Periodontitis and systemic markers of neurodegeneration: A case–control study

Abstract

Aim:To investigate whether periodontitis is associated with amyloid beta (Aβ) peptides and whether systemic inflammation could act as a potential mediator of this link. Materials and Methods:A case-control study was designed including 75 patients with periodontitis (cases) and 75 age-balanced and gender-matched participants without periodontitis (controls). Full-mouth periodontal evaluation was performed in all participants. Demographic, clinical and behaviour data were also recorded. Fasting blood samples were collected, and serum levels of interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), Aβ 1-40 and Aβ 1-42 were determined.Results: Cases showed higher levels of IL-6 (8.7 ± 3.2 vs. 4.8 ± 0.5 pg/ml), hs-CRP (3.3 ± 1.2 vs. 0.9 ± 0.7 mg/L), Aβ 1-40 (37.3 ± 6.0 vs. 30.3 ± 1.8 pg/ml) and Aβ 1-42 (54.5 ± 10.6 vs. 36.5 ± 10.0 pg/ml) when compared to controls (all p < .001). Diagnosis of periodontitis was statistically significantly associated with cir-culating Aβ 1-40 ( coefficient adjusted = 6.9, 95% CI: 5.4-8.3; p < .001) and Aβ ( coefficient adjusted = 17.8, 95% CI: 14.4-21.3; p < .001). Mediation analysis confirmed hs-CRP and IL-6 as mediators of this association. Conclusions:Periodontitis is associated with increased peripheral levels of Aβ. This finding could be explained by enhanced systemic inflammation that can be seen in patients with periodontitis.

Mild systemic inflammation enhances response to OnabotulinumtoxinA in chronic migraineurs

“…It has been hypothesized that the ulcerated periodontal epithelium in periodontitis patients may act as an entrance to the bloodstream of IL-6 and many other pro-inflammatory molecules which evoke an acute-phase response in the liver resulting in the overexpression of systemic inflammatory mediators such as C-reactive protein (CRP), fibrinogen and serum amyloid A 1,2 or even specific proteins involved in the process of neurogenic inflammation [i.e., calcitonin gene-related peptide (CGRP)] typically seen in the physiopathology of head pain 3 . Based on this, untreated periodontitis has been suggested to lead to a low-grade chronic systemic inflammatory state in both human and animal studies 4,5 .…”

Association of bacterial vaginosis with periodontitis in a cross-sectional American nationwide survey

“…Diabetes mellitus was categorized as yes or no according to the self-reported questionnaire. Medical conditions were assessed as the sum of binary variables (to note the presence of asthma, congestive heart failure, coronary heart disease, angina, stroke, heart attack, emphysema, overweight, bronchitis, liver, thyroid and cancer) as previously done in Leira et al 88 .…”

“…We used PISA as a proxy for periodontal (local) inflammation and serum levels of CRP as a proxy for systemic inflammation, respectively 88,90 .…”

Oral health and healthy chewing for healthy cognitive ageing: A comprehensive narrative review

“…However, most of the studies referenced above focus on few inflammatory markers, such as the C-reactive protein (CRP). 63 It may be suspected that a subject susceptible to periodontal disease has a higher inflammatory response profile. An increased inflammatory response would not occur only in the periodontium but everywhere.…”

“…Lower mini‐mental state examination (MMSE) results are related to a higher state of periodontal deterioration as measured by the levels of cytokines produced by exposure to bacteria lipopolysaccharides (LPS), such as interleukin (IL) 1 beta, IL6, IL10 and tumour necrosis factor (TNF) alpha 59 . Periodontitis and the associated inflammatory mediators have also been associated with higher levels of tau protein, 60,61 and plasma levels of amyloid beta (Aβ) − 1‐42 62 and Aβ 1‐40 , 63 which may reinforce the inflammatory hypothesis. Both tau protein and Aß are associated with AD when they become hyperphosphorylated and form fibrillar structures in the form of plaques, respectively.…”