Abstract

BackgroundPeriodontal disease is suggested to increase the risk of atherothrombotic disease by inducing dyslipidemia. Recently, we demonstrated that proprotein convertase subtilisin/kexin type 9 (PCSK9), which is known to play a critical role in the regulation of circulating low-density lipoprotein (LDL) cholesterol levels, is elevated in periodontitis patients. However, the underlying mechanisms of elevation of PCSK9 in periodontitis patients are largely unknown. Here, we explored whether Porphyromonas gingivalis, a representative periodontopathic bacterium, -induced inflammatory response regulates serum PCSK9 and cholesterol levels using animal models.MethodsWe infected C57BL/6 mice intraperitoneally with Porphyromonas gingivalis, a representative strain of periodontopathic bacteria, and evaluated serum PCSK9 levels and the serum lipid profile. PCSK9 and LDL receptor (LDLR) gene and protein expression, as well as liver X receptors (Lxrs), inducible degrader of the LDLR (Idol), and sterol regulatory element binding transcription factor (Srebf)2 gene expression, were examined in the liver.ResultsP. gingivalis infection induced a significant elevation of serum PCSK9 levels and a concomitant elevation of total and LDL cholesterol compared with sham-infected mice. The LDL cholesterol levels were significantly correlated with PCSK9 levels. Expression of the Pcsk9, Ldlr, and Srebf2 genes was upregulated in the livers of the P. gingivalis-infected mice compared with the sham-infected mice. Although Pcsk9 gene expression is known to be positively regulated by sterol regulatory element binding protein (SREBP)2 (human homologue of Srebf2), whereas Srebf2 is negatively regulated by cholesterol, the elevated expression of Srebf2 found in the infected mice is thought to be mediated by P. gingivalis infection.ConclusionsP. gingivalis infection upregulates PCSK9 production via upregulation of Srebf2, independent of cholesterol levels. Further studies are required to elucidate how infection regulates Srebf2 expression and subsequently influences lipid metabolism.

Highlights

  • Periodontal disease is suggested to increase the risk of atherothrombotic disease by inducing dyslipidemia

  • Serum SAA and proprotein convertase subtilisin/kexin type 9 (PCSK9) levels Systemic infection with P. gingivalis induced a significant elevation of serum amyloid A (SAA) levels

  • Plasma lipid profiles The total and low-density lipoprotein (LDL) cholesterol levels were significantly higher in the P. gingivalis-infected mice compared with the sham-infected mice

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Summary

Introduction

Periodontal disease is suggested to increase the risk of atherothrombotic disease by inducing dyslipidemia. The underlying mechanisms of elevation of PCSK9 in periodontitis patients are largely unknown. It has been found that periodontitis decreases HDL cholesterol and increases LDL cholesterol levels. It has been reported that the presence of periodontal pockets was positively associated with higher LDL and total cholesterol in humans [1]. Löesche et al showed that the levels of total and LDL cholesterol were significantly higher in 50- to 60-year-old patients with moderate periodontitis compared with ageand sex-matched controls [2]. Intensive periodontal therapy consisting of subgingival mechanical debridement with adjunctive local delivery of minocycline significantly decreased total and LDL cholesterol compared with baseline levels [3]. The mechanisms underlying the elevation of LDL cholesterol levels in periodontitis patients have not yet been elucidated

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