High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis

Abstract

Periodontal disease (PD) is generated by microorganisms. These microbes can enter the general circulation causing a bacteraemia. The result can be adverse systemic effects, which could promote conditions such as cardiovascular disease. Level A evidence supports that PD is independently associated with arterial disease. PD is a common chronic condition affecting the majority of Americans 30 years of age and older. Atherosclerosis remains the largest cause of death and disability. Studies indicate that the adverse cardiovascular effects from PD are due to a few putative or high-risk bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola or Fusobacterium nucleatum. There are three accepted essential elements in the pathogenesis of atherosclerosis: lipoprotein serum concentration, endothelial permeability and binding of lipoproteins in the arterial intima. There is scientific evidence that PD caused by the high-risk pathogens can influence the pathogenesis triad in an adverse manner. With this appreciation, it is reasonable to state PD, due to high-risk pathogens, is a contributory cause of atherosclerosis. Distinguishing this type of PD as causal provides a significant opportunity to reduce arterial disease.

Citrullination as a plausible link to periodontitis, rheumatoid arthritis, atherosclerosis and Alzheimer’s disease

“…Atherosclerosis is common in the elderly and remains the major cause of death and disability in this group. The American Heart Association (AHA) recognizes that PD is independently associated with arteriosclerotic vascular disease (ASVD) [44]. The connection between citrullinated peptides and the development of atherosclerosis remains unclear in comparison to RA.…”

Periodontal Disease And Its Impact on Health, From Cardiovascular Diseases to Metabolic Syndrome

“…It seems that the links between these two pathologies could be explained by common risk behaviours in subjects such as obesity or smoking. Thus, the associations observed between one of these diseases are difficult to explain [14].…”

A national imperative

“…Periodontal diseases are generated by microorganisms that readily can enter the general circulation and cause bacteremia, resulting in adverse systemic effects that can promote conditions such as atherosclerosis. 2 Study investigators assert that adverse cardiovascular effects from periodontal diseases are due to a few highrisk oral microorganisms associated with the pathogenesis of atherosclerosis via increased lipoprotein concentrations, endothelial permeability, and binding of lipoproteins in the arterial intima. 2 In this guest editorial we assert that oral bacteria influence the pathogenesis of atherosclerosis and a number of other chronic degenerative diseases.…”

“…2 Study investigators assert that adverse cardiovascular effects from periodontal diseases are due to a few highrisk oral microorganisms associated with the pathogenesis of atherosclerosis via increased lipoprotein concentrations, endothelial permeability, and binding of lipoproteins in the arterial intima. 2 In this guest editorial we assert that oral bacteria influence the pathogenesis of atherosclerosis and a number of other chronic degenerative diseases. We argue that sufficient scientific and health economic evidence support providing oral health benefits to older adults through the Medicare mechanism.…”

“…2 Furthermore, periodontal diseases share genetically determined risk factors with other chronic degenerative diseases with an inflammatory response such as ulcerative colitis, juvenile arthritis, and systemic lupus erythematosus. These conditions are associated closely with increased production of proinflammatory cytokines that serve as indicators of susceptibility to severe chronic degenerative diseases.…”