Oral bacteria in the occluded arteries of patients with Buerger disease
Oral bacteria in the occluded arteries of patients with Buerger disease
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DOI：
10.1016/j.jvs.2005.03.016
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发表时间：
2005-07-01
影响因子：
4.3
通讯作者：
Ishikawa, I
中科院分区：
文献类型：
--
作者：
Iwai, T;Inoue, Y;Ishikawa, I
目的：近年来的研究表明，感染性微生物在血管疾病中发挥作用。在这项研究中，为了探讨口腔感染和Buerger病之间的可能联系，我们调查了口腔（牙周）细菌是否存在于从特征性Buerger病患者中取出的闭塞动脉中。本研究纳入了14例有吸烟史的男性患者，他们在50岁之前出现了Buerger病的特征。取出并研究闭塞动脉，包括股浅动脉（n = 4）、腘动脉（n = 2）、胫前动脉（n = 4）和胫后动脉（n = 4）。牙周病医生对每位患者进行牙周检查，同时收集牙菌斑和唾液样本。聚合酶链反应方法被应用于检测是否有7种牙周细菌牙龈卟啉单胞菌，坦那氏菌，密螺旋体denticola，弯曲杆菌直，放线菌伴放线杆菌，中间普雷沃菌，和黑色普雷沃菌-存在于闭塞的动脉和口腔样本。此外，7例对照患者的动脉标本进行了聚合酶链反应分析。14例动脉标本中13例检出口腔细菌DNA，所有口腔标本均检出。在12份动脉和所有口腔样本中发现齿垢密螺旋体。在14%至43%的动脉样本和71%至100%的口腔样本中发现了直弯曲杆菌、牙龈卟啉单胞菌、中间普雷沃菌、坦纳氏菌和变黑普雷沃菌。病理学检查显示动脉标本表现出Buerger病的中期慢性期或慢性期病变的特征。所有14例Buerger病患者均患有中度至重度牙周炎。对照组动脉标本均未检出牙周细菌。这是第一个研究，以确定口腔微生物在病变的伯格病。我们的研究结果表明，伯格病和慢性感染如口腔细菌感染之间可能存在病因学联系。
Objective: Recent studies have suggested that infectious organisms play a role in vascular diseases. In this study, to explore a possible link between oral infection and Buerger disease, we investigated whether oral (periodontal) bacteria were present in occluded arteries removed from patients with characteristic Buerger disease.Methods. Fourteen male patients with a smoking history who had developed characteristics of Buerger disease before the age of 50 years were included in this study. Occluded arteries, including superficial femoral (n = 4), popliteal (n = 2), anterior tibial (n = 4), and posterior tibial (n = 4) arteries, were removed and studied. A periodontist performed a periodontal examination on each patient and collected dental plaque and saliva samples from them at the same time. The polymerase chain reaction method was applied to detect whether seven species of periodontal bacteria-Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Campylobacter rectus, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Prevotella nigrescens-were present in the occluded arteries and oral samples. In addition, arterial specimens from seven control patients were examined by polymerase chain reaction analysis.Results. DNA of oral bacteria was detected in 13 of 14 arterial samples and all oral samples of patients with Buerger disease. Treponema denticola was found in 12 arterial and all oral samples. Campylobacter rectus, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and Prevotella nigrescens were found in 14% to 43% of the arterial samples and 71% to 100% of the oral samples. A pathologic examination revealed that arterial specimens showed the characteristics of an intermediate-chronic-stage or chronic-stage lesion of Buerger disease. All 14 patients with Buerger disease had moderate to severe periodontitis. None of the control arterial samples was positive for periodontal bacteria.Conclusions. This is the first study to identify oral microorganisms in the lesions of Buerger disease. Our findings suggest a possible etiologic link between Buerger disease and chronic infections such as oral bacterial infections.