Background and Objective: A relationship between some systemic diseases and periodontitis has been described. Several studies have reported a link between periodontal disease and atherosclerosis. This study aimed (i) to support the link between the two diseases by evaluating the statistically significant simultaneous detection of five putative periodontopathogens (A.actynomicetemcomitans, P.intermedia, T.forsythia, F.nucleatum and P.gingivalis) in periodontal pockets and carotid atheromatous plaques, and (ii) to analyze the risk factors associated to atherosclerosis and/or periodontitis in the study population.Materials and Methods: A complete periodontal and medical examination was conducted on 31 patients scheduled for carotid endarterectomy. Subgingival samples and atheromatous plaques were microbiologically analyzed using nested polimerase chain reaction to improve the bacterial threshold detection level in atheroma. Histological analysis of atheromatous plaques was also performed.Results: All subgingival and atheroma samples were positive to at least one of the five target periodontopathogens. P.gingivalis, T.forsythia and F.nucleatum established a statistically significant relationship between the concomitant presence of bacteria in atheroma and periodontal pockets. A strong link was demonstrated between increased glucose serum levels and the presence of P.intermedia in atheroma. High lymphocytes serum levels were also strongly related to the detection of the five target periodotopathogens in atheroma. Conclusion: The concomitant presence of P.gingivalis, F.nucleatum, and T.forsythia in the subgingival plaque and atheroma samples suggests that these bacteria might play an important role in the development of atherosclerosis. Serum glucose levels could be responsible for the colonization of periodontopathogens in atheromatous plaques and the progression of cardiovascular disease. Atherosclerosis and periodontitis might be strongly linked by a direct and an indirect pathogenic pathway. / Antecedentes y Objetivos: Se ha descrito en la literatra una relación entre la periodontitis y algunas enfermedades sistémicas. Además, diversos estudios han demostrado una relación entre la aterosclerosis. Este estudio tuvo como objetivos (i) reforzar la relación entre ambas enfermedades evaluando la significancia estadística de la detección simultánea de cinco periodontopatógenos (A.actynomicetemcomitans, P.intermedia, T.forsythia, F.nucleatum and P.gingivalis) en bolsas periodontales y placas de ateroma de los mismos pacientes y (ii) analizar los factores de riesgo asociados a la aterosclerosis y/o periodontitis en la población de estudio. Materiales y Métodos: Se realizó un examen periodontal y médico completo en una población de 31 pacientes proramados para tromboendarterectomía carotídea. Las muestras de placa subgingival y de ateroma se analizaron microbiológicamente mediante reacción en cadena de la polimerasa (nested-PCR), para aumentar el umbral de detección bacteriana de las muestras de ateroma. Asimismos, se realizó un análisis histológico de las biopsias de placas de ateroma.Resultados: Todas las muestras subgingivales y de placas de ateroma fueron positivas para alguna de las cinco bacterias de estudio. P.gingivalis, T.forsythia y F.nucleatum demostraron una relación estadísticamente significativa entre la presencia simultánea en la bolsa periodontal y las placas de ateroma. Los niveles altos de glucosa en sangre y la presencia de P.intermedia en las placas de ateroma también demostraron una relación fuerte. Asimismo, niveles altos de linfocitos en sangre demostraron estar fuertemente relacionados con la detección de los cinco periodontopatógenos en las placas de ateroma.Conclusiones: la presencia concomitante de P.gingivalis, F.nucleatum y T.forsythia en las bolsas periodontales y las placas de ateroma de los mismos pacientes sugiere que estas bacterias juegan un papel importante en el desarrollo de la aterosclerosis. Los niveles de glucosa en suero y la carga bacteriana en las bolsas periodontales pueden ser responsables de la colonización de periodontopatógenos en las placas de ateroma y de la progresión de la enfermedad cardiovascular. Los resultados obtenidos sugieren que la periodontitis y la aterosclerosis pueden estar relacionadas tanto directamente como indirectamente.

The heart is the first functioning organ to develop during embryogenesis to maintain the growing embryo with oxygen and nutrients. However, cardiogenesis is a complex and highly coordinated biological process, and any perturbation to this process can result in detrimental defects to the heart. Haemodynamics is known to play an important role in cardiac growth and vasculature remodelling. Congenital heart defects (CHDs) accounts for 0.4-1.3% of all live birth, whereas cardiomyopathy accounts for 8-11% of cardiovascular disease diagnoses detected in utero. Although the heart defects and cardiomyopathies are known to be attributed by genetic mutations, most cases have unknown etiology. Hence, OFT-banding model was employed to alter the haemodynamic loading via pressure overloading. Upon alteration of haemodynamics, enlargement of the heart with a spectrum of cardiac anomalies were found (e.g ventricular septal defects, thickened epicardium and dysmorphic atrioventricular valves) upon morphological and stereological analysis. A study of global differential expression of OFT-banded hearts by RNA sequencing revealed a number of differentially expressed genes and they were associated with cardioprotection, metabolism, shear stress and valve development; further, a reduction of apoptosis was seen in these banded hearts as well. One of the cardiac phenotypes seen upon OFT-banding, the abnormal primordial atrioventricular valve, was further characterized to provide an insight how the atrioventricular valve is affected upon alteration of haemodynamics. Aberrant expressions of extracellular matrix (ECM) genes such as TBX20, Aggrecan and Periostin alongside with the shear stress responsive genes (KLF2 and EDN1) were found, and a decrease in apoptosis was seen. Moreover, dysregulation of ECM proteins such as fibrillin-2, type III collagen and tenascin were further demonstrated in more mature primordial AV leaflets at HH35, with a concomitant decrease of ECM cross-linking enzyme, transglutaminase-2. In addition, for many years sarcomeric proteins have been associated with a range of cardiomyopathies, but only in recent years they have been linked to congenital heart defects (CHDs). To date, cardiac troponin T (TNNT2) has been associated with cardiomyopathies but not with isolated CHDs. TNNT2 encodes for cTnT regulatory proteins of the thin filament of the sarcomere and is vital for muscle contraction and force generation within cardiomyocytes. To investigate a role of TNNT2 in the early developing heart, targeted manipulation of TNNT2 was performed in embryonic chick to reduce the protein levels of cTNT (protein product of TNNT2) in ovo via translational block. Abnormal atrial septal growth, reduced ventricular trabeculation and ventricular diverticula were found upon TNNT2 morpholino treatment. The abnormal phenotype observed in the TNNT2 morpholino-treated groups was potentially suggested by differential expression of shear stress responsive gene, NOS3 gene.