Associations of Antibodies Targeting Periodontal Pathogens With Subclinical Coronary, Carotid, and Peripheral Arterial Atherosclerosis in Rheumatoid Arthritis.
Associations of Antibodies Targeting Periodontal Pathogens With Subclinical Coronary, Carotid, and Peripheral Arterial Atherosclerosis in Rheumatoid Arthritis.
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DOI：
10.1002/art.41572
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Konig MF
中科院分区：
文献类型：
--
作者：
Giles JT;Reinholdt J;Andrade F;Konig MF
牙周病和心血管疾病（CVD）在类风湿关节炎（RA）中都有过高的发病率。然而，牙周病原体对风湿性关节炎CVD的影响尚不清楚。RA患者分别通过计算机断层扫描、超声和多普勒超声评估冠状动脉钙化（CAC）、颈动脉内膜中膜厚度和斑块以及踝肱指数。检测血清中针对牙龈卟啉单胞菌（抗pg）、放线菌聚集杆菌血清b型（抗Aa）和Aa白毒素A（抗ltxa）的抗体。针对这些牙周病原体的抗体与动脉粥样硬化措施的关联使用广义线性模型进行了探讨。在197例RA患者中，72例（37%）检测到抗pg， 41例（21%）检测到抗aa， 84例（43%）检测到抗ltxa。校正相关混杂因素和报告的牙齿脱落后，抗aa和/或抗ltxa患者的平均CAC评分比没有任何抗体的患者高90%[分别为19和10个单位（p=0.033）]。抗aa和/或抗ltxa患者CAC≥100单位的校正几率比无抗体者高2.23倍（p=0.040）。除颈动脉斑块外，抗- aa和/或抗- ltxa血清阳性与所有其他动脉粥样硬化评估指标显著相关。抗- pg与动脉粥样硬化的任何指标无关。仅在抗aa和/或抗ltxa组中，较高的肿胀关节计数与CAC相关。针对Aa和/或其主要毒力因子LtxA的免疫反应性与RA患者多血管床动脉粥样硬化相关，并放大了关节肿胀对冠状动脉粥样硬化的影响，提示牙周病的治疗/预防在RA中预防CVD的作用。
Both periodontal disease and cardiovascular disease (CVD) are over-represented in rheumatoid arthritis (RA). However, the contribution of periodontal pathogens to CVD in RA is unknown. RA patients underwent assessments of coronary artery calcification (CAC), carotid intima media thickness and plaque, and ankle-brachial index via computed tomography, ultrasound, and Doppler ultrasound, respectively. Sera were assayed for antibodies targeting Porphyromonas gingivalis (anti-Pg), Aggregatibacter actinomycetemcomitans serotype b (anti-Aa), and Aa leukotoxin A (anti-LtxA). Associations of antibodies against these periodontal pathogens with measures of atherosclerosis were explored using generalized linear models. Among 197 RA patients, anti-Pg was detected in 72 (37%), anti-Aa in 41 (21%), and anti-LtxA in 84 (43%). Adjusting for relevant confounders and reported tooth loss, the mean CAC score was 90% higher in those with anti-Aa and/or anti-LtxA vs. those without either antibody [19 vs. 10 units, respectively (p=0.033)]. The adjusted odds of CAC≥100 units was 2.23-fold higher for those with anti-Aa and/or anti-LtxA vs. those without either antibody (p=0.040). Anti-Aa and/or anti-LtxA seropositivity was associated significantly with all other assessed measures of atherosclerosis except carotid plaque. Anti-Pg was not associated with any measure of atherosclerosis. Higher swollen joint count was associated with CAC exclusively in the group with anti-Aa and/or anti-LtxA. Immunoreactivity against Aa and/or its major virulence factor LtxA was associated with atherosclerosis in multiple vascular beds of RA patients, and amplified the effect of swollen joints on coronary atherosclerosis, suggesting a role for treatment/prevention of periodontal disease in the prevention of CVD in RA.
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影响因子：
3.8
作者：
Dietmann, Anelia;Millonig, Alban;Combes, Valery;Couraud, Pierre-Olivier;Kachlany, Scott C.;Grau, Georges E.
通讯作者：
Grau, Georges E.
影响因子：
17.1
作者：
Konig MF;Giles JT;Teles RP;Moutsopoulos NM;Andrade F
通讯作者：
Andrade F
影响因子：
5.2
作者：
How KY;Song KP;Chan KG
通讯作者：
Chan KG
影响因子：
7.3
作者：
Konig MF;Andrade F
通讯作者：
Andrade F
影响因子：
13.8
作者：
Mankia, Kulveer;Cheng, Zijian;Emery, Paul
通讯作者：
Emery, Paul