Biomarkers of periodontitis and inflammation in ischemic stroke: A case-control study
Biomarkers of periodontitis and inflammation in ischemic stroke: A case-control study
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DOI：
10.1177/1753425913501214
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发表时间：
2014-07-01
期刊：
影响因子：
3.2
通讯作者：
Pussinen, Pirkko
中科院分区：
文献类型：
--
作者：
Palm, Frederick;Lahdentausta, Laura;Pussinen, Pirkko
牙周炎是一种常见的感染性疾病，与缺血性中风的风险增加有关，尽管目前机制尚不清楚。在一项病例对照研究中，我们调查了四种牙周病原体的唾液水平，以及全身和局部炎症标志物。研究对象包括98名急性缺血性中风患者(平均年龄68.2+/-9.7岁；女性占45.9%)和100名健康对照(69.1+/-5.2岁；女性占47.0%)。与对照组相比，患者更常无牙，牙齿更少(13.8+/-10.8比16.6+/-10.1)。在调整了中风危险因素和牙齿数量后，对照组的唾液基质金属蛋白酶-8(MMP-8)、髓过氧化物酶(MPO)、IL-1β、伴生放线杆菌和血清内毒素活性水平较高。患者血清MMP8和MPO水平较高，伴生放线菌qPCR阳性(37.9%比19.0%)和牙周病>；=3种联合阳性(50.0%比33.0%)更常见。我们得出的结论是，对照组更多地有当前牙周感染的证据，牙周病原菌数量较高，内毒素血症，局部炎症和组织破坏。中风患者更多的是有终末期牙周炎的证据，并伴有无牙和牙齿缺失。他们更多地是唾液中几种牙周病病原体的携带者，特别是伴生放线菌。此外，炎症负担可能导致与卒中易感性增加相关的高全身性炎症。
Periodontitis is a common infectious disease associated with increased risk for ischemic stroke though presently unclear mechanisms. In a case-control study, we investigated salivary levels of four periodontal pathogens, as well as systemic and local inflammatory markers. The population comprised 98 patients with acute ischemic stroke (mean +/- SD, 68.2 +/- 9.7 yrs; 45.9% women) and 100 healthy controls (69.1 +/- 5.2 yrs; 47.0% women). Patients were more often edentulous and had fewer teeth than controls (13.8 +/- 10.8 versus 16.6 +/- 10.1). After adjusting for stroke risk factors and number of teeth, controls had higher saliva matrix metalloproteinase-8 (MMP-8), myeloperoxidase (MPO), IL-1 beta, Aggregatibacter actinomycetemcomitans, and serum LPS activity levels. Patients had higher serum MMP-8 and MPO, and they were more often qPCR-positive for A. actinomycetemcomitans (37.9% versus 19.0%) and for >= 3 periodontopathic species combined (50.0% versus 33.0%). We conclude that controls more often had evidence of current periodontal infection with higher periodontal pathogen amount, endotoxemia, local inflammation and tissue destruction. Stroke patients more often had evidence of end-stage periodontitis with edentulism and missing teeth. They were more often carriers of several periodontopathic pathogens in saliva, especially A. actinomycetemcomitans. Additionally, inflammatory burden may contribute to high systemic inflammation associated with elevated stroke susceptibility.