Quantitative detection of periodontopathic bacteria in atherosclerotic plaques from coronary arteries

Abstract

Oral pathogens, including periodontopathic bacteria, are thought to be aetiological factors in the development of cardiovascular disease. In this study, the presence of Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum-periodonticum-simiae group, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens and Tannerella forsythia in atheromatous plaques from coronary arteries was determined by real-time PCR. Forty-four patients displaying cardiovascular disease were submitted to periodontal examination and endarterectomy of coronary arteries. Approximately 60-100 mg atherosclerotic tissue was removed surgically and DNA was obtained. Quantitative detection of periodontopathic bacteria was performed using universal and species-specific TaqMan probe/primer sets. Total bacterial and periodontopathic bacterial DNA were found in 94.9 and 92.3 %, respectively, of the atheromatous plaques from periodontitis patients, and in 80.0 and 20.0 %, respectively, of atherosclerotic tissues from periodontally healthy subjects. All periodontal bacteria except for the F. nucleatum-periodonticum-simiae group were detected, and their DNA represented 47.3 % of the total bacterial DNA obtained from periodontitis patients. Porphyromonas gingivalis, A. actinomycetemcomitans and Prevotella intermedia were detected most often. The presence of two or more periodontal species could be observed in 64.1 % of the samples. In addition, even in samples in which a single periodontal species was detected, additional unidentified microbial DNA could be observed. The significant number of periodontopathic bacterial DNA species in atherosclerotic tissue samples from patients with periodontitis suggests that the presence of these micro-organisms in coronary lesions is not coincidental and that they may in fact contribute to the development of vascular diseases. INTRODUCTIONAtherosclerosis has been defined as a progressive process that causes focal thickening of large-to medium-sized muscular and large elastic arteries (Pucar et al., 2007). In addition, several risk factors have been associated with its progression, such as hypertension, hypercholesterolaemia, diabetes, marked obesity, smoking, physical inactivity and chronic bacterial infection (Taylor-Robinson et al., 2002;Pucar et al., 2007). The development of atheromatous plaques seems to be relevant to cardiovascular disease as a result of endothelial cell damage and by maintenance of the inflammatory reactions in the walls of blood vessels (Libby et al., 2002).Studies have demonstrated a close association between cardiovascular disease and periodontitis, and oral hygiene and periodontal status are closely related to the occurrence of heart attacks (Kozarov et al., 2006;Aimetti et al., 2007; Johansson et al., 2008). A relationship between periodontal status and cardiovascular diseases has been suggested, where the periodontium represents the source of inflammatory mediators, in addition to micro-organisms systemically disseminated by the blood flow (Li et al., 2000).Consid...

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

“…Oral bacteria can enter the circulation and cause bacteraemia by actively crossing the periodontal epithelium [18–20], or by being inoculated through mechanical procedures, including periodontal debridement, flossing and brushing [21,22]. Periodontal pathogens, such as Aggregatibacter actinomycetemcomitans, Treponema denticola and Porphyromonas gingivalis are also capable of invading endothelial cells [23–27], and they have been detected in atherosclerotic plaques, heart valves, aortic aneurysms, carotid and coronary vessels [28–33]. Studies in a variety of animal models have demonstrated that recurrent bacteraemia or oral administration with P. gingivalis can enhance atherogenesis [34,35].…”

Human oral, gut, and plaque microbiota in patients with atherosclerosis

“…Furthermore, in a study where bacterial DNA was identified in atherosclerotic plaques, 51.5% of the patients tested positive for Chlamydia in their atheromas (17). Several studies suggest an oral source for atherosclerotic plaque-associated bacteria (18)(19)(20)(21). However, to date, no single study has directly compared the microbial diversity of oral, gut, and atherosclerotic plaque microbiotas within individuals.…”

The Association between Periodontal Conditions and Serum Lipids among Elderly Participants in Gadjah Mada Medical Centre, Yogyakarta

“…[13][14][15] Periodontal pathogens were found to be the possible association between periodontal disease and atherosclerosis. [16][17][18][19] Atherosclerosis is a chronic inflammatory disease of artery vessels, starting from the endothelial injury and thrombus formation in the advanced plaque. 20,21 Atherogenesis development may be caused by multiple mechanism which induced by lipopolysaccharides (LPS) from periodontal pathogens in the formation of pro-atherogenic in lipid profile.…”