Antibodies to Periodontal Pathogens and Stroke Risk

Abstract

Background and Purpose-The association between cerebrovascular events and periodontitis has been found in few studies based on clinical periodontal examinations. However, evidence on the association between periodontal pathogens and stroke is lacking. Therefore, the aim of the study was to investigate whether elevated levels of serum antibodies to major periodontal pathogens predict stroke in a case-control study. Methods-The study population comprised 6950 subjects (aged 45 to 64 years) who participated in the Mobile Clinic Health Survey in 1973 to 1976 in Finland. During a follow-up of 13 years, a total of 173 subjects had a stroke. From these, 64 subjects had already experienced a stroke or had signs of coronary heart disease (CHD) at baseline, whereas 109 subjects were apparently healthy. Two controls per case were matched for age, gender, municipality, and disease status. Serum IgG and IgA class antibody levels to the periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, were determined by multiserotype enzyme-linked immunosorbent assay. Results-The cases identified during the follow-up that were free of stroke or CHD at baseline were more often IgA-seropositive for A. actinomycetemcomitans than were their controls, 41.3% versus 29.3%. Compared with the seronegative, the seropositive subjects had a multivariate odds ratio of 1.6 (95% CI, 1.0 to 2.6) for stroke. The patients with a history of stroke or CHD at baseline were more often IgA-seropositive for P. gingivalis than were their controls, 79.7% versus 70.2%. When compared with the seronegative, the seropositive subjects had an odds ratio of 2.6 (1.0 to 7.0) for secondary stroke. Conclusions-The present prospective study provides serological evidence that an infection caused by major periodontal pathogens is associated with future stroke.

High Incidence of Actinobacillus Actinomycetemcomitans Infection in Acute Coronary Syndrome

“…These results are supported by recent studies showing that elevated serum anti-A. actinomycetemcomitans antibody levels predict stroke 28) and coronary heart disease. 29) A. actinomycetemcomitans possesses a number of putative virulence factors, including a leukotoxin that targets and destroys specific host immune cells (neutrophils and monocytes).…”

Immunoglobulin G antibodies againstPorphyromonas gingivalisorAggregatibacter actinomycetemcomitansin cardiovascular disease and periodontitis

“…In relation to CVD, increased levels of circulating antibodies towards periodontal bacteria, including both P. gingivalis and A. actinomycetemcomitans , have been associated with increased carotid intima-media thickness [18], and shown to be predictive of future myocardial infarction [19] and stroke [20]. Also, cross-sectional and case-control studies have reported positive associations between levels of antibodies against A. actinomycetemcomitans and P. gingivalis and the presence of coronary heart disease within large population-based cohorts [21–23].…”

Link between Periodontal Disease and Coronary Artery Disease: Bangladesh Perspective

“…23 For the purpose of epidemiological studies, 3 clinical parameters are typically recorded to assess the prevalence of PD: (1) Bleeding on probing, (2) pocket depth, and (3) clinical attachment level, which reflects the amount of periodontal tissue loss. 3 Other markers of periodontitis include detection of subgingival microbial colonization by selected periodontal organisms [24][25][26][27] and evaluation of serum IgG or IgA antibodies to selected periodontal bacteria [28][29][30][31][32][33][34][35] . to 10-fold higher rates of myocardial infarction and death before the age of 40 years.…”