Detection of periodontal microorganisms in coronary atheromatous plaque specimens of myocardial infarction patients: A systematic review and meta-analysis

Abstract

Background: Microbial translocation from inflamed periodontal pockets into coronary atheroma via systemic circulation is one of the proposed pathways that links periodontitis and myocardial infarction (MI). The purpose of this systematic review is to determine the reported prevalence of periodontal microorganisms in coronary atheroma and/or aspirated clot samples collected from MI patients with periodontal disease. Methodology: The "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines were followed. Six databases were systematically searched using Medical Subject Headings/Index and Entree terms. After a thorough screening, fourteen publications spanning over ten years (2007-2017) were eligible for this systematic review and meta-analysis. Results: Out of 14 included studies, 12 reported presence of periodontal bacterial DNA in coronary atherosclerotic plaque specimens. Overall, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were the most frequently detected periodontal bacterial species. Metaanalysis revealed that the prevalence of P. gingivalis was significantly higher than A. actinomycetemcomitans in coronary atheromatous plaque samples. Apart from periodontal microbes, DNA from a variety of other microbes e.g. Pseudomonas fluorescens, Streptococcus species, Chlamydia pneumoniae were also recovered from the collected samples. Conclusion: Consistent detection of periodontal bacterial DNA in coronary atheroma suggests their systemic dissemination from periodontal sites. It should further be investigated whether they are merely bystanders or induce any structural changes within coronary arterial walls.

Porphyromonas gingivalis and Its Systemic Impact: Current Status

“…Furthermore, analysis of thrombi collected from patients with acute MI showed the existence of periodontal pathogens. A recent meta-analysis that focused on the detection of periodontal bacteria in atherosclerotic plaque specimens from MI patients revealed that P. gingivalis was the most frequently detected species, with an average prevalence of 40% [ 49 ]. Further in vivo evidence proved that experimental P. gingivalis bacteremia induced myocarditis and/or MI in mice [ 50 ].…”

Gingipain R1 and Lipopolysaccharide From Porphyromonas gingivalis Have Major Effects on Blood Clot Morphology and Mechanics

“…Because there are numerous reports that P.gingivalis and its inflammagens are important contributary agents in neuroinflammatory, as well as cardiovascular conditions, including T2DM, the question now arose as to how gingipains and LPS from P. gingivalis interact with circulating plasma proteins. Microbial translocation from inflamed periodontal pockets into coronary atheroma via systemic circulation is also one of the proposed pathways that links periodontitis and myocardial infarction ( 55 ). We therefore seek to get specific answers with regards to their effects on both morphology and mechanics of clots.…”

Biosensor and Lab-on-a-chip Biomarker-identifying Technologies for Oral and Periodontal Diseases

“…Since periodontitis is a chronic inflammatory disease associated with microbial dysbiosis and host-driven tissue destruction (Atieh et al, 2014;Artese et al, 2015;Garde et al, 2019;Baeza et al, 2020) (Darre et al, 2008Engebretson and Kocher, 2013;Faggion Jr. et al, 2016;Ziukaite et al, 2018;Jain et al, 2019) Cardiovascular disease (Mustapha et al, 2007;Paraskevas et al, 2008;Freitas et al, 2012;Teeuw et al, 2014;Munz et al, 2018;Roca-Millan et al, 2018;Joshi et al, 2019;Munoz Aguilera et al, 2020) ( Bahekar et al, 2007;Blaizot et al, 2009;Almeida et al, 2018) Rheumatoid arthritis (Han and Reynolds, 2012;Kaur et al, 2014;Bender et al, 2017;Calderaro et al, 2017;Eskandari-Nasab et al, 2017;Hussain et al, 2020) ( Tang et al, 2017;Qiao et al, 2020) Obesity (Akram et al, 2016) (Papageorgiou et al, 2015) Irritable bowel disease * (Eskandari-Nasab et al, 2017;Papageorgiou et al, 2017;Lauritano et al, 2019;She et al, 2020) Osteoporosis (Kornman, 2008;Darveau, 2010), it is recognized that a single oral pathogen would not be sufficient to induce the most common forms of periodontitis. However, historically there were several studies focused on small subgroups of patients with rapidly progressing bone destruction occurring around certain teeth (molars and incisors), called localized aggressive periodontitis, whi...…”