Periodontitis decreases the antiatherogenic potency of high density lipoprotein

Abstract

Periodontitis, a consequence of persistent bacterial infection and chronic inflammation, has been suggested to predict coronary heart disease (CHD). The aim of this study was to investigate the impact of periodontitis on HDL structure and antiatherogenic function in cholesterol efflux in vitro. HDL was isolated from 30 patients (age 43.6 ؎ 6.1 years, mean ؎ SD) with periodontitis before and after (3.2 ؎ 1.4 months) periodontal treatment. The capacity of HDL for cholesterol efflux from macrophages (RAW 264.7), HDL composition, and key proteins of HDL metabolism were determined. After periodontal treatment, phospholipid transfer protein (PLTP) activity was 6.2% ( P Ͻ 0.05) lower, and serum HDL cholesterol concentration, PLTP mass, and cholesteryl ester transfer protein activity were 10.7% ( P Ͻ 0.001), 7.1% ( P ‫؍‬ 0.078), and 19.4% ( P Ͻ 0.001) higher, respectively. The mean HDL 2 /HDL 3 ratio increased from 2.16 ؎ 0.87 to 3.56 ؎ 0.48 ( P Ͻ 0.05). HDL total phospholipid mass and sphingomyelin-phosphatidylcholine ratio were 7.4% ( P Ͻ 0.05) and 36.8% ( P Ͻ 0.001) higher, respectively. The HDL-mediated cholesterol efflux tended to be higher after periodontal treatment; interestingly, this increase was significant ( P Ͻ 0.05) among patients whose C-reactive protein decreased (53.7% reduction, P ‫؍‬ 0.015) and who were positive by PCR for Actinobacillus actinomycetemcomitans . These results suggest that periodontitis causes similar, but milder, changes in HDL metabolism than those that occur during the acute-phase response and that periodontitis may diminish the antiatherogenic potency of HDL, thus increasing the risk for CHD. -Pussinen, P. J., M. Jauhiainen, T. Vilkuna-Rautiainen, J. Sundvall, M. Vesanen, K. Mattila, T. Palosuo, G. Alfthan, and S. Asikainen. Periodontitis decreases the antiatherogenic potency of high density lipoprotein.

Periodontal treatment influences risk markers for atherosclerosis in patients with severe periodontitis

“…If a standard periodontal treatment could positively influence established risk markers for CVD, then this could be interpreted as sign of causality. Previous intervention studies suggest that periodontal treatment decreases the levels of inflammatory markers such as CRP, fibrinogen and IL-6 [12,14]. However, these studies were fairly small and the follow-up periods were only between 3 and 6 months.…”

“…HDL-C concentrations slowly increased during the 12-month study period, which corresponds well with the periodontal infection treatment. Both chronic and acute infections decreased circulating HDL-C concentrations by various mechanisms, including an increase in apolipoprotein A-I catabolism and changes in HDL-C subclass distribution [11,12]. The observed decrease of LDL-C concentration may be due to alterations in lipase and lipid transfer protein activities, as well as expression levels of LDL-C receptors.…”

Tooth Loss Is Associated With an Increased Risk of Hypertension in Postmenopausal Women

“…6 -18 Periodontal disease, a local chronic bacterial infection in the oral cavity, may contribute to endothelial dysfunction, 12 carotid artery plaque formation, 11,13,15,17 or deterioration of the antiatherogenic potency of HDL. 18 A second pathway is that tooth loss may affect dietary quality and nutrient intake, leading to an increased risk of vascular diseases. 19 -21 A third is confounding variables such as smoking or diabetes mellitus that largely affect both tooth loss and vascular diseases may produce spurious association between 2 phenomena.…”

Inflammation buccale et accidents vasculaires cérébraux ischémiques non fatals

“…Pour Pussinen et al, A. actinomycetemconcomitans diminuerait le taux de HDL ce qui augmenterait le risque de développer une athérosclérose [40]. Ceci conforte l'hypothèse de Ross qui a retrouvé un état biologique proinflammatoire et pro-athéromateux chez les patients atteints d'une parodontite sévère, illustrant ainsi le rôle de l'inflammation buccale dans l'athérogénèse [41].…”