A Potential New Risk Factor for Stroke: Streptococcus Mutans With Collagen-Binding Protein

Inenaga, Chikanori; Hokamura, Kazuya; Nakano, Kazuhiko; Nomura, Ryota; Naka, Shuhei; Ohashi, Toshihiko; Ooshima, Takashi; Kuriyama, Nagato; Hamasaki, Toshimitsu; Wada, Koichiro; Umemura, Kazuo; Tanaka, Tokutaro

doi:10.1016/j.wneu.2018.01.158

Cited by 34 publications

(29 citation statements)

References 17 publications

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“…In addition to prior studies finding DNA of oral bacteria in unruptured and ruptured IA walls [11,12], a recent study showed an association between being a carrier of a dental cariogenic pathogen Streptococcus mutans with aSAH [15] and another recent case series reported high prevalence of periodontitis in IA patients [16]. The present study is, however, the first to investigate the association of actual clinical periodontitis with the development and rupture of IA in humans with a control study setting.…”

Section: Discussionmentioning

confidence: 55%

“…Oral bacterial DNA has been found in both ruptured (58-69%) and unruptured IA walls (71%) [11,12], suggesting oral infections may contribute to IA wall inflammation, especially since oral infections have been previously shown to accelerate inflammation in the wall of other types of aneurysms [13,14]. Furthermore, a recent epidemiological study reported possible association between increased risk of aSAH and the presence of a specific strain of Streptococcus mutans bacteria in the oral cavity [15], suggesting oral infections might indeed predispose IAs to rupture and subsequent aSAH.…”

Section: Introductionmentioning

confidence: 99%

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Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid hemorrhage

et al. 2019

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Oral bacteria DNA has been found in intracranial aneurysms (IA) and a high prevalence of periodontitis was reported in IA patients. We investigated whether periodontitis associates with IA formation and aneurysmal subarachnoid hemorrhage (aSAH). First, we compared in a case-control setting the prevalence of periodontal disease in IA patients (42 unruptured IA, 34 ruptured IA) and in age-and gender-matched controls (n = 70) from the same geographical area (Health 2000 Survey, BRIF8901). Next, we investigated whether periodontitis at baseline associated with aSAH in a 13-year follow-up study of 5170 Health 2000 Survey participants. Follow-up data was obtained from national hospital discharge and cause of death registries. Univariate analysis, logistic regression, and Cox-regression were used. Periodontitis (≥ 4mm gingival pocket) and severe periodontitis (≥ 6mm gingival pocket) were found in 92% and 49% of IA patients respectively and associated with IAs (OR 5.3, 95%CI 1.1-25.9, p < 0.000 and OR 6.3, 95%CI 1.3-31.4, p < 0.001, respectively). Gingival bleeding had an even stronger association, especially if detected in 4-6 teeth sextants (OR 34.4, 95%CI 4.2-281.3). Severe periodontitis in ≥ 3 teeth or gingival bleeding in 4-6 teeth sextants at baseline increased the risk of aSAH during follow-up (HR 22.5, 95%CI 3.6-139.5, p = 0.001 and HR 8.3, 95%CI 1.5-46.1, p = 0.015, respectively). Association of periodontitis and gingival bleeding with risk of IA development and aSAH was independent of gender, smoking status, hypertension, or alcohol abuse. Periodontitis and gingival bleeding associate with increased risk for IA formation and eventual aSAH. Further epidemiological and mechanistic studies are indicated.

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid hemorrhage

et al. 2019

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“…Very recently, our group showed that periodontitis or gingivitis associate also with aSAH and IA formation [25]. In addition to this, another recent study reported an association between aSAH and being a carriage of specific strains of Streptococcus mutans, a significant contributor to tooth decay [31]. These clinical studies suggest that oral infections and exposure to oral pathogens associate with risk of IA formation and aSAH.…”

Section: Intracranial Aneurysms Show Chronic Inflammation That Is Assmentioning

confidence: 57%

“…The cause of this inflammation in the IA wall is unclear. Potential triggers of inflammation include circulating lipids [20,88] and periodontal and cariogenic bacteria [31,64,65].…”

Section: Intracranial Aneurysms Show Chronic Inflammation That Is Assmentioning

confidence: 99%

Role of oral pathogens in the pathogenesis of intracranial aneurysm: review of existing evidence and potential mechanisms

et al. 2020

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Degeneration of intracranial aneurysm wall is under active research and recent studies indicate an increased risk of rupture of intracranial aneurysm among patients with periodontal diseases. In addition, oral bacterial DNA has been identified from wall samples of ruptured and unruptured aneurysms. These novel findings led us to evaluate if oral diseases could predispose to pathological changes seen on intracranial aneurysm walls eventually leading to subarachnoid hemorrhage. The aim of this review is to consider mechanisms on the relationship between periodontitis and aneurysm rupture, focusing on recent evidence.

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“…An excellent guideline to help direct clinical judgment in this regard was published by Giacaman et al 413 Additional papers A Japanese group published a noteworthy report in World Neurosurgery. 414 Although rare, there are strains of S. mutans (cnm-positive) that are identified in cardiovascular specimens, likely due to the collagen-binding activity of these strains. Their presence has been linked to inhibition of platelet aggregation and damage to arterial walls.…”

Section: Sealing Infiltration Of Caries and Partial Caries Removalmentioning

confidence: 99%

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

Cagna

Donovan

McKee³

et al. 2019

The Journal of Prosthetic Dentistry

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A Potential New Risk Factor for Stroke: Streptococcus Mutans With Collagen-Binding Protein

Cited by 34 publications

References 17 publications

Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid hemorrhage

Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid hemorrhage

Role of oral pathogens in the pathogenesis of intracranial aneurysm: review of existing evidence and potential mechanisms

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

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