Periodontitis-associated up-regulation of systemic inflammatory mediator level may increase the risk of coronary heart disease

Authors

  • T. Nakajima,

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
    3. General Dentistry and Education Unit, Niigata University Medical and Dental Hospital, Niigata
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  • T. Honda,

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
    3. Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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  • H. Domon,

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
    3. Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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  • T. Okui,

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
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  • K. Kajita,

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
    3. Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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  • H. Ito,

    1. Center for Transdisciplinary Research, Niigata University, Niigata
    2. Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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  • N. Takahashi,

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
    3. Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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  • T. Maekawa,

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
    3. Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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  • K. Tabeta,

    1. Center for Transdisciplinary Research, Niigata University, Niigata
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  • K. Yamazaki

    1. Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata
    2. Center for Transdisciplinary Research, Niigata University, Niigata
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Dr Kazuhisa Yamazaki, Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, 5274 Gakkocho 2-ban-cho, Niigata 951-8514, Japan
Tel: +81 25 227 0744
Fax: +81 25 227 0744
e-mail: kaz@dent.niigata-u.ac.jp

Abstract

Nakajima T, Honda T, Domon H, Okui T, Kajita K, Ito H, Takahashi N, Maekawa T, Tabeta K, Yamazaki K. Periodontitis-associated up-regulation of systemic inflammatory mediator level may increase the risk of coronary heart disease. J Periodont Res 2009; doi: 10.1111/j.1600-0765.2009.01209.x. © 2009 John Wiley & Sons A/S

Background and Objective:  Although an elevation in the concentration of high-sensitivity C-reactive protein (hs-CRP) as a result of periodontal infection may account for an increased risk of developing coronary heart disease (CHD), the effect of periodontal infection on the level of hs-CRP in an otherwise healthy Japanese population has not yet been reported. The aim of the present study was to confirm, on a larger scale, our previous pilot study findings that both chronic periodontitis and subsequent periodontal treatment alter the serum levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α).

Material and Methods:  The concentrations of serum hs-CRP, IL-6 and TNF-α were measured in 78 periodontitis patients at baseline and at re-assessment, and in 40 periodontally healthy subjects at the time of examination.

Results:  The concentrations of hs-CRP and IL-6 in the sera of periodontitis patients were significantly higher than those in control subjects. By contrast, the concentration of TNF-α was significantly lower in periodontitis patients than in control subjects. Whereas periodontal treatment decreased the levels of serum hs-CRP and IL-6, no such effect was observed for TNF-α. When the patients were subdivided into four groups according to their initial concentration of hs-CRP, only the CRP and IL-6 concentrations of the highest quartile group showed a significant reduction following periodontal treatment. No significant difference in the initial clinical parameters was observed in any quartile.

Conclusion:  Although periodontal infection does affect the concentration of hs-CRP and IL-6 in serum, a subgroup of patients exist who are highly susceptible to an increased risk of CHD associated with periodontitis, suggesting that there may be subjects who have an elevated risk of CHD independent of susceptibility to periodontal tissue destruction per se.

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