Background: Periodontitis is a chronic inflammatory disease with a possible infectious component. Anemia of inflammation (AI) occurring in various chronic diseases alters the hemoglobin (Hb) concentration and iron status. Currently, the association between periodontitis and AI is still controversial. The aim of this study was to assess the alterations of the level of hematological parameters and iron metabolism markers in patients with or without periodontitis. Methods: Electronic databases (MEDLINE, EMBASE, and Cochrane) were searched to identify publications about anemia and periodontitis. Subgroup analyses regarding gender, extent of periodontitis, and sample size were performed using STATA 12.1. Results: Sixteen studies were included in this meta-analysis. Pooled results showed a decrease in Hb [standardized mean difference (SMD) = −0.76, 95% CI = (−1.15, −0.37)], red blood cell [SMD = −0.69, 95% CI = (−1.09, −0.29)], hematocrit [SMD = −1.13, 95% CI = (−1.69, −0.57)], mean corpuscular volume [SMD = −0.16, 95% CI = (−0.32, −0.01)], and mean corpuscular Hb [SMD = −0.16, 95% CI = (−0.28, −0.04)], but upregulation in erythrocyte sedimentation rate [SMD = 0.63, 95% CI = (0.06, 1.19)]. In addition, patients with periodontitis had a higher level of hepcidin [SMD = 0.59, CI = (0.05, 1.12)] and decreased level of transferrin [SMD = −4.6, CI = (−13.1, −3.90)], with high heterogeneity. Conclusion: This meta-analysis indicates that periodontitis decreases Hb concentration and disturbs the balance of iron metabolism, which confirms strength of association between periodontitis and the development tendency of AI, especially for severe periodontitis. More unbiased cohort studies with larger sample sizes are still warranted to make a definitive judgment in the future.
Introduction The relationship between periodontal disease (PD) and erectile dysfunction (ED) is still conflicting. Aim To investigate whether a link between PD and ED exists, and if so, the degree to which it is significant. Methods The search strategy included using electronic databases and hand searching works published up to June 2018. MEDLINE via PubMed, EMBASE, Proceedings Web of Science, and Current Contents Connect were searched by 2 independent reviewers. Case-control, cohort, or cross-sectional studies including patients with measures of periodontitis and ED were included in the analysis. Quality assessments and sensitivity analysis of selected studies were performed. Main Outcome Measure The strength of the association between PD and the prevalence of ED was evaluated. Results 5 case-control studies with 213,076 participants met the eligibility criteria and were included in the meta-analysis. Patients with PD were 2.85-fold more likely to be diagnosed with ED (OR = 2.85, 95% CI = [1.83, 4.46]). Asian men were reported to be 3.07 times more likely to be at greater risk for the prevalence of ED. Moreover, studies with high quality and case-control design showed 2 times higher risk for ED in PD (OR = 2.44, 95% CI = [1.44, 4.14]). However, the present evidence was not robust enough owing to the high heterogeneity and instability in sensitivity analysis. Clinical Implications Patients with PD may have increased risk of ED, suggesting that dental hygiene should be of concern to clinicians when managing patients with ED. Strength & Limitations This article includes a large literature search to confirm the evidence that PD increases the occurrence of ED. However, there are several confounders, such as age and the type of ED, that failed to be adjusted and that generate bias and affect the correlation between the incidence of ED and PD. Conclusion This system review and meta-analysis strengthens the evidence that PD might have important clinical implications for risk stratification of ED.
Objective: Periodontitis is a chronic inflammatory disease with a downregulated immune response. The mechanisms of the immune response, especially regarding immune-related long non-coding RNAs (lncRNAs), in periodontitis remain unclear. This study aimed to analyze the immune cell landscapes and immune-related transcriptome expression in periodontitis. Materials and Methods: The periodontitis-related microarray data set GSE16134 was downloaded from the Gene Expression Omnibus database. Then, the proportions of the infiltrated immune cell subpopulations were evaluated by Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT). Differentially expressed immune-related genes (DEMGs) and lncRNAs were analyzed by the "limma" package in R software. Co-expression of DEMGs and lncRNAs in immune cell subpopulations was evaluated. Gene set enrichment analysis (GSEA) was performed to identify alterations in immune function through potential pathways. Results: Increased numbers of plasma cells were observed in periodontitis-affected tissues versus those of healthy tissues, while T cells were downregulated. A total of 51 DEMGs were identified, and 12 immune-related signaling pathways were enriched by GSEA, most of which were related to the stimulation and function of B cells and T cells. Only 3 differentially upregulated lncRNAs (FAM30A, GUSBP11, and LINC00525) were screened for the regulation of the immune response. Besides, the level of lncRNAs (FAM30A, GUSBP11, and LINC00525) expression were positively correlated with the fraction of plasma cells in periodontitis. Conclusion: The discovery of differentially expressed immune-related transcriptomes in periodontitis lesions helps to explain the regulation of the immune mechanism in the development of periodontitis.
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