Saliva and Serum Immune Responses in Apical Periodontitis

Pietiäinen, Milla; Liljestrand, John M.; Akhi, Ramin; Buhlin, Kåre; Johansson, Anders; Paju, Susanna; Salminen, Aino; Mäntylä, Päivi; Sinisalo, Juha; Tjäderhane, Leo; Hörkkö, Sohvi; Pussinen, Pirkko J.

doi:10.3390/jcm8060889

Cited by 22 publications

(52 citation statements)

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“…To date, findings on IgA/IgG binding to periodontal bacteria in saliva are limited to A. actinomycetemcomitans , P. gingivalis , T. denticola , P. intermedia , and F. nucleatum [ 10 , 42 , 43 , 44 ]. In the present population, we also determined the salivary antibodies against T. forsythia and P. endodontalis [ 28 , 45 ]. Elevated salivary levels of IgA antibodies against A. actinomycetemcomitans and P. gingivalis [ 10 ] and salivary IgG levels against A. actinomycetemcomitans leukotoxins [ 19 ] have been detected in periodontitis patients.…”

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confidence: 99%

Immunological and Microbiological Profiling of Cumulative Risk Score for Periodontitis

et al. 2020

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The cumulative risk score (CRS) is a mathematical salivary diagnostic model to define an individual’s risk of having periodontitis. In order to further validate this salivary biomarker, we investigated how periodontal bacteria, lipopolysaccharide (LPS), and systemic and local host immune responses relate to CRS. Subgingival plaque, saliva, and serum samples collected from 445 individuals were used in the analyses. Plaque levels of 28 microbial species, especially those of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, and Tannerella forsythia, and serum and salivary levels of IgA and IgG against these five species were determined. Additionally, LPS activity was measured. High CRS associated strongly with all IgA/IgG antibody and LPS levels in saliva, whereas in serum the associations were not that obvious. In the final logistic regression model, the best predictors of high CRS were saliva IgA burden against the five species (OR 7.04, 95% CI 2.25–22.0), IgG burden (3.79, 1.78–8.08), LPS (2.19, 1.38–3.47), and the sum of 17 subgingival Gram-negative species (6.19, 2.10–18.3). CRS is strongly associated with microbial biomarker species of periodontitis and salivary humoral immune responses against them.

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Section: Discussionmentioning

confidence: 99%

Immunological and Microbiological Profiling of Cumulative Risk Score for Periodontitis

et al. 2020

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“…2017, Pietiäinen et al . 2019). Although the exact mechanisms are unclear, oral pathogens may mediate systemic inflammation contributing to the development of atherosclerosis (Pietiäinen et al .…”

Section: Discussionmentioning

confidence: 99%

“…The species were divided into gram‐positive ( n = 45) and gram‐negative ( n = 33; Pietiäinen et al . 2019). The bacterial levels were logarithmically transformed and summed up.…”

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confidence: 99%

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Carotid artery calcification in panoramic radiographs associates with oral infections and mortality

et al. 2020

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Aim To study the prevalence of carotid artery calcification (CAC) in relation to apical and marginal periodontitis, subgingival dysbiotic bacterial species and serum and saliva immune responses against them. In addition, the aim was to analyse the association of CAC with angiographically verified coronary artery disease (CAD) and mortality. Methodology In the present random Parogene cohort, the patients had an indication for coronary angiography. Apical and marginal periodontitis were diagnosed during clinical and radiographic oral examinations, and CAC on panoramic radiographs (n = 492). Presence and severity of CAD were registered from angiography. Subgingival dysbiotic bacterial species were quantitated using checkerboard DNA-DNAhybridization, and serum and saliva antibody levels were determined by immunoassays. The cohort was followed-up for 10 years or until death (median 9.9, range 0.21-10.4) via linkage to the national death register. The statistical models were adjusted for age, gender, smoking, hypertension, diabetes and dyslipidemia. Results A total of 102 (20.7%) patients had detectable CAC, which was moderate in 81 (16.4%) and severe in 21 (4.3%). CAC was associated (OR, 95% CI) with severe apical periodontitis (2.25, 1.15-4.41), root canal fillings (1.15, 1.04-1.26), alveolar bone loss (2.66, 1.21-5.84), severe periodontal inflammation (2.23, 1.11-4.47), high level of gram-negative subgingival species (2.73, 1.34-5.50), saliva IgG against dysbiotic species (1.05, 1.01-1.10/unit) and severe (2.58, 1.36-4.90) and chronic (2.13, 1.15-3.93) CAD. A total of 105 (20.7%) patients died during the follow-up and 53 (10.4%) deaths were because of cardiovascular diseases (CVD). Severe CAC predicted worse survival with HRs (95% CI) of 3.08 (1.58-6.06) for all-cause and 3.43 (1.42-8.25) for CVD death. Conclusions CAC on panoramic tomography was associated with (i) apical and marginal periodontitis and dysbiotic bacterial species giving rise to an immunological response, and with (ii) severe, chronic CAD and increased mortality. The results further emphasize the role of oral infections in CAD and the importance of referring a patient with CAC for a cardiovascular evaluation.

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“…These responses normally prevents microbial invasion deeper into the tissues surrounding the teeth, or into circulation. The work by Pietiäinen and collaborators [4] focuses on the immune response against bacteria occurring in apical periodontitis, an inflammatory disease that affects the tissues surrounding the apex of the tooth, which is initially triggered by oral pathogens infecting the root canals. The study investigated serum and saliva antibodies against several oral pathogens associated with apical periodontitis, and the role of cross-reactive antibodies in the disease.…”

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Comment from the Editor to the Special Issue: “Periodontitis: From Dysbiotic Microbial Immune Response to Systemic Inflammation”

Oscarsson

Johansson

2019

JCM

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The human oral cavity contains a large number of different microbial habitats. When microbes from the oral indigenous flora colonize the interspace between the tooth and the connective tissue, they induce an inflammatory response. If the microbes are in sufficient numbers, and release components that cause an imbalance in the host inflammatory response, degenerative processes in the surrounding tissues are induced, ultimately resulting in periodontal disease. The disease progress depends on bacterial load, the composition of the microbial community, and host genetic factors. The two most studied periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans express virulence factors, including proteases and exotoxins. Periodontal infections are also linked to the risk pattern of several systemic diseases. We would like to shed light on the mechanisms behind periodontitis and the associations of periodontal infections with systemic inflammation. Seven articles are included in this Special Issue and cover several pathogenic processes in the periodontal infection with capacity to cause imbalance in the host response. Highlights from each of the published papers are summarized and discussed below.

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Saliva and Serum Immune Responses in Apical Periodontitis

Cited by 22 publications

References 59 publications

Immunological and Microbiological Profiling of Cumulative Risk Score for Periodontitis

Immunological and Microbiological Profiling of Cumulative Risk Score for Periodontitis

Carotid artery calcification in panoramic radiographs associates with oral infections and mortality

Comment from the Editor to the Special Issue: “Periodontitis: From Dysbiotic Microbial Immune Response to Systemic Inflammation”

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