Effects of periodontal therapy on C-reactive protein and HDL in serum of subjects with periodontitis

Leite, Anne Carolina Eleutério; Carneiro, Valéria Martins de Araújo; Guimarães, Maria do Carmo Machado

doi:10.5935/1678-9741.20140013

Cited by 23 publications

(17 citation statements)

References 20 publications

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“…Additionally, rigorous therapeutic protocols and periodontal maintenance contributed to the restoration of phagocytic function in peripheral blood neutrophils (Carneiro et al, 2012) and a reduction in hs-CRP levels in patients with severe periodontitis (Leite et al, 2014). These findings also support the conclusions of D' Aiuto et al (2004b;2004c) and Kamil et al (2011) when reporting a greater reduction in the levels of systemic inflammatory markers among those with better clinical responses to periodontal therapy.…”

Section: Discussionsupporting

confidence: 79%

“…In a previous study by our group, we found levels of high-sensitivity C-reactive protein (hs-CRP) >0.3 mg/dL in individuals with severe periodontitis compared to controls (60.87 versus 23.08, respectively; p = 0.0216) (Leite et al, 2014) and periodontal therapy was associated with a decrease in hs-CRP levels circulating in serum and an increase in High Density Lipoprotein (HDL).…”

Section: Discussionmentioning

confidence: 85%

“…However, other studies (Pejcic et al, 2011;Gaddale et al, 2014) have confirmed an increased number of WBCs and neutrophils in the peripheral blood of patients with moderate to severe periodontitis, with a positive correlation between disease severity and number of WBCs in the blood.…”

Section: Discussionmentioning

confidence: 93%

“…In Brazil, the most recent National Survey of Oral Health reported a prevalence of 19.4% and the most severe forms of periodontal disease was more significant in adults between 35-44 years of age (Leite et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Role of Cytokines and Transcription Factors in Periodontitis: A Review of Cellular and Molecular Mechanisms

Leite¹,

Carneiro²,

Nunes

et al. 2015

American Journal of Immunology

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Periodontal Diseases (PD) are characterized by pathological manifestation of host immune response to bacterial infection at the tooth/gingival interface. Evidences points periodontitis as a risk factor for pathological systemic conditions, such as, cardiovascular diseases and diabetes. The identification of host factors that determine their susceptibility to immune subversion can provide useful information in the pathogenesis of periodontitis. Protective acute inflammatory response fails to remove inflammatory cells, especially neutrophils, evolving to chronic, destructive and pathological lesions. T and B cells actively participate in pathogenesis of the disease. CD4+ naive T cells are activated by antigenic stimulation and differentiate into subpopulations of distinct effector cells, characterized by its specific cytokine production profiles and functions. In periodontal infection, activated Th17 and regulatory T lymphocytes (Tregs) play antagonistic roles as effector and suppressor cells, respectively. In presence of Tregs, there is a decrease in the levels of pro-inflammatory cytokines, such as, Interferon gamma (IFN-γ), Interleukin (IL) -17, Tumor Necrosis Factor (TNF) and IL-1 β, at sites of disease. Absence of Tregs may cause a variety of disorders, such as, periodontitis. The RANKL/RANK system and Osteoprotegerin (OPG) are modulators of bone resorption in periodontitis. The balance between periodontal bone resorption by osteoclasts and bone formation by osteoblasts controls bone mass. RANKL induces osteoclast differentiation and maturation and OPG inhibits RANK/RANKL interaction and prevents bone resorption. RANKL mRNA and the RANKL/OPG mRNA ratio were enhanced in chronic periodontitis. Furthermore, the role of NF-kB, FoxP3 and T-bet transcription factors were explored. Therapies for periodontitis involving cellular and molecular biology are not specific and have many side effects. Current therapies to successfully control the PD reduces clinical signs of inflammation at local sites of the disease; however, new treatments for periodontitis should address the contribution of immune cells in bone resorption, particularly in the natural course of the disease, considering its periods of remission and progression.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Role of Cytokines and Transcription Factors in Periodontitis: A Review of Cellular and Molecular Mechanisms

Leite¹,

Carneiro²,

Nunes

et al. 2015

American Journal of Immunology

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“…Moderate to severe periodontitis has been linked to increased serum levels of either CRP (Christodoulides et al 2007, Giannopoulou et al 2012, Nakajima et al 2010, Zhang et al 2013, Bokhari et al 2014, Caúla et al 2014, Kumari et al 2014, Arregoces et al 2014, Leite et al 2014, Kalburgi et al 2014, Sharma et al 2014), or ProCT (Bassim et al 2008, Giannopoulou et al 2012), which are two acute-phase inflammatory markers. Salivary CRP (Pederson et al 1995, Christodoulides et al 2007, Ouellet-Morin et al 2011, Foley et al 2012) and ProCT (Bassim et al 2008) levels also have been shown to be higher in patients with moderate to severe periodontitis than in patients with an essentially healthy periodontium.…”

mentioning

confidence: 99%

Salivary and serum procalcitonin and C-reactive protein as biomarkers of periodontitis in United States veterans with osteoarthritis or rheumatoid arthritis

Redman¹,

Kerr

Payne

et al. 2016

Biotechnic & Histochemistry

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Serum procalcitonin (ProCT) is elevated in response to bacterial infections, whereas high sensitivity C-reactive protein (hsCRP) is a nonspecific inflammatory marker that is increased by excess adipose tissue. We examined the efficacy of ProCT and hsCRP as biomarkers of periodontitis in the saliva and serum of patients with arthritis, which is characterized by variable levels of systemic inflammation that potentially can confound the interpretation of inflammatory biomarkers. Blood and unstimulated whole saliva were collected from 33 patients with rheumatoid arthritis (RA) and 50 with osteoarthritis (OA). Periodontal status was assessed by full mouth examination and patients were categorized as having no/mild, moderate or severe periodontitis by standard parameters. Salivary and serum ProCT and hsCRP concentrations were compared. BMI, diabetes, anti-inflammatory medications and smoking status were ascertained from the patient records. Differences between OA and RA in proportionate numbers of patients were compared for race, gender, diabetes, adiposity and smoking status. Serum ProCT was significantly higher in arthritis patients with moderate to severe and severe periodontitis compared with no/mild periodontitis patients. There were no significant differences in salivary ProCT or salivary or serum hsCRP in RA patients related to periodontitis category. Most of the OA and RA patients were middle aged or older, 28.9% were diabetic, 78.3% were overweight or obese, and slightly more than half were either current or past smokers. The OA and RA groups differed by race, but not gender; blacks and males were predominant in both groups. The OA and RA groups did not differ in terms of controlled or uncontrolled diabetes, smoking status or BMI. The RA patients had been prescribed more anti-inflammatory medication than the OA patients. Our results demonstrate that circulating ProCT is a more discriminative biomarker for periodontitis than serum hsCRP in patients with underlying arthritis. Any elevation in salivary and serum hsCRP due to periodontitis apparently was overshadowed by differences among these patients in factors that influence CRP, such as the extent of inflammation between RA and OA, the extent of adipose tissue, the use of anti-inflammatory medications and smoking status. Although our study showed no differences in salivary ProCT related to severity of periodontitis, this biomarker also may be useful with further refinement.

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Relationship between C‐reactive protein level and periodontitis and systemic diseases

Lee,

Mun

2023

Journal of Periodontology

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BackgroundPeriodontitis affects systemic disease risk, although the relationship thereof in the context of different C‐reactive protein (CRP) levels is not clear. This study investigated the association of periodontitis with systemic diseases according to high‐sensitivity CRP (hs‐CRP) level and sought to identify the risk of systemic diseases in patients with periodontitis.MethodsWe used data from the seventh (2016–2018) Korea National Health and Nutrition Examination Survey. In a total of 16,489 subjects, the hs‐CRP group was classified into the hs‐CRP low‐risk group and the hs‐CRP high‐risk group. Propensity score matching (PSM) is used for 1:1 matching of confounding variables (e.g., age, gender, income, and education) between hs‐CRP low‐risk and hs‐CRP at‐risk groups to analyze the final 5316 subjects. The association between general characteristics and prevalence of systemic diseases was analyzed using descriptive statistics and the chi‐squared test. The associations between hs‐CRP level and systemic and periodontitis were analyzed using logistic regression analyses.ResultsWithin the hs‐CRP group, the presence of periodontitis was associated with a significantly increased prevalence of hypertension, diabetes mellitus, and stroke. In the hs‐CRP risk group, periodontitis significantly increased the risk of hypertension and diabetes mellitus by 2.1 and 2.4 times, respectively.ConclusionsThe presence of periodontitis significantly increases the prevalence of systemic diseases and more so in individuals with higher hs‐CRP levels. This indicates the significance of maintaining oral health in reducing the risk of systemic diseases.

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Effects of periodontal therapy on C-reactive protein and HDL in serum of subjects with periodontitis

Cited by 23 publications

References 20 publications

Role of Cytokines and Transcription Factors in Periodontitis: A Review of Cellular and Molecular Mechanisms

Role of Cytokines and Transcription Factors in Periodontitis: A Review of Cellular and Molecular Mechanisms

Salivary and serum procalcitonin and C-reactive protein as biomarkers of periodontitis in United States veterans with osteoarthritis or rheumatoid arthritis

Relationship between C‐reactive protein level and periodontitis and systemic diseases

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