Systemic burden and cardiovascular risk to Porphyromonas species in apical periodontitis

Constanza Jiménez; Mauricio Garrido; Pirkko Pussinen; María José Bordagaray; Alejandra Fernández; Claudia Vega; Alejandra Chaparro; Anilei Hoare; Marcela Hernández

doi:10.1007/s00784-021-04083-4

Systemic burden and cardiovascular risk to Porphyromonas species in apical periodontitis

Constanza Jiménez, Mauricio Garrido, Pirkko Pussinen, María José Bordagaray, Alejandra Fernández, Claudia Vega, Alejandra Chaparro, Anilei Hoare, Marcela Hernández^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Objective: Porphyromonas (P.) species (spp.) are a major etiological agent of apical periodontitis (AP), which in turn represents a risk factor for cardiovascular diseases. This study explored the associations between endodontic infection with Porphyromonas species, the systemic bacterial burden, and cardiovascular risk, based on high-sensitivity C-reactive protein (hsCRP), in young adults with AP. Materials and methods: Cross-sectional study. Otherwise, healthy individuals with AP and controls (n = 80, ≤ 40 years) were recruited at the University Dental Clinic. Oral parameters and classic cardiovascular risk factors were registered. Endodontic Porphyromonas endodontalis and Porphyromonas gingivalis were identified using conventional PCR. Serum concentrations of anti-P. endodontalis and anti-P. gingivalis antibodies, and endotoxins were determined through ELISA and Limulus-amebocyte assays. Serum hsCRP was determined for cardiovascular risk stratification. Results: Intracanal detection of P. endodontalis and P. gingivalis in AP were 33.3% and 22.9%, respectively. Serum anti-P. endodontalis and anti-P. gingivalis IgG was higher in AP than controls (p < 0.05 and p = 0.057, respectively). Intracanal P. endodontalis associated with higher endotoxemia (p < 0.05). Among endodontic factors, the presence (OR 4.2–5.5, p < 0.05) and the number of apical lesions (OR 2.3, p < 0.05) associated with moderate-severe cardiovascular risk, whereas anti-P. endodontalis IgG were protective (OR 0.3, p > 0.05). Conclusions: AP and infection with P. endodontalis positively associated with cardiovascular risk based on hsCRP levels and endotoxemia, respectively, whereas anti-P. endodontalis IgG response seems to be protective against low-grade systemic inflammation. Clinical relevance: Apical periodontitis and endodontic P. endodontalis can influence the systemic burden with impact on the surrogate cardiovascular risk marker hsCRP, providing mechanistic links.

Original language	English
Journal	Clinical Oral Investigations
DOIs	https://doi.org/10.1007/s00784-021-04083-4
State	Published - 2021

Bibliographical note

Funding Information:
The work was supported by the Chilean National Fund for Scientific and Technologic Development (FONDECYT; grants #1060741 and 1200098, M.H.), the Päivikki and Sakari Sohlberg Foundation (P.J.P.), the Sigrid Juselius Foundation (P.J.P.), the European Society of Endodontology (P.J.P.), and the Aarne Koskelo foundation.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords

Apical periodontitis
C-reactive protein
Cardiovascular disease
Immunoglobulins
Porphyromonas
Systemic inflammation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00784-021-04083-4

Cite this

@article{cda70fbd4d0e4466b33e7698d385c9d4,

title = "Systemic burden and cardiovascular risk to Porphyromonas species in apical periodontitis",

abstract = "Objective: Porphyromonas (P.) species (spp.) are a major etiological agent of apical periodontitis (AP), which in turn represents a risk factor for cardiovascular diseases. This study explored the associations between endodontic infection with Porphyromonas species, the systemic bacterial burden, and cardiovascular risk, based on high-sensitivity C-reactive protein (hsCRP), in young adults with AP. Materials and methods: Cross-sectional study. Otherwise, healthy individuals with AP and controls (n = 80, ≤ 40 years) were recruited at the University Dental Clinic. Oral parameters and classic cardiovascular risk factors were registered. Endodontic Porphyromonas endodontalis and Porphyromonas gingivalis were identified using conventional PCR. Serum concentrations of anti-P. endodontalis and anti-P. gingivalis antibodies, and endotoxins were determined through ELISA and Limulus-amebocyte assays. Serum hsCRP was determined for cardiovascular risk stratification. Results: Intracanal detection of P. endodontalis and P. gingivalis in AP were 33.3% and 22.9%, respectively. Serum anti-P. endodontalis and anti-P. gingivalis IgG was higher in AP than controls (p < 0.05 and p = 0.057, respectively). Intracanal P. endodontalis associated with higher endotoxemia (p < 0.05). Among endodontic factors, the presence (OR 4.2–5.5, p < 0.05) and the number of apical lesions (OR 2.3, p < 0.05) associated with moderate-severe cardiovascular risk, whereas anti-P. endodontalis IgG were protective (OR 0.3, p > 0.05). Conclusions: AP and infection with P. endodontalis positively associated with cardiovascular risk based on hsCRP levels and endotoxemia, respectively, whereas anti-P. endodontalis IgG response seems to be protective against low-grade systemic inflammation. Clinical relevance: Apical periodontitis and endodontic P. endodontalis can influence the systemic burden with impact on the surrogate cardiovascular risk marker hsCRP, providing mechanistic links.",

keywords = "Apical periodontitis, C-reactive protein, Cardiovascular disease, Immunoglobulins, Porphyromonas, Systemic inflammation",

author = "Constanza Jim{\'e}nez and Mauricio Garrido and Pirkko Pussinen and Bordagaray, {Mar{\'i}a Jos{\'e}} and Alejandra Fern{\'a}ndez and Claudia Vega and Alejandra Chaparro and Anilei Hoare and Marcela Hern{\'a}ndez",

note = "Funding Information: The work was supported by the Chilean National Fund for Scientific and Technologic Development (FONDECYT; grants #1060741 and 1200098, M.H.), the P{\"a}ivikki and Sakari Sohlberg Foundation (P.J.P.), the Sigrid Juselius Foundation (P.J.P.), the European Society of Endodontology (P.J.P.), and the Aarne Koskelo foundation. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2021",

doi = "10.1007/s00784-021-04083-4",

language = "English",

journal = "Clinical Oral Investigations",

issn = "1432-6981",

publisher = "Springer Verlag",

}

TY - JOUR

T1 - Systemic burden and cardiovascular risk to Porphyromonas species in apical periodontitis

AU - Jiménez, Constanza

AU - Garrido, Mauricio

AU - Pussinen, Pirkko

AU - Bordagaray, María José

AU - Fernández, Alejandra

AU - Vega, Claudia

AU - Chaparro, Alejandra

AU - Hoare, Anilei

AU - Hernández, Marcela

N1 - Funding Information: The work was supported by the Chilean National Fund for Scientific and Technologic Development (FONDECYT; grants #1060741 and 1200098, M.H.), the Päivikki and Sakari Sohlberg Foundation (P.J.P.), the Sigrid Juselius Foundation (P.J.P.), the European Society of Endodontology (P.J.P.), and the Aarne Koskelo foundation. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2021

Y1 - 2021

N2 - Objective: Porphyromonas (P.) species (spp.) are a major etiological agent of apical periodontitis (AP), which in turn represents a risk factor for cardiovascular diseases. This study explored the associations between endodontic infection with Porphyromonas species, the systemic bacterial burden, and cardiovascular risk, based on high-sensitivity C-reactive protein (hsCRP), in young adults with AP. Materials and methods: Cross-sectional study. Otherwise, healthy individuals with AP and controls (n = 80, ≤ 40 years) were recruited at the University Dental Clinic. Oral parameters and classic cardiovascular risk factors were registered. Endodontic Porphyromonas endodontalis and Porphyromonas gingivalis were identified using conventional PCR. Serum concentrations of anti-P. endodontalis and anti-P. gingivalis antibodies, and endotoxins were determined through ELISA and Limulus-amebocyte assays. Serum hsCRP was determined for cardiovascular risk stratification. Results: Intracanal detection of P. endodontalis and P. gingivalis in AP were 33.3% and 22.9%, respectively. Serum anti-P. endodontalis and anti-P. gingivalis IgG was higher in AP than controls (p < 0.05 and p = 0.057, respectively). Intracanal P. endodontalis associated with higher endotoxemia (p < 0.05). Among endodontic factors, the presence (OR 4.2–5.5, p < 0.05) and the number of apical lesions (OR 2.3, p < 0.05) associated with moderate-severe cardiovascular risk, whereas anti-P. endodontalis IgG were protective (OR 0.3, p > 0.05). Conclusions: AP and infection with P. endodontalis positively associated with cardiovascular risk based on hsCRP levels and endotoxemia, respectively, whereas anti-P. endodontalis IgG response seems to be protective against low-grade systemic inflammation. Clinical relevance: Apical periodontitis and endodontic P. endodontalis can influence the systemic burden with impact on the surrogate cardiovascular risk marker hsCRP, providing mechanistic links.

AB - Objective: Porphyromonas (P.) species (spp.) are a major etiological agent of apical periodontitis (AP), which in turn represents a risk factor for cardiovascular diseases. This study explored the associations between endodontic infection with Porphyromonas species, the systemic bacterial burden, and cardiovascular risk, based on high-sensitivity C-reactive protein (hsCRP), in young adults with AP. Materials and methods: Cross-sectional study. Otherwise, healthy individuals with AP and controls (n = 80, ≤ 40 years) were recruited at the University Dental Clinic. Oral parameters and classic cardiovascular risk factors were registered. Endodontic Porphyromonas endodontalis and Porphyromonas gingivalis were identified using conventional PCR. Serum concentrations of anti-P. endodontalis and anti-P. gingivalis antibodies, and endotoxins were determined through ELISA and Limulus-amebocyte assays. Serum hsCRP was determined for cardiovascular risk stratification. Results: Intracanal detection of P. endodontalis and P. gingivalis in AP were 33.3% and 22.9%, respectively. Serum anti-P. endodontalis and anti-P. gingivalis IgG was higher in AP than controls (p < 0.05 and p = 0.057, respectively). Intracanal P. endodontalis associated with higher endotoxemia (p < 0.05). Among endodontic factors, the presence (OR 4.2–5.5, p < 0.05) and the number of apical lesions (OR 2.3, p < 0.05) associated with moderate-severe cardiovascular risk, whereas anti-P. endodontalis IgG were protective (OR 0.3, p > 0.05). Conclusions: AP and infection with P. endodontalis positively associated with cardiovascular risk based on hsCRP levels and endotoxemia, respectively, whereas anti-P. endodontalis IgG response seems to be protective against low-grade systemic inflammation. Clinical relevance: Apical periodontitis and endodontic P. endodontalis can influence the systemic burden with impact on the surrogate cardiovascular risk marker hsCRP, providing mechanistic links.

KW - Apical periodontitis

KW - C-reactive protein

KW - Cardiovascular disease

KW - Immunoglobulins

KW - Porphyromonas

KW - Systemic inflammation

UR - http://www.scopus.com/inward/record.url?scp=85111352029&partnerID=8YFLogxK

U2 - 10.1007/s00784-021-04083-4

DO - 10.1007/s00784-021-04083-4

M3 - Article

AN - SCOPUS:85111352029

SN - 1432-6981

JO - Clinical Oral Investigations

JF - Clinical Oral Investigations

ER -

Systemic burden and cardiovascular risk to Porphyromonas species in apical periodontitis

Abstract

Bibliographical note

Keywords

UN SDGs

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