Abstract
Nitric oxide (NO), a small gaseous and multifunctional signaling molecule, is involved in the maintenance of metabolic and cardiovascular homeostasis. It is endogenously produced in the vascular endothelium by specific enzymes known as NO synthases (NOSs). Subsequently, NO is readily oxidized to nitrite and nitrate. Nitrite is also derived from exogenous inorganic nitrate (NO3) contained in meat, vegetables, and drinking water, resulting in greater plasma NO2 concentration and major reduction in systemic blood pressure (BP). The recycling process of nitrate and nitrite to NO (nitrate-nitrite-NO pathway), known as the enterosalivary cycle of nitrate, is dependent upon oral commensal nitrate-reducing bacteria of the dorsal tongue. Veillonella, Actinomyces, Haemophilus, and Neisseria are the most copious among the nitrate-reducing bacteria. The use of chlorhexidine mouthwashes and tongue cleaning can mitigate the bacterial nitrate-related BP lowering effects. Imbalances in the oral reducing microbiota have been associated with a decrease of NO, promoting endothelial dysfunction, and increased cardiovascular risk. Although there is a relationship between periodontitis and hypertension (HT), the correlation between nitrate-reducing bacteria and HT has been poorly studied. Restoring the oral flora and NO activity by probiotics may be considered a potential therapeutic strategy to treat HT.
Highlights
There is a known correlation between oral health and systemic disease [1]
Nitric oxide (NO) is a multifunctional signaling molecule involved in the maintenance of metabolic and cardiovascular homeostasis and a potent endogenous vasodilator that suppresses the formation of vascular lesions in atherosclerosis
The aim of this review is to investigate the correlation between the oral nitrate-reducing bacteria and measured blood pressure (BP) in healthy and hypertensive individuals
Summary
There is a known correlation between oral health and systemic disease [1]. significant evidences associate periodontal bacteria and tooth loss to systemic disorders and to cardiovascular disease, such as high BP. It is thought that a decreased quantity of oral nitrate-reducing bacteria and an increased quantity of pathogenic bacteria, are responsible for a correlation between oral hygiene and chronic periodontitis and, at a later stage, cardiovascular diseases (CVD). In addition to being synthesized by NOS, nitrogen can derive from the bioconversion of nitrates, originating from the diet and in from vegetables and drinking water, into nitrite by means of oral bacteria, through a process known as NO3-NO2-NO reduction pathway [7]. This pathway is capable of reducing BP in either healthy young or old adults. The aim of this review is to investigate the correlation between the oral nitrate-reducing bacteria and measured BP in healthy and hypertensive individuals
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