Treatment of periodontitis reduces systemic inflammation in type 2 diabetes

Preshaw, Philip M.; Taylor, John J.; Jaedicke, Katrin M.; Jäger, Mark D.; Bikker, Jan Willem; Selten, Wieke; Bissett, Susan M; Whall, Kerry M.; Merwe, Rachel van de; Areibi, Aisha; Jitprasertwong, Paiboon; Al-Shahwani, Rana Majid Shareef; Weaver, Jolanta U.; Taylor, R.; Wassall, Rebecca

doi:10.1111/jcpe.13274

Cited by 64 publications

(55 citation statements)

References 34 publications

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“…Clinical and animal studies showed that active inflammatory processes were present in both ASVD and VHD, and that inflammation drove cardiovascular calcification and osteoporotic bone remodelling (Abdelbaky et al., 2015), (Hjortnaes et al., 2010). Treatment of periodontitis was shown to reduce both oral and systemic inflammatory markers in diabetic patients (Preshaw et al., 2020). Our study showed that after propensity scores for these common risk factors were matched, periodontitis was still significantly associated with VHD.…”

Section: Discussionmentioning

confidence: 99%

Periodontitis is associated with incidental valvular heart disease: A nationwide population‐based cohort study

Sia

Jan

Wang

et al. 2021

J Clinic Periodontology

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Aim: Periodontitis and valvular heart disease (VHD) are common diseases. Both diseases are related to chronic inflammation and share many common risk factors.Previous periodontal studies had focused mainly on atherosclerotic cardiovascular disease. This study aimed to determine whether periodontitis is associated with the development of VHD. Materials and methods:This was a retrospective nationwide cohort study using Taiwan's Longitudinal Health Insurance Database. Using ICD-9-CM coding, both the periodontitis and non-periodontitis groups were matched.Results: There were 8483 cases and 4919 cases of VHD diagnosed in the periodontitis group and non-periodontitis group, respectively. The cumulative incidence of VHD was significantly higher in the periodontitis group (log-rank test, p < .001), with the incidence density of 6.44 (95% CI, 6.31-6.58) per 1000 person-years in the periodontitis group compared to 4.65 (95% CI, 4.52-4.78) in the non-periodontitis group. The relative risk for VHD was 1.39 (95% CI, 1.34-1.44). After multivariate analysis, periodontitis was independently associated with a risk for VHD (HR, 1.38; 95% CI, 1.33-1.42, p < .001). Intensive treatment of periodontitis significantly lowered the risk for VHD (HR, 0.68; 95% CI, 0.60-0.77, p < .001). Conclusions:Periodontitis was significantly associated with the development of VHD.Treatment of periodontitis reduced the risk for VHD. K E Y W O R D Speriodontitis, taiwan national health insurance research database (NHIRD), valvular heart disease Clinical Relevance• Scientific rationale for study: Is there an association between periodontitis and valvular heart disease ? No large-scale epidemiology study had ever answered this topic.• Principal finding: In this large-scale retrospective cohort study, periodontitis was statistically associated with a significant risk for valvular heart disease (HR, 1.38). Treatment of periodontal disease reduced the risk (HR, 0.43).

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Section: Discussionmentioning

confidence: 99%

Periodontitis is associated with incidental valvular heart disease: A nationwide population‐based cohort study

Sia

Jan

Wang

et al. 2021

J Clinic Periodontology

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“…IL-1β may serve as a link between periodontitis and diabetes since elevated levels of IL-1β have been detected in gingival tissues of human and animal models with diabetes (Sanz et al 2018). Periodontal treatment resulted in reduction of systemic and local inflammation, including a decrease in serum and GCF IL-1β levels in periodontitis patients with and without type 2 diabetes (Preshaw et al 2020). Blocking IL-1R or knocking down IL-1R in animal models of periodontitis resulted in reduced periodontal tissue destruction compared to control animals, supporting the role of IL-1 in promoting periodontitis (Graves 2008).…”

Section: Il-1mentioning

confidence: 99%

IL-1 Superfamily Members and Periodontal Diseases

et al. 2020

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Periodontitis is a complex, multifactorial chronic disease involving continuous interactions among bacteria, host immune/inflammatory responses, and modifying genetic and environmental factors. More than any other cytokine family, the interleukin (IL)–1 family includes key signaling molecules that trigger and perpetuate periodontal inflammation. Over the years, the IL-1 family expanded to include 11 members of cytokines, some with agonist activity (IL-1α, IL-1β, IL-18, IL-33, IL-36α, IL-36β, and IL-36γ), receptor antagonists (IL-1Ra, IL-36Ra), and 2 anti-inflammatory cytokines (IL-37, IL-38). The IL-1 receptor antagonist (IL-1Ra) has emerged as a pivotal player in the defense against periodontitis. IL-33 primarily induces the production of Th2-associated cytokines but acts as an “alarmin” via stimulation of mast cells. The IL-36 subclass of cytokines may be important in regulating mucosal inflammation and homeostasis. IL-37 suppresses innate and acquired immune responses. IL-38 is the most recent member of the IL-1 superfamily and has anti-inflammatory properties similar to those of IL-37 but through different receptors. However, limited evidence exists regarding the role of IL-37 and IL-38 in periodontitis. Despite the development of IL-1 blocking agents, therapeutic blockade of select IL-1 family members for periodontitis has only been partially investigated in preclinical and clinical research, while the development of IL-37 and IL-38 as novel anti-inflammatory drugs has not been considered adequately. Here, we review the key properties of the IL-1 family members and provide insights into targeting or promoting select cytokines as new therapeutic agents.

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“…The International Diabetes Federation estimated that 700 million people of the global population will be living with diabetes until 2045 [ 9 ]. Diabetes increased the risk of developing periodontitis by 86% [ 10 ] and individuals with both diabetes and periodontitis have higher systemic inflammation when compared with healthy controls [ 11 ]. The underlying pathogenic pathways are certainly bidirectional.…”

Section: Introductionmentioning

confidence: 99%

The Association of Periodontitis and Peripheral Arterial Occlusive Disease in a Prospective Population-Based Cross-Sectional Cohort Study

Jacobi

Walther

Borof

et al. 2021

JCM

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Objectives: Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entities using high quality research data and multiple phenotypes derived from an epidemiological cohort study. Design: This population-based cross-sectional cohort study included data from 3271 participants aged between 45 and 74 years enrolled in the Hamburg City Health Study (NCT03934957). Material & Methods: An ankle-brachial-index below 0.9, color-coded ultrasound of the lower extremity arteries, and survey data was used to identify participants with either asymptomatic or symptomatic PAOD. Periodontitis data was collected at six sites per tooth and included the probing depth, gingival recession, clinical attachment loss, and bleeding on probing index. Multivariate analyses using logistic regression models were adjusted for variables including age, sex, smoking, education, diabetes, and hypertension. Results: The baseline characteristics differed widely between participants neither affected by periodontitis nor PAOD vs. the group where both PAOD and severe periodontitis were identified. A higher rate of males, higher age, lower education level, smoking, diabetes, and cardiovascular disease was observed in the group affected by both diseases. After adjusting, presence of severe periodontitis (odds ratio 1.265; 97.5% CI 1.006–1.591; p = 0.045) was independently associated with PAOD. Conclusion: In this cross-sectional analysis of a prospective cohort study, an independent association between periodontitis and PAOD was revealed. The results of the current study emphasize a potential for preventive medicine in an extremely sensitive target population. Future studies should determine the underlying factors modifying the relationship between both diseases.

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Treatment of periodontitis reduces systemic inflammation in type 2 diabetes

Cited by 64 publications

References 34 publications

Periodontitis is associated with incidental valvular heart disease: A nationwide population‐based cohort study

Periodontitis is associated with incidental valvular heart disease: A nationwide population‐based cohort study

IL-1 Superfamily Members and Periodontal Diseases

The Association of Periodontitis and Peripheral Arterial Occlusive Disease in a Prospective Population-Based Cross-Sectional Cohort Study

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