High incidence of Aggregatibacter actinomycetemcomitans infection in patients with cerebral infarction and diabetic renal failure: a cross-sectional study.
High incidence of Aggregatibacter actinomycetemcomitans infection in patients with cerebral infarction and diabetic renal failure: a cross-sectional study.
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DOI：
10.1186/1471-2334-13-557
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发表时间：
2013-11-24
影响因子：
3.7
通讯作者：
Isobe M
中科院分区：
文献类型：
--
作者：
Murakami M;Suzuki J;Yamazaki S;Ikezoe M;Matsushima R;Ashigaki N;Aoyama N;Kobayashi N;Wakayama K;Akazawa H;Komuro I;Izumi Y;Isobe M
最近的流行病学研究表明，牙周炎是肾衰竭和脑梗塞的主要危险因素。本研究的目的是评估牙周炎、肾衰竭和脑梗塞之间的关联，重点关注微生物学和免疫学特征。 21 名接受血液透析 (HD) 治疗的患者参加了这项研究。其中 8 名患有糖尿病肾病，13 名患有非糖尿病肾病。所有患者均进行了血液检查、牙周检查、脑磁共振成像（MRI）和牙科X光检查。使用定量实时聚合酶链反应 (qRT-PCR) 和酶联免疫吸附测定 (ELISA) 分析龈下菌斑、唾液和血液样本中的牙周病原体、伴放线聚集杆菌 (A. actinomycetemcomitans)、牙龈卟啉单胞菌 (P. gingivalis) 和中间普雷沃氏菌 (P. intermedia)。我们发现，与非糖尿病肾病患者相比，糖尿病肾病患者牙菌斑中伴放线放线菌较多（P = 0.038）。此外，与非糖尿病肾病患者相比，糖尿病肾病患者的脑梗死发生率显着升高（P = 0.029）。糖尿病肾病组患者的临床口腔和影像学评分往往高于非糖尿病肾病组。牙周病原体，特别是伴放线放线菌，可能在日本糖尿病肾病 HD 患者脑梗死的发生过程中发挥作用，至少是部分作用。
Recent epidemiological studies suggest that periodontitis is a major risk factor for renal failure and cerebral infarction. The aim of this study was to evaluate the association among periodontitis, renal failure, and cerebral infarction, focusing on microbiological and immunological features. Twenty-one patients treated with hemodialysis (HD) were enrolled in this study. They were 8 with diabetic nephropathy and 13 with non-diabetic nephropathy. Blood examination, periodontal examination, brain magnetic resonance image (MRI), and dental radiography were performed on all patients. Subgingival plaque, saliva, and blood samples were analyzed for the periodontal pathogens, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Prevotella intermedia (P. intermedia) using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). We found that the patients with diabetic nephropathy had more A. actinomycetemcomitans compared with non-diabetic nephropathy (P = 0.038) in dental plaque. Furthermore, the patients with diabetic nephropathy showed a significantly higher incidence of cerebral infarction compared with those with non-diabetic nephropathy (P = 0.029). Clinical oral and radiographic scores tended to be higher among patients in the diabetic nephropathy group than in the non-diabetic nephropathy group. Periodontal pathogens, particularly A. actinomycetemcomitans, may play a role, at least a part, in the development of cerebral infarction in Japanese HD patients with diabetic nephropathy.