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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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Mosaddad SA, Mahootchi P, Safari S, Rahimi H, Aghili SS. Interactions between systemic diseases and oral microbiota shifts in the aging community: A narrative review. J Basic Microbiol 2023. [PMID: 37173818 DOI: 10.1002/jobm.202300141] [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: 03/18/2023] [Revised: 04/23/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
As a gateway to general health and a diverse microbial habitat, the oral cavity is colonized by numerous microorganisms such as bacteria, fungi, viruses, and archaea. Oral microbiota plays an essential role in preserving oral health. Besides, the oral cavity also significantly contributes to systemic health. Physiological aging influences all body systems, including the oral microbial inhabitants. The cited effect can cause diseases by forming dysbiotic communities. Since it has been demonstrated that microbial dysbiosis could disturb the symbiosis state between the host and the resident microorganism, shifting the condition toward a more pathogenic one, this study investigated how the oral microbial shifts in aging could associate with the development or progression of systemic diseases in older adults. The current study focused on the interactions between variations in the oral microbiome and prevalent diseases in older adults, including diabetes mellitus, Sjögren's syndrome, rheumatoid arthritis, pulmonary diseases, cardiovascular diseases, oral candidiasis, Parkinson's disease, Alzheimer's disease, and glaucoma. Underlying diseases can dynamically modify the oral ecology and the composition of its resident oral microbiome. Clinical, experimental, and epidemiological research suggests the associations of systemic disorders with bacteremia and inflammation after oral microbial changes in older adults.
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Affiliation(s)
- Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pegah Mahootchi
- Department of Oral and Maxillofacial Diseases, School of Dentistry, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Sajedeh Safari
- Department of Prosthodontics, Islamic Azad University, Tehran, Iran
| | - Hussein Rahimi
- Student Research Committee, School of Dentistry, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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3
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Aravindraja C, Vekariya KM, Botello-Escalante R, Rahaman SO, Chan EKL, Kesavalu L. Specific microRNA Signature Kinetics in Porphyromonas gingivalis-Induced Periodontitis. Int J Mol Sci 2023; 24:2327. [PMID: 36768651 PMCID: PMC9916963 DOI: 10.3390/ijms24032327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Porphyromonas gingivalis is one of the major bacteria constituting the subgingival pathogenic polymicrobial milieu during periodontitis. Our objective is to determine the global microRNA (miRNA, miR) expression kinetics in 8- and 16-weeks duration of P. gingivalis infection in C57BL/6J mice and to identify the miRNA signatures at specific time-points in mice. We evaluated differential expression (DE) miRNAs in mandibles (n = 10) using high-throughput NanoString nCounter® miRNA expression panels. The bacterial colonization, alveolar bone resorption (ABR), serum immunoglobulin G (IgG) antibodies, and bacterial dissemination were confirmed. In addition, all the infected mice showed bacterial colonization on the gingival surface, significant increases in ABR (p < 0.0001), and specific IgG antibody responses (p < 0.05-0.001). The miRNA profiling showed 26 upregulated miRNAs (e.g., miR-804, miR-690) and 14 downregulated miRNAs (e.g., miR-1902, miR-1937a) during an 8-weeks infection, whereas 7 upregulated miRNAs (e.g., miR-145, miR-195) and one downregulated miR-302b were identified during a 16-weeks infection. Both miR-103 and miR-30d were commonly upregulated at both time-points, and all the DE miRNAs were unique to the specific time-points. However, miR-31, miR-125b, miR-15a, and miR-195 observed in P. gingivalis-infected mouse mandibles were also identified in the gingival tissues of periodontitis patients. None of the previously identified miRNAs reported in in vitro studies using cell lines (periodontal ligament cells, gingival epithelial cells, human leukemia monocytic cell line (THP-1), and B cells) exposed to P. gingivalis lipopolysaccharide were observed in the in vivo study. Most of the pathways (endocytosis, bacterial invasion, and FcR-mediated phagocytosis) targeted by the DE miRNAs were linked with bacterial pathogen recognition and clearance. Further, eighteen miRNAs were closely associated with the bacterial invasion of epithelial cells. This study highlights the altered expression of miRNA in gingiva, and their expression depends on the time-points of infection. This is the first in vivo study that identified specific signature miRNAs (miR-103 and miR-30d) in P. gingivalis invasion of epithelial cells, establishes a link between miRNA and development of periodontitis and helping to better understand the pathobiology of periodontitis.
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Affiliation(s)
- Chairmandurai Aravindraja
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Krishna Mukesh Vekariya
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Ruben Botello-Escalante
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Shaik O. Rahaman
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA
| | - Edward K. L. Chan
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
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4
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Periodontal status and the incidence of selected bacterial pathogens in periodontal pockets and vascular walls in patients with atherosclerosis and abdominal aortic aneurysms. PLoS One 2022; 17:e0270177. [PMID: 35951554 PMCID: PMC9371326 DOI: 10.1371/journal.pone.0270177] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/06/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of the study was to examine the periodontal status of patients with atherosclerosis and abdominal aortic aneurysms. The occurrence of 5 periodontopathogens was evaluated in periodontal pockets and atheromatous plaques together with specimens from pathologically changed vascular walls of aortic aneurysms. The study comprised 39 patients who qualified for vascular surgeries. Patients with periodontitis and concomitant atherosclerosis or aneurysms were enrolled in the study. Periodontal indices were evaluated, and subgingival plaque samples were examined together with atheromatous plaques or specimens from vascular walls to identify, by polymerase chain reaction (PCR), the following periodontopathogens: Porphyromonas gingivalis, Tanarella forsythia, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Treponema denticola. The majority of patients had chronic severe generalized periodontitis in stages III and IV. Laboratory investigations showed the occurrence of one or more of the five targeted periodontopathogens in 94.6% of the periodontal pockets examined. Of the examined periodontopathogens, only Porphyromonas gingivalis was confirmed in 1 atheromatous plaque sample collected from the wall of an aortic aneurysm. Therefore, the occurrence of this bacterium in these vessels was considered to be occasional in patients with chronic periodontitis.
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Global Noncoding microRNA Profiling in Mice Infected with Partial Human Mouth Microbes (PAHMM) Using an Ecological Time-Sequential Polybacterial Periodontal Infection (ETSPPI) Model Reveals Sex-Specific Differential microRNA Expression. Int J Mol Sci 2022; 23:ijms23095107. [PMID: 35563501 PMCID: PMC9105503 DOI: 10.3390/ijms23095107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 05/02/2022] [Indexed: 11/17/2022] Open
Abstract
Periodontitis (PD) is a polymicrobial dysbiotic immuno-inflammatory disease. It is more prevalent in males and has poorly understood pathogenic molecular mechanisms. Our primary objective was to characterize alterations in sex-specific microRNA (miRNA, miR) after periodontal bacterial infection. Using partial human mouth microbes (PAHMM) (Streptococcus gordonii, Fusobacterium nucleatum, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) in an ecological time-sequential polybacterial periodontal infection (ETSPPI) mouse model, we evaluated differential mandibular miRNA profiles by using high-throughput Nanostring nCounter® miRNA expression panels. All PAHMM mice showed bacterial colonization (100%) in the gingival surface, an increase in alveolar bone resorption (p < 0.0001), and the induction of a specific immunoglobin G antibody immune response (p < 0.001). Sex-specific differences in distal organ bacterial dissemination were observed in the heart (82% male vs. 28% female) and lungs (2% male vs. 68% female). Moreover, sex-specific differential expression (DE) of miRNA was identified in PAHMM mice. Out of 378 differentially expressed miRNAs, we identified seven miRNAs (miR-9, miR-148a, miR-669a, miR-199a-3p, miR-1274a, miR-377, and miR-690) in both sexes that may be implicated in the pathogenesis of periodontitis. A strong relationship was found between male-specific miR-377 upregulation and bacterial dissemination to the heart. This study demonstrates sex-specific differences in bacterial dissemination and in miRNA differential expression. A novel PAHMM mouse and ETSPPI model that replicates human pathobiology can be used to identify miRNA biomarkers in periodontitis.
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Zhou J, Liu L, Wu P, Zhao L, Wu Y. Fusobacterium nucleatum Accelerates Atherosclerosis via Macrophage-Driven Aberrant Proinflammatory Response and Lipid Metabolism. Front Microbiol 2022; 13:798685. [PMID: 35359716 PMCID: PMC8963492 DOI: 10.3389/fmicb.2022.798685] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/03/2022] [Indexed: 12/18/2022] Open
Abstract
Periodontitis, an oral chronic inflammatory disease, is reported to show an association with atherosclerotic vascular disease. Fusobacterium nucleatum is an oral commensal bacterium that is abundantly implicated in various forms of periodontal diseases; however, its role in the pathogenesis of atherosclerosis is unclear. This study aimed to elucidate the underlying pathogenic mechanisms of atherosclerosis induced by F. nucleatum to provide new insight on the prevention and treatment of atherosclerosis. We used an animal model, that is, ApoE–/– mice were infected with F. nucleatum by oral gavage, and in vitro co-culture models to assess the pathogenicity of F. nucleatum. The results indicate that F. nucleatum ATCC 25586 invaded aortic tissues and substantially increased the progression of atherosclerotic lesions. In addition, F. nucleatum changed plaque composition into a less-stable phenotype, characterized with increased subcutaneous macrophage infiltration, M1 polarization, lipid deposition, cell apoptosis, and reduced extracellular matrix and collagen content. The serum levels of pro-atherosclerotic factors, such as interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein-1 (MCP-1), c-reactive protein, and oxidized low-density lipoprotein (ox-LDL) and microRNAs (miR-146a, miR-155, and miR-23b) were considerably increased after F. nucleatum stimulation, whereas HDL-c level was reduced. F. nucleatum induced in vitro macrophage apoptosis in a time- and dose-dependent manner. F. nucleatum facilitated ox-LDL–induced cholesterol phagocytosis and accumulation by regulating the expression of lipid metabolism-related genes (AR-A1, ACAT1, ABCA1, and ABCG1). F. nucleatum further worsened the atherosclerotic plaque microenvironment by considerably increasing the levels of IL-6; IL-1β; TNF-α; MCP-1; and MMP-2, 8, and 9 and by suppressing fibronectin (FN) 1 levels during foam cell formation. This study shows that F. nucleatum ATCC 25586 is implicated in atherosclerosis by causing aberrant activation and lipid metabolism in macrophage.
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Affiliation(s)
- Jieyu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peiyao Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yafei Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Salivary Pro-Inflammatory Markers and Smoking Status Influences the Treatment Effectiveness of Periodontal Disease Patients with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147364. [PMID: 34299815 PMCID: PMC8305443 DOI: 10.3390/ijerph18147364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hypertension and periodontal diseases share several risk factors. Inflammation biomarkers in saliva are related to hypertension and periodontal disease. The aim of this study was to explore the role of the salivary inflammatory biomarkers in the treatment effectiveness of patients with hypertension and periodontal disease. METHODS This observational study enrolled 160 subjects diagnosed with periodontitis, 40 of which had a history of hypertension. All subjects had completed scaling and root planning therapeutic procedures within four weeks. The clinical periodontal parameters (i.e., bleeding on probing, plaque control record (PCR), and probing depth (PD)) were evaluated before and after the treatment. Pro-inflammatory markers were determined using a commercial kit. RESULTS The recovery rate (PD 4-9 mm) in non-hypertensive subjects was significantly higher than in hypertensive subjects (60.47% vs. 52.60%, respectively; p = 0.04). All clinical parameters, excluding PCR, positively correlated with salivary IL-1β at baseline and after completing treatment. Our results showed that increased salivary IL-1β levels were positively associated with decreased PCR (β = -27.65 and p = 0.05) and PD recovery rate (β = -17.05 and p = 0.02) in hypertensive subjects. CONCLUSIONS The present study sheds important light on the clinical use of salivary pro-inflammatory cytokines as valuable biomarkers for predicting the treatment effectiveness of patients suffering from hypertension and periodontitis.
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Vitkov L, Muñoz LE, Knopf J, Schauer C, Oberthaler H, Minnich B, Hannig M, Herrmann M. Connection between Periodontitis-Induced Low-Grade Endotoxemia and Systemic Diseases: Neutrophils as Protagonists and Targets. Int J Mol Sci 2021; 22:4647. [PMID: 33925019 PMCID: PMC8125370 DOI: 10.3390/ijms22094647] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/11/2022] Open
Abstract
Periodontitis is considered a promoter of many systemic diseases, but the signaling pathways of this interconnection remain elusive. Recently, it became evident that certain microbial challenges promote a heightened response of myeloid cell populations to subsequent infections either with the same or other pathogens. This phenomenon involves changes in the cell epigenetic and transcription, and is referred to as ''trained immunity''. It acts via modulation of hematopoietic stem and progenitor cells (HSPCs). A main modulation driver is the sustained, persistent low-level transmission of lipopolysaccharide from the periodontal pocket into the peripheral blood. Subsequently, the neutrophil phenotype changes and neutrophils become hyper-responsive and prone to boosted formation of neutrophil extracellular traps (NET). Cytotoxic neutrophil proteases and histones are responsible for ulcer formations on the pocket epithelium, which foster bacteremia and endoxemia. The latter promote systemic low-grade inflammation (SLGI), a precondition for many systemic diseases and some of them, e.g., atherosclerosis, diabetes etc., can be triggered by SLGI alone. Either reverting the polarized neutrophils back to the homeostatic state or attenuation of neutrophil hyper-responsiveness in periodontitis might be an approach to diminish or even to prevent systemic diseases.
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Affiliation(s)
- Ljubomir Vitkov
- Vascular & Exercise Biology Unit, Department of Biosciences, University of Salzburg, 5020 Salzburg, Austria; (L.V.); (H.O.); (B.M.)
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, 66424 Homburg, Germany
| | - Luis E. Muñoz
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
| | - Jasmin Knopf
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
| | - Christine Schauer
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
| | - Hannah Oberthaler
- Vascular & Exercise Biology Unit, Department of Biosciences, University of Salzburg, 5020 Salzburg, Austria; (L.V.); (H.O.); (B.M.)
| | - Bernd Minnich
- Vascular & Exercise Biology Unit, Department of Biosciences, University of Salzburg, 5020 Salzburg, Austria; (L.V.); (H.O.); (B.M.)
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, 66424 Homburg, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3—Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany; (L.E.M.); (J.K.); (C.S.); (M.H.)
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9
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Effect of periodontal therapy on COPD outcomes: a systematic review. BMC Pulm Med 2021; 21:92. [PMID: 33736634 PMCID: PMC7976708 DOI: 10.1186/s12890-021-01429-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/02/2021] [Indexed: 01/02/2023] Open
Abstract
Background Latest evidence suggests that periodontitis is prevalent among patients with chronic obstructive pulmonary disease (COPD), while recent studies have also reported a potential benefit of periodontal treatment on several COPD outcomes. This systematic review aims to determine the impact of periodontal treatment on exacerbation rate, lung function and quality of life of COPD patients. Methods A systematic search of electronic databases of PubMed, Scopus, Virtual Health Library, ScienceDirect, Wiley Online Library, Web of Science, ProQuest Dissertation and Theses Global and Google Scholar was conducted. Search restricted to studies involving human subjects which were published from January 2000 to March 2020 in English language. Distiller Systematic Review software was used for data management. Risk of bias was assessed using Risk of Bias 2 (RoB2) and Risk of Bias for non-randomized studies of intervention (ROBINS-I) tools. Overall quality of evidence was judged based on Grading of Recommendations Assessment, Development and Evaluation working group methodology. Results Out of 1442 articles retrieved, 7 full text articles were included in the review. Limited evidence suggests that periodontal treatment in patients with COPD and periodontitis is associated with reduced exacerbation frequency and a slower lung function decline rate, while its effects on quality of life remain unclear. In addition, periodontal treatment in COPD is associated with lower hospitalization rates and reduced all-cause mortality. Significant methodological differences were noted amongst included studies, while very low-to-moderate overall quality of evidence was demonstrated. Conclusions Although it is reasonable to advise COPD patients not to neglect their dental health, further studies are warranted to determine the role of periodontal therapy on COPD clinical outcomes. Trial Registration: PROSPERO 2020 (CRD42020158481). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158481 Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01429-2.
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10
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Farrugia C, Stafford GP, Potempa J, Wilkinson RN, Chen Y, Murdoch C, Widziolek M. Mechanisms of vascular damage by systemic dissemination of the oral pathogen Porphyromonas gingivalis. FEBS J 2021; 288:1479-1495. [PMID: 32681704 PMCID: PMC9994420 DOI: 10.1111/febs.15486] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/15/2020] [Accepted: 07/14/2020] [Indexed: 01/04/2023]
Abstract
Several studies have shown a clear association between periodontal disease and increased risk of cardiovascular disease. Porphyromonas gingivalis (Pg), a key oral pathogen, and its cell surface-expressed gingipains, induce oedema in a zebrafish larvae infection model although the mechanism of these vascular effects is unknown. Here, we aimed to determine whether Pg-induced vascular damage is mediated by gingipains. In vitro, human endothelial cells from different vascular beds were invaded by wild-type (W83) but not gingipain-deficient (ΔK/R-ab) Pg. W83 infection resulted in increased endothelial permeability as well as decreased cell surface abundance of endothelial adhesion molecules PECAM-1 and VE-cadherin compared to infection with ΔK/R-ab. In agreement, when transgenic zebrafish larvae expressing fluorescently labelled PECAM-1 or VE-cadherin were systemically infected with W83 or ΔK/R-ab, a significant reduction in adhesion molecule fluorescence was observed specifically in endothelium proximal to W83 bacteria through a gingipain-dependent mechanism. Furthermore, this was associated with increased vascular permeability in vivo when assessed by dextran leakage microangiography. These data are the first to show that Pg directly mediates vascular damage in vivo by degrading PECAM-1 and VE-cadherin. Our data provide a molecular mechanism by which Pg might contribute to cardiovascular disease.
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Affiliation(s)
- Cher Farrugia
- School of Clinical Dentistry, University of Sheffield, UK
| | | | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.,Department of Oral Immunity and Infectious Diseases, University of Louisville School of Dentistry, KY, USA
| | | | - Yan Chen
- Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, UK
| | - Craig Murdoch
- School of Clinical Dentistry, University of Sheffield, UK
| | - Magdalena Widziolek
- School of Clinical Dentistry, University of Sheffield, UK.,Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.,Department of Evolutionary Immunology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University, Kraków, Poland
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11
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Orekhova LY, Petrov AA, Loboda ES, Berezkina IV, Shadrina KV. Study of functional state of microcirculatory channel system in periodontal tissues in persons of different age groups. Pediatr Dent 2020. [DOI: 10.33925/1683-3031-2020-20-2-88-94] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Relevance. The study of age-related features of microcirculation in periodontal tissues, using non-invasive functional research methods, allows us to develop the optimal range of therapeutic measures, as well as form a “personalized therapeutic case”.Purpose. Study of the functional state of the microvasculature in the tissues of the parodont in individuals of various age groups.Materials and methods. A standard dental examination of 80 patients was carried out, the sample of participants was ranked in 4 groups by age: 1 group – 12 years old, 2 group – 15 years old, 3 group – from 16 to 18 years old, 4 group – from 22 to 24 years old. Hygiene and periodontal indices were determined for all patients, such as papillarymarginal-alveolar (PMA) in the Parma modification, the Mulleman bleeding index in the Cowell modification (SBI), and the simplified Green Vermillion index of oral hygiene (OHI–s), caries intensity indicators for a permanent bite (CPI), as well as ultrasound dopplerography of periodontal tissues using the apparatus "Minimax-Doppler-K".Results. When studying microcirculation in periodontal tissues, distinctive characteristics of linear (Vas) and volumetric (Qas) blood flow rates, as well as indicators of pulsation indices (PI) and peripheral resistance (RI) in people of different age groups were recorded.Conclusions. This study confirms the presence of various hemodynamic indicators of periodontal tissues in the studied groups, which is due to structural features of the circulatory system in age periods.
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Affiliation(s)
- L. Yu. Orekhova
- First St. Petersburg State Medical University named after academician I.P. Pavlov; City Periodontal Center «PAKS» Ltd
| | - A. A. Petrov
- First St. Petersburg State Medical University named after academician I.P. Pavlov
| | - E. S. Loboda
- First St. Petersburg State Medical University named after academician I.P. Pavlov; City Periodontal Center «PAKS» Ltd
| | - I. V. Berezkina
- First St. Petersburg State Medical University named after academician I.P. Pavlov
| | - K. V. Shadrina
- First St. Petersburg State Medical University named after academician I.P. Pavlov
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12
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Chen HH, Ho CW, Hsieh MC, Chen CC, Hsu SP, Lin CL, Kao CH. Gout can increase the risk of periodontal disease in Taiwan. Postgrad Med 2020; 132:521-525. [PMID: 32298158 DOI: 10.1080/00325481.2020.1757267] [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: 10/24/2022]
Abstract
Objectives: To evaluate the risk of periodontal disease (PD) in gout patients. Methods: This retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2000. The gout cohort included 31,759 patients newly diagnosed with gout from 2000 to 2012, and the comparison (nongout) cohort included 63,517 patients. Univariate and multivariable adjusted hazard ratios (aHRs), with corresponding 95% confidence intervals (CIs), were estimated using the Cox proportional hazard model for determining the occurrence of PD in both cohorts. We also measured the cumulative incidence of PD in these two cohorts using the Kaplan-Meier method and assessed the curve difference using the log-rank test. Results: The mean follow-up time was more than 6 years for both cohorts. The overall incidence rate of PD was significantly higher in the gout cohort than in the comparison cohort (5.04 vs 4.16 per 10,000 person-years; aHR = 1.13, 95% CI = 1.10-1.16). Only patients using colchicine had a significantly lower risk of PD (aHR = 0.85, 95% CI = 0.79-0.91). Conclusion: In our study, patients with gout showed an increased risk of PD, and treatment with colchicine could decrease the risk. Abbreviations: PD: periodontal disease; LHID: Longitudinal Health Insurance Research Database; NHIRD, National Health Insurance Research Database; ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical Modification; CI: confidence interval; HR: hazard ratio.
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Affiliation(s)
- Hsin-Hung Chen
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan.,School of Medicine, Institute of Medicine and Public Health, Chung Shan Medical University , Taichung, Taiwan
| | - Chun-Wei Ho
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital , Taichung, Taiwan.,Graduate Institute of Integrative Medicine, China Medical University , Taichung, Taiwan.,Division of Clinical Nutrition, China Medical University Hospital , Taichung, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital , Taichung, Taiwan.,School of Chinese Medicine, China Medical University , Taichung, Taiwan
| | - Sheng-Pang Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital , Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital , Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University , Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University , Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital , Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University , Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital , Taichung, Taiwan
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13
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Ko CY, Hu AK, Chou D, Huang LM, Su HZ, Yan FR, Zhang XB, Zhang HP, Zeng YM. Analysis of oral microbiota in patients with obstructive sleep apnea-associated hypertension. Hypertens Res 2019; 42:1692-1700. [PMID: 30976074 PMCID: PMC8075895 DOI: 10.1038/s41440-019-0260-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/28/2019] [Accepted: 03/09/2019] [Indexed: 02/08/2023]
Abstract
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is an independent risk factor for hypertension (HTN). The oral microbiota plays a pathophysiological role in cardiovascular diseases; however, there are few reports directly investigating and identifying the organisms involved in OSAHS-related HTN. Therefore, this study aimed to identify those organisms. We obtained 139 oral samples and determined the microbiome composition using pyrosequencing and bioinformatic analyses of the 16S rRNA. We examined the fasting levels of cytokines and homocysteine in all participants and analyzed the correlations between the oral microbiota and homocysteine levels. We determined the molecular mechanism underlying HTN by investigating the genetic composition of the strains in the blood. We detected higher relative abundances of Porphyromonas and Aggregatibacter and elevated proinflammatory cytokines in patients with OSAHS of varying severity compared with individuals without OSAHS; however, the two organisms were not measured in the blood samples from all participants. High levels of specific Porphyromonas bacteria were detected in patients with OSAHS with and without HTN, whereas the relative abundance of Aggregatibacter was negatively correlated with the homocysteine level. The receiver operating characteristic curve analysis of controls and patients with OSAHS resulted in area under the curve values of 0.759 and 0.641 for patients with OSAHS with or without HTN, respectively. We found that the predictive function of oral microbiota was different in patients with OSAHS with and without HTN. However, there was no direct invasion by the two organisms causing endothelial cell injury, leading to speculation regarding the other mechanisms that may lead to HTN. Elucidating the differences in the oral microbiome will help us understand the pathogenesis of OSAHS-related HTN.
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Affiliation(s)
- Chih-Yuan Ko
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China. .,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China. .,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China. .,Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.
| | - An-Ke Hu
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Dylan Chou
- Zhuhai Campus of Zunyi Medical University, Zhuhai, 519090, Guangdong, China
| | - Li-Mei Huang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Huan-Zhang Su
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Fu-Rong Yan
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China.,Center for Molecular Diagnosis and Therapy, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China
| | - Xiao-Bin Zhang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Hua-Ping Zhang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China. .,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China. .,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China.
| | - Yi-Ming Zeng
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China. .,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China. .,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China.
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14
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Kikuchi Y, Kimizuka R, Kato T, Okuda K, Kokubu E, Ishihara K. Treponema denticola Induces Epithelial Barrier Dysfunction in Polarized Epithelial Cells. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 59:265-275. [PMID: 30333370 DOI: 10.2209/tdcpublication.2017-0052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Treponema denticola, an anaerobic spirochete found mainly in the oral cavity, is associated with periodontal disease and has a variety of virulence factors. Although in vitro studies have shown that T. denticola is able to penetrate epithelial cell monolayers, its effect on the epithelial barrier junction is not known. Human gingival epithelial cells are closely associated with adjacent membranes, forming barriers in the presence of tight junction proteins, including zonula occludens-1 (ZO-1), claudin-1, and occludin. Tight junction proteins are also expressed by Madin-Darby canine kidney (MDCK) cells in culture. In this study, the MDCK cell profile was investigated following infection with T. denticola (ATCC 35405) wild-type, as well as with its dentilisin-deficient mutant, K1. Basolateral exposure of MDCK cell monolayers to T. denticola at a multiplicity of infection (MOI) of 104 resulted in a decrease in transepithelial electrical resistance (TER). Transepithelial electrical resistance in MDCK cell monolayers also decreased following apical exposure to T. denticola (MOI=104), although this took longer with basolateral exposure. The effect on the TER was time-dependent and required the presence of live bacteria. Meanwhile, MDCK cell viability showed a decrease with either basolateral or apical exposure. Immunofluorescence analysis demonstrated decreases in the amounts of immunoreactive ZO-1 and claudin-1 in association with disruption of cell-cell junctions in MDCK cells exposed apically or basolaterally to T. denticola. Western blot analysis demonstrated degradation of ZO-1 and claudin-1 in culture lysates derived from T. denticola-exposed MDCK cells, suggesting a bacteria-induced protease capable of cleaving these tight junction proteins.
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Affiliation(s)
- Yuichiro Kikuchi
- Department of Microbiology, Tokyo Dental College.,Oral Health Science Center, Tokyo Dental College
| | | | - Tetsuo Kato
- Laboratory of Chemistry, Tokyo Dental College
| | | | - Eitoyo Kokubu
- Department of Microbiology, Tokyo Dental College.,Oral Health Science Center, Tokyo Dental College
| | - Kazuyuki Ishihara
- Department of Microbiology, Tokyo Dental College.,Oral Health Science Center, Tokyo Dental College
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15
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Chukkapalli SS, Ambadapadi S, Varkoly K, Jiron J, Aguirre JI, Bhattacharyya I, Morel LM, Lucas AR, Kesavalu L. Impaired innate immune signaling due to combined Toll-like receptor 2 and 4 deficiency affects both periodontitis and atherosclerosis in response to polybacterial infection. Pathog Dis 2018; 76:5142697. [PMID: 30351354 DOI: 10.1093/femspd/fty076] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 10/22/2018] [Indexed: 12/15/2022] Open
Abstract
Plasma membrane-associated Toll-like receptor (TLR2 and TLR4) signaling contributes to oral microbe infection-induced periodontitis and atherosclerosis. We recently reported that either TLR2 or TLR4 receptor deficiency alters recognition of a consortium of oral pathogens, modifying host responses in periodontitis and atherosclerosis. We evaluated the effects of combined TLR2-/-TLR4-/- double knockout mice on innate immune signaling and induction of periodontitis and atherosclerosis after polybacterial infection with Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia and Fusobacterium nucleatum in a mouse model. Multispecies infections established gingival colonization in all TLR2-/-TLR4-/- mice and induced production of bacterial-specific IgG antibodies. In combined TLR2-/-TLR4-/- deficiency there was, however, reduced alveolar bone resorption and mild gingival inflammation with minimal migration of junctional epithelium and infiltration of inflammatory cells. This indicates a central role for TLR2 and TLR4 in periodontitis. Atherosclerotic plaque progression was markedly reduced in infected TLR2-/-TLR4-/- mice or in heterozygotes indicating a profound effect on plaque growth. However, bacterial genomic DNA was detected in multiple organs in TLR2-/-TLR4-/- mice indicating an intravascular dissemination from gingival tissue to heart, aorta, kidney and lungs. TRL2 and TLR4 were dispensable for systemic spread after polybacterial infections but TLR2 and 4 deficiency markedly reduces atherosclerosis induced by oral bacteria.
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Affiliation(s)
- Sasanka S Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Sriram Ambadapadi
- Biodesign Institute, Arizona State University, Tempe, 727 E Tyler St 85287, AZ, USA
| | - Kyle Varkoly
- Biodesign Institute, Arizona State University, Tempe, 727 E Tyler St 85287, AZ, USA
| | - Jessica Jiron
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jose Ignacio Aguirre
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Indraneel Bhattacharyya
- Department of Oral Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Laurence M Morel
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Alexandra R Lucas
- Biodesign Institute, Arizona State University, Tempe, 727 E Tyler St 85287, AZ, USA
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA.,Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
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16
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Kumar J, Teoh SL, Das S, Mahakknaukrauh P. Oxidative Stress in Oral Diseases: Understanding Its Relation with Other Systemic Diseases. Front Physiol 2017; 8:693. [PMID: 28959211 PMCID: PMC5603668 DOI: 10.3389/fphys.2017.00693] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 08/29/2017] [Indexed: 12/18/2022] Open
Abstract
Oxidative stress occurs in diabetes, various cancers, liver diseases, stroke, rheumatoid arthritis, chronic inflammation, and other degenerative diseases related to the nervous system. The free radicals have deleterious effect on various organs of the body. This is due to lipid peroxidation and irreversible protein modification that leads to cellular apoptosis or programmed cell death. During recent years, there is a rise in the oral diseases related to oxidative stress. Oxidative stress in oral disease is related to other systemic diseases in the body such as periodontitis, cardiovascular, pancreatic, gastric, and liver diseases. In the present review, we discuss the various pathways that mediate oxidative cellular damage. Numerous pathways mediate oxidative cellular damage and these include caspase pathway, PERK/NRF2 pathway, NADPH oxidase 4 pathways and JNK/mitogen-activated protein (MAP) kinase pathway. We also discuss the role of inflammatory markers, lipid peroxidation, and role of oxygen species linked to oxidative stress. Knowledge of different pathways, role of inflammatory markers, and importance of low-density lipoprotein, fibrinogen, creatinine, nitric oxide, nitrates, and highly sensitive C-reactive proteins may be helpful in understanding the pathogenesis and plan better treatment for oral diseases which involve oxidative stress.
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Affiliation(s)
- Jaya Kumar
- Department of Physiology, Universiti Kebangsaan Malaysia Medical CentreKuala Lumpur, Malaysia
| | - Seong Lin Teoh
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical CentreKuala Lumpur, Malaysia
| | - Srijit Das
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical CentreKuala Lumpur, Malaysia
| | - Pasuk Mahakknaukrauh
- Forensic Osteology Research, Chiang Mai UniversityChiang Mai, Thailand
- Excellence in Osteology Research and Training Center, Chiang Mai UniversityChiang Mai, Thailand
- Department of Anatomy, Faculty of Medicine, Chiang Mai UniversityChiang Mai, Thailand
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17
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Review. The Link between Periodontal Disease, Inflammation and Atherosclerosis — an Interdisciplinary Approach. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Abstract
Periodontal disease is a chronic inflammatory disease that results from the activity of altered oral microbiome, leading to altered immune reaction, destruction of tissues supporting the teeth, and oral bone loss. This disease is particularly associated with an expressed systemic inflammation, being considered nowadays an inflammatory disorder. At the same time, inflammation has been recognized to play a major role in the development of atherosclerotic lesions. Atheromatous plaque formation is triggered by alterations in the structure of the endothelium, which lead to the expression of adhesion molecules and recruitment of immune cells such as macrophages, in the arterial wall. While the association between periodontal disease, inflammation and cardiovascular diseases has been well established, the causality relation between these three entities has not been demonstrated so far. This review presents the most common advances in understanding the complex link between periodontal disease, inflammation and atherosclerosis, as a common pathway leading to increased cardiovascular risk.
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