Systemic endotoxin levels in chronic indolent periodontal infections

Abstract

Background and Objective: Periodontal disease has been linked with an increased risk of various systemic diseases. A plausible biologic explanation for this link includes the opportunity for oral pathogens to translocate to the circulation as a result of breakdown in integrity of the oral epithelium. This study refined a methodology used to detect endotoxin activity in the serum of subjects with indolent periodontal infections. Material and Methods: The QCL® Kinetic Chromogenic Assay (Cambrex) is a kinetic measure of endotoxin activity. Sera from 211 pregnant women with periodontitis enrolled in the Obstetrics and Periodontal Therapy Trial were used to develop the assay further and to evaluate the detection of endotoxin activity that might accompany a low-level bacteremia in chronic periodontitis. Results: We optimized the system to increase the sensitivity and reproducibility of the assay. The refined system was able to detect endotoxin activity in serum at > 0.0125 EU/mL. At baseline (13–16 wk of gestation), 35.5% of the women were positive for endotoxin activity (1.62 ± 2.21; range: 0.38–15 EU/mL). Conclusion: This report describes a sensitive measure of endotoxin activity in serum. The procedure allowed us to document levels of this microbial virulence factor in serum of individuals with indolent infections such as periodontal disease.

Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study

“…Although periodontal disease is a local bacterial infection of the oral cavity, it is thought to exert an effect on kidney dysfunction via an inflammatory pathway because periodontal pathogens can access systemic circulation and potentially induce kidney injury through an innate immune response 22 , 23 . Therefore, it seems reasonable that the greatest association between periodontal disease and kidney function decline would be observed among those with the highest inflammatory burden, i.e., the highest PISA quartile, rather than among those with evidence of the most “end‐stage” periodontal disease as found in this study.…”

Chronic kidney disease and use of dental services in a united states public healthcare system: a retrospective cohort study

“…Though periodontal disease is a local bacterial infection of the oral cavity, periodontal pathogens can access systemic circulation [15,16] and potentially induce kidney injury through an innate immune response. However, in the resource-poor public healthcare setting, recommended regular preventive dental care may not be readily accessible.…”

Diabetes and Periodontal Disease: An Update for Health Care Providers

“…However, endotoxins from bacteria identified in periodontal pockets and associated with periodontitis can be found in serum in > 30% of nondiabetic patients who present with early signs of periodontitis. 12 In general, the bacterial infection in periodontitis does not differ between nondiabetic patients and those with type 2 diabetes. However, the immune response to periodontal bacterial infection does differ in that patients with type 2 diabetes do not develop antibodies to pathogens associated with periodontitis.…”