Prisustvo bakterije Tannerella forsythia kod bolesnika sa hroničnom periodontalnom bolešću i arterosklerozom
Sažetak
Uvod/Cilj. Parodontopatija je zapaljensko oboljenje potpornog aparata zuba, koje se javlja kao odgovor na prisustvo dentalnog plaka. Između ostalih, Tannerella forsythia (Tf) je jedna od značajnih i veoma specifičnih bakterija koja se nalazi u periodontalnom džepu i pripada bakterijama „crvenog kompleksa“. Ateroskleroza je progresivno sužavanje arterija koje može, konačno, dovesti do njihovog potpunog začepljenja, kao rezultat nakupljanja masti. Smatra se vodećim uzrokom koronarne srčane bolesti (80%), kao i infarkta miokarda i moždanog udara. Sve više je objavljenih radova na temu potencijalne povezanosti parodontopatija i kardiovaskulranih oboljenja, gde se smatra da bakterije prisutne u periodontalnom džepu, između ostalih Tf, mogu prodreti u sistemsku cirkulaciju direktnim ili indirektnim putem. Cilj ove studije bio je utvrđivanje prisutnosti Tf u aterosklerotskim plakovima različitih krvnih sudova osoba obolelih od hronične parodontopatije. Metode. U ovu studiju je bilo uključeno 90 pacijenata (61 muškarac i 29 žena) sa dijagnozom parodontopatije i ateroskleroze koji su bili podvrgnuti endarterektomiji ili perkutanoj transluminalnoj koronarnoj angioplastici. Klinički pregled za parodontopatiju sastojao se od utvrđivanja plak indeksa (po Silness Lӧu), gingivalnog indeksa (po Lӧe Silnes), indeksa krvarenja iz sulkusa (po Mühleman-Son) i dubine periodontalnog džepa. Prisustvo Tf u periodontalnom džepu i aterosklerozom izmenjenim krvnim sudovima detektovano je metodom lančane reakcije polimeraze [polymerase chain reaction (PCR)] uz Tf ATCC 43037 kao pozitivne kontrole. Rezultati. Tf je bila prisutna u subgingivalnom plaku kod 68 (76%) pacijenata, dok je njeno prisustvo u aterosklerotskim plakovima zabeleženo kod njih 42 (53,3%). Značajno prisustvo Tf je zabeleženo u koronarnim arterijama (41,7%), karotidnim arterijama (35,4%), zatim u aneurizmama a. abdominalis (12,5%), a. mamaria (8,5%) i a. femoralis (2,1%), dok u a. iliaca Tf nije bila prisutna. Zaključak. Ovom studijom utvrđena je jaka povezanost parodontopatije i aterogeneze, te se smatra da bi se parodontopatija trebala uvrstiti u potencijalne faktore rizika od nastanka ateroskleroze. Takođe, bilo bi neophodno da se kontroliše parodontopatija kako bi se smanjio rizik od oboljevanja i smrtnosti povezanih sa aterosklerozom.
Reference
Schützhold S, Kocher T, Biffar R, Hoffmann T, Schmidt CO, Micheelis W, et al. Changes in prevalence of periodontitis in two German population-based studies. J Clin Periodontol 2015; 42(2): 121–30.
Pucar A, Milasin J, Lekovic V, Vukadinovic M, Ristic M, Putnik S, Keet al. Correlation between atherosclerosis and periodontal putative pathogenic bacterial infections in coronary and inter-nal mammary arteries. J Periodontol 2007; 78(4): 677–82.
Koshi E, Rajesh S, Koshi P, Arunima PR. Risk assessment for periodontal disease. J Indian Soc Periodontol. 2012; 16(3): 324–8.
Kanjuh V, Ostojić M, Bojić M, Đurić D, Gojković-Bukarica Lj, Tasić N, et al. Atherosclerosis at the threshold of the III mil-lennium (Morphological clinical correlation of atherosclerotic lesions of relevant clinical syndromes). In: Nedeljković IS, Kanjuh IV, Vukotić RM, editors. Cardiology. 3rd ed. Begrade: D.P za izdavačko trgovinsku delatnost, 2000; p. 2393–423. (Serbian)
Beck JD, Garsia R, Heiss G, Vokonas P, Ofenbacher S. Periodon-tal disease and cardiovascular disease. J Periodontol 1996; 67(10 Suppl): 1123–37.
De Stefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortali-ty. BMJ 1993; 306 (6879): 688–91.
Chhibber-Goel J, Singhal V, Bhowmik D, Vivek R, Parakh N, Bhargava B, et al. Linkages between oral commensal bacteria and atherosclerotic plaques in coronary artery disease patients. NPJ Biofilms Microbiomes 2016; 2: 7.
Libby P. The vascular biology of aterosclerosos. In: Libby P, Bonow RO, Mann DL, Zipes D, Braunwald E, editors. Braun-wald’s Heart disease. 8ht ed. Philadelphia, PA: Sounders Else-vier, 2008; p. 985–1002.
Friedrich V, Pubingers S, Chen T, Messner P, Dewhirst FE, Schäffer C. Draft genome sequence of Tannerella forsythia type strain ATCC 43037. Genome Announc 2015; 3(3): pii: e00660-15.
Cairo F, Castellani S, Gori AM, Nieri M, Baldelli G, Abbate R, et al. Severe periodontitis in young adults is associated with sub-clinical atherosclerosis. J Clin Periodontol 2008; 35(6): 465–72.
Armitage GC. Development of a classification system for peri-odontal diseases and conditions. Ann Periodontol. 1999; 4(1): 1–6.
Papapanou PN. Systemic effects of periodontitis: lessons learned from research on atherosclerotic vascular disease and adverse pregnancy outcomes. Int Dent J 2015; 65(6): 283–91.
Mahalakshmi K, Krishnan P, Arumugam SB. Association of peri-odontopathic anaerobic bacterial co-occurrence to atheroscle-rosis-a cross-sectional study. Anaerobe 2017; 44: 66–72.
Ohki T, Itabashi Y, Kohno T, Yoshizawa A, Nishikubo S, Watanabe S, et al. Detection of periodontal bacteria in throm-bi of patients with acute myocardial infarction by polymerase chain reaction. Am Heart J 2012; 163(2): 164–7.
Perunovic ND, Rakic MM, Nikolic LI, Jankovic SM, Aleksic ZM, Plecas DV, et al. The Association Between Periodontal In-flammation and Labor Triggers (Elevated Cytokine Levels) in Preterm Birth: A Cross-Sectional Study. J Periodontol 2016; 87(3): 248–56.
Mattila KJ, Valle MS, Neiminen MS, Valtonen W, Hietanierni KL. Dental infections and coronary atherosclerosis. Athero-sclerosis. 1993; 103(2): 205–11.
Mattila KJ, Asikanen S, Wolf J, Jousimies-Somer H, Valtonen V, Nieminen M. Age, dental infections,and coronary heart disease. J Dent Res 2000; 79(2): 756–60.
Chistiakov DA, Orekhov AN, Bobryshev YV. Links between ath-erosclerotic and periodontal disease. Exp Mol Pathol 2016; 100(1): 220–35.
Szulc M, Kustrzycki W, Janczak D, Michalowska D, Baczynska D, Radwan-Oczko M. Presence of Periodontopathic Bacteria DNA in Atheromatous Plaques from Coronary and Carotid Arteries. Biomed Res Int 2015; 2015: 825397.
Velsko IM, Chukkapalli SS, Rivera MF, Lee JY, Chen H, Zheng D, et al. Active invasion of oral and aortic tissues by Porphy-romonas gingivalis in mice causally links periodontitis and ath-erosclerosis. PLoS One 2014; 9(5): e97811.
Hussain M, Stover CM, Dupont AP. Gingivalis in periodontal disease and atherosclerosis – scenes of action for antimicrobial peptides and complement. Front Immunol 2015; 6: 45.
Kholy KE, Genco RJ, Van Dyke TE. Oral infections and cardio-vascular disease. Trends Endocrinol Metab 2015; 26(6): 315–21.
Rangé H, Labreuche J, Louedec L, Rondeau P, Planesse C, Sebbag U, et al. Periodontal bacteria in human carotid atherothrom-bosis as a potential trigger for neutrophil activation. Athero-sclerosis 2014; 236(2): 448–55.
Haraszthy VI, Zambon JJ, Trevisan M, Zeid M, Genco RJ. Identi-fication of periodontal pathogens in atheromatous plaques. J Periodontol 2000; 71(10): 1554–60.
Figuero Е, Sánchez-Beltrán М, Cuesta-Frechoso S, Tejerina MJ, Castro JA, Gutiérrez JM, et al. Detection of periodontal bacte-ria in atheromatous plaque by nested polymerase chain. J Peri-odontol 2011; 82(10): 1469–77.
Kurihara N, Inoue Y, Iwai T, Umeda M, Huang Y, Ishikawa I. De-tection and localization of periodontopathic bacteria in ab-dominal aortic aneurysms. Eur J Vasc Endovasc Surg 2004; 28(5): 553–8.