Periodontal disease, Porphyromonas gingivalis serum antibody levels and orodigestive cancer mortality

Abstract

Periodontitis, the progressive loss of the alveolar bone around the teeth and the major cause of tooth loss in adults, is due to oral microorganisms, including Porphyromonas gingivalis. Periodontitis is associated with a local overly aggressive immune response and a spectrum of systemic effects, but the role of this condition in orodigestive cancers is unclear. We prospectively examined clinically ascertained periodontitis (N = 12,605) and serum IgG immune response to P.gingivalis (N = 7852) in relation to orodigestive cancer mortality among men and women in the National Health and Nutrition Examination Survey III. A detailed oral health exam was conducted from 1988 to 1994 in survey Phases I and II, whereas serum IgG for P.gingivalis was measured from 1991 to 1994 in Phase II only. One hundred and five orodigestive cancer deaths were ascertained through 31 December 2006. Periodontitis (moderate or severe) was associated with increased orodigestive cancer mortality [relative risks (RR) = 2.28, 95% confidence interval (CI) = 1.17-4.45]; mortality risks also increased with increasing severity of periodontal disease (P trend = 0.01). Periodontitis-associated mortality was in excess for colorectal (RR = 3.58; 95% CI = 1.15-11.16) and possibly for pancreatic cancer (RR = 4.56; 95% CI = 0.93-22.29). Greater serum P.gingivalis IgG tended to be associated overall with increased orodigestive cancer mortality (P trend = 0.06); P.gingivalis-associated excess orodigestive mortality was also found for healthy subjects not exhibiting overt periodontal disease (RR = 2.25; 95% CI = 1.23-4.14). Orodigestive cancer mortality is related to periodontitis and to the periodontal pathogen, P.gingivalis, independent of periodontal disease. Porphyromonas gingivalis is a biomarker for microbe-associated risk of death due to orodigestive cancer.

Periodontal systemic associations: review of the evidence

“…A recent study (Ahn et al 2012) followed up participants in NHANES III and reported that periodontitis was associated with increased orodigestive cancer mortality (OR = 2.28, 95%CI 1.17-4.45). There was a trend for an increase in risk with increasing severity of periodontitis.…”

Defining the gut microbiota in individuals with periodontal diseases: an exploratory study

“…Among those, periodontal diseases are complex polymicrobial inflammatory diseases associated with dysbiosis of the dental biofilm that induces a long-lasting chronic inflammation of the periodontal supporting tissues, leading to alveolar bone destruction, and eventual tooth loss [6]. Over the years, strong evidence has accumulated to indicate that the pathogenic microbiota and the chronic inflammation established in periodontitis contribute to the onset and/or progression of several systemic inflammatory diseases such as cardiovascular diseases [7,8], diabetes [9], obesity [10], metabolic syndrome [11], respiratory disease [12], cancer [13], chronic kidney disease (CKD) [14] and rheumatoid arthritis (RA) [15]. Most research on the periodontitis-systemic disease relationship, however, has not determined causality, and the link between these diseases are bi-directional associations [16].…”

Periodontal Disease and Nuclear and Oxidative DNA Damage

“…Nuclear and oxidative DNA damage area increased in subjects with periodontal disease, and genetic damage is a critical event not only in the initiation phase but also in the promotion and progression phases, which could be related to carcinogenesis events. Moreover, recent studies have associated periodontitis with some cancer including head and neck cancer [44], pancreatic cancer [45], colon cancer [46], and orodigestive cancers [47], which are relevant to the control of this disease and to promote the importance of good oral health.…”