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Huebbe P, Bilke S, Rueter J, Schloesser A, Campbel G, Glüer CC, Lucius R, Röcken C, Tholey A, Rimbach G. Human APOE4 Protects High-Fat and High-Sucrose Diet Fed Targeted Replacement Mice against Fatty Liver Disease Compared to APOE3. Aging Dis 2024; 15:259-281. [PMID: 37450924 PMCID: PMC10796091 DOI: 10.14336/ad.2023.0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Recent genome- and exome-wide association studies suggest that the human APOE ε4 allele protects against non-alcoholic fatty liver disease (NAFLD), while ε3 promotes hepatic steatosis and steatohepatitis. The present study aimed at examining the APOE genotype-dependent development of fatty liver disease and its underlying mechanisms in a targeted replacement mouse model. Male mice expressing the human APOE3 or APOE4 protein isoforms on a C57BL/6J background and unmodified C57BL/6J mice were chronically fed a high-fat and high-sucrose diet to induce obesity. After 7 months, body weight gain was more pronounced in human APOE than endogenous APOE expressing mice with elevated plasma biomarkers suggesting aggravated metabolic dysfunction. APOE3 mice exhibited the highest liver weights and, compared to APOE4, massive hepatic steatosis. An untargeted quantitative proteome analysis of the liver identified a high number of proteins differentially abundant in APOE3 versus APOE4 mice. The majority of the higher abundant proteins in APOE3 mice could be grouped to inflammation and damage-associated response, and lipid storage, amongst others. Results of the targeted qRT-PCR and Western blot analyses contribute to the overall finding that APOE3 as opposed to APOE4 promotes hepatic steatosis, inflammatory- and damage-associated response signaling and fibrosis in the liver of obese mice. Our experimental data substantiate the observation of an increased NAFLD-risk associated with the human APOEε3 allele, while APOEε4 appears protective. The underlying mechanisms of the protection possibly involve a higher capacity of nonectopic lipid deposition in subcutaneous adipose tissue and lower hepatic pathogen recognition in the APOE4 mice.
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Affiliation(s)
- Patricia Huebbe
- Institute of Human Nutrition and Food Science, Kiel University, D-24118 Kiel, Germany.
| | - Stephanie Bilke
- Institute of Experimental Medicine, Proteomics & Bioanalytics, Kiel University, D-24105 Kiel, Germany.
| | - Johanna Rueter
- Institute of Human Nutrition and Food Science, Kiel University, D-24118 Kiel, Germany.
| | - Anke Schloesser
- Institute of Human Nutrition and Food Science, Kiel University, D-24118 Kiel, Germany.
| | - Graeme Campbel
- Section Biomedical Imaging, Department of Radiology and Neuroradiology, Kiel University, D-24118 Kiel, Germany.
| | - Claus-C. Glüer
- Section Biomedical Imaging, Department of Radiology and Neuroradiology, Kiel University, D-24118 Kiel, Germany.
| | - Ralph Lucius
- Anatomical Institute, Kiel University, D-24118 Kiel, Germany.
| | - Christoph Röcken
- Department of Pathology, Kiel University and University Hospital Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany.
| | - Andreas Tholey
- Institute of Experimental Medicine, Proteomics & Bioanalytics, Kiel University, D-24105 Kiel, Germany.
| | - Gerald Rimbach
- Institute of Human Nutrition and Food Science, Kiel University, D-24118 Kiel, Germany.
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Cherry-Peppers G, Fryer C, Jackson AD, Ford D, Glascoe A, Smith D, Dunmore-Griffith J, Iris M, Woods D, Robinson-Warner G, Davidson A, McIntosh C, Sonnier J, Slade L, Downer G, Mundey S, Darden-Wilson J, Dawson N, Downes A, Rizkalla A, Bellamy A, Mahone I, Tompkins S, Kiffin G, Mncube-Barnes F, Peppers G, Watkins-Bryant T. A review of the risks and relationships between oral health and chronic diseases. J Natl Med Assoc 2024:S0027-9684(24)00008-7. [PMID: 38326141 DOI: 10.1016/j.jnma.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 09/25/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024]
Abstract
Advances in medical science and in preventive dentistry have changed the context of oral health. The American population is living longer with numerous complex chronic diseases. This paper is to raise awareness about the impact of multiple chronic diseases and their associations with oral diseases. Comorbidities can worsen the course of dental treatment. Inflammation has been the connecting factor in the bidirectional pattern of oral and systemic diseases. High occurrences of chronic diseases generally occur in aging as well as disadvantaged populations. Serious infections, slow healing, prolonged bleeding, and hospitalizations can escalate in patients with uncontrolled chronic diseases. A multidisciplinary team-based approach to patient management can minimize complications and unexpected challenges.
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Affiliation(s)
| | - Cheryl Fryer
- Academic Affairs, Howard University College of Dentistry, USA
| | | | - Debra Ford
- Academic Affairs, Howard University College of Medicine, USA
| | - Alison Glascoe
- Comprehensive Care, Chair, Howard University College of Dentistry, USA
| | - Dawn Smith
- Department of Dental Hygiene, Howard University College of Dentistry, USA
| | | | - Morton Iris
- Comprehensive Care, Howard University College of Dentistry, USA
| | - Dexter Woods
- Comprehensive Care, Howard University College of Dentistry, USA
| | | | | | - Crystal McIntosh
- Department of Periodontics, Howard University College of Dentistry, USA
| | - Jezelle Sonnier
- Department of Restorative Dentistry, Howard University College of Dentistry, USA
| | - Lisa Slade
- Department of Endodontics, Howard University College of Dentistry, USA
| | | | - Shakeya Mundey
- Comprehensive Care, Howard University College of Dentistry, USA
| | | | - Nyree Dawson
- Comprehensive Care, Howard University College of Dentistry, USA
| | - Arielle Downes
- Summer Research Project, Howard University College of Dentistry
| | - Adel Rizkalla
- Comprehensive Care, Howard University College of Dentistry
| | - Ashleigh Bellamy
- Research Summer Project, Howard University College of Dentistry, USA
| | - Ian Mahone
- Research Summer Project, Howard University College of Dentistry, USA
| | - Sydney Tompkins
- Summer Research Project, Howard University College of Dentistry, USA
| | - Gawain Kiffin
- Summer Research Project, Howard University College of Dentistry, USA
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3
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Brun A, Petit C, Huck O, Bouchard P, Carra MC, Gosset M. [Periodontitis : An underestimated risk of cardiovascular diseases]. Med Sci (Paris) 2024; 40:35-41. [PMID: 38299901 DOI: 10.1051/medsci/2023193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Epidemiological studies have identified periodontitis as a contributing factor to cardiovascular risk. Periodontitis is a chronic inflammatory disease that affects the tissues supporting the teeth. Although the nature of the association between periodontitis and cardiovascular disease (CVD) remains to be defined, the low-grade systemic inflammation and chronic bacteremia associated with periodontitis appear to be involved in the development of atherosclerosis and associated cardiovascular pathologies. Periodontal treatment has been shown to improve cardiovascular health parameters. A bidirectional preventive approach, involving the management of both periodontitis and cardiovascular risk factors, could lead to a reduction in morbidity and mortality related to cardiovascular disease.
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Affiliation(s)
- Adrian Brun
- Unité de recherche URP2496, Biomedical Research In Odontology (BRIO), France - Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Henri Mondor (AP-HP), service de médecine bucco-dentaire, Créteil, France
| | - Catherine Petit
- Laboratoire de nanomédecine régénérative, Inserm UMR 1260, CRBS, 1 rue Eugène Boeckel, 67000 Strasbourg, France - Département de parodontologie, faculté de chirurgie dentaire Robert Frank, Strasbourg, France - Hôpitaux universitaires de Strasbourg, pôle de médecine et chirurgie bucco-dentaire, Strasbourg, France
| | - Olivier Huck
- Laboratoire de nanomédecine régénérative, Inserm UMR 1260, CRBS, 1 rue Eugène Boeckel, 67000 Strasbourg, France - Département de parodontologie, faculté de chirurgie dentaire Robert Frank, Strasbourg, France - Hôpitaux universitaires de Strasbourg, pôle de médecine et chirurgie bucco-dentaire, Strasbourg, France
| | - Philippe Bouchard
- Unité de recherche URP2496, Biomedical Research In Odontology (BRIO), France - Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Rothschild (AP-HP), service d'odontologie, 5 rue Santerre 75012 Paris
| | - Maria Clotilde Carra
- Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Rothschild (AP-HP), service d'odontologie, 5 rue Santerre 75012 Paris - Epidemiology and Statistics Research Centre, Inserm UMR1153, Paris, France
| | - Marjolaine Gosset
- Unité de recherche URP2496, Biomedical Research In Odontology (BRIO), France - Université Paris Cité, faculté de santé, UFR d'odontologie, Montrouge, France - Hôpital Charles Foix (AP-HP), service de médecine bucco-dentaire, Ivry/Seine, France
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4
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Margiana R. Mesenchymal stem cell-derived exosomes in preeclampsia: A next-generation therapeutic tool. Cell Biochem Funct 2024; 42:e3908. [PMID: 38269498 DOI: 10.1002/cbf.3908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/29/2023] [Accepted: 12/10/2023] [Indexed: 01/26/2024]
Abstract
Preeclampsia (PE) is a major gestational disorder that causes both long- and short-term damage to both the mother and the fetus. Endometrium decidualization and the formation of the placenta are orchestrated by mesenchymal stem cells (MSCs). MSCs obtained from patients with PE exhibit an elevated rate of aging and apoptosis, which impairs the interplay between MSCs and endothelium, trophoblast, and immune cells in the placenta, accelerating the onset of PE. Preclinical and clinical evidence imply that the MSC-based therapy approach for PE is prospective. Importantly, as a novel cell-free approach, MSC-derived exosomes can improve symptoms and maternal-fetal survival in PE models by raising cell metabolism, encouraging angiogenesis balance, and regulating immune responses. Even following allogeneic administration, the likelihood of immune rejection is very limited as a result of the small quantity of exosome membrane-bound proteins. Furthermore, because exosomes do not expand, developing tumors is not probable. As a result, MSC-derived exosomes show superiority over MSCs in terms of safety. For the first time, we outline the properties of MSC-exosomes and highlight their functions and potential as a new paradigm for PE therapy in this review.
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Affiliation(s)
- Ria Margiana
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Andrology Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Catunda RQ, Ho KKY, Patel S, Roy CB, Alexiou M, Levin L, Ulrich BJ, Kaplan MH, Febbraio M. Loricrin and Cytokeratin Disorganisation in Severe Forms of Periodontitis. Int Dent J 2023; 73:862-872. [PMID: 37316411 PMCID: PMC10658443 DOI: 10.1016/j.identj.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/05/2023] [Accepted: 05/22/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE The aim of this research was to investigate the role of the cornified epithelium, the outermost layer of the oral mucosa, engineered to prevent water loss and microorganism invasion, in severe forms of periodontitis (stage III or IV, grade C). METHODS Porphyromonas gingivalis, a major periodontal disease pathogen, can affect cornified epithelial protein expression through chronic activation of signal transducer and activator of transcription 6 (Stat6). We used a mouse model, Stat6VT, that mimics this to determine the effects of barrier defect on P gingivalis-induced inflammation, bone loss, and cornified epithelial protein expression, and compared histologic and immunohistologic findings with tissues obtained from human controls and patients with stage III and IV, grade C disease. Alveolar bone loss in mice was assessed using micro-computerised tomography, and soft tissue morphology was qualitatively and semi-quantitatively assessed by histologic examination for several proteins, including loricrin, filaggrin, cytokeratin 1, cytokeratin 14, a proliferation marker, a pan-leukocyte marker, as well as morphologic signs of inflammation. Relative cytokine levels were measured in mouse plasma by cytokine array. RESULTS In the tissues from patients with periodontal disease, there were greater signs of inflammation (rete pegs, clear cells, inflammatory infiltrates) and a decrease and broadening of expression of loricrin and cytokeratin 1. Cytokeratin 14 expression was also broader and decreased in stage IV. P gingivalis-infected Stat6VT mice showed greater alveolar bone loss in 9 out of 16 examined sites, and similar patterns of disruption to human patients in expression of loricrin and cytokeratins 1 and 14. There were also increased numbers of leukocytes, decreased proliferation, and greater signs of inflammation compared with P gingivalis-infected control mice. CONCLUSIONS Our study provides evidence that changes in epithelial organisation can exacerbate the effects of P gingivalis infection, with similarities to the most severe forms of human periodontitis.
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Affiliation(s)
- Raisa Queiroz Catunda
- Department of Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Karen Ka-Yan Ho
- Department of Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Srushti Patel
- Department of Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Christopher Bryant Roy
- Department of Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Maria Alexiou
- Department of Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Liran Levin
- Department of Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | | | - Mark H Kaplan
- Department of Microbiology & Immunology, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Maria Febbraio
- Department of Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
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6
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Shen M, Li Z, Li H, Yan X, Feng B, Xu L. Association of periodontitis and tooth loss with extent of coronary atherosclerosis in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1243992. [PMID: 38075042 PMCID: PMC10702216 DOI: 10.3389/fendo.2023.1243992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Aim The objective was to investigate the association of periodontitis and tooth loss with extent of diabetic coronary atherosclerosis. Materials and methods 272 patients who were hospitalized at Shanghai East hospital and underwent a coronary artery calcium (CAC) CT scan were enrolled in this study. Individuals were grouped based on their CAC scores into a normal-to-mild coronary atherosclerosis (AS) group (0 ≤ score ≤ 100, n=184) and a moderate-to-severe group (score≥101, n=88). Periodontitis parameters and number of missing teeth were evaluated for every patient. The severity of periodontitis was categorized as mild, moderate, or severe. The taxonomic composition of the microbiota was determined using full-length 16S ribosomal RNA gene sequencing. Salivary inflammatory factors were tested by ELISA. Results Clinical attachment loss (CAL) (P =0.05) and the number of teeth lost (P = 0.016) were significantly higher in the moderate-to-severe coronary AS group, with these differences being more obvious in younger patients and patients with short-duration diabetes. Multivariate logistic regression analysis revealed that CAL (OR = 1.231, 95% CI = 1.066-1.214, P = 0.047) and having 10-19 missing teeth (OR = 1.604, 95% CI = 1.393-6.555, P = 0.05) were strongly associated with the presence of moderate-to-severe coronary AS. Salivary IL-6 and TNF-α levels, as well as levels of Porphyromonas gingivalis and Neisseria mucosa, were significantly elevated in the moderate-to-severe coronary AS group. Conclusion It was found that both tooth loss and CAL were related to the extent of diabetic coronary AS. Saliva inflammatory factors and oral bacteremia may be new biomarkers for moderate-to-severe coronary AS.
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Affiliation(s)
- Minhua Shen
- Department of Stomatology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhen Li
- Department of Stomatology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huizhi Li
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xinfeng Yan
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Feng
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Xu
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
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7
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Huang X, Xie M, Lu X, Mei F, Song W, Liu Y, Chen L. The Roles of Periodontal Bacteria in Atherosclerosis. Int J Mol Sci 2023; 24:12861. [PMID: 37629042 PMCID: PMC10454115 DOI: 10.3390/ijms241612861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Atherosclerosis (AS) is an inflammatory vascular disease that constitutes a major underlying cause of cardiovascular diseases (CVD) and stroke. Infection is a contributing risk factor for AS. Epidemiological evidence has implicated individuals afflicted by periodontitis displaying an increased susceptibility to AS and CVD. This review concisely outlines several prevalent periodontal pathogens identified within atherosclerotic plaques, including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum. We review the existing epidemiological evidence elucidating the association between these pathogens and AS-related diseases, and the diverse mechanisms for which these pathogens may engage in AS, such as endothelial barrier disruption, immune system activation, facilitation of monocyte adhesion and aggregation, and promotion of foam cell formation, all of which contribute to the progression and destabilization of atherosclerotic plaques. Notably, the intricate interplay among bacteria underscores the complex impact of periodontitis on AS. In conclusion, advancing our understanding of the relationship between periodontal pathogens and AS will undoubtedly offer invaluable insights and potential therapeutic avenues for the prevention and management of AS.
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Affiliation(s)
- Xiaofei Huang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Mengru Xie
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Xiaofeng Lu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Feng Mei
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Wencheng Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Yang Liu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
| | - Lili Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (X.H.); (M.X.); (X.L.); (F.M.); (W.S.)
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
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Zhou LJ, Lin WZ, Meng XQ, Zhu H, Liu T, Du LJ, Bai XB, Chen BY, Liu Y, Xu Y, Xie Y, Shu R, Chen FM, Zhu YQ, Duan SZ. Periodontitis exacerbates atherosclerosis through Fusobacterium nucleatum-promoted hepatic glycolysis and lipogenesis. Cardiovasc Res 2023; 119:1706-1717. [PMID: 36943793 DOI: 10.1093/cvr/cvad045] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/06/2022] [Accepted: 01/20/2023] [Indexed: 03/23/2023] Open
Abstract
AIMS Positive associations between periodontitis (PD) and atherosclerosis have been established, but the causality and mechanisms are not clear. We aimed to explore the causal roles of PD in atherosclerosis and dissect the underlying mechanisms. METHODS AND RESULTS A mouse model of PD was established by ligation of molars in combination with application of subgingival plaques collected from PD patients and then combined with atherosclerosis model induced by treating atheroprone mice with a high-cholesterol diet (HCD). PD significantly aggravated atherosclerosis in HCD-fed atheroprone mice, including increased en face plaque areas in whole aortas and lesion size at aortic roots. PD also increased circulating levels of triglycerides and cholesterol, hepatic levels of cholesterol, and hepatic expression of rate-limiting enzymes for lipogenesis. Using 16S ribosomal RNA (rRNA) gene sequencing, Fusobacterium nucleatum was identified as the most enriched PD-associated pathobiont that is present in both the oral cavity and livers. Co-culture experiments demonstrated that F. nucleatum directly stimulated lipid biosynthesis in primary mouse hepatocytes. Moreover, oral inoculation of F. nucleatum markedly elevated plasma levels of triglycerides and cholesterol and promoted atherogenesis in HCD-fed ApoE-/- mice. Results of RNA-seq and Seahorse assay indicated that F. nucleatum activated glycolysis, inhibition of which by 2-deoxyglucose in turn suppressed F. nucleatum-induced lipogenesis in hepatocytes. Finally, interrogation of the molecular mechanisms revealed that F. nucleatum-induced glycolysis and lipogenesis by activating PI3K/Akt/mTOR signalling pathway in hepatocytes. CONCLUSIONS PD exacerbates atherosclerosis and impairs lipid metabolism in mice, which may be mediated by F. nucleatum-promoted glycolysis and lipogenesis through PI3K/Akt/mTOR signalling in hepatocytes. Treatment of PD and specific targeting of F. nucleatum are promising strategies to improve therapeutic effectiveness of hyperlipidaemia and atherosclerosis.
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Affiliation(s)
- Lu-Jun Zhou
- Department of General Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Wen-Zhen Lin
- Department of General Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Xiao-Qian Meng
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Hong Zhu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Ting Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Lin-Juan Du
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Xue-Bing Bai
- Department of General Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Bo-Yan Chen
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Yan Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Yuanzhi Xu
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yufeng Xie
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
- Department of Periodontology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Rong Shu
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
- Department of Periodontology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Fa-Ming Chen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Ya-Qin Zhu
- Department of General Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
| | - Sheng-Zhong Duan
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, 115 Jinzun Road, Pudong New District, Shanghai 200125, China
- National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China
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9
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Ricciardi RM, Cipollone A, D'Ardes D, Di Giacomo D, Pignatelli P, Cipollone F, Curia MC, Magni P, Bucci M. Risk Factors and Immunoinflammatory Mechanisms Leading to Atherosclerosis: Focus on the Role of Oral Microbiota Dysbiosis. Microorganisms 2023; 11:1479. [PMID: 37374981 DOI: 10.3390/microorganisms11061479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Cardiovascular diseases (CVD), including myocardial infarction and stroke, are currently the leading cause of morbidity, disability and mortality worldwide. Recently, researchers have focused their attention on the alterations of the gut and oral microbiota, investigating the possible role of their dysbiosis in the pathogenesis and/or progression of CVD. In this regard, it has been shown that endothelial dysfunction, a major feature of CVD, can also be induced by chronic periodontal infection, due to a systemic pro-inflammatory condition, as suggested by increased plasma levels of acute phase proteins, IL-6 and fibrinogen. Moreover, proatherogenic dysfunctions can also be promoted by direct bacterial invasion of the endothelium. This review reports the current evidence about the possible role of oral microbiota dysbiosis and the related immunoinflammatory components in the pathophysiology of atherosclerosis and associated CVD. It is concluded that integration of oral microbiota sampling into clinical practice may result in a more accurate assessment of CV risk in patients and even modify their prognosis.
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Affiliation(s)
- Riccardo Mattia Ricciardi
- Department of Medicine and Aging Sciences, Università degli Studi "Gabriele d'Annunzio" di Chieti-Pescara, 66100 Chieti, Italy
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital-ASL, 66100 Chieti, Italy
| | - Alessia Cipollone
- Department of Medicine and Aging Sciences, Università degli Studi "Gabriele d'Annunzio" di Chieti-Pescara, 66100 Chieti, Italy
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital-ASL, 66100 Chieti, Italy
| | - Damiano D'Ardes
- Department of Medicine and Aging Sciences, Università degli Studi "Gabriele d'Annunzio" di Chieti-Pescara, 66100 Chieti, Italy
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital-ASL, 66100 Chieti, Italy
| | - Davide Di Giacomo
- Department of Medicine and Aging Sciences, Università degli Studi "Gabriele d'Annunzio" di Chieti-Pescara, 66100 Chieti, Italy
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital-ASL, 66100 Chieti, Italy
| | - Pamela Pignatelli
- COMDINAV DUE, Nave Cavour, Italian Navy, Stazione Navale Mar Grande-Viale Jonio, 74122 Taranto, Italy
| | - Francesco Cipollone
- Department of Medicine and Aging Sciences, Università degli Studi "Gabriele d'Annunzio" di Chieti-Pescara, 66100 Chieti, Italy
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital-ASL, 66100 Chieti, Italy
| | - Maria Cristina Curia
- Department of Medical, Oral and Biotechnological Sciences, Università degli Studi "Gabriele d'Annunzio" di Chieti-Pescara, 66100 Chieti, Italy
| | - Paolo Magni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, 20133 Milan, Italy
- IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy
| | - Marco Bucci
- Department of Medicine and Aging Sciences, Università degli Studi "Gabriele d'Annunzio" di Chieti-Pescara, 66100 Chieti, Italy
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital-ASL, 66100 Chieti, Italy
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10
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Zhang Z, Ji C, Wang D, Wang M, Song D, Xu X, Zhang D. The burden of diabetes on the soft tissue seal surrounding the dental implants. Front Physiol 2023; 14:1136973. [PMID: 36875028 PMCID: PMC9978121 DOI: 10.3389/fphys.2023.1136973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Abstract
Soft tissue seal around implant prostheses is considered the primary barrier against adverse external stimuli and is a critical factor in maintaining dental implants' stability. Soft tissue seal is formed mainly by the adhesion of epithelial tissue and fibrous connective tissue to the transmembrane portion of the implant. Type 2 diabetes mellitus (T2DM) is one of the risk factors for peri-implant inflammation, and peri-implant disease may be triggered by dysfunction of the soft tissue barrier around dental implants. This is increasingly considered a promising target for disease treatment and management. However, many studies have demonstrated that pathogenic bacterial infestation, gingival immune inflammation, overactive matrix metalloproteinases (MMPs), impaired wound healing processes and excessive oxidative stress may trigger poor peri-implant soft tissue sealing, which may be more severe in the T2DM state. This article reviews the structure of peri-implant soft tissue seal, peri-implant disease and treatment, and moderating mechanisms of impaired soft tissue seal around implants due to T2DM to inform the development of treatment strategies for dental implants in patients with dental defects.
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Affiliation(s)
- Zhanwei Zhang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Provincial Clinical Research Center for Oral, Shandong University , Jinan, China
| | - Chonghao Ji
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Provincial Clinical Research Center for Oral, Shandong University , Jinan, China
| | | | - Maoshan Wang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Provincial Clinical Research Center for Oral, Shandong University , Jinan, China
| | - Dawei Song
- School of Stomatology, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Provincial Clinical Research Center for Oral, Shandong University , Jinan, China
| | - Dongjiao Zhang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Provincial Clinical Research Center for Oral, Shandong University , Jinan, China
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11
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Gan G, Zhang R, Lu B, Luo Y, Chen S, Lei H, Li Y, Cai Z, Huang X. Gut microbiota may mediate the impact of chronic apical periodontitis on atherosclerosis in apolipoprotein E-deficient mice. Int Endod J 2023; 56:53-68. [PMID: 36208054 DOI: 10.1111/iej.13845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 12/13/2022]
Abstract
AIM There are growing evidences linking chronic apical periodontitis (CAP) to atherosclerosis. Gut microbiota is found to be involved in the development of atherosclerosis. Recent studies have shown that CAP could change the diversity and composition of the gut microbiota. It was therefore, we hypothesized that gut microbiota and its metabolites could mediate the impact of CAP on atherosclerosis. METHODOLOGY Twenty-four 5-week-old lipoprotein E knockout (apoE-/- ) mice were randomly divided into four groups: the CAP group, Con group, Co-CAP (cohoused with CAP) and Co-Con (cohoused with Con) group. In the CAP group, sterile cotton wool containing P. gingivalis was placed into the exposed pulp chamber, followed by coronal resin-based composite restoration of the bilateral maxillary first and second molars. In the Con group, a sham operation was performed. Biweekly, mice in the CAP group were anaesthetised to check the sealing of coronal access. Meanwhile, the animals in the Con group were anaesthetised. The cohousing approach was used to introduce gut microbiota from the CAP and Con groups into the Co-CAP and Co-Con groups, respectively. Alterations in the abundance and diversity of the gut microbiota were detected using 16S rRNA sequencing, Oil-red O staining was used to demonstrate the extent of lesions, and serum levels of trimethylamine N-oxide (TMAO), and immunohistochemistry of flavin-containing monooxygenase 3 (FMO3) in liver were used to assess TMAO-related metabolic alterations. RESULTS Alterations of alpha and beta diversity were shown both in the CAP and the Co-CAP groups. Moreover, the percentage of atherosclerotic lesion area increased in the CAP and Co-CAP groups (p < .05). Linear discriminant analysis effect size (LEfSe) at the family level found the increases of Lachnospiraceae and Ruminococcaceae (p < .05), which were positively correlated with serum TMAO levels (p < .05). In the redundancy analysis technique (RDA), serum levels of TMAO were positively associated with the atherosclerotic lesions. Co-occurrence analysis revealed that the relative abundances of Lachnospiraceae and Porphyromonadacae were positively correlated with both the percentage of lesion area and TMAO level (p < .05). CONCLUSION Thus, within the limitations of this study, the data suggest that the gut microbiota can mediate the effects of CAP on atherosclerosis.
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Affiliation(s)
- Guowu Gan
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ren Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Beibei Lu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Yufang Luo
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Shuai Chen
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Huaxiang Lei
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Yijun Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Zhiyu Cai
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatology Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
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12
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Omar M, Alexiou M, Rekhi UR, Lehmann K, Bhardwaj A, Delyea C, Elahi S, Febbraio M. DNA methylation changes underlie the long-term association between periodontitis and atherosclerotic cardiovascular disease. Front Cardiovasc Med 2023; 10:1164499. [PMID: 37153468 PMCID: PMC10160482 DOI: 10.3389/fcvm.2023.1164499] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/22/2023] [Indexed: 05/09/2023] Open
Abstract
Periodontitis, the leading cause of adult tooth loss, has been identified as an independent risk factor for cardiovascular disease (CVD). Studies suggest that periodontitis, like other CVD risk factors, shows the persistence of increased CVD risk even after mitigation. We hypothesized that periodontitis induces epigenetic changes in hematopoietic stem cells in the bone marrow (BM), and such changes persist after the clinical elimination of the disease and underlie the increased CVD risk. We used a BM transplant approach to simulate the clinical elimination of periodontitis and the persistence of the hypothesized epigenetic reprogramming. Using the low-density lipoprotein receptor knockout (LDLRo ) atherosclerosis mouse model, BM donor mice were fed a high-fat diet to induce atherosclerosis and orally inoculated with Porphyromonas gingivalis (Pg), a keystone periodontal pathogen; the second group was sham-inoculated. Naïve LDLR o mice were irradiated and transplanted with BM from one of the two donor groups. Recipients of BM from Pg-inoculated donors developed significantly more atherosclerosis, accompanied by cytokine/chemokines that suggested BM progenitor cell mobilization and were associated with atherosclerosis and/or PD. Using whole-genome bisulfite sequencing, 375 differentially methylated regions (DMRs) and global hypomethylation in recipients of BM from Pg-inoculated donors were observed. Some DMRs pointed to the involvement of enzymes with major roles in DNA methylation and demethylation. In validation assays, we found a significant increase in the activity of ten-eleven translocase-2 and a decrease in the activity of DNA methyltransferases. Plasma S-adenosylhomocysteine levels were significantly higher, and the S-adenosylmethionine to S-adenosylhomocysteine ratio was decreased, both of which have been associated with CVD. These changes may be related to increased oxidative stress as a result of Pg infection. These data suggest a novel and paradigm-shifting mechanism in the long-term association between periodontitis and atherosclerotic CVD.
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13
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Miyabe M, Nakamura N, Saiki T, Miyabe S, Ito M, Sasajima S, Minato T, Matsubara T, Naruse K. Porphyromonas gingivalis Lipopolysaccharides Promote Proliferation and Migration of Human Vascular Smooth Muscle Cells through the MAPK/TLR4 Pathway. Int J Mol Sci 2022; 24:ijms24010125. [PMID: 36613563 PMCID: PMC9820797 DOI: 10.3390/ijms24010125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Atherosclerosis is a major cause of mortality worldwide. The initial change in atherosclerosis is intimal thickening due to muscle cell proliferation and migration. A correlation has been observed between periodontal disease and atherosclerosis. Here, we investigated the proliferation and migration of human aortic smooth muscle cells (HASMCs) using Porphyromonas gingivalis-derived LPS (Pg-LPS). To elucidate intracellular signaling, toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (MyD88) of HASMCs were knocked down, and the role of these molecules in Pg-LPS-stimulated proliferation and migration was examined. The role of mitogen-activated protein kinase (MAPK) in HASMC proliferation and migration was further elucidated by MAPK inhibition. Pg-LPS stimulation increased the proliferation and migration of HASMCs and activated the TLR4/MyD88 pathway. TLR4 knockdown inhibited Pg-LPS stimulated HASMCs proliferation and migration. Pg-LPS stimulation led to the phosphorylation of P38 MAPK, JNK, and ERK, and MyD88 knockdown inhibited the phosphorylation of P38 MAPK and JNK but not ERK. P38 MAPK and SAPK/JNK inhibition did not suppress the proliferation of HASMCs upon Pg-LPS stimulation, but ERK inhibition significantly inhibited proliferation. SAPK/JNK and ERK inhibition suppressed Pg-LPS-stimulated migration of HASMCs. In conclusion, our findings suggest that Pg-LPS may promote atherosclerosis via the activation of MAPK through TLR4.
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Affiliation(s)
- Megumi Miyabe
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
- Correspondence: ; Tel./Fax: +81-52-759-2168
| | - Nobuhisa Nakamura
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Tomokazu Saiki
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
- Department of Pharmacy, Aichi Gakuin University Dental Hospital, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Satoru Miyabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Mizuho Ito
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Sachiko Sasajima
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Tomomi Minato
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
- Department of Clinical Laboratory, Aichi Gakuin University Dental Hospital, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Tatsuaki Matsubara
- The Graduate Center of Human Sciences, Aichi Mizuho College, Syunko-cho, Mizuho-ku, Nagoya 467-0867, Japan
| | - Keiko Naruse
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, 2-11, Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
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14
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Bacterial Infections and Atherosclerosis – A Mini Review. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Atherosclerosis is the most challenging subsets of coronary artery disease in humans, in which risk factors emerge from childhood, and its prevalence increases with age. Experimental research demonstrates that infections due to bacteria stimulate atherogenic events. Atherosclerosis has complex pathophysiology that is linked with several bacterial infections by damaging the inner arterial wall and heart muscles directly and indirectly by provoking a systemic pro-inflammation and acute-phase protein. Repeated bacterial infections trigger an inflammatory cascade that triggers immunological responses that negatively impact cardiovascular biomarkers includes triglycerides, high-density lipoprotein, C-reactive protein, heat shock proteins, cytokines, fibrinogen, and leukocyte count. Herein, we intended to share the role of bacterial infection in atherosclerosis and evaluate existing evidence of animal and human trials on the association between bacterial infections and atherosclerosis on update.
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15
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Curia MC, Pignatelli P, D’Antonio DL, D’Ardes D, Olmastroni E, Scorpiglione L, Cipollone F, Catapano AL, Piattelli A, Bucci M, Magni P. Oral Porphyromonas gingivalis and Fusobacterium nucleatum Abundance in Subjects in Primary and Secondary Cardiovascular Prevention, with or without Heterozygous Familial Hypercholesterolemia. Biomedicines 2022; 10:biomedicines10092144. [PMID: 36140246 PMCID: PMC9496065 DOI: 10.3390/biomedicines10092144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Low-grade chronic inflammation, promoted by dysbiosis of the gut and oral microbiota, has been shown to contribute to individual susceptibility to atherosclerotic cardiovascular disease (ASCVD). High oral Porphyromonas gingivalis (Pg) and lower Fusobacterium nucleatum (Fn) concentrations have been associated with clinical and experimental atherosclerosis. We assessed oral Pg and Fn abundance in very high-risk patients with previously diagnosed ASCVD, with or without heterozygous familial hypercholesterolemia (HeFH), in subjects with HeFH in primary prevention and in healthy subjects. Methods: In this cross-sectional study, 40 patients with previously diagnosed ASCVD (10 with genetically proven HeFH, and 30 without FH), 26 subjects with HeFH in primary prevention, and 31 healthy subjects were selected to quantify oral Pg and Fn abundance by qPCR and assess oral health status. Results: Compared to healthy subjects, patients with previously diagnosed ASCVD showed greater Pg abundance (1101.3 vs. 192.4, p = 0.03), but similar Fn abundance. HeFH patients with ASCVD had an even greater Pg abundance than did non-HeFH patients and healthy subjects (1770.6 vs. 758.4 vs. 192.4, respectively; p = 0.048). No differences were found in the levels of Pg and Fn abundance in HeFH subjects in primary prevention, as compared to healthy subjects. Conclusions: Greater oral Pg abundance is present in very high-risk patients with previously diagnosed ASCVD, with or without FH, suggesting a potential relationship with CV events. Future studies will assess the predictive value of Pg abundance measurement in ASCVD risk stratification.
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Affiliation(s)
- Maria Cristina Curia
- Department of Medical, Oral and Biotechnological Sciences, Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: (M.C.C.); (M.B.); (P.M.)
| | - Pamela Pignatelli
- Department of Medical, Oral and Biotechnological Sciences, Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Domenica Lucia D’Antonio
- Department of Medical, Oral and Biotechnological Sciences, Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Damiano D’Ardes
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Elena Olmastroni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | - Luca Scorpiglione
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Cipollone
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
| | - Alberico Luigi Catapano
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy
| | - Adriano Piattelli
- Master Course in Microsurgery in Odontostomatology, Saint Camillus International University for Health Sciences (Unicamillus), 00131 Rome, Italy
- Fondazione Villaserena per la Ricerca, 65013 Città Sant’Angelo, Pescara, Italy
- Casa di Cura Villa Serena, 65013 Città Sant’Angelo, Pescara, Italy
| | - Marco Bucci
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, “SS Annunziata” Hospital—ASL, 66100 Chieti, Italy
- C.A.S.T., Università degli Studi “Gabriele d’Annunzio” di Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: (M.C.C.); (M.B.); (P.M.)
| | - Paolo Magni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy
- Correspondence: (M.C.C.); (M.B.); (P.M.)
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16
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Engineering a novel immunogenic chimera protein utilizing bacterial infections associated with atherosclerosis to induce a deviation in adaptive immune responses via Immunoinformatics approaches. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 102:105290. [PMID: 35568333 DOI: 10.1016/j.meegid.2022.105290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/29/2022] [Accepted: 04/25/2022] [Indexed: 12/16/2022]
Abstract
Recent studies have established the role of bacteria including Streptococcus pneumoniae, Helicobacter pylori, Chlamydia pneumonia, Mycobacterium tuberculosis, and Porphyromonas gingivalis in the development of atherosclerosis. These bacteria contribute to plaque formation via promoting Th1 immune responses and speeding up ox-LDL formation. Hence, we employed computational reverse vaccinology (RV) approaches to deviate immune response toward Th2 via engineering a novel immunogenic chimera protein. Prominent atherogenic antigens from related bacteria were identified. Then, machine learning-based servers were employed for predicting CTL and HTL epitopes. We selected epitopes from a wide variety of HLAs. Then, a chimeric protein sequence containing TAT peptide, adjuvant, IL-10 inducer, and linker-separated epitopes was designed. The conformational structure of the vaccine was built via multiple-template homology modelling using MODELLER. The initial structure was refined and validated by Ramachandran plot. The vaccine was also docked with TLR4. After that, molecular dynamics (MD) simulation of the docked vaccine-TLR4 was conducted. Finally, the immune simulation of the vaccine was conducted via the C-ImmSim server. A chimera protein with 629 amino acids was built and, classified as a non-allergenic probable antigen. An improved ERRAT score of 80.95 for the refined structure verified its stability. Additionally, validation via the Ramachandran plot showed 98.09% of the residues were located in the most favorable and permitted regions. MD simulations showed the vaccine-TLR4 complex reached a stable conformation. Also, RMS fluctuations analysis revealed no sign of protein denaturation or unfolding. Finally, immune response simulations indicated a promising response by innate and adaptive immunity. In summary, we built an immunogenic vaccine against atherosclerosis and demonstrated its favorable properties via advanced Immunoinformatics analyses. This study may pave the path for combat against atherosclerosis.
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Kim S, Bando Y, Chang C, Kwon J, Tarverti B, Kim D, Lee SH, Ton-That H, Kim R, Nara PL, Park NH. Topical application of Porphyromonas gingivalis into the gingival pocket in mice leads to chronic‑active infection, periodontitis and systemic inflammation. Int J Mol Med 2022; 50:103. [PMID: 35703359 PMCID: PMC9242655 DOI: 10.3892/ijmm.2022.5159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Porphyromonas gingivalis (Pg), one of the 'red-complex' perio-pathogens known to play a critical role in the development of periodontitis, has been used in various animal models to mimic human bacteria-induced periodontitis. In order to achieve a more realistic animal model of human Pg infection, the present study investigated whether repeated small-volume topical applications of Pg directly into the gingival pocket can induce local infection, including periodontitis and systemic vascular inflammation in wild-type mice. Freshly cultured Pg was topically applied directly into the gingival pocket of the second molars for 5 weeks (3 times/week). After the final application, the mice were left in cages for 4 or 8 weeks and sacrificed. The status of Pg colony formation in the pocket, gingival inflammation, alveolar bone loss, the expression levels of pro-inflammatory cytokines in the serum and aorta, the presence of anti-Pg lipopolysaccharide (LPS) and gingipain (Kpg and RgpB) antibodies in the serum, as well as the accumulation of Pg LPS and gingipain aggregates in the gingiva and arterial wall were evaluated. The topical application of Pg into the gingival pocket induced the following local and systemic pathohistological changes in mice when examined at 4 or 8 weeks after the final topical Pg application: Pg colonization in the majority of gingival pockets; increased gingival pocket depths; gingival inflammation indicated by the increased expression of TNF-α, IL-6 and IL-1β; significant loss of alveolar bone at the sites of topical Pg application; and increased levels of pro-inflammatory cytokines, such as TNF-α, IL-1β, IL-17, IL-13, KC and IFN-γ in the serum in comparison to those from mice receiving PBS. In addition, the Pg application/colonization model induced anti-Pg LPS and gingipain antibodies in serum, as well as the accumulation of Pg LPS and gingipain aggregates in the gingivae and arterial walls. To the best of our knowledge, this mouse model represents the first example of creating a more sustained local infection in the gingival tissues of wild-type mice and may prove to be useful for the investigation of the more natural and complete pathogenesis of the bacteria in the development of local oral and systemic diseases, such as atherosclerosis. It may also be useful for the determination of a treatment/prevention/efficacy model associated with Pg-induced colonization periodontitis in mice.
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Affiliation(s)
- Sharon Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Yasuhiko Bando
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Chungyu Chang
- Section of Oral Biology, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Jeonga Kwon
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Berta Tarverti
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Doohyun Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Sung Hee Lee
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Hung Ton-That
- Section of Oral Biology, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Reuben Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Peter L Nara
- Keystone Bio Incorporated, Suite 200, St. Louis, MO 63110, USA
| | - No-Hee Park
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA
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Suh J, Kim S, Lee S, Kim R, Park NH. Hyperlipidemia is necessary for the initiation and progression of atherosclerosis by severe periodontitis in mice. Mol Med Rep 2022; 26:273. [PMID: 35795972 PMCID: PMC9309540 DOI: 10.3892/mmr.2022.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/07/2022] [Indexed: 11/08/2022] Open
Abstract
Hyperlipidemia is a major risk of atherosclerosis; however, systemic inflammatory diseases such as rheumatoid arthritis, psoriasis, systemic lupus erythematosus and systemic sclerosis are also known risks for the development of atherosclerosis. Periodontitis, a local and systemic inflammatory condition, has also been reported as a risk for atherosclerosis, but the specific link between periodontitis and atherosclerosis remains somewhat controversial. We previously reported that ligature-induced periodontitis exacerbates atherosclerosis in hyperlipidemic Apolipoprotein E-deficient (ApoE−/−) mice. To understand whether hyperlipidemia is necessary for the development and exacerbation of atherosclerosis associated with periodontitis, the present study created ligature-induced periodontitis in both wild-type (WT) and ApoE−/− mice. Subsequently, the status of local, systemic and vascular inflammation, serum lipid contents and arterial lipid deposition were examined with histological analysis, µCT, en face analysis, serum lipid and cytokine measurements, reverse transcription-quantitative PCR and immunohistochemical analysis. Ligature placement induced severe periodontitis in both WT and ApoE−/− mice at the local level as demonstrated by gingival inflammation, alveolar bone loss, increased osteoclastic activities and inflammation in alveolar bone. Systemic inflammation was also induced by ligature placement in both WT and ApoE−/− mice, albeit more so in ApoE−/− mice. The serum cholesterol levels were not altered by the ligature in both WT and ApoE−/− mice. However, the vascular inflammation and arterial lipid deposition were induced by ligature-induced periodontitis only in ApoE−/− mice, but not in WT mice. The present study indicated that the coupling of systemic inflammation and hyperlipidemia was necessary for the development and exacerbation of atherosclerosis induced by ligature-induced periodontitis in mice.
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Affiliation(s)
- Jin Suh
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, School of Dentistry, Los Angeles, CA 90095, USA
| | - Sharon Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, School of Dentistry, Los Angeles, CA 90095, USA
| | - Sung Lee
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, School of Dentistry, Los Angeles, CA 90095, USA
| | - Reuben Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, School of Dentistry, Los Angeles, CA 90095, USA
| | - No-Hee Park
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, School of Dentistry, Los Angeles, CA 90095, USA
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Leaky Gum: The Revisited Origin of Systemic Diseases. Cells 2022; 11:cells11071079. [PMID: 35406643 PMCID: PMC8997512 DOI: 10.3390/cells11071079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 12/10/2022] Open
Abstract
The oral cavity is the gateway for microorganisms into your body where they disseminate not only to the directly connected respiratory and digestive tracts but also to the many remote organs. Oral microbiota, travelling to the end of the intestine and circulating in our bodies through blood vessels, not only affect a gut microbiome profile but also lead to many systemic diseases. By gathering information accumulated from the era of focal infection theory to the age of revolution in microbiome research, we propose a pivotal role of “leaky gum”, as an analogy of “leaky gut”, to underscore the importance of the oral cavity in systemic health. The oral cavity has unique structures, the gingival sulcus (GS) and the junctional epithelium (JE) below the GS, which are rarely found anywhere else in our body. The JE is attached to the tooth enamel and cementum by hemidesmosome (HD), which is structurally weaker than desmosome and is, thus, vulnerable to microbial infiltration. In the GS, microbial biofilms can build up for life, unlike the biofilms on the skin and intestinal mucosa that fall off by the natural process. Thus, we emphasize that the GS and the JE are the weakest leaky point for microbes to invade the human body, making the leaky gum just as important as, or even more important than, the leaky gut.
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Rodrigues KE, Azevedo A, Gonçalves PR, Pontes MHB, Alves GM, Oliveira RR, Amarante CB, Issa JPM, Gerlach RF, Prado AF. Doxycycline Decreases Atherosclerotic Lesions in the Aorta of ApoE-⁄- and Ovariectomized Mice with Correlation to Reduced MMP-2 Activity. Int J Mol Sci 2022; 23:ijms23052532. [PMID: 35269673 PMCID: PMC8910467 DOI: 10.3390/ijms23052532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 02/05/2023] Open
Abstract
Atherogenic events promote changes in vessel walls, with alteration of the redox state, and increased activity of matrix metalloproteinases (MMPs). Thus, this study aims to evaluate aortic remodeling, MMP activity, and reactive oxygen species (ROS) levels after treatment with doxycycline in ApoE-⁄- and ovariectomized mice (OVX). Female ApoE-⁄--knockout mice (5 weeks) were submitted to ovariectomy surgery to induce experimental menopause. They then received chow enriched with 1% cholesterol to induce hypercholesterolemia. The animals were divided into two experimental groups: ApoE-⁄-/OVX vehicle and ApoE-⁄-/OVX doxycycline (30 mg/kg) administered by gavage once a day for 28 days (15th to the 18th week of life). Blood samples were collected to measure total cholesterol and fractions. The aorta was used for morphometry and to measure the activity and expression of MMP-2 and ROS levels. The ApoE-⁄-/OVX doxycycline group showed no change in total and fraction cholesterol levels. However, there was a reduction in ROS levels, MMP-2 expression, and activity that correlated with a decrease in atherosclerotic lesions relative to the ApoE-⁄-/OVX vehicle (p > 0.05). Therefore, we conclude that doxycycline in ApoE-⁄-/OVX animals promotes a reduction in atherosclerotic lesions by reducing ROS and MMP-2 activity and expression.
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Affiliation(s)
- Keuri E. Rodrigues
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Aline Azevedo
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Faculty of Medicine of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14049-900, SP, Brazil;
| | - Pricila R. Gonçalves
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Maria H. B. Pontes
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Gustavo M. Alves
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Ruan R. Oliveira
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
| | - Cristine B. Amarante
- Coordination of Earth Sciences and Ecology, Museu Paraense Emílio Goeldi, Belem 66077-830, PA, Brazil;
| | - João P. M. Issa
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo (FORP/USP), Ribeirao Preto 14040-904, SP, Brazil; (J.P.M.I.); (R.F.G.)
| | - Raquel F. Gerlach
- Department of Basic and Oral Biology, School of Dentistry of Ribeirao Preto, University of Sao Paulo (FORP/USP), Ribeirao Preto 14040-904, SP, Brazil; (J.P.M.I.); (R.F.G.)
| | - Alejandro F. Prado
- Institute of Biological Sciences, Federal University of Pará, Cardiovascular System Pharmacology and Toxicology Laboratory, Belém 66075-110, PA, Brazil; (K.E.R.); (P.R.G.); (M.H.B.P.); (G.M.A.); (R.R.O.)
- Correspondence:
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The etiology of preeclampsia. Am J Obstet Gynecol 2022; 226:S844-S866. [PMID: 35177222 PMCID: PMC8988238 DOI: 10.1016/j.ajog.2021.11.1356] [Citation(s) in RCA: 148] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 02/08/2023]
Abstract
Preeclampsia is one of the "great obstetrical syndromes" in which multiple and sometimes overlapping pathologic processes activate a common pathway consisting of endothelial cell activation, intravascular inflammation, and syncytiotrophoblast stress. This article reviews the potential etiologies of preeclampsia. The role of uteroplacental ischemia is well-established on the basis of a solid body of clinical and experimental evidence. A causal role for microorganisms has gained recognition through the realization that periodontal disease and maternal gut dysbiosis are linked to atherosclerosis, thus possibly to a subset of patients with preeclampsia. The recent reports indicating that SARS-CoV-2 infection might be causally linked to preeclampsia are reviewed along with the potential mechanisms involved. Particular etiologic factors, such as the breakdown of maternal-fetal immune tolerance (thought to account for the excess of preeclampsia in primipaternity and egg donation), may operate, in part, through uteroplacental ischemia, whereas other factors such as placental aging may operate largely through syncytiotrophoblast stress. This article also examines the association between gestational diabetes mellitus and maternal obesity with preeclampsia. The role of autoimmunity, fetal diseases, and endocrine disorders is discussed. A greater understanding of the etiologic factors of preeclampsia is essential to improve treatment and prevention.
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22
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Xiao L, Huang L, Zhou X, Zhao D, Wang Y, Min H, Song S, Sun W, Gao Q, Hu Q, Xie S. Experimental Periodontitis Deteriorated Atherosclerosis Associated With Trimethylamine N-Oxide Metabolism in Mice. Front Cell Infect Microbiol 2022; 11:820535. [PMID: 35118014 PMCID: PMC8804528 DOI: 10.3389/fcimb.2021.820535] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background Periodontitis is considered a risk factor for atherosclerosis, but the mechanism is not clear. It was reported that oral administration of Porphyromonas gingivalis altered the gut microbiota in mice. Gut dysbiosis and the intestinal metabolite trimethylamine N-oxide (TMAO) were verified to be associated with atherosclerosis. Therefore, the possible TMAO-related mechanism between periodontitis and atherosclerosis needs to be explored. Methods Experimental periodontitis was established by oral administration of P. gingivalis for 2 months in ApoE−/− mice. Mouse hemi-mandibles were scanned using Micro-CT. Quantification of TMAO was performed using liquid chromatography–tandem mass spectrometry. Mouse feces were collected and the bacterial DNA was extracted, then the gut microbiota was analyzed using 16S rRNA genes. Atherosclerotic lesion areas were quantified. Livers, small intestines, and large intestines were analyzed for gene expression. Results Aggravated atherosclerosis plaques were found in experimental periodontitis mice. Plasma TMAO, a pathogenic factor of atherosclerosis, was initially found to be increased in periodontitis mice. Changes in the composition and abundance of the intestinal microflora of periodontitis mice were found. Flavin monooxygenase 3 (FMO3), the catalyzing enzyme of TMAO in the liver, was significantly increased, accompanied by an increase of IL-6 in liver, the abnormal intestinal integrity and enhanced plasma LPS. The IL-6 and LPS were verified to be able to increase FMO3 in HepG2 cells. Conclusion Our research discovered that experimental periodontitis in ApoE−/− mice induced gut dysbiosis and an increase in TMAO. These results suggest a possible mechanism by which periodontitis may accelerate atherosclerosis by influencing the intestinal microbes and the metabolism, which were triggered by inflammation of the liver and intestine.
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Affiliation(s)
- Lingling Xiao
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
- Department of Stomatology, The Second People’s Hospital of Taizhou, Taizhou, China
| | - Lingyan Huang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xin Zhou
- The Affiliated Stomatological Hospital of Soochow University, Suzhou, China
| | - Dan Zhao
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yan Wang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Haiyan Min
- The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shiyu Song
- Center for Translational Medicine and Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
| | - Weibin Sun
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qian Gao
- Center for Translational Medicine and Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- *Correspondence: Sijing Xie, ; Qingang Hu, ; Qian Gao,
| | - Qingang Hu
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
- *Correspondence: Sijing Xie, ; Qingang Hu, ; Qian Gao,
| | - Sijing Xie
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
- *Correspondence: Sijing Xie, ; Qingang Hu, ; Qian Gao,
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Moest T, Lutz R, Jahn AE, Heller K, Schiffer M, Adler W, Deschner J, Weber M, Kesting MR. Frequency of the necessity of dentoalveolar surgery or conservative treatment in patients before kidney transplantation depending on the duration of dialysis and causative nephrological disease. Clin Oral Investig 2021; 26:2383-2390. [PMID: 34623508 PMCID: PMC8898213 DOI: 10.1007/s00784-021-04202-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This retrospective study evaluates intraoral surgical and conservative treatment need in patients with a chronic kidney end-stage disease, depending on the duration of dialysis treatment and the causative nephrological disease. MATERIAL AND METHODS This study is based on data of patients referred to the Department of Oral and Maxillofacial Surgery of the University Hospital Erlangen, Germany, prior to kidney transplantation between January 2015 and March 2020. The necessity for oral surgical or dental therapy was determined by clinical and radiological examinations. Data on renal replacement therapy, cause of underlying renal disease, lifestyle, and general health were collected. RESULTS Data of N = 89 patients demonstrated that surgical treatment need depends on dialysis duration (p = 0.042). Patients, who had been dialyzing for 2 to 3 years showed the highest need for surgical intervention (80.0%; p = 0.024), followed by dialysis patients with a dialysis time of more than 3 years (48.1%). Similarly, dialysis patients in the second or third year of dialysis had the highest need for conservative treatment (73.3%; p > 0.05), followed by 55.6% of dialysis patients in the third year of dialysis. CONCLUSIONS Operative and conservative treatment is essential to optimize subsequent kidney transplantation. The greatest necessity could be detected for patients in the second and third years of dialysis. CLINICAL RELEVANCE Oral health addressing surgical and conservative treatment need depends on the duration of dialysis in patients with a chronic kidney end-stage disease.
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Affiliation(s)
- Tobias Moest
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054, Erlangen, Germany.
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054, Erlangen, Germany
| | - Arne Eric Jahn
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054, Erlangen, Germany
| | - Katharina Heller
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Mario Schiffer
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology (IMBE), University of Erlangen-Nuremberg, Erlangen, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University of Mainz, Mainz, Germany
| | - Manuel Weber
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054, Erlangen, Germany
| | - Marco Rainer Kesting
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstraße 11, 91054, Erlangen, Germany
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Hallikainen J, Pyysalo M, Keränen S, Kellokoski J, Koivisto T, Suominen AL, Pussinen P, Pessi T, Frösen J. Systemic immune response against the oral pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans is associated with the formation and rupture of intracranial aneurysms. Eur J Neurol 2021; 28:3089-3099. [PMID: 34145948 DOI: 10.1111/ene.14986] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Periodontal infections are associated with the formation and rupture of intracranial aneurysms (IAs). This study investigated the role of two key periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. METHODS Immunoglobulin A (IgA) and IgG antibodies against P. gingivalis and A. actinomycetemcomitans were measured with enzyme immune assay from the serum of 227 IA patients, of whom 64 also underwent clinical oral examination. As a control group, 1096 participants in a cross-sectional health survey, Health 2000, underwent serological studies and oral examination. Logistic regression was used for multivariate analysis. Immunohistochemistry was performed to demonstrate bacteria-derived epitopes in the IA wall. RESULTS Widespread gingivitis and severe periodontitis were more common in IA patients than in controls (2× and 1.5×, respectively). IgA antibodies against P. gingivalis and A. actinomycetemcomitans were 1.5× and 3-3.4× higher, respectively, in both unruptured and ruptured IA patients compared to controls (p ≤ 0.003). IgG antibodies against P. gingivalis were 1.8× lower in unruptured IA patients (p < 0.001). In multivariate analysis, high IgA, but low IgG, antibody levels against P. gingivalis (odds ratio [OR] = 1.4, 95% confidence interval [Cl] = 1.1-1.8 and OR = 1.5, 95% Cl = 1.1-1.9; OR = 0.6, 95% Cl = 0.4-0.7 and OR = 0.5, 95% Cl = 0.4-0.7) and against A. actinomycetemcomitans (OR = 2.3, 95% Cl = 1.7-3.1 and OR = 2.1, 95% Cl = 1.5-2.9; OR = 0.6, 95% Cl = 0.4-0.8 and OR = 0.6, 95% Cl = 0.5-0.9) were associated with the risk of IA formation and rupture. Immunohistochemistry showed P. gingivalis epitopes in the IA wall. CONCLUSIONS Exposure to the periodontal pathogens P. gingivalis and A. actinomycetemcomitans and dysfunctional acquired immune response against them may increase the risk of IA formation and IA rupture.
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Affiliation(s)
- Joona Hallikainen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland
| | - Mikko Pyysalo
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland
| | - Sara Keränen
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland.,A. I. Virtanen Institute, University of Eastern Finland, Kuopio, Finland
| | - Jari Kellokoski
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Timo Koivisto
- Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tanja Pessi
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland
| | - Juhana Frösen
- Hemorrhagic Brain Pathology Research Group, University of Tampere, Tampere, Finland.,Department of Neurosurgery, Tampere University Hospital, Tampere, Finland
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Blank E, Grischke J, Winkel A, Eberhard J, Kommerein N, Doll K, Yang I, Stiesch M. Evaluation of biofilm colonization on multi-part dental implants in a rat model. BMC Oral Health 2021; 21:313. [PMID: 34144677 PMCID: PMC8212458 DOI: 10.1186/s12903-021-01665-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/02/2021] [Indexed: 01/15/2023] Open
Abstract
Background Peri-implant mucositis and peri-implantitis are highly prevalent biofilm-associated diseases affecting the tissues surrounding dental implants. As antibiotic treatment is ineffective to fully cure biofilm mediated infections, antimicrobial modifications of implants to reduce or prevent bacterial colonization are called for. Preclinical in vivo evaluation of the functionality of new or modified implant materials concerning bacterial colonization and peri-implant health is needed to allow progress in this research field. For this purpose reliable animal models are needed. Methods Custom made endosseous dental implants were installed in female Sprague Dawley rats following a newly established three-step implantation procedure. After healing of the bone and soft tissue, the animals were assigned to two groups. Group A received a continuous antibiotic treatment for 7 weeks, while group B was repeatedly orally inoculated with human-derived strains of Streptococcus oralis, Fusobacterium nucleatum and Porphyromonas gingivalis for six weeks, followed by 1 week without inoculation. At the end of the experiment, implantation sites were clinically assessed and biofilm colonization was quantified via confocal laser scanning microscopy. Biofilm samples were tested for presence of the administered bacteria via PCR analysis. Results The inner part of the custom made implant screw could be identified as a site of reliable biofilm formation in vivo. S. oralis and F. nucleatum were detectable only in the biofilm samples from group B animals. P. gingivalis was not detectable in samples from either group. Quantification of the biofilm volume on the implant material revealed no statistically significant differences between the treatment groups. Clinical inspection of implants in group B animals showed signs of mild to moderate peri-implant mucositis (4 out of 6) whereas the mucosa of group A animals appeared healthy (8/8). The difference in the mucosa health status between the treatment groups was statistically significant (p = 0.015). Conclusions We developed a new rodent model for the preclinical evaluation of dental implant materials with a special focus on the early biofilm colonization including human-derived oral bacteria. Reliable biofilm quantification on the implant surface and the symptoms of peri-implant mucositis of the bacterially inoculated animals will serve as a readout for experimental evaluation of biofilm-reducing modifications of implant materials.
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Affiliation(s)
- Eva Blank
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. .,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany.
| | - Jasmin Grischke
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Andreas Winkel
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Joerg Eberhard
- The University of Sydney Dental School & The Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Nadine Kommerein
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Katharina Doll
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Ines Yang
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Meike Stiesch
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
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26
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Rojas C, García MP, Polanco AF, González-Osuna L, Sierra-Cristancho A, Melgar-Rodríguez S, Cafferata EA, Vernal R. Humanized Mouse Models for the Study of Periodontitis: An Opportunity to Elucidate Unresolved Aspects of Its Immunopathogenesis and Analyze New Immunotherapeutic Strategies. Front Immunol 2021; 12:663328. [PMID: 34220811 PMCID: PMC8248545 DOI: 10.3389/fimmu.2021.663328] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/10/2021] [Indexed: 12/17/2022] Open
Abstract
Periodontitis is an oral inflammatory disease in which the polymicrobial synergy and dysbiosis of the subgingival microbiota trigger a deregulated host immune response, that leads to the breakdown of tooth-supporting tissues and finally tooth loss. Periodontitis is characterized by the increased pathogenic activity of T helper type 17 (Th17) lymphocytes and defective immunoregulation mediated by phenotypically unstable T regulatory (Treg), lymphocytes, incapable of resolving the bone-resorbing inflammatory milieu. In this context, the complexity of the immune response orchestrated against the microbial challenge during periodontitis has made the study of its pathogenesis and therapy difficult and limited. Indeed, the ethical limitations that accompany human studies can lead to an insufficient etiopathogenic understanding of the disease and consequently, biased treatment decision-making. Alternatively, animal models allow us to manage these difficulties and give us the opportunity to partially emulate the etiopathogenesis of periodontitis by inoculating periodontopathogenic bacteria or by placing bacteria-accumulating ligatures around the teeth; however, these models still have limited translational application in humans. Accordingly, humanized animal models are able to emulate human-like complex networks of immune responses by engrafting human cells or tissues into specific strains of immunodeficient mice. Their characteristics enable a viable time window for the study of the establishment of a specific human immune response pattern in an in vivo setting and could be exploited for a wider study of the etiopathogenesis and/or treatment of periodontitis. For instance, the antigen-specific response of human dendritic cells against the periodontopathogen Porphyromonas gingivalis favoring the Th17/Treg response has already been tested in humanized mice models. Hypothetically, the proper emulation of periodontal dysbiosis in a humanized animal could give insights into the subtle molecular characteristics of a human-like local and systemic immune response during periodontitis and support the design of novel immunotherapeutic strategies. Therefore, the aims of this review are: To elucidate how the microbiota-elicited immunopathogenesis of periodontitis can be potentially emulated in humanized mouse models, to highlight their advantages and limitations in comparison with the already available experimental periodontitis non-humanized animal models, and to discuss the potential translational application of using these models for periodontitis immunotherapeutics.
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Affiliation(s)
- Carolina Rojas
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Michelle P García
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Alan F Polanco
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Luis González-Osuna
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Alfredo Sierra-Cristancho
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Faculty of Dentistry, Universidad Andres Bello, Santiago, Chile
| | - Samanta Melgar-Rodríguez
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Emilio A Cafferata
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
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27
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Rekhi UR, Catunda RQ, Alexiou M, Sharma M, Fong A, Febbraio M. Impact of a CD36 inhibitor on Porphyromonas gingivalis mediated atherosclerosis. Arch Oral Biol 2021; 126:105129. [PMID: 33934042 DOI: 10.1016/j.archoralbio.2021.105129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine if AP5055 drug, an inhibitor of CD36, prevents the increase in Porphyromonas gingivalis (P. gingivalis) mediated atherosclerosis in low-density lipoprotein receptor knockout (LDLR KO) mice by targeting CD36. METHODS Male LDLR KO mice were infected with P. gingivalis by oral lavage to induce periodontal disease and fed a western diet to induce atherosclerosis. Mice were treated with the CD36 inhibitor, AP5055 (1 mg/kg), or vehicle (1% DMSO). Aortae were dissected and stained with oil red-O for morphometric analysis; blood/plasma was collected to determine markers of inflammation by cytokine array and cholesterol levels. P. gingivalis-induced bone loss in mandibles was assessed using micro-CT. P. gingivalis lipopolysaccharide stimulated nuclear factor-kappa B (NF-κB) activity was measured using a reporter gene (secreted alkaline phosphatase) assay in AP5055 treated or untreated RAW-Blue macrophages. RESULTS Isolated aortae showed a significant decrease in lesion area in the AP5055 treated group as compared to the control group. Mechanistically, in vitro analysis demonstrated that AP5055 inhibited NF-κB activity. Cytokine array showed a decrease in the expression of pro-inflammatory cytokines and decreased levels of plasma cholesterol in AP5055 treated mice. Micro-CT measurements of bone loss were not significant between the two groups. CONCLUSION CD36 inhibitor AP5055 abrogates atherosclerotic lesion burden associated with periodontal disease, accompanied by a reduction in markers of inflammation. These experiments may support the development of drugs targeting CD36 for human disease.
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Affiliation(s)
- Umar Rauf Rekhi
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Raisa Queiroz Catunda
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Maria Alexiou
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Monika Sharma
- Department of Neurology, Harvard Medical School and Brigham & Women's Hospital, Boston, MA, USA; Advanced Center for Parkinson's Disease Research of Harvard Medical School and Brigham & Women's Hospital, Boston, MA, USA
| | - Aaron Fong
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Maria Febbraio
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
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28
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Kato-Kogoe N, Sakaguchi S, Kamiya K, Omori M, Gu YH, Ito Y, Nakamura S, Nakano T, Tamaki J, Ueno T, Hoshiga M. Characterization of Salivary Microbiota in Patients with Atherosclerotic Cardiovascular Disease: A Case-Control Study. J Atheroscler Thromb 2021; 29:403-421. [PMID: 33612553 PMCID: PMC8894113 DOI: 10.5551/jat.60608] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims:
Oral bacteria have been reported to be associated with the pathogenesis of atherosclerosis; however, the relationship between the oral microbiota and atherosclerosis remains unclear. The present study aimed to investigate whether or not salivary microbiota of patients with atherosclerotic cardiovascular disease (ACVD) differs from that of subjects without ACVD, and to characterize the salivary microbiota of patients with ACVD.
Methods:
This study included 43 patients with ACVD and 86 age- and sex-matched non-ACVD individuals. 16S rRNA metagenomic analysis were performed using DNA isolated from the saliva samples of the participants. To select unique operational taxonomic unit (OTU) sets of ACVD, we conducted the random forest algorithm in machine learning, followed by confirmation via 10-fold cross-validation
Results:
There was no difference in richness or evenness between the ACVD and non-ACVD groups (alpha diversity; observed OTU index,
p
=0.503; Shannon’s index,
p
=0.478). However, significant differences were found in the overall salivary microbiota structure (beta diversity; unweighted UniFrac distances,
p
=0.001; weighted UniFrac distances,
p
=0.001). The Actinobacteria phylum was highly abundant in patients with ACVD, while the Bacteroidetes phylum was less abundant. The random forest classifier identified 43 OTUs as an optimal marker set of ACVD. In a 10-fold cross validation using the validation data, an area under the curve (AUC) of 0.933 (95% CI, 0.855–1.000) was obtained.
Conclusions:
The salivary microbiota in patients with ACVD was distinct from that of non-ACVD individuals, indicating that the salivary microbiota may be related to ACVD.
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Affiliation(s)
| | - Shoichi Sakaguchi
- Department of Microbiology and Infection Control, Osaka Medical College
| | - Kuniyasu Kamiya
- Department of Hygiene and Public Health, Osaka Medical College
| | - Michi Omori
- Department of Dentistry and Oral Surgery, Osaka Medical College
| | - Yan-Hong Gu
- Department of Hygiene and Public Health, Osaka Medical College
| | - Yuri Ito
- Research and Development Center, Osaka Medical College
| | - Shota Nakamura
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University
| | - Takashi Nakano
- Department of Microbiology and Infection Control, Osaka Medical College
| | - Junko Tamaki
- Department of Hygiene and Public Health, Osaka Medical College
| | - Takaaki Ueno
- Department of Dentistry and Oral Surgery, Osaka Medical College
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29
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Catunda RQ, Ho KKY, Patel S, Febbraio M. A 2-plane micro-computed tomographic alveolar bone measurement approach in mice. Imaging Sci Dent 2021; 51:389-398. [PMID: 34987999 PMCID: PMC8695470 DOI: 10.5624/isd.20210058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/27/2021] [Accepted: 06/11/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose This study introduces a standardized 2-plane approach using 8 landmarks to assess alveolar bone levels in mice using micro-computed tomography. Materials and Methods Bone level differences were described as distance from the cemento-enamel junction (CEJ) to alveolar bone crest (ABC) and as percentages of vertical bone height and vertical bone loss, comparing mice infected with Porphyromonas gingivalis (Pg) to controls. Eight measurements were obtained per tooth: 2 in the sagittal plane (mesial and distal) and 6 in the coronal plane (mesiobuccal, middle-buccal, distobuccal, mesiolingual, middle-lingual, and distolingual). Results Significant differences in the CEJ-to-ABC distance between Pg-infected mice and controls were found in the coronal plane (middle-lingual, mesiobuccal, and distolingual for the first molar; and mesiobuccal, middle-buccal, and distolingual for the second molar). In the sagittal plane, the distal measurement of the second molar was different. The middle-buccal, mesiobuccal, and distolingual sites of the first and second molars showed vertical bone loss relative to controls; the second molar middle-lingual site was also different. In the sagittal plane, the mesial sites of the first and second molars and the distal site of the second molar showed loss. Significantly different vertical bone height percentages were found for the mesial and distal sites of the second molar (sagittal plane) and the middle-lingual and distolingual sites of the first molar(coronal plane). Conclusion A reliable, standardized technique for linear periodontal assessments in mice is described. Alveolar bone loss occurred mostly on the lingual surface of the coronal plane, which is often omitted in studies.
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Affiliation(s)
- Raisa Queiroz Catunda
- Department of Dentistry, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Karen Ka-Yan Ho
- Department of Dentistry, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Srushti Patel
- Department of Dentistry, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Maria Febbraio
- Department of Dentistry, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
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30
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Association of Periodontitis with Atherosclerotic Cardiovascular Diseases: A Nationwide Population-based Retrospective Matched Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197261. [PMID: 33020434 PMCID: PMC7578974 DOI: 10.3390/ijerph17197261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 11/16/2022]
Abstract
We investigated the association between periodontitis and atherosclerotic cardiovascular disease (ACVD) development using the National Health Insurance Service—National Sample Cohort 2.0 (NHIS-NSC2) database, which contains data for approximately 1 million nationally representative random participants. We selected 52,425 participants aged 20+ years and diagnosed with periodontitis from January to December 2003 and used propensity score matching to select an equivalent number of participants who were never diagnosed with periodontitis in the period covered by the NHIS-NSC2 database (2002–2015). The propensity scores were based on sex, age group, type of national health insurance, household income, diabetes status, and hypertension status and were used for 1:1 matching of individuals with similar propensities. A total of 104,850 participants were selected for the study. A multivariable Cox proportional hazard regression model was used to investigate the risk of ACVD development due to periodontitis from 2003 to 2015 after adjusting for sex, age, type of national health insurance, household income, hypertension status, and diabetes status. Participants with periodontitis had a higher risk of ACVD (adjusted hazard ratio: 1.09, 95% confidence interval: 1.05–1.13) than those without periodontitis. Thus, periodontitis can increase the risk of ACVD, and prevention of periodontitis may help reduce the risk of cardiovascular disease.
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31
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Niemiec B, Gawor J, Nemec A, Clarke D, McLeod K, Tutt C, Gioso M, Steagall PV, Chandler M, Morgenegg G, Jouppi R. World Small Animal Veterinary Association Global Dental Guidelines. J Small Anim Pract 2020; 61:E36-E161. [PMID: 32715504 DOI: 10.1111/jsap.13132] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.
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Fujitani T, Aoyama N, Hirata F, Minabe M. Association between periodontitis and vascular endothelial function using noninvasive medical device-A pilot study. Clin Exp Dent Res 2020; 6:576-582. [PMID: 32737946 PMCID: PMC7545230 DOI: 10.1002/cre2.312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
The present study aimed to assess the relationship between periodontal condition and endothelial function using a noninvasive device. Many recent studies have reported associations between periodontitis and cardiovascular diseases. Endothelial dysfunction is the first step of atherosclerosis, but information on the association between periodontal disease and endothelial dysfunction remains limited. Thirty‐three subjects were recruited from among patients at a private medical clinic. We examined vascular endothelial function using a noninvasive medical device and periodontal measurements including probing pocket depth, attachment level, tooth mobility, and oral cleaning condition. Subjects were divided into two groups according to endothelial function score. Tooth mobility and number of lost teeth were increased in the group with endothelial dysfunction. A greater frequency of elderly subjects and altered hemoglobin A1c levels were seen in the endothelial dysfunction group. On multiple logistic regression analysis, increased tooth mobility was independently associated with endothelial dysfunction. Increased tooth mobility, a major periodontal parameter, appears related to endothelial dysfunction.
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Affiliation(s)
- Takahito Fujitani
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Norio Aoyama
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | | | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
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Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000 2020; 83:90-106. [PMID: 32385879 DOI: 10.1111/prd.12304] [Citation(s) in RCA: 165] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Atherosclerosis is central to the pathology of cardiovascular diseases, a group of diseases in which arteries become occluded with atheromas that may rupture, leading to different cardiovascular events, such as myocardial infarction or ischemic stroke. There is a large body of epidemiologic and animal model evidence associating periodontitis with atherosclerotic disease, and many potential mechanisms linking these diseases have been elucidated. This chapter will update knowledge on these mechanisms, which generally fall into 2 categories: microbial invasion and infection of atheromas; and inflammatory and immunologic. With respect to the invasion and infection of atheromas, it is well established that organisms from the subgingival biofilm can enter the circulation and lodge in most distant tissues. Bacteremias resulting from oral interventions, and even oral hygiene activities, are well documented. More recently, indirect routes of entry of oral organisms (via phagocytes or dendritic cells) have been described for many oral organisms, into many tissues. Such organisms include the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, and Fusobacterium nucleatum. Intracellular survival of these organisms with dissemination to distant sites (The Trojan Horse approach) has been described. Their relative contribution to atheroma formation and progression has been studied mainly in experimental research, with results demonstrating that these organisms can invade endothelial cells and phagocytic cells within the atheroma, leading to pathogenic changes and progression of the atheroma lesion. The second category of mechanisms potentially linking periodontitis to atherosclerosis includes the dumping of inflammatory mediators originating from periodontal lesions into the systemic circulation. These inflammatory mediators, such as C-reactive protein, matrix metalloproteinases, fibrinogen, and other hemostatic factors, would further accelerate atheroma formation and progression, mainly through oxidative stress and inflammatory dysfunction. Moreover, direct effects on lipid oxidation have also been described. In summary, the evidence supports the concept that periodontitis enhances the levels of systemic mediators of inflammation that are risk factors for atherosclerotic diseases.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, NewYork, New York, USA
| | - Robert Genco
- Departments of Oral Biology, and Microbiology and Immunology, Center for Microbiome Research, University at Buffalo, Buffalo, New York, USA
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Bilgin Çetin M, Önder C, Orhan K, Kumbasar D, Serdar MA, Ünsal E. Relationship of periodontitis and edentulism to angiographically diagnosed coronary artery disease: A cross-sectional study. J Periodontal Res 2020; 55:895-904. [PMID: 32648271 DOI: 10.1111/jre.12782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 06/01/2020] [Accepted: 06/10/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The objective of the study is to examine the connection between oral status and the extent of coronary artery disease (CAD), which is diagnosed by angiography. BACKGROUND Periodontitis and tooth loss have been linked to atherosclerosis and CAD in previous studies. However, no distinct connection was revealed due to the diversity of the results and the variety of diagnostic methods. To provide a more consistent data pool and stronger evidence, there is a need for studies with standard measurements and diagnostic criteria. METHODS 309 patients, who consulted to Ankara University, Faculty of Medicine, Department of Cardiology and had coronary angiography, were enrolled to this study. Individuals were grouped based on their coronary angiography results, as CAD (+) (n = 233) and CAD (-) (n = 76). Studied parameters included cardiovascular risk factors, plaque index (PI), remaining teeth count, bleeding on probing (BOP), and probing pocket depth (PPD). Periapical radiographs were taken from teeth with ≥4 mm PPD. Oral status was categorized as periodontally healthy subjects/patients with gingivitis (Group 1), patients with periodontitis (Group 2), and edentulous subjects (Group 3). RESULTS PI (P < 0.001), PPD (P = 0.001), BOP (P = 0.004), the number of patients with less than 10 teeth (P = 0.014), and edentulism (P = 0.009) were significantly higher in CAD (+) patients, who were mostly older (P < 0.001) and male (P < 0.001). Multivariate logistic regression analysis revealed that Group 2 (odds ratio = 2.48, 95% confidence interval = 1.24-4.95, P = 0.010) and Group 3 (odds ratio = 2.01, 95% confidence interval = 1.14-5.17, P = 0.040) were highly associated with CAD. Two and three stenosed vessels were significantly higher in Groups 2 and 3 compared to Group 1 (P = 0.003). CONCLUSIONS It was found that both edentulism and periodontitis were related to CAD.
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Affiliation(s)
- Mehtap Bilgin Çetin
- Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Canan Önder
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Kaan Orhan
- Department of Dento Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Deniz Kumbasar
- Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Elif Ünsal
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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35
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Liu XR, Xu Q, Xiao J, Deng YM, Tang ZH, Tang YL, Liu LS. Role of oral microbiota in atherosclerosis. Clin Chim Acta 2020; 506:191-195. [DOI: 10.1016/j.cca.2020.03.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/08/2023]
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Porphyromonas gingivalis, a Long-Range Pathogen: Systemic Impact and Therapeutic Implications. Microorganisms 2020; 8:microorganisms8060869. [PMID: 32526864 PMCID: PMC7357039 DOI: 10.3390/microorganisms8060869] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is an inflammatory disease associated with a dysbiosis of the oral flora characterized by a chronic sustained inflammation leading to destruction of tooth-supporting tissues. Over the last decade, an association between periodontitis and systemic disorders such as cardiovascular diseases, rheumatoid arthritis and obesity has been demonstrated. The role of periodontal pathogens, notably Porphyromonas gingivalis (P. gingivalis), in the onset or exacerbation of systemic diseases has been proposed. P. gingivalis expresses several virulence factors that promote its survival, spreading, and sustaining systemic inflammation. Recently, the impact of periodontitis on gut dysbiosis has also been suggested as a potential mechanism underlying the systemic influence of periodontitis. New therapeutic strategies for periodontitis and other dysbiotic conditions, including the use of beneficial microbes to restore healthy microbial flora, may pave the way to improved therapeutic outcomes and more thorough patient management.
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A Diet Rich in Saturated Fat and Cholesterol Aggravates the Effect of Bacterial Lipopolysaccharide on Alveolar Bone Loss in a Rabbit Model of Periodontal Disease. Nutrients 2020; 12:nu12051405. [PMID: 32422858 PMCID: PMC7284766 DOI: 10.3390/nu12051405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 12/13/2022] Open
Abstract
Increasing evidence connects periodontitis with a variety of systemic diseases, including metabolic syndrome, atherosclerosis, and non-alcoholic fatty liver disease (NAFLD). The proposal of this study was to evaluate the role of diets rich in saturated fat and cholesterol in some aspects of periodontal diseases in a lipopolysaccharide (LPS)-induced model of periodontal disease in rabbits and to assess the influence of a periodontal intervention on hyperlipidemia, atherosclerosis, and NAFLD progression to non-alcoholic steatohepatitis. Male rabbits were maintained on a commercial standard diet or a diet rich in saturated fat (3% lard w/w) and cholesterol (1.3% w/w) (HFD) for 40 days. Half of the rabbits on each diet were treated 2 days per week with intragingival injections of LPS from Porphyromonas gingivalis. Morphometric analyses revealed that LPS induced higher alveolar bone loss (ABL) around the first premolar in animals receiving standard diets, which was exacerbated by the HFD diet. A higher score of acinar inflammation in the liver and higher blood levels of triglycerides and phospholipids were found in HFD-fed rabbits receiving LPS. These results suggest that certain dietary habits can exacerbate some aspects of periodontitis and that bad periodontal health can contribute to dyslipidemia and promote NAFLD progression, but only under certain conditions.
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Abstract
The susceptibility and severity of periodontal diseases is made more severe by diabetes, with the impact on the disease process inversely proportional to the level of glycemic control. Although type 1 diabetes mellitus and type 2 diabetes mellitus have different etiologies, and their impact on bone is not identical, they share many of the same complications. Studies in animals and humans agree that both forms of diabetes increase inflammatory events in periodontal tissue, impair new bone formation, and increase expression of RANKL in response to bacterial challenge. High levels of glucose, reactive oxygen species, and advanced glycation end-products are found in the periodontium of diabetic individuals and lead to increased activation of nuclear factor-kappa B and expression of inflammatory cytokines such as tumor necrosis factor and interleukin-1. Studies in animals, moreover, suggest that there are multiple cell types in periodontal tissues that are affected by diabetes, including leukocytes, vascular cells, mesenchymal stem cells, periodontal ligament fibroblasts, osteoblasts, and osteocytes. The etiology of periodontal disease involves the host response to bacterial challenge that is affected by diabetes, which increases the expression of RANKL and reduces coupled bone formation. In addition, the inflammatory response also modifies the oral microbiota to render it more pathogenic, as demonstrated by increased inflammation and bone loss in animals where bacteria are transferred from diabetic donors to germ-free hosts compared with transfer from normoglycemic donors. This approach has the advantage of not relying upon limited knowledge of the specific bacterial taxa to determine pathogenicity, and examines the overall impact of the microbiota rather than the presumed pathogenicity of a few bacterial groups. Thus, animal studies have provided new insights into pathogenic mechanisms that identify cause-and-effect relationships that are difficult to perform in human studies.
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Affiliation(s)
- Dana T Graves
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Zhenjiang Ding
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Pediatric Dentistry, School of Stomatology, China Medical University, Shenyang, China
| | - Yingming Yang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
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Assante SM, Morimoto S, Tedesco TK, Gimenez T, Ramalho KM. Correlations between dental assistance/oral health and clinical intercurrences in an end-stage kidney disease patients: a historical cohort study. MINERVA STOMATOLOGICA 2020; 69:100-105. [PMID: 32489089 DOI: 10.23736/s0026-4970.19.04151-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND The aim of this study was to correlate the self-report oral health, oral hygiene and dental assistance with clinic intercurrences with hospitalization in adults in End-Stage Kidney Disease patients. METHODS Seventy-seven patients were interviewed during dialysis therapy concerning their self-report oral health, oral hygiene habits and available dental assistance. Clinical intercurrences were assessed in clinical records. Pearson correlations and linear regression tests were applied for statistical analysis. RESULTS There was a strong negative correlation between the number of brushing times/day and patient hospitalization; there was a negative correlation between oral health and patient hospitalization, there was a positive correlation between the number of teeth in the mouth and oral diseases. CONCLUSIONS The study shows an important correlation between oral health, oral hygiene habits, dental assistance and clinical intercurrences with hospitalization in dialysis patients. The results are weighty to establish protocols that can, directly improve, critical health outcomes of end-stage kidney disease patients under dialysis treatment.
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Berlin‐Broner Y, Alexiou M, Levin L, Febbraio M. Characterization of a mouse model to study the relationship between apical periodontitis and atherosclerosis. Int Endod J 2020; 53:812-823. [DOI: 10.1111/iej.13279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/10/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Y. Berlin‐Broner
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - M. Alexiou
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - L. Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - M. Febbraio
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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Role of oral pathogens in the pathogenesis of intracranial aneurysm: review of existing evidence and potential mechanisms. Neurosurg Rev 2020; 44:239-247. [PMID: 32034564 PMCID: PMC7850994 DOI: 10.1007/s10143-020-01253-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/12/2020] [Accepted: 01/27/2020] [Indexed: 12/13/2022]
Abstract
Degeneration of intracranial aneurysm wall is under active research and recent studies indicate an increased risk of rupture of intracranial aneurysm among patients with periodontal diseases. In addition, oral bacterial DNA has been identified from wall samples of ruptured and unruptured aneurysms. These novel findings led us to evaluate if oral diseases could predispose to pathological changes seen on intracranial aneurysm walls eventually leading to subarachnoid hemorrhage. The aim of this review is to consider mechanisms on the relationship between periodontitis and aneurysm rupture, focusing on recent evidence.
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Isola G, Polizzi A, Santonocito S, Alibrandi A, Ferlito S. Expression of Salivary and Serum Malondialdehyde and Lipid Profile of Patients with Periodontitis and Coronary Heart Disease. Int J Mol Sci 2019; 20:E6061. [PMID: 31805680 PMCID: PMC6928957 DOI: 10.3390/ijms20236061] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023] Open
Abstract
Malondialdehyde (MAA) within a lipid pathway has been demonstrated to possess an important role in endothelial function that undergoes periodontitis and coronary heart disease (CHD) development. This study evaluated the impact of periodontitis, CHD, or a combination of both diseases (periodontitis + CHD) on salivary and serum MAA levels. The periodontal and clinical characteristics, serum, and saliva samples were collected from 32 healthy subjects, 34 patients with periodontitis, 33 patients with CHD, and 34 patients with periodontitis and CHD. Lipid profile and levels of MDA and C-reactive protein (CRP) were assessed. Patients in the periodontitis group (serum: 3.92 (3.7-4.4) µmol/L; salivary 1.81 (1-2.1) µmol/g protein, p < 0.01) and in the periodontitis + CHD (serum: 4.34 (3.7-4.8) µmol/L; salivary 1.96 (1.7-2.3) µmol/g protein, p < 0.001) group presented higher median concentrations of salivary and serum MAA compared to patients in the CHD (serum: 3.72 (3.5-4.1) µmol/L; salivary 1.59 (0.9-1.8) µmol/g protein, p < 0.01) and control group (serum: 3.14 (2.8-3.7) µmol/L; salivary 1.41 (0.8-1.6) µmol/g protein, p < 0.01). In univariate models, periodontitis (p = 0.034), CHD (p < 0.001), and CRP (p < 0.001) were significantly associated with MAA. In the multivariate model, only CRP remained a significant predictor of serum and salivary MAA (p < 0.001) MAA levels. Patients with periodontitis and with periodontitis + CHD presented higher levels of salivary and serum MAA compared to healthy subjects and CHD patients. CRP has been found to be a significant predictor of increased salivary and serum MAA levels.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, 98122 Messina, Italy
| | - Sebastiano Ferlito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
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Qi J, Zihang Z, Zhang J, Park YM, Shrestha D, Jianling B, Merchant AT. Periodontal Antibodies and All-Cause and Cardiovascular Disease Mortality. J Dent Res 2019; 99:51-59. [PMID: 31634041 DOI: 10.1177/0022034519884012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Periodontitis is positively linked to cardiovascular disease (CVD), diabetes, cancer, and increased mortality. Empirically derived clusters of IgG antibodies against 19 selected periodontal microorganisms have been associated with hyperglycemia. We further investigated associations between these serum IgG antibody clusters and all-cause and CVD mortality in a representative US population. Participants free of CVD and cancer and aged ≥40 y at baseline (N = 6,491) from the Third National Health and Nutrition Examination Survey (1988 to 1994) were followed up until December 31, 2011. Antibodies were categorized into 4 clusters: red-green, orange-red, yellow-orange, and orange-blue. Over a 23-y follow-up, 2,702 deaths occurred, including 810 CVD-related deaths. In fully adjusted Cox proportional hazard models, the red-green cluster was positively associated with all-cause mortality (tertile 3 vs. tertile 1: hazard ratio [HR] = 1.43, 95% CI = 1.08 to 1.90, P = 0.015). The yellow-orange cluster was inversely associated with all-cause mortality (tertile 3 vs. tertile 1: HR = 0.78, 95% CI = 0.63 to 0.97, P = 0.028) and CVD mortality (tertile 2 vs. tertile 1: HR = 0.57, 95% CI = 0.42 to 0.77, P = 0.005). The orange-blue cluster (composed of antibodies against Eubacterium nodatum and Actinomyces naeslundii) was inversely associated with all-cause mortality (tertile 3 vs. tertile 1: HR = 0.65, 95% CI = 0.55 to 0.78, P < 0.0001) and CVD mortality (tertile 3 vs. tertile 1: HR = 0.65, 95% CI = 0.47 to 0.88, P = 0.007). These antibodies could predict prognosis or be potential intervention targets to prevent systemic effects of periodontal disease if further studies establish a causal relationship.
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Affiliation(s)
- J Qi
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Z Zihang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - J Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Y M Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - D Shrestha
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - B Jianling
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - A T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Ebrahim HF, Abdel Hamid FF, Haykal MA, Soliman AF. Cyclophilin A and matrix metalloproteinase-9: Their relationship, association with, and diagnostic relevance in stable coronary artery disease. Vascular 2019; 28:212-221. [PMID: 31594532 DOI: 10.1177/1708538119879589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objectives Data about the circulating levels of cyclophilin A and matrix metalloproteinase-9 in stable coronary artery disease are contradictory. Moreover, their relationship in this disease is not established yet. Thus, this study was designed to assess the relationship between the circulating levels of cyclophilin A and matrix metalloproteinase-9 in coronary artery disease patients with and without type 2 diabetes mellitus (T2DM). Methods Serum levels of cyclophilin A, matrix metalloproteinase-9, and high sensitive C-reactive protein (hsCRP) along with fasting blood glucose, glycated hemoglobin, serum lipids, and the anthropometric parameters were measured in 120 participants who were divided equally into four groups (i) normal controls, (ii) T2DM patients, (iii) stable coronary artery disease patients with T2DM, and (iv) stable coronary artery disease patients without T2DM. Results Levels of cyclophilin A and matrix metalloproteinase-9 were significantly elevated in sera of coronary artery disease patients with and without T2DM compared to normal controls and T2DM patients. In multiple linear regression models, only cyclophilin A was observed in the final model where it explained the 24.9% variability of matrix metalloproteinase-9. Additionally, high circulating levels of cyclophilin A and matrix metalloproteinase-9 were associated with an increased risk of developing stable coronary artery disease. Finally, the diagnostic efficacy of cyclophilin A and matrix metalloproteinase-9 to discriminate stable coronary artery disease patients with and without T2DM from subjects without coronary artery disease was found to be higher than that of hsCRP. Conclusion Serum level of cyclophilin A might be a determinant factor of matrix metalloproteinase-9 level; both may contribute to the pathogenesis of stable coronary artery disease and they appear to be valuable diagnostic biomarkers of stable coronary artery disease with and without T2DM.
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Affiliation(s)
- Hala F Ebrahim
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Fatma F Abdel Hamid
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Mohamed A Haykal
- Cardiovascular and Ultrasonography Unit, Research Institute of Ophthalmology, Council of Research Centers and Institutes, Giza, Egypt
| | - Ahmed F Soliman
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
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Suh JS, Kim S, Boström KI, Wang CY, Kim RH, Park NH. Periodontitis-induced systemic inflammation exacerbates atherosclerosis partly via endothelial-mesenchymal transition in mice. Int J Oral Sci 2019; 11:21. [PMID: 31257363 PMCID: PMC6802639 DOI: 10.1038/s41368-019-0054-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/07/2019] [Accepted: 05/19/2019] [Indexed: 12/20/2022] Open
Abstract
Growing evidence suggests close associations between periodontitis and atherosclerosis. To further understand the pathological relationships of these associations, we developed periodontitis with ligature placement around maxillary molars or ligature placement in conjunction with Porphyromonas gingivalis lipopolysaccharide injection at the ligature sites (ligature/P.g. LPS) in Apolipoprotein E knock out mice and studied the atherogenesis process in these animals. The mice were fed with high fat diet for 11 weeks and sacrificed for analyzing periodontitis, systemic inflammation, and atherosclerosis. Controls did not develop periodontitis or systemic inflammation and had minimal lipid deposition in the aortas, but mice receiving ligature or ligature/P.g. LPS showed severe periodontitis, systemic inflammation, and aortic plaque formation. The aortic plaque contained abundant macrophages and cells expressing both endothelial and mesenchymal cell markers. The severity of periodontitis was slightly higher in mice receiving ligature/P.g. LPS than ligature alone, and the magnitude of systemic inflammation and aortic plaque formation were also notably greater in the mice with ligature/P.g. LPS. These observations indicate that the development of atherosclerosis is due to systemic inflammation caused by severe periodontitis. In vitro, P.g. LPS enhanced the secretion of pro-inflammatory cytokines from macrophages and increased the adhesion of monocytes to endothelial cells by upregulating the expression of adhesion molecules from endothelial cells. Moreover, secretory proteins, such as TNF-α, from macrophages induced endothelial–mesenchymal transitions of the endothelial cells. Taken together, systemic inflammation induced by severe periodontitis might exacerbate atherosclerosis via, in part, causing aberrant functions of vascular endothelial cells and the activation of macrophages in mice.
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Affiliation(s)
- Jin Sook Suh
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Sol Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Kristina I Boström
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Cun-Yu Wang
- Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, CA, USA.,UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Bioengineering, UCLA Samueli School of Engineering, Los Angeles, CA, USA
| | - Reuben H Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA.,UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - No-Hee Park
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA. .,Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. .,UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
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Getz TM, Hoffman GS, Padmanabhan R, Villa-Forte A, Roselli EE, Blackstone E, Johnston D, Pettersson G, Soltesz E, Svensson LG, Calabrese LH, Clifford AH, Eng C. Microbiomes of Inflammatory Thoracic Aortic Aneurysms Due to Giant Cell Arteritis and Clinically Isolated Aortitis Differ From Those of Non-Inflammatory Aneurysms. Pathog Immun 2019; 4:105-123. [PMID: 30993253 PMCID: PMC6438704 DOI: 10.20411/pai.v4i1.269] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 02/21/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE We sought to characterize microbiomes of thoracic aortas from patients with non-infectious aortitis due to giant cell arteritis (GCA) and clinically isolated aortitis (CIA) and to compare them to non-inflammatory aorta aneurysm controls. We also compared microbiomes from concurrently processed and separately reported temporal arteries (TA) and aortas. METHODS From 220 prospectively enrolled patients undergoing surgery for thoracic aorta aneurysm, 49 were selected. Inflammatory and non-inflammatory cases were selected based on ability to match for age (+/-10 years), gender, and race. Biopsies were collected under aseptic conditions and snap-frozen. Taxonomic classification of bacterial sequences was performed to the genus level and relative abundances were calculated. Microbiome differential abundances were analyzed by principal coordinates analysis. RESULTS Forty-nine patients with thoracic aortic aneurysms (12 CIA, 14 GCA, 23 non-inflammatory aneurysms) were enrolled. Alpha (P=0.018) and beta (P=0.024) diversity differed between specimens from aortitis cases and controls. There were no significant differences between CIA and GCA (P>0.7). The largest differential abundances between non-infectious aortitis and non-inflammatory control samples included Enterobacteriaceae, Phascolarctobacterium, Acinetobactor, Klebsiella, and Prevotella. Functional metagenomic predictions with PICRUSt revealed enrichment of oxidative phosphorylation and porphyrin metabolism pathways and downregulation of transcription factor pathways in aortitis compared to controls. Microbiomes of aortic samples differed significantly from temporal artery samples from a companion study, in both control and GCA groups (P=0.0002). CONCLUSION Thoracic aorta aneurysms, far from being sterile, contain unique microbiomes that differ from those found in temporal arteries. The aorta microbiomes are most similar between aneurysms that were associated with inflammation, GCA, and CIA, but differed from those associated with non-inflammatory etiologies. These findings are promising in that they indicate that microbes may play a role in the pathogenesis of aortitis-associated aneurysms or non-inflammatory aneurysms by promoting or protecting against inflammation. However, we cannot rule out that these changes are related to alterations in tissue substrate that favor secondary changes in microbial communities.
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Affiliation(s)
- Ted M. Getz
- Genomic Medicine Institute; Lerner Research Institute; Cleveland Clinic; Cleveland, Ohio
| | - Gary S. Hoffman
- Center for Vasculitis Care and Research; Department of Rheumatic and Immunologic Diseases; Cleveland Clinic; Cleveland, Ohio
| | - Roshan Padmanabhan
- Genomic Medicine Institute; Lerner Research Institute; Cleveland Clinic; Cleveland, Ohio
| | - Alexandra Villa-Forte
- Center for Vasculitis Care and Research; Department of Rheumatic and Immunologic Diseases; Cleveland Clinic; Cleveland, Ohio
| | - Eric E. Roselli
- Center for Aortic Diseases; Heart Vascular Institute; Cleveland Clinic; Cleveland, Ohio
| | - Eugene Blackstone
- Center for Aortic Diseases; Heart Vascular Institute; Cleveland Clinic; Cleveland, Ohio
| | - Douglas Johnston
- Center for Aortic Diseases; Heart Vascular Institute; Cleveland Clinic; Cleveland, Ohio
| | - Gosta Pettersson
- Center for Aortic Diseases; Heart Vascular Institute; Cleveland Clinic; Cleveland, Ohio
| | - Edward Soltesz
- Center for Aortic Diseases; Heart Vascular Institute; Cleveland Clinic; Cleveland, Ohio
| | - Lars G. Svensson
- Center for Aortic Diseases; Heart Vascular Institute; Cleveland Clinic; Cleveland, Ohio
| | - Leonard H. Calabrese
- Center for Vasculitis Care and Research; Department of Rheumatic and Immunologic Diseases; Cleveland Clinic; Cleveland, Ohio
| | - Alison H. Clifford
- Center for Vasculitis Care and Research; Department of Rheumatic and Immunologic Diseases; Cleveland Clinic; Cleveland, Ohio
- Division of Rheumatology; Department of Medicine; University of Alberta; Edmonton, Alberta T6G 2R7, Canada
| | - Charis Eng
- Genomic Medicine Institute; Lerner Research Institute; Cleveland Clinic; Cleveland, Ohio
- Taussig Cancer Institute; Cleveland Clinic; Cleveland, Ohio
- Department of Genetics and Genome Sciences; Case Western Reserve University School of Medicine; Cleveland, Ohio
- Germline High Risk Focus Group; CASE Comprehensive Cancer Center; Case Western Reserve University School of Medicine; Cleveland, Ohio
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Pan W, Yin W, Yang L, Xue L, Ren J, Wei W, Lu Q, Ding H, Liu Z, Nabar NR, Wang M, Hao L. Inhibition of Ctsk alleviates periodontitis and comorbid rheumatoid arthritis via downregulation of the TLR9 signalling pathway. J Clin Periodontol 2019; 46:286-296. [PMID: 30636333 DOI: 10.1111/jcpe.13060] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 11/27/2018] [Accepted: 01/04/2019] [Indexed: 02/05/2023]
Abstract
AIM In this study, we investigate the mechanistic link between rheumatoid arthritis (RA) and periodontitis to identify a novel target (cathepsin K; Ctsk) for the treatment of comorbid periodontitis and RA. METHODS An experimental model of periodontitis with arthritis was established in DBA/1 mice. We then tested the effect of BML-244, a specific inhibitor of Ctsk, by quantifying several inflammatory markers of TLR9 signalling both in vivo and in vitro. RESULTS Our results showed that periodontitis-rheumatoid arthritis comorbidity causes severer periodontal bone and joint cartilage destruction than either disease alone. Inhibition of Ctsk reduced infiltration by dendritic cells and T cells and inflammatory cytokine production; these improvements alleviated the hard-tissue erosion in periodontitis and RA as measured by bone erosion in periodontal lesions and cartilage destruction in knee joints. Inhibition of Ctsk also decreased the expression of TLR4 and TLR9 in vivo, whereas in vitro experiments indicated that Ctsk is involved specifically in the production of cytokines in response to TLR9 engagement. CONCLUSION Our data reveal that periodontitis and RA may have additive pathological effects through dysregulation of the TLR9 pathway and that Ctsk is a critical mediator of this pathway and contributes to the pathogenesis of RA and periodontitis.
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Affiliation(s)
- Weiyi Pan
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Wuwei Yin
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Li Yang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Lili Xue
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jie Ren
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Wei Wei
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Qiuyu Lu
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Handong Ding
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Zhaohui Liu
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Neel R Nabar
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Min Wang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Liang Hao
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
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O'Boyle C, Haley MJ, Lemarchand E, Smith CJ, Allan SM, Konkel JE, Lawrence CB. Ligature-induced periodontitis induces systemic inflammation but does not alter acute outcome after stroke in mice. Int J Stroke 2019; 15:175-187. [PMID: 30794103 PMCID: PMC7045281 DOI: 10.1177/1747493019834191] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Stroke is a major cause of disability and mortality. Poorer outcome after stroke is associated with concomitant inflammatory and infectious disease. Periodontitis is a chronic inflammatory disease of the dental supporting structures and is a prominent risk factor for many systemic disorders, including cardiovascular disease and stroke. While epidemiological studies suggest that periodontitis increases the likelihood of stroke, its impact on stroke severity is poorly understood. Here, we sought to determine the contribution of periodontitis to acute stroke pathology. Methods We characterized a murine ligature model of periodontitis for inflammatory responses that could potentially impact stroke outcome. We applied this model and then subjected mice to either transient or permanent middle cerebral artery occlusion. We also enhanced the periodontitis model with repeated intravenous administration of a periodontal-specific lipopolysaccharide to better mimic the clinical condition. Results Ligature-induced periodontitis caused bone loss, bacterial growth, and increased local inflammatory cell trafficking. Systemically, periodontitis increased circulating levels of pro-inflammatory cytokines, and primed bone marrow monocytes to produce elevated tumour necrosis factor-alpha (TNFα). Despite these changes, periodontitis alone or in tandem with repeated lipopolysaccharide challenge did not alter infarct volume, blood–brain barrier breakdown, or systemic inflammation after experimental stroke. Conclusions Our data show that despite elevated systemic inflammation in periodontitis, oral inflammatory disease does not impact acute stroke pathology in terms of severity, determined primarily by infarct volume. This indicates that, at least in this experimental paradigm, periodontitis alone does not alter acute outcome after cerebral ischemia.
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Affiliation(s)
- Conor O'Boyle
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Michael J Haley
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Eloise Lemarchand
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Craig J Smith
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,Greater Manchester Comprehensive Stroke Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK
| | - Stuart M Allan
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Joanne E Konkel
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,Manchester Collaborative Centre for Inflammation Research (MCCIR), Core Technology Facility, The University of Manchester, Manchester, UK
| | - Catherine B Lawrence
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
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Akhi R, Wang C, Nissinen AE, Kankaanpää J, Bloigu R, Paju S, Mäntylä P, Buhlin K, Sinisalo J, Pussinen PJ, Hörkkö S. Salivary IgA to MAA-LDL and Oral Pathogens Are Linked to Coronary Disease. J Dent Res 2019; 98:296-303. [PMID: 30669938 DOI: 10.1177/0022034518818445] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A large body of literature has established the link between periodontal disease and cardiovascular disease. Oxidized low-density lipoproteins (OxLDLs) have a crucial role in atherosclerosis progression through initiation of immunological response. Monoclonal IgM antibodies to malondialdehyde-modified low-density lipoprotein (MDA-LDL) and to malondialdehyde acetaldehyde-modified low-density lipoprotein (MAA-LDL) have been shown to cross-react with the key virulence factors of periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. We have previously shown that salivary IgA antibodies to MAA-LDL cross-react with P. gingivalis in healthy humans. In this study, we aim to assess whether oral mucosal immune response represented by salivary IgA to MAA-LDL and oral pathogens is associated with coronary artery disease (CAD). Also, the molecular mimicry through antibody cross-reaction between salivary IgA to MAA-LDL and oral pathogens was evaluated. The study subjects consisted of 451 patients who underwent a coronary angiography with no CAD ( n = 133), stable CAD ( n = 169), and acute coronary syndrome (ACS, n = 149). Elevated salivary IgA antibody levels to MAA-LDL, Rgp44 (gingipain A hemagglutinin domain of P. gingivalis), and Aa-HSP60 (heat shock protein 60 of A. actinomycetemcomitans) were discovered in stable-CAD and ACS patients when compared to no-CAD patients. In a multinomial regression model adjusted for known cardiovascular risk factors, stable CAD and ACS were associated with IgA to MAA-LDL ( P = 0.016, P = 0.043), Rgp44 ( P = 0.012, P = 0.004), Aa-HSP60 ( P = 0.032, P = 0.030), Tannerella forsythia ( P = 0.002, P = 0.004), Porphyromonas endodontalis ( P = 0.016, P = 0.020), Prevotella intermedia ( P = 0.038, P = 0.005), and with total IgA antibody concentration ( P = 0.002, P = 0.016). Salivary IgA to MAA-LDL showed cross-reactivity with the oral pathogens tested in the study patients. The study highlights an association between salivary IgA to MAA-LDL and atherosclerosis. However, whether salivary IgA to MAA-LDL and the related oral humoral responses play a causal role in the development in the CAD should be elucidated in the future.
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Affiliation(s)
- R Akhi
- 1 Medical Microbiology and Immunology, Research Unit of Biomedicine, University of Oulu, Oulu, Finland.,2 Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,3 Nordlab, Oulu University Hospital, Oulu, Finland
| | - C Wang
- 1 Medical Microbiology and Immunology, Research Unit of Biomedicine, University of Oulu, Oulu, Finland.,2 Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,3 Nordlab, Oulu University Hospital, Oulu, Finland
| | - A E Nissinen
- 1 Medical Microbiology and Immunology, Research Unit of Biomedicine, University of Oulu, Oulu, Finland.,2 Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,3 Nordlab, Oulu University Hospital, Oulu, Finland
| | - J Kankaanpää
- 1 Medical Microbiology and Immunology, Research Unit of Biomedicine, University of Oulu, Oulu, Finland.,2 Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,3 Nordlab, Oulu University Hospital, Oulu, Finland
| | - R Bloigu
- 4 Medical Informatics and Statistics Research Group Oulu, University of Oulu, Oulu, Finland
| | - S Paju
- 5 Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P Mäntylä
- 5 Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,6 Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,7 Kuopio University Hospital, Oral and Maxillofacial Diseases, Kuopio, Finland
| | - K Buhlin
- 5 Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,8 Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - J Sinisalo
- 9 HUCH Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - P J Pussinen
- 5 Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S Hörkkö
- 1 Medical Microbiology and Immunology, Research Unit of Biomedicine, University of Oulu, Oulu, Finland.,2 Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,3 Nordlab, Oulu University Hospital, Oulu, Finland
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50
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Pereira LC, Nascimento JCR, Rêgo JMC, Canuto KM, Crespo-Lopez ME, Alvarez-Leite JI, Baysan A, Oriá RB. Apolipoprotein E, periodontal disease and the risk for atherosclerosis: a review. Arch Oral Biol 2018; 98:204-212. [PMID: 30503976 DOI: 10.1016/j.archoralbio.2018.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/25/2018] [Accepted: 11/10/2018] [Indexed: 12/26/2022]
Abstract
The association between cardiovascular and periodontal diseases is characterized by chronic inflammatory processes, with a high prevalence worldwide and complex genetic-environment interactions. Although apolipoprotein E4 (ApoE4), one of the isoforms coded by a polymorphic APOE gene, has been widely recognized as a risk factor for cardiovascular diseases and as an immunoinflammatory factor, less is known regarding how ApoE4 affects atherosclerosis in periodontitis patients. The aim of this review was to investigate the potential underlying mechanisms related to APOE4 that could increase the risk of periodontal disease and, ultimately, of atherosclerosis. There have only been a few studies addressing apoE polymorphisms in patients with chronic periodontitis. To date, no studies have been performed that have assessed how ApoE4 affects atherosclerotic disease in chronic periodontitis patients. Although clinical studies are warranted, experimental studies have consistently documented the presence of periodontal pathogens, which are usually found in the oral cavity and saliva, in the atherosclerotic plaques of ApoE-deficient mice. In addition, in this review, the potential role of the APOE4 allele as an example of antagonistic pleiotropy during human evolution and its relation to oral health is discussed.
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Affiliation(s)
- L C Pereira
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - J C R Nascimento
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - J M C Rêgo
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - K M Canuto
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - M E Crespo-Lopez
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Para, Belém, PA, Brazil
| | - J I Alvarez-Leite
- Institute of Biological Sciences, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - A Baysan
- Institute of Dentistry, Barts and the London, School of Medicine and Dentistry, Queen Mary University, London, UK
| | - R B Oriá
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil.
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