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Fawzy El-Sayed K, Mahlandt E, Schlicht K, Enthammer K, Tölle J, Wagner J, Hartmann K, Ebeling PR, Graetz C, Laudes M, Dörfer CE, Schulte DM. Effects of oxidized LDL versus IL-1ß/TNF-ɑ/INFɣ on human gingival mesenchymal stem cells properties. J Periodontal Res 2024. [PMID: 38952262 DOI: 10.1111/jre.13319] [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: 04/23/2024] [Revised: 06/12/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
AIMS Oxidized low-density lipoprotein (oxLDL) is an important player in the course of metabolic inflammatory diseases. oxLDL was identified in the gingival crevicular fluid, denoting possible associations between oxLDL-induced inflammation and periodontal disease. The current investigation compared for the first-time direct effects of oxLDL to a cytokine cocktail of IL-1ß/TNF-ɑ/INF-γ on gingival mesenchymal stem cells' (G-MSCs) attributes. METHODS Human third passage G-MSCs, isolated from connective tissue biopsies (n = 5) and characterized, were stimulated in three groups over 7 days: control group, cytokine group (IL-1β[1 ng/mL], TNF-α[10 ng/mL], IFN-γ[100 ng/mL]), or oxLDL group (oxLDL [50 μg/mL]). Next Generation Sequencing and KEGG pathway enrichment analysis, stemness gene expression (NANOG/SOX2/OCT4A), cellular proliferation, colony-formation, multilinear potential, and altered intracellular pathways were investigated via histochemistry, next-generation sequencing, and RT-qPCR. RESULTS G-MSCs exhibited all mesenchymal stem cells' characteristics. oxLDL group and cytokine group displayed no disparities in their stemness markers (p > .05). Next-generation-sequencing revealed altered expression of the TXNIP gene in response to oxLDL treatment compared with controls (p = .04). Following an initial boosting for up to 5 days by inflammatory stimuli, over 14 day, cellular counts [median count ×10-5 (Q25/Q75)] were utmost in control - [2.6607 (2.0804/4.5357)], followed by cytokine - [0.0433 (0.0026/1.4215)] and significantly lowered in the oxLDL group [0.0274 (0.0023/0.7290); p = .0047]. Osteogenic differentiation [median relative Ca2+ content(Q25/Q75)] was significantly lower in cytokine - [0.0066 (0.0052/0.0105)] compared to oxLDL - [0.0144 (0.0108/0.0216)] (p = .0133), with no differences notable for chondrogenic and adipogenic differentiation (p > .05). CONCLUSIONS Within the current investigation's limitations, in contrast to cytokine-mediated inflammation, G-MSCs appear to be minimally responsive to oxLDL-mediated metabolic inflammation, with little negative effect on their differentiation attributes and significantly reduced cellular proliferation.
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Affiliation(s)
- Karim Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Schleswig-Holstein, Kiel, Germany
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Stem Cells and Tissue Engineering Unit, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Elena Mahlandt
- Institute of Diabetes and Clinical Metabolic Research, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Kristina Schlicht
- Institute of Diabetes and Clinical Metabolic Research, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Kim Enthammer
- Institute of Diabetes and Clinical Metabolic Research, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Johannes Tölle
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Schleswig-Holstein, Kiel, Germany
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
- Institute of Immunology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Juliane Wagner
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Katharina Hartmann
- Institute of Diabetes and Clinical Metabolic Research, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Mathias Laudes
- Institute of Diabetes and Clinical Metabolic Research, University Hospital of Schleswig-Holstein, Kiel, Germany
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Dominik M Schulte
- Institute of Diabetes and Clinical Metabolic Research, University Hospital of Schleswig-Holstein, Kiel, Germany
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
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Ebersole JL, Nguyen LM, Gonzalez OA. Gingival tissue antibody gene utilization in aging and periodontitis. J Periodontal Res 2022; 57:780-798. [PMID: 35582846 DOI: 10.1111/jre.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/20/2022] [Accepted: 04/29/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study used a nonhuman primate model of ligature-induced periodontitis to document the characteristics of immunoglobulin (Ig) gene usage in gingival tissues with disease and affected by age. BACKGROUND Adaptive immune responses to an array of oral bacteria are routinely detected in local gingival tissues and the systemic circulation across the human population. The level and diversity of antibody increases with periodontitis, reflecting the increased quantity of B cells and plasmacytes in the tissues at sites of periodontal lesions. METHODS Macaca mulatta (n = 36) in four groups (young - ≤3 years; adolescent >3-7 years; adult - 12-15 years; aged - 17-23 years) were used in this study. Gingival tissues were sampled at baseline (health), 2 weeks (initiation), 1 and 3 months (progression), and 5 months (resolution) of the lesion development and transcriptomic analysis included 78 Ig-related genes. RESULTS The results demonstrated extensive variation in Ig gene usage patterns and changes with the disease process that was substantially affected by the age of the animal. Of note was that the aged animals generally demonstrated elevated expression on multiple Ig genes even in the baseline/healthy gingival tissues. The expression levels revealed 5 aggregates of Ig gene change profiles across the age groups. The number of gene changes were greatly increased in adult animals with the initiation of disease, while the young and adolescent animals showed extensive changes with disease progression. Elevated Ig gene transcripts remained with disease resolution except in the aged animals. The response profiles demonstrated selective heavy/light change gene transcripts that differed with age and clustering of the transcript expression was dominated by the age of the animals. CONCLUSIONS The results suggested potential critical variations in the molecular aspects of Ig gene expression in gingival tissues that can contribute to understanding the kinetics of periodontal lesions, as well as the variation in episodes, rapidity of progression, and role in resolution that are impacted by age.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Linh M Nguyen
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Octavio A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA.,Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
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Ebersole JL, Kirakodu SS, Orraca L, Gonzalez Martinez J, Gonzalez OA. Gingival transcriptomics of follicular T cell footprints in progressing periodontitis. Clin Exp Immunol 2021; 204:373-395. [PMID: 33565609 DOI: 10.1111/cei.13584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/22/2022] Open
Abstract
Follicular helper T cells (Tfh) cells have been identified in the circulation and in tertiary lymphoid structures in chronic inflammation. Gingival tissues with periodontitis reflect chronic inflammation, so genomic footprints of Tfh cells should occur in these tissues and may differ related to aging effects. Macaca mulatta were used in a ligature-induced periodontitis model [adult group (aged 12-23 years); young group (aged 3-7 years)]. Gingival tissue and subgingival microbiome samples were obtained at matched healthy ligature-induced disease and clinical resolution sites. Microarray analysis examined Tfh genes (n = 54) related to microbiome characteristics documented using 16S MiSeq. An increase in the major transcription factor of Tfh cells, BCL6, was found with disease in both adult and young animals, while master transcription markers of other T cell subsets were either decreased or showed minimal change. Multiple Tfh-related genes, including surface receptors and transcription factors, were also significantly increased during disease. Specific microbiome patterns were significantly associated with profiles indicative of an increased presence/function of Tfh cells. Importantly, unique microbial complexes showed distinctive patterns of interaction with Tfh genes differing in health and disease and with the age of the animals. An increase in Tfh cell responsiveness occurred in the progression of periodontitis, affected by age and related to specific microbial complexes in the oral microbiome. The capacity of gingival Tfh cells to contribute to localized B cell activation and active antibody responses, including affinity maturation, may be critical for controlling periodontal lesions and contributing to limiting and/or resolving the lesions.
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Affiliation(s)
- J L Ebersole
- Department of Biomedical Science, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - S S Kirakodu
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - L Orraca
- School of Dental Medicine, University of Puerto Rico, San Juan, PR, USA
| | - J Gonzalez Martinez
- Caribbean Primate Research Center, University of Puerto Rico, Toa Baja, PR, USA
| | - O A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.,Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, KY, USA
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4
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Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000 2020; 83:90-106. [PMID: 32385879 DOI: 10.1111/prd.12304] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerosis is central to the pathology of cardiovascular diseases, a group of diseases in which arteries become occluded with atheromas that may rupture, leading to different cardiovascular events, such as myocardial infarction or ischemic stroke. There is a large body of epidemiologic and animal model evidence associating periodontitis with atherosclerotic disease, and many potential mechanisms linking these diseases have been elucidated. This chapter will update knowledge on these mechanisms, which generally fall into 2 categories: microbial invasion and infection of atheromas; and inflammatory and immunologic. With respect to the invasion and infection of atheromas, it is well established that organisms from the subgingival biofilm can enter the circulation and lodge in most distant tissues. Bacteremias resulting from oral interventions, and even oral hygiene activities, are well documented. More recently, indirect routes of entry of oral organisms (via phagocytes or dendritic cells) have been described for many oral organisms, into many tissues. Such organisms include the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum. Intracellular survival of these organisms with dissemination to distant sites (The Trojan Horse approach) has been described. Their relative contribution to atheroma formation and progression has been studied mainly in experimental research, with results demonstrating that these organisms can invade endothelial cells and phagocytic cells within the atheroma, leading to pathogenic changes and progression of the atheroma lesion. The second category of mechanisms potentially linking periodontitis to atherosclerosis includes the dumping of inflammatory mediators originating from periodontal lesions into the systemic circulation. These inflammatory mediators, such as C-reactive protein, matrix metalloproteinases, fibrinogen, and other hemostatic factors, would further accelerate atheroma formation and progression, mainly through oxidative stress and inflammatory dysfunction. Moreover, direct effects on lipid oxidation have also been described. In summary, the evidence supports the concept that periodontitis enhances the levels of systemic mediators of inflammation that are risk factors for atherosclerotic diseases.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, NewYork, New York, USA
| | - Robert Genco
- Departments of Oral Biology, and Microbiology and Immunology, Center for Microbiome Research, University at Buffalo, Buffalo, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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Hong M, Park JB, Kim YS, Lee DH, Kim H, Lee JI, Ahn HS, Sohn TS, Lee TK, Song JY, Jeong SC, Yeo CD, Chae HS, Do Han K, Vu D, Lee YB. Association between Cockroach-specific Immunoglobulin E and periodontitis in Korean male adults Based on Korean National Health and Nutrition Examination Survey. Sci Rep 2017; 7:46373. [PMID: 28401926 PMCID: PMC5388886 DOI: 10.1038/srep46373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/15/2017] [Indexed: 01/22/2023] Open
Abstract
Periodontitis is an inflammatory disease affecting the tooth supporting tissues (periodontium) and associated with chronic diseases such as cardiovascular disease and insulin resistance. However, there has been no nation-wide population based epidemiologic study regarding any association between periodontitis and serum IgE. Among the 8,958 participants in the 2010 Korean National Health and Nutrition Examination Survey (KNHANES V-1), 1,731 adults aged 19 to 64 who had measured serum IgE were included in the analysis. Dentists examined the periodontal status of the participants. Multiple logistic regression analyses were used to evaluate the odds ratio of periodontitis in association with total IgE and specific IgE to cockroach and house dust mite. In males, total IgE showed a positive correlation with the presence of periodontitis. The participants in the highest tertile of cockroach specific IgE (T3, >31.6 kU/L) had a significantly increased risk of periodontitis (OR = 2.108; 95% CI, 1.233–3.606). In females, the inverse association occurred between total IgE and periodontitis (OR = 0.409; 95% CI, 0.200–0.839). The present study firstly demonstrated the association between periodontitis and serum IgE, using the Korean nationwide, population-based, cross-sectional health examination and survey. This study suggested a positive correlation between periodontitis and cockroach-specific IgE in Korean male adults.
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Affiliation(s)
- Mihee Hong
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jun-Beom Park
- Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Soo Kim
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong-Hee Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - HeeYeon Kim
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae-Im Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyo-Suk Ahn
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Tae Seo Sohn
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Tae-Kyu Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Yen Song
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seong Cheol Jeong
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Dong Yeo
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hiun Suk Chae
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyung Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - David Vu
- Wing Dental Center, Alberta, Canada
| | - Young Bok Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Ampuero J, Ranchal I, Gallego-Durán R, Pareja MJ, Del Campo JA, Pastor-Ramírez H, Rico MC, Picón R, Pastor L, García-Monzón C, Andrade R, Romero-Gómez M. Oxidized low-density lipoprotein antibodies/high-density lipoprotein cholesterol ratio is linked to advanced non-alcoholic fatty liver disease lean patients. J Gastroenterol Hepatol 2016; 31:1611-8. [PMID: 26946071 DOI: 10.1111/jgh.13335] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/26/2016] [Accepted: 02/26/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM A small but significant proportion of patients with normal body mass index show non-alcoholic fatty liver disease (NAFLD). Oxidized low-density lipoprotein (LDL) is a powerful immunogenic molecule, which causes oxidative stress and produces antibodies (oxLDL-ab). We aimed to analyze the role of oxLDL-ab on histological features in lean-NAFLD patients. METHODS Seventy-two biopsy-proven NAFLD patients were included. Lean patients showed body index mass of <30 kg/m(2) . Liver biopsies were assessed by one pathologist blinded to clinical data. Histological features were non-alcoholic steatohepatitis (NASH), steatosis, hepatocellular ballooning, and liver fibrosis. Metabolic and hepatic profiles were analyzed, and lipid-lowering medication was recorded. OxLDL-ab levels were measured by ELISA. OxLDL-ab-based lipid indexes analyzed: oxLDL-ab/total cholesterol ratio; oxLDL-ab/LDL-c ratio; oxLDL-ab/high-density lipoprotein cholesterol (HDL-c) ratio; and oxLDL-ab/oxLDL ratio. RESULTS Lean-NAFLD patients presented 26.5% (9/34) of NASH. OxLDL-ab/HDL-c ratio (r = 0.570; n = 34; P = 0.001) correlated with NAS score and was the only variable associated with NASH in the multivariate analysis [odds ratio, OR, 1.10 (95% confidence interval, CI: 1.01-1.21); P = 0.039]. Severe steatosis was present in 41.2% (14/34) of lean-NAFLD patients. OxLDL-ab/HDL-c ratio was higher in patients with grade-III steatosis (54.9 (37.3-124.6)) than those with grade II (37.1 (20.2-71.1)) and grade I (17.7 (13.1-22.8)) (P = 0.018). Hepatocellular ballooning was present in 20.6% (7/34) of lean-NAFLD patients, and OxLDL-ab/HDL-c ratio (OR 1.03 [95% CI: 1.01-1.05]; P = 0.050) was independently associated with histological features. OxLDL-ab/HDL-c ratio was higher in patients with advanced fibrosis (39.8 (22.9-121.6) vs 17.7 (13.9-30.9); P = 0.025), increasing gradually with the fibrosis stage (P = 0.042) and remained in the final multivariate model [OR 1.05 (95% CI: 1.00-1.11); P = 0.05]. However, in obese-NAFLD patients, oxLDL/HDL-c ratio was not associated with histological features. CONCLUSIONS Oxidized low-density lipoprotein antibodies/high-density lipoprotein cholesterol ratio could represent an interesting biomarker associated with NASH, hepatocellular ballooning, and liver fibrosis, in lean patients. OxLDL-ab/HDL-c could play an important role for distinguishing patients with and without NAFLD complications.
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Affiliation(s)
- Javier Ampuero
- Inter-Centre Unit of Digestive Diseases & CIBERehd. Virgen Macarena - Virgen del Rocío University Hospitals, University of Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | | | - Rocío Gallego-Durán
- Inter-Centre Unit of Digestive Diseases & CIBERehd. Virgen Macarena - Virgen del Rocío University Hospitals, University of Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | | | - Jose Antonio Del Campo
- Instituto de Biomedicina de Sevilla, Sevilla, Spain.,Valme University Hospital, Sevilla, Spain
| | - Helena Pastor-Ramírez
- Inter-Centre Unit of Digestive Diseases & CIBERehd. Virgen Macarena - Virgen del Rocío University Hospitals, University of Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - María Carmen Rico
- Inter-Centre Unit of Digestive Diseases & CIBERehd. Virgen Macarena - Virgen del Rocío University Hospitals, University of Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Rocío Picón
- Cardiology Unit, Valme University Hospital, Sevilla, Spain
| | - Luis Pastor
- Cardiology Unit, Valme University Hospital, Sevilla, Spain
| | - Carmelo García-Monzón
- Liver Research Unit, Department of Gastroenterology, Santa Cristina University Hospital, Madrid, Spain
| | - Raúl Andrade
- Unit for the Medical Management of Digestive Diseases & CIBERehd, Virgen de la Victoria University Hospital, Biomedical Research Institute of Málaga - IBIMA, Málaga, Spain
| | - Manuel Romero-Gómez
- Inter-Centre Unit of Digestive Diseases & CIBERehd. Virgen Macarena - Virgen del Rocío University Hospitals, University of Sevilla, Sevilla, Spain. .,Instituto de Biomedicina de Sevilla, Sevilla, Spain.
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Yadalam PK, Rajapandian K, Ravishankar PL, Vartharajan K, Subramaniam S, Dinakar M. Evaluation of anticardiolipin antibodies in tobacco users and non-tobacco users with severe chronic periodontal disease. J Int Soc Prev Community Dent 2016; 6:256-60. [PMID: 27382544 PMCID: PMC4916802 DOI: 10.4103/2231-0762.183115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 05/19/2016] [Indexed: 01/22/2023] Open
Abstract
Aims: Many studies have proven that b2-glycoprotein-I-dependent anticardiolipin is elevated in periodontal diseases. Systemic lupus erythematosus and antiphospholipid syndrome, which are usually associated with high antiphospholipid antibodies, are more prone to adverse pregnancy outcomes and cardiovascular sequelae. Therefore, the aim of the present study is to evaluate IgG, IgM anticardiolipin antibodies in tobacco users and non-tobacco users with severe chronic periodontal disease. Materials and Methods: Based on the Armitage classification, 2000, 40 severe periodontitis (group D) (mean clinical attachment loss greater than 2.5 mm) male patients were selected for the study with the age range of 35–65 years and good general health from the Department of periodontics, SRM Kattankulathur Dental College, Chennai. They were classified as smokers (20 subjects) and non-smokers (20 subjects). Blood samples were collected and IgG, IgM antibodies were semi-quantitatively analyzed by enzyme-linked immunosorbent assay. The data thus collected were statistically analyzed by independent student's t-test. Results: Results showed that smokers with severe periodontitis exhibited marked increase in anticardiolipin IgG, IgM compared to non-smokers. They showed a positive correlation and statistical significance (P < 0.0001) between mean clinical attachment loss and IgG and IgM values. Conclusions: Results showed a rise in anticardiolipin antibodies in smokers with severe periodontitis, which indicates that these patients are more prone to coronary heart disease.
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Affiliation(s)
- Pradeep K Yadalam
- Department of Periodontics, SRM Kattankulathur Dental College, SRM University, Chennai, Tamil Nadu, India
| | - K Rajapandian
- Department of Periodontics, SRM Kattankulathur Dental College, SRM University, Chennai, Tamil Nadu, India
| | - P L Ravishankar
- Department of Periodontics, SRM Kattankulathur Dental College, SRM University, Chennai, Tamil Nadu, India
| | - Kalaivani Vartharajan
- Department of Periodontics, SRM Kattankulathur Dental College, SRM University, Chennai, Tamil Nadu, India
| | - Srinath Subramaniam
- Department of Periodontics, SRM Kattankulathur Dental College, SRM University, Chennai, Tamil Nadu, India
| | - Mithra Dinakar
- Department of Periodontics, SRM Kattankulathur Dental College, SRM University, Chennai, Tamil Nadu, India
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Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Clin Periodontol 2016; 40 Suppl 14:S51-69. [PMID: 23627334 DOI: 10.1111/jcpe.12060] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/17/2022]
Abstract
AIMS In this article, inflammatory mechanisms that link periodontal diseases to cardiovascular diseases are reviewed. METHODS This article is a literature review. RESULTS Studies in the literature implicate a number of possible mechanisms that could be responsible for increased inflammatory responses in atheromatous lesions due to periodontal infections. These include increased systemic levels of inflammatory mediators stimulated by bacteria and their products at sites distant from the oral cavity, elevated thrombotic and hemostatic markers that promote a prothrombotic state and inflammation, cross-reactive systemic antibodies that promote inflammation and interact with the atheroma, promotion of dyslipidemia with consequent increases in pro-inflammatory lipid classes and subclasses, and common genetic susceptibility factors present in both disease leading to increased inflammatory responses. CONCLUSIONS Such mechanisms may be thought to act in concert to increase systemic inflammation in periodontal disease and to promote or exacerbate atherogenesis. However, proof that the increase in systemic inflammation attributable to periodontitis impacts inflammatory responses during atheroma development, thrombotic events or myocardial infarction or stroke is lacking.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, Virginia Commonwealth University, Richmond, VA 23298-0566, USA.
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10
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Buhlin K, Holmer J, Gustafsson A, Hörkkö S, Pockley AG, Johansson A, Paju S, Klinge B, Pussinen PJ. Association of periodontitis with persistent, pro-atherogenic antibody responses. J Clin Periodontol 2015; 42:1006-14. [PMID: 26362847 DOI: 10.1111/jcpe.12456] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 12/16/2022]
Abstract
AIM To study antibody responses associated with molecular mimicry in periodontitis. MATERIAL & METHODS Fifty-four periodontitis cases (mean age 54.0 years) and 44 controls (53.6 years) were examined, after which cases received periodontal treatment. Established immunoassays were used to analyse levels of antibodies against two pathogens, Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg), heat shock proteins (Hsp), Hsp60, Hsp65, and Hsp70, and epitopes of oxidized low-density lipoprotein (oxLDL) (CuOx-LDL and MDA-LDL) in plasma samples that were collected at baseline and after 3 (n = 48) and 6 (n = 30) months. RESULTS When age, sex, smoking habit, and the number of teeth were considered in multivariate logistic regressions, Aa and Pg IgG, Hsp65-IgA, CuOx-LDL-IgG and -IgM, and MDA-LDL-IgG antibody levels were associated with periodontitis, whereas Hsp60-IgG2 antibody levels were inversely associated. The Aa antibody levels significantly correlated with the levels of IgA antibodies to Hsp65 and Hsp70, and both OxLDL IgA antibody levels. The levels of antibodies to Pg correlated with IgG antibodies to Hsp60, Hsp70, and both oxLDL antibody epitopes. None of the antibody levels changed significantly after treatment. CONCLUSIONS Periodontitis is associated with persistently high levels of circulating antibodies that are reactive with pathogen- and host-derived antigens.
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Affiliation(s)
- Kåre Buhlin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jacob Holmer
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Anders Gustafsson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sohvi Hörkkö
- Department of Medical Microbiology and Immunology and Medical Research Center, University of Oulu & Nordlab Oulu, Oulu University Hospital, Oulu, Finland
| | - Alan Graham Pockley
- The John van Geest Cancer Research Centre, Nottingham Trent University, Nottingham, UK
| | - Anders Johansson
- Department of Molecular Periodontology, Umeå University, Umeå, Sweden
| | - Susanna Paju
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Björn Klinge
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Periodontology, Faculty of Odontology, Malmo University, Malmo, Sweden
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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11
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Wang CY, Chyuan IT, Wang YL, Kuo MYP, Chang CW, Wu KJ, Hsu PN, Nagasawa T, Wara-aswapati N, Chen YW. β2-Glycoprotein I-Dependent Anti-Cardiolipin Antibodies Associated With Periodontitis in Patients With Systemic Lupus Erythematosus. J Periodontol 2015; 86:995-1004. [PMID: 25817824 DOI: 10.1902/jop.2015.140664] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND It was reported that patients with systemic lupus erythematosus (SLE) exhibited increased levels of anticardiolipin (anti-CL) antibodies, a class of antiphospholipid antibodies associated with thrombosis. β2-glycoprotein I (β2GPI) has been considered as the actual target antigen for anti-CL antibodies. This study investigates the association of periodontal infection with anti-CL antibodies in patients with SLE. METHODS Fifty-three SLE female patients and 56 healthy female volunteers were recruited in this case-control study. All participants received periodontal examinations. The presence of Porphyromonas gingivalis and Treponema denticola in saliva and plaque samples was detected by polymerase chain reaction. Levels of serum anti-CL and anti-β2GPI antibodies were examined using enzyme-linked immunosorbent assay. RESULTS Patients with SLE exhibited more periodontal attachment loss and increased titers of serum anti-CL and anti-β2GPI antibodies compared with healthy controls. Patients with active SLE who harbored P. gingivalis or P. gingivalis together with T. denticola intraorally exhibited significantly higher anti-CL and anti-β2GPI antibodies than those without these bacteria. Anti-CL and anti-β2GPI antibody levels correlated positively with clinical attachment level. Furthermore, increased anti-β2GPI antibody levels were significantly associated with C-reactive protein and erythrocyte sedimentation rate. CONCLUSIONS Elevated anti-CL and anti-β2GPI antibody levels were associated with periodontopathic bacteria and periodontal breakdown in patients with SLE. Periodontitis might be a modifiable risk factor for SLE.
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Affiliation(s)
- Chen-Ying Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Tsu Chyuan
- Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan
| | - Ya-Li Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Mark Yen-Ping Kuo
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Wen Chang
- Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - King-Jean Wu
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ping-Ning Hsu
- Graduate Institute of Immunology, College of Medicine, National Taiwan University.,Department of Internal Medicine, National Taiwan University Hospital
| | - Toshiyuki Nagasawa
- Department of Integrated Dental Education, Division of Advanced Clinical Education, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Nawarat Wara-aswapati
- Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Yi-Wen Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
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12
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Shah R, Thomas R, Mehta DS. Oxidized-low density lipoprotein in gingival crevicular fluid of patients with chronic periodontitis: a possible link to atherogenesis. Acta Odontol Scand 2014; 72:154-6. [PMID: 23822906 DOI: 10.3109/00016357.2013.810772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate a possible link between periodontitis and atherogenesis by examining the levels of anti-oxidized low density lipoprotien (ox LDL) and low density lipoprotien (LDL) in gingival crevicular fluid (GCF) and serum of healthy subjects and chronic periodontitis patients. METHODS Sixty male subjects (35-55 years) were grouped into 30 healthy individuals and 30 subjects with chronic periodontitis. Serum and GCF samples were obtained from each subject and were assessed for anti-ox LDL and LDL levels. RESULTS A significant difference (p < 0.001) was found between the anti-ox-LDL levels in GCF of healthy vs chronic periodontitis groups. Also the ratio of GCF anti-ox LDL to GCF LDL was significantly higher (p < 0.001) in chronic periodontitis patients as compared to the healthy group. CONCLUSIONS A significant rise in ox LDL level in otherwise systemically healthy chronic periodontitis patients may put these subjects at an increased risk of developing atherosclerosis.
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Affiliation(s)
- Rucha Shah
- Department of Periodontics, Bapuji Dental College and Hospital , Davangere, Karnataka , India
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13
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Cunningham LL, Novak MJ, Madsen M, Abadi B, Ebersole JL. A bidirectional relationship of oral-systemic responses: observations of systemic host responses in patients after full-mouth extractions. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:435-44. [PMID: 24630161 DOI: 10.1016/j.oooo.2013.11.502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 11/18/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This investigation tested the hypothesis that systemic inflammatory responses would be attenuated by minimizing the oral microbial burden in patients with moderate to severe periodontitis. STUDY DESIGN Patients (n = 73) scheduled for full-mouth extractions were categorized as case type I/II (gingivitis/mild periodontitis) or case type III/IV (moderate/severe periodontitis). Serum levels of acute phase proteins (APPs) and immunoglobulin G (IgG) antibody were assessed at baseline and through 1 year after extraction. RESULTS At baseline, the levels of multiple APPs (e.g., fibrinogen, C-reactive protein) and antibodies to periodontal pathogens were significantly higher with case type III/IV vs I/II. These differences were sustained 12 months after extractions for most APPs. CONCLUSIONS The results demonstrated that removal of disease by full-mouth extraction of teeth altered the overall burden of challenge to the host. Continued elevation in various APPs in the III/IV group suggested a potential underlying constitutive difference in systemic response characteristics of this population.
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Affiliation(s)
- L L Cunningham
- Division of Oral and Maxillofacial Surgery, College of Dentistry, University of Kentucky, Lexington, KY, USA; Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.
| | - M J Novak
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - M Madsen
- Department of Oral and Maxillofacial Surgery, University of Louisville School of Dentistry, Louisville, KY, USA
| | - B Abadi
- Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - J L Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
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14
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Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Periodontol 2013; 84:S51-69. [DOI: 10.1902/jop.2013.134006] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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15
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Recognition of Porphyromonas gingivalis gingipain epitopes by natural IgM binding to malondialdehyde modified low-density lipoprotein. PLoS One 2012; 7:e34910. [PMID: 22496875 PMCID: PMC3320647 DOI: 10.1371/journal.pone.0034910] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 03/08/2012] [Indexed: 12/29/2022] Open
Abstract
Objective Increased risk for atherosclerosis is associated with infectious diseases including periodontitis. Natural IgM antibodies recognize pathogen-associated molecular patterns on bacteria, and oxidized lipid and protein epitopes on low-density lipoprotein (LDL) and apoptotic cells. We aimed to identify epitopes on periodontal pathogen Porphyromonas gingivalis recognized by natural IgM binding to malondialdehyde (MDA) modified LDL. Methods and Results Mouse monoclonal IgM (MDmAb) specific for MDA-LDL recognized epitopes on P. gingivalis on flow cytometry and chemiluminescence immunoassays. Immunization of C57BL/6 mice with P. gingivalis induced IgM, but not IgG, immune response to MDA-LDL and apoptotic cells. Immunization of LDLR−/− mice with P. gingivalis induced IgM, but not IgG, immune response to MDA-LDL and diminished aortic lipid deposition. On Western blot MDmAb bound to P. gingivalis fragments identified as arginine-specific gingipain (Rgp) by mass spectrometry. Recombinant domains of Rgp produced in E. coli were devoid of phosphocholine epitopes but contained epitopes recognized by MDmAb and human serum IgM. Serum IgM levels to P. gingivalis were associated with anti-MDA-LDL levels in humans. Conclusion Gingipain of P. gingivalis is recognized by natural IgM and shares molecular identity with epitopes on MDA-LDL. These findings suggest a role for natural antibodies in the pathogenesis of two related inflammatory diseases, atherosclerosis and periodontitis.
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16
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Xiao X, Li Y, Zhang G, Gao Y, Kong Y, Liu M, Tan Y. Detection of bacterial diversity in rat's periodontitis model under imitational altitude hypoxia environment. Arch Oral Biol 2011; 57:23-9. [PMID: 21840496 DOI: 10.1016/j.archoralbio.2011.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 07/08/2011] [Accepted: 07/17/2011] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Oral epidemiologic investigations in China western territory have showed that the immigrants in the plateau have a higher morbidity with periodontitis. To find the possible relationship between the pathogenesis of periodontitis and altitude hypoxia, we designed a periodontitis rat model via housed in low pressure oxygen chamber and investigated the bacterial diversity in the gingival crevicular fluid (GCF). DESIGN Eighty Sprague-Dawley rats were divided into CON-normal, CON-hypoxia, EXP-normal and EXP-hypoxia group, without or with periodontal induce, breeding in normal environment or altitude hypoxia environment. Periodontal parameters (including gingival index, GI, and tooth mobility, TM) were measured after 2, 4, 6 and 8 weeks; periodontal samples were collected for histological analysis after rats were sacrificed at the 8th week. The 16S rDNA of bacteria in GCF was amplified by PCR at the 8th week, and separated by the denaturing gradient gel electrophoresis (DGGE) approach. RESULTS EXP-hypoxia group's GI and TM showed later and more severe periodontal tissue damage than EXP-normal (p<0.05 or 0.01). The histologic analyses did not find any pathologic difference between EXP-hypoxia and EXP-normal groups except for a slight difference on the lesion degree. By the DGGE analyses, the bacteria of five samples in the same group showed high concordance, but the bacteria in the different groups showed a great diversity. CONCLUSION The course of periodontitis in altitude hypoxia environment is later than normal, but the degree of periodontal lesion was more severe and microbial community in GCF can be affected by the altitude hypoxia environment.
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Affiliation(s)
- Xian Xiao
- The First Outpatient Department of Chengdu Military District Institution, Chengdu Army General Hospital, Chengdu, PR China
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17
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Tew JG, El Shikh ME, El Sayed RM, Schenkein HA. Dendritic cells, antibodies reactive with oxLDL, and inflammation. J Dent Res 2011; 91:8-16. [PMID: 21531918 DOI: 10.1177/0022034511407338] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Periodontitis appears to promote chronic inflammatory diseases, including atherosclerosis, but relevant mechanisms need clarification. Oral bacteria induce antibodies that bind not only bacteria, but also oxLDL. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans induce remarkable IgG responses that are dominated by IgG2, and IgG2 is IFN-γ-dependent and is promoted by dendritic cells (DCs). LDL-reactive antibodies induced by P. gingivalis and A. actinomycetemcomitans include anti-phosphorylcholine (α-PC) and β2-glycoprotein-1-dependent anticardiolipin (α-CL), and these antibodies may link chronic inflammatory diseases at a mechanistic level. Antibody-mediated uptake of oxLDL or bacteria dramatically enhances DC-IL-12, and DC-IL-12 induces NK-cell-IFN-γ responses that promote Th-1 responses and sustained inflammation. DCs may be derived from monocytes, and this is striking in cultures of aggressive periodontitis (AgP) monocytes, where DC numbers are about double control levels. Moreover, serum α-CL levels in individuals with AgP are frequently elevated, and these antibodies promote atherosclerosis in persons with antiphospholipid syndrome. Elevated serum levels of soluble-intercellular adhesion molecule, soluble-vascular cell adhesion molecule, and soluble-E-selectin are atherosclerosis-associated indicators of vascular inflammation, and these markers are elevated in the subset of AgP patients with high α-CL. We reason that periodontitis patients with elevated antibodies reactive with oxLDL could be a subgroup at high risk for cardiovascular sequelae.
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Affiliation(s)
- J G Tew
- Clinical Research Center for Periodontal Diseases, School of Dentistry, VCU, Richmond, VA 23298-0556, USA.
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18
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Kikuchi T, El Shikh MM, El Sayed RM, Purkall DB, Elaasser MM, Sarraf A, Barbour SE, Schenkein HA, Tew JG. Anti-phosphorylcholine-opsonized low-density lipoprotein promotes rapid production of proinflammatory cytokines by dendritic cells and natural killer cells. J Periodontal Res 2010; 45:720-30. [PMID: 20572914 DOI: 10.1111/j.1600-0765.2010.01292.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Epidemiological and animal studies suggest that periodontal infections increase atherosclerosis risk. Periodontitis patients have elevated levels of anti-phosphorylcholine (anti-PC) reactive not only with numerous periodontal organisms but also with minimally modified low-density lipoprotein (mmLDL). Dendritic cells (DCs) reside in arterial walls and accumulate in atherosclerotic lesions. The ability of anti-PC to bind mmLDL prompted the hypothesis that opsonized mmLDL would stimulate DCs and enhance the production of proinflammatory cytokines that promote atherogenic plaque development. MATERIAL AND METHODS Monocyte-derived DCs (mDCs) were generated using granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin (IL)-4, then stimulated with mmLDL or with anti-PC-opsonized mmLDL. The anti-PC effect was determined using flow cytometry, cofocal microscopy and cytokine assays. The production of CD83, IL-12p35 mRNA, IL-12p40 mRNA, IL-12p70 and IL-10 by DCs was monitored. RESULTS Dendritic cells stimulated with mmLDL expressed little CD83 and produced little IL-12p70. However, anti-PC-opsonized mmLDL enhanced DC maturation, as indicated by upregulated CD83 and rapid (≤ 48 h) production of IL-12p70 if a source of interferon-γ (IFN-γ) was available. In leukocyte cultures, natural killer (NK) cells rapidly produced IFN-γ (≤ 48 h) when interacting with IL-12-producing DCs activated by anti-PC-opsonized mmLDL. Moreover, IFN-γ promoted DC IL-12 responses that were further augmented when mmLDL was opsonized with anti-PC. CONCLUSION Minimally modified LDL-stimulated DCs and NK cells were mutually stimulatory, with DC IL-12p70 needed by NK cells and with NK cell IFN-γ needed by DCs. Moreover, production of these proinflammatory cytokines was markedly enhanced when LDL was opsonized by anti-PC. In short, the data suggest that the elevated anti-PC levels in periodontitis patients could promote a mechanism that facilitates atherosclerosis.
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Affiliation(s)
- T Kikuchi
- Clinical Research Center for Periodontal Diseases, School of Dentistry, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA, USA
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Nagasawa T, Kiji M, Yashiro R, Hormdee D, Lu H, Kunze M, Suda T, Koshy G, Kobayashi H, Oda S, Nitta H, Ishikawa I. Roles of receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoprotegerin in periodontal health and disease. Periodontol 2000 2007; 43:65-84. [PMID: 17214836 DOI: 10.1111/j.1600-0757.2006.00185.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Toshiyuki Nagasawa
- Division of Periodontology, Department of Hard Tissue Engineering, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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20
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Mayr M, Kiechl S, Tsimikas S, Miller E, Sheldon J, Willeit J, Witztum JL, Xu Q. Oxidized Low-Density Lipoprotein Autoantibodies, Chronic Infections, and Carotid Atherosclerosis in a Population-Based Study. J Am Coll Cardiol 2006; 47:2436-43. [PMID: 16781371 DOI: 10.1016/j.jacc.2006.03.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2005] [Revised: 01/03/2006] [Accepted: 02/01/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We investigated whether associations exist between immune reactions to oxidized low-density lipoproteins (OxLDLs), chronic infections, and carotid atherosclerosis as quantified by ultrasound. BACKGROUND Atherosclerosis is a chronic immuno-inflammatory disease wherein both oxidized lipids and infectious agents are incriminated as possible contributors. METHODS We measured immunoglobulin (Ig)G and IgM autoantibody titers to copper-oxidized-LDL and malondialdehyde-LDL (OxLDL-AB), IgG and IgM apolipoprotein B-100-immune complexes (ApoB-IC), and titers of antibodies to Escherichia coli and chlamydial lipopolysaccharide (LPS), mycobacterial heat shock protein 65 (mHSP65), Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus and evaluated their relationship to cardiovascular risk factors, chronic infections, and incident/progressive carotid atherosclerosis in the Bruneck study. RESULTS The OxLDL-AB and ApoB-IC levels remained stable over time as indicated by strong correlations between 1995 and 2000 measurements (p < 0.001 each). Significant associations existed between all OxLDL markers and antibody titers to pathogens, especially to E. coli-LPS and mHSP65. Both OxLDL-AB and ApoB-IC levels showed a rise with increasing pathogen burden. Notably, OxLDL-ABs were also elevated in subjects with chronic infection as defined by clinical criteria. Titers of IgG, but not IgM, OxLDL-AB, or ApoB-IC inversely correlated with total cholesterol, LDL cholesterol, and apoB concentrations. The IgG OxLDL markers were positively and IgM markers were inversely associated with incident and progressive carotid atherosclerosis in univariate analyses but were not independent predictors in multivariate analyses. CONCLUSIONS Our study provides evidence for an association between human oxLDL markers and chronic infections. Moreover, in this population-based study, neither IgG nor IgM OxLDL autoantibodies were independently predictive of atherosclerosis progression in the carotid arteries.
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Affiliation(s)
- Manuel Mayr
- Department of Cardiac and Vascular Sciences, St. George's, University of London, London, United Kingdom
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Rufail ML, Schenkein HA, Barbour SE, Tew JG, van Antwerpen R. Altered lipoprotein subclass distribution and PAF-AH activity in subjects with generalized aggressive periodontitis. J Lipid Res 2005; 46:2752-60. [PMID: 16179738 DOI: 10.1194/jlr.m500389-jlr200] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In this study, we examined whether the documented increase of plasma triglycerides in patients with generalized aggressive periodontitis (GAgP) is associated with changes in lipoprotein subclass distribution and/or LDL-associated platelet-activating factor acetylhydrolase (PAF-AH) activity. Lipoprotein subclasses were analyzed in whole plasma samples using nuclear magnetic resonance methods. Compared with subjects without periodontitis (NP subjects; n = 12), GAgP subjects (n = 12) had higher plasma levels of large, medium, and small VLDL (35.0 +/- 6.7 vs. 63.1 +/- 9.6 nmol/l; P = 0.025), higher levels of intermediate density lipoprotein (24.8 +/- 11.6 vs. 87.2 +/- 16.6 nmol/l; P = 0.006), lower levels of large LDL (448.3 +/- 48.5 vs. 315.8 +/- 59.4 nmol/l; P = 0.098), and higher levels of small LDL (488.2 +/- 104.2 vs. 946.7 +/- 151.6 nmol/l; P = 0.021). The average size of LDL from NP and GAgP subjects was 21.4 +/- 0.2 and 20.6 +/- 0.3 nm, respectively (P = 0.031). Compared with NP subjects, GAgP subjects had a greater number of circulating LDL particles (961.3 +/- 105.3 vs. 1,349.0 +/- 133.2 nmol/l; P = 0.032). Differences in the plasma levels of large, medium, and small HDL were not statistically significant. NP and GAgP subjects had similar plasma levels of total LDL-associated PAF-AH activity; however, LDL of GAgP subjects contained less PAF-AH activity per microgram of LDL protein (1,458.0 +/- 171.0 and 865.2 +/- 134 pmol/min/microg; P = 0.014). These results indicate that, in general, GAgP subjects have a more atherogenic lipoprotein profile and lower LDL-associated PAF-AH activity than NP subjects. These differences may help explain the increased risk of GAgP subjects for cardiovascular disease.
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Affiliation(s)
- Miguel L Rufail
- Department of Biochemistry, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298, USA
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Abstract
PURPOSE OF REVIEW Several lines of evidence from the last few decades suggest that periodontitis is an important risk factor for cardiovascular diseases. In this review we discuss the recent findings on the systemic effects of periodontitis, which may contribute to the pathogenesis of atherosclerosis, with a special emphasis on lipoproteins. RECENT FINDINGS In addition to the epidemiological studies exploring the direct or indirect relationship between clinical periodontitis and cardiovascular diseases, studies utilizing serology, animal models, cell cultures, and biochemistry of lipoproteins have been published. Local infection in the periodontal pockets triggers a systemic inflammatory response releasing inflammatory mediators and awakens a strong immune response against periodontal pathogens. Elevated systemic antibody levels especially to Porphyromonas gingivalis are associated with an increased risk for atherosclerosis. Periodontitis is also accompanied by proatherogenic changes in both low and high density lipoproteins, which lead to enhanced cholesteryl ester uptake by and reduced cholesterol efflux from macrophages. Vesicles and lipopolysaccharide isolated from P. gingivalis activate macrophages to convert into foam cells. Moreover, animal studies have demonstrated that infection by P. gingivalis enhances progression of atherosclerosis. SUMMARY Recent studies have clarified the mechanisms by which periodontitis may contribute to the development of atherosclerosis. Serological, animal, and cell culture studies provide evidence that infection by P. gingivalis may promote atherosclerosis. The influence of periodontitis on lipoprotein metabolism has emerged as a new, important factor. Recent studies provide experimental proof that periodontitis may predispose to atherosclerosis.
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Affiliation(s)
- Pirkko J Pussinen
- Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland.
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