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Korkmaz H, Hatipoğlu M, Kayar NA. Interleukin-38: A crucial player in periodontitis. Oral Dis 2024; 30:2523-2532. [PMID: 37455397 DOI: 10.1111/odi.14657] [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: 03/06/2023] [Revised: 05/08/2023] [Accepted: 06/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The objective of this study was to compare the levels of gingival crevicular fluid (GCF), salivary, and serum matrix metalloproteinase-9, interleukin (IL)-17, IL-36γ, and IL-38 in individuals with healthy periodontium, gingivitis, and periodontitis and to evaluate their correlations with clinical periodontal parameters. MATERIALS AND METHODS Ninety systemically healthy and nonsmoking volunteers divided into a healthy (H) group (n = 30), a gingivitis (G) group (n = 30), and a periodontitis (P) group (n = 30) were included in this study. Clinical periodontal parameters of volunteers were recorded, and GCF, unstimulated saliva, and serum samples were collected. Data analysis was done with enzyme-linked immunosorbent assays. The Kruskal-Wallis test and Bonferroni correction were used for multiple comparisons and post hoc statistical analyses. RESULTS The group H had significantly lower clinical parameters than the group P (p < 0.001). GCF and salivary IL-36γ and IL-38 levels were significantly higher in the group P than in the H and G groups (p < 0.05). Positive correlations between biochemical findings and clinical periodontal parameters were observed. CONCLUSIONS IL-36γ and IL-38 levels in GCF, saliva, and serum correlate with clinical periodontal parameters and may play a role in determining the activity of periodontitis.
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Affiliation(s)
- Hilal Korkmaz
- Department of Periodontology, Faculty of Dentistry Akdeniz University, Antalya, Turkey
| | - Mükerrem Hatipoğlu
- Department of Periodontology, Faculty of Dentistry Akdeniz University, Antalya, Turkey
| | - Nezahat Arzu Kayar
- Department of Periodontology, Faculty of Dentistry Akdeniz University, Antalya, Turkey
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Aremu JB, Pérez CM, Joshipura KJ. Longitudinal Association between Periodontitis and the Risk of Hypertension. Int J Dent 2023; 2023:2644623. [PMID: 37361411 PMCID: PMC10290562 DOI: 10.1155/2023/2644623] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/11/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
Objectives Hypertension poses a major public health challenge due to its association with increased risk of heart disease, chronic kidney disease, and death. The objective of this study is to evaluate the longitudinal association between periodontitis and the risk of hypertension. Methods Using a cohort study design, 540 participants free of diagnosed hypertension/prehypertension in the San Juan Overweight Adults Longitudinal Study and with complete 3-year follow-up data were included. Periodontitis was classified according to the 2012 Centers for Disease Control and Prevention/American Academy of Periodontology definition. Participants were considered to have developed hypertension if they reported physician-diagnosed hypertension over the follow-up period or had average systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg at follow-up. Participants free of diagnosed hypertension or prehypertension and with normal BP at baseline (SBP < 120 mm Hg and DBP < 80 mm Hg) were considered to develop prehypertension if they had SBP between 120 and 139 mm Hg or DBP between 80 and 89 mm Hg at follow-up. An additional (secondary) outcome was defined as the development of prehypertension/hypertension over the follow-up period among participants who had normal BP at baseline. We used Poisson regression, adjusting for age, sex, smoking status, physical activity, alcohol intake, diabetes, waist circumference, and family history of hypertension. Results One hundred and six (19.6%) participants developed hypertension, and 58 of the 221 with normal BP (26%) developed prehypertension/hypertension. There was no consistent association between periodontitis and the risk of developing hypertension. However, people with severe periodontitis had an increased incidence of prehypertension/hypertension (multivariate incidence rate ratios: 1.47; 95% confidence interval: 1.01, 2.17) than people without periodontitis after adjusting for confounders. Conclusion There was no association between periodontitis and hypertension in this cohort study. However, severe periodontitis was associated with an increased risk of prehypertension/hypertension.
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Affiliation(s)
- John B. Aremu
- College of Nursing and Health Professions, Arkansas State University, Jonesboro, AR, USA
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
- Department of General Dentistry, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Cynthia M. Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA
| | - Kaumudi J. Joshipura
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- School of Public Health, Ahmedabad University, Gujarat, India
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Lieske B, Makarova N, Jagemann B, Walther C, Ebinghaus M, Zyriax BC, Aarabi G. Inflammatory Response in Oral Biofilm during Pregnancy: A Systematic Review. Nutrients 2022; 14:nu14224894. [PMID: 36432584 PMCID: PMC9694722 DOI: 10.3390/nu14224894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/20/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
Understanding the inflammatory response in oral biofilm during pregnancy and its association with oral and maternal health is essential for identifying biomarker patterns that may serve as markers of pregnancy-related complications. We aimed to conduct a systematic review of the available literature to assess: (1) inflammatory responses in oral biofilm during pregnancy, (2) the association between inflammatory responses in oral biofilm during pregnancy and maternal, oral or systemic conditions, (3) changes in the response of inflammatory biomarkers found in the oral biofilm during different pregnancy stages, and (4) the value of other risk factors such as nutrition and lifestyle. PubMed, Web of Science and Cochrane Library were systematically searched from inception until April 2022. From 5441 records, 39 studies were included for qualitative assessment. The oral biofilm in pregnant women was associated with increased inflammatory biomarkers when compared to non-pregnant women. Levels of inflammatory biomarkers in the oral biofilm were found to be highest in pregnant women with systemic conditions. Increased inflammatory biomarkers in the oral biofilm were also associated with worse oral health outcomes. Given the importance of nutrition and lifestyle for pregnancy and oral health outcomes and the fact that these factors were largely excluded in the included studies, future research should consider a holistic view of the mother during pregnancy to capture physiological, hormonal, immunologic, and metabolic changes in the context of inflammatory responses.
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Affiliation(s)
- Berit Lieske
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, O58, 20246 Hamburg, Germany
- Midwifery Science–Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W38, 20246 Hamburg, Germany
- Correspondence:
| | - Nataliya Makarova
- Midwifery Science–Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W38, 20246 Hamburg, Germany
| | - Bettina Jagemann
- Midwifery Science–Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W38, 20246 Hamburg, Germany
| | - Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, O58, 20246 Hamburg, Germany
| | - Merle Ebinghaus
- Midwifery Science–Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W38, 20246 Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science–Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W38, 20246 Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, O58, 20246 Hamburg, Germany
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Angiotensin-Converting Enzyme 2 as a Possible Correlation between COVID-19 and Periodontal Disease. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186224] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
SARS-CoV-2 propagation in the world has led to rapid growth and an acceleration in the discoveries and publications of various interests. The main focus of a consistent number of studies has been the role of angiotensin-converting enzyme 2 (ACE2) in binding the virus and its role in expression of the inflammatory response after transmission. ACE2 is an enzyme involved in the renin–angiotensin system (RAS), whose key role is to regulate and counter angiotensin-converting enzyme (ACE), reducing the amount of angiotensin II and increasing angiotensin 1–7 (Ang1–7), making it a promising drug target for treating cardiovascular diseases. The classical RAS axis, formed by ACE, angiotensin II (Ang II), and angiotensin receptor type 1 (AT1), activates several cell functions and molecular signalling pathways related to tissue injury and inflammation. In contrast, the RAS axis composed of ACE2, Ang1–7, and Mas receptor (MasR) exerts the opposite effect concerning the inflammatory response and tissue fibrosis. Recent studies have shown the presence of the RAS system in periodontal sites where osteoblasts, fibroblasts, and osteoclasts are involved in bone remodelling, suggesting that the role of ACE2 might have a fundamental function in the under- or overexpression of cytokines such as interleukin-6 (IL-6), interleukin-7 (IL-7), tumour necrosis factor alpha (TNF-α), interleukin-2 (IL-2), interleukin-1 beta (IL-1β), monocyte chemoattractant protein-1 (MCP-1), and transforming growth factor-beta (TGF-β), associated with a periodontal disorder, mainly during coinfection with SARS-CoV-2, where ACE2 is underexpressed and cannot form the ACE2–Ang1–7–MasR axis. This renders the patient unresponsive to an inflammatory process, facilitating periodontal loss.
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Muñoz Aguilera E, Suvan J, Buti J, Czesnikiewicz-Guzik M, Barbosa Ribeiro A, Orlandi M, Guzik TJ, Hingorani AD, Nart J, D'Aiuto F. Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovasc Res 2020; 116:28-39. [PMID: 31549149 DOI: 10.1093/cvr/cvz201] [Citation(s) in RCA: 184] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/12/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022] Open
Abstract
Recent evidence suggests a link between periodontitis (PD) and hypertension, but the nature of this association remains unclear. The overall aim of this review was to critically appraise the evidence linking these two common disorders. Systematic search was conducted for studies published up to December 2018. Prevalence of hypertension in patients with PD (moderate/severe groups) vs. those without PD (non-PD) was the primary outcome. Additional outcomes included adjusted mean difference in systolic (SBP) and diastolic (DBP) blood pressure (BP) levels in PD vs. non-PD, assessment of biomarkers in PD and hypertension, and BP changes after periodontal therapy. From 81 studies selected, 40 were included in quantitative meta-analyses. Diagnoses of moderate-severe PD [odds ratio (OR) = 1.22; 95% confidence interval (CI): 1.10-1.35] and severe PD (OR = 1.49; 95% CI: 1.09-2.05) were associated with hypertension. Prospective studies confirmed PD diagnosis increased likelihood of hypertension occurrence (OR = 1.68; 95% CI: 0.85-3.35). Patients with PD exhibited higher mean SBP [weighted mean difference (WMD) of 4.49 mmHg; 95% CI: 2.88-6.11] and DBP (2.03 mmHg; 95% CI: 1.25-2.81) when compared with non-PD. Lastly, only 5 out of 12 interventional studies confirmed a reduction in BP following periodontal therapy, ranging from 3 to 12.5 mmHg of SBP and from 0 to 10 mmHg of DBP. PD is associated with increased odds of hypertension (SORT C) and higher SBP/DBP levels. The evidence suggesting that PD therapy could reduce BP is inconclusive. Although additional research is warranted on this association, these results suggest that oral health assessment and management of PD could not only improve oral/overall health and quality of life but also be of relevance in the management of patients with hypertension.
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Affiliation(s)
- Eva Muñoz Aguilera
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK.,Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Jean Suvan
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Jacopo Buti
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Marta Czesnikiewicz-Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Experimental Dentistry and Dental Prophylaxis, Jagiellonian University, Krakow, Poland.,Department of Internal and Agricultural Medicine, Jagiellonian University, Krakow, Poland
| | - Aline Barbosa Ribeiro
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Marco Orlandi
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
| | - Tomasz J Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow G12 8QQ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK.,Department of Experimental Dentistry and Dental Prophylaxis, Jagiellonian University, Krakow, Poland.,Department of Internal and Agricultural Medicine, Jagiellonian University, Krakow, Poland
| | - Aroon D Hingorani
- Genetic Epidemiology, Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London WC1E 6BT, UK
| | - Jose Nart
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Francesco D'Aiuto
- Periodontology Unit, University College London Eastman Dental Institute, London WC1X 8LD, UK
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Repeated Porphyromonas gingivalis W83 exposure leads to release pro-inflammatory cytokynes and angiotensin II in coronary artery endothelial cells. Sci Rep 2019; 9:19379. [PMID: 31852912 PMCID: PMC6920421 DOI: 10.1038/s41598-019-54259-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 10/08/2019] [Indexed: 12/17/2022] Open
Abstract
The role of Porphyromonas gingivalis (P. gingivalis) or its virulence factors, including lipopolysaccharide (LPS) not only has been related with periodontitis but also with endothelial dysfunction, a key mechanism involved in the genesis of atherosclerosis and hypertension that involving systemic inflammatory markers as angiotensin II (Ang II) and cytokines. This study compares the effect of repeated and unique exposures of P. gingivalis W83 LPS and live bacteria on the production and expression of inflammatory mediators and vasoconstrictor molecules with Ang II. Human coronary artery endothelial cells (HCAEC) were stimulated with purified LPS of P. gingivalis (1.0, 3.5 or 7.0 μg/mL) or serial dilutions of live bacteria (MOI 1: 100 - 1:0,1) at a single or repeated exposure for a time of 24 h. mRNA expression levels of AGTR1, AGTR2, IL-8, IL-1β and MCP-1 were determined by RT-qPCR, and IL-6, MCP-1, IL-8, IL-1β and GM-CSF levels were measured by flow cytometry, ELISA determined Ang II levels. Live bacteria in a single dose increased mRNA levels of AGTR1, and repeated doses increased mRNA levels of IL-8 and IL-1β (p < 0.05). Repeated exposure of live-P. gingivalis induced significant production IL-6, MCP-1 and GM-CSF (p < 0.05). Moreover, these MCP-1, IL-6 and GM-CSF levels were greater than in cells treated with single exposure (p < 0.05), The expression of AGTR1 and production of Ang II induced by live-P. gingivalis W83 showed a vasomotor effect of whole bacteria in HCAEC more than LPS. In conclusion, the findings of this study suggest that repeated exposure of P. gingivalis in HCAEC induces the activation of proinflammatory and vasoconstrictor molecules that lead to endothelial dysfunction being a key mechanism of the onset and progression of arterial hypertension and atherosclerosis.
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Virtanen E, Yakob M, Tervahartiala T, Söder PÖ, Andersson LC, Sorsa T, Meurman JH, Söder B. Salivary MMP-13 gender differences in periodontitis: A cross-sectional study from Sweden. Clin Exp Dent Res 2017; 3:165-170. [PMID: 29744196 PMCID: PMC5839226 DOI: 10.1002/cre2.76] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/06/2017] [Accepted: 07/09/2017] [Indexed: 01/13/2023] Open
Abstract
We investigated serum and saliva concentrations of matrix metalloproteinases, MMP-8, MMP-9, and MMP-13, and their tissue inhibitor TIMP-1, in a group of patients with and without periodontitis from Sweden. The hypothesis was that these biomarkers are higher in the periodontitis patients. Ninety patients participated in this cross-sectional study. Fifty-one patients had periodontitis whereas 39 were periodontally healthy. Saliva and serum samples were analyzed with immunofluorometric, enzyme-linked immunosorbent assay and western blot. Results were statistically analyzed with independent t test, Mann-Whitney U test, Bonferroni corrections, and regression analyses. MMP-13 was not detected in serum, but in saliva, higher values were found among the periodontally healthy compared with periodontitis subjects (0.32 ± 0.26 vs. 0.21 ± 0.23 ng/ml, p < .05). Female gender and clinical attachment loss were the explanatory factors for higher salivary MMP-13 values with odds ratio 3.08 (95% confidence interval [1.17, 8.11]) and 3.57 (95% confidence interval [1.08, 11.82]), respectively. No statistically significant differences between groups were found in serum and saliva values of MMP-8, MMP-9, and TIMP-1. Contrary to our hypothesis, no statistically significant differences between patients with and without periodontitis were seen in MMP-8, MMP-9, and TIMP-1 values. However, higher MMP-13 concentrations in saliva were associated with female gender and higher clinical attachment loss. Metabolism of MMP-13 may thus have some gender implications in periodontitis.
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Affiliation(s)
- Eunice Virtanen
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Finland
| | - Maha Yakob
- Department of Dental Medicine Karolinska Institutet Sweden
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Finland
| | | | - Leif C Andersson
- Department of Pathology, Haartman Institute University of Helsinki Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Finland
- Department of Dental Medicine Karolinska Institutet Sweden
| | - Jukka H Meurman
- Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Finland
| | - Birgitta Söder
- Department of Dental Medicine Karolinska Institutet Sweden
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Noack B, Kipping T, Tervahartiala T, Sorsa T, Hoffmann T, Lorenz K. Association between serum and oral matrix metalloproteinase-8 levels and periodontal health status. J Periodontal Res 2017; 52:824-831. [DOI: 10.1111/jre.12450] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/22/2023]
Affiliation(s)
- B. Noack
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
| | - T. Kipping
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
| | - T. Tervahartiala
- Department of Oral and Maxillofacial Diseases; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - T. Sorsa
- Department of Oral and Maxillofacial Diseases; University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Division of Periodontology; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - T. Hoffmann
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
| | - K. Lorenz
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
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