Abstract
ABSTRACTObjectives: The aim was to elucidate whether levels of circulating antibodies to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis correlate to loss of attachment, as a marker for periodontitis and cardiovascular disease (CVD).Design: Sera were collected from 576 participants of the Danish Health Examination Survey (DANHES). Immunoglobulin G antibodies against lipopolysaccharide (LPS) and protein antigens from the a, b and c serotypes of A. actinomycetemcomitans and P. gingivalis were quantified by titration in ELISA plates coated with a mixture of antigens prepared by disintegration of bacteria.Results: Levels of antibodies against P. gingivalis (OR = 1.48) and A. actinomycetemcomitans (1.31) associated with periodontitis, as determined by univariable logistic regression analysis. These antibody levels also associated with CVD (1.17 and 1.37), respectively, However, after adjusting for other risk factors, including age, smoking, gender, alcohol consumption, overweight, and level of education using multivariable logistic regression analysis, only increasing body mass index (BMI; 1.09), previous smoking (1.99), and increasing age (decades) (2.27) remained associated with CVD. Increased levels of antibodies against P. gingivalis (1.34) remained associated with periodontitis after adjusting for other risk factors.Conclusions: CVD and periodontitis were associated with levels of IgG antibodies to P. gingivalis or A. actinomycetemcomitans in univariable analyses, but only the association of P. gingivalis antibody levels with periodontitis reached statistical significance after adjustment for common confounders. Age, in particular, influenced this relationship.
Highlights
Periodontitis is a highly prevalent, multifactorial inflammatory disease induced by biofilms colonizing the tooth surfaces along the gingival crevice [1]
Periodontitis, defined as a mean clinical loss of attachment of 2.55 mm or more, representing the 75 percentile of the entire study population of the oral part of Danish Health Examination Survey (DANHES) [27], was significantly associated with IgG antibodies against both P. gingivalis (OR = 1.48 [95% CI: 1.31–1.67]) and A. actinomycetemcomitans (1.31 [1.13–1.52]) using univariable logistic regression analysis (Table 2)
In the present study we have examined the associations between periodontitis, cardiovascular disease (CVD), and concentration of IgG antibodies to P. gingivalis and A. actinomycetemcomitans in a cohort of 576 subjects (Table 1), which is a large cohort in comparison to the existing literature on this topic [9,19,20,21,22,23]
Summary
Periodontitis is a highly prevalent, multifactorial inflammatory disease induced by biofilms colonizing the tooth surfaces along the gingival crevice [1]. On the basis of structurally and antigenically distinct O-antigens, six serotypes of A. actinomycetemcomitans (a–f) have been described, with serotype b, the highly leukotoxic JP2 clone, being the dominant serotype isolated from patients with early onset aggressive periodontitis [7,10]. Both A. actinomycetemcomitans and P. gingivalis are capable of inducing strong antibody responses exceeding those found in many other bacterial infections [11]. Elevated levels of circulating antibodies against A. actinomycetemcomitans and P. gingivalis in patients with periodontitis have often been reported [12,13,14,15,16]; and in a large population of adults, who participated in the third US National Health and Nutrition Examination Survey, high titers of antibodies against P. gingivalis were consistently associated with periodontitis [17]
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