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Varma S, Thomas B, Subrahmanyam K, Duarte K, Alsaegh MA, Gopinath D, Kuriadom ST, Narayanan J, Desai VB, Khair AMB, Afrashtehfar KI. Salivary levels of inflammatory and anti-inflammatory biomarkers in periodontitis patients with and without acute myocardial infarction: implications for cardiovascular risk assessment. FRONTIERS IN ORAL HEALTH 2024; 5:1332980. [PMID: 38433948 PMCID: PMC10904480 DOI: 10.3389/froh.2024.1332980] [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: 11/04/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Background Periodontitis is initiated by a dysbiotic activity and furthermore leads to a chronic inflammatory response. The presence of pro-inflammatory markers plays an important role in the inflammatory load. Macrophage inflammatory protein-1 alpha (MIP-1α) and C-reactive protein (CRP) are pro- inflammatory biomarkers that quantify clinical and subclinical inflammation in cardiac ischemia in cardiac inflammation and disease. Adiponectin is an anti-inflammatory marker associated with good health. The susceptibility of periodontitis patients to cardiovascular events needs to be evaluated. Objective This study aims to assess the levels of biomarkers in periodontitis patients with and without acute myocardial infarction (AMI) compared to controls. Material and methods Pro-inflammatory and anti-inflammatory analytes were examined by collecting unstimulated saliva from three groups (n = 20/each): healthy individuals, individuals with stage III periodontitis, and post-myocardial infarction patients with stage III periodontitis. The samples were collected within 48 h of AMI. Results Adiponectin levels were significantly lower in patients with periodontitis with and without AMI compared to controls, while CRP and MIP-1α were significantly higher in patients with periodontitis with and without AMI compared to controls. The highest titers for MIP-1α and CRP were detected among patients with periodontitis with and AMI. Conclusion Our study provides possible evidence of the association between periodontitis and salivary analytes that occur in tandem with cardiovascular disease. The lower levels of Adiponectin and higher levels of CRP and MIP-1α in patients with periodontitis indicate that this condition is a potential risk factor for cardiovascular disease. The findings emphasize the importance of early detection and intervention for periodontitis patients to prevent cardiovascular events.
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Affiliation(s)
- Sudhir Varma
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates
| | - Biju Thomas
- AB Shetty Memorial Institute of Dental Sciences, Mangalore, India
- NITTE (Deemed to be University), Mangalore, India
| | - K. Subrahmanyam
- NITTE (Deemed to be University), Mangalore, India
- K.S. Hegde Hospital, Mangalore, India
| | - Kimberly Duarte
- AB Shetty Memorial Institute of Dental Sciences, Mangalore, India
- K.S. Hegde Hospital, Mangalore, India
| | - Mohammed A. Alsaegh
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Divya Gopinath
- Department of Basic Sciences, Ajman University, Ajman, United Arab Emirates
| | - Sam T. Kuriadom
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates
| | - Jayaraj Narayanan
- Department of Basic Sciences, Ajman University, Ajman, United Arab Emirates
| | - Vijay B. Desai
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates
| | | | - Kelvin I. Afrashtehfar
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates
- Bern Center for Precision Medicine, Medical School, University of Bern, Bern, Switzerland
- Department of Orthodontics, University Hospital RWTH Aachen, Aachen, Germany
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Szustkiewicz-Karoń A, Schönborn M, Patrycja Pasieka, Płotek A, Maga P, Gregorczyk-Maga I. Biomarkers of Cardiovascular Diseases in Saliva and Gingival Crevicular Fluid: A Review. Angiology 2023; 74:909-947. [PMID: 36268801 DOI: 10.1177/00033197221134757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Due to the fact that cardiovascular diseases (CVDs) have become the most serious problem in public health, there is a need for new and efficient methods for screening and early detection. In the recent literature, saliva and gingival crevicular fluid (GCF) have been gaining recognition as sources of many potential biomarkers of various systemic diseases, mainly because of correlation between the level of some compounds in the blood and saliva and association between the composition of saliva and health status. In this review, we summarize published findings of patients with atherosclerosis, arterial hypertension, coronary artery disease (CAD), acute coronary syndrome (ACS), and stroke in the context of clinical utility of saliva and GCF in diagnosing and assessing CVD severity. We hypothesize that substances in saliva including inflammatory markers, enzymes, or hormones might become novel contributors to the diagnosis and screening of CVDs. In particular, C-reactive protein (CRP), tumor necrosis alpha (TNFα), and cortisol seem to be the most promising. However, further investigation is warranted to determine the most effective markers and methods for their analysis.
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Affiliation(s)
| | - Martyna Schönborn
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
- Doctoral School of Medical and Health Sciences, Jagiellonian University, Kraków, Poland
| | - Patrycja Pasieka
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Płotek
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Maga
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | - Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
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Shi L, Du X, Li J, Zhang G. Bioinformatics and Systems Biology Approach to Identify the Pathogenetic Link Between Psoriasis and Cardiovascular Disease. Clin Cosmet Investig Dermatol 2023; 16:2283-2295. [PMID: 37635735 PMCID: PMC10460209 DOI: 10.2147/ccid.s421193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
Objective This study aimed to identify hub genes and common pathways shared between psoriasis and cardiovascular disease (CVD) using bioinformatics analysis and predict the transcription factors (TFs) of hub genes. Methods GSE133555 data from the Gene Expression Omnibus (GEO) database were used to identify differentially expressed genes (DEGs) between involved and uninvolved skin lesions in psoriasis, employing the limma package in R. Additionally, CVD-related genes were obtained from the GeneCards database. The intersection of DEGs and CVD-related genes yielded CVD-DEGs. Gene Ontology and signaling pathway analyses were performed using the clusterProfiler package in R. Hub genes were identified by intersecting six algorithms in the CytoHubba plugin of Cytoscape. To identify potential biomarkers, the GSE14905 dataset was subjected to receiver operating characteristic analysis, resulting in the identification of eight central hub genes. Finally, the NetworkAnalyst web tool was used to identify the TFs of the eight hub genes. Results We identified 92 significant DEGs out of 1825 CVD-related genes in psoriasis obtained from the GSE13355 and GeneCard data. Functional enrichment analysis revealed the involvement of these genes in various signaling pathways, including the interleukin-17 signaling, tumor necrosis factor signaling, lipid and atherosclerosis, chemokine signaling, and cytokine signaling pathways in the immune system. The eight hub genes identified included interleukin-1 beta, C-X-C motif chemokine ligand 8, signal transducer and activator of transcription 3, C-C motif chemokine ligand 2, arginase 1, C-X-C motif chemokine receptor 4, cyclin D1, and matrix metallopeptidase 9, with forkhead box C1 also identified as an associated TF of these genes. These hub genes and TF may act as key regulators in the context of CVD. Conclusion This study identified several hub genes and signaling pathways associated with both CVD and psoriasis. These findings lay the groundwork for potential therapeutic interventions for patients with psoriasis affected by CVD.
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Affiliation(s)
- Liping Shi
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
- Candidate Branch of National Clinical Research Center for Skin Diseases, Shijiazhuang, People’s Republic of China
| | - Xiaoqing Du
- Department of Dermatology, Bethune International Peace Hospital, Shijiazhuang, People’s Republic of China
| | - Jing Li
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
- Candidate Branch of National Clinical Research Center for Skin Diseases, Shijiazhuang, People’s Republic of China
| | - Guoqiang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China
- Candidate Branch of National Clinical Research Center for Skin Diseases, Shijiazhuang, People’s Republic of China
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Nijakowski K, Jankowski J, Gruszczyński D, Surdacka A. Salivary Alterations of Myeloperoxidase in Patients with Systemic Diseases: A Systematic Review. Int J Mol Sci 2023; 24:12078. [PMID: 37569455 PMCID: PMC10418962 DOI: 10.3390/ijms241512078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Salivary myeloperoxidase (MPO) is a key mediator of the oral immune system, acting as an enzyme that utilises H2O2 to generate molecules with high bactericidal activity. While MPO determination in plasma is quite common, the use of saliva is still rare. Our systematic review was designed to answer the question "Are salivary levels of myeloperoxidase altered in patients with systemic diseases?". Following the inclusion and exclusion criteria, we included twenty-six studies. Altered MPO levels in saliva were most commonly found in patients with cardiovascular and gastrointestinal diseases. Most studies concerned unstimulated whole saliva, and only a few of them stimulated, mainly by chewing paraffin. Enzyme-linked immunosorbent assay (ELISA) was the most common method for determination of MPO concentrations in saliva. Increased salivary MPO levels were more often observed for inflammatory diseases, except patients with inflammatory bowel diseases who were eligible for biologic therapy. In conclusion, MPO could be altered in the saliva of patients with systematic diseases, especially cardiovascular or gastrointestinal diseases. However, further investigations are recommended to validate these outcomes.
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Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
| | - Jakub Jankowski
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (J.J.); (D.G.)
| | - Dawid Gruszczyński
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland; (J.J.); (D.G.)
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
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Lähteenmäki H, Pätilä T, Pärnänen CP, Räisänen I, Tervahartiala T, Gupta S, Sorsa T. aMMP-8 point-of-care - diagnostic methods and treatment modalities in periodontitis and peri-implantitis. Expert Opin Ther Targets 2023; 27:627-637. [PMID: 37522314 DOI: 10.1080/14728222.2023.2240014] [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: 04/19/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION When collected in a standardized fashion, oral fluid analysis can refine the diagnosis of periodontal and peri-implant disease. In practice, dental professionals can perform active matrix metalloproteinase (aMMP-8) analysis chairside. AREAS COVERED Periodontal tissues are mainly made up of type I collagen, and collagen breakdown is one of the main events in periodontal and peri-implantitis destructive lesions. In addition to traditional measurements, their diagnosis can be refined with tests utilizing oral fluids. The active matrix metalloproteinase-8 (aMMP-8) is possible to be determined from the gingival crevicular fluid (GCF), peri-implant sulcus fluid (PISF), and other oral fluids such as mouth rinse and saliva. We also investigated the applicability of aMMP-8 chair-side test kits in the evaluation of oral health benefits of different adjunctive host-modulating periodontal therapies including fermented lingonberry mouthwash (FLJ) and antibacterial photodynamic therapy (aPDT). EXPERT OPINION The aMMP-8 levels can more reliably detect early activation of periodontal and peri-implant disease as compared to traditional diagnostic methods that assess the experienced health status or past disease, rather than the present or future pathology. Novel therapies like, fermented lingonberry juice as a mouthrinse or aPDT, are potential host-modulating adjunctive treatments to reduce the signs of oral inflammation and infection.
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Affiliation(s)
- Hanna Lähteenmäki
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Tommi Pätilä
- Department of Pediatric Heart Surgery and Organ Transplantation, New Children's Hospital, Helsinki University, Helsinki, Finland
| | - C Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Ismo Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Shipra Gupta
- Unit of Periodontology, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Rathnayake N, Gustafsson A, Sorsa T, Norhammar A, Bostanci N. Association of peptidoglycan recognition protein 1 to post-myocardial infarction and periodontal inflammation: A subgroup report from the PAROKRANK (Periodontal Disease and the Relation to Myocardial Infarction) study. J Periodontol 2022; 93:1325-1335. [PMID: 35344208 PMCID: PMC9796725 DOI: 10.1002/jper.21-0595] [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: 10/11/2021] [Revised: 01/27/2022] [Accepted: 02/21/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Peptidoglycan recognition protein 1 (PGLYRP1) is an antimicrobial and proinflammatory innate immunity protein activated during infections. We aimed to investigate whether PGYLRP1 and associated molecules of the immune response in saliva is a cumulative outcome result of both MI and periodontal inflammation. METHODS AND RESULTS Two hundred patients with MI and another 200 matched non-MI controls were included. A full-mouthexamination was conducted to assess periodontal inflammation and collection of stimulated saliva was performed 6 to 10 weeks after the first MI. PGLYRP1, triggering receptor expressed on myeloid cells 1 (TREM-1), interleukin-1 beta (IL-1β) were analyzed by ELISA. Matrix metalloproteinase (MMP)-8 levels were determined by IFMA. Compared to controls, MI patients showed higher salivary PGLYRP1, but not TREM-1 levels. The difference in PGLYRP1 levels remained after adjustment for covariates. In MI patients, the PGLYRP1 levels positively correlated with BOP and PPD 4 to 5 mm. Among non-MI subjects, the levels of PGLYRP1 correlated positively and significantly with BOP and total PPD. Salivary PGLYRP1 concentrations also showed strong positive correlations with levels of TREM-1, IL-1β and MMP-8. In multivariate linear regression analysis, in MI patients, BOP and former smokingstatus displayed an association with salivary PGLYRP1 concentration. CONCLUSION MI patients showed higher salivary PGLYRP1 levels than healthy controls, also after adjusting for smoking, sex, age and periodontal health status. Salivary levels of PGLYRP1 may reflect the overall inflammatory burden to chronic bacterial exposure, possibly underpinning the observed associations between periodontitis and exposure with MI.
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Affiliation(s)
- Nilminie Rathnayake
- Section of Oral Health and PeriodontologyDivision of Oral DiseasesDepartment of Dental Medicine, Karolinska InstitutetHuddingeSweden,University of HelsinkiHelsinki University Central HospitalDepartment of Oral and Maxillofacial DiseasesHelsinkiFinland
| | - Anders Gustafsson
- Section of Oral Health and PeriodontologyDivision of Oral DiseasesDepartment of Dental Medicine, Karolinska InstitutetHuddingeSweden
| | - Timo Sorsa
- University of HelsinkiHelsinki University Central HospitalDepartment of Oral and Maxillofacial DiseasesHelsinkiFinland
| | - Anna Norhammar
- Cardiology UnitDepartment of MedicineKarolinska InstitutetKarolinska University Hospital SolnaStockholmSweden,Capio Saint Göran's HospitalStockholmSweden
| | - Nagihan Bostanci
- Section of Oral Health and PeriodontologyDivision of Oral DiseasesDepartment of Dental Medicine, Karolinska InstitutetHuddingeSweden
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Gao S, Tian J, Li Y, Liu T, Li R, Yang L, Xing Z. Periodontitis and Number of Teeth in the Risk of Coronary Heart Disease: An Updated Meta-Analysis. Med Sci Monit 2021; 27:e930112. [PMID: 34421117 PMCID: PMC8394608 DOI: 10.12659/msm.930112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background A positive link between periodontitis and chronic systemic disease has been indicated. However, few studies focused on the loss of teeth. Our analysis aims to analyze the relationship of periodontitis and number of teeth with the risk of coronary heart disease (CHD). Material/Methods A meta-analysis was conducted on qualified data extracted from the PubMed, Embase, and Cochrane Library databases. Only cohort studies were included in this study. We screened articles that assessed the periodontal condition and teeth number as well as the incidence or mortality of CHD. Hazard ratio (HR) and relative risk (RR) were calculated by Stata SE software. Results A total of 11 prospective studies with over 200 000 total participants were analyzed. Ten studies reported on periodontitis and CHD, and 4 studies included data on number of teeth. After adjusting for multivariate factors, there was a significant association between periodontitis and the risk of CHD (RR, 1.18; 95% confidence interval [CI], 1.10–1.26); the RR of CHD in the edentulous population was 1.20 (95% CI, 1.08–1.34). Moreover, results on the RR values for number of teeth were as follows: 24–17 teeth (RR, 1.12; 95% CI, 1.05–1.19); 16–11 (RR, 1.28; 95% CI, 1.15–1.42); and ≤10 (RR, 1.55; 95% CI, 1.43–1.69). Conclusions Our study showed that periodontitis is a risk factor for CHD and that the number of removed teeth is positively correlated with the risk of CHD. During clinical assessment, both factors need to be considered as factors associated with cardiovascular risks.
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Affiliation(s)
- Shuting Gao
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Jinhui Tian
- Center of Evidence-Based Medicine, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Yiting Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Tingjie Liu
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Ruiping Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Lan Yang
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Zhankui Xing
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
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Isola G, Polizzi A, Ronsivalle V, Alibrandi A, Palazzo G, Lo Giudice A. Impact of Matrix Metalloproteinase-9 during Periodontitis and Cardiovascular Diseases. Molecules 2021; 26:molecules26061777. [PMID: 33810003 PMCID: PMC8004886 DOI: 10.3390/molecules26061777] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 02/07/2023] Open
Abstract
Matrix metalloproteinase-9 (MMP-9) has been shown to play a key role in endothelial function and perhaps pivotal in the correlation between periodontal disease and cardiovascular disease (CVD). For the study, the impact of MMP-9 of periodontitis and CVD on serum and saliva concentrations was analyzed. For the study patients with periodontitis (n = 31), CVD (n = 31), periodontitis + CVD (n = 31), and healthy patients (n = 31) were enrolled. Clinical and demographic characteristics as well as serum and salivary MMP-9 were evaluated. MMP-9 concentrations in serum and saliva were statistically elevated in patients with CVD (p < 0.01) and in patients with periodontitis plus CVD (p < 0.001) compared to patients with periodontitis and healthy subjects. Multivariate regression analysis showed that c-reactive protein (hs-CRP) was the only significant predictor for MMP-9 serum (p < 0.001), whereas hs-CRP (p < 0.001) and total cholesterol (p = 0.029) were the statistically significant salivary MMP-9 predictors. This study evidenced that patients with CVD and periodontitis + CVD presented elevated MMP-9 concentrations in serum and saliva compared to patients with periodontitis and healthy subjects. Furthermore, hs-CRP was a negative predictor of serum and salivary MMP-9.
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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; (A.P.); (V.R.); (G.P.); (A.L.G.)
- Correspondence: ; Tel.: +39-095-378-2453
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, 98122 Messina, Italy;
| | - Giuseppe Palazzo
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (A.P.); (V.R.); (G.P.); (A.L.G.)
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Gwon JG, Choi J, Kim SH, Kim SH, Ryu JJ, Cho DH, Song IS. Risk of acute and chronic coronary syndrome in a population with periodontitis: A cohort study. Oral Dis 2021; 28 Suppl 2:2522-2529. [PMID: 33660304 DOI: 10.1111/odi.13816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/08/2021] [Accepted: 02/20/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To investigate the role of periodontitis in the risk of acute and chronic coronary syndrome with compounding factors, including sociodemographic factors and medication use. METHODS This retrospective cohort study used nationwide, population-based data from the Korean National Health Insurance Service-Health Screening Cohort database (514,866 individuals, 40-79 years). Propensity score matching was used for analysis. Information of subjects for 12 years was included. Socioeconomic and clinical factors were recorded and analysed. RESULTS The periodontitis group had a greater risk of overall acute coronary syndrome (hazard ratio [95% confidence interval] =1.25 [1.15, 1.35], p < .001) and non-fatal acute coronary syndrome (1.26 [1.16, 1.37], p < .001). The hazard ratio for chronic coronary syndrome was higher in patients with periodontitis (1.35 [1.25, 1.46], p < .001). The cumulative incidence of both acute and chronic coronary syndrome gradually increased, and the hazard ratios reached 1.25 and 1.35 at the 12-year follow-up, respectively. Subgroup analysis revealed that periodontitis had a significantly greater link with acute coronary syndrome incidence in males, younger adults, smokers and subjects without hypertension (p < .01) and with chronic coronary syndrome incidence in smokers, subjects without hypertension and subjects without dyslipidaemia (p < .05). CONCLUSIONS Periodontitis is associated with an increased risk of acute and chronic coronary syndrome.
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Affiliation(s)
- Jun Gyo Gwon
- Department of Transplantation Vascular Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jimi Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Seung-Hyun Kim
- Department of Medical Humanities, Korea University College of Medicine, Seoul, Korea
| | - Soo-Ho Kim
- Department of Dentistry, Chungnam National University Hospital, Daejeon, Korea
| | - Jae-Jun Ryu
- Department of Dentistry, Korea University Anam Hospital, Seoul, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In-Seok Song
- Department of Dentistry, Korea University Anam Hospital, Seoul, Korea
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Shin M, Park SH, Mun S, Lee J, Kang HG. Biomarker Discovery of Acute Coronary Syndrome Using Proteomic Approach. Molecules 2021; 26:molecules26041136. [PMID: 33672727 PMCID: PMC7924321 DOI: 10.3390/molecules26041136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022] Open
Abstract
Acute coronary syndrome (ACS) is a condition in which the coronary artery supplying blood to the heart is infarcted via formation of a plaque and thrombus, resulting in abnormal blood supply and high mortality and morbidity. Therefore, the prompt and efficient diagnosis of ACS and the need for new ACS diagnostic biomarkers are important. In this study, we aimed to identify new ACS diagnostic biomarkers with high sensitivity and specificity using a proteomic approach. A discovery set with samples from 20 patients with ACS and 20 healthy controls was analyzed using mass spectrometry. Among the proteins identified, those showing a significant difference between each group were selected. Functional analysis of these proteins was conducted to confirm their association with functions in the diseased state. To determine ACS diagnostic biomarkers, standard peptides of the selected protein candidates from the discovery set were quantified, and these protein candidates were validated in a validation set consisting of the sera of 50 patients with ACS and 50 healthy controls. We showed that hemopexin, leucine-rich α-2-glycoprotein, and vitronectin levels were upregulated, whereas fibronectin level was downregulated, in patients with ACS. Thus, the use of these biomarkers may increase the accuracy of ACS diagnosis.
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Affiliation(s)
- Miji Shin
- Department of Senior Healthcare, Graduate School, Eulji University, Seongnam 13135, Korea; (M.S.); (S.M.)
| | - Sang Hyun Park
- Department of Internal Medicine, School of Medicine, Eulji University, Daejeon 34824, Korea;
| | - Sora Mun
- Department of Senior Healthcare, Graduate School, Eulji University, Seongnam 13135, Korea; (M.S.); (S.M.)
| | - Jiyeong Lee
- Department of Biomedical Laboratory Science, School of Medicine, Eulji University, Uijeongbu 11759, Korea
- Correspondence: (J.L.); (H.-G.K.); Tel.: +82-42-259-1752 (J.L.); +82-31-740-7315 (H.-G.K.)
| | - Hee-Gyoo Kang
- Department of Senior Healthcare, Graduate School, Eulji University, Seongnam 13135, Korea; (M.S.); (S.M.)
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Seongnam 13135, Korea
- Correspondence: (J.L.); (H.-G.K.); Tel.: +82-42-259-1752 (J.L.); +82-31-740-7315 (H.-G.K.)
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Using Salivary MMP-9 to Successfully Quantify Periodontal Inflammation during Orthodontic Treatment. J Clin Med 2021; 10:jcm10030379. [PMID: 33498206 PMCID: PMC7863927 DOI: 10.3390/jcm10030379] [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: 12/20/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is one of the most common immune-mediated inflammatory conditions resulting in progressive destruction of periodontium. Metalloproteinase-9 (MMP-9), an enzyme that is involved in the degradation of gelatin and collagen and present in the gingival crevicular fluid, is markedly increased in periodontitis. The aim of the study is to evaluate the effects of periodontal treatment either alone or in combination with orthodontic treatment on MMP-9 levels. In this study, 60 individuals were subjected to periodontal treatment (PD) or periodontal treatment combined with orthodontic treatment (POD). Both periodontal and periodontal plus orthodontic treatments significantly improved clinical parameters and lowered MMP-9 levels compared to control group. However, the combination of periodontal with orthodontic treatment further improved clinical parameters and enhanced the lowering effect on MMP-9 levels compared to periodontal or control groups alone. Finally, the degree of malocclusion significantly affected the effect of the treatment on MPP-9 levels with PD treatment having the most pronounced effect. We concluded that salivary MMP-9 can serve to accurately predict the level of inflammation in affected periodontal tissues during orthodontic treatment that is also associated with the type of malocclusion, making it a viable diagnosis tool in monitoring the progression of the periodontium during orthodontic treatment.
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12
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Bahbah EI, Noehammer C, Pulverer W, Jung M, Weinhaeusel A. Salivary biomarkers in cardiovascular disease: An insight into the current evidence. FEBS J 2020; 288:6392-6405. [PMID: 33370493 DOI: 10.1111/febs.15689] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/28/2020] [Accepted: 12/23/2020] [Indexed: 01/08/2023]
Abstract
Cardiovascular diseases (CVDs) are the most common cause of mortality worldwide. In acute cardiovascular conditions, time is a crucial player in the outcomes of disease management. Given the ease and noninvasiveness of obtaining saliva, salivary biomarkers may provide a rapid and efficient diagnosis of CVD. Here, we reviewed the published data on the value of salivary molecules for diagnosis of CVD, especially in acute care settings. In this review, we show that some biomarkers such as salivary creatinine kinase myocardial band, C-reactive protein, troponin-1, and myoglobin exhibited promising diagnostic values that were comparable to their serum counterparts. Other molecules were also investigated and showed controversial results, including myeloperoxidase, brain natriuretic peptide, and some oxidative stress markers. Based on our review, we concluded that the clinical use of salivary biomarkers to diagnose CVD is promising; however, it is still in the early stage of development. Further studies are needed to validate these findings, determine cutoff values for diagnosis, and compare them to other established biomarkers currently in clinical use.
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Affiliation(s)
- Eshak I Bahbah
- AIT Molecular Diagnostics, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria.,Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Christa Noehammer
- AIT Molecular Diagnostics, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Walter Pulverer
- AIT Molecular Diagnostics, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Martin Jung
- AIT Molecular Diagnostics, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Andreas Weinhaeusel
- AIT Molecular Diagnostics, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria
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13
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Silva NNQ, Albuquerque E Aguiar IH, Gomes MVSW, Neto OBDO, Penteado LADM, de Lima FJC. Is there evidence that periodontal diseases are risk factors for coronary arterial disease?-Scoping review. SPECIAL CARE IN DENTISTRY 2020; 41:66-77. [PMID: 33215733 DOI: 10.1111/scd.12542] [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: 07/03/2020] [Revised: 10/08/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022]
Abstract
AIM To determine the scientific evidence regarding the condition of periodontal diseases (PDs) as risk factors of coronary artery diseases. MATERIALS AND METHODS A scoping review was performed through the selection of articles from online databases (Medline via PubMed, LILACS, and Cochrane CENTRAL), using a search algorithm and eligibility criteria for data extraction and data synthesis of included papers. Four hundred forty-one studies from online databases and 1364 from reference lists were initially identified, and 34 articles were selected for inclusion. Articles had to be published between 2015 and 2020 and had to associate PDs to coronary arterial diseases. All studies comprised a sample of 446443 participants. Favorable opinions totaled 70.59%, and the cross-sectional observational study design was more frequently found (32.35%). Biochemical outcomes were showed more frequently, such as inflammatory biomarkers (58.82%). Despite a large advantage for favorable opinions, a statistically significant result was not found when extracted data were combined with studies opinions. CONCLUSION The evidence was classified as level II-3, hence, still distant from the best ranks and can therefore be considered as unclear. Moreover, studies with the higher potential to generate evidence showed a high risk of bias.
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Affiliation(s)
| | | | | | - Olavo Barbosa de Oliveira Neto
- Institute of Health and Biological Sciences, Federal University of Alagoas, Maceió, AL, Brazil.,CESMAC University Center, Maceió, AL, Brazil
| | | | - Fernando José Camello de Lima
- Human Anatomy Division, Institute of Health and Biological Sciences, Federal University of Alagoas, Maceió, AL, Brazil
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14
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Effect of Subantimicrobial Dose Doxycycline Treatment on Gingival Crevicular Fluid Levels of MMP-9 and MMP-13 in Periodontitis Stage 2, Grade B in Subjects with Type 2 Diabetes Mellitus. J Immunol Res 2020; 2020:2807259. [PMID: 33294463 PMCID: PMC7700048 DOI: 10.1155/2020/2807259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/05/2020] [Accepted: 10/28/2020] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to investigate the effect of using subantimicrobial dose doxycycline as an adjunct in periodontitis stage 2, grade B in subjects with type 2 diabetes mellitus. A total of thirty patients were divided into the following two groups with reference to periodontitis, type 2 diabetes mellitus, and administration of the doxycycline drug: Group I: patients with periodontitis stage 2, grade B and type 2 diabetes mellitus who received SRP only. Group II: patients with periodontitis stage 2, grade B and type 2 diabetes mellitus who received SRP and doxycycline 20 mg. The following clinical measurements were recorded at baseline (prior to scaling and root planning) and after one and three months postoperatively: GI, PI, and PD with a periodontal calibrated probe. The levels of both MMP-9 and MMP-13, from 60 GCF samples, were analyzed by ELISA. Patients treated with SRP and doxycycline 20 mg showed a significant reduction of PD, PI, GI, MMP-9, and MMP-13 than patients who received SRP only. Improvements in parameters clinically and biochemically were observed following the adjunctive use of doxycycline subantimicrobial dose therapy for the management of stage 2, grade B periodontitis patients with type 2 diabetes mellitus.
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15
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Diagnostic Models for Screening of Periodontitis with Inflammatory Mediators and Microbial Profiles in Saliva. Diagnostics (Basel) 2020; 10:diagnostics10100820. [PMID: 33066545 PMCID: PMC7602207 DOI: 10.3390/diagnostics10100820] [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: 09/01/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022] Open
Abstract
This study aims to investigate and assess salivary biomarkers and microbial profiles as a means of diagnosing periodontitis. A total of 121 subjects were included: 28 periodontally healthy subjects, 24 with Stage I periodontitis, 24 with Stage II, 23 with Stage III, and 22 with Stage IV. Salivary proteins (including active matrix metalloproteinase-8 (MMP-8), pro-MMP-8, total MMP-8, C-reactive protein, secretory immunoglobulin A) and planktonic bacteria (including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas nigrescens, Parvimonas micra, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Actinomyces viscosus) were measured from salivary samples. The performance of the diagnostic models was assessed by receiver operating characteristics (ROCs) and area under the ROC curve (AUC) analysis. The diagnostic models were constructed based on the subjects’ proteins and/or microbial profiles, resulting in two potential diagnosis models that achieved better diagnostic powers, with an AUC value > 0.750 for the diagnosis of Stages II, III, and IV periodontitis (Model PA-I; AUC: 0.796, sensitivity: 0.754, specificity: 0.712) and for the diagnosis of Stages III and IV periodontitis (Model PA-II; AUC: 0.796, sensitivity: 0.756, specificity: 0.868). This study can contribute to screening for periodontitis based on salivary biomarkers.
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16
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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: 159] [Impact Index Per Article: 39.8] [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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17
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Ramachandra CJA, Ja KPMM, Chua J, Cong S, Shim W, Hausenloy DJ. Myeloperoxidase As a Multifaceted Target for Cardiovascular Protection. Antioxid Redox Signal 2020; 32:1135-1149. [PMID: 31847538 DOI: 10.1089/ars.2019.7971] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Significance: Myeloperoxidase (MPO) is a heme peroxidase that is primarily expressed by neutrophils. It has the capacity to generate several reactive species, essential for its inherent antimicrobial activity and innate host defense. Dysregulated MPO release, however, can lead to tissue damage, as seen in several diseases. Increased MPO levels in circulation are therefore widely associated with conditions of increased oxidative stress and inflammation. Recent Advances: Several studies have shown a strong correlation between MPO and cardiovascular disease (CVD), through which elevated levels of circulating MPO are linked to poor prognosis with increased risk of CVD-related mortality. Accordingly, circulating MPO is considered a "high-risk" biomarker for patients with acute coronary syndrome, atherosclerosis, heart failure, hypertension, and stroke, thereby implicating MPO as a multifaceted target for cardiovascular protection. Consistently, recent studies that target MPO in animal models of CVD have demonstrated favorable outcomes with regard to disease progression. Critical Issues: Although most of these studies have established a critical link between circulating MPO and worsening cardiac outcomes, the mechanisms by which MPO exerts its detrimental effects in CVD remain unclear. Future Directions: Elucidating the mechanisms by which elevated MPO leads to poor prognosis and, conversely, investigating the beneficial effects of therapeutic MPO inhibition on alleviating disease phenotype will facilitate future MPO-targeted clinical trials for improving CVD-related outcomes.
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Affiliation(s)
- Chrishan J A Ramachandra
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore.,Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - K P Myu Mai Ja
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore
| | - Jasper Chua
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore.,Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Shuo Cong
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore.,Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Winston Shim
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Derek J Hausenloy
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore.,Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore.,The Hatter Cardiovascular Institute, University College London, London, United Kingdom.,Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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18
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Levels of Myeloperoxidase and Metalloproteinase-9 in Gingival Crevicular Fluid from Diabetic Subjects with and without Stage 2, Grade B Periodontitis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5613514. [PMID: 31355267 PMCID: PMC6634279 DOI: 10.1155/2019/5613514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/29/2019] [Indexed: 01/16/2023]
Abstract
Objective The present study aimed to compare levels of matrix metalloproteinase-9 (MMP-9) and myeloperoxidase (MPO) in gingival crevicular fluid (GCF) from subjects with controlled and noncontrolled Type 2 Diabetes Mellitus (T2D), with and without stage 2 grade B periodontitis (POD2B) versus healthy (H) subjects. Methods The levels of both enzymes, from 80 GCF samples collected with PerioPaper strips, were analyzed by a Multiplex/Luminex assay. Five groups were formed, all current patients at the Institutional Dentistry Service, and distributed as follows: two groups of diabetics (one controlled and one poorly controlled); two groups with the previous conditions and diagnosed with POD2B; and one H group. Results The highest concentration of MMP-9 corresponded to the H group, while the lowest corresponded to the T2D controlled group. Regarding MPO levels, the highest levels were associated with the T2D controlled with POD2B group and the lowest with the T2D controlled group. Conclusions No apparent relationship between the elevation of MMP-9 and MPO levels was observed among subjects with T2D, with and without POD2B, compared to H subjects.
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19
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Schmalz G, Hübscher AE, Angermann H, Schmidt J, Schmickler J, Legler TJ, Ziebolz D. Associations of chairside salivary aMMP-8 findings with periodontal parameters, potentially periodontal pathogenic bacteria and selected blood parameters in systemically healthy adults. Diagn Microbiol Infect Dis 2019; 95:179-184. [PMID: 31174997 DOI: 10.1016/j.diagmicrobio.2019.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/30/2019] [Accepted: 05/04/2019] [Indexed: 12/19/2022]
Abstract
The aim of this cross-sectional study was to investigate associations between salivary active matrix-metalloproteinase 8 (aMMP-8) and periodontitis severity, potentially periodontal pathogenic bacteria as well as blood parameters in generally healthy participants. Therefore, 188 participants with a mean age of 48.9 ± 8 years were examined. The periodontitis severity was assessed based on periodontal probing depth and clinical attachment loss. Both, aMMP-8 and microbiological analysis were performed using a validated, commercially available test system. Blood values were utilized from regular differential blood count. The aMMP-8 findings were associated with the periodontitis severity (P < 0.01), as well as with the prevalence of Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Parvimonas micra, Camphylobacter rectus and Eubacterium nodatum (Pi < 0.05). No associations between aMMP-8 and the examined blood parameters were found (Pi > 0.05). In conclusion, salivary aMMP-8 findings seem to reflect periodontal disease severity as a result of an immunoreaction, especially against bacteria with high periodontal pathogenic potential.
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Affiliation(s)
- Gerhard Schmalz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Anna Elisabeth Hübscher
- Dept. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Germany
| | - Helena Angermann
- Dept. of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Germany
| | - Jana Schmidt
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Jan Schmickler
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Tobias J Legler
- Department of Transfusion Medicine, University Medical Centre Goettingen, Germany
| | - Dirk Ziebolz
- Dept. of Cariology, Endodontology and Periodontology, University of Leipzig, Germany.
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20
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Mahmood Z, Enocsson H, Bäck M, Chung RWS, Lundberg AK, Jonasson L. Salivary and plasma levels of matrix metalloproteinase-9 and myeloperoxidase at rest and after acute physical exercise in patients with coronary artery disease. PLoS One 2019; 14:e0207166. [PMID: 30726210 PMCID: PMC6364871 DOI: 10.1371/journal.pone.0207166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/09/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Low-grade systemic inflammation is a predictor of recurrent cardiac events in patients with coronary artery disease (CAD). Plasma proteins such as matrix metalloproteinase (MMP)-9 and myeloperoxidase (MPO) have been shown to reflect basal as well as stress-induced inflammation in CAD. Measurements of MMP-9 and MPO in saliva might pose several advantages. Therefore, we investigated whether salivary levels of MMP-9 and MPO corresponded to plasma levels in patients with coronary artery disease (CAD), both at rest and after acute physical exercise. METHODS A bicycle ergometer test was used as a model for stress-induced inflammation. Twenty-three CAD patients performed the test on two occasions 3-6 months apart. Whole unstimulated saliva was collected before, directly after and 30 min after exercise while plasma was collected before and after 30 min. MMP-9 and MPO in saliva and plasma were determined by Luminex. RESULTS MMP-9 and MPO levels were 2- to 4-fold higher in saliva than in plasma. Amongst the saliva samples, and also to a great extent amongst the plasma samples, the levels of both types of protein showed strong intercorrelations between the levels at rest and after exercise during the two visits. However, there were no (or weak) correlations between salivary and plasma MMP-9 and none between salivary and plasma MPO. CONCLUSION We conclude that salivary diagnostics cannot be used to assess systemic levels of MMP-9 and MPO in CAD patients, neither at rest nor after acute physical exercise.
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Affiliation(s)
- Zeid Mahmood
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University,Linköping, Sweden
| | - Helena Enocsson
- Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Maria Bäck
- Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Rosanna W. S. Chung
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University,Linköping, Sweden
| | - Anna K. Lundberg
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University,Linköping, Sweden
| | - Lena Jonasson
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University,Linköping, Sweden
- * E-mail:
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21
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Rasperini G, Pellegrini G, Sugai J, Mauro C, Fiocchi S, Corvi Mora P, Dellavia C. Effects of food supplements on periodontal status and local and systemic inflammation after nonoperative periodontal treatment. J Oral Sci 2019; 61:213-220. [DOI: 10.2334/josnusd.18-0048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan
- Foundation Scientific Institute of Hospitalization and Care (IRCCS), Ca’ Granda Policlinic
| | - Gaia Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan
| | - Jim Sugai
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry
| | - Cesare Mauro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan
| | | | | | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan
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22
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Lahdentausta L, Paju S, Mäntylä P, Buhlin K, Pietiäinen M, Tervahartiala T, Nieminen MS, Sinisalo J, Sorsa T, Pussinen PJ. Smoking confounds the periodontal diagnostics using saliva biomarkers. J Periodontol 2018; 90:475-483. [PMID: 30447005 DOI: 10.1002/jper.18-0545] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Smoking is a risk factor for periodontal disease because of its complex impact on the inflammatory response in the periodontium. We investigated the effect of smoking on salivary periodontal biomarkers, matrix metalloproteinase (MMP)-8, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-1 and myeloperoxidase (MPO). METHODS Saliva biomarkers were analyzed in the Parogene population (n = 480) comprising a random cohort of patients that have undergone coronary angiography and oral examination. The effect of time since cessation and pack years of smoking on biomarkers were investigated. RESULTS Saliva MMP-8, MMP-9, TIMP-1, and MPO concentrations distinguished periodontitis patients significantly from patients without periodontitis. When the time since cessation was considered, the area-under-the-curve values (p-value) for periodontitis were 0.76 (<0.001), 0.74 (<0.001), 0.70 (<0.001), and 0.76 (<0.001), respectively. Adding information about smoking habits in the models improved slightly the sensitivities of all biomarkers. In logistic regression model saliva, MMP-8 was mainly affected by pack years of smoking, whereas saliva MMP-9, TIMP-1, and MPO were mostly affected by time since cessation, especially if smoking currently or quit recently (<1 year ago). CONCLUSION Smoking confounds the salivary diagnostics of periodontitis and should be considered when interpreting the results obtained by potential diagnostic tests.
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Affiliation(s)
- Laura Lahdentausta
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Susanna Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Päivi Mäntylä
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Kuopio University Hospital, Oral and Maxillofacial Diseases, Kuopio, Finland
| | - Kåre Buhlin
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Milla Pietiäinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
| | - Markku S Nieminen
- HUCH Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Juha Sinisalo
- HUCH Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Finland
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23
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Lahdentausta LSJ, Paju S, Mäntylä P, Buhlin K, Tervahartiala T, Pietiäinen M, Alfthan H, Nieminen MS, Sinisalo J, Sorsa T, Pussinen PJ. Saliva and serum biomarkers in periodontitis and coronary artery disease. J Clin Periodontol 2018; 45:1045-1055. [DOI: 10.1111/jcpe.12976] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/14/2018] [Accepted: 07/02/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Laura S. J. Lahdentausta
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
| | - Susanna Paju
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
| | - Päivi Mäntylä
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Diseases; Kuopio University Hospital; Kuopio Finland
| | - Kåre Buhlin
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
- Division of Periodontology; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
| | - Milla Pietiäinen
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
| | - Henrik Alfthan
- Laboratory, HUSLAB; Helsinki University Hospital; Helsinki Finland
| | - Markku S. Nieminen
- HUCH Heart and Lung Center; Helsinki University Central Hospital; Helsinki Finland
| | - Juha Sinisalo
- HUCH Heart and Lung Center; Helsinki University Central Hospital; Helsinki Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
- Division of Periodontology; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - Pirkko J. Pussinen
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital; University of Helsinki; Helsinki Finland
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Gohel V, Jones JA, Wehler CJ. Salivary biomarkers and cardiovascular disease: a systematic review. ACTA ACUST UNITED AC 2018; 56:1432-1442. [DOI: 10.1515/cclm-2017-1018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/13/2018] [Indexed: 12/21/2022]
Abstract
Abstract
Background:
The purpose of this systematic review is to summarize the literature examining associations between salivary biomarkers and cardiovascular disease (CVD) status.
Contents:
An advanced search was conducted using MeSH terms related to salivary biomarkers and CVD, and entered into the PubMed, Web of Science, and Google Scholar search databases. Four hundred and thirty-three records were narrowed to 22 accepted articles. Included titles were assessed for quality using the Newcastle-Ottawa scale, and ranked into categories of low, moderate, or high.
Summary:
A total of 40 salivary biomarkers were analyzed among accepted articles. The most studied markers were salivary creatine kinase isoform MB, C-reactive protein (CRP), matrix metalloproteinase-9, troponin I, myeloperoxidase, myoglobin, and brain natriuretic peptide. Salivary CRP provided the most consistent trends. Statistically significant increases of salivary CRP were present with CVD in every study that analyzed it. The remaining six markers demonstrated varying patterns.
Outlook:
Existing studies provide insufficient data to draw definitive conclusions. Current research shows that there is an association between some salivary biomarkers and CVD, but the details of existing studies are conflicting. Despite inconclusive results, the diagnostic potential of saliva shows promise as a non-invasive means of cardiovascular risk assessment.
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Affiliation(s)
- Vishal Gohel
- Boston University Henry M. Goldman School of Dental Medicine , 100 East Newton Street , Boston, MA 02118-2308 , USA
| | - Judith A. Jones
- Boston University Henry M. Goldman School of Dental Medicine , Boston, MA , USA
- University of Detroit Mercy School of Dentistry , Detroit, MI , USA
| | - Carolyn J. Wehler
- Boston University Henry M. Goldman School of Dental Medicine , Boston, MA , USA
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25
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Bostanci N, Selevsek N, Wolski W, Grossmann J, Bao K, Wahlander A, Trachsel C, Schlapbach R, Öztürk VÖ, Afacan B, Emingil G, Belibasakis GN. Targeted Proteomics Guided by Label-free Quantitative Proteome Analysis in Saliva Reveal Transition Signatures from Health to Periodontal Disease. Mol Cell Proteomics 2018; 17:1392-1409. [PMID: 29610270 DOI: 10.1074/mcp.ra118.000718] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 03/28/2018] [Indexed: 12/18/2022] Open
Abstract
Periodontal diseases are among the most prevalent worldwide, but largely silent, chronic diseases. They affect the tooth-supporting tissues with multiple ramifications on life quality. Their early diagnosis is still challenging, due to lack of appropriate molecular diagnostic methods. Saliva offers a non-invasively collectable reservoir of clinically relevant biomarkers, which, if utilized efficiently, could facilitate early diagnosis and monitoring of ongoing disease. Despite several novel protein markers being recently enlisted by discovery proteomics, their routine diagnostic application is hampered by the lack of validation platforms that allow for rapid, accurate and simultaneous quantification of multiple proteins in large cohorts. Here we carried out a pipeline of two proteomic platforms; firstly, we applied open ended label-free quantitative (LFQ) proteomics for discovery in saliva (n = 67, including individuals with health, gingivitis, and periodontitis), followed by selected-reaction monitoring (SRM)-targeted proteomics for validation in an independent cohort (n = 82). The LFQ platform led to the discovery of 119 proteins with at least 2-fold significant difference between health and disease. The 65 proteins chosen for the subsequent SRM platform included 50 functionally related proteins derived from the significantly enriched processes of the LFQ data, 11 from literature-mining, and four house-keeping ones. Among those, 60 were reproducibly quantifiable proteins (92% success rate), represented by a total of 143 peptides. Machine-learning modeling led to a narrowed-down panel of five proteins of high predictive value for periodontal diseases with maximum area under the receiver operating curve >0.97 (higher in disease: Matrix metalloproteinase-9, Ras-related protein-1, Actin-related protein 2/3 complex subunit 5; lower in disease: Clusterin, Deleted in Malignant Brain Tumors 1). This panel enriches the pool of credible clinical biomarker candidates for diagnostic assay development. Yet, the quantum leap brought into the field of periodontal diagnostics by this study is the application of the biomarker discovery-through-verification pipeline, which can be used for validation in further cohorts.
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Affiliation(s)
- Nagihan Bostanci
- From the ‡Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden;
| | - Nathalie Selevsek
- §Functional Genomics Center Zürich, University of Zürich/ETH Zürich, Zürich, Switzerland
| | - Witold Wolski
- §Functional Genomics Center Zürich, University of Zürich/ETH Zürich, Zürich, Switzerland
| | - Jonas Grossmann
- §Functional Genomics Center Zürich, University of Zürich/ETH Zürich, Zürich, Switzerland
| | - Kai Bao
- From the ‡Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Asa Wahlander
- ¶AstraZeneca Translational Biomarkers and Bioanalysis, Drug Safety and Metabolism, Innovative Medicines, Mölndal, Sweden
| | - Christian Trachsel
- §Functional Genomics Center Zürich, University of Zürich/ETH Zürich, Zürich, Switzerland
| | - Ralph Schlapbach
- §Functional Genomics Center Zürich, University of Zürich/ETH Zürich, Zürich, Switzerland
| | - Veli Özgen Öztürk
- ‖Department of Periodontology, School of Dentistry, Adnan Menderes University, Aydin, Turkey
| | - Beral Afacan
- ‖Department of Periodontology, School of Dentistry, Adnan Menderes University, Aydin, Turkey
| | - Gulnur Emingil
- **Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Georgios N Belibasakis
- From the ‡Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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26
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Herrero E, Boon N, Bernaerts K, Slomka V, Verspecht T, Quirynen M, Teughels W. Clinical concentrations of peroxidases cause dysbiosis in in vitro oral biofilms. J Periodontal Res 2018. [DOI: 10.1111/jre.12534] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- E.R. Herrero
- Department of Oral Health Sciences; KU Leuven; Leuven Belgium
| | - N. Boon
- Center for Microbial Ecology and Technology (CMET); Ghent University; Gent Belgium
| | - K. Bernaerts
- Bio- and Chemical Systems Technology; Reactor Engineering and Safety; Department of Chemical Engineering; KU Leuven (University of Leuven); Leuven Chem & Tech; Leuven Belgium
| | - V. Slomka
- Department of Oral Health Sciences; KU Leuven; Leuven Belgium
| | - T. Verspecht
- Department of Oral Health Sciences; KU Leuven; Leuven Belgium
| | - M. Quirynen
- Department of Oral Health Sciences; KU Leuven; Leuven Belgium
- Dentistry; University Hospitals Leuven; Leuven Belgium
| | - W. Teughels
- Department of Oral Health Sciences; KU Leuven; Leuven Belgium
- Dentistry; University Hospitals Leuven; Leuven Belgium
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27
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Zhang L, Li X, Yan H, Huang L. Salivary matrix metalloproteinase (MMP)-8 as a biomarker for periodontitis: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e9642. [PMID: 29504999 PMCID: PMC5779768 DOI: 10.1097/md.0000000000009642] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/20/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Salivary matrix metalloproteinase (MMP)-8 is currently considered to be one of the most promising biomarkers for early diagnosis of periodontitis, however, several recent studies showed conflicting results. OBJECTIVE To determine the salivary matrix metalloproteinase (MMP)-8 levels between periodontitis patients and healthy individuals, and to assess its diagnostic value in periodontitis. METHODS Literatures were searched on PubMed and Embase databases up to August 2017, for articles reporting salivary MMP-8 levels between periodontitis patients and health controls with the data of means ± standard deviation (SD). Methodological quality was assessed by the Newcastle Ottawa scale (NOS). Standard mean differences (SMDs), heterogeneity, and publication bias were assessed by Stata 13.0 software. RESULTS A total of 10 studies including 485 periodontitis patients and 379 healthy controls that met the preset inclusion criteria were included, the qualities of these studies were either good (n = 7) or moderate (n = 3). Eight studies showed salivary MMP-8 levels were higher in periodontitis patients compared with healthy controls (P < .05), while 2 studies showed opposite results (P > .05). The pooled SMD was 1.195 (95% CI: 0.720-1.670), with I of 89.3%, indicating high heterogeneity. Funnel plot showed publication bias existed. CONCLUSION Our meta-analysis showed that salivary MMP-8 levels were significantly higher in periodontitis patients compared with healthy controls overall. Due to the heterogeneity and publication bias of included studies, further high quality studies are still needed to verify the conclusion.
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Affiliation(s)
| | - Xiue Li
- Department of Nursing, Peking University School and Hospital of Stomatology
| | - Hong Yan
- Department of VIP Dental Service
| | - Lei Huang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, China
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28
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Björnfot Holmström S, Clark R, Zwicker S, Bureik D, Kvedaraite E, Bernasconi E, Nguyen Hoang AT, Johannsen G, Marsland BJ, Boström EA, Svensson M. Gingival Tissue Inflammation Promotes Increased Matrix Metalloproteinase-12 Production by CD200Rlow Monocyte-Derived Cells in Periodontitis. THE JOURNAL OF IMMUNOLOGY 2017; 199:4023-4035. [DOI: 10.4049/jimmunol.1700672] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/06/2017] [Indexed: 12/29/2022]
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29
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Proteomic Profiling and Differential Messenger RNA Expression Correlate HSP27 and Serpin Family B Member 1 to Apical Periodontitis Outcomes. J Endod 2017; 43:1486-1493. [DOI: 10.1016/j.joen.2017.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/20/2017] [Accepted: 03/13/2017] [Indexed: 02/07/2023]
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30
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Rathnayake N, Buhlin K, Kjellström B, Klinge B, Löwbeer C, Norhammar A, Rydén L, Sorsa T, Tervahartiala T, Gustafsson A. Saliva and plasma levels of cardiac-related biomarkers in post-myocardial infarction patients. J Clin Periodontol 2017; 44:692-699. [PMID: 28453865 DOI: 10.1111/jcpe.12740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 11/27/2022]
Abstract
AIM To relate cardiac biomarkers, such as cystatin C and growth differentiation factor-15 (GDF-15) in saliva to myocardial infarction (MI) and to periodontal status, and to investigate the relation between salivary and plasma cardiac biomarkers. MATERIALS AND METHODS Two hundred patients with MI admitted to coronary care units and 200 matched controls without MI were included. Dental examination and collection of blood and saliva samples was performed 6-10 weeks after the MI for patients and in close proximity thereafter for controls. Analysing methods: ARCHITECT i4000SR, Immulite 2000 XPi or ELISA. RESULTS The mean age was 62 ± 8 years and 84% were male. Total probing pocket depth, fibrinogen, white blood cell counts and HbA1c were higher in patients than controls. GDF-15 levels correlated with most of the included clinical variables in both study groups. No correlation was found between plasma and saliva levels of cystatin C or GDF-15. CONCLUSION Salivary cystatin C and GDF-15 could not differentiate between MI patients and controls.
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Affiliation(s)
- Nilminie Rathnayake
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden
| | - Kåre Buhlin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden
| | - Barbro Kjellström
- Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden
| | - Bjorn Klinge
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden.,Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christian Löwbeer
- Department of Clinical Chemistry, Aleris Medilab, Täby, Sweden.,Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Anna Norhammar
- Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden.,Cardiology Unit, Capio S:t Görans Hospital, Stockholm, Sweden
| | - Lars Rydén
- Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden
| | - Timo Sorsa
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden.,Helsinki University Central Hospital, Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Taina Tervahartiala
- Helsinki University Central Hospital, Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Anders Gustafsson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Solna, Sweden
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31
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Akcalı A, Bostanci N, Özçaka Ö, Gümüş P, Öztürk-Ceyhan B, Tervahartiala T, Husu H, Buduneli N, Sorsa T, Belibasakis GN. Gingival Inflammation and Salivary or Serum Granulocyte-Secreted Enzymes in Patients With Polycystic Ovary Syndrome. J Periodontol 2017; 88:1145-1152. [PMID: 28598286 DOI: 10.1902/jop.2017.170043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The objective of this cross-sectional study is to investigate levels of salivary and serum matrix metalloproteinase (MMP)-9, myeloperoxidase (MPO), neutrophil elastase (NE), and MMP-9/tissue inhibitor of MMP-1 (TIMP)-1 ratio in patients with polycystic ovary syndrome (PCOS) and systemically healthy controls in the presence or absence of gingivitis. METHODS Serum and salivary levels of these biomarkers were evaluated in the following: 1) periodontally healthy women with PCOS (n = 45); 2) women with PCOS and gingivitis (n = 35); 3) systemically and periodontally healthy women (n = 25); and 4) systemically healthy women with gingivitis (n = 20). Enzyme-linked immunosorbent assay was used to determine levels of these biomarkers. A full-mouth clinical periodontal evaluation was performed for each patient. RESULTS Salivary MMP-9 and NE levels, as well as MMP-9/TIMP-1 ratios, were higher in the systemically healthy women with gingivitis compared with periodontally healthy women with PCOS (P <0.001; P <0.01; and P <0.0001, respectively). Serum MMP-9 and MPO levels were higher in women with PCOS and gingivitis compared with periodontally healthy women with PCOS (P <0.05). Serum MMP-9 levels were lower in healthy women with gingivitis than systemically and periodontally healthy women or women with PCOS and gingivitis (P <0.05). PCOS groups exhibited a positive correlation among clinical periodontal parameters and serum MMP-9 levels or salivary MPO, NE levels, and MMP-9/MMP-1 ratio. Correlation was negative among clinical periodontal parameters and serum MMP-9 levels and MMP-9/TIMP-1 ratio in systemically healthy patients (P <0.05). CONCLUSIONS The present findings emphasize that PCOS and gingival inflammation are associated with each other, as evidenced by salivary and serum levels of neutrophilic enzymes. This interaction may contribute to the perturbation of ovarian remodeling in PCOS.
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Affiliation(s)
- Aliye Akcalı
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Nagihan Bostanci
- Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Özgun Özçaka
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Pınar Gümüş
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | | | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Heidi Husu
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Timo Sorsa
- Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.,Department of Oral and Maxillofacial Diseases, Institute of Dentistry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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32
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Review. The Link between Periodontal Disease, Inflammation and Atherosclerosis — an Interdisciplinary Approach. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Abstract
Periodontal disease is a chronic inflammatory disease that results from the activity of altered oral microbiome, leading to altered immune reaction, destruction of tissues supporting the teeth, and oral bone loss. This disease is particularly associated with an expressed systemic inflammation, being considered nowadays an inflammatory disorder. At the same time, inflammation has been recognized to play a major role in the development of atherosclerotic lesions. Atheromatous plaque formation is triggered by alterations in the structure of the endothelium, which lead to the expression of adhesion molecules and recruitment of immune cells such as macrophages, in the arterial wall. While the association between periodontal disease, inflammation and cardiovascular diseases has been well established, the causality relation between these three entities has not been demonstrated so far. This review presents the most common advances in understanding the complex link between periodontal disease, inflammation and atherosclerosis, as a common pathway leading to increased cardiovascular risk.
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33
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Akcalı A, Gümüş P, Özçaka Ö, Öztürk-Ceyhan B, Tervahartiala T, Husu H, Heikkinen AM, Sorsa T, Buduneli N. Proteolytic Mediators in Gestational Diabetes Mellitus and Gingivitis. J Periodontol 2017; 88:289-297. [DOI: 10.1902/jop.2016.160158] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Aliye Akcalı
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Pınar Gümüş
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Özgün Özçaka
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | | | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Heidi Husu
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
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34
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Ebersole JL, Kryscio RJ, Campbell C, Kinane DF, McDevitt J, Christodoulides N, Floriano PN, Miller CS. Salivary and serum adiponectin and C-reactive protein levels in acute myocardial infarction related to body mass index and oral health. J Periodontal Res 2016; 52:419-427. [PMID: 27549083 DOI: 10.1111/jre.12406] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Adiponectin is produced by adipose cells and is considered an anti-inflammatory molecule. In contrast, C-reactive protein (CRP) has been identified as a hallmark of systemic inflammation and used as a risk marker of cardiovascular disease (CVD). Of interest was the relationship of these two biomarkers to oral health and CVD risk. MATERIAL AND METHODS This investigation examined these two molecules in serum and unstimulated whole saliva of patients within 48 h of an acute myocardial infarction (AMI) compared to control subjects. We hypothesized a differential response in these biomolecules resulting from the heart attack that would be affected by both the body mass index and oral health characteristics of the individuals. RESULTS Significantly lower adiponectin levels were observed in the serum of patients with AMI. Serum adiponectin in both groups and salivary adiponectin in patients with AMI decreased with increasing body mass index. Oral health was significantly worse in patients with AMI, and both serum and salivary adiponectin were elevated with better oral health in control subjects. Serum CRP levels were increased in patients with AMI regardless of their oral health, and both serum and salivary CRP were significantly elevated in S-T wave elevated patients with MI. CONCLUSIONS These initial data provide evidence relating obesity and oral health to salivary and serum analyte levels that occur in association with cardiac events. Relationships have been described between CVD risk and periodontal disease. Additionally, various systemic inflammatory biomarkers appear to reflect both the CVD risk and the extent/severity of periodontitis. Our findings indicated that oral health and obesity contribute to altering levels of these salivary and serum analytes in association with cardiac events. The potential that serum and/or salivary biomarkers could aid in evaluating CVD risk requires knowledge regarding how the oral health of the individual would impact the effectiveness of these biological measures.
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Affiliation(s)
- J L Ebersole
- Department of Oral Health Practice & Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - R J Kryscio
- Department of Statistics, College of Arts and Sciences and Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - C Campbell
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - D F Kinane
- College of Dentistry, University of Pennsylvania, Philadelphia, PA, USA
| | - J McDevitt
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA
| | - N Christodoulides
- Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA
| | - P N Floriano
- Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA
| | - C S Miller
- Department of Oral Health Practice & Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
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35
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Kellesarian SV, Yunker M, Malmstrom H, Almas K, Romanos GE, Javed F. Male Infertility and Dental Health Status: A Systematic Review. Am J Mens Health 2016; 12:1976-1984. [PMID: 27339766 DOI: 10.1177/1557988316655529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A limited number of studies have reported an association between male factor infertility (MFI) and dental health status (DHS). The aim of the present study was to assess the association between DHS and MFI through a systematic review of indexed literature. To address the focused question-"Is there a relationship between DHS and MFI?"-indexed databases were searched up to March 2016 using various key words "infertility," "periodontal disease," "periodontitis," "dental infection," "caries," and "odontogenic infection." Letters to the editor, case reports, commentaries, historic reviews, and experimental studies were excluded. In total seven studies were included in the present systematic review and processed for data extraction. All the studies reported a positive association between MFI and DHS. The number of study participants ranged between 18 and 360 individuals. Results from six studies showed a positive association between chronic periodontitis and MFI. Three studies reported a positive relationship between MFI and odontogenic infections associated to necrotic pulp, chronic apical osteitis, and radicular cysts. One study reported a relationship between caries index and MFI. From the literature reviewed, there seems to be a positive association between MFI and DHS; however, further longitudinal studies and randomized control trials assessing confounders are needed to establish real correlation. Dentists and general practitioners should be aware that oral diseases can influence the systemic health. Andrological examination should include comprehensive oral evaluation, and physicians detecting oral diseases should refer the patient to a dentist for further evaluation.
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Affiliation(s)
| | | | | | | | - Georgios E Romanos
- 3 University of Frankfurt, Frankfurt, Germany.,4 Stony Brook University, Stony Brook, NY, USA
| | - Fawad Javed
- 1 University of Rochester, Rochester, NY, USA
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36
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Alfakry H, Malle E, Koyani CN, Pussinen PJ, Sorsa T. Neutrophil proteolytic activation cascades: a possible mechanistic link between chronic periodontitis and coronary heart disease. Innate Immun 2016; 22:85-99. [PMID: 26608308 DOI: 10.1177/1753425915617521] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/13/2015] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular diseases are chronic inflammatory diseases that affect a large segment of society. Coronary heart disease (CHD), the most common cardiovascular disease, progresses over several years and affects millions of people worldwide. Chronic infections may contribute to the systemic inflammation and enhance the risk for CHD. Periodontitis is one of the most common chronic infections that affects up to 50% of the adult population. Under inflammatory conditions the activation of endogenous degradation pathways mediated by immune responses leads to the release of destructive cellular molecules from both resident and immigrant cells. Matrix metalloproteinases (MMPs) and their regulators can activate each other and play an important role in immune response via degrading extracellular matrix components and modulating cytokines and chemokines. The action of MMPs is required for immigrant cell recruitment at the site of inflammation. Stimulated neutrophils represent the major pathogen-fighting immune cells that upregulate expression of several proteinases and oxidative enzymes, which can degrade extracellular matrix components (e.g. MMP-8, MMP-9 and neutrophil elastase). The activity of MMPs is regulated by endogenous inhibitors and/or candidate MMPs (e.g. MMP-7). The balance between MMPs and their inhibitors is thought to mirror the proteolytic burden. Thus, neutrophil-derived biomarkers, including myeloperoxidase, may activate proteolytic destructive cascades that are involved in subsequent immune-pathological events associated with both periodontitis and CHD. Here, we review the existing studies on the contribution of MMPs and their regulators to the infection-related pathology. Also, we discuss the possible proteolytic involvement and role of neutrophil-derived enzymes as an etiological link between chronic periodontitis and CHD.
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Affiliation(s)
- Hatem Alfakry
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ernst Malle
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Chintan N Koyani
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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