1
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de Medeiros RA, da Silva YM, Miranda YMS, Gomes DDS, Carvalho TRB, Tanaka EB, de Oliveira PGFP, Nogueira JSE, de Menezes SAF, Menezes TODA, Laurentino RV, Fonseca RRDS, Machado LFA. Digital Form for Assessing Dentistry Undergraduates Regarding Periodontal Disease Associated with Cardiovascular Diseases. Medicina (B Aires) 2023; 59:medicina59030509. [PMID: 36984510 PMCID: PMC10053880 DOI: 10.3390/medicina59030509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Throughout recent years, periodontal disease (PD) has been linked to innumerable medical systemic conditions, such as cardiovascular disease (CVD). This association could negatively impact oral health, so the knowledge of dentists who have graduated must follow modern dentistry in order to promote oral health, mainly in systemically compromised patients. Therefore, the present study aimed to determine and evaluate the knowledge level of dentistry undergraduate students (DUS) regarding the correct periodontal treatment and management of cardiac patients with PD. Methods: This cross-sectional and populational-based study was conducted between March and June 2022 in northern Brazil. A total of 153 DUS received an anonymous digital form (Google Forms Platform) using a non-probabilistic “snowball” sampling technique. The digital form was composed of four blocks of dichotomous and multiple-choice questions. After signing the informed consent term, DUS were divided into three groups according to their period/semester in dentistry graduation during the study time (G1: 1st period/semester; G2: 5th period/semester and G3: 10th period/semester). A total of 25 questions referring to demographic, educational and knowledge data about the dental and periodontal care of cardiac patients with PD were asked, and all data were presented as descriptive percentages and then analyzed using the Kappa test. Results: From a total of 153 (100%) DUS, the sample was mostly composed of 104 (68%) female participants, with an average age of 21.1 years. Regarding basic knowledge, the majority of answers were no, with G1 being higher than G2 and G3. Regarding clinical questions, 1247 (58.3%) answers were no. Additionally, regarding fundamental clinical questions 1, 2, 3, 7, 9, 11, 13 and 14, the majority of G1, G2 and G3 answered no, demonstrating a major lack of knowledge. Conclusions: In our study, DUS demonstrated a low knowledge level of the dental and periodontal care of cardiac patients with PD and its bi-directional link. Thus, according to our results, an improvement in dentistry educational programs regarding periodontal medicine must be implemented.
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Affiliation(s)
| | | | | | | | | | - Erich Brito Tanaka
- School of Dentistry, University Center of State of Pará, Belém 66060-575, PA, Brazil
| | | | | | | | | | - Rogério Valois Laurentino
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Ricardo Roberto de Souza Fonseca
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Luiz Fernando Almeida Machado
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
- Correspondence:
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2
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Toy VE, Ataoglu T, Eltas A, Otlu HG, Karabulut AB. Obesity as a modifying factor of periodontal therapy outcomes: local and systemic adipocytokines and oxidative stress markers. Clin Oral Investig 2023:10.1007/s00784-022-04854-7. [PMID: 36604342 DOI: 10.1007/s00784-022-04854-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Adipocytokines and oxidative stress (OS) are involved in the pathogenesis of both obesity and periodontitis. The aim of this study was to evaluate periodontal therapy outcomes in terms of serum and gingival crevicular fluid (GCF) levels of adipocytokines and OS markers in obese patients with periodontitis, in order to have an insight into the association between obesity and periodontitis. MATERIALS AND METHODS A total of 39 patients (20 obese, 19 non-obese) with periodontitis were included in this study. Clinical periodontal parameters were assessed; serum and GCF levels of adipocytokines and OS markers were evaluated by ELISA at baseline and 3 months after non-surgical periodontal therapy. RESULTS Significant improvements in clinical periodontal parameters were observed in both groups at 3 months (p < 0.01). While serum levels of TNF-α, leptin, and total oxidant status (TOS) in the obese group were higher at baseline (p < 0.01), leptin levels remained higher at 3 months despite a significant decrease (p < 0.01). Although NSPT improved GCF levels of total antioxidant status (TAS) and TOS in both groups, they were significantly different between the groups after therapy (p < 0.05). CONCLUSIONS It seems that leptin, TNF-α, and TOS contribute to systemic inflammatory and oxidative state in patients with obesity. Despite improvements in clinical periodontal parameters, obesity might be a modulating factor in the development and progression of periodontal disease in terms of some adipocytokines and OS markers. CLINICAL RELEVANCE Since the global burden of both obesity and periodontitis is continuously increasing, the management of these inflammatory diseases has become more important. The current study contributes to our understanding of the role of OS and adipocytokines on the relationship between obesity and periodontitis by response to periodontal treatment.
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Affiliation(s)
- Vesile Elif Toy
- Department of Periodontology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
| | - Tamer Ataoglu
- Department of Periodontology, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | - Abubekir Eltas
- Department of Periodontology, Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - Husniye Gul Otlu
- Medical Laboratory Techniques Program, Vocational School of Health Services, Turgut Ozal University, Malatya, Turkey
| | - Aysun Bay Karabulut
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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3
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Exploring the Mechanisms and Association between Oral Microflora and Systemic Diseases. Diagnostics (Basel) 2022; 12:diagnostics12112800. [PMID: 36428859 PMCID: PMC9689323 DOI: 10.3390/diagnostics12112800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/01/2022] [Accepted: 10/12/2022] [Indexed: 11/18/2022] Open
Abstract
The scope of dentistry is ever-changing and dynamic in all fields of dentistry including periodontal health and disease. Recent studies show that oral health and systemic health are interdependent, particularly in the way that poor oral hygiene and periodontal health affect the systemic health of an individual and vice versa. Periodontal diseases are multifactorial in nature in which the role of bacterial infections is inevitable. Furthermore, high-throughput sequencing technologies have shed light on the dysregulation of the growth of oral microbial flora and their environment, including those that are associated with periodontitis and other oral and non-oral diseases. Under such circumstances, it becomes important to explore oral microbiota and understand the effects of periodontal pathogens in the pathogenesis of systemic diseases. In addition, it may strengthen our view that a better understanding of oral microbial flora and proper examination of the oral cavity may aid in the early diagnosis and possible treatment of systemic diseases and conditions. This will eventually lead to providing better care to our patients. Therefore, in this research, we attempt to outline the periodontal pathophysiology along with the role of periodontal pathogens in some commonly encountered systemic conditions.
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El-Seedi HR, Eid N, Abd El-Wahed AA, Rateb ME, Afifi HS, Algethami AF, Zhao C, Al Naggar Y, Alsharif SM, Tahir HE, Xu B, Wang K, Khalifa SAM. Honey Bee Products: Preclinical and Clinical Studies of Their Anti-inflammatory and Immunomodulatory Properties. Front Nutr 2022; 8:761267. [PMID: 35047540 PMCID: PMC8762236 DOI: 10.3389/fnut.2021.761267] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022] Open
Abstract
Inflammation is a defense process triggered when the body faces assaults from pathogens, toxic substances, microbial infections, or when tissue is damaged. Immune and inflammatory disorders are common pathogenic pathways that lead to the progress of various chronic diseases, such as cancer and diabetes. The overproduction of cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α, is an essential parameter in the clinical diagnosis of auto-inflammatory diseases. In this review, the effects of bee products have on inflammatory and autoimmune diseases are discussed with respect to the current literature. The databases of Google Scholar, PubMed, Science Direct, Sci-Finder and clinical trials were screened using different combinations of the following terms: “immunomodulatory”, “anti-inflammatory”, “bee products”, “honey”, “propolis”, “royal jelly”, “bee venom”, “bee pollen”, “bee bread”, “preclinical trials”, “clinical trials”, and “safety”. Honey bee products, including propolis, royal jelly, honey, bee venom, and bee pollen, or their bioactive chemical constituents like polyphenols, demonstrate interesting therapeutic potential in the regulation of inflammatory mediator production as per the increase of TNF-α, IL-1β, IL-6, Il-2, and Il-7, and the decrease of reactive oxygen species (ROS) production. Additionally, improvement in the immune response via activation of B and T lymphocyte cells, both in in vitro, in vivo and in clinical studies was reported. Thus, the biological properties of bee products as anti-inflammatory, immune protective, antioxidant, anti-apoptotic, and antimicrobial agents have prompted further clinical investigation.
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Affiliation(s)
- Hesham R El-Seedi
- Pharmacognosy Group, Department of Pharmaceutical Biosciences, Biomedical Centre, Uppsala University, Uppsala, Sweden.,International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, China.,International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu Education Department, Jiangsu University, Zhenjiang, China.,Department of Chemistry, Faculty of Science, Menoufia University, Shebeen El-Kom, Egypt
| | - Nehal Eid
- Department of Chemistry, Faculty of Science, Menoufia University, Shebeen El-Kom, Egypt
| | - Aida A Abd El-Wahed
- Department of Bee Research, Plant Protection Research Institute, Agricultural Research Centre, Giza, Egypt
| | - Mostafa E Rateb
- School of Computing, Engineering & Physical Sciences, University of the West of Scotland, Paisley, United Kingdom
| | - Hanan S Afifi
- Food Research Section, R&D Division, Abu Dhabi Agriculture and Food Safety Authority (ADAFSA), Abu Dhabi, United Arab Emirates
| | | | - Chao Zhao
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Yahya Al Naggar
- General Zoology Group, Institute for Biology, Martin Luther University Halle-Wittenberg, Halle, Germany.,Zoology Department, Faculty of Science, Tanta University, Tanta, Egypt
| | - Sultan M Alsharif
- Biology Department, Faculty of Science, Taibah University, Medina, Saudi Arabia
| | | | - Baojun Xu
- Programme of Food Science and Technology, BNU-HKBU United International College, Zhuhai, China
| | - Kai Wang
- Institute of Apicultural Research, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Shaden A M Khalifa
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
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5
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Gupta S, Mohindra R, Singla M, Khera S, Sahni V, Kanta P, Soni RK, Kumar A, Gauba K, Goyal K, Singh MP, Ghosh A, Kajal K, Mahajan V, Bhalla A, Sorsa T, Räisänen I. The clinical association between Periodontitis and COVID-19. Clin Oral Investig 2021; 26:1361-1374. [PMID: 34448073 PMCID: PMC8390180 DOI: 10.1007/s00784-021-04111-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/27/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The study aimed to clinically assess the association between periodontitis and COVID-19-related outcomes. MATERIAL AND METHODS Data pertaining to patient demographics, medical history, blood parameters, periodontal clinical examination and aMMP-8 point-of-care diagnostics (both site-level and patient-level) was recorded for eighty-two COVID-19-positive patients. COVID-19-related outcomes such as COVID-19 pneumonia, death/survival, types of hospital admission and need of assisted ventilation were also assessed. RESULTS Males were predominantly afflicted with COVID-19, with advanced age exhibiting a greater association with the presence of periodontitis. Higher severity of periodontitis led to 7.45 odds of requiring assisted ventilation, 36.52 odds of hospital admission, 14.58 odds of being deceased and 4.42 odds of COVID-19-related pneumonia. The aMMP-8 mouthrinse kit was slightly more sensitive but less specific than aMMP-8 site-specific tests. CONCLUSIONS Based on the findings of the present study, periodontitis seems to be related to poorer COVID-19-related outcomes. However, within the constraints of this work, a direct causality may not be established. Periodontitis, by means of skewing the systemic condition for a number of comorbidities, may eventually influence COVID-19 outcomes in an indirect manner. CLINICAL RELEVANCE The study is the first to clinically, and by means of a validated point-of-care diagnostic methodology, assess the association between periodontal health and COVID-19-related outcomes. Assessment of the periodontal status of individuals can aid in the identification of risk groups during the pandemic along with reinforcing the need to maintain oral hygiene and seeking periodontal care.
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Affiliation(s)
- Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
| | - Ritin Mohindra
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Mohita Singla
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Sagar Khera
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | | | - Poonam Kanta
- Department of Virology, PGIMER, Chandigarh, India
| | | | - Amit Kumar
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Krishan Gauba
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Kapil Goyal
- Department of Virology, PGIMER, Chandigarh, India
| | - Mini P Singh
- Department of Virology, PGIMER, Chandigarh, India
| | - Arnab Ghosh
- Department of Virology, PGIMER, Chandigarh, India
| | - Kamal Kajal
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Varun Mahajan
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oral Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Ismo Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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6
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Bobetsis YA, Kotsikoris I, Liapis CD, Liasis N, Kakisis J, Kourlaba G, Lazari P, Antonopoulos CN, Deliargyris EN, Madianos PN. Association between periodontal disease and vulnerable plaque morphology in patients undergoing carotid endarterectomy. IJC HEART & VASCULATURE 2020; 30:100601. [PMID: 32802936 PMCID: PMC7419330 DOI: 10.1016/j.ijcha.2020.100601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 01/23/2023]
Abstract
Periodontal disease is associated with echolucent plaques. Periodontal disease is associated with increased macrophages in plaques. Periodontal disease is associated with decreased smooth muscle cells in plaques. Periodontal disease is associated with plaque instability.
Background Periodontal disease (PD) is a chronic inflammatory oral condition with potentially important systemic sequelae. We sought to determine whether the presence of PD in patients with severe carotid disease was associated with morphological features consistent with carotid plaque instability. Methods A total of 52 dentate patients hospitalized for carotid endarterectomy (CEA) had standardized assessments of their periodontal status, including measurements of probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BoP). Carotid plaque morphology was assessed by ultrasound using the gray scale median (GSM) score and by immunohistochemistry using anti-CD68 and anti-alpha-actin antibodies, markers for macrophages and smooth muscle cells (SMCs) respectively. Results In total 30/52 patients (58%) had PD. Significant associations were noted between low GSM on ultrasound and each mm in PPD (p = 0.001), each mm in CAL (p = 0.002) and with a 10% increase in BoP (p = 0.009). Using the standardized PERIO definition the association remained robust (aOR = 10.4 [95% CI:2.3–46.3], p = .002). Significant associations were also observed with high macrophage accumulation and each individual PD measure (p < 0.01 for PPD, CAL and BoP) and with the PERIO definition (aOR = 15 [95% CI:1.8–127.8], p = .01). Similarly, low SMC density was also significantly associated with individual measures of PD (p < 0.05 for PPD, CAL and BoP), but not with the PERIO definition (aOR 3.4 [95% CI:0.9–12.8], p = .07). Conclusions The presence of PD was significantly associated with both ultrasound and immunohistochemistry features of carotid plaque instability in patients undergoing CEA.
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Affiliation(s)
- Yiorgos A Bobetsis
- Dept of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | | | - Christos D Liapis
- Dept of Vascular Surgery, Medical School, National and Kapodistrian University of Athens, Greece.,Vascular & Endovascular Clinic, Athens Medical Center, Athens, Greece
| | - Nikolaos Liasis
- Dept of Vascular Diagnosis, Euromedic Greece, Athens, Greece
| | - John Kakisis
- Dept of Vascular Surgery, Medical School, National and Kapodistrian University of Athens, Greece
| | - Georgia Kourlaba
- 1 and 2 Dept of Pediatrics, Medical School, National and Kapodistrian University of Athens, Greece
| | - Paraskevi Lazari
- Dept of Pathology, Nikaia General Hospital, Piraeus, Greece.,Dept of Pathology, West Attica General Hospital, Athens, Greece
| | | | | | - Phoebus N Madianos
- Dept of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Greece
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Caribé PMV, Villar CC, Romito GA, Takada JY, Pacanaro AP, Strunz CMC, César LAM, Mansur ADP. Prospective, case-controlled study evaluating serum concentration of sirtuin-1 and mannose-binding lectin in patients with and without periodontal and coronary artery disease. Ther Adv Chronic Dis 2020; 11:2040622320919621. [PMID: 32435441 PMCID: PMC7223200 DOI: 10.1177/2040622320919621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/25/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Atherosclerosis and periodontal disease (PD) are inflammatory diseases that have been shown in studies to have a direct association. Mannose-binding lectin (MBL) is an immune system protein that binds to periodontal pathogens favoring phagocytosis. Conversely, increased serum sirtuin-1 (SIRT1) concentration reduces the inflammatory process. Methods: This was a prospective, case-controlled study that analyzed serum concentration of biomarkers in patients with or without coronary artery disease (CAD) and PD. A total of 78 patients were evaluated: 20 healthy individuals, 18 patients with CAD, 20 patients with PD, and 20 patients with both PD and CAD. Clinical and laboratory characteristics were analyzed before and after nonsurgical treatment of PD and also at two equivalent times in patients without PD. Serum MBL and SIRT1 concentration were analyzed by enzyme-linked immunosorbent assay. Results: A negative correlation was observed between changes in serum concentration of MBL and SIRT1 (r = −0.30; p = 0.006). Comparison between pre- and post-treatment of PD showed a reduction in MBL levels (886.27 ± 906.72 versus 689.94 ± 808.36; p = 0.002) and an increase in SIRT1 values (0.80 ± 1.01 versus 1.49 ± 1.55; p = 0.005) in patients with PD and without CAD. The same result was observed in patients with PD and CAD for MBL and SIRT1, respectively, of 1312.43 ± 898.21 versus 1032.90 ± 602.52 (p = 0.010) and 1.32 ± 1.0 versus 1.82 ± 1.75 (p = 0.044). Conclusion: PD treatment reduced MBL serum concentration and increased SIRT1 serum concentration in patients with and without CAD.
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Affiliation(s)
| | - Cristina Cunha Villar
- Division of Periodontology, Stomatology Department, Dental School, University of São Paulo, São Paulo, Brazil
| | - Guiseppe Alexandre Romito
- Division of Periodontology, Stomatology Department, Dental School, University of São Paulo, São Paulo, Brazil
| | - Júlio Yoshio Takada
- Clinical Department, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Ana Paula Pacanaro
- Clinical Department, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | | | | | - Antonio de Padua Mansur
- Clinical Department, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas C. Aguiar, 44, CEP, São Paulo, 05403-000, Brazil
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8
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Modified lipoproteins in periodontitis: a link to cardiovascular disease? Biosci Rep 2019; 39:BSR20181665. [PMID: 30842338 PMCID: PMC6434390 DOI: 10.1042/bsr20181665] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/04/2019] [Accepted: 02/28/2019] [Indexed: 12/16/2022] Open
Abstract
There is a strong association between periodontal disease and atherosclerotic cardiovascular disorders. A key event in the development of atherosclerosis is accumulation of modified lipoproteins within the arterial wall. We hypothesise that patients with periodontitis have an altered lipoprotein profile towards an atherogenic form. Therefore, the present study aims at identifying modifications of plasma lipoproteins in periodontitis. Lipoproteins from ten female patients with periodontitis and gender- and age-matched healthy controls were isolated by density-gradient ultracentrifugation. Proteins were separated by 2D gel-electrophoresis and identified by map-matching or by nano-LC followed by MS. Apolipoprotein (Apo) A-I (ApoA-I) methionine oxidation, Oxyblot, total antioxidant capacity and a multiplex of 71 inflammation-related plasma proteins were assessed. Reduced levels of apoJ, phospholipid transfer protein, apoF, complement C3, paraoxonase 3 and increased levels of α-1-antichymotrypsin, apoA-II, apoC-III were found in high-density lipoprotein (HDL) from the patients. In low-density lipoprotein (LDL)/very LDL (VLDL), the levels of apoL-1 and platelet-activating factor acetylhydrolase (PAF-AH) as well as apo-B fragments were increased. Methionine oxidation of apoA-I was increased in HDL and showed a relationship with periodontal parameters. α-1 antitrypsin and α-2-HS glycoprotein were oxidised in LDL/VLDL and antioxidant capacity was increased in the patient group. A total of 17 inflammation-related proteins were important for group separation with the highest discriminating proteins identified as IL-21, Fractalkine, IL-17F, IL-7, IL-1RA and IL-2. Patients with periodontitis have an altered plasma lipoprotein profile, defined by altered protein levels as well as post-translational and other structural modifications towards an atherogenic form, which supports a role of modified plasma lipoproteins as central in the link between periodontal and cardiovascular disease (CVD).
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9
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Abraham S, Premnath A, Arunima PR, Kassim RM. Critical Appraisal of Bidirectional Relationship between Periodontitis and Hyperlipidemia. J Int Soc Prev Community Dent 2019; 9:112-118. [PMID: 31058060 PMCID: PMC6489519 DOI: 10.4103/jispcd.jispcd_316_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022] Open
Abstract
Periodontal disease and hyperlipidemia are both multifactorial disease with a high prevalence Worldwide. Cross-sectional and longitudinal prospective clinical studies show some evidence for a bidirectional relationship. Periodontitis and hyperlipidemia share some common risk factors and there exist a mechanistic link between both. Studies have found a positive response to periodontal therapy among hyperlipidemic patients, and statin use by hyperlipidemic patients has shown to influence the periodontal health. However, in spite of the rising prevalence of both diseases, many people remain unaware of their association with each other. Hence, this article summarizes the cyclic relationship between periodontal disease and hyperlipidemia.
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Affiliation(s)
- Seba Abraham
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Arya Premnath
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - P. R. Arunima
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Reejamol Mohammed Kassim
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
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10
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Natto ZS, Hameedaldain A. Methodological Quality Assessment of Meta-analyses and Systematic Reviews of the Relationship Between Periodontal and Systemic Diseases. J Evid Based Dent Pract 2019; 19:131-139. [PMID: 31326045 DOI: 10.1016/j.jebdp.2018.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/21/2018] [Accepted: 12/23/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aims of this article are to identify all the published systematic reviews (SRs) and meta-analyses (MAs) that studied the relationship between periodontal and systemic diseases and to assess their quality using 2 scales (the Overview Quality Assessment Questionnaire [OQAQ] and A Measurement Tool to Assess Systematic Reviews [AMSTAR] checklist). METHODS For SRs and MAs to be included, they should have investigated one of the following systemic diseases: pulmonary conditions, cardiac conditions, endocrine conditions, cancer, blood disorders, psychological conditions, anxiety, depression, mood disorders, and several other diseases. Two investigators screened MEDLINE via PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews. The tools used to evaluate quality were the AMSTAR scale and OQAQ. The protocol was prospectively registered in PROSPERO (CRD42018102208). RESULTS The search strategy found 691 unique articles, 42 of which met the eligibility criteria and were included in this review. Diabetes mellitus was the most investigated disease (14 out of 42 studies), followed by obesity (11 studies) and cardiovascular diseases (5 studies). A total of 40 reviews reported on the characteristics of included studies, and, as per the AMSTAR scale, 39 reviews had an a priori design. The number of reviews that fulfilled the status of publication criterion was the lowest (7 reviews only), followed by the number used in the assessment of publication bias (11 reviews). The number of high-quality reviews was higher with the OQAQ than with the AMSTAR checklist (33 vs 25 studies), but the AMSTAR showed a higher number of medium-quality reviews than the OQAQ (14 vs 6 studies). Both showed the same number of low-quality reviews. CONCLUSIONS High-quality SRs and MAs are crucial to understanding the relationship between systemic and periodontal diseases. Medical practitioners must be able to inform patients about oral health and specific periodontal health concerns.
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Affiliation(s)
- Zuhair S Natto
- Department of Dental Public Health, School of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Alhassan Hameedaldain
- Department of Dental Public Health, School of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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11
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Lönn J, Ljunggren S, Klarström-Engström K, Demirel I, Bengtsson T, Karlsson H. Lipoprotein modifications by gingipains of Porphyromonas gingivalis. J Periodontal Res 2018; 53:403-413. [PMID: 29341140 PMCID: PMC5969291 DOI: 10.1111/jre.12527] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Several studies have shown an association between periodontitis and cardiovascular disease (CVD). Atherosclerosis is the major cause of CVD, and a key event in the development of atherosclerosis is accumulation of lipoproteins within the arterial wall. Bacteria are the primary etiologic agents in periodontitis and Porphyromonas gingivalis is the major pathogen in the disease. Several studies support a role of modified low-density lipoprotein (LDL) in atherogenesis; however, the pathogenic stimuli that induce the changes and the mechanisms by which this occur are unknown. This study aims to identify alterations in plasma lipoproteins induced by the periodontopathic species of bacterium, P. gingivalis, in vitro. MATERIAL AND METHODS Plasma lipoproteins were isolated from whole blood treated with wild-type and gingipain-mutant (lacking either the Rgp- or Kgp gingipains) P. gingivalis by density/gradient-ultracentrifugation and were studied using 2-dimensional gel electrophoresis followed by matrix-assisted laser desorption/ionization mass spectrometry. Porphyromonas gingivalis-induced lipid peroxidation and antioxidant levels were measured by thiobarbituric acid-reactive substances and antioxidant assay kits, respectively, and lumiaggregometry was used for measurement of reactive oxygen species (ROS) and aggregation. RESULTS Porphyromonas gingivalis exerted substantial proteolytic effects on the lipoproteins. The Rgp gingipains were responsible for producing 2 apoE fragments, as well as 2 apoB-100 fragments, in LDL, and the Kgp gingipain produced an unidentified fragment in high-density lipoproteins. Porphyromonas gingivalis and its different gingipain variants induced ROS and consumed antioxidants. Both the Rgp and Kgp gingipains were involved in inducing lipid peroxidation. CONCLUSION Porphyromonas gingivalis has the potential to change the expression of lipoproteins in blood, which may represent a crucial link between periodontitis and CVD.
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MESH Headings
- Adhesins, Bacterial/blood
- Adhesins, Bacterial/genetics
- Adhesins, Bacterial/metabolism
- Antioxidants/analysis
- Apolipoprotein A-I/metabolism
- Apolipoprotein B-100/metabolism
- Cysteine Endopeptidases/blood
- Cysteine Endopeptidases/genetics
- Cysteine Endopeptidases/metabolism
- Cysteine Endopeptidases/pharmacokinetics
- Gingipain Cysteine Endopeptidases
- Humans
- Lipid Peroxidation
- Lipoproteins/blood
- Lipoproteins/drug effects
- Lipoproteins/metabolism
- Lipoproteins, HDL/blood
- Lipoproteins, HDL/metabolism
- Lipoproteins, LDL/blood
- Lipoproteins, LDL/drug effects
- Lipoproteins, LDL/metabolism
- Methionine/metabolism
- Periodontitis/metabolism
- Periodontitis/microbiology
- Porphyromonas gingivalis/metabolism
- Porphyromonas gingivalis/pathogenicity
- Reactive Oxygen Species/metabolism
- Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
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Affiliation(s)
- J Lönn
- Department of Oral Biology, Institute of Odontology, Malmö University, Malmö, Sweden
- PEAS Institute AB, Linköping, Sweden
| | - S Ljunggren
- Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine Center, Linköping University, Linköping, Sweden
| | | | - I Demirel
- Department of Medical Sciences, Örebro University, Örebro, Sweden
| | - T Bengtsson
- Department of Medical Sciences, Örebro University, Örebro, Sweden
| | - H Karlsson
- Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine Center, Linköping University, Linköping, Sweden
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12
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Tooth loss is associated with accelerated cognitive decline and volumetric brain differences: a population-based study. Neurobiol Aging 2018; 67:23-30. [PMID: 29609079 DOI: 10.1016/j.neurobiolaging.2018.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 01/07/2023]
Abstract
Tooth loss has been related to cognitive impairment; however, its relation to structural brain differences in humans is unknown. Dementia-free participants (n = 2715) of age ≥60 years were followed up for up to 9 years. A subsample (n = 394) underwent magnetic resonance imaging at baseline. Information on tooth loss was collected at baseline, and cognitive function was assessed using the Mini-Mental State Examination at baseline and at follow-ups. Data were analyzed using linear mixed effects models and linear regression models. At baseline, 404 (14.9%) participants had partial tooth loss, and 206 (7.6%) had complete tooth loss. Tooth loss was significantly associated with a steeper cognitive decline (β: -0.18, 95% confidence interval [CI]: -0.24 to -0.11) and remained significant after adjusting for or stratifying by potential confounders. In cross-sectional analyses, persons with complete or partial tooth loss had significantly lower total brain volume (β: -28.89, 95% CI: -49.33 to -8.45) and gray matter volume (β: -22.60, 95% CI: -38.26 to -6.94). Thus, tooth loss may be a risk factor for accelerated cognitive aging.
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13
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Alexia V, Chloé V, Pierre B, Sara LD. Periodontal Diseases and Systemic Disorders: What Do Our Doctors Know? A General Practitioner's Survey Conducted in Southern France. J Evid Based Dent Pract 2017; 17:361-369. [DOI: 10.1016/j.jebdp.2017.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/16/2017] [Accepted: 05/19/2017] [Indexed: 01/22/2023]
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14
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Chukkapalli SS, Easwaran M, Rivera-Kweh MF, Velsko IM, Ambadapadi S, Dai J, Larjava H, Lucas AR, Kesavalu L. Sequential colonization of periodontal pathogens in induction of periodontal disease and atherosclerosis in LDLRnull mice. Pathog Dis 2017; 75:ftx003. [PMID: 28104616 DOI: 10.1093/femspd/ftx003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/13/2017] [Indexed: 12/13/2022] Open
Abstract
Periodontal disease (PD) and atherosclerotic vascular disease (ASVD) are both chronic inflammatory diseases with a polymicrobial etiology and have been epidemiologically associated. The purpose is to examine whether periodontal bacteria that infect the periodontium can also infect vascular tissues and enhance pre-existing early aortic atherosclerotic lesions in LDLRnull mice. Mice were orally infected with intermediate bacterial colonizer Fusobacterium nucleatum for the first 12 weeks followed by late bacterial colonizers (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia) for the remaining 12 weeks mimicking the human oral microbiota ecological colonization. Genomic DNA from all four bacterial was detected in gingival plaque by PCR, consistently demonstrating infection of mouse gingival surfaces. Infected mice had significant levels of IgG and IgM antibodies, alveolar bone resorption, and showed apical migration of junctional epithelium revealing the induction of PD. These results support the ability of oral bacteria to cause PD in mice. Detection of bacterial genomic DNA in systemic organs indicates hematogenous dissemination from the gingival pockets. Bacterial infection did not alter serum lipid fractions or serum amyloid A levels and did not induce aortic atherosclerotic plaque. This is the first study examining the causal role of periodontal bacteria in induction of ASVD in LDLRnull mice.
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Affiliation(s)
- Sasanka S Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610-0424, USA
| | - Meena Easwaran
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610-0424, USA
| | - Mercedes F Rivera-Kweh
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610-0424, USA
| | - Irina M Velsko
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610-0424, USA
| | - Sriram Ambadapadi
- Biodesign Institute, Arizona state University, Tempe, AZ 85287-5001, USA
| | - Jiayin Dai
- Division of Periodontics and Dental Hygiene, University of British Columbia, Vancouver, BCV6T 1Z4, Canada
| | - Hannu Larjava
- Division of Periodontics and Dental Hygiene, University of British Columbia, Vancouver, BCV6T 1Z4, Canada
| | - Alexandra R Lucas
- Biodesign Institute, Arizona state University, Tempe, AZ 85287-5001, USA
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610-0424, USA.,Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL 32610-0424, USA
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15
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Mathews MJ, Mathews EH, Mathews GE. Oral health and coronary heart disease. BMC Oral Health 2016; 16:122. [PMID: 27846870 PMCID: PMC5111198 DOI: 10.1186/s12903-016-0316-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 11/06/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND It is well documented that there is some correlation between poor oral health in the form of periodontal disease and coronary heart disease (CHD). It is unclear whether this correlation is due to a causal relationship or shared underlying disorder such as inflammation. A suitable integrated model of the CHD pathogenetic pathways relevant to periodontal disease may help to elucidate the association. Such a model is currently not available in literature. METHODS A previously developed integrated model of CHD was used to investigate potential pathogenetic pathways linking periodontal disease to CHD biomarkers. RESULTS The integrated model was created to provide insight into possible higher-order biological interactions underlying CHD and periodontal disease. In order to simplify these interactions a novel 'connection graph' was developed. It quantitatively illustrates the relationship between periodontal disease and various serological biomarkers of CHD. The pathogenesis of periodontitis shows various possible pathways which could link periodontitis to CHD pathogenesis. CONCLUSION An integrated model of CHD was developed which provides a summary of the potential CHD effects of periodontal disease. Further research must refine and validate the model.
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Affiliation(s)
- Marc J. Mathews
- CRCED, North-West University, P.O. Box 11207, Silver Lakes, 0054 South Africa
| | - Edward H. Mathews
- CRCED, North-West University, P.O. Box 11207, Silver Lakes, 0054 South Africa
| | - George E. Mathews
- CRCED, North-West University, P.O. Box 11207, Silver Lakes, 0054 South Africa
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16
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Gardener SL, Rainey-Smith SR, Martins RN. Diet and Inflammation in Alzheimer's Disease and Related Chronic Diseases: A Review. J Alzheimers Dis 2016; 50:301-34. [PMID: 26682690 DOI: 10.3233/jad-150765] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Inflammation is one of the pathological features of the neurodegenerative disease, Alzheimer's disease (AD). A number of additional disorders are likewise associated with a state of chronic inflammation, including obesity, cardiovascular disease, and type-2 diabetes, which are themselves risk factors for AD. Dietary components have been shown to modify the inflammatory process at several steps of the inflammatory pathway. This review aims to evaluate the published literature on the effect of consumption of pro- or anti-inflammatory dietary constituents on the severity of both AD pathology and related chronic diseases, concentrating on the dietary constituents of flavonoids, spices, and fats. Diet-based anti-inflammatory components could lead to the development of potent novel anti-inflammatory compounds for a range of diseases. However, further work is required to fully characterize the therapeutic potential of such compounds, including gaining an understanding of dose-dependent relationships and limiting factors to effectiveness. Nutritional interventions utilizing anti-inflammatory foods may prove to be a valuable asset in not only delaying or preventing the development of age-related neurodegenerative diseases such as AD, but also treating pre-existing conditions including type-2 diabetes, cardiovascular disease, and obesity.
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Affiliation(s)
- Samantha L Gardener
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Perth, Australia.,Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Perth, Australia
| | - Stephanie R Rainey-Smith
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Perth, Australia.,Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Perth, Australia
| | - Ralph N Martins
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Perth, Australia.,Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Perth, Australia
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17
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Matrix factorization reveals aging-specific co-expression gene modules in the fat and muscle tissues in nonhuman primates. Sci Rep 2016; 6:34335. [PMID: 27703186 PMCID: PMC5050522 DOI: 10.1038/srep34335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 09/12/2016] [Indexed: 11/29/2022] Open
Abstract
Accurate identification of coherent transcriptional modules (subnetworks) in adipose and muscle tissues is important for revealing the related mechanisms and co-regulated pathways involved in the development of aging-related diseases. Here, we proposed a systematically computational approach, called ICEGM, to Identify the Co-Expression Gene Modules through a novel mathematical framework of Higher-Order Generalized Singular Value Decomposition (HO-GSVD). ICEGM was applied on the adipose, and heart and skeletal muscle tissues in old and young female African green vervet monkeys. The genes associated with the development of inflammation, cardiovascular and skeletal disorder diseases, and cancer were revealed by the ICEGM. Meanwhile, genes in the ICEGM modules were also enriched in the adipocytes, smooth muscle cells, cardiac myocytes, and immune cells. Comprehensive disease annotation and canonical pathway analysis indicated that immune cells, adipocytes, cardiomyocytes, and smooth muscle cells played a synergistic role in cardiac and physical functions in the aged monkeys by regulation of the biological processes associated with metabolism, inflammation, and atherosclerosis. In conclusion, the ICEGM provides an efficiently systematic framework for decoding the co-expression gene modules in multiple tissues. Analysis of genes in the ICEGM module yielded important insights on the cooperative role of multiple tissues in the development of diseases.
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18
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Garg P, Chaman C. Apical Periodontitis - Is It Accountable for Cardiovascular Diseases? J Clin Diagn Res 2016; 10:ZE08-12. [PMID: 27656588 DOI: 10.7860/jcdr/2016/19863.8253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/25/2016] [Indexed: 11/24/2022]
Abstract
The aim of this review was to assess the relationship between apical periodontitis and cardiovascular diseases and the predictive factors regarding this association. Cross sectional and observational studies have been included, which are mostly retrospective. A comprehensive search was performed in the Systematic Electronic Databases, PUBMED and MEDLINE from 1919 till September 2014. Articles were also hand searched. From 86 studies identified, all were read and 58 articles which were relevant were included in the text. Some articles were excluded because they were pertaining to periodontology and other systemic disorders. Some were solely animal studies and were thus excluded. Our results suggest an independent association between cardiovascular diseases and apical periodontitis. A causal relationship could not be established since weak parameters of risk have been assessed in the studies, population taken is difficult to compare and other confounding factors have not been ruled out. Only a more focused and better instituted scientific research can determine this association. Establishing a cause and effect relationship between apical periodontitis and cardiovascular diseases can affect the course of treatment of cardiovascular diseases. It is not only of interest from the scientific point of view but also from public health perspective.
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Affiliation(s)
- Paridhi Garg
- Senior Lecturer, Department of Consevative Dentistry and Endodontics, Inderprastha Dental College and Hospital , Sahibabad, Uttar Pradesh, India
| | - Chandrakar Chaman
- Reader, Department of Consevative Dentistry and Endodontics, Kothiwal Dental College and Research Centre , Moradabad, Uttar Pradesh. India
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19
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Oktay S, Chukkapalli SS, Rivera-Kweh MF, Velsko IM, Holliday LS, Kesavalu L. Periodontitis in rats induces systemic oxidative stress that is controlled by bone-targeted antiresorptives. J Periodontol 2016; 86:137-45. [PMID: 25101489 DOI: 10.1902/jop.2014.140302] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Periodontitis is a chronic, polymicrobial inflammatory disease that degrades connective tissue and alveolar bone and results in tooth loss. Oxidative stress has been linked to the onset of periodontal tissue breakdown and systemic inflammation, and the success of antiresorptive treatments will rely on how effectively they can ameliorate periodontal disease-induced oxidative stress during oral infection. METHODS Rats were infected with polybacterial inoculum consisting of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, as an oral lavage every other week for 12 weeks. Daily subcutaneous injections of enoxacin, bis-enoxacin, alendronate, or doxycycline were administered for 6 weeks after 6 weeks of polybacterial infection in rats. The serum levels of oxidative stress parameters and antioxidant enzymes, including glutathione peroxidase, superoxide dismutase, and catalase, were evaluated in each of the infected, treated, and sham-infected rats. RESULTS Rats infected with the periodontal pathogens displayed a five-fold increase in the oxidative stress index compared with controls as a result of increased levels of serum oxidants and decreases in total antioxidant activity. The overall decrease in antioxidant activity occurred despite increases in three important antioxidant enzymes, suggesting an imbalance between antioxidant macromolecules/small molecules production and antioxidant enzyme levels. Surprisingly, the bone-targeted antiresorptives bis-enoxacin and alendronate inhibited increases in oxidative stress caused by periodontitis. Bis-enoxacin, which has both antiresorptive and antibiotic activities, was more effective than alendronate, which acts only as an antiresorptive. CONCLUSION To the best of the authors' knowledge, this is the first study to demonstrate that the increased oxidative stress induced by periodontal infection in rats can be ameliorated by bone-targeted antiresorptives.
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Affiliation(s)
- Sehkar Oktay
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL
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20
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Willems HM, Xu Z, Peters BM. Polymicrobial Biofilm Studies: From Basic Science to Biofilm Control. ACTA ACUST UNITED AC 2016; 3:36-44. [PMID: 27134811 DOI: 10.1007/s40496-016-0078-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Microbes rarely exist as single species planktonic forms as they have been commonly studied in the laboratory. Instead, the vast majority exists as part of complex polymicrobial biofilm communities attached to host and environmental surfaces. The oral cavity represents one of the most diverse and well-studied polymicrobial consortia. Despite a burgeoning field of mechanistic biofilm research within the past decades, our understanding of interactions that occur between microbial members within oral biofilms is still limited. Thus, the primary objective of this review is to focus on polymicrobial biofilm formation, microbial interactions and signaling events that mediate oral biofilm development, consequences of oral hygiene on both local and systemic disease, and potential therapeutic strategies to limit oral dysbiosis.
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Affiliation(s)
- Hubertine Me Willems
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Sciences Center, 881 Madison Ave, Memphis, TN 38163, USA
| | - Zhenbo Xu
- College of Light Industry and Food Sciences, South China University of Technology, Guangzhou 510640, China
| | - Brian M Peters
- Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Sciences Center, 881 Madison Ave, Memphis, TN 38163, USA.; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Sciences Center, 858 Madison Ave, Memphis, TN 38163, USA
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21
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Gangula P, Ravella K, Chukkapalli S, Rivera M, Srinivasan S, Hale A, Channon K, Southerland J, Kesavalu L. Polybacterial Periodontal Pathogens Alter Vascular and Gut BH4/nNOS/NRF2-Phase II Enzyme Expression. PLoS One 2015; 10:e0129885. [PMID: 26111153 PMCID: PMC4482323 DOI: 10.1371/journal.pone.0129885] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/14/2015] [Indexed: 02/06/2023] Open
Abstract
Periodontal disease is a highly prevalent chronic inflammatory disease and is associated with complex microbial infection in the subgingival cavity. Recently, American Heart Association supported a century old association between periodontal disease and atherosclerotic vascular disease. We have recently shown that polybacterial periodontal infection led to aortic atherosclerosis and modulation of lipid profiles; however the underlying mechanism(s) has not been yet demonstrated. Altered nitric oxide (NO) synthesis and tetrahydrobiopterin (BH4), a cofactor for nitric oxide synthases (NOS) has long been shown to be associated with vascular dysfunction and gastrointestinal motility disorders. We sought to examine the mechanism of periodontal infection leading to altered vascular and gastrointestinal smooth muscle relaxation, focusing on the BH4/nNOS pathways. In addition, we also have investigated how the antioxidant system (NRF2-Phase II enzyme expression) in vascular and GI specimens is altered by oral infection. Eight week old male ApoEnull mice were either sham-infected or infected orally for 16 weeks with a mixture of major periodontal bacteria Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia to induce experimental periodontitis. Serum, vascular (mesenteric), stomach, and colon specimens were collected at the end of periodontal pathogen infection. Bacterial infection induced significant (p<0.05) reductions in the levels of BH4,in ratio of BH4:BH2+B and also in nitric oxide levels compared to sham-infected controls. In addition, we identified a significant (p<0.05) reduction in eNOS dimerization, nNOS dimerization and protein expression of BH4 biosynthesis enzymes; GCH-1, DHFR and NRF2 & Phase II enzymes in infected mice versus controls in both mesenteric artery and colon tissues. However, we found no differences in nNOS/BH4 protein expression in stomach tissues of infected and sham-infected mice. This suggests that a polybacterial infection can cause significant changes in the vascular and colonic BH4/nNOS/NRF2 pathways which might lead to impaired vascular relaxation and colonic motility.
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Affiliation(s)
- Pandu Gangula
- Department of Physiology, Meharry Medical College, Nashville, TN, United States of America
- School of Dentistry, Meharry Medical College, Nashville, TN, United States of America
| | - Kalpana Ravella
- Department of Physiology, Meharry Medical College, Nashville, TN, United States of America
| | - Sasanka Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Mercedes Rivera
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Shanthi Srinivasan
- Department of Medicine, Division of Digestive Diseases, Emory University, Atlanta, Georgia, United States of America
| | - Ashley Hale
- Department of Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Keith Channon
- Department of Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Janet Southerland
- School of Dentistry, Meharry Medical College, Nashville, TN, United States of America
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
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Non-Nutrient, Naturally Occurring Phenolic Compounds with Antioxidant Activity for the Prevention and Treatment of Periodontal Diseases. Antioxidants (Basel) 2015; 4:447-81. [PMID: 26783837 PMCID: PMC4665427 DOI: 10.3390/antiox4030447] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 01/27/2023] Open
Abstract
One of the main factors able to explain the pathophysiological mechanism of inflammatory conditions that occur in periodontal disease is oxidative stress. Given the emerging understanding of this relationship, host-modulatory therapies using antioxidants could be interesting to prevent or slow the breakdown of soft and hard periodontal tissues. In this context, non-nutrient phenolic compounds of various foods and plants have received considerable attention in the last decade. Here, studies focusing on the relationship between different compounds of this type with periodontal disease have been collected. Among them, thymoquinone, coenzyme Q (CoQ), mangiferin, resveratrol, verbascoside and some flavonoids have shown to prevent or ameliorate periodontal tissues damage in animal models. However evidence regarding this effect in humans is poor and only limited to topical treatments with CoQ and catechins. Along with animal experiments, in vitro studies indicate that possible mechanisms by which these compounds might exert their protective effects include antioxidative properties, oxygen and nitrogen scavenging abilities, and also inhibitory effects on cell signaling cascades related to inflammatory processes which have an effect on RNS or ROS production as well as on antioxidant defense systems.
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23
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Mathews MJ, Liebenberg L, Mathews EH. The mechanism by which moderate alcohol consumption influences coronary heart disease. Nutr J 2015; 14:33. [PMID: 25889723 PMCID: PMC4389579 DOI: 10.1186/s12937-015-0011-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 02/13/2015] [Indexed: 02/06/2023] Open
Abstract
Background Moderate alcohol consumption is associated with a lower risk for coronary heart disease (CHD). A suitably integrated view of the CHD pathogenesis pathway will help to elucidate how moderate alcohol consumption could reduce CHD risk. Methods A comprehensive literature review was conducted focusing on the pathogenesis of CHD. Biomarker data were further systematically analysed from 294 cohort studies, comprising 1 161 560 subjects. From the above a suitably integrated CHD pathogenetic system for the purpose of this study was developed. Results The resulting integrated system now provides insight into the integrated higher-order interactions underlying CHD and moderate alcohol consumption. A novel ‘connection graph’ further simplifies these interactions by illustrating the relationship between moderate alcohol consumption and the relative risks (RR) attributed to various measureable CHD serological biomarkers. Thus, the possible reasons for the reduced RR for CHD with moderate alcohol consumption become clear at a glance. Conclusions An integrated high-level model of CHD, its pathogenesis, biomarkers, and moderate alcohol consumption provides a summary of the evidence that a causal relationship between CHD risk and moderate alcohol consumption may exist. It also shows the importance of each CHD pathway that moderate alcohol consumption influences.
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Affiliation(s)
- Marc J Mathews
- CRCED, North-West University, and Consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054, South Africa.
| | - Leon Liebenberg
- CRCED, North-West University, and Consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054, South Africa.
| | - Edward H Mathews
- CRCED, North-West University, and Consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054, South Africa.
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Mathews MJ, Liebenberg L, Mathews EH. How do high glycemic load diets influence coronary heart disease? Nutr Metab (Lond) 2015; 12:6. [PMID: 25774201 PMCID: PMC4359552 DOI: 10.1186/s12986-015-0001-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 01/30/2015] [Indexed: 12/14/2022] Open
Abstract
Background Diet has a significant relationship with the risk of coronary heart disease (CHD). Traditionally the effect of diet on CHD was measured with the biomarker for low-density lipoprotein (LDL) cholesterol. However, LDL is not the only or even the most important biomarker for CHD risk. A suitably integrated view of the mechanism by which diet influences the detailed CHD pathogenetic pathways is therefore needed in order to better understand CHD risk factors and help with better holistic CHD prevention and treatment decisions. Methods A systematic review of the existing literature was conducted. From this an integrated CHD pathogenetic pathway system was constructed. CHD biomarkers, which are found on these pathways, are the only measurable data to link diet with these CHD pathways. They were thus used to simplify the link between diet and the CHD mechanism. Data were systematically analysed from 294 cohort studies of CHD biomarkers constituting 1 187 350 patients. Results and discussion The resulting integrated analysis provides insight into the higher-order interactions underlying CHD and high-glycemic load (HGL) diets. A novel “connection graph” illustrates the measurable relationship between HGL diets and the relative risks attributed to the important CHD serological biomarkers. The “connection graph” vividly shows that HGL diets not only influence the lipid and metabolic biomarkers, but also the inflammation, coagulation and vascular function biomarkers in an important way. Conclusion A focus primarily on the low density lipoprotein cholesterol biomarker for CHD risk has led to the traditional guidelines of CHD dietary recommendations. This has however inadvertently led to HGL diets. The influence of HGL diets on the other CHD biomarkers is not always fully appreciated. Thus, new diets or other interventions which address the full integrated CHD impact, as shown in this paper, are required.
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Affiliation(s)
- Marc J Mathews
- CRCED, North-West University, and consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054 South Africa
| | - Leon Liebenberg
- CRCED, North-West University, and consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054 South Africa
| | - Edward H Mathews
- CRCED, North-West University, and consultants to TEMM International (Pty) Ltd, P.O. Box 11207, Silver Lakes, 0054 South Africa
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Chukkapalli SS, Rivera-Kweh MF, Velsko IM, Chen H, Zheng D, Bhattacharyya I, Gangula PR, Lucas AR, Kesavalu L. Chronic oral infection with major periodontal bacteria Tannerella forsythia modulates systemic atherosclerosis risk factors and inflammatory markers. Pathog Dis 2015; 73:ftv009. [PMID: 25663343 DOI: 10.1093/femspd/ftv009] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Tannerella forsythia is a Gram-negative anaerobic organism that inhabits the subgingival cavity and initiates connective tissue destruction and alveolar bone resorption in periodontal disease (PD). PD is a chronic immunoinflammatory disease and has been linked to several systemic diseases including atherosclerosis. This study evaluated the effects of a chronic oral infection with T. forsythia ATCC 43037 on the induction of PD, inflammatory markers and atherosclerosis risk factors in hyperlipidemic ApoE(null) mice. Mice were orally infected for 12 and 24 weeks prior to euthanasia. Bacterial colonization of the oral cavity and bacteremia was confirmed via isolation of genomic DNA from oral plaque and tissues. Oral infection elicited significantly elevated levels of serum IgG and IgM antibodies and alveolar bone resorption compared to control mice. Tannerella forsythia-infected mice had increased serum amyloid A, and significantly reduced serum nitric oxide when compared to controls. Tannerella forsythia chronic infection also significantly increased serum lipoproteins suggesting altered cholesterol metabolism and potential for aortic inflammation. Despite enhanced acute phase reactants and altered lipid profiles, T. forsythia infection was associated with decreased aortic plaque. This study investigates the potential of a known periodontal bacterial pathogen found in atherosclerotic plaque in humans to accelerate atherosclerosis in hyperlipdemic mice.
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Affiliation(s)
- Sasanka S Chukkapalli
- Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | | | - Irina M Velsko
- Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Hao Chen
- Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Donghang Zheng
- Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Indraneel Bhattacharyya
- Oral Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Pandu R Gangula
- Department of Physiology, Department of Oral Biology and Research, School of Medicine and School of Dentistry, CWHR Nashville, TN 37208, USA
| | - Alexandra R Lucas
- Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Lakshmyya Kesavalu
- Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA Dept. of Periodontology and Oral Biology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
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Lucas AR, Verma RK, Dai E, Liu L, Chen H, Kesavalu S, Rivera M, Velsko I, Ambadapadi S, Chukkapalli S, Kesavalu L. Myxomavirus anti-inflammatory chemokine binding protein reduces the increased plaque growth induced by chronic Porphyromonas gingivalis oral infection after balloon angioplasty aortic injury in mice. PLoS One 2014; 9:e111353. [PMID: 25354050 PMCID: PMC4213024 DOI: 10.1371/journal.pone.0111353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/21/2014] [Indexed: 01/30/2023] Open
Abstract
Thrombotic occlusion of inflammatory plaque in coronary arteries causes myocardial infarction. Treatment with emergent balloon angioplasty (BA) and stent implant improves survival, but restenosis (regrowth) can occur. Periodontal bacteremia is closely associated with inflammation and native arterial atherosclerosis, with potential to increase restenosis. Two virus-derived anti-inflammatory proteins, M-T7 and Serp-1, reduce inflammation and plaque growth after BA and transplant in animal models through separate pathways. M-T7 is a broad spectrum C, CC and CXC chemokine-binding protein. Serp-1 is a serine protease inhibitor (serpin) inhibiting thrombotic and thrombolytic pathways. Serp-1 also reduces arterial inflammation and improves survival in a mouse herpes virus (MHV68) model of lethal vasculitis. In addition, Serp-1 demonstrated safety and efficacy in patients with unstable coronary disease and stent implant, reducing markers of myocardial damage. We investigate here the effects of Porphyromonas gingivalis, a periodontal pathogen, on restenosis after BA and the effects of blocking chemokine and protease pathways with M-T7 and Serp-1. ApoE−/− mice had aortic BA and oral P. gingivalis infection. Arterial plaque growth was examined at 24 weeks with and without anti-inflammatory protein treatment. Dental plaques from mice infected with P. gingivalis tested positive for infection. Neither Serp-1 nor M-T7 treatment reduced infection, but IgG antibody levels in mice treated with Serp-1 and M-T7 were reduced. P. gingivalis significantly increased monocyte invasion and arterial plaque growth after BA (P<0.025). Monocyte invasion and plaque growth were blocked by M-T7 treatment (P<0.023), whereas Serp-1 produced only a trend toward reductions. Both proteins modified expression of TLR4 and MyD88. In conclusion, aortic plaque growth in ApoE−/− mice increased after angioplasty in mice with chronic oral P. gingivalis infection. Blockade of chemokines, but not serine proteases significantly reduced arterial plaque growth, suggesting a central role for chemokine-mediated inflammation after BA in P. gingivalis infected mice.
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Affiliation(s)
- Alexandra R. Lucas
- Division of Cardiovascular Medicine, Departments of Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
- * E-mail: (AL); (LK)
| | - Raj K. Verma
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Erbin Dai
- Division of Cardiovascular Medicine, Departments of Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Liying Liu
- Division of Cardiovascular Medicine, Departments of Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Hao Chen
- Division of Cardiovascular Medicine, Departments of Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Sheela Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Mercedes Rivera
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Irina Velsko
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Sriram Ambadapadi
- Division of Cardiovascular Medicine, Departments of Medicine and Molecular Genetics & Microbiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Sasanka Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Lakshmyya Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- * E-mail: (AL); (LK)
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Chrysanthakopoulos NA, Chrysanthakopoulos PA. Association between indices of clinically-defined periodontitis and self-reported history of systemic medical conditions. ACTA ACUST UNITED AC 2014; 7:27-36. [PMID: 25048420 DOI: 10.1111/jicd.12119] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 05/29/2014] [Indexed: 12/12/2022]
Abstract
AIM The aim of the current research was to investigate whether possible associations exist between indices of clinically-defined periodontitis and several systemic medical conditions in outpatients referred to a special hospital clinic. METHODS The study sample consisted of 3360 outpatients aged 45-65 years. Data were collected by means of an oral clinical examination and a self-administered questionnaire. Statistical analysis of the questionnaire items was done with Fisher's exact test and the logistic regression model to assess possible associations between systemic medical conditions as independent variables, and the relative frequency of periodontal pockets ≥5 mm and clinical attachment loss (CAL) of ≥6 mm as dependent variables. RESULTS The depth of periodontal pockets was significantly associated with male sex, the presence of vascular disease, hypertension, stroke, heart attack, diabetes mellitus, other endocrine diseases, thyroid disease, respiratory allergies, and rheumatoid arthritis. CAL was significantly associated with the mentioned conditions, and also infective endocarditis and chronic obstructive pulmonary disease, but not other endocrine and thyroid disease. CONCLUSIONS The findings confirm the results from previous investigations in which a number of systemic medical conditions were significantly associated with probing pocket depth and/or CAL.
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Gundala R, Chava VK, Ramalingam K. Association of Leptin in Periodontitis and Acute Myocardial Infarction. J Periodontol 2014; 85:917-24. [DOI: 10.1902/jop.2012.110620] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Yu H, Qi LT, Liu LS, Wang XY, Zhang Y, Huo Y, Luan QX. Association of Carotid Intima-media Thickness and Atherosclerotic Plaque with Periodontal Status. J Dent Res 2014; 93:744-51. [PMID: 24935064 DOI: 10.1177/0022034514538973] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 05/17/2014] [Indexed: 12/29/2022] Open
Abstract
Studies have suggested an association between clinical/subclinical atherosclerosis and periodontal status. The purpose of this study was to investigate the association among maximal carotid intima-media thickness (cIMT), atherosclerotic plaque, and periodontal status in Chinese elderly patients. A cross-sectional study was conducted of 847 participants (age, 70.64 ± 9.03 yr) with ≥10 teeth. A questionnaire survey, routine biochemical tests, a periodontal examination, and maximal cIMT measurement were performed for each. Traditional risk factors for atherogenesis were considered in the statistical analysis. Mean plaque index, which reflects oral hygiene, was correlated with maximal cIMT and atherosclerotic plaque in the study sample overall (β = 0.068, p < .001; OR = 2.051, p < .001) and in euglycemic participants (β = 0.066, p = .008; odds ratio = 2.122, p = .009). In hyperglycemic participants, multiple linear regression analysis (p = .006) and multivariate logistic regression analysis (p = .025) revealed a linear and dose-dependent association between mean clinical attachment loss and maximal cIMT after adjustment for traditional risk factors. Each 1-mm increase in mean clinical attachment loss corresponded to a 0.018-mm increase in maximal cIMT. The risk of atherosclerotic plaque increased by 18.3% with each 1-mm increase in mean clinical attachment loss. Other indicators of periodontal exposure, including percentage of sites with attachment loss ≥ 3 to 5 mm (3%-5%), were also correlated with cIMT and atherosclerotic plaque in hyperglycemic patients. In this elderly population, a linear and dose-dependent association among mean clinical attachment loss, attachment loss 3% to 5%, maximal cIMT, and atherosclerotic plaque was verified in those with hyperglycemia. Poor oral hygiene was correlated with maximal cIMT and atherosclerotic plaque in all participants, including those with normal blood glucose.
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Affiliation(s)
- H Yu
- Peking University School and Hospital of Stomatology, Department of Periodontology, Beijing, China
| | - L T Qi
- Peking University First Hospital, Cardiology Department, Beijing, China
| | - L S Liu
- Beijing Hypertension League Institute, Laboratory of Human Genetics, Beijing, China
| | - X Y Wang
- Beijing Hypertension League Institute, Laboratory of Human Genetics, Beijing, China
| | - Y Zhang
- Peking University School and Hospital of Stomatology, Department of Periodontology, Beijing, China
| | - Y Huo
- Peking University First Hospital, Cardiology Department, Beijing, China
| | - Q X Luan
- Peking University School and Hospital of Stomatology, Department of Periodontology, Beijing, China
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Periodontal disease and systemic diseases in an older population. Arch Gerontol Geriatr 2014; 59:474-9. [PMID: 25015876 DOI: 10.1016/j.archger.2014.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 05/26/2014] [Accepted: 05/28/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the relationship between older adults' medical and oral conditions and their self-reports of periodontal conditions with clinically obtained data. BACKGROUND Concerns about oral health of elders and its association with systemic diseases have been gaining more attention. METHODS A total of 201 older subjects were interviewed about their previous medical and dental histories and were asked to complete a health questionnaire. Each subject received full mouth exam, including counting number of natural teeth remaining, gingival (GI) and plaque index (PI), CPITN and denture status. RESULTS Elders who completed health questionnaires had mean age of 62.5. Mean CPITN score was 1.62(± 1.12), PI was 1.57(± 1.48), and GI was 1.55(± 1.31). Women had higher prevalence of CVD and osteoporosis than men (p=0.008, p=0.0001, respectively). Subjects who reported bleeding upon brushing had higher PI and GI scores (p=0.03, p=0.05, respectively). Smokers were more likely to describe their periodontal tissues as unhealthy (72.3% vs. 27.7%, p=0.01), whereas self-reports of healthy vs. unhealthy gums did not differ between non-smokers. CONCLUSION These findings suggest that a number of systemic conditions are associated with indicators of periodontal disease, and self-reports of oral conditions are independent of systemic diseases.
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Velsko IM, Chukkapalli SS, Rivera MF, Lee JY, Chen H, Zheng D, Bhattacharyya I, Gangula PR, Lucas AR, Kesavalu L. Active invasion of oral and aortic tissues by Porphyromonas gingivalis in mice causally links periodontitis and atherosclerosis. PLoS One 2014; 9:e97811. [PMID: 24836175 PMCID: PMC4024021 DOI: 10.1371/journal.pone.0097811] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/24/2014] [Indexed: 12/14/2022] Open
Abstract
Atherosclerotic vascular disease is a leading cause of myocardial infarction and cerebrovascular accident, and independent associations with periodontal disease (PD) are reported. PD is caused by polymicrobial infections and aggressive immune responses. Genomic DNA of Porphyromonas gingivalis, the best-studied bacterial pathogen associated with severe PD, is detected within atherosclerotic plaque. We examined causal relationships between chronic P. gingivalis oral infection, PD, and atherosclerosis in hyperlipidemic ApoEnull mice. ApoEnull mice (n = 24) were orally infected with P. gingivalis for 12 and 24 weeks. PD was assessed by standard clinical measurements while the aorta was examined for atherosclerotic lesions and inflammatory markers by array. Systemic inflammatory markers serum amyloid A, nitric oxide, and oxidized low-density lipoprotein were analyzed. P. gingivalis infection elicited specific antibodies and alveolar bone loss. Fluorescent in situ hybridization detected viable P. gingivalis within oral epithelium and aorta, and genomic DNA was detected within systemic organs. Aortic plaque area was significantly increased in P. gingivalis-infected mice at 24 weeks (P<0.01). Aortic RNA and protein arrays indicated a strong Th2 response. Chronic oral infection with P. gingivalis results in a specific immune response, significant increases in oral bone resorption, aortic inflammation, viable bacteria in oral epithelium and aorta, and plaque development.
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Affiliation(s)
- Irina M. Velsko
- Department of Periodontology, University of Florida, Gainesville, Florida, United States of America
| | - Sasanka S. Chukkapalli
- Department of Periodontology, University of Florida, Gainesville, Florida, United States of America
| | - Mercedes F. Rivera
- Department of Periodontology, University of Florida, Gainesville, Florida, United States of America
| | - Ju-Youn Lee
- Department of Periodontology, School of Dentistry Pusan National University, Yangsan City, Republic of Korea
| | - Hao Chen
- Department of Cardiovascular Medicine and Molecular Genetics & Microbiology, University of Florida, Gainesville, Florida, United States of America
| | - Donghang Zheng
- Department of Cardiovascular Medicine and Molecular Genetics & Microbiology, University of Florida, Gainesville, Florida, United States of America
| | - Indraneel Bhattacharyya
- Department of Oral Diagnostic Sciences, University of Florida, Gainesville, Florida, United States of America
| | - Pandu R. Gangula
- Department of Physiology, Oral Biology and Research, CWHR Meharry Medical College, Nashville, Tennessee, United States of America
| | - Alexandra R. Lucas
- Department of Cardiovascular Medicine and Molecular Genetics & Microbiology, University of Florida, Gainesville, Florida, United States of America
| | - Lakshmyya Kesavalu
- Department of Periodontology, University of Florida, Gainesville, Florida, United States of America
- Department of Oral Biology, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Chaturvedi R, Gupta M, Jain A, Das T, Prashar S. Soluble CD40 ligand: a novel biomarker in the pathogenesis of periodontal disease. Clin Oral Investig 2014; 19:45-52. [PMID: 24595688 DOI: 10.1007/s00784-014-1216-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 02/17/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Periodontitis involves a complex interplay of micro-organisms and host immune response via numerous mediator molecules playing strategic roles in its pathogenesis. Soluble CD40L (sCD40L) is one such co-stimulatory molecule which is essential for T-helper cell activation and is a well-known risk indicator of cardiovascular diseases. The levels of this marker in crevicular fluid of patients of chronic periodontitis have been explored in the present study for the first time along with an analysis of its association with levels in serum in otherwise systemically healthy patients. METHODOLOGY Sixty patients 20 healthy and 40 of chronic periodontitis (18 moderate and 22 severe) participated in the study. Patients of the diseased group underwent non-surgical periodontal therapy. Clinical evaluation and collection of gingival crevicular fluid (GCF) and serum samples was done at baseline, and 6 weeks after phase I periodontal therapy. sCD40L levels were quantified in the fluids using ELISA. RESULTS Levels of sCD40L in GCF were significantly higher in the diseased group (p ≤ 0.001) and strongly correlated not only with increasing severity of disease but also with levels in serum. In post-treatment, the levels decreased significantly in both the biological fluids (p ≤ 0.001). CONCLUSIONS The present study brings to light the role of sCD40L as a novel marker in mediating periodontal destruction and disease progression. Evaluation of local treatment outcomes seems promising in minimizing these effects. CLINICAL RELEVANCE Positive association of its local levels with those in serum further implicates the possibility of widespread systemic effects of this infection.
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Affiliation(s)
- Rashi Chaturvedi
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Panjab University, Chandigarh, India
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Evaluation of serum anti-cardiolipin antibodies after non-surgical periodontal treatment in chronic periodontitis patients. Odontology 2014; 103:203-9. [PMID: 24526469 DOI: 10.1007/s10266-014-0149-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 01/09/2014] [Indexed: 01/18/2023]
Abstract
The present study investigated the effect of non-surgical periodontal therapy on serum level of anti-cardiolipin antibodies (aCLA), which are potentially involved in the pathogenesis of cardiovascular diseases in periodontal patients. Twenty volunteers (11 females and 9 males) with the mean age of 40.55 years participated in this study. Generalized chronic periodontitis was diagnosed through clinical periodontal examination at baseline visit. This examination included measuring the probing pocket depth and clinical attachment loss. Plaque index and gingival index were also recorded. After baseline examination, all the subjects received full-mouth non-surgical periodontal treatment. Subjects returned for a final visit 6 weeks after the last session of scaling for reevaluation of the periodontal parameters. At baseline and final visits 2 ml of venous blood was collected from each patient and an available commercially enzyme-linked immunosorbent assay was used for analyzing aCLA (IgM and IgG). The collected data were analyzed using the paired sample t test. Mean levels of both forms of aCLA, before and after treatment, showed statistically significant difference (P = 0.003 for IgM and P = 0.001 for IgG). In addition, study results showed significant reductions in periodontal parameters after non-surgical periodontal therapy (P < 0.001). The results of this study suggested that successful periodontal therapy can improve the serum level of one of the inflammatory biomarkers involved in the cardiovascular problems.
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Sun HT, Zhang J, Hou N, Zhang X, Wang J, Bai Y. Spontaneous periodontitis is associated with metabolic syndrome in rhesus monkeys. Arch Oral Biol 2014; 59:386-92. [PMID: 24508670 DOI: 10.1016/j.archoralbio.2014.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 12/24/2013] [Accepted: 01/12/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The present study was designed to investigate (1) whether the non-human primate would be an appropriate animal model for the study of spontaneous periodontitis and its association with metabolic syndrome (MetS), and (2) whether microRNAs (miRNAs) play roles in the co-development of metabolic disorders and periodontitis. DESIGN Rhesus monkeys (aged 12-29 years) with or without MetS were analyzed for the prevalence of periodontitis. The potential mechanisms underlying the association between MetS and periodontitis were explored using miRNA profiling of the gingival tissues from the MetS monkey groups with or without periodontitis as well as the age-matched controls. RESULTS Among the 57 rhesus monkeys examined, 18 were diagnosed with periodontitis according to the inclusion criteria, with an overall prevalence of 31.6%. Moreover, the prevalence of periodontitis was 8.3% in the control group, 18.2% in the at-risk group, and 44.1% in the MetS group. The C-reactive protein level was doubled in the MetS periodontitis group, compared to the non-periodontitis sub-groups. Most importantly, only 3 miRNAs were confirmed to be differentially expressed between the MetS periodontitis and non-periodontitis subgroups while other miRNAs showed similar expression profiles. CONCLUSIONS The results indicate that the monkey with MetS is an ideal model for studies of spontaneous periodontitis and its association with MetS. miRNA profiling using this unique model showed that miRNAs play roles in the co-development of MetS and periodontitis.
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Affiliation(s)
- Hai-Tao Sun
- Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Jun Zhang
- Institute of Molecular Medicine, Peking University, Beijing 100871, China
| | - Ning Hou
- Institute of Molecular Medicine, Peking University, Beijing 100871, China
| | - Xiuqin Zhang
- Institute of Molecular Medicine, Peking University, Beijing 100871, China
| | - Jue Wang
- Institute of Molecular Medicine, Peking University, Beijing 100871, China.
| | - Yuxing Bai
- Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China.
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Pires JR, Dezem TU, Barroso EM, Toledo BECD, Monteiro SCM, Martins AT, Zuza EP. Cardiovascular risk in obese patients with chronic periodontitis: a clinical controlled study. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000300008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Studies have shown that obesity is considered a risk factor for the development of periodontal disease and cardiovascular events. OBJECTIVE: The objective was to evaluate the risk for cardiovascular diseases (CVDs) in obese patients with and without periodontal. MATERIAL AND METHOD: One hundred patients were divided into four groups: Group O - obese without chronic periodontitis (n=25); Group OP - obese with chronic periodontitis (n=25); Group NO - non-obese without chronic periodontitis (n=25); and Group NOP - non-obese with chronic periodontitis (n=25). Demographic and laboratorial data (total cholesterol, high-density lipoprotein - HDL and low-density lipoprotein - LDL, triglycerides, and glucose); anthropometric measurements (body mass index - BMI; waist circumference - WC; body fat - BF); blood pressure; and periodontal parameters (bleeding on probing - BOP, periodontal probing depth - PPD, and the clinical attachment level - CAL) were evaluated. Cardiovascular risk was obtained according to the PROCAM's score. The correlation between obesity, periodontal disease and risk for CVD was verified by Spearman's test (α = 0.05). RESULT: The group OP showed a statistically higher rate of PPD > 7 mm (11.2 ± 2.03) when compared with other groups, as well as higher levels of triglycerides, total cholesterol, and LDL (p<0.05). The risk for CVD was statistically higher in the group OP (28.1 ± 3.3) when compared with group O (16.5 ± 3.5), group NOP (12.8 ± 3.9), and group NO (7.7 ± 0.9). Obesity and periodontal disease are directly related to a moderate increase in CVD risk (r = 0.53, p <0.0001 and r = 0.62, p <0.0001, respectively). CONCLUSION: It was concluded that obesity and periodontal disease increases the risk to cardiovascular events.
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Rivera MF, Lee JY, Aneja M, Goswami V, Liu L, Velsko IM, Chukkapalli SS, Bhattacharyya I, Chen H, Lucas AR, Kesavalu LN. Polymicrobial infection with major periodontal pathogens induced periodontal disease and aortic atherosclerosis in hyperlipidemic ApoE(null) mice. PLoS One 2013; 8:e57178. [PMID: 23451182 PMCID: PMC3581444 DOI: 10.1371/journal.pone.0057178] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 01/18/2013] [Indexed: 01/12/2023] Open
Abstract
Periodontal disease (PD) and atherosclerosis are both polymicrobial and multifactorial and although observational studies supported the association, the causative relationship between these two diseases is not yet established. Polymicrobial infection-induced periodontal disease is postulated to accelerate atherosclerotic plaque growth by enhancing atherosclerotic risk factors of orally infected Apolipoprotein E deficient (ApoEnull) mice. At 16 weeks of infection, samples of blood, mandible, maxilla, aorta, heart, spleen, and liver were collected, analyzed for bacterial genomic DNA, immune response, inflammation, alveolar bone loss, serum inflammatory marker, atherosclerosis risk factors, and aortic atherosclerosis. PCR analysis of polymicrobial-infected (Porphyromonas gingivalis [P. gingivalis], Treponema denticola [T. denticola], and Tannerella forsythia [T. forsythia]) mice resulted in detection of bacterial genomic DNA in oral plaque samples indicating colonization of the oral cavity by all three species. Fluorescent in situ hybridization detected P. gingivalis and T. denticola within gingival tissues of infected mice and morphometric analysis showed an increase in palatal alveolar bone loss (p<0.0001) and intrabony defects suggesting development of periodontal disease in this model. Polymicrobial-infected mice also showed an increase in aortic plaque area (p<0.05) with macrophage accumulation, enhanced serum amyloid A, and increased serum cholesterol and triglycerides. A systemic infection was indicated by the detection of bacterial genomic DNA in the aorta and liver of infected mice and elevated levels of bacterial specific IgG antibodies (p<0.0001). This study was a unique effort to understand the effects of a polymicrobial infection with P. gingivalis, T. denticola and T. forsythia on periodontal disease and associated atherosclerosis in ApoEnull mice.
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Affiliation(s)
- Mercedes F. Rivera
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Ju-Youn Lee
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Korea
| | - Monika Aneja
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Vishalkant Goswami
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Liying Liu
- Departments of Medicine and Molecular Genetics & Microbiology, Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Irina M. Velsko
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Sasanka S. Chukkapalli
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Indraneel Bhattacharyya
- Department of Oral Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
| | - Hao Chen
- Departments of Medicine and Molecular Genetics & Microbiology, Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Alexandra R. Lucas
- Departments of Medicine and Molecular Genetics & Microbiology, Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Lakshmyya N. Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Gupta M, Chaturvedi R, Jain A. Role of monocyte chemoattractant protein-1 (MCP-1) as an immune-diagnostic biomarker in the pathogenesis of chronic periodontal disease. Cytokine 2013; 61:892-7. [PMID: 23375122 DOI: 10.1016/j.cyto.2012.12.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/06/2012] [Accepted: 12/19/2012] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Monocyte chemoattractant protein-1 (MCP-1) is an important chemokine responsible for the initiation, regulation and mobilization of monocytes to the active sites of severe periodontal inflammation. The present study aims at evaluating the levels of MCP-1 in GCF, saliva and serum and to analyze the changes following phase I periodontal therapy. Assessment of possible correlations between levels of MCP-1 in the three biological fluids was also done. METHODS Fifteen healthy and 30 patients of severe chronic periodontitis (diseased) participated in the study. Patients of the diseased group underwent scaling/root planing. Evaluation of PI, GI, PD, CAL and collection of samples of GCF, serum and saliva was done at baseline and 6 weeks following periodontal therapy. MCP-1 levels were quantified in all samples using ELISA. RESULTS Compared to healthy controls, MCP-1 levels were statistically significantly higher in GCF (p<0.001), saliva (p=0.002) and serum (p<0.001) in subjects with chronic periodontitis. Levels of MCP-1 in all the three fluids decreased significantly in patients after periodontal therapy (p<0.001). There was a significant positive correlation between MCP-1 levels in GCF, saliva and serum in patients of chronic periodontitis both pre (r>0.9) and post-treatment (r>0.6). CONCLUSIONS The results suggest that levels of MCP-1 in GCF and saliva can be reliable indicators of severity of periodontal destruction and their serum levels reflect the systemic impact of this local inflammatory disease thereby strengthening the reciprocal oro-systemic association.
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Affiliation(s)
- Mili Gupta
- Department of Biochemistry, Dr. Harvansh Singh Judge, Institute of Dental Sciences & Hospital, Panjab University, Chandigarh, India.
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Zeng Q, Jin C, Ao L, Cleveland JC, Song R, Xu D, Fullerton DA, Meng X. Cross-talk between the Toll-like receptor 4 and Notch1 pathways augments the inflammatory response in the interstitial cells of stenotic human aortic valves. Circulation 2012; 126:S222-30. [PMID: 22965987 DOI: 10.1161/circulationaha.111.083675] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Calcific aortic stenosis is a chronic inflammatory disease, and aortic valve interstitial cells (AVIC) play an important role in valvular inflammation. Whereas AVIC from stenotic aortic valves exhibit an augmented response to Toll-like receptor 4 (TLR4) stimulation, the underlying mechanism is unclear. This study tested the hypothesis that an excessive cross-talk between the TLR4 and Notch1 pathways is responsible for augmentation of the inflammatory response to lipopolysaccharide (LPS) in AVIC of stenotic valves. METHODS AND RESULTS Human AVIC were isolated from normal and stenotic leaflets. Nuclear factor kappa-B (NF-κB) activation and production of interleukin-8, monocyte chemoattactrant protein-1, and intercellular adhesion molecule-1 were analyzed after treatment with LPS. The role of Notch1 in the inflammatory response was determined using inhibitor, siRNA, and specific ligand. Cells from diseased valves produced greater levels of chemokines and intercellular adhesion molecule-1 that are associated with enhanced NF-κB activation. Interestingly, diseased cells exhibited augmented Jagged1 release and Notch1 activation after TLR4 stimulation. Inhibition and silencing of Notch1 each resulted in greater suppression of the TLR4-induced inflammatory response in diseased cells. Conversely, activation of Notch1 with a specific ligand, Jagged1, enhanced the LPS-induced inflammatory response in normal AVIC. Further, Notch1 intracellular domain was coimmunoprecipited with the inhibitor of NF-κB kinase after LPS stimulation, and inhibition of Notch1 abrogated the difference in the level of NF-κB activation between diseased and normal cells. CONCLUSION Notch1 enhances the inflammatory response to TLR4 stimulation in human AVIC through modulating NF-κB activation. Excessive cross-talk between the TLR4 and Notch1 pathways is responsible for augmentation of the TLR4 response in AVIC of stenotic valves.
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Affiliation(s)
- Qingchun Zeng
- Department of Surgery, University of Colorado Denver, Aurora, CO, USA
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Bokhari SAH, Khan AA, Khalil M, Abubakar MM, Mustahsen-U-Rehaman, Azhar M. Oral health status of CHD and non-CHD adults of Lahore, Pakistan. J Indian Soc Periodontol 2011; 15:51-4. [PMID: 21772722 PMCID: PMC3134048 DOI: 10.4103/0972-124x.82273] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 09/15/2010] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Evidence on association of oral health and coronary heart diseases (CHD) is mounting in the literature. This study was designed to observe an association between status of oral health and cardiac diseases in Pakistani adults. MATERIALS AND METHODS A case-control study was conducted on CHD and non-CHD adults aged >30 years. Age-gender matched individuals without CHD, fulfilling the inclusion criteria as for CHD patients were selected for comparison. Bleeding on probing (BOP), periodontal pocket depth (PPD) and tooth loss were noted as oral health parameters. RESULTS 45 CHD patients and 35 non-CHD individuals were examined. 53.75% were males and 46.25% females, 37.5% subjects were uneducated, 65% belonged to lower income group, 58.75% subjects were ≥obese and 88.75% were non-smokers. Mean of percent sites of BOP (P =0.007), PPD (P =0.031) and tooth loss (P =0.021) were significantly higher in study group. In stepwise logistic regression analysis, BOP and tooth loss showed a significant positive association with CHD; however, association of PPD was not significant. CONCLUSION Oral health parameters were significantly higher in CHD patients. Bleeding on probing and tooth loss was positively associated with CHD after adjusting for other socio-demographic variables.
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Furuta M, Ekuni D, Takao S, Suzuki E, Morita M, Kawachi I. Social capital and self-rated oral health among young people. Community Dent Oral Epidemiol 2011; 40:97-104. [PMID: 21995413 DOI: 10.1111/j.1600-0528.2011.00642.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A few studies have revealed the impact of neighborhood social capital on oral health among young people. We sought to examine the associations of social capital in three settings (families, neighborhoods, and schools) with self-rated oral health among a sample of college students in Japan. METHODS Cross-sectional survey of 967 students in Okayama University, aged 18 and 19 years, was carried out. Logistic regression was used to examine the associations of poor self-rated oral health with perceptions of social capital, adjusting for self-perceived household income category and oral health behaviors. RESULTS The prevalence of subjects with poor self-rated oral health was 22%. Adjusted for gender, self-perceived household income category, dental fear, toothbrush frequency, and dental floss use, poor self-rated oral health was significantly associated with lower level of neighborhood trust [odds ratio (OR) 2.22; 95% confidence interval (CI): 1.40-3.54] and lower level of vertical trust in school (OR 1.71; 95% CI: 1.05-2.80). Low informal social control was unexpectedly associated with better oral health (OR 0.54; 95% CI: 0.34-0.85). CONCLUSIONS The association of social capital with self-rated oral health is not uniform. Higher trust is associated with better oral health, whereas higher informal control in the community is associated with worse oral health.
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Affiliation(s)
- Michiko Furuta
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Yukitake H, Naito M, Sato K, Shoji M, Ohara N, Yoshimura M, Sakai E, Nakayama K. Effects of non-iron metalloporphyrins on growth and gene expression of Porphyromonas gingivalis. Microbiol Immunol 2011; 55:141-53. [PMID: 21204951 DOI: 10.1111/j.1348-0421.2010.00299.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The oral anaerobic bacterium Porphyromonas gingivalis, which is implicated as an important pathogen for chronic periodontitis, requires heme for its growth. Non-iron metalloporphyrins, In-PPIX and Ga-PPIX, were examined for antibacterial effects on P. gingivalis. Both In-PPIX and Ga-PPIX caused retardation of P. gingivalis growth in a dose-dependent fashion. Microarray and qPCR analyses revealed that In-PPIX treatment upregulated the expression of several genes encoding proteins including ClpB and ClpC, which are members of the Clp (caseinolytic protease, Hsp100) family, and aRNR, aRNR-activating protein and thioredoxin reductase, whereas In-PPIX treatment had no effect on the expression of genes encoding proteins involved in heme uptake pathways, Hmu-mediated, Iht-mediated and Tlr-mediated pathways. P. gingivalis ihtA and ihtB mutants were more resistant to In-PPIX than was the wild-type parent, whereas hmuR and tlr mutants did not show such resistance to In-PPIX. The results suggest that In-PPIX is incorporated by the Iht-mediated heme uptake pathway and that it influences protein quality control and nucleotide metabolism and retards growth of P. gingivalis.
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Affiliation(s)
- Hideharu Yukitake
- Division of Microbiology and Oral Infection, Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
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Carlo Reis EC, Borges APB, Araújo MVF, Mendes VC, Guan L, Davies JE. Periodontal regeneration using a bilayered PLGA/calcium phosphate construct. Biomaterials 2011; 32:9244-53. [PMID: 21885122 DOI: 10.1016/j.biomaterials.2011.08.040] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 08/14/2011] [Indexed: 10/17/2022]
Abstract
The regeneration of tissues affected by periodontal disease is a complex process; it encompasses the formation of bone, cementum and periodontal ligament. We developed a semi-rigid PLGA (polylactide-co-glycolide acid)/CaP (calcium phosphate) bilayered biomaterial construct to promote periodontal regeneration, which has a continuous outer barrier membrane and an inner topographically complex component. Our experimental model compared periodontal prophylaxis alone with prophylaxis and biomaterial implantation in the treatment of class II furcation defects in dogs. Clinical evaluation, micro-computed tomography, histology and backscattered electron imaging were used for data analysis. Healing occurred uneventfully and bone volumetric values, trabecular number and trabecular thickness were all significantly greater in the treated group; while trabecular separation was significantly greater in the control group. New cementum, bone, and periodontal ligament with Sharpey fibre insertions were only seen in the treated group. Although periodontal regeneration has been reported elsewhere, the advantages of employing our bilayered PLGA + CaP construct are twofold: 1)it did not collapse into the defect; and, 2) its inner side was able to retain the blood clot throughout the buccal defect. The result was greater periodontal regeneration than has previously been reported with traditional flexible membranes.
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Affiliation(s)
- Emily C Carlo Reis
- Departamento de Veterinária, Universidade Federal de Viçosa, Campus Universitário s/n, Viçosa, Minas Gerais, CEP 36570-000, Brazil
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Bullon P, Cordero MD, Quiles JL, Morillo JM, del Carmen Ramirez-Tortosa M, Battino M. Mitochondrial dysfunction promoted by Porphyromonas gingivalis lipopolysaccharide as a possible link between cardiovascular disease and periodontitis. Free Radic Biol Med 2011; 50:1336-43. [PMID: 21354301 DOI: 10.1016/j.freeradbiomed.2011.02.018] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 02/03/2011] [Accepted: 02/15/2011] [Indexed: 11/22/2022]
Abstract
Oxidative stress is one of the factors that could explain the pathophysiological mechanism of inflammatory conditions that occur in cardiovascular disease (CVD) and periodontitis. Such inflammatory response is often evoked by specific bacteria, as the lipopolysaccharide (LPS) of Porphyromonas gingivalis is a key factor in this process. The aim of this research was to study the role of mitochondrial dysfunction in peripheral blood mononuclear cells (PBMCs) from periodontitis patients and to evaluate the influence of LPS on fibroblasts to better understand the pathophysiology of periodontitis and its relationship with CVD. PBMCs from patients showed lower CoQ10 levels and citrate synthase activity, together with high levels of ROS production. LPS-treated fibroblasts provoked increased oxidative stress and mitochondrial dysfunction by a decrease in mitochondrial protein expression, mitochondrial mass, and mitochondrial membrane potential. Our study supports the hypothesis that LPS-mediated mitochondrial dysfunction could be at the origin of oxidative stress in periodontal patients. Abnormal PBMC performance may promote oxidative stress and alter cytokine homeostasis. In conclusion, mitochondrial dysfunction could represent a possible link to understanding the interrelationships between two prominent inflammatory diseases: periodontitis and CVD.
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Affiliation(s)
- Pedro Bullon
- Department of Periodontology, Dental School, University of Sevilla, Sevilla, Spain
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Gunupati S, Chava VK, Krishna BP. Effect of phase I periodontal therapy on anti-cardiolipin antibodies in patients with acute myocardial infarction associated with chronic periodontitis. J Periodontol 2011; 82:1657-64. [PMID: 21486181 DOI: 10.1902/jop.2011.110002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Serum anti-cardiolipin (aCL) antibodies are prevalent in patients with periodontal diseases. These increased aCL concentrations were identified to play a modulating role in cardiovascular diseases. The present study aims to explore the effect of phase I periodontal therapy on immunoglobulin (Ig)M and IgG aCL antibodies in patients with acute myocardial infarction (AMI) associated with chronic periodontitis. METHODS A cross-sectional randomized clinical study was conducted within two groups comprising a sample size of 72 patients (n = 36 each). Group 1 had clinical features of AMI, and group 2 had clinical features of AMI associated with chronic periodontitis. After a thorough clinical and oral examination, the plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were recorded. Serum sample collection by venipuncture was done for estimation of serum IgM and IgG aCL concentration by using an enzyme-linked immunosorbent assay method. In group 2, phase I periodontal therapy was performed, and clinical and biochemical parameters were reanalyzed after 1 month. RESULTS In group 2, the mean PI, GI, PD, clinical AL, and serum IgM and IgG aCL antibody levels were significantly higher than in group 1 patients. In addition, study results showed significant alterations in concentrations of serum IgM (P = 0.008) and IgG (P <0.001) aCL along with periodontal parameters after phase I periodontal therapy. CONCLUSION The phase I periodontal therapy altered levels of serum IgG and IgM aCL antibodies in patients with AMI associated with chronic periodontitis.
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Affiliation(s)
- Sumanth Gunupati
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Figuero E, Sánchez-Beltrán M, Cuesta-Frechoso S, Tejerina JM, del Castro JA, Gutiérrez JM, Herrera D, Sanz M. Detection of periodontal bacteria in atheromatous plaque by nested polymerase chain reaction. J Periodontol 2011; 82:1469-77. [PMID: 21453047 DOI: 10.1902/jop.2011.100719] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND In recent years, increasing evidence regarding the potential association between periodontal diseases and cardiovascular diseases has been identified. The available evidence underlines the importance of detecting periodontal pathogens on atheromatous plaque as the first step in demonstrating the causal relationship between the two conditions. The main aim of this investigation is to detect periodontitis-associated bacteria from carotid artery atheromatous plaque from patients who received an endarterectomy using strict sample procurement and laboratory procedures. METHODS Atheromatous plaque from endarterectomies from carotid arteries were scraped and homogenized, and bacterial DNA was extracted. To obtain a representative concentration of amplicons, two amplifications of the bacterial 16S ribosomal-RNA gene were carried out for each sample with universal eubacteria primers by a polymerase chain reaction (PCR). A nested PCR with specific primers for the target bacteria was performed next. Statistical tests included the χ(2) test. RESULTS Forty-two atheromatous plaque were analyzed. All of them were positive for ≥1 target bacterial species. The bacterial species most commonly found was Porphyromonas gingivalis (78.57%; 33 of 42), followed by Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) (66.67%; 28 of 42), Tannerella forsythia (previously T. forsythensis) (61.90%; 26 of 42), Eikenella corrodens (54.76%; 23 of 42), Fusobacterium nucleatum (50.00%; 21 of 42), and Campylobacter rectus (9.52%; four of 42). The simultaneous presence of various bacterial species within the same specimen was a common observation. CONCLUSION Within the limitations of this study, the presence of DNA from periodontitis-associated bacteria in carotid artery atheromatous plaque retrieved by endarterectomy is confirmed.
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Affiliation(s)
- Elena Figuero
- Section of Graduate Periodontology, Complutense University, Madrid, Spain.
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Polymicrobial infection with periodontal pathogens specifically enhances microRNA miR-146a in ApoE-/- mice during experimental periodontal disease. Infect Immun 2011; 79:1597-605. [PMID: 21263019 DOI: 10.1128/iai.01062-10] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia are periodontal pathogens associated with the etiology of adult periodontitis as polymicrobial infections. Recent studies demonstrated that oral infection with P. gingivalis induces both periodontal disease and atherosclerosis in hyperlipidemic and proatherogenic ApoE(-/-) mice. In this study, we explored the expression of microRNAs (miRNAs) in maxillas (periodontium) and spleens isolated from ApoE(-/-) mice infected with P. gingivalis, T. denticola, and T. forsythia as a polymicrobial infection. miRNA expression levels, including miRNA miR-146a, and associated mRNA expression levels of the inflammatory cytokines tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β) were measured in the maxillas and spleens from mice infected with periodontal pathogens and compared to those in the maxillas and spleens from sham-infected controls. Furthermore, in response to these periodontal pathogens (as mono- and polymicrobial heat-killed and live bacteria), human THP-1 monocytes demonstrated similar miRNA expression patterns, including that of miR-146a, in vitro. Strikingly, miR-146a had a negative correlation with TNF-α secretion in vitro, reducing levels of the adaptor kinases IL-1 receptor-associated kinase 1 (IRAK-1) and TNF receptor-associated factor 6 (TRAF6). Thus, our studies revealed a persistent association of miR-146a expression with these periodontal pathogens, suggesting that miR-146a may directly or indirectly modulate or alter the chronic periodontal pathology induced by these microorganisms.
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Chin UJ, Ji S, Lee SY, Ryu JJ, Lee JB, Shin C, Shin SW. Relationship between tooth loss and carotid intima-media thickness in Korean adults. J Adv Prosthodont 2010; 2:122-7. [PMID: 21264190 PMCID: PMC3024501 DOI: 10.4047/jap.2010.2.4.122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 09/18/2010] [Accepted: 10/05/2010] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.
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Affiliation(s)
- Ui-Jung Chin
- Department of Prosthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Korea
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HAUBEK DORTE. The highly leukotoxic JP2 clone of Aggregatibacter actinomycetemcomitans: evolutionary aspects, epidemiology and etiological role in aggressive periodontitis. APMIS 2010:1-53. [DOI: 10.1111/j.1600-0463.2010.02665.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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