A relação entre periodontite e doenças cardiovasculares (DCV) tem sido amplamente discutida, embora os mecanismos de interação não estejam claros. Foi sugerido que pacientes com periodontite apresentam inflamação sistêmica e um pequeno aumento no risco cardiovascular. Patógenos periodontais foram encontrados em placas de ateroma, mas a influência destes microrganismos na aterosclerose ainda não é compreendida. O objetivo primário deste estudo foi delinear o perfil inflamatório sistêmico de pacientes submetidos à endarterectomia carotídea. Os objetivos secundários foram associar o perfil inflamatório dos participantes à condição periodontal e à presença de patógenos orais encontrados na cavidade oral e em placas de ateroma. Trinta e cinco pacientes submetidos à endarterectomia carotídea foram incluídos neste estudo. Antes da cirurgia vascular, um exame clínico periodontal foi realizado e foram coletadas amostras de sangue, saliva e biofilme subgengival. Durante a endarterectomia, uma amostra da placa de ateroma foi coletada. As amostras de soro foram testadas com o ensaio imunoenzimático de alta sensibilidade Multiplex para dezessete marcadores de células Th17. Amostras de saliva, biofilme subgengival e placa de ateroma foram submetidas ao PCR quantitativo para avaliação de dez patógenos periodontais. Este estudo foi capaz de detectar vários marcadores inflamatórios circulantes, o que indica a presença de inflamação sistêmica como uma característica da população. T. forsythia foi o microrganismo mais frequentemente encontrado em amostras de ateroma (37% das amostras). Níveis de T. forsythia em amostras de ateroma foram positivamente correlacionados com os níveis séricos de IL-7, IL-6, IL-17, IL-13, IL-12p70, IFN-?, GCS-F (p<0,05) e IL-10 (p<0,01). Níveis séricos de IL-2 foram positivamente correlacionados com os concentrações salivares de P. intermedia, P. endodontalis (p<0,05) e T. denticola (p<0,01). Níveis séricos de TNF-? foram positivamente correlacionados com concentrações salivares de P. endodontalis (p<0,01). Concentrações de P. endodontalis em amostras subgengivais foram correlacionadas positivamente com IL-2 (p<0,05). A inflamação periodontal (PISA) foi positivamente correlacionada com IL-2 (p<0,05). A coexistência de patógenos periodontais comuns na cavidade oral e na placa de ateroma está associada a um estado inflamatório sistêmico, o que poderia ser relevante para a compreensão dos mecanismos que ligam periodontite com DCV. / The relationship between periodontitis and cardiovascular diseases (CVD) has been widely discussed, although the mechanisms of interaction are not clear. It has been suggested that patients with periodontitis exhibit systemic inflammation and mild increase in future cardiovascular risk. Periodontal pathogens have been found in atheromatous plaques, but their exact role in atherosclerosis are not yet undertstood. The primary aim of this study was to screen the systemic inflammation profile in patients undergoing carotid endarterectomy. The secondary aims were to associate participant\'s inflammatory profiles with periodontal status and the presence of periodontal pathogens found in oral cavity and atheromatous plaques. Thirty-five patients who underwent carotid endarterectomy were enrolled in this study. Prior to the vascular surgery, a clinical periodontal exam was conducted, and samples of blood, saliva and subgingival biofilm were collected. During endarterectomy, a sample of the atheromatous plaque was retrieved. Serum samples were assayed with high sensitivity Multiplex assay for seventeen Th17 biomarkers. Saliva, subgingival biofilm and atheromatous plaque samples were submited to quantitative PCR for ten periodontal pathogens. This study was able to detect several circulating inflammatory markers, indicating the systemic inflammatory burden as a characteristic of this population. T. forsythia was the more frequent microorganism found in atheromatous samples (37% of the samples). T. forsythia titres in atheromatous samples were positively correlated with serum levels of IL-7, IL-6, IL-17, IL-13, IL-12p70, IFN- ?, GCS-F (p<0.05) and IL-10 (p<0.01). Circulating levels of IL-2 were positively correlated with salivary titres of P. intermedia, P. endodontalis (p<0.05) and T. denticola (p<0.01). Circulating levels of TNF-? were positively correlated with salivary titres of P. endodontalis (p<0.01). Subgingival levels of P. endodontalis were positively correlated with IL-2 (p<0.05). Periodontal inflammation (PISA) was positively correlated with IL-2 (p<0.05). The co-existence of common periodontal pathogens in the oral cavity and in atheromatous plaque is associated with a systemic inflammatory state that could be relevant to understanding the mechanisms linking periodontitis to CVD.

A relação entre periodontite e doenças cardiovasculares (DCV) tem sido amplamente discutida, embora os mecanismos de interação não estejam claros. Foi sugerido que pacientes com periodontite apresentam inflamação sistêmica e um pequeno aumento no risco cardiovascular. Patógenos periodontais foram encontrados em placas de ateroma, mas a influência destes microrganismos na aterosclerose ainda não é compreendida. O objetivo primário deste estudo foi delinear o perfil inflamatório sistêmico de pacientes submetidos à endarterectomia carotídea. Os objetivos secundários foram associar o perfil inflamatório dos participantes à condição periodontal e à presença de patógenos orais encontrados na cavidade oral e em placas de ateroma. Trinta e cinco pacientes submetidos à endarterectomia carotídea foram incluídos neste estudo. Antes da cirurgia vascular, um exame clínico periodontal foi realizado e foram coletadas amostras de sangue, saliva e biofilme subgengival. Durante a endarterectomia, uma amostra da placa de ateroma foi coletada. As amostras de soro foram testadas com o ensaio imunoenzimático de alta sensibilidade Multiplex para dezessete marcadores de células Th17. Amostras de saliva, biofilme subgengival e placa de ateroma foram submetidas ao PCR quantitativo para avaliação de dez patógenos periodontais. Este estudo foi capaz de detectar vários marcadores inflamatórios circulantes, o que indica a presença de inflamação sistêmica como uma característica da população. T. forsythia foi o microrganismo mais frequentemente encontrado em amostras de ateroma (37% das amostras). Níveis de T. forsythia em amostras de ateroma foram positivamente correlacionados com os níveis séricos de IL-7, IL-6, IL-17, IL-13, IL-12p70, IFN-?, GCS-F (p<0,05) e IL-10 (p<0,01). Níveis séricos de IL-2 foram positivamente correlacionados com os concentrações salivares de P. intermedia, P. endodontalis (p<0,05) e T. denticola (p<0,01). Níveis séricos de TNF-? foram positivamente correlacionados com concentrações salivares de P. endodontalis (p<0,01). Concentrações de P. endodontalis em amostras subgengivais foram correlacionadas positivamente com IL-2 (p<0,05). A inflamação periodontal (PISA) foi positivamente correlacionada com IL-2 (p<0,05). A coexistência de patógenos periodontais comuns na cavidade oral e na placa de ateroma está associada a um estado inflamatório sistêmico, o que poderia ser relevante para a compreensão dos mecanismos que ligam periodontite com DCV. / The relationship between periodontitis and cardiovascular diseases (CVD) has been widely discussed, although the mechanisms of interaction are not clear. It has been suggested that patients with periodontitis exhibit systemic inflammation and mild increase in future cardiovascular risk. Periodontal pathogens have been found in atheromatous plaques, but their exact role in atherosclerosis are not yet undertstood. The primary aim of this study was to screen the systemic inflammation profile in patients undergoing carotid endarterectomy. The secondary aims were to associate participant\'s inflammatory profiles with periodontal status and the presence of periodontal pathogens found in oral cavity and atheromatous plaques. Thirty-five patients who underwent carotid endarterectomy were enrolled in this study. Prior to the vascular surgery, a clinical periodontal exam was conducted, and samples of blood, saliva and subgingival biofilm were collected. During endarterectomy, a sample of the atheromatous plaque was retrieved. Serum samples were assayed with high sensitivity Multiplex assay for seventeen Th17 biomarkers. Saliva, subgingival biofilm and atheromatous plaque samples were submited to quantitative PCR for ten periodontal pathogens. This study was able to detect several circulating inflammatory markers, indicating the systemic inflammatory burden as a characteristic of this population. T. forsythia was the more frequent microorganism found in atheromatous samples (37% of the samples). T. forsythia titres in atheromatous samples were positively correlated with serum levels of IL-7, IL-6, IL-17, IL-13, IL-12p70, IFN- ?, GCS-F (p<0.05) and IL-10 (p<0.01). Circulating levels of IL-2 were positively correlated with salivary titres of P. intermedia, P. endodontalis (p<0.05) and T. denticola (p<0.01). Circulating levels of TNF-? were positively correlated with salivary titres of P. endodontalis (p<0.01). Subgingival levels of P. endodontalis were positively correlated with IL-2 (p<0.05). Periodontal inflammation (PISA) was positively correlated with IL-2 (p<0.05). The co-existence of common periodontal pathogens in the oral cavity and in atheromatous plaque is associated with a systemic inflammatory state that could be relevant to understanding the mechanisms linking periodontitis to CVD.

No description available.

<p>More than 20 million infants in the world (15.5 % of all births) are born with low birth weight. Ninety-five % of them are in developing countries. Oral colonization of Gramnegative anaerobes has&nbsp / been implicated as a risk factor for preterm delivery of low birth weight (PLBW) infants. The objective of this study was to investigate the association between periodontal pathogens and pre-term&nbsp / delivery of low birth weight (PLBW) infants. The study sample included 200 randomly selected women admitted to the department of obstetrics-gynecology of the teaching hospital of Butare in&nbsp / Rwanda. Mothers were asked to complete a questionnaire in order to identify factors which might pose a health risk to them and their infants. Gingival crevicular fluid (GCF) was collected from each quadrant of the mother&rsquo / s month (using paper points) within 24 hours of delivery. Ten ml of foetal cord serum samples were collected at delivery and 10 ml of maternal serum samples were&nbsp / collected within 48 of delivery. GCF was examined by PCR for the presence of 5 periodontopathogens and ELISA was used for the evaluation of cytokines (IL-6 and IL-10) and immunoglobulins (IgM, IgG) in foetal cord and maternal blood against the periodontopathogens. P. intermedia showed significant associations either on its own or in combinations with most indicators of&nbsp / periodontal disease used in this study, while Aa and members of the red complex were significantly associated with gum bleeding and reduced frequency of tooth brushing. A strong association&nbsp / between PLBW and maternal and foetal cord serum sample levels of IL-10 was observed. Also, a good association was observed between PLBW and FCB sample levels of IL-6. Significant&nbsp / associations were observed between PLBW and maternal IgG against the different peridontopathogens. The findings of this study may suggest that the levels of maternal IgG and foetal IgM&nbsp / against the different periodontopathogens are associated with dissemination of maternal periodontopathogens to the foetus thereby illiciting an inflammatory response which contributes to&nbsp / PLBW. </p>

Ziel der Arbeit war es, zu untersuchen, ob parodontalpathogene Mikroorganismen im Myokard des Herzens nachweisbar sind. Dabei wurde die Wechselwirkung der Toxine (Lipopolysaccharide) am myokardialen Gewebe erfasst und auf diese Weise mögliche Entzündungsreaktionen in den Myokardzellen untersucht. Material und Methoden: 30 Patienten (20 Männer, 10 Frauen) mit Aortenklappenstenosen bzw. -insuffizienzen wurden zahnärztlich auf den aktuellen Zahnstatus und Parodontalstatus untersucht. Gingivale Erkrankungen wurden mit Hilfe des PBI erhoben. Anhand der Sondierungstiefen und des klinischen Attachmentlevels erfolgte die Einteilung in keine/ milde Parodontitis, moderate Parodontitis und schwere Parodontitis. Das Herzgewebe wurde mittels Gewebeschnitten von Ventrikel, Atrium und Klappe histologisch aufbereitet und mittels Lichtmikroskop über eine Kamera aufgezeichnet. Für einen Probanden ergaben sich pro Gewebeschnitt und pro Färbung 12 Aufnahmen. Insgesamt ergaben sich nach allen Färbungen aller Gewebeschnitte für einen Patienten 84 Bilder. Es wurde ein Inflammationsscore (0-3) erhoben für die Bewertung der H.E.-Färbung. Parameter für die immunhistochemischen Färbungen wurden durchgeführt für CD68/ Makrophagen und CD14/ LPS- Bindungsprotein-Rezeptor. Diese dienten dem Nachweis von möglichen Wechselwirkungen zwischen Parodontalpathogenen und myokardialen Geweben. Es erfolgte die direkte Zählung der Makrophagen pro Mikroskopie-Gesichtsfeld. Ergebnisse: Bei zahnärztlicher Untersuchung wurde festgestellt, dass 22 Probanden eine leichte oder keine gingivale Erkrankung hatten (Gruppe PBI 1) und 8 Patienten eine fortgeschrittene gingivale Erkrankung vorwiesen (Gruppe PBI 2). An einer schweren parodontalen Erkrankung litten 23 Patienten (Gruppe Parodontitis 2) und nur 7 Patienten wiesen ein moderate, milde oder keine Parodontitis auf (Gruppe Parodontitis 1). Die Ergebnisse der histologischen Untersuchungen der H.E.-Färbung zeigten, dass im Median im Atrium und Ventrikel der Score 2 dominiert. Desweiteren konnten für CD68 und CD14 signifikante Mittelwertunterschiede zwischen der Gruppe Parodontitis 1 und 2 gezeigt werden. Für die Gruppe PBI 1 und 2 konnte weder für den Parameter CD68 noch für CD14 das Signifikanzniveau erreicht werden. Schlussfolgerung: Die histologischen Färbemethoden lassen die Tendenz erahnen, dass höhere Scores und Mittelwerte mit höheren Entzündungsgraden und Destruktionen in Zusammenhang stehen. Gesündere parodontale Verhältnisse sind mit niedrigeren Scores und Mittelwerten verbunden. Zwischen den Gruppen PBI 1 und 2 lag kein statistisch nachweisbarer Unterschied vor. Anders ergab es sich in den Gruppen Parodontitis 1 und 2. Für CD68 (Monozyten/Makrophagen) lag die Signifikanz bei 3% und für CD14 (LPS-Bindungsprotein-Rezeptor) bei 0,8% zwischen den Parodontitis Gruppen. Die entzündlich bedingte Genese von Parodontitis und Herzinsuffizienz lässt schlussfolgern, dass die Parodontitis als Ursache nicht auszuschließen war. Durch die multifaktorielle Entwicklung beider Leiden lässt sich mittels vorliegender Untersuchung kein eindeutiger Kausalzusammenhang nachweisen. Die genauen, noch ungeklärten Assoziationen sollten in weiterführenden Studien erforscht werden.

<p>More than 20 million infants in the world (15.5 % of all births) are born with low birth weight. Ninety-five % of them are in developing countries. Oral colonization of Gramnegative anaerobes has&nbsp / been implicated as a risk factor for preterm delivery of low birth weight (PLBW) infants. The objective of this study was to investigate the association between periodontal pathogens and pre-term&nbsp / delivery of low birth weight (PLBW) infants. The study sample included 200 randomly selected women admitted to the department of obstetrics-gynecology of the teaching hospital of Butare in&nbsp / Rwanda. Mothers were asked to complete a questionnaire in order to identify factors which might pose a health risk to them and their infants. Gingival crevicular fluid (GCF) was collected from each quadrant of the mother&rsquo / s month (using paper points) within 24 hours of delivery. Ten ml of foetal cord serum samples were collected at delivery and 10 ml of maternal serum samples were&nbsp / collected within 48 of delivery. GCF was examined by PCR for the presence of 5 periodontopathogens and ELISA was used for the evaluation of cytokines (IL-6 and IL-10) and immunoglobulins (IgM, IgG) in foetal cord and maternal blood against the periodontopathogens. P. intermedia showed significant associations either on its own or in combinations with most indicators of&nbsp / periodontal disease used in this study, while Aa and members of the red complex were significantly associated with gum bleeding and reduced frequency of tooth brushing. A strong association&nbsp / between PLBW and maternal and foetal cord serum sample levels of IL-10 was observed. Also, a good association was observed between PLBW and FCB sample levels of IL-6. Significant&nbsp / associations were observed between PLBW and maternal IgG against the different peridontopathogens. The findings of this study may suggest that the levels of maternal IgG and foetal IgM&nbsp / against the different periodontopathogens are associated with dissemination of maternal periodontopathogens to the foetus thereby illiciting an inflammatory response which contributes to&nbsp / PLBW. </p>

Philosophiae Doctor - PhD / More than 20 million infants in the world (15.5 % of all births) are born with low birth weight. Ninety-five % of them are in developing countries. Oral colonization of Gramnegative anaerobes has been implicated as a risk factor for preterm delivery of low birth weight (PLBW) infants. The objective of this study was to investigate the association between periodontal pathogens and pre-term delivery of low birth weight (PLBW) infants. The study sample included 200 randomly selected women admitted to the department of obstetrics-gynecology of the teaching hospital of Butare in Rwanda. Mothers were asked to complete a questionnaire in order to identify factors which might pose a health risk to them and their infants. Gingival crevicular fluid (GCF) was collected from each quadrant of the mother’s month (using paper points) within 24 hours of delivery. Ten ml of foetal cord serum samples were collected at delivery and 10 ml of maternal serum samples were collected within 48 of delivery. GCF was examined by PCR for the presence of 5 periodontopathogens and ELISA was used for the evaluation of cytokines (IL-6 and IL-10) and immunoglobulins (IgM, IgG) in foetal cord and maternal blood against the periodontopathogens. P. intermedia showed significant associations either on its own or in combinations with most indicators of periodontal disease used in this study, while Aa and members of the red complex were significantly associated with gum bleeding and reduced frequency of tooth brushing. A strong association between PLBW and maternal and foetal cord serum sample levels of IL-10 was observed. Also, a good association was observed between PLBW and FCB sample levels of IL-6. Significant associations were observed between PLBW and maternal IgG against the different peridontopathogens. The findings of this study may suggest that the levels of maternal IgG and foetal IgM against the different periodontopathogens are associated with dissemination of maternal periodontopathogens to the foetus thereby illiciting an inflammatory response which contributes to PLBW. / South Africa

Philosophiae Doctor - PhD / More than 20 million infants in the world (15.5 % of all births) are born with low birth weight. Ninety-five % of them are in developing countries. Oral colonization of Gramnegative anaerobes has been implicated as a risk factor for preterm delivery of low birth weight (PLBW) infants. The objective of this study was to investigate the association between periodontal pathogens and pre-term delivery of low birth weight (PLBW) infants. The study sample included 200 randomly selected women admitted to the department of obstetrics-gynecology of the teaching hospital of Butare in Rwanda. Mothers were asked to complete a questionnaire in order to identify factors which might pose a health risk to them and their infants. Gingival crevicular fluid (GCF) was collected from each quadrant of the mother’s month (using paper points) within 24 hours of delivery. Ten ml of foetal cord serum samples were collected at delivery and 10 ml of maternal serum samples were collected within 48 of delivery. GCF was examined by PCR for the presence of 5 periodontopathogens and ELISA was used for the evaluation of cytokines (IL-6 and IL-10) and immunoglobulins (IgM, IgG) in foetal cord and maternal blood against the periodontopathogens. P. intermedia showed significant associations either on its own or in combinations with most indicators of periodontal disease used in this study, while Aa and members of the red complex were significantly associated with gum bleeding and reduced frequency of tooth brushing. A strong association between PLBW and maternal and foetal cord serum sample levels of IL-10 was observed. Also, a good association was observed between PLBW and FCB sample levels of IL-6. Significant associations were observed between PLBW and maternal IgG against the different peridontopathogens. The findings of this study may suggest that the levels of maternal IgG and foetal IgM against the different periodontopathogens are associated with dissemination of maternal periodontopathogens to the foetus thereby illiciting an inflammatory response which contributes to PLBW.

Indiana University-Purdue University Indianapolis (IUPUI) / Periodontal disease is the leading cause of tooth loss in adults. Bacterial biofilm on tooth surfaces is the primary initiator of periodontal disease. Various factors contribute to the severity of periodontal disease including the different virulence factors of the bacteria within the biofilm. In the progression of periodontal disease, the microflora evolves from a predominantly Gram positive microbial population to a mainly Gram negative population. Specific gram negative bacteria with pronounced virulence factors have been implicated in the etiology and pathogenesis of periodontal disease, namely Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola which form the red complex of bacteria. The orange complex bacteria become more dominant in the maturation process of dental plaque and act to bridge the early colonizers of plaque with the later more dominant red complex bacterial and consists of such bacteria as Campylobacter showae, Campylobacter rectus, Fusobacterium nucleatum and Prevotella intermedia. Perhaps the most investigated contributing factor is the relationship between smoking and periodontal disease. When examining the association between cigarette smoking and interproximal bone loss, greater bone loss is associated with higher cigarette consumption, longer duration (i.e., pack year history) and higher lifetime exposure. The presence of various virulence factors such as the production of a capsular material, as well as the proteolytic activity of the various periopathodontic bacteria has been associated with the pathogenesis of periodontitis. Even though many different enzymes are produced in large quantities by these periodontal bacteria, trypsin-like enzymes, chymotrypsin-like enzymes and elastase-like enzymes, as well as dipeptidyl peptidase-like enzymes, have been thought to increase the destructive potential of the bacterium and mediate destruction of the periodontal apparatus. More specifically, it is hypothesized that the proteolytic activity of other clinically important periodontal pathogens, such as Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas assacharolyticus, is increased in the presence of nicotine. The purpose of this study was to determine the effects of nicotine on F. nucleatum, P. intermedia and P. assacharolyticus proteolytic activity. Cultures were maintained on anaerobic blood agar plates containing 3% sheep blood. Bacterial cells were harvested from the plates and washed. Washed F. nucleatum, P. intermedia and P. assacharolyticus cells were incubated with 1 mg/ml of nicotine. Bacterial cells not incubated with nicotine were used as positive controls. Secreted enzymatic activity was measured using the synthetic chromogenic substrates glycyl-L-proline-p-nitroanilide (GPPNA), N-succinyl-L-alanyl-L-alanyl-L-alanyl-p-nitroanilide (SAAAPNA), N-succinyl-alanine-alanine-proline-phenylalanine-p-nitroanilide (SAAPPPNA) and N-α-benzoyl-L-arginine-p-nitroanilide (L-BAPNA) (Sigma-Aldrich Products, St. Louis, MO, USA). Appropriate means and standard deviations were determined for each of the enzymatic activities measured and analysis of variance (ANOVA) was used to compare the groups utilizing a 5% significance level for all comparisons. Results demonstrated that after 60 minutes of incubation of F. nucleatum, P. intermedia and P. assacharolyticus cells with 1 mg/ml of nicotine and the various synthetic substrates, had the following proteolytic activity for GPPNA: 0.83 ± 0.14, 0.72 ± 0.03 and 0.67 ± 0.10, respectively; SAAAPNA: 0.82 ± 0.06, 0.76 ± 0.05 and 0.68 ± 0.08, respectively; SAAPPPNA: 0.90 ± 0.13, 0.85 ± 0.17 and 0.72 ± 0.03, respectively; and BAPNA: 0.81 ± 0.15, 0.74 ± 0.13 and 0.74 ± 0.16, respectively. In conclusion, the results indicate that in the presence of 1 mg/ml of nicotine, the proteolytic activity of F. nucleatum and P. assacharolyticus was increased with all of the synthetic substrates (with statistical significance seen only in the increases with F. nucleatum and GPPNA, SAAAPNA and BAPNA). The proteolytic activity exhibited an increasing trend in activity for P. intermedia with SAAPPPNA and BAPNA but a decreasing trend in activity with GPPNA and SAAAPNA when incubated with 1 mg/ml of nicotine, once again demonstrating no statistical significance for any of the substrates. Therefore, it could be concluded that based on these results nicotine at a concentration of 1 mg/ml may increase the proteolytic activity of periodontal pathogens and thus may increase periodontal disease activity and subsequent periodontal breakdown. Further studies are needed to validate these results utilizing different concentrations of nicotine.

No description available.