Treatment of periodontitis and <scp>C</scp>‐reactive protein: A systematic review and meta‐analysis of randomized clinical trials

Luthra, Shailly; Orlandi, Marco; Hussain, Syed Basit; Leira, Yago; Botelho, João; Machado, Vanessa; Mendes, José João; Marletta, Debora; Harden, Simon; D’Aiuto, Francesco

doi:10.1111/jcpe.13709

Cited by 22 publications

(18 citation statements)

References 60 publications

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“…Currently, the relation between periodontal disease and CRP is not unequivocal [19,21,[46][47][48][49]. Several observational studies have shown that periodontitis has also been linked to elevated CRP levels [40].…”

Section: Discussionmentioning

confidence: 99%

“…A meta-analysis showed that twenty-six randomized controlled clinical trials reported changes amongst 2579 participants about CRP levels at 6 months or more after treatment. Treatment of periodontitis reduced CRP levels by 0.69 mg/L (95% confidence interval: -0.97 to 0.40) after 6 months, but limited evidence was retrieved from studies with longer follow-ups [19]. Another meta-analysis screening of the initially 448 identified studies and reference checking resulted in 18 suitable papers.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly to what is seen in human periodontitis, experimental animal periodontitis causes increased serum levels of acute phase proteins (such as CRP and serum amyloid A) [15][16][17][18]. Interestingly, several other studies have shown that the relationship between the extent of periodontal disease and CRP is not clear [19][20][21]. Therefore, some contradictory results have emerged from previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Genetic association of C-reactive protein with periodontitis: a two-sample Mendelian randomization study

Liu

Jiang

et al. 2023

Preprint

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Background The association between C-reactive protein (CRP) and periodontitis has been reported in several observational studies. However, those studies are prone to residual confounding , thus limiting our understanding of the causal conclusions. Therefore, we aimed to assess the relationship between CRP and periodontitis by using the two sample Mendelian randomization (MR) method. Methods We analyzed the data from two genome-wide association studies (GWAS) of European ancestry, including CRP (204,402 individuals) and periodontitis (17353 cases and 28210 controls). We primarily used inverse variance weighted (IVW) to assess the causal effects. Pleiotropy was determined by using MR-Egger regression. Heterogeneity was examined with Cochran’s Q test. The leave-one-out analysis tested the robustness of the results. Results We obtained 54 SNPs as instrumental variables (IVs) for CRP, and these IVs had no significant horizontal pleiotropy, heterogeneity, or bias. MR analysis revealed no obvious causal effect between CRP and periodontitis (ORIVW=1.026, 95% CI 0.998–1.055, P=0.066; ORMR-Egge=1.026, 95% CI: 0.983-1.070, p = 0.242; ORweighted median=1.030, 95% CI: 0.991-1.070, p = 0.132). Conclusions The MR analysis indicated that CRP could not increase the risk of periodontitis in people of European ancestry.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Genetic association of C-reactive protein with periodontitis: a two-sample Mendelian randomization study

Liu

Jiang

et al. 2023

Preprint

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“…In this process, the dysbiotic biofilm causes not only a local inflammatory response but also a systemic inflammatory response, which is related to various noncommunicable diseases and can influence their development and progression [ 340 ].…”

Section: Individual Approachesmentioning

confidence: 99%

“…In summary, given the potential links between periodontal inflammation and AD, minimizing intraoral biofilm, and consequently reducing the inflammatory response is most likely to be beneficial with respect to the development and progression of dementia. For other chronic diseases, such as cardiovascular disease, this benefit has already been adequately demonstrated: For example, a recent systematic review with meta-analysis concluded that professional and home-based management of oral biofilm as a non-pharmacological intervention reduced systemic inflammation to an extent equivalent to that achieved by drug interventions to treat residual cardiovascular risk [ 340 ].…”

Section: Individual Approachesmentioning

confidence: 99%

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Ablinger¹,

Dressel

Rott³

et al. 2022

Biomedicines

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Alzheimer’s disease is one of the most common neurodegenerative diseases in the western population. The incidence of this disease increases with age. Rising life expectancy and the resulting increase in the ratio of elderly in the population are likely to exacerbate socioeconomic problems. Alzheimer’s disease is a multifactorial disease. In addition to amyloidogenic processing leading to plaques, and tau pathology, but also other molecular causes such as oxidative stress or inflammation play a crucial role. We summarize the molecular mechanisms leading to Alzheimer’s disease and which potential interventions are known to interfere with these mechanisms, focusing on nutritional approaches and physical activity but also the beneficial effects of cognition-oriented treatments with a focus on language and communication. Interestingly, recent findings also suggest a causal link between oral conditions, such as periodontitis or edentulism, and Alzheimer’s disease, raising the question of whether dental intervention in Alzheimer’s patients can be beneficial as well. Unfortunately, all previous single-domain interventions have been shown to have limited benefit to patients. However, the latest studies indicate that combining these efforts into multidomain approaches may have increased preventive or therapeutic potential. Therefore, as another emphasis in this review, we provide an overview of current literature dealing with studies combining the above-mentioned approaches and discuss potential advantages compared to monotherapies. Considering current literature and intervention options, we also propose a multidomain interdisciplinary approach for the treatment of Alzheimer’s disease patients that synergistically links the individual approaches. In conclusion, this review highlights the need to combine different approaches in an interdisciplinary manner, to address the future challenges of Alzheimer’s disease.

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Temporal and spatial effects on C‐reactive protein's regulation of inducible nitric oxide synthase production in periodontal disease

Jia

Hou

et al. 2023

Journal of Periodontology

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BackgroundInducible nitric oxide synthase (iNOS) is associated with inflammation and osteoclastic differentiation in periodontal disease. This study was conducted to compare the time‐dependent variation in iNOS production between the gingiva and other periodontal tissues and to explore the potential association with C‐reactive protein (CRP) in early periodontal disease.MethodsLigature‐induced periodontal disease models (0–14 days) were established in wild‐type and CRP knockout rats. Changes in CRP, iNOS, and autophagy levels were examined in the gingiva and other periodontal tissues. Macrophages were treated with lipopolysaccharide and chloroquine to explore the role of autophagy in iNOS production. iNOS, CRP, and autophagy‐related proteins were analyzed using Western blotting, immunostaining, and enzyme‐linked immunosorbent assays. mRNA expression was detected by quantitative real‐time polymerase chain reaction. Hematoxylin and eosin staining was used for histological analysis. Cathepsin K immunostaining and microcomputed tomography of the maxillae were performed to compare alveolar bone resorption.ResultsiNOS and CRP levels increased rapidly in periodontal tissues, as observed on Day 2 of ligature, then decreased more rapidly in the gingiva than in other periodontal tissues. CRP deficiency did not prevent iNOS generation, but effectively accelerated iNOS reduction and delayed alveolar bone loss. The CRP effect on iNOS was accompanied by a change in autophagy, which was reduced by CRP knockout.ConclusionsThe regulation of iNOS by CRP shows temporospatial variation in early periodontal disease and is potentially associated with autophagy. These findings may contribute to the early detection and targeted treatment of periodontal disease.

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Treatment of periodontitis and C‐reactive protein: A systematic review and meta‐analysis of randomized clinical trials

Cited by 22 publications

References 60 publications

Genetic association of C-reactive protein with periodontitis: a two-sample Mendelian randomization study

Genetic association of C-reactive protein with periodontitis: a two-sample Mendelian randomization study

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Temporal and spatial effects on C‐reactive protein's regulation of inducible nitric oxide synthase production in periodontal disease

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