Salivary levels of last generation specific pro‐resolving lipid mediators (SPMs) (protectin and maresin) in patients with cardiovascular and periodontal disease: A case‐control study

Abstract

Background and Objective Periodontal disease and cardiovascular disease (CVD), which are both deemed to be triggered by inflammation, are recognized as public health problems. Evidence of host modulation via pro‐resolving lipid shown in previous studies supports a two‐way relationship between periodontitis and CVD. Last generation endogenous specific pro‐resolution lipid mediators (SPMs) such as protectins (PDs) and maresins (MaRs) may have potential effects on inflammatory pathogenesis via activation and resolution mechanisms. Currently, there are no data on SPM levels in patients with CVD and periodontal disease. We aimed to evaluate salivary levels of PD and MaR in patients with CVD and periodontal disease. Materials and Methods At total of 181 individuals comprising of 79 healthy controls (C) and 102 patients with diagnosed CVD were included cross‐sectionally. Unstimulated total salivary samples were obtained, and clinical periodontal parameters were determined. Salivary levels of PD and MaR were evaluated by ELISA. The periodontal status of the study population was classified as gingivitis (g) or periodontitis (p). Results Patients with CVD showed lower sociodemographic characteristics, increased clinical periodontal parameters (p < .05), decreased salivary PD (p < .001), and increased salivary MaR levels (p > .05). In the CVDg group, leukocyte, hemoglobin, hematocrit, and high‐density lipoprotein values were higher (p < .05). The CVDp group had a higher neutrophil‐to‐lymphocyte ratio (p < .05). While the PD level was highest in the Cg group, MaR was highest in the CVDp group. The salivary levels of PD and MaR were independent of other confounders in CVD and periodontal disease (p > .05). Conclusion(s) PDs and MaRs may play effective roles in pathogenesis associated with worsening cardiometabolic and periodontal status. These SPMs could also be predictors for conversion from a healthy (systemically and periodontally) to diseased state (CVD and/or periodontitis). Elucidation of the role of SPMs in the relationship between periodontal disease and CVD will enable the development of new host modulation strategies in the prevention and treatment of both diseases, and may also constitute an important public health step by increasing the quality of life of patients with CVD and periodontal disease.

Maresin: Macrophage Mediator for Resolving Inflammation and Bridging Tissue Regeneration—A System-Based Preclinical Systematic Review

“…Saliva was found to have a greater amount of MaR1 in periodontitis patients (0.69 vs. 0.49 ng/mL in control), and patients with cardiovascular disease (CVD) and generalized periodontitis had a more pronounced level. However, within the observed period in the study, no correlation was found with the rate of periodontitis progression, but evidence suggested that an increase in MaR1 and a reduction in protectins’ (PD) salivary levels could be predictors of developing CVD and/or periodontal disease [ 160 , 161 ]. Moreover, it found that MaR1, 14-HDHA, and 7(s)-MaR1 have correlations with different subgingival microbiota of subgingival plaque between the healthy group, periodontitis before scaling and root planning (SRP) treatment, and periodontitis after SRP treatment [ 162 ].…”

Omega-3 (n-3) Fatty Acid–Statin Interaction: Evidence for a Novel Therapeutic Strategy for Atherosclerotic Cardiovascular Disease

“…Recent studies on CVDs reported oxylipin production to be dysregulated [64][65][66]. In this regard, a cross-sectional study has reported novel insights into the oxylipin profile, finding an increased salivary maresin concentration and decreased protectin concentrations in patients with CVD compared to healthy controls [67]. The salivary levels of protectins and maresins were independent of other confounding factors contributing to CVDs [67].…”

“…In this regard, a cross-sectional study has reported novel insights into the oxylipin profile, finding an increased salivary maresin concentration and decreased protectin concentrations in patients with CVD compared to healthy controls [67]. The salivary levels of protectins and maresins were independent of other confounding factors contributing to CVDs [67]. Plasma levels of SPMs and pro-inflammatory oxylipins (i.e., leukotriene (LT) B4 and prostaglandins) were measured in patients with coronary artery disease (CAD) to explore the association with coronary plaque progression [68].…”

Potential Clinical Applications of Pro-Resolving Lipids Mediators from Docosahexaenoic Acid

“…Ischemic heart disease is the main cause of disability and death in the whole word and is the result of an insufficient supply of blood and oxygen to the heart [127]. It has been reported that rats subjected to RvD1 at the beginning of ischemia in vivo decreased infarct size by reducing the mechanism involving phosphoinositide 3-kinase (PI3K)/Akt [128].…”