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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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Brain MRI. Representative brain MRI findings (T2-WI) of non-diabetic (A) and diabetic (B) nephropathy patients are shown. Arrows indicate cerebral infarctions.
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Figure 4: Brain MRI. Representative brain MRI findings (T2-WI) of non-diabetic (A) and diabetic (B) nephropathy patients are shown. Arrows indicate cerebral infarctions.

Mentions: Representative brain MRI findings (T2-WI) of HD patients are presented in Figure 4. It was found that 75% of the patients with diabetic nephropathy (6/8) had cerebral infarction, whereas 23% of those with non-diabetic nephropathy (3/13) had cerebral infarction (P = 0.029). Among patients with cerebral infarction, all showed lacunar infarction. Eight patients had silent cerebral infarction and only one patient with diabetic nephropathy had symptomatic cerebral infarction.


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)

Brain MRI. Representative brain MRI findings (T2-WI) of non-diabetic (A) and diabetic (B) nephropathy patients are shown. Arrows indicate cerebral infarctions.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Brain MRI. Representative brain MRI findings (T2-WI) of non-diabetic (A) and diabetic (B) nephropathy patients are shown. Arrows indicate cerebral infarctions.
Mentions: Representative brain MRI findings (T2-WI) of HD patients are presented in Figure 4. It was found that 75% of the patients with diabetic nephropathy (6/8) had cerebral infarction, whereas 23% of those with non-diabetic nephropathy (3/13) had cerebral infarction (P = 0.029). Among patients with cerebral infarction, all showed lacunar infarction. Eight patients had silent cerebral infarction and only one patient with diabetic nephropathy had symptomatic cerebral infarction.

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