Biomarkers of periodontitis and inflammation in ischemic stroke: A case-control study. Issue 5 (July 2014)

• Record Type: Journal Article
• Authors: Palm, Frederick; Lahdentausta, Laura; Sorsa, Timo; Tervahartiala, Taina; Gokel, Pia; Buggle, Florian; Safer, Anton; Becher, Heiko; Grau, Armin J; Pussinen, Pirkko
• Is Part Of: Innate immunity. Volume 20:Issue 5(2014:Oct.)
• Page Start: 511
• Page End: 518
• Publication Date: 2014-07
• Subjects: Ischemic stroke -- inflammation -- periodontitis; Natural immunity -- Periodicals; Endotoxins -- Periodicals; 616.07905
• DOI: 10.1177/1753425913501214
• Languages: English
• ISSNs: 1753-4259

Abstract

Periodontitis is a common infectious disease associated with increased risk for ischemic stroke though presently unclear mechanisms. In a case-control study, we investigated salivary levels of four periodontal pathogens, as well as systemic and local inflammatory markers. The population comprised 98 patients with acute ischemic stroke (mean ± SD, 68.2 ± 9.7 yrs; 45.9% women) and 100 healthy controls (69.1 ± 5.2 yrs; 47.0% women). Patients were more often edentulous and had fewer teeth than controls (13.8 ± 10.8 versus 16.6 ± 10.1). After adjusting for stroke risk factors and number of teeth, controls had higher saliva matrix metalloproteinase-8 (MMP-8), myeloperoxidase (MPO), IL-1β, Aggregatibacter actinomycetemcomitans, and serum LPS activity levels. Patients had higher serum MMP-8 and MPO, and they were more often qPCR-positive for A. actinomycetemcomitans (37.9% versus 19.0%) and for ≥3 periodontopathic species combined (50.0% versus 33.0%). We conclude that controls more often had evidence of current periodontal infection with higher periodontal pathogen amount, endotoxemia, local inflammation and tissue destruction. Stroke patients more often had evidence of end-stage periodontitis with edentulism and missing teeth. They were more often carriers of several periodontopathic pathogens in saliva, especially A. actinomycetemcomitans . Additionally, inflammatory burden may contribute to high systemic inflammation associated with elevated stroke susceptibility.