MECHANISMS OF PERIODONTITIS - INDUCED ATHEROSCLEROSIS
Vol. 1 No. 3 (2010)
Articles
September 6, 2010
Downloads
Nowadays CVD become the most common cause of death in US and worldwide. Atherosclerosis plays an important role in CVDs pathogenesis. Atherosclerosis decreases the elasticity of the vascular. Atherosclerosis shares the same risk factor as CVD, in which obesity, hyperlipidemia, hypertension and lack of physical activity may initiate it. However, 50% of all CVD patients are lack of the usual causes of CVD. The purpose of this review is to reveal the mechanism of periodontitis-induced atherosclerosis. Inflammation and autoimmune disease might play an important role in initiate the CVD. Periodontitis is one of the oral diseases which can cause systemic inflammation and may induce the atherosclerosis. Porphyromonas gingivalis (Pg) which is the major cause of periodontitis can induce it by expressing protein gp130 in its fimbriae. Periodontics patients are prone to have bacteremia by daily routine oral hygiene activity. Chronic bacteremia may alter the endothelial physiology, which is resulted in neointima formation, EC dysfunction, and lipid accumulation. It is concluded that periodontitis may play an important role in initiation and progression of atherosclerosis.
Hudyono, R., & Sunariani, J. (2010). MECHANISMS OF PERIODONTITIS - INDUCED ATHEROSCLEROSIS. Indonesian Journal of Tropical and Infectious Disease, 1(3), 138–145. https://doi.org/10.20473/ijtid.v1i3.2197
1. Neyer JR, Greenlund KJ, Denny CH, Keenan NL, Labarthe DR, Croft
JB. Prevalence of heart disease – united states. CDC 2007; 56(06):
113–8.
2. Gaziano JM. Fundamentals of cardiovascular disease. In: Libby
P, Bonow RO, Mann DL, Zipes DP. Braunwald�s heart disease:
A textbook of cardiovascular medicine. 8th ed. USA: Saunders; 2008. p. 1–21.
3. Vasan RS, Benjamin EJ, Sullivan LM, D�Agostino RB. The burden of increasing worldwide cardiovascular disease. In: Fuster V, Alexander RW, O�Rourke RA. Hurst�s the heart. 11
th ed. New York: McGrawHill Med Publ; 2004. p. 15–6.
4. World Health Organization. The World Health Report 2002: Reducing risks, promoting healthy life. Geneva: WHO; 2002.
5. Bonow RO, Smaha LA, Smith SC. World Heart Day 2002: The
International Burden of cardiovascular disease: responding to the
emerging global epidemic. Circulation 2002; 106(13): 1602–5.
6. American Heart Association. Cardiovascular Disease Statistics.
Accessed from http://www.americanheart.org on May 5
, 2010. 7. Kristensen PL, Wedderkopp N, Mí¸ller NC, Andersen LB, Bai CN, Froberg K. Tracking and prevalence of cardiovascular disease risk
factors across socio-economic classes: A longitudinal substudy of
the European Youth Heart Study. BMC Public Health 2006; 6:20
Accessed from http://www.biomedcentral.com/1471-2458/6/20 on
May 5th, 2010.
8. Libby P. The vascular biology of atherosclerosis. In: Libby P,
Bonow RO, Mann DL, Zipes DP. Braunwald�s heart disease: A
textbook of cardiovascular medicine. 8th ed. USA: Saunders; 2008.
p. 985–1002.
9. Falk E, Shah PK, Fuster V. Atherothrombosis and thrombosis-prone plaques. In: Fuster V, Alexander RW, O�Rourke RA. Hurst�s the heart. 11th ed. New York: McGraw-Hill Med Publ; 2004. p. 1123–40.
10. Epstein SE, Zhou YF, Zhu J. Infection and atherosclerosis emerging mechanistic paradigms. J of Am Heart Assc Circulation 1999; 100:e20–e28.
11. Shoenfeld Y, Gerli R, Doria A, Matsuura E, Cerinic MM, Ronda
N, Jara LJ, Abu-Shakra M, Meroni PL, dan Sherer Y. Accelerated
atherosclerosis in autoimmune rheumatic diseases. Circulation 2005;
112: 3337–47.
12. Kiechl S, Egger G, Mayr M, Wiedermann CJ, Bonora E, Oberhollenzer F, Muggeo M, Xu Q, Wick G, Poewe W, Willeit J. Chronic infections and the risk of carotid atherosclerosis: prospective results from a large population study. Circulation 2001; 103: 1064–70.
13. DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortality. BMJ 1993; 306: 688–91.
14. Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesäniemi YA,
Syrjälä SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction.
BMJ 1989; 298: 779–81.
15. Stein JM, Kuch B, Conrads G, Fickl S, Chrobot J, Schulz S,
Ocklenburg C, Smeets R. Clinical periodontal and microbiologic
parameters in patients with acute myocardial infarction. J Periodontol. 2009; 80(10): 1581–9.
16. Paul A, Ko KWS, Li L, Yechoor V, McCrory MA, Szalai AJ, Chan L.
C-Reactive Protein Accelerates the Progression of Atherosclerosis in
Apolipoprotein E–Deficient Mice. Circulation 2004; 109: 647–55.
17. Prasad A, Zhu J, Halcox JPJ, Waclawiw MA, Epstein SE, Quyyumi
AA. Predisposition to Atherosclerosis by Infections: Role of
Endothelial Dysfunction. Circulation 2002; 106: 184–90.
18. Klein EC, Rupprecht HJ, Blankenberg S, Bickel C, Kopp H, Rippin G, Victor A, Hafner G, Schlumberger W, Meyer J. Impact of infectious
burden on extent and long-term prognosis of atherosclerosis.
Circulation 2002; 105: 15–21.
19. Tzoulaki I, Murray GD, Lee AJ, Rumley A, Lowe GD, Fowkes GR.
C-reactive protein, interleukin-6, and soluble adhesion molecules as
predictors of progressive peripheral atherosclerosis in the general
population: edinburgh artery study. Circulation 2005; 112: 976–83.
20. Fruchart JC, Nierman MC, Stroes ESG, Kastelein JJP, Duriez P. New risk factors for atherosclerosis and patient risk assessment. Circulation 2004; 109: III-15-III-19.
21. Dietrich T, Jimenez M, Kaye EAK, Vokonas PS, Garcia RI. Agedependent associations
between chronic periodontitis/edentulism and risk of coronary heart disease. Circulation 2008; 117: 1668–74.th
22. Beck JD, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodontal disease and cardiovascular disease. J Periodontol. 1996; 67(10 Suppl): 1123–37.
23. Beck JD, Offenbacher S. Relationships among clinical measures of periodontal disease and their associations with systemic markers. Ann Periodontol. 2002 Dec; 7(1): 79–89.
24. Beck JD, Pankow J, Tyroler HA, Offenbacher S. Dental infections
and atherosclerosis. Am Heart J. 1999; 138(5 Pt 2): S528–33.
25. Mattila KJ, Asikainen S, Wolf J, Jousimies-Somer H, Valtonen V,
Nieminen M. Age, dental infections, and coronary heart disease.
Journal of Dental Research 2000; 79(2): 756–60.
26. Gibson, III FC, Hong C, Chou HH, Yumoto H, Chen J, Lien E,
Wong J, Genco CA. Innate immune recognition of invasive bacteria
accelerates atherosclerosis in apolipoprotein E-deficient mice.
Circulation 2004; 109: 2801–6.
27. Humagain M, Nayak DG, Uppoor AS. Periodontal infections
and cardiovascular disease: Is it a mere association? Kathmandu
University Medical Journal 2006: 4(3): 379–82.
28. Friedewald VE, Kornman KS, Beck JD, Genco R, Goldfine A,
Libby P, Offenbacher S, Ridker PM, Van Dyke TE Roberts WC.
The American Journal of Cardiology and Journal of Periodontology
Editors' Consensus: periodontitis and atherosclerotic cardiovascular
disease. Journal of Periodontology and The American Journal of
Cardiology 2009.
29. Pitiphat W, Savetsilp W, Wara-Aswapati N. C-reactive protein
associated with periodontitis in a Thai population. J Clin Periodontol.
2008; 35(2): 120–5.
30. Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, De Nardin
E. Periodontal infections contribute to elevated systemic C-reactive
protein level. J Periodontol. 2001; 72(9): 1221–7.
31. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH.
Plasma concentration of C-reactive protein and risk of developing
peripheral vascular disease. Circulation 1998; 97: 425–8.
32. Schillinger M, Exner M, Mlekusch W, Sabeti S, Amighi J, Nikowitsch R, Timmel E, Kickinger B, Minar C, Pones M, Lalouschek W, Rumpold H, Maurer G, Wagner O, Minar E. Inflammation and carotid artery”risk for atherosclerosis study (ICARAS). Circulation 2005; 111: 2203–9.
33. Hommels MJ, van der Ven AJ, Kroon AA, Kessels AG, van DieijenVisser MP, van Engelshoven JA, Bruggeman CA, de Leeuw PW.
C-reactive protein, atherosclerosis and kidney function in hypertensive patients. Journal of Human Hypertension 2005; 19: 521–6.
34. Schillinger M, Exner M, Amighi J, Mlekusch W, Sabeti S, Rumpold
H, Wagner O, Minar E. Joint effects of C-reactive protein and glycated
hemoglobin in predicting future cardiovascular events of patients with
advanced atherosclerosis. Circulation 2003; 108: 2323–8.
35. Venugopal SK, Devaraj S, Jialal I. C-reactive protein decreases
prostacyclin release from human aortic endothelial cells. Circulation
2003; 108: 1676–8.
36. Pasceri V, Willerson JT, dan Yeh ETH. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000; 102: 2165–8.
37. Messer JV. C-reactive protein and cardiovascular disease. Circulation 2006; 114: e253–e254.
38. Khera A, de Lemos JA, Peshock RM, Lo HS, Stanek HG, Murphy
SA, Wians FH, Grundy SM, McGuire DK. Relationship between
C-reactive protein and subclinical atherosclerosis. The Dallas Heart
Study. Circulation 2006; 113: 38–43.
39. Haynes WG, Stanford C. Periodontal disease and atherosclerosis:
from dental to arterial plaque. Arterioscler Thromb Vasc Biol 2003;
23: 1309–11.
40. Ishihara K, Nabuchi A, Ito R, Miyachi K, Kuramitsu HK, Okuda K.
Correlation between detection rates of periodontopathic bacterial
DNA in carotid coronary stenotic artery plaque and in dental plaque
samples. Journal of Clin Microbiology 2004; 42(3): 1313–5.
41. Mueller HP. Periodontology the essentials. Germany: Georg Thieme Verlag; 2005. p. 31–6, 56.
42. Vernino AR. Etiology of periodontal disease. In: Vernino AR, Gray J, Hughes E. The periodontic syllabus. 5th ed. Philadelphia: Lippincott
Williams and Wilkins; 2008. p. 15–25.
JB. Prevalence of heart disease – united states. CDC 2007; 56(06):
113–8.
2. Gaziano JM. Fundamentals of cardiovascular disease. In: Libby
P, Bonow RO, Mann DL, Zipes DP. Braunwald�s heart disease:
A textbook of cardiovascular medicine. 8th ed. USA: Saunders; 2008. p. 1–21.
3. Vasan RS, Benjamin EJ, Sullivan LM, D�Agostino RB. The burden of increasing worldwide cardiovascular disease. In: Fuster V, Alexander RW, O�Rourke RA. Hurst�s the heart. 11
th ed. New York: McGrawHill Med Publ; 2004. p. 15–6.
4. World Health Organization. The World Health Report 2002: Reducing risks, promoting healthy life. Geneva: WHO; 2002.
5. Bonow RO, Smaha LA, Smith SC. World Heart Day 2002: The
International Burden of cardiovascular disease: responding to the
emerging global epidemic. Circulation 2002; 106(13): 1602–5.
6. American Heart Association. Cardiovascular Disease Statistics.
Accessed from http://www.americanheart.org on May 5
, 2010. 7. Kristensen PL, Wedderkopp N, Mí¸ller NC, Andersen LB, Bai CN, Froberg K. Tracking and prevalence of cardiovascular disease risk
factors across socio-economic classes: A longitudinal substudy of
the European Youth Heart Study. BMC Public Health 2006; 6:20
Accessed from http://www.biomedcentral.com/1471-2458/6/20 on
May 5th, 2010.
8. Libby P. The vascular biology of atherosclerosis. In: Libby P,
Bonow RO, Mann DL, Zipes DP. Braunwald�s heart disease: A
textbook of cardiovascular medicine. 8th ed. USA: Saunders; 2008.
p. 985–1002.
9. Falk E, Shah PK, Fuster V. Atherothrombosis and thrombosis-prone plaques. In: Fuster V, Alexander RW, O�Rourke RA. Hurst�s the heart. 11th ed. New York: McGraw-Hill Med Publ; 2004. p. 1123–40.
10. Epstein SE, Zhou YF, Zhu J. Infection and atherosclerosis emerging mechanistic paradigms. J of Am Heart Assc Circulation 1999; 100:e20–e28.
11. Shoenfeld Y, Gerli R, Doria A, Matsuura E, Cerinic MM, Ronda
N, Jara LJ, Abu-Shakra M, Meroni PL, dan Sherer Y. Accelerated
atherosclerosis in autoimmune rheumatic diseases. Circulation 2005;
112: 3337–47.
12. Kiechl S, Egger G, Mayr M, Wiedermann CJ, Bonora E, Oberhollenzer F, Muggeo M, Xu Q, Wick G, Poewe W, Willeit J. Chronic infections and the risk of carotid atherosclerosis: prospective results from a large population study. Circulation 2001; 103: 1064–70.
13. DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortality. BMJ 1993; 306: 688–91.
14. Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesäniemi YA,
Syrjälä SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction.
BMJ 1989; 298: 779–81.
15. Stein JM, Kuch B, Conrads G, Fickl S, Chrobot J, Schulz S,
Ocklenburg C, Smeets R. Clinical periodontal and microbiologic
parameters in patients with acute myocardial infarction. J Periodontol. 2009; 80(10): 1581–9.
16. Paul A, Ko KWS, Li L, Yechoor V, McCrory MA, Szalai AJ, Chan L.
C-Reactive Protein Accelerates the Progression of Atherosclerosis in
Apolipoprotein E–Deficient Mice. Circulation 2004; 109: 647–55.
17. Prasad A, Zhu J, Halcox JPJ, Waclawiw MA, Epstein SE, Quyyumi
AA. Predisposition to Atherosclerosis by Infections: Role of
Endothelial Dysfunction. Circulation 2002; 106: 184–90.
18. Klein EC, Rupprecht HJ, Blankenberg S, Bickel C, Kopp H, Rippin G, Victor A, Hafner G, Schlumberger W, Meyer J. Impact of infectious
burden on extent and long-term prognosis of atherosclerosis.
Circulation 2002; 105: 15–21.
19. Tzoulaki I, Murray GD, Lee AJ, Rumley A, Lowe GD, Fowkes GR.
C-reactive protein, interleukin-6, and soluble adhesion molecules as
predictors of progressive peripheral atherosclerosis in the general
population: edinburgh artery study. Circulation 2005; 112: 976–83.
20. Fruchart JC, Nierman MC, Stroes ESG, Kastelein JJP, Duriez P. New risk factors for atherosclerosis and patient risk assessment. Circulation 2004; 109: III-15-III-19.
21. Dietrich T, Jimenez M, Kaye EAK, Vokonas PS, Garcia RI. Agedependent associations
between chronic periodontitis/edentulism and risk of coronary heart disease. Circulation 2008; 117: 1668–74.th
22. Beck JD, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodontal disease and cardiovascular disease. J Periodontol. 1996; 67(10 Suppl): 1123–37.
23. Beck JD, Offenbacher S. Relationships among clinical measures of periodontal disease and their associations with systemic markers. Ann Periodontol. 2002 Dec; 7(1): 79–89.
24. Beck JD, Pankow J, Tyroler HA, Offenbacher S. Dental infections
and atherosclerosis. Am Heart J. 1999; 138(5 Pt 2): S528–33.
25. Mattila KJ, Asikainen S, Wolf J, Jousimies-Somer H, Valtonen V,
Nieminen M. Age, dental infections, and coronary heart disease.
Journal of Dental Research 2000; 79(2): 756–60.
26. Gibson, III FC, Hong C, Chou HH, Yumoto H, Chen J, Lien E,
Wong J, Genco CA. Innate immune recognition of invasive bacteria
accelerates atherosclerosis in apolipoprotein E-deficient mice.
Circulation 2004; 109: 2801–6.
27. Humagain M, Nayak DG, Uppoor AS. Periodontal infections
and cardiovascular disease: Is it a mere association? Kathmandu
University Medical Journal 2006: 4(3): 379–82.
28. Friedewald VE, Kornman KS, Beck JD, Genco R, Goldfine A,
Libby P, Offenbacher S, Ridker PM, Van Dyke TE Roberts WC.
The American Journal of Cardiology and Journal of Periodontology
Editors' Consensus: periodontitis and atherosclerotic cardiovascular
disease. Journal of Periodontology and The American Journal of
Cardiology 2009.
29. Pitiphat W, Savetsilp W, Wara-Aswapati N. C-reactive protein
associated with periodontitis in a Thai population. J Clin Periodontol.
2008; 35(2): 120–5.
30. Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, De Nardin
E. Periodontal infections contribute to elevated systemic C-reactive
protein level. J Periodontol. 2001; 72(9): 1221–7.
31. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH.
Plasma concentration of C-reactive protein and risk of developing
peripheral vascular disease. Circulation 1998; 97: 425–8.
32. Schillinger M, Exner M, Mlekusch W, Sabeti S, Amighi J, Nikowitsch R, Timmel E, Kickinger B, Minar C, Pones M, Lalouschek W, Rumpold H, Maurer G, Wagner O, Minar E. Inflammation and carotid artery”risk for atherosclerosis study (ICARAS). Circulation 2005; 111: 2203–9.
33. Hommels MJ, van der Ven AJ, Kroon AA, Kessels AG, van DieijenVisser MP, van Engelshoven JA, Bruggeman CA, de Leeuw PW.
C-reactive protein, atherosclerosis and kidney function in hypertensive patients. Journal of Human Hypertension 2005; 19: 521–6.
34. Schillinger M, Exner M, Amighi J, Mlekusch W, Sabeti S, Rumpold
H, Wagner O, Minar E. Joint effects of C-reactive protein and glycated
hemoglobin in predicting future cardiovascular events of patients with
advanced atherosclerosis. Circulation 2003; 108: 2323–8.
35. Venugopal SK, Devaraj S, Jialal I. C-reactive protein decreases
prostacyclin release from human aortic endothelial cells. Circulation
2003; 108: 1676–8.
36. Pasceri V, Willerson JT, dan Yeh ETH. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000; 102: 2165–8.
37. Messer JV. C-reactive protein and cardiovascular disease. Circulation 2006; 114: e253–e254.
38. Khera A, de Lemos JA, Peshock RM, Lo HS, Stanek HG, Murphy
SA, Wians FH, Grundy SM, McGuire DK. Relationship between
C-reactive protein and subclinical atherosclerosis. The Dallas Heart
Study. Circulation 2006; 113: 38–43.
39. Haynes WG, Stanford C. Periodontal disease and atherosclerosis:
from dental to arterial plaque. Arterioscler Thromb Vasc Biol 2003;
23: 1309–11.
40. Ishihara K, Nabuchi A, Ito R, Miyachi K, Kuramitsu HK, Okuda K.
Correlation between detection rates of periodontopathic bacterial
DNA in carotid coronary stenotic artery plaque and in dental plaque
samples. Journal of Clin Microbiology 2004; 42(3): 1313–5.
41. Mueller HP. Periodontology the essentials. Germany: Georg Thieme Verlag; 2005. p. 31–6, 56.
42. Vernino AR. Etiology of periodontal disease. In: Vernino AR, Gray J, Hughes E. The periodontic syllabus. 5th ed. Philadelphia: Lippincott
Williams and Wilkins; 2008. p. 15–25.
The Indonesian Journal of Tropical and Infectious Disease (IJTID) is a scientific peer-reviewed journal freely available to be accessed, downloaded, and used for research. All articles published in the IJTID are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which is under the following terms:
Attribution ” You must give appropriate credit, link to the license, and indicate if changes were made. You may do so reasonably, but not in any way that suggests the licensor endorses you or your use.
NonCommercial ” You may not use the material for commercial purposes.
ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
