An involvement and influence of periodontopathic bacteria for aortic atherosclerotic lesions

最近的流行病学调查报告了牙周炎与心血管或颈动脉疾病的关系。我们研究了动脉疾病与牙周炎或单核细胞因子之间的关系。其中动脉硬化闭塞性动脉瘤（ASO组）55例，腹主动脉瘤（AAA组）50例。对患者进行牙周病分级、唾液和动脉病变的牙周病细菌- dna聚合酶链反应、牙周病细菌- dna定位。在LPS刺激后，患者还进行了血液分析和单核细胞因子（TNF-α, IL-1β）的测定。ASO组牙周炎分级为重度（牙袋直径0 ~ 5mm） 26例，中度（2 ~ 5mm） 19例，正常（小于2mm） 2例，无牙8例。AAA组牙周炎分级为重度28例，中度14例，正常2例，无牙6例。牙周病细菌- dna在唾液、动脉粥样硬化病变和吻合口（轻度病变）的检出率分别为40/53（94%）、9/10（90%）和21/43（48%）。而AAA组在唾液和动脉瘤壁的阳性率分别为43/50（86%）和41/50（82%）。牙周病细菌- dna阳性率（86%）明显高于ASO（56.6%）。在10例患者中评估了牙周病细菌- dna的定位，在所有5例AAA患者中，在所有3层均检测到细菌- dna，而在所有5例ASO患者中，仅在内膜和中膜检测到细菌- dna。与ASO组比较，AAA组单核细胞TNF-α荧光强度明显升高。牙周炎患病率高于日本人群，牙周病细菌- dna常见于动脉病变处。通过对动脉壁牙周病细菌dna的鉴定，推测牙周病细菌对动脉疾病的影响。TNF-α上调基质金属蛋白酶的产生，使主动脉壁的胶原蛋白降解。AAA组单核细胞TNF-α荧光强度明显高于ASO组，推测与动脉瘤形成有关。少

Recent epidemiologic survey reported a relationship between periodontitis and cardiovascular or carotid artery diseases. We investigated a relationship between arterial disease and periodontitis or monocyte cytokines. The patients comprised of arteriosclerosis obliterans (ASO group) : 55 cases, and abdominal aortic aneurysms (AAA group) : 50 cases. The patients were evaluated as grading of periodontal disease, periodontopathic bacteria-DNA of the saliva and arterial lesions by polymerase chain reaction, and localization of periodontopathic bacteria-DNA. The patients also underwent blood analysis and measurement of monocyte cytokines (TNF-α, IL-1β) after LPS stimulation.The grading of periodontitis was severe (dental pocket > 5mm) : 26 cases, moderate (2-5mm) : 19 cases, normal (< 2mm) : 2 cases, and edentulous 8 cases in the ASO group. The grading of periodontitis was severe : 28 cases, moderate : 14 cases, normal : 2 cases, and edentulous : 6 cases in the AAA group. In the ASO group, … More positive rates of periodontopathic bacteria-DNA were 40/53 (94%), 9/10 (90%), and 21/43 (48%), in the saliva, atherosclerotic lesion, and anastomotic site (mild lesion), respectively. In contrast, the positive rates of the AAA group were 43/50 (86%), and 41/50 (82%), in the saliva, and aneurysmal wall, respectively. Positive rate of periodontopathic bacteria-DNA was significantly higher in AAA (86%) than in ASO (56.6%). Localization of periodontopathic bacteria-DNA was evaluated in 10 patients, which was detected at all three layers in all five patients with AAA, and only at the intima and media in all five patients with ASO. Fluorescent intensity of monocyte TNF-α was significantly increased in the AAA group compared with the ASO group.Prevalence of periodontitis was higher than that of Japanese population, and periodontopathic bacteria-DNA was frequently detected at the arterial lesions. Periodontopathic bacteria were supposed to influence arterial disease by identification of periodontopathic bacteria-DNA at the arterial wall. TNF-α upregulated production of matrix metalloproteinase, which degraded collagen of the aortic wall. Fluorescent intensity of monocyte TNF-α was significantly higher in the AAA group than in the ASO group, which was supposed to be related with aneurysmal formation. Less