only harmful to oral health but is also a risk factor for the onset and progress of various vascular diseases, such as hypertension, atherosclerosis, and coronary arterial disease. Vascular endothelial dysfunction is the initial key pathological feature of vascular diseases. Clarifying the association between periodontitis and vascular endothelial dysfunction is undoubtedly a key breakthrough for understanding the potential relationship between periodontitis and vascular diseases. However, there is currently a lack of an updated review of their relationship. Therefore, we aim to focus on the implications of periodontitis in vascular endothelial dysfunction in this review.
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Affiliation(s)
- Qian Li
- Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- *Correspondence: Xiangying Ouyang, ; Jiang Lin,
| | - Jiang Lin
- Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- *Correspondence: Xiangying Ouyang, ; Jiang Lin,
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10
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Rapone B, Ferrara E, Qorri E, Dipalma G, Mancini A, Corsalini M, Fabbro MD, Scarano A, Tartaglia GM, Inchingolo F. The Impact of Periodontal Inflammation on Endothelial Function Assessed by Circulating Levels of Asymmetric Dimethylarginine: A Single-Blinded Randomized Clinical Trial. J Clin Med 2022; 11:jcm11144173. [PMID: 35887937 PMCID: PMC9316194 DOI: 10.3390/jcm11144173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Endothelial dysfunction is one of the early pathogenic events of the atherosclerotic process. Severe periodontitis is considered to be an independent contributing risk factor for the pathophysiology of endothelial dysfunction. High blood concentration of asymmetric dimethylarginine (ADMA), an L-arginine analogue that inhibits nitric oxide (NO) formation, has emerged as one of the most powerful independent risk predictors of cardiovascular disease. Abrogation of periodontal inflammation might have clinical relevance, affecting the ADMA. Insufficient clinical evidence exists for drawing clear conclusions regarding the long-term effects of periodontal disease on endothelial function, and even less evidence is available specifically on ADMA concentrations and their relationship with periodontitis. The objective of this study was to evaluate the effects of intensive periodontal treatment in modulating the endothelial function via the assessment of plasma ADMA concentration in patients diagnosed severe periodontitis. Methods: This was a 6-month randomized controlled trial, including 140 patients between 41 and 63 years old who were diagnosed with severe periodontitis, free from cardiovascular disease (CVD), and had traditional cardiovascular risk factors. All patients underwent a complete medical and clinical periodontal examination, a laboratory analysis of ADMA, and an ultrasound assessment of FMD of the right brachial artery. After the screening, they were randomly assigned to receive either intensive periodontal treatment (test group, n = 70) or community-based periodontal care (control group, n = 70). A full examination was carried out at baseline, 3 and 6 months after the periodontal treatment. Results: A total of 236 individuals diagnosed with periodontitis were screened. One hundred forty participants were enrolled. No statistically significant difference was observed over the time in ADMA concentration after the intensive periodontal treatment within the test group. No differences were revealed between the groups in the ADMA concentration at baseline and during follow-up. Conclusions: Intensive periodontal treatment does not affect the plasma levels of ADMA in patients without any risk for cardiovascular disease.
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Affiliation(s)
- Biagio Rapone
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (M.C.); (F.I.)
- Correspondence: ; Tel.: +39-3477619817
| | - Elisabetta Ferrara
- Complex Operative Unit of Odontostomatology, Hospital S.S. Annunziata, 66100 Chieti, Italy;
| | - Erda Qorri
- Dean Faculty of Medical Sciences, Albanian University, Bulevardi Zogu I, 1001 Tirana, Albania;
| | - Gianna Dipalma
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (M.C.); (F.I.)
| | - Antonio Mancini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (M.C.); (F.I.)
| | - Massimo Corsalini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (M.C.); (F.I.)
| | - Massimo Del Fabbro
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.D.F.); (G.M.T.)
| | - Antonio Scarano
- Department of Oral Science, Nano and Biotechnology and CeSi-Met University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.D.F.); (G.M.T.)
| | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (G.D.); (A.M.); (M.C.); (F.I.)
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11
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Song E, Park MJ, Kim JA, Roh E, Yu JH, Kim NH, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi KM. Implication of thyroid function in periodontitis: a nationwide population-based study. Sci Rep 2021; 11:22127. [PMID: 34764408 PMCID: PMC8586139 DOI: 10.1038/s41598-021-01682-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022] Open
Abstract
Possible links between periodontitis and various cardiometabolic and autoimmune diseases have been advocated on the basis of chronic inflammation or oxidative stress. However, the association between periodontitis and thyroid dysfunction is under-researched. Participants without previous thyroid disease or ongoing thyroid-related medication were included from a nationwide population-level survey. Participants were categorized into tertiles of thyroid stimulating hormone (TSH) levels (first tertile < 1.76 mIU/L; second tertile 1.76-2.83 mIU/L; third tertile > 2.83 mIU/L), and periodontal condition was assessed using the Community Periodontal Index. Of the total of 5468 participants, 1423 had periodontitis (26%). A significant difference in the weighted prevalence of periodontitis according to TSH tertiles was observed, with the highest prevalence in the first tertile (26.5%) and the lowest prevalence in the third tertile (20.9%, p = 0.003). Subjects in the first TSH tertile had higher odds for periodontitis than those in the third tertile (OR 1.36, 95% CI 1.10-1.68; p for trend = 0.005) after adjusting for covariates. This association was consistent across subgroups and within sensitivity analyses among subjects without specific factors affecting thyroid function or diseases reported to be related to periodontitis. The present study demonstrated that low TSH levels were associated with significantly higher odds for periodontitis.
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Affiliation(s)
- Eyun Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Min Jeong Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Jung A Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea.
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12
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Parveen S. Impact of calorie restriction and intermittent fasting on periodontal health. Periodontol 2000 2021; 87:315-324. [PMID: 34463980 DOI: 10.1111/prd.12400] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The scientific evidence indicates that calorie restriction and intermittent fasting are among the appropriate strategies targeting factual causative factors of various inflammatory and lifestyle-related disorders. Periodontitis is a common oral inflammatory disease leading to bone loss that is associated with various systemic problems. Previous studies suggest that calorie restriction may dampen inflammation and concomitant tissue damage under inflammatory conditions, such as periodontal diseases in nonhuman primates. However, insufficient research has been carried out to assess the effects of a calorie-restricted diet on the initiation and progression of periodontal disease in humans. This review of the literature aims to describe the general concepts of calorie restriction, its clinical implications, and related therapeutic potential in controlling periodontal inflammation. The review shows that fasting regimen groups have shown lesser bone loss because of an increase in osteoprogenitor cells than non-fasting groups. Calorie restriction dampens the inflammatory response and reduces circulating inflammatory mediators like tumor necrosis factor-alpha, interleukin-6, matrix metalloproteinase-8, matrix metalloproteinase-9, and interleukin-1-beta in gingival crevicular fluid. However, the incorporation of this form of dietary intervention continues to be challenging in our current society, in which obesity is a major public concern. Calorie restriction and intermittent fasting can play a key role in the cost-effective resolution of periodontal inflammation as a primary prevention strategy for the management of chronic inflammatory diseases, including periodontal diseases.
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Affiliation(s)
- Sameena Parveen
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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13
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Abstract
The treatment of periodontitis has numerous positive effects on established chronic health conditions, including cardiovascular disease and diabetes. However, ethical considerations do limit the establishment of human trials to investigate whether periodontitis promotes the early stages of chronic conditions. Therefore, the aim of this study was to investigate whether periodontitis induces endothelial dysfunction in hyperlipidemic apolipoprotein E gene-deficient (ApoE-/-) mice. Forty-five 8-week-old ApoE-/- mice were challenged by oral lavage with Porphyromonas gingivalis and Streptococcus gordonii for 4 weeks. A subgroup of animals (n = 15-17/group) was placed in a metabolic chamber immediately before euthanasia at 4 weeks to measure VO2/CO2 concentrations and voluntary locomotion. In infected and control animals alveolar bone levels were measured by x-ray imaging and endothelial function was determined by measuring endothelial-dependent vasorelaxation of aortic rings. The mRNA expression levels of serum amyloid A and tumor necrosis factor were determined in liver tissues by qRT PCR and protein concentrations in serum by ELISA. Caecal contents were analysed by sequencing to determine changes to the gut microbiota to investigate linkages between microbiome and systemic changes. The results showed that oral lavage of P. gingivalis and S. gordonii for 4 weeks, initiated periodontitis in ApoE-/- mice, similar to the human situation. The oral inflammation was accompanied by a significant increase in mRNA expression of pro-inflammatory mediators serum amyloid A1 and tumor necrosis factor in the liver. Mice with periodontitis also exhibited impaired endothelial-dependent vasorelaxation responses to acetylcholine. This systemic response was connected to increased energy expenditure, locomotion and respiratory quotient. No differences were detected in caecal microbiota between the infected and control animals. Overall, this is the first report that provide evidence that periodontitis induces endothelial dysfunction in mice. Other systemic responses observed in response to the local reaction need further investigation. The study suggests that early prevention of periodontitis may help limit the early stages of endothelial dysfunction that is linked to atherogenesis in humans.
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14
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Moritz E, Jedlitschky G, Negnal J, Tzvetkov MV, Daum G, Dörr M, Felix SB, Völzke H, Nauck M, Schwedhelm E, Meisel P, Kocher T, Rauch BH, Holtfreter B. Increased Sphingosine-1-Phosphate Serum Concentrations in Subjects with Periodontitis: A Matter of Inflammation. J Inflamm Res 2021; 14:2883-2896. [PMID: 34234513 PMCID: PMC8256099 DOI: 10.2147/jir.s302117] [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: 01/15/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Periodontitis is an inflammatory disease of the oral cavity with an alarmingly high prevalence within the adult population. The signaling lipid sphingosine-1-phosphate (S1P) plays a crucial role in inflammatory and immunomodulatory responses. In addition to cardiovascular disease, sepsis and tumor entities, S1P has been recently identified as both mediator and biomarker in osteoporosis. We hypothesized that S1P may play a role in periodontitis as an inflammation-prone bone destructive disorder. The goal of our study was to evaluate associations between periodontitis and S1P serum concentrations in the Study of Health in Pomerania (SHIP)-Trend cohort. In addition, we investigated the expression of S1P metabolizing enzymes in inflamed gingival tissue. PATIENTS AND METHODS We analyzed data from 3371 participants (51.6% women) of the SHIP-Trend cohort. Periodontal parameters and baseline characteristics were assessed. Serum S1P was measured by liquid chromatography tandem mass spectrometry. The expression of S1P metabolizing enzymes was determined by immunofluorescence staining of human gingival tissue. RESULTS S1P serum concentrations were significantly increased in subjects with both moderate and severe periodontitis, assessed as probing depth and clinical attachment loss. In contrast, no significant association of S1P was seen with caries variables (number and percentage of decayed or filled surfaces). S1P concentrations significantly increased with increasing high-sensitivity C-reactive protein (hs-CRP) levels. Interestingly, inflamed compared to normal human gingival tissue exhibited elevated expression levels of the S1P-generating enzyme sphingosine kinase 1 (SphK1). CONCLUSION We report an intriguingly significant association of various periodontal parameters with serum levels of the inflammatory lipid mediator S1P. Our data point towards a key role of S1P during periodontitis pathology. Modulation of local S1P levels or its signaling properties may represent a potential future therapeutic strategy to prevent or to retard periodontitis progression and possibly reduce periodontitis-related tooth loss.
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Affiliation(s)
- Eileen Moritz
- Institute of Pharmacology, Department of General Pharmacology, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Gabriele Jedlitschky
- Institute of Pharmacology, Department of General Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Josefine Negnal
- Institute of Pharmacology, Department of General Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Mladen V Tzvetkov
- Institute of Pharmacology, Department of General Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Günter Daum
- Clinic and Polyclinic for Vascular Medicine, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Marcus Dörr
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Stephan B Felix
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Edzard Schwedhelm
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Humburg, Germany
| | - Peter Meisel
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - Bernhard H Rauch
- Institute of Pharmacology, Department of General Pharmacology, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Carl von Ossietzky Universität Oldenburg, Department of Human Medicine, Section of Pharmacology and Toxicology, Oldenburg, Germany
| | - Birte Holtfreter
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
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15
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Isola G, Polizzi A, Ronsivalle V, Alibrandi A, Palazzo G, Lo Giudice A. Impact of Matrix Metalloproteinase-9 during Periodontitis and Cardiovascular Diseases. Molecules 2021; 26:molecules26061777. [PMID: 33810003 PMCID: PMC8004886 DOI: 10.3390/molecules26061777] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 02/07/2023] Open
Abstract
Matrix metalloproteinase-9 (MMP-9) has been shown to play a key role in endothelial function and perhaps pivotal in the correlation between periodontal disease and cardiovascular disease (CVD). For the study, the impact of MMP-9 of periodontitis and CVD on serum and saliva concentrations was analyzed. For the study patients with periodontitis (n = 31), CVD (n = 31), periodontitis + CVD (n = 31), and healthy patients (n = 31) were enrolled. Clinical and demographic characteristics as well as serum and salivary MMP-9 were evaluated. MMP-9 concentrations in serum and saliva were statistically elevated in patients with CVD (p < 0.01) and in patients with periodontitis plus CVD (p < 0.001) compared to patients with periodontitis and healthy subjects. Multivariate regression analysis showed that c-reactive protein (hs-CRP) was the only significant predictor for MMP-9 serum (p < 0.001), whereas hs-CRP (p < 0.001) and total cholesterol (p = 0.029) were the statistically significant salivary MMP-9 predictors. This study evidenced that patients with CVD and periodontitis + CVD presented elevated MMP-9 concentrations in serum and saliva compared to patients with periodontitis and healthy subjects. Furthermore, hs-CRP was a negative predictor of serum and salivary MMP-9.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
- Correspondence: ; Tel.: +39-095-378-2453
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, 98122 Messina, Italy;
| | - Giuseppe Palazzo
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
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16
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Hamza SA, Asif S, Bokhari SAH. Oral health of individuals with dementia and Alzheimer's disease: A review. J Indian Soc Periodontol 2021; 25:96-101. [PMID: 33888939 PMCID: PMC8041071 DOI: 10.4103/jisp.jisp_287_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 11/04/2022] Open
Abstract
This paper explores the epidemiological evidence about oral health of individuals with neurodegenerative conditions of Alzheimer's disease (AD) and dementia. PubMed, Web of Science, and Scopus were searched to identify the relevant research papers published during January 2012 to June 2020. All cross-sectional, case-control, and cohort studies reporting oral and dental morbid conditions for status and association with AD and dementia were explored. The explored literature from 22 studies shows that oral health parameters of oral health and levels of oral inflammatory markers were deranged and exaggerated in patients suffering from AD and dementia. Many studies have observed poor oral hygiene as result of lack or irregularity in toothbrushing. Regarding decayed, missing, and filled teeth status in AD/dementia populations, no significant difference is reported. Periodontal diseases have been noted at raised levels in AD and dementia patients and shown progression with aggravation in neurological disorders. Both edentulousness and low chewing efficacies are associated with low cognition. Stomatitis and coated tongue and other oral pathologies are significantly higher in AD patients. AD patients have demonstrated higher bacterial load and inflammation levels than controls, and consequently, inflammatory biomarker levels are also raised. AD patients have reduced salivary secretions and with low buffering capacity. Evidence from the current literature update postulates that individuals suffering from AD and dementia have special oral health-care needs. Appropriate oral health management may thus significantly improve their oral health-related and general quality of life.
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Affiliation(s)
- Syed Ameer Hamza
- Department of Oral Medicine, University Medical and Dental College, The University of Faisalabad, Faisalabad, Pakistan
| | - Saba Asif
- Department of Periodontology, College of Dentistry, Sharif Medical and Dental College Lahore, Pakistan
| | - Syed Akhtar Hussain Bokhari
- Department of Preventive Dental Sciences, Committee for Postgraduate Studies and Research College of Dentistry, King Faisal University Al-Ahsa, Saudi Arabia
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17
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Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis. Pharmacol Res 2021; 166:105511. [PMID: 33617973 DOI: 10.1016/j.phrs.2021.105511] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 01/02/2023]
Abstract
AIM Quantitative comparison of the effects of intensive (IPT) or conventional (CPT) periodontal treatment on arterial blood pressure, endothelial function and inflammatory/metabolic biomarkers. MATERIALS AND METHODS A systematic search was conducted to identify randomized controlled trials (RCT) of IPT (supra and subgingival instrumentation). Eight RCTs were included in the meta-analysis. Difference in change of systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after IPT or CPT were the primary outcomes. The secondary outcomes included: endothelial function and selected inflammatory/anti-inflammatory (CRP, IL-6, IL-10, IFN-γ) and metabolic biomarkers (HDL, LDL, TGs). RESULTS The overall effect estimates (pooled Weighted Mean Difference (WMD)) of the primary outcome for SBP and DBP was -4.3 mmHg [95%CI: -9.10-0.48], p = 0.08 and -3.16 mmHg [95%CI: -6.51-0.19], p = 0.06 respectively. These studies were characterized by high heterogeneity. Therefore, random effects model for meta-analysis was performed. Sub-group analyses confirmed statistically significant reduction in SBP [WMD = -11.41 mmHg (95%CI: -13.66, -9.15) P < 0.00001] and DBP [WMD = -8.43 mmHg (95%CI: -10.96,-5.91)P < 0.00001] after IPT vs CPT among prehypertensive/hypertensive patients, while this was not observed in normotensive individuals. The meta-analyses showed significant reductions in CRP and improvement of endothelial function following IPT at all analysed timepoints. CONCLUSIONS IPT leads to improvement of the cardiovascular health in hypertensive and prehypertensive individuals.
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18
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Chansawang K, Lertpimonchai A, Siripaiboonpong N, Thienpramuk L, Vathesatogkit P, Limpijankit T, Charatkulangkun O. The severity and extent of periodontitis is associated with cardio-ankle vascular index, a novel arterial stiffness parameter. Clin Oral Investig 2020; 25:3487-3495. [PMID: 33180188 DOI: 10.1007/s00784-020-03670-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/29/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To evaluate the association between the severity and extent of periodontitis and arterial stiffness using the cardio-ankle vascular index (CAVI). MATERIALS AND METHODS A cross-sectional study of 2888 Electricity Generation Authority of Thailand (EGAT) employees aged 44-78 years was conducted. The severity of periodontitis was evaluated based on mean clinical attachment level (CAL). The percentage of sites with CAL ≥ 5 mm was used to divide the extent of periodontitis into healthy (0%), localized (> 0-< 30%), and generalized (≥ 30%). The CAVI value, a novel blood pressure-independent arterial stiffness parameter, was analyzed as both continuous and categorical data (low: < 9 or high: ≥ 9). Regression analysis was used to estimate the level of association. RESULTS The participants demonstrated a mean CAL, % sites with CAL ≥ 5 mm, and a CAVI value of 3.2 ± 1.2 mm, 16.0 ± 20.8%, and 8.24 ± 1.12, respectively. Higher mean CAVI was observed with greater mean CAL and % sites with CAL ≥ 5 mm. The mean CAVI of the healthy, localized, and generalized periodontitis groups were 8.01 ± 1.11, 8.22 ± 1.12, and 8.51 ± 1.04, respectively (p < 0.01). Linear and logistic regression analysis demonstrated a significant relationship between CAVI and all periodontal variables with β = 0.004-0.17 and OR = 1.01-1.58, respectively. CONCLUSIONS There is a significant dose-dependent association between the severity and extent of periodontitis and arterial stiffness measured by CAVI in Thai adults. CLINICAL RELEVANCE Preventing arterial stiffness, an early sign of cardiovascular events, by controlling the emerging risk factors, such as periodontitis, might have a high impact on health promotion.
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Affiliation(s)
- Kansurang Chansawang
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Nisachon Siripaiboonpong
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | | | | | - Orawan Charatkulangkun
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand.
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, 10330, Thailand.
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19
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Isola G, Polizzi A, Alibrandi A, Indelicato F, Ferlito S. Analysis of Endothelin-1 Concentrations in Individuals with Periodontitis. Sci Rep 2020; 10:1652. [PMID: 32015361 PMCID: PMC6997234 DOI: 10.1038/s41598-020-58585-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 01/17/2020] [Indexed: 02/07/2023] Open
Abstract
Endothelin 1 (ET-1) has been shown to have a key role in homeostasis and function of endothelium and maybe fundamental in the relationship between coronary heart disease (CHD) and periodontitis. In this trial, we assessed the influence on serum and salivary ET-1 levels of gingival health, CHD, periodontitis, or a combination of periodontitis-CHD. Clinical and periodontal parameters, were collected from periodontitis patients (n = 34), CHD patients (n = 34), periodontitis + CHD patients (n = 34), and from healthy patients (n = 34) together with saliva and serum samples. The median concentrations of salivary and serum ET-1 were significantly higher in the CHD patients [serum: 1.4(1.1-1.6) pg/ml; saliva 1.2 (0.9-1.6) µmol/g, p < 0.01] and in the periodontitis + CHD patients [serum: 1.7 (1.2-21.8) pg/ml; salivary 1.4(1-1.6) µmol/g, p < 0.001] respect to periodontitis and control patients. Through a univariate regression analysis, c-reactive protein (CRP) and CHD (both p < 0.001) and periodontitis (p = 0.029) were statistically correlated with ET-1 in serum. The multivariate regression analysis demonstrated that only CRP was the statistically predictor of ET-1 in serum(p < 0.001). The multivariate regression analysis in saliva demonstrated that, regarding ET-1 levels the only predictor were CRP (p < 0.001) and total cholesterol (p = 0.042). The present study evidenced that subjects with CHD and periodontitis plus CHD had higher serum and salivary levels of ET-1 compared to subjects with periodontitis and healthy controls. Moreover, only CRP remained a major predictor of increased ET-1 concentrations in both serum and saliva.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy
| | - Francesco Indelicato
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Sebastiano Ferlito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
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20
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Isola G, Polizzi A, Muraglie S, Leonardi R, Lo Giudice A. Assessment of Vitamin C and Antioxidant Profiles in Saliva and Serum in Patients with Periodontitis and Ischemic Heart Disease. Nutrients 2019; 11:E2956. [PMID: 31817129 PMCID: PMC6950653 DOI: 10.3390/nu11122956] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023] Open
Abstract
Vitamin C and antioxidants play a crucial role in endothelial function and may be a link for the known interaction of periodontitis and ischemic heart disease (CAD). This pilot study evaluates the association of gingival health, periodontitis, CAD, or both conditions with salivary and serum vitamin C and antioxidant levels. The clinical and periodontal characteristics, serum, and saliva samples were collected from 36 patients with periodontitis, 35 patients with CAD, 36 patients with periodontitis plus CAD, and 36 healthy controls. Levels of vitamin C, antioxidants, and C-reactive protein (hs-CRP) were assessed with a commercially available kit. The median concentrations of salivary and serum vitamin C and antioxidants (α-tocopherol, β-carotene, lutein, and lycopene) were significantly lower in the CAD group (p < 0.001) and in the periodontitis plus CAD group (p < 0.001) compared to periodontitis patients and controls. In univariate models, periodontitis (p = 0.034), CAD (p < 0.001), and hs-CRP (p < 0.001) were significantly negatively associated with serum vitamin C; whereas, in a multivariate model, only hs-CRP remained a significant predictor of serum vitamin C (p < 0.001). In a multivariate model, the significant predictors of salivary vitamin C levels were triglycerides (p = 0.028) and hs-CRP (p < 0.001). Patients with CAD and periodontitis plus CAD presented lower levels of salivary and serum vitamin C compared to healthy subjects and periodontitis patients. hs-CRP was a significant predictor of decreased salivary and serum vitamin C levels.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy (S.M.); (R.L.); (A.L.G.)
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy (S.M.); (R.L.); (A.L.G.)
| | - Simone Muraglie
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy (S.M.); (R.L.); (A.L.G.)
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy (S.M.); (R.L.); (A.L.G.)
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy (S.M.); (R.L.); (A.L.G.)
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, University of Messina, 98125 Messina, Italy
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21
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Isola G, Polizzi A, Santonocito S, Alibrandi A, Ferlito S. Expression of Salivary and Serum Malondialdehyde and Lipid Profile of Patients with Periodontitis and Coronary Heart Disease. Int J Mol Sci 2019; 20:E6061. [PMID: 31805680 PMCID: PMC6928957 DOI: 10.3390/ijms20236061] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023] Open
Abstract
Malondialdehyde (MAA) within a lipid pathway has been demonstrated to possess an important role in endothelial function that undergoes periodontitis and coronary heart disease (CHD) development. This study evaluated the impact of periodontitis, CHD, or a combination of both diseases (periodontitis + CHD) on salivary and serum MAA levels. The periodontal and clinical characteristics, serum, and saliva samples were collected from 32 healthy subjects, 34 patients with periodontitis, 33 patients with CHD, and 34 patients with periodontitis and CHD. Lipid profile and levels of MDA and C-reactive protein (CRP) were assessed. Patients in the periodontitis group (serum: 3.92 (3.7-4.4) µmol/L; salivary 1.81 (1-2.1) µmol/g protein, p < 0.01) and in the periodontitis + CHD (serum: 4.34 (3.7-4.8) µmol/L; salivary 1.96 (1.7-2.3) µmol/g protein, p < 0.001) group presented higher median concentrations of salivary and serum MAA compared to patients in the CHD (serum: 3.72 (3.5-4.1) µmol/L; salivary 1.59 (0.9-1.8) µmol/g protein, p < 0.01) and control group (serum: 3.14 (2.8-3.7) µmol/L; salivary 1.41 (0.8-1.6) µmol/g protein, p < 0.01). In univariate models, periodontitis (p = 0.034), CHD (p < 0.001), and CRP (p < 0.001) were significantly associated with MAA. In the multivariate model, only CRP remained a significant predictor of serum and salivary MAA (p < 0.001) MAA levels. Patients with periodontitis and with periodontitis + CHD presented higher levels of salivary and serum MAA compared to healthy subjects and CHD patients. CRP has been found to be a significant predictor of increased salivary and serum MAA levels.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, 98122 Messina, Italy
| | - Sebastiano Ferlito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
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Niswade G, Niswade A, Gattani D, Bhutada G. Study of common carotid and brachial artery hemodynamic variations in periodontal disease in Central India-a clinical study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2019.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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23
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Shimizu Y, Yamanashi H, Kitamura M, Furugen R, Iwasaki T, Fukuda H, Hayashida H, Kawasaki K, Kiyoura K, Kawashiri SY, Saito T, Kawakami A, Maeda T. Association between human T cell leukemia virus 1 (HTLV-1) infection and advanced periodontitis in relation to hematopoietic activity among elderly participants: a cross-sectional study. Environ Health Prev Med 2019; 24:42. [PMID: 31182010 PMCID: PMC6558682 DOI: 10.1186/s12199-019-0796-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We reported that human T cell leukemia virus 1 (HTLV-1) infection is positively associated with atherosclerosis. Recent evidence has revealed a close association of periodontitis with atherosclerosis, endothelial dysfunction, and disruption of the microcirculation. However, the association between HTLV-1 and advanced periodontitis has not been investigated to date. Since hematopoietic activity is closely linked to endothelial maintenance activity and is known to decline with age, we hypothesized that the state of hematopoietic activity influenced the association between HTLV-1 and advanced periodontitis in elderly participants. METHODS A cross-sectional study was performed including 822 elderly participants aged 60-99 years who participated in a dental health check-up. Advanced periodontitis was defined as a periodontal pocket ≥ 6.0 mm. Participants were classified as having low or high hematopoietic activity according to the median values of reticulocytes. RESULTS HTLV-1 infection was positively related to advanced periodontitis among participants with lower hematopoietic activity (lower reticulocyte count), but not among participants with higher hematopoietic activity (higher reticulocyte count). The adjusted odds ratio (95% confidence interval) considering potential confounding factors was 1.92 (1.05-3.49) for participants with a lower reticulocyte count and 0.69 (0.35-1.36) for participants with a higher reticulocyte count. CONCLUSIONS Among elderly participants, the association between HTLV-1 infection and advanced periodontitis is influenced by hematopoietic activity. Since hematopoietic activity is associated with endothelial maintenance, these findings provide an efficient tool for clarifying the underlying mechanism of the progression of periodontitis among elderly participants.
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Affiliation(s)
- Yuji Shimizu
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523 Japan
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka, Japan
| | - Hirotomo Yamanashi
- Department of General Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masayasu Kitamura
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Reiko Furugen
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Iwasaki
- Department of Community Oral Health, School of Dentistry, Asahi University, Gifu, Japan
| | - Hideki Fukuda
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideaki Hayashida
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koji Kawasaki
- Community Medical Network Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Kairi Kiyoura
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523 Japan
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523 Japan
| | - Toshiyuki Saito
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523 Japan
- Department of General Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Nikolaeva EN, Tsarev VN, Tsareva TV, Ippolitov EV, Arutyunov SD. Interrelation of Cardiovascular Diseases with Anaerobic Bacteria of Subgingival Biofilm. Contemp Clin Dent 2019; 10:637-642. [PMID: 32792823 PMCID: PMC7390421 DOI: 10.4103/ccd.ccd_84_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aims: The aim of this study is to study the colonization of subgingival biofilm (SGB) with periodontopathogenic bacteria species and endothelium-dependent vasodilation in patients with coronary heart disease and concomitant periodontitis. Subjects and Methods: Forty-five patients with cardiovascular diseases (CVDs) were examined – 28 women (62%) and 17 men (38%) aged 53–76 years, including 15 patients with acute myocardial infarction (AMI), 15 patients with exertional angina (pectoris), and 15 patients with chronic periodontitis (CP) without CVD. Dental and cardiological health conditions were determined, a biochemical blood test was conducted, endothelium-dependent vasodilation in the brachial artery was measured, and DNA of periodontopathogenic bacteria in SGB was detected. Results: A reliable interrelation between the colonization of SGB with periodontopathogenic bacteria and development of AMI was established. In AMI patients, the frequency of Porphyromonas gingivalis, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans detection was significantly higher than in the group of participants without cardiovascular disease. The presence of P. gingivalis and A. actinomycetemcomitans in patients with CP directly correlated with severity of periodontal tissue destruction. Endothelium-dependent vasodilation in the brachial artery moderately correlated with patient's cardiological condition (r = 0.3284), biochemical markers of atherosclerosis development (r = 0.6465), and frequency of P. intermedia detection in periodontal pockets (r = 0.3828). Conclusions: Periodontal status in patients with AMI is characterized by unsatisfactory and poor hygiene, increased indices of bleeding on probing, and periodontal pocket depth in comparison to groups of patients with angina pectoris and CP without cardiovascular pathology.
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Affiliation(s)
- Elena Nikolaevna Nikolaeva
- Department of Microbiology, Virology and Immunology, Moscow State University of Medicine and Dentistry Named After A. I. Evdokimov, Moscow, Russia
| | - Viktor Nikolaevich Tsarev
- Department of Microbiology, Virology and Immunology, Moscow State University of Medicine and Dentistry Named After A. I. Evdokimov, Moscow, Russia
| | - Tatyana Viktorovna Tsareva
- Department of Microbiology, Virology and Immunology, Moscow State University of Medicine and Dentistry Named After A. I. Evdokimov, Moscow, Russia
| | - Evgenii Valeryevich Ippolitov
- Department of Microbiology, Virology and Immunology, Moscow State University of Medicine and Dentistry Named After A. I. Evdokimov, Moscow, Russia
| | - Sergey Darchoevich Arutyunov
- Department of Propaedeutics of Dental Diseases, Moscow State University of Medicine and Dentistry Named After A. I. Evdokimov, Moscow, Russia
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Mesa F, Magan-Fernandez A, Castellino G, Chianetta R, Nibali L, Rizzo M. Periodontitis and mechanisms of cardiometabolic risk: Novel insights and future perspectives. Biochim Biophys Acta Mol Basis Dis 2018; 1865:476-484. [PMID: 30529255 DOI: 10.1016/j.bbadis.2018.12.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 01/08/2023]
Abstract
Periodontitis is an infectious and inflammatory disease of the tooth-supporting tissues caused by the accumulation of subgingival plaque and the action of specific periodontopathogenic bacteria. Periodontitis has been associated with cardiovascular diseases and considered a cardiovascular risk factor. Several mechanisms have been proposed to explain this association, such as the infection of atherosclerotic plaques by periodontal pathogens, the pro-atherogenic effect on the lipid profile, the systemic dissemination of pro-inflammatory mediators or the contribution to type 2 diabetes mellitus. Periodontal treatment has also been related to improvement in cardiometabolic risk variables, and oral hygiene techniques may be useful in reducing cardiometabolic risk. The aim of this review is to provide new and recent insights on the relationship between periodontitis and cardiometabolic risk, focusing on recent evidence. Comments on shared potential therapeutic targets, such as the role of glucagon-like peptide 1, are also highlighted.
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Affiliation(s)
- Francisco Mesa
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
| | | | - Giuseppa Castellino
- Biomedical Department of Internal Medicine and Specialties, University of Palermo, Italy
| | - Roberta Chianetta
- Biomedical Department of Internal Medicine and Specialties, University of Palermo, Italy
| | - Luigi Nibali
- Centre for Oral Immunobiology & Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Specialties, University of Palermo, Italy
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26
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Iwasaki M, Kimura Y, Ogawa H, Yamaga T, Ansai T, Wada T, Sakamoto R, Ishimoto Y, Fujisawa M, Okumiya K, Miyazaki H, Matsubayashi K. Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5‐year cohort study. J Periodontal Res 2018; 54:233-240. [DOI: 10.1111/jre.12623] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Masanori Iwasaki
- Division of Preventive DentistryDepartment of Oral Health ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - Yumi Kimura
- Graduate School of Human SciencesOsaka University Osaka Japan
| | - Hiroshi Ogawa
- Division of Preventive DentistryDepartment of Oral Health ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Takayuki Yamaga
- Division of Preventive DentistryDepartment of Oral Health ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Toshihiro Ansai
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - Taizo Wada
- Center for Southeast Asian StudiesKyoto University Kyoto Japan
| | - Ryota Sakamoto
- Center for Southeast Asian StudiesKyoto University Kyoto Japan
| | - Yasuko Ishimoto
- Department of Health and Sports ScienceFaculty of Health Science and TechnologyKawasaki University of Medical Welfare Kurashiki Japan
| | | | | | - Hideo Miyazaki
- Division of Preventive DentistryDepartment of Oral Health ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
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Aarabi G, Thomalla G, Heydecke G, Seedorf U. Chronic oral infection: An emerging risk factor of cerebral small vessel disease. Oral Dis 2018; 25:710-719. [DOI: 10.1111/odi.12912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Ghazal Aarabi
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Götz Thomalla
- Department of NeurologyHead‐ and NeurocenterUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Guido Heydecke
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Udo Seedorf
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
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28
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Shearer DM, Thomson WM, Cameron CM, Ramrakha S, Wilson G, Wong TY, Williams MJA, McLean R, Theodore R, Poulton R. Periodontitis and multiple markers of cardiometabolic risk in the fourth decade: A cohort study. Community Dent Oral Epidemiol 2018; 46:615-623. [PMID: 30160305 DOI: 10.1111/cdoe.12414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/11/2018] [Accepted: 07/18/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine associations between periodontitis at ages 32 and 38 and a range of early cardiometabolic risk biomarkers at age 38. METHODS Periodontal probing depth and bleeding on probing data collected during the age-32 and age-38 assessments in the Dunedin Multidisciplinary Health and Development Study were used to quantify periodontal inflammatory load. Retinal microvascular abnormalities, endothelial dysfunction, and metabolic syndrome data were collected during the age-38 assessment. Regression models were used to examine associations between these cardiometabolic risk markers and (1) the inflammatory load at age 38 and (2) the change in inflammatory load between ages 32 and 38. RESULTS Periodontal inflammatory load was recorded for 890 Study members at age 32, 891 at age 38, and 856 at both ages. Retinal vessel data were available for 922, endothelial dysfunction data for 909 and metabolic syndrome data for 905 at age 38. Neither the inflammatory load of periodontitis at 38 nor the changes in inflammatory load 32-38 were found to be associated with any of the three cardiometabolic risk markers. CONCLUSIONS Periodontitis was not associated with markers of cardiometabolic risk at this relatively early stage in the life course. It is possible that any influence of periodontitis on cardiometabolic health develops later in life, or periodontitis is not involved in the putative causal chain comprising systemic inflammation, cardiometabolic risk markers, and subsequent cardiovascular risk.
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Affiliation(s)
- Dara M Shearer
- Department of Oral Sciences, Faculty of Dentistry, Dunedin, New Zealand
| | - W Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, Dunedin, New Zealand
| | - Claire M Cameron
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Graham Wilson
- Department of Ophthalmology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Michael J A Williams
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Rachael McLean
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Reremoana Theodore
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
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29
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Catanzaro DP, Mena Laura EE, Cestari TM, Arantes RVN, Garlet GP, Taga R, Assis GF. Green tea prevents vascular disturbs and attenuates periodontal breakdown in long-term hyperglycaemia in T1D rats. J Clin Periodontol 2018; 45:557-569. [PMID: 29500839 DOI: 10.1111/jcpe.12883] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 12/11/2022]
Abstract
AIM The effects of green tea on the modulation of vascularization during the progression of spontaneous periodontitis in long-term hyperglycaemia in streptozotocin-induced type 1 diabetic (T1D) rats were evaluated. MATERIALS AND METHODS Wistar rats normoglycaemic (NG) and T1D were divided into two control groups, which received water (NG-W and T1D-W) and two experimental groups that received green tea (NG-GT and T1D-GT). Periodontal structures were evaluated by microtomographic and histological analyses. Number of immunostained cells for VEGF (NcVEGF+/mm2 ) and CD31 (NcCD31+/mm2 ), as well microvessel density (MVD) in the periodontal ligament (PDL) were evaluated. RESULTS Long-term hyperglycaemia in T1D-W rats induced vascular alterations in PDL with a reduction of 36% in MVD, a decrease of 33% in NcCD31+/mm2 and an increase of 53% in NcVEGF+/mm2 . Concomitantly, a severe degree of periodontitis with higher reduction in bone volume and periodontal bone level was observed. In T1D-GT, green tea maintained the MVD, NcCD31+/mm2 and NcVEGF+/mm2 in the PDL similar to normoglycaemic groups. Clinically, in T1D-GT rats, green tea reduced dental plaque accumulation and the degree of periodontitis when compared to T1D-W. CONCLUSION Daily green tea consumption has a therapeutic effect on the diabetic vascular disorder in PDL and the progression of periodontitis in long-term hyperglycaemia in T1D rats.
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Affiliation(s)
- Daniela Pereira Catanzaro
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ever Elias Mena Laura
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Tania Mary Cestari
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Gustavo Pompermaier Garlet
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rumio Taga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gerson Francisco Assis
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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30
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Lamure J, Chevalier M, Rathelot P, Mignolet F, Precheur I. In Vitro Screening of the Antibacterial and Anti-Candida Properties of Crushed Nonantimicrobial Drugs Frequently Prescribed in Nursing Homes. Res Gerontol Nurs 2018; 11:82-90. [PMID: 29451932 DOI: 10.3928/19404921-20180131-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 12/14/2017] [Indexed: 01/21/2023]
Abstract
Frail older adults often experience swallowing disorders, prompting nursing staff to crush tablets, open capsules, and mix drugs into their meals or gelled water. However, crushing drugs can lead to pharmacological and gustatory problems. As crushed drugs can stay in prolonged contact with oral microbial biofilm, the current study aimed to investigate their antimicrobial properties. Crushed drugs were diluted in 1 mL of isotonic water and assayed in vitro for: (a) growth inhibition of five bacterial strains and Candida albicans by the diffusion method; (b) inhibition of Streptococcus salivarius and C. albicans biofilm formation; and (c) elimination of a preformed biofilm of S. salivarius and C. albicans after 5-minute contact. Eight of 29 crushed drugs inhibited bacterial and/or fungal growth on agar plates. Twenty-eight of 29 crushed drugs reduced the total biomass when incubated with S. salivarius, and 28 of 29 crushed drugs inhibited C. albicans biofilm formation. Preformed biomass was reduced by ≥25% by seven of 29 drugs. Crushed drugs may unbalance oral ecosystems and contribute to oral inflammation. [Res Gerontol Nurs. 2018; 11(2):82-90.].
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31
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Punj A, Shenoy SB, Subramanyam K. Comparison of Endothelial Function in Healthy Patients and Patients With Chronic Periodontitis and Myocardial Infarction. J Periodontol 2017; 88:1234-1243. [DOI: 10.1902/jop.2017.160748] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Anahita Punj
- Department of Periodontology, A.B. Shetty Memorial Institute of Dental Sciences, NITTE University, Deralakatte, Mangalore, Karnataka, India
| | - Santhosh B. Shenoy
- Department of Periodontology, A.B. Shetty Memorial Institute of Dental Sciences, NITTE University, Deralakatte, Mangalore, Karnataka, India
| | - K. Subramanyam
- Department of Cardiology, K.S. Hegde Medical Academy, NITTE University, Deralakatte, Mangalore, Karnataka, India
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32
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Wang Y, Liu HN, Zhen Z, Yiu KH, Tse HF, Pelekos G, Tonetti M, Jin L. Periodontal treatment modulates gene expression of endothelial progenitor cells in diabetic patients. J Clin Periodontol 2017; 44:1253-1263. [DOI: 10.1111/jcpe.12806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Yi Wang
- Discipline of Periodontology; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - Hin Nam Liu
- Discipline of Periodontology; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - Zhe Zhen
- Division of Cardiology; Department of Medicine; Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Kai Hang Yiu
- Division of Cardiology; Department of Medicine; Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Hung Fat Tse
- Division of Cardiology; Department of Medicine; Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - George Pelekos
- Discipline of Periodontology; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - Maurizio Tonetti
- Discipline of Periodontology; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - Lijian Jin
- Discipline of Periodontology; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
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Moura MF, Navarro TP, Silva TA, Cota LOM, Soares Dutra Oliveira AM, Costa FO. Periodontitis and Endothelial Dysfunction: Periodontal Clinical Parameters and Levels of Salivary Markers Interleukin-1β, Tumor Necrosis Factor-α, Matrix Metalloproteinase-2, Tissue Inhibitor of Metalloproteinases-2 Complex, and Nitric Oxide. J Periodontol 2017; 88:778-787. [DOI: 10.1902/jop.2017.170023] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Marcela Faria Moura
- School of Dentistry, Department of Clinical, Pathology and Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Túlio Pinho Navarro
- School of Dentistry, Department of Clinical, Pathology and Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Tarcília Aparecida Silva
- School of Dentistry, Department of Clinical, Pathology and Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Luís Otávio Miranda Cota
- School of Dentistry, Department of Clinical, Pathology and Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernando Oliveira Costa
- School of Dentistry, Department of Clinical, Pathology and Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Goulart AC, Armani F, Arap AM, Nejm T, Andrade JB, Bufarah HB, Dezen DHS. Relationship between periodontal disease and cardiovascular risk factors among young and middle-aged Brazilians. Cross-sectional study. SAO PAULO MED J 2017; 135:226-233. [PMID: 28746658 PMCID: PMC10019846 DOI: 10.1590/1516-3180.2016.0357300117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/30/2017] [Indexed: 01/31/2023] Open
Abstract
CONTEXT AND OBJECTIVE: It has been suggested in the literature that periodontal disease (PD) is associated with cardiovascular risk. The objective of this study was to appraise the relationship between periodontal disease (gingivitis and periodontitis) and traditional cardiovascular risk factors (obesity, hypertension, dyslipidemia, diabetes and metabolic syndrome) among young and middle-aged adults attended at a health promotion and check-up center in the city of São Paulo, Brazil. DESIGN AND SETTING: Cross-sectional study at the Health Promotion and Check-up Center of Hospital Sírio-Libanês, São Paulo, Brazil. METHODS: We consecutively evaluated 539 subjects without prior cardiovascular disease who were seen within a health promotion program that included cardiovascular and dental evaluation between February and November 2012. Odds ratios (OR) with respective 95% confidence intervals (95% CI) for the association between PD and cardiovascular risk factors were ascertained through multinomial logistic regression. RESULTS: In this sample of mean age 45 years (standard deviation, SD ± 8.8), which was 82% male, we found PD in 63.2% (gingivitis 50.6% and periodontitis 12.6%). Individuals with PD were older, more obese (without PD 15.2%; versus gingivitis 22.1% and periodontitis 32.4%) and more diabetic (without PD 5.1%; versus gingivitis 4.8% and periodontitis 13.2%), compared with those without PD. Among all cardiovascular risk factors evaluated, obesity was associated with periodontitis (multivariate OR, 2.36; 95% CI, 1.23-4.52). However, after additional adjustment for oral hygiene, this finding was no longer significant (multivariate OR, 1.63; 95% CI, 0.79-3.37). CONCLUSIONS: We did not find any significant associations between cardiovascular risk factors and periodontal disease in this sample.
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Affiliation(s)
- Alessandra Carvalho Goulart
- MD, PhD. Clinical Epidemiologist, Health Promotion and Check-up Center, Hospital Sírio Libanês, São Paulo (SP); and Clinical Epidemiologist, Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo (USP), São Paulo (SP), Brazil.
| | - Favius Armani
- DDS. Dentist, Health Promotion and Check-up Center, Hospital Sírio Libanês, São Paulo (SP), Brazil.
| | - Astrid Marie Arap
- MSc. Dentist, Health Promotion and Check-up Center, Hospital Sírio Libanês, São Paulo (SP), Brazil.
| | - Thais Nejm
- DDS. Dentist, Health Promotion and Check-up Center, Hospital Sírio Libanês, São Paulo (SP), Brazil.
| | - Juliana Barros Andrade
- DDS. Dentist, Health Promotion and Check-up Center, Hospital Sírio Libanês, São Paulo (SP), Brazil.
| | - Henry Bittar Bufarah
- DDS. Dentist, Health Promotion and Check-up Center, Hospital Sírio Libanês, São Paulo (SP), Brazil.
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Widén C, Holmer H, Coleman M, Tudor M, Ohlsson O, Sättlin S, Renvert S, Persson GR. Systemic inflammatory impact of periodontitis on acute coronary syndrome. J Clin Periodontol 2016; 43:713-9. [PMID: 26935585 DOI: 10.1111/jcpe.12540] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 11/29/2022]
Abstract
AIM A causative relationship between acute coronary syndrome (ACS) and periodontitis has yet to be defined. The aim of this study was to assess differences in levels of serum cytokines between individuals with or without ACS or periodontal comorbidity. MATERIAL AND METHODS In a case-control study, individuals with ACS (78 individuals, 10.3% females) and matching healthy controls (78 individuals, 28.2% females) were included. Medical and dental examinations were performed to diagnose ACS and periodontitis. Serum levels of cytokines were assessed, using Luminex technology. RESULTS A diagnosis of periodontitis in the ACS and control group was diagnosed in 52.6% and 12.8% of the individuals, respectively. The unadjusted odds-ratio that individuals with ACS also had periodontitis was 7.5 (95% CI: 3.4, 16.8, p < 0.001). Independent of periodontal conditions, individuals with ACS had significantly higher serum levels of IL8 (mean: 44.3 and 40.0 pg/ml) and vascular endothelial growth factor (VEGF) (mean: 82.3 and 55.3 pg/ml) than control individuals. A diagnosis of periodontitis made no difference in serum cytokine expressions. CONCLUSION Elevated serum levels of VEGF were associated with ACS. Serum cytokine expression in individuals with ACS is unrelated to periodontal conditions.
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Affiliation(s)
- Cecilia Widén
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | | | | | - Marian Tudor
- Kristianstad Central Hospital, Kristianstad, Sweden
| | - Ola Ohlsson
- School of Health and Society, Kristianstad University, Kristianstad, Sweden.,Kristianstad Central Hospital, Kristianstad, Sweden
| | - Susanna Sättlin
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Stefan Renvert
- School of Health and Society, Kristianstad University, Kristianstad, Sweden.,Blekinge Institute of Technology, Karlskrona, Sweden.,Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Goesta Rutger Persson
- School of Health and Society, Kristianstad University, Kristianstad, Sweden.,University of Washington, Seattle, WA, USA
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Schmitt A, Carra MC, Boutouyrie P, Bouchard P. Periodontitis and arterial stiffness: a systematic review and meta-analysis. J Clin Periodontol 2015; 42:977-87. [PMID: 26465940 DOI: 10.1111/jcpe.12467] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 01/11/2023]
Abstract
INTRODUCTION AND AIMS Patients with periodontitis have a higher risk of cardiovascular diseases, although a causal relationship between these conditions remains unclear. Arterial stiffness is considered a marker of arteriosclerosis and a risk factor for cardiovascular diseases. A systematic review of the literature on clinical studies using pulse wave velocity (PWV) to assess arterial stiffness in patients with periodontitis was carried out to answer the following questions: (i) Do patients with periodontitis have impaired arterial stiffness compared to non-periodontal diseased subjects? (ii) Is periodontal treatment effective as a means to improve arterial stiffness in patients with periodontitis? LITERATURE REVIEW Literature search was done on different databases up to September 2014. All clinical studies (excluding case reports) using PWV in patients with periodontitis were retrieved for a full-text evaluation. A total of 10 studies were included. Patients with periodontitis have increased arterial stiffness compared to controls (PWV mean difference 0.85 m/s; 95% confidence interval: 0.53-1.16; p<0.00001). The only two interventional studies showed contradictory results on the effects of periodontal treatment on PWV. CONCLUSION Patients with periodontitis appear to have higher values of PWV compared to controls. The effect of periodontal treatment on arterial stiffness remains unclear.
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Affiliation(s)
- Audrey Schmitt
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Université Paris 7 - Denis Diderot, U.F.R. of Odontology, Paris, France
| | - Maria Clotilde Carra
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Université Paris 7 - Denis Diderot, U.F.R. of Odontology, Paris, France
| | - Pierre Boutouyrie
- Department of Pharmacology, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.,INSERM U970, Université Paris Descartes, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Université Paris 7 - Denis Diderot, U.F.R. of Odontology, Paris, France.,EA 2496, Université Paris Descartes, Paris, France
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37
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Hasturk H, Kantarci A. Activation and resolution of periodontal inflammation and its systemic impact. Periodontol 2000 2015; 69:255-73. [PMID: 26252412 PMCID: PMC4530469 DOI: 10.1111/prd.12105] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2015] [Indexed: 02/06/2023]
Abstract
Inflammation is a highly organized event impacting upon organs, tissues and biological systems. Periodontal diseases are characterized by dysregulation or dysfunction of resolution pathways of inflammation that results in failure to heal and in a dominant chronic, progressive, destructive and predominantly unresolved inflammation. The biological consequences of inflammatory processes may be independent of the etiological agents, such as trauma, microbial organisms and stress. The impact of the inflammatory pathological process depends upon the tissues or organ system affected. Whilst mediators are similar, there is tissue specificity for the inflammatory events. It is plausible that inflammatory processes in one organ could directly lead to pathologies in another organ or tissue. Communication between distant parts of the body and their inflammatory status is also mediated by common signaling mechanisms mediated via cells and soluble mediators. This review focuses on periodontal inflammation, its systemic associations and advances in therapeutic approaches based on mediators acting through orchestration of natural pathways to resolution of inflammation. We also discuss a new treatment concept in which natural pathways of resolution of periodontal inflammation can be used to limit systemic inflammation and promote healing and regeneration.
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Affiliation(s)
- Hatice Hasturk
- The Forsyth Institute, Department of Applied Oral Sciences, Center for Periodontology, Cambridge, MA 02142, USA. Phone: 617-892-8499; Fax: 617-892-8505
| | - Alpdogan Kantarci
- The Forsyth Institute, Department of Applied Oral Sciences, Center for Periodontology, Cambridge, MA 02142, USA. Phone: 617-892-8530
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38
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Budzyński J, Wiśniewska J, Ciecierski M, Kędzia A. Association between Bacterial Infection and Peripheral Vascular Disease: A Review. Int J Angiol 2015; 25:3-13. [PMID: 26900306 DOI: 10.1055/s-0035-1547385] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There are an increasing number of data showing a clinically important association between bacterial infection and peripheral artery disease (PAD). Bacteria suspected of being involved in PAD pathogenesis are: periodontal bacteria, gut microbiota, Helicobacter pylori, and Chlamydia pneumoniae. Infectious agents may be involved in the pathogenesis of atherosclerosis via activation of a systemic or local host immunological response to contamination of extravascular tissues or the vascular wall, respectively. A systemic immunological reaction may damage vascular walls in the course of autoimmunological cross-reactions between anti-pathogen antibodies and host vascular antigens (immunological mimicry), pathogen burden mechanisms (nonspecific activation of inflammatory processes in the vascular wall), and neuroendocrine-immune cross-talk. Besides activating the inflammatory pathway, bacterial infection may trigger PAD progression or exacerbation by enhancement of platelet reactivity, by a stimulatory effect on von Willebrand factor binding, factor VIII, fibrinogen, P-selectin activation, disturbances in plasma lipids, increase in oxidative stress, and resistance to insulin. Local inflammatory host reaction and induction of atherosclerotic plaque progression and/or instability result mainly from atherosclerotic plaque colonization by microorganisms. Despite these premises, the role of bacterial infection in PAD pathogenesis should still be recognized as controversial, and randomized, controlled trials are required to evaluate the outcome of periodontal or gut bacteria modification (through diet, prebiotics, and probiotics) or eradication (using antibiotics) in hard and surrogate cardiovascular endpoints.
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Affiliation(s)
- Jacek Budzyński
- Chair of Vascular and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland; Department of Vascular and Internal Diseases, Jan Biziel Hospital No. 2, Bydgoszcz, Poland
| | - Joanna Wiśniewska
- Department of Vascular and Internal Diseases, Jan Biziel Hospital No. 2, Bydgoszcz, Poland
| | - Marek Ciecierski
- Department of Vascular and Internal Diseases, Jan Biziel Hospital No. 2, Bydgoszcz, Poland
| | - Anna Kędzia
- Department of Oral Microbiology, Chair of Microbiology, Medical University, Gdańsk, Poland
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Armingohar Z, Jørgensen JJ, Kristoffersen AK, Schenck K, Dembic Z. Polymorphisms in the interleukin-10 gene and chronic periodontitis in patients with atherosclerotic and aortic aneurysmal vascular diseases. J Oral Microbiol 2015; 7:26051. [PMID: 25700628 PMCID: PMC4336353 DOI: 10.3402/jom.v7.26051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/22/2014] [Accepted: 01/13/2015] [Indexed: 12/18/2022] Open
Abstract
Background Chronic periodontitis (CP), atherosclerotic and aortic aneurysmal vascular diseases (VD) are chronic inflammatory conditions with multifactorial etiologies, including involvement of predisposing genetic factors. In a previous study, polymorphisms in the gene for the anti-inflammatory interleukin-1 receptor antagonist were associated with CP in patients with VD. Objective This study investigates whether polymorphisms in the gene for the anti-inflammatory interleukin-10 (IL10) could be related to CP in the same manner. Methods Seventy-two patients with VD of whom 35 had CP were genotyped for single nucleotide polymorphisms (SNPs) in the IL10 −592 (rs1800872), −819 (rs1800871), and −1,082 (rs1800896) gene by Taqman rtPCR method and by DNA sequencing. Results The C alleles and C/C genotypes of IL10 −592 and IL10 −819 frequencies were significantly higher, while the frequencies of the IL10 −592 (C/A) and IL10 −819 (C/T) heterozygote genotypes were significantly lower in the VD group with CP compared to those without CP. The IL10 haplotype ATA frequency (−1,082, −819, −592) showed a trend to a significant difference between the two groups indicating protection against CP. Conclusions Taken together, our findings suggest an independent association of genetic polymorphisms in the IL-10 gene locus with CP in patients with VD. Development of CP and the implications on vascular disease emphasize the importance of early detection and adequate treatment of periodontitis among these patients.
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Affiliation(s)
- Zahra Armingohar
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway;
| | | | - Anne K Kristoffersen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Karl Schenck
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Zlatko Dembic
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Mawardi HH, Elbadawi LS, Sonis ST. Current understanding of the relationship between periodontal and systemic diseases. Saudi Med J 2015; 36:150-8. [PMID: 25719577 PMCID: PMC4375690 DOI: 10.15537/smj.2015.2.9424] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Periodontal disease (PD) is among the most common infectious diseases affecting humans. While the burden of periodontal disease on oral health has been extensively investigated, a possible specific relationship between the disease and systemic health is a relatively new area of interest. More recently it has been suggested that PD has an etiological role in the development of atherosclerotic cardiovascular disease, diabetes mellitus, and preterm low-birth weight, among others. In this review, we critically evaluate the current knowledge on the relation between PD and systemic diseases overall, and specifically with cardiovascular diseases. The best available evidence today suggests that the infection and inflammatory reaction associated with PD may contribute toward systemic disease. It is critical that dentists and physicians are well informed of the potential general health impact of periodontal disease so that they are in a position to knowledgeably counsel patients.
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Affiliation(s)
- Hani H Mawardi
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States of America. E-mail.
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41
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Gil-Montoya JA, Sanchez-Lara I, Carnero-Pardo C, Fornieles F, Montes J, Vilchez R, Burgos JS, Gonzalez-Moles MA, Barrios R, Bravo M. Is periodontitis a risk factor for cognitive impairment and dementia? A case-control study. J Periodontol 2014; 86:244-53. [PMID: 25345338 DOI: 10.1902/jop.2014.140340] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Dementia is a multi-etiologic syndrome characterized by multiple cognitive deficits but not always by the presence of cognitive impairment. Cognitive impairment is associated with multiple non-modifiable risk factors but few modifiable factors. Epidemiologic studies have shown an association between periodontitis, a potentially modifiable risk factor, and cognitive impairment. The objective of this study is to determine whether clinical periodontitis is associated with the diagnosis of cognitive impairment/dementia after controlling for known risk factors, including age, sex, and education level. METHODS A case-control study was conducted in Granada, Spain, in two groups of dentate individuals aged >50 years: 1) cases with a firm diagnosis of mild cognitive impairment or dementia of any type or severity and 2) controls with no subjective memory loss complaints and a score >30 in the Phototest cognitive test (screening test for cognitive impairment). Periodontitis was evaluated by measuring tooth loss, plaque and bleeding indexes, probing depths, and clinical attachment loss (AL). RESULTS The study included 409 dentate adults, 180 with cognitive impairment and 229 without. A moderate and statistically significant association was observed between AL and cognitive impairment after controlling for age, sex, education level, oral hygiene habits, and hyperlipidemia (P = 0.049). No significant association was found between tooth loss and cognitive impairment. CONCLUSION Periodontitis appears to be associated with cognitive impairment after controlling for confounders such as age, sex, and education level.
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42
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The effect of periodontal treatment on hemoglobin a1c levels of diabetic patients: a systematic review and meta-analysis. PLoS One 2014; 9:e108412. [PMID: 25255331 PMCID: PMC4177914 DOI: 10.1371/journal.pone.0108412] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 08/28/2014] [Indexed: 02/07/2023] Open
Abstract
Background There is growing evidence that periodontal treatment may affect glycemic control in diabetic patients. And several systematic reviews have been conducted to assess the effect of periodontal treatment on diabetes outcomes. Researches of this aspect are widely concerned, and several new controlled trials have been published. The aim of this study was to update the account for recent findings. Methods A literature search (until the end of January 2014) was carried out using various databases with language restriction to English. A randomized controlled trial (RCT) was selected if it investigated periodontal therapy for diabetic subjects compared with a control group received no periodontal treatment for at least 3 months of the follow-up period. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were periodontal parameters included probing pocket depth (PPD) and clinical attachment level (CAL). Results Ten trials of 1135 patients were included in the analysis. After the follow-up of 3 months, treatment substantially lowered HbA1c compared with no treatment after periodontal therapy (–0.36%, 95%CI, −0.52% to −0.19%, P<0.0001). Clinically substantial and statistically significant reduction of PPD and CAL were found between subjects with and without treatment after periodontal therapy (PPD −0.42 mm, 95%CI: −0.60 to −0.23, P<0.00001; CAL −0.34 mm, 95%CI: −0.52 to −0.16, P = 0.0002). And there is no significant change of the level of HbA1c at the 6-month comparing with no treatment (–0.30%, 95%CI, −0.69% to 0.09%, P = 0.13). Conclusions Periodontal treatment leads to the modest reduction in HbA1c along with the improvement of periodontal status in diabetic patients for 3 months, and this result is consistent with previous systematic reviews. And the effect of periodontal treatment on HbA1c cannot be observed at 6-month after treatment.
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Grabe HJ, Assel H, Bahls T, Dörr M, Endlich K, Endlich N, Erdmann P, Ewert R, Felix SB, Fiene B, Fischer T, Flessa S, Friedrich N, Gadebusch-Bondio M, Salazar MG, Hammer E, Haring R, Havemann C, Hecker M, Hoffmann W, Holtfreter B, Kacprowski T, Klein K, Kocher T, Kock H, Krafczyk J, Kuhn J, Langanke M, Lendeckel U, Lerch MM, Lieb W, Lorbeer R, Mayerle J, Meissner K, zu Schwabedissen HM, Nauck M, Ott K, Rathmann W, Rettig R, Richardt C, Saljé K, Schminke U, Schulz A, Schwab M, Siegmund W, Stracke S, Suhre K, Ueffing M, Ungerer S, Völker U, Völzke H, Wallaschofski H, Werner V, Zygmunt MT, Kroemer HK. Cohort profile: Greifswald approach to individualized medicine (GANI_MED). J Transl Med 2014; 12:144. [PMID: 24886498 PMCID: PMC4040487 DOI: 10.1186/1479-5876-12-144] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/17/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Individualized Medicine aims at providing optimal treatment for an individual patient at a given time based on his specific genetic and molecular characteristics. This requires excellent clinical stratification of patients as well as the availability of genomic data and biomarkers as prerequisites for the development of novel diagnostic tools and therapeutic strategies. The University Medicine Greifswald, Germany, has launched the "Greifswald Approach to Individualized Medicine" (GANI_MED) project to address major challenges of Individualized Medicine. Herein, we describe the implementation of the scientific and clinical infrastructure that allows future translation of findings relevant to Individualized Medicine into clinical practice. METHODS/DESIGN Clinical patient cohorts (N > 5,000) with an emphasis on metabolic and cardiovascular diseases are being established following a standardized protocol for the assessment of medical history, laboratory biomarkers, and the collection of various biosamples for bio-banking purposes. A multi-omics based biomarker assessment including genome-wide genotyping, transcriptome, metabolome, and proteome analyses complements the multi-level approach of GANI_MED. Comparisons with the general background population as characterized by our Study of Health in Pomerania (SHIP) are performed. A central data management structure has been implemented to capture and integrate all relevant clinical data for research purposes. Ethical research projects on informed consent procedures, reporting of incidental findings, and economic evaluations were launched in parallel.
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Affiliation(s)
- Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald 17475, Germany
| | - Heinrich Assel
- Faculty of Theology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Thomas Bahls
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, partner site Greifswald, Greifswald, Germany
| | - Karlhans Endlich
- Institute of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Nicole Endlich
- Institute of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Pia Erdmann
- DZNE (German Center for Neurodegenerative Diseases), partner site Rostock/Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine, Pulmonary Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Stephan B Felix
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, partner site Greifswald, Greifswald, Germany
| | - Beate Fiene
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Tobias Fischer
- Institute of the History of Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Steffen Flessa
- Department of Health Care Management, Faculty of Law and Economics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Nele Friedrich
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Mariacarla Gadebusch-Bondio
- Institute of the History of Medicine, University Medicine Greifswald, Greifswald, Germany
- Institute of History and Ethics of Medicine, Technical University Munich, Munich, Germany
| | - Manuela Gesell Salazar
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Elke Hammer
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christoph Havemann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Michael Hecker
- Institute for Microbiology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- DZNE (German Center for Neurodegenerative Diseases), partner site Rostock/Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
| | - Tim Kacprowski
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Kathleen Klein
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
| | - Holger Kock
- Strategic Research Management, University Medicine Greifswald, Greifswald, Germany
| | - Janina Krafczyk
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Jana Kuhn
- Institute of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Martin Langanke
- Faculty of Theology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Uwe Lendeckel
- Institute of Medical Biochemistry and Molecular Biology, University Medicine Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Lieb
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany
| | - Roberto Lorbeer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Julia Mayerle
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Konrad Meissner
- Department of Anaesthesiology and Intensive Care, University Medicine Greifswald, Greifswald, Germany
| | - Henriette Meyer zu Schwabedissen
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
- Department of Pharmaceutical Research, University Basel, Basel, Switzerland
| | - Matthias Nauck
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Konrad Ott
- Department of Philosophy, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
- Department of Philosophy, Christian-Albrechts University Kiel, Kiel, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Rainer Rettig
- Institute of Physiology, University Medicine Greifswald, Greifswald, Germany
| | - Claudia Richardt
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Karen Saljé
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Andrea Schulz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald 17475, Germany
| | - Matthias Schwab
- Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- Department of Clinical Pharmacology, University Hospital, Tuebingen, Germany
| | - Werner Siegmund
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Sylvia Stracke
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Karsten Suhre
- Institute for Bioinformatics and Systems Biology, Helmholtz Zentrum, München, Germany
- Bioinformatics Core, Weill Cornell Medical College, Doha, Qatar
| | - Marius Ueffing
- Resarch Unit of Protein Science, Helmholtz Zentrum, München, Germany
- Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Saskia Ungerer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Vivian Werner
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marek T Zygmunt
- Department of Obstetrics and Gynaecology, University Medicine, Greifswald, Germany
| | - Heyo K Kroemer
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
- Dean’s office, University Medicine Göttingen, Göttingen, Germany
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44
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Periodontal pathogens and atherosclerosis: implications of inflammation and oxidative modification of LDL. BIOMED RESEARCH INTERNATIONAL 2014; 2014:595981. [PMID: 24949459 PMCID: PMC4052162 DOI: 10.1155/2014/595981] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/07/2014] [Accepted: 04/28/2014] [Indexed: 12/29/2022]
Abstract
Inflammation is well accepted to play a crucial role in the development of atherosclerotic lesions, and recent studies have demonstrated an association between periodontal disease and cardiovascular disease. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, causative agents of destructive chronic inflammation in the periodontium, can accelerate atheroma deposition in animal models. Emerging evidence suggests that vaccination against virulence factors of these pathogens and anti-inflammatory therapy may confer disease resistance. In this review, we focus on the role of inflammatory mechanisms and oxidative modification in the formation and activation of atherosclerotic plaques accelerated by P. gingivalis or A. actinomycetemcomitans in an ApoE-deficient mouse model and high-fat-diet-fed mice. Furthermore, we examine whether mucosal vaccination with a periodontal pathogen or the anti-inflammatory activity of catechins can reduce periodontal pathogen-accelerated atherosclerosis.
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