Abstract
BackgroundPeriodontitis is a chronic inflammatory gum disease associated with systemic diseases such as cardiovascular diseases.AimTo investigate the association of systemic blood biomarkers, C-reactive protein (CRP), levels of lipopolysaccharide (LPS), and IgG levels against periodontal pathogens Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) with the stability, based on the aortic diameter, the growth rate and the eligibility for surgical intervention, of patients with abdominal aortic aneurysm (AAA).MethodsPatients with stable AAA (n = 30) and unstable AAA (n = 31) were recruited. The anti-A. actinomycetemcomitans and anti-P. gingivalis IgG levels were analyzed by ELISA, the LPS analysis was performed by using the limulus amebocyte lysate (LAL) test, and plasma levels of CRP were determined using an immune turbidimetric method. The association between these blood systemic biomarkers, AAA features, periodontal clinical parameters and oral microbial profiles were explored. Regression models were used to test the relationship between variables.ResultsThe presence of antibodies against Pg and Aa, LPS and high CRP concentrations were found in all AAA patients. The IgG levels were similar in patients with stable and unstable AAA (both for Aa and Pg). Among investigated blood biomarkers, only CRP was associated with AAA stability. The amount of LPS in saliva, supra, and subgingival plaque were significantly associated with the systemic LPS (p <0.05).ConclusionsThis post-hoc study emphasizes the presence of antibodies against Pg and Aa, LPS and high CRP concentrations in all AAA patients. The presence of Pg in saliva and subgingival plaque was significantly associated with the blood LPS levels. For further studies investigating periodontitis and systemic diseases, specific predictive blood biomarkers should be considered instead of the use of antibodies alone.
Highlights
AAA is a chronic degenerative disorder of the abdominal aorta promoted by genetic and environmental risk factors such as smoking, older age, Caucasian ethnicity, and the male gender (Sakalihasan et al, 2018)
In patients suffering from cardiovascular diseases (CVD) as AAA, the concentrations of immunoglobulin G (IgG) against periodontal bacteria (Nakagawa et al, 1994; Albandar et al, 2001; Dye et al, 2009; Pussinen et al, 2011), LPS (Ebersole et al, 2010) and Creactive protein (CRP) might be relevant periodontitis-related blood biomarkers to characterize sequelae linked to periodontitis
The aim of this study was to investigate the relationship between blood biomarkers and serologic immunological profiles related to periodontitis (CRP, LPS, and serum antiAggregatibacter actinomycetemcomitans [Aa] and antiPorphyromonas gingivalis [Pg] IgG) in abdominal aortic aneurysm patients
Summary
AAA is a chronic degenerative disorder of the abdominal aorta promoted by genetic and environmental risk factors such as smoking, older age, Caucasian ethnicity, and the male gender (Sakalihasan et al, 2018). It has been hypothesized that periodontitis may induce bacteremia, the release of inflammatory mediators and the progression of systemic diseases (Forner et al, 2006; Amano, 2010a) Among these inflammatory mediators released by Pg, hemagglutinin can promote the platelet aggregation (Belanger et al, 2012) and gingipains can neutralized the host immune response extra-orally, in a metastatic site (Nassar et al, 2002). Other virulence factors such as the lipopolysaccharide (Bainbridge et al, 2002) (LPS) of Pg or the cytotoxin of Aa (Tan et al, 2002), can impair systemic diseases, as CVD by disturbing the immune host response (Deshpande et al, 1998a; Deshpande et al, 1998b; Amano, 2010a). Periodontitis is a chronic inflammatory gum disease associated with systemic diseases such as cardiovascular diseases
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