Abstract
Oral infections occur frequently in humans and often lead to chronic inflammations affecting the teeth (i.e., caries), the gingival tissues surrounding the teeth (i.e., gingivitis and endodontic lesions), and the tooth-supporting structures (i.e., periodontitis). At least four basic pathogenic mechanisms have been proposed that involve oral inflammations in the pathogenesis of atherosclerosis: (1) low level bacteremia by which oral bacteria enter the blood stream and invade the arterial wall; (2) systemic inflammation induced by inflammatory mediators released from the sites of the oral inflammation into the blood stream; (3) autoimmunity to host proteins caused by the host immune response to specific components of oral pathogens; (4) pro-atherogenic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. In this narrative review, we summarize published experimental evidence related to these four mechanisms and discuss their impact on the pathogenesis of atherosclerosis.
Highlights
Atherosclerosis is a chronic inflammatory condition affecting arterial blood vessels [1,2]
At least four basic pathogenic mechanisms have been proposed that involve oral inflammations in the pathogenesis of atherosclerosis: (1) low level bacteremia by which oral bacteria enter the blood stream and invade the arterial wall; (2) systemic inflammation induced by inflammatory mediators released from the sites of the oral inflammation into the blood stream; (3) autoimmunity to host proteins caused by the host immune response to specific components of oral pathogens; (4) pro-atherogenic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria
We summarize published experimental evidence related to these four mechanisms and discuss their impact on the pathogenesis of atherosclerosis
Summary
Atherosclerosis is a chronic inflammatory condition affecting arterial blood vessels [1,2]. Due to its causal role in the pathogenesis of cardiovascular diseases (CVD), atherosclerosis is closely related to one of the most frequent causes of morbidity and mortality worldwide [3]. In Europe, CVD is responsible for about 40% of all deaths, killing over 3.9 million people each year, the majority of deaths resulting from heart disease and stroke [4]. There are other forms of frequent oral inflammations, most notably endodontic inflammations which typically result from deep dental caries penetrating through the root canal to the apex of the teeth’s root where a periapical abscess is formed [15]. It may be assumed that a significant fraction of most populations is exposed to endodontic inflammations
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