Periodontal therapy and endothelial function in coronary artery disease: A randomized controlled trial

Saffi, Marco Aurélio Lumertz; Rabelo‐Silva, Eneida Rejane; Polanczyk, Carísi Anne; Furtado, Mariana Vargas; Montenegro, Márlon Munhoz; Ribeiro, Ingrid Helena; Kampits, Cássio; Rösing, Cassiano Kuchenbecker; Haas, Alex Nogueira

doi:10.1111/odi.12909

Cited by 39 publications

(37 citation statements)

References 34 publications

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“…In addition, leukocyte-endothelial cell adhesion induced by TNFα leads to an increased production of ROS by said cells [42,43], which promotes leukocyte transmigration to the subendothelial space. Although there is increasing evidence that periodontal treatment can improve endothelial function [44][45][46][47], as far as we know, there are no reports to date about its effect in an obese population. Previous randomized clinical trials have evaluated the effect of periodontal treatment on vasodilation and subclinical arterial thickness in patients with periodontitis in the presence or absence of comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study

Martínez-Herrera

Abad-Jiménez

Silvestre

et al. 2020

JCM

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Aim: The primary objective of this pilot study was to evaluate the effect of non-surgical periodontal treatment. The secondary aim was to evaluate the effect of dietary therapy on both parameters of oxidative stress in leukocytes and leukocyte-endothelial cell interactions in an obese population. Methods: This was a pilot study with a before-and-after design. Forty-nine obese subjects with periodontitis were randomized by means of the minimization method and assigned to one of two groups, one of which underwent dietary therapy while the other did not. All the subjects underwent non-surgical periodontal treatment. We determined periodontal, inflammatory and oxidative stress parameters—total reactive oxygen species (ROS), superoxide production, intracellular Ca2+, mitochondrial membrane potential and superoxide dismutase (SOD) activity. We also evaluated interactions between leukocytes and endothelium cells—velocity, rolling flux and adhesion—at baseline and 12 weeks after intervention. Results: Periodontal treatment improved the periodontal health of all the patients, with a reduction in serum retinol-binding protein 4 (RBP4), total superoxide production and cytosolic Ca2+ in leukocytes. In the patients undergoing dietary therapy, there were less leukocyte adhesion to the endothelium, an effect that was accompanied by a decrease in TNFα, P-selectin and total ROS and an increase in SOD activity. Conclusions: Whereas non-surgical periodontal treatment induces an improvement in leukocyte homeostasis, dietary therapy as an adjuvant reduces systemic inflammation and increases antioxidant status which, in turn, modulates leukocyte-endothelium dynamics.

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Section: Discussionmentioning

confidence: 99%

Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study

Martínez-Herrera

Abad-Jiménez

Silvestre

et al. 2020

JCM

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“…Another study has reported high levels of sICAM -1 in the saliva of individuals diagnosed with periodontal disease. 19 In our study, a significant difference was detected in median salivary TNF -α-R1 concentrations in individuals with obesity (237.38 pg/ml) when compared with healthy individuals (113.11 pg/ml). This may indicate an increase in TNF -α concentrations and could explain the persistent moderate inflammation and a tendency for cell apoptosis in obese patients.…”

Section: What's New?mentioning

confidence: 44%

Characteristics of salivary inflammation profile in obesity

Lehmann

Nijakowski

Swora-Cwynar

et al. 2020

Polish Archives of Internal Medicine

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well as their severe consequences like cardiovascular disease, diabetes, metabolic disorders, carcinogenesis, and severe asthma. 1-5 New molecular technologies within the last decade have focused on analyses of salivary proteome and transcriptome. Saliva has been studied as an alternative biological fluid in the noninvasive diagnostics of several systemic diseases, such as endocrine, cardiovascular, autoimmune, or infectious diseases. 6,7 Saliva is generally composed of water (about 99%), proteins (eg, enzymes and immunoglobulins), and electrolytes (eg, sodium and calcium). All these substances are delivered to saliva mainly by salivary glands, gingival crevices, and upper respiratory mucosa. The majority of blood components pass to saliva via intracellular mechanisms, such as passive or active transport or ultrafiltration between cell junctions, by analogy to INTROduCTION Adipose tissue plays an important role in storage of excessive nutrients and regulating energy balance. Due to limited ability of adipocytes for fat deposition, overnutrition generates the production of oxygen free radicals resulting in oxidative stress and, consequently, inflammation. In obesity, low-grade inflammatory status is primarily caused by the activity of adipocytes and immune cells secreting various proinflammatory molecules, such as tumor necrosis factor-α receptors 1 (TNF-α-R1) and 2 (TNF-α-R2), pentraxin 3 (PTX3), interleukin 15 (IL-15), monocyte chemoattractant protein 1 (MCP-1), soluble intercellular adhesion molecule 1 (sICAM-1), or soluble CD40 ligand (sCD40L). All these signaling molecules are responsible for such processes as chronic systemic inflammation, adipogenesis, atherosclerosis, or insulin resistance, as

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“…The oxidative stress levels in these patients exhibited a downtrend, returning to normal in 90 days post treatment [142] . Periodontal treatment however did not improve vasodilation in coronary disease patients in a brief follow-up period, even though it maintained the titers of vascular inflammation markers [143] . An in-depth review on oxidative stress in periodontal disease, focusing on the relationship between the local and systemic markers of oxidative stress and periodontal disease is in [144] .…”

Section: Effect Of Periodontal Treatment On Atherosclerotic Inflammationmentioning

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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Periodontal therapy and endothelial function in coronary artery disease: A randomized controlled trial

Abstract: Periodontal treatment did not provide better vasodilation in patients with coronary disease in a short-term follow-up period, although it maintained blood concentrations of markers of vascular inflammation.

Cited by 39 publications

References 34 publications

Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study

Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study

Characteristics of salivary inflammation profile in obesity

Atherosclerosis microbiome: upcoming target for vaccine and drug development

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