Abstract
Several cohort studies have shown that periodontal disease is associated with an increased risk for stroke. However, it remains unclear whether serum antibody titers for a specific periodontal pathogen are associated with outcome after ischemic stroke, and which kinds of pathogens are associated with ischemic stroke. We examined the relationship between serum IgG titers to periodontal pathogens and outcome in ischemic stroke patients. A total of 445 patients with acute ischemic stroke (194 female [44.0%], mean age 71.9±12.3 years) were registered in this study. Serum IgG titers to 9 periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Prevotella nigrescens, Fusobacterium nucleatum, Treponema denticola, Tannerella forsythensis, Campylobacter rectus, Eikenella corrodens) were evaluated using the enzyme-linked immunosorbent assay (ELISA) method. An unfavorable outcome was defined as a 3 or higher on the modified Rankin Scale. The proportion of patients with unfavorable outcome was 25.4% (113 patients). Based on multivariate logistic regression analysis, numbers of IgG antibodies positive for periodontal pathogens (odds ratio 1.20, 95% CI 1.02-1.41, p = 0.03) were independent predictors of unfavorable outcome in ischemic stroke patients.
Highlights
Periodontal disease is a persistent bacterial infection causing chronic inflammation in periodontal tissues that is characterized by loss of connective tissue and alveolar bone support, leading to tooth loss [1]
The numbers of IgG antibodies positive for periodontal pathogens were independent predictors of unfavorable outcome in ischemic stroke patients
We demonstrated that serum IgG titers to periodontal pathogens predict 3-month outcome in ischemic stroke patients
Summary
Periodontal disease is a persistent bacterial infection causing chronic inflammation in periodontal tissues that is characterized by loss of connective tissue and alveolar bone support, leading to tooth loss [1]. Several cohort studies have shown that periodontal disease is associated with an increased risk of stroke [2,3,4,5]. A recent meta-analysis of 2 cohort studies found that periodontal disease increased the risk of ischemic stroke by 1.6-fold [6]. Serum antibody titers related to a specific periodontal pathogen have been shown to indicate the risk factor of systemic diseases, such as coronary heart disease, non-alcoholic fatty liver disease and Alzheimer’s disease [9,10,11]. We previously reported that serum antibody titers related to a specific periodontal pathogen were associated with atrial fibrillation and carotid artery atherosclerosis [12]. We examined the relationship between serum IgG titers to periodontal pathogens and outcome in ischemic stroke patients
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