Dental plaque, platelets, and cardiovascular diseases.
Dental plaque, platelets, and cardiovascular diseases.
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DOI：
10.1902/annals.1998.3.1.151
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发表时间：
1998-07-01
期刊：
影响因子：
--
通讯作者：
Weyer, M W
中科院分区：
文献类型：
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作者：
Herzberg, M C;Weyer, M W
心血管疾病，包括动脉粥样硬化和心肌缺血，是由一系列复杂的遗传和环境因素造成的。牙周炎期间，牙菌斑微生物可能通过血液传播感染血管内皮，导致动脉粥样硬化的发生以及心肌缺血和梗塞的风险。心肌缺血和梗塞通常先发生急性血栓栓塞事件。在血栓形成的体外模型中，某些牙菌斑细菌会诱导血小板聚集。血小板聚集是由斑块细菌（包括血链球菌和牙龈卟啉单胞菌）上表达的血小板聚集相关蛋白 [PAAPJ] 诱导的。此前已证明，给兔子静脉注射血链球菌会引起心电图（ECG）、心率、血压和心肌收缩力的变化。这些变化与心肌梗死的发生是一致的。现在显示，在输注 PAAP+ 血链球菌后 30 秒内，心电图开始发生变化，随后血压和呼吸频率发生变化。这些变化在 30 分钟内间歇性地发生，并在一次心跳内变为正常模式，然后突然恢复为异常模式。 15 只兔子中有 13 只出现间歇性心电图异常，包括电轴左偏、ST 段压低、室前性期前收缩、交替和二联现象。还发生了剂量依赖性血小板减少症、111In标记的血小板在肺部积聚以及呼吸急促。 PAAp-菌株没有发生任何变化。数据表明，PAPP+血链球菌与循环血小板相互作用，诱导血栓栓塞，导致肺和心脏异常。因此，在牙周炎期间，PAAP+ 血链球菌和牙龈卟啉单胞菌菌血症可能会导致急性血栓栓塞事件的发生。
Cardiovascular diseases, including atherosclerosis and myocardial ischemia, occur as a result of a complex set of genetic and environmental factors. During periodontitis, dental plaque microorganisms may disseminate through the blood to infect the vascular endothelium and contribute to the occurrence of atherosclerosis and risk of myocardial ischemia and infarction. Myocardial ischemia and infarction are often preceded by acute thromboembolic events. In an in vitro model of thrombosis, certain dental plaque bacteria induce platelets to aggregate. Aggregation of platelets is induced by the platelet aggregation-associated protein [PAAPJ expressed on plaque bacteria, including Streptococcus sanguis and Porphyromonas gingivalis. Intravenous infusion of S. sanguis into rabbits has been shown previously to cause changes in the electrocardiogram (ECG), heart rate, blood pressure, and cardiac contractility. These changes are consistent with the occurrence of myocardial infarction. The ECG changes are now shown to begin within 30 seconds after infusion of PAAP+ S. sanguis, followed by alterations in blood pressure and respiratory rate. These changes occurred intermittently over a 30-minute period and changed within one heartbeat to a normal pattern and suddenly back to abnormal. Intermittent ECG abnormalities were seen in 13 of 15 rabbits, including left axis deviation, ST-segment depression, preventricular contractions, alternans, and bigemnia. Dose-dependent thrombocytopenia, accumulation of 111Indium-labeled platelets in the lungs, and tachypnea also occurred. No changes occurred with the PAAp- strain. The data indicated that PAPP+ S. sanguis interacts with circulating platelets, inducing thromboemboli to cause the pulmonary and cardiac abnormalities. During periodontitis, therefore, PAAP+ S. sanguis and P. gingivalis bacteremia may contribute to the chance of acute thromboembolic events.