Immunologic burden links periodontitis to acute coronary syndrome

Liljestrand, John M.; Paju, Susanna; Pietiäinen, Milla; Buhlin, Kåre; Persson, G. Rutger; Nieminen, Markku S.; Sinisalo, Juha; Mäntylä, Päivi; Pussinen, Pirkko J.

doi:10.1016/j.atherosclerosis.2017.12.007

Cited by 64 publications

(56 citation statements)

References 51 publications

(56 reference statements)

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“…In a recent study, we found, in confounder‐adjusted analyses, that the combined serum antibody levels to A. actinomycetemcomitans , P. gingivalis , Porphyromonas endodontalis , Prevotella intermedia, T. forsythia , Campylobacter rectus , and Fusobacterium nucleatum indicated past or present periodontal disease and was associated with the acute coronary syndrome . A formal statistical test of mediation showed that the subgingival abundance of these species had a statistically significant indirect effect on acute coronary syndrome through the corresponding systemic IgA burden , suggesting that the deleterious effects of the periodontal microbiota on CVD could be partly mediated by the adaptive immune response.…”

Section: Periodontal Bacteria As Antigensmentioning

confidence: 92%

Mediators between oral dysbiosis and cardiovascular diseases

Pietiäinen

Liljestrand

Kopra

et al. 2018

European J Oral Sciences

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Clinical periodontitis is associated with an increased risk for cardiovascular diseases (CVDs) through systemic inflammation as the etiopathogenic link. Whether the oral microbiota, especially its quality, quantity, serology, and virulence factors, plays a role in atherogenesis is not clarified. Patients with periodontitis are exposed to bacteria and their products, which have access to the circulation directly through inflamed oral tissues and indirectly (via saliva) through the gastrointestinal tract, resulting in systemic inflammatory and immunologic responses. Periodontitis is associated with persistent endotoxemia, which has been identified as a notable cardiometabolic risk factor. The serology of bacterial biomarkers for oral dysbiosis is associated with an increased risk for subclinical atherosclerosis, prevalent and future coronary artery disease, and incident and recurrent stroke. In addition to species-specific antibodies, the immunologic response includes persistent, cross-reactive, proatherogenic antibodies against host-derived antigens. Periodontitis may affect lipoprotein metabolism at all levels, and all lipoprotein classes are affected. Periodontitis or its bacterial signatures may be involved not only in increased storage of proatherogenic lipids but also in attenuation of the anti-atherogenic processes, thereby putatively increasing the net risk of atherosclerosis. In this review we summarize possible molecular mediators between the dysbiotic oral microbiota and atherosclerotic processes.

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Section: Periodontal Bacteria As Antigensmentioning

confidence: 92%

Mediators between oral dysbiosis and cardiovascular diseases

Pietiäinen

Liljestrand

Kopra

et al. 2018

European J Oral Sciences

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“…The serum IgA/IgG burden indicated higher risk for acute coronary syndrome (OR = 1.84, 95%CI: 1.01 to 3.35 for IgA; OR = 1.87, 95%CI: 1.01 to 3.46 for IgG). This risk was independent of other cardiovascular risk factors (body mass index, number of teeth, subgingival bacterial levels and periodontal diagnosis) [61] . The serological differences in periodontitis patients may present risk factors for atherosclerosis.…”

Section: Seroepidemiologymentioning

confidence: 80%

Atherosclerosis microbiome: upcoming target for vaccine and drug development

Kozarov¹,

Progulske‐Fox²

2020

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Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in adults and is one critical area of the medical sciences. Atherosclerosis is the main underlying pathology and is characterized by chronic inflammation of the arterial walls. The current treatment modalities for CVD target hypertension, hyperlipidemia and hemostasis, and suppress inflammation without directly addressing the origin of inflammation. Thus, many individuals with multiple classic risk factors for CVD do not experience acute ischemic events. Moreover, myocardial infarction and stroke continue to occur in up to two-thirds of all patients. Because many cardiovascular events have not been explained by genetics or other risk factors, and multiple epidemiologic studies have consistently suggested an infectious component, the introduction of entirely novel approaches for diagnostics and treatment that target infections are acutely needed. These complementary novel approaches addressing additional manageable risk factors such as infections will be based on the concept of personalized medicine to control CVD and achieve longevity, while also increasing the quality of life. There are a variety of avenues that could enable such novel approaches. These focus on the discovery and characterization of the infective component of atherosclerosis, the atherosclerosis microbiome. Specifically, we provide an update of the latest developments in the oral microbiome and its relation to CVD.

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“…Chryseomonas sp was identified in all atherosclerotic plaque samples with Veillonella sp and Streptococcus sp identified in a majority of the samples 32. Several species, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans , were shown to cause an increase in plaque size in animal models following an oral or intravenous infection 33–35…”

Section: The Heart-gut Axis: a Role For The Gut Microbiome In The Patmentioning

confidence: 99%

The heart-gut axis: new target for atherosclerosis and congestive heart failure therapy

Forkosh

Ilan

2019

Open Heart

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The human gut microbiota has been identified as a possible novel risk factor for cardiovascular disease. The intestinal microbiome plays a role in the pathogenesis of atherosclerosis and heart failure. Even though studies in rodents suggested that gut microbes may affect the risk of heart disease, this link has not been shown in humans. In the present study, we review several potential mechanisms by which the gut microbiome and bacterial translocation are associated with the development of cardiac disorders making them potential targets for novel therapeutic measures for these conditions. Modulation of the gut microbiota as a mechanism for altering the pathogenesis of disorders is an area of growing interest. Alteration in the gut microbiota is being explored as a method of reducing risk factors associated with cardiac diseases.

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Immunologic burden links periodontitis to acute coronary syndrome

Abstract: Our findings support the hypothesis that the association between periodontitis and cardiovascular diseases is partly mediated by the immunologic response for periodontal pathogens.

Cited by 64 publications

References 51 publications

Mediators between oral dysbiosis and cardiovascular diseases

Mediators between oral dysbiosis and cardiovascular diseases

Atherosclerosis microbiome: upcoming target for vaccine and drug development

The heart-gut axis: new target for atherosclerosis and congestive heart failure therapy

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