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High incidence of Aggregatibacter actinomycetemcomitans infection in patients with cerebral infarction and diabetic renal failure: a cross-sectional study.

Murakami M, Suzuki J, Yamazaki S, Ikezoe M, Matsushima R, Ashigaki N, Aoyama N, Kobayashi N, Wakayama K, Akazawa H, Komuro I, Izumi Y, Isobe M - BMC Infect. Dis. (2013)

Bottom Line: We found that the patients with diabetic nephropathy had more A. actinomycetemcomitans compared with non-diabetic nephropathy (P = 0.038) in dental plaque.Furthermore, the patients with diabetic nephropathy showed a significantly higher incidence of cerebral infarction compared with those with non-diabetic nephropathy (P = 0.029).Clinical oral and radiographic scores tended to be higher among patients in the diabetic nephropathy group than in the non-diabetic nephropathy group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Advanced Clinical Science and Therapeutics, University of Tokyo, Tokyo, Japan. junichisuzuki-circ@umin.ac.jp.

ABSTRACT

Background: Recent epidemiological studies suggest that periodontitis is a major risk factor for renal failure and cerebral infarction. The aim of this study was to evaluate the association among periodontitis, renal failure, and cerebral infarction, focusing on microbiological and immunological features.

Methods: Twenty-one patients treated with hemodialysis (HD) were enrolled in this study. They were 8 with diabetic nephropathy and 13 with non-diabetic nephropathy. Blood examination, periodontal examination, brain magnetic resonance image (MRI), and dental radiography were performed on all patients. Subgingival plaque, saliva, and blood samples were analyzed for the periodontal pathogens, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Prevotella intermedia (P. intermedia) using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA).

Results: We found that the patients with diabetic nephropathy had more A. actinomycetemcomitans compared with non-diabetic nephropathy (P = 0.038) in dental plaque. Furthermore, the patients with diabetic nephropathy showed a significantly higher incidence of cerebral infarction compared with those with non-diabetic nephropathy (P = 0.029). Clinical oral and radiographic scores tended to be higher among patients in the diabetic nephropathy group than in the non-diabetic nephropathy group.

Conclusions: Periodontal pathogens, particularly A. actinomycetemcomitans, may play a role, at least a part, in the development of cerebral infarction in Japanese HD patients with diabetic nephropathy.

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Related in: MedlinePlus

PCR analysis. The results of PCR analysis of subgingival plaque (A) and saliva (B) are demonstrated. An asterisk (*) indicates a significant difference. A boxplot shows median, and interquatile range between 25th and 75th percent. Data are presented in number (%) or median (interquartile range). P-values were calculated by Mann–Whitney test.
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Figure 2: PCR analysis. The results of PCR analysis of subgingival plaque (A) and saliva (B) are demonstrated. An asterisk (*) indicates a significant difference. A boxplot shows median, and interquatile range between 25th and 75th percent. Data are presented in number (%) or median (interquartile range). P-values were calculated by Mann–Whitney test.

Mentions: The results of PCR analysis on subgingival plaque and saliva samples for all subjects are shown in Figure 2 and Tables 4 and 5. Although each pathogen did not demonstrate the statistical differences between the two groups, A. actinomycetemcomitans in the diabetic nephropathy group tended to have a higher prevalence rate compared to the non-diabetic nephropathy group in both saliva and plaque. Moreover, the patients with diabetic nephropathy had significantly more A. actinomycetemcomitans quantitatively compared to the patients with non-diabetic nephropathy (P = 0.038) in dental plaque. P. gingivalis and P. intermedia in both dental plaque and saliva did not differ quantitatively between the diabetic and non-diabetic groups. There were 5 (56%) and 3 (33%) patients who were positive for A. actinomycetemcomitans salivary and subgingivally of the 9 patients with cerebral infarction, respectively.


High incidence of Aggregatibacter actinomycetemcomitans infection in patients with cerebral infarction and diabetic renal failure: a cross-sectional study.

Murakami M, Suzuki J, Yamazaki S, Ikezoe M, Matsushima R, Ashigaki N, Aoyama N, Kobayashi N, Wakayama K, Akazawa H, Komuro I, Izumi Y, Isobe M - BMC Infect. Dis. (2013)

PCR analysis. The results of PCR analysis of subgingival plaque (A) and saliva (B) are demonstrated. An asterisk (*) indicates a significant difference. A boxplot shows median, and interquatile range between 25th and 75th percent. Data are presented in number (%) or median (interquartile range). P-values were calculated by Mann–Whitney test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222637&req=5

Figure 2: PCR analysis. The results of PCR analysis of subgingival plaque (A) and saliva (B) are demonstrated. An asterisk (*) indicates a significant difference. A boxplot shows median, and interquatile range between 25th and 75th percent. Data are presented in number (%) or median (interquartile range). P-values were calculated by Mann–Whitney test.
Mentions: The results of PCR analysis on subgingival plaque and saliva samples for all subjects are shown in Figure 2 and Tables 4 and 5. Although each pathogen did not demonstrate the statistical differences between the two groups, A. actinomycetemcomitans in the diabetic nephropathy group tended to have a higher prevalence rate compared to the non-diabetic nephropathy group in both saliva and plaque. Moreover, the patients with diabetic nephropathy had significantly more A. actinomycetemcomitans quantitatively compared to the patients with non-diabetic nephropathy (P = 0.038) in dental plaque. P. gingivalis and P. intermedia in both dental plaque and saliva did not differ quantitatively between the diabetic and non-diabetic groups. There were 5 (56%) and 3 (33%) patients who were positive for A. actinomycetemcomitans salivary and subgingivally of the 9 patients with cerebral infarction, respectively.

Bottom Line: We found that the patients with diabetic nephropathy had more A. actinomycetemcomitans compared with non-diabetic nephropathy (P = 0.038) in dental plaque.Furthermore, the patients with diabetic nephropathy showed a significantly higher incidence of cerebral infarction compared with those with non-diabetic nephropathy (P = 0.029).Clinical oral and radiographic scores tended to be higher among patients in the diabetic nephropathy group than in the non-diabetic nephropathy group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Advanced Clinical Science and Therapeutics, University of Tokyo, Tokyo, Japan. junichisuzuki-circ@umin.ac.jp.

ABSTRACT

Background: Recent epidemiological studies suggest that periodontitis is a major risk factor for renal failure and cerebral infarction. The aim of this study was to evaluate the association among periodontitis, renal failure, and cerebral infarction, focusing on microbiological and immunological features.

Methods: Twenty-one patients treated with hemodialysis (HD) were enrolled in this study. They were 8 with diabetic nephropathy and 13 with non-diabetic nephropathy. Blood examination, periodontal examination, brain magnetic resonance image (MRI), and dental radiography were performed on all patients. Subgingival plaque, saliva, and blood samples were analyzed for the periodontal pathogens, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Prevotella intermedia (P. intermedia) using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA).

Results: We found that the patients with diabetic nephropathy had more A. actinomycetemcomitans compared with non-diabetic nephropathy (P = 0.038) in dental plaque. Furthermore, the patients with diabetic nephropathy showed a significantly higher incidence of cerebral infarction compared with those with non-diabetic nephropathy (P = 0.029). Clinical oral and radiographic scores tended to be higher among patients in the diabetic nephropathy group than in the non-diabetic nephropathy group.

Conclusions: Periodontal pathogens, particularly A. actinomycetemcomitans, may play a role, at least a part, in the development of cerebral infarction in Japanese HD patients with diabetic nephropathy.

Show MeSH
Related in: MedlinePlus