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The Two-Way Association of Periodontal Infection with Systemic Disorders: An Overview.

Nagpal R, Yamashiro Y, Izumi Y - Mediators Inflamm. (2015)

Bottom Line: However, despite a significant increase in the prevalence of periodontal infections and systemic diseases in the past few decades, the fundamental biological mechanisms of connection between these ailments are still not fully explicated.Consequently, the mechanisms by which this bidirectional damage occurs are being explored with a concentric vision to develop strategies that could prevent or control the complications of these ailments.This paper attempts to summarize and hypothesize the diverse mechanisms that hint to a certain connection between the two prevalent chronic situations.

View Article: PubMed Central - PubMed

Affiliation: Probiotics Research Laboratory, Graduate School of Medicine, Juntendo University, Tokyo 113-0033, Japan.

ABSTRACT
Oral cavity that harbors diverse bacterial populations could also act as a site of origin for spread of pathogenic microorganisms to different body sites, particularly in immunocompromised hosts, patients, the elderly, or the underprivileged. A number of recent publications have advocated that patients with periodontal diseases are more susceptible to metabolic endotoxemia, inflammation, obesity, type 2 diabetes, and other related systemic complications, concluding that periodontal diseases could be a potential contributing risk factor for a wide array of clinically important systemic diseases. However, despite a significant increase in the prevalence of periodontal infections and systemic diseases in the past few decades, the fundamental biological mechanisms of connection between these ailments are still not fully explicated. Consequently, the mechanisms by which this bidirectional damage occurs are being explored with a concentric vision to develop strategies that could prevent or control the complications of these ailments. This paper attempts to summarize and hypothesize the diverse mechanisms that hint to a certain connection between the two prevalent chronic situations.

No MeSH data available.


Related in: MedlinePlus

Potential consequences of periodontal disease leading to stroke, infarction, atherosclerosis, and other neuropathological complications.
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Related In: Results  -  Collection


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fig3: Potential consequences of periodontal disease leading to stroke, infarction, atherosclerosis, and other neuropathological complications.

Mentions: Although the precise role and underlying mechanisms of periodontal infections in the pathology of systemic diseases still remain to be completely established, several hypotheses have been proposed based on the findings of various clinical and epidemiological investigations (Figure 3) [5, 44–46]. The primary factor includes the shared risk factors among oral infection and systemic diseases, such as genetic or environmental factors including age, smoking, lifestyle, and socioeconomic status. Another mechanism is the systemic inflammation against the local infection or circulating bacteria and associated higher levels of circulating inflammatory biomarkers which could play a contributing role in systemic disease. Also, the significant role of infection and inflammation in diseases such as atherosclerosis, cardiovascular disease (CVD), and coronary heart disease (CHD) also underscores the possible etiological role of periodontal infections in these diseases [28, 30, 47–50]. The pathogens from periodontal pockets may also enter into the connective tissues, endothelial cells, and the bloodstream and thus could lead to the formation of thrombus by platelet aggregation degrading collagen [51–53]. Chronic periodontal infections can contribute to atherogenesis either directly by triggering the platelet aggregation and invasion causing damage to endothelial cells or indirectly by stimulating the synthesis of intracellular adhesion molecules and production of antibodies against bacterial LPS thereby causing a discrepancy of the immune system [54, 55]. Moreover, P. gingivalis and A. actinomycetemcomitans have also been detected in atheromatous plaques of CVD patients, indicating a connection between periodontal infections and the formation of atherogenic lesions [56–59]. A recent systematic meta-analysis of epidemiologic literature has also suggested that periodontal infection could be an independent risk factor for CHD (although relatively weak) and that various measures of periodontal infections could explicate 30% increase in risk of CHD [60].


The Two-Way Association of Periodontal Infection with Systemic Disorders: An Overview.

Nagpal R, Yamashiro Y, Izumi Y - Mediators Inflamm. (2015)

Potential consequences of periodontal disease leading to stroke, infarction, atherosclerosis, and other neuropathological complications.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4539125&req=5

fig3: Potential consequences of periodontal disease leading to stroke, infarction, atherosclerosis, and other neuropathological complications.
Mentions: Although the precise role and underlying mechanisms of periodontal infections in the pathology of systemic diseases still remain to be completely established, several hypotheses have been proposed based on the findings of various clinical and epidemiological investigations (Figure 3) [5, 44–46]. The primary factor includes the shared risk factors among oral infection and systemic diseases, such as genetic or environmental factors including age, smoking, lifestyle, and socioeconomic status. Another mechanism is the systemic inflammation against the local infection or circulating bacteria and associated higher levels of circulating inflammatory biomarkers which could play a contributing role in systemic disease. Also, the significant role of infection and inflammation in diseases such as atherosclerosis, cardiovascular disease (CVD), and coronary heart disease (CHD) also underscores the possible etiological role of periodontal infections in these diseases [28, 30, 47–50]. The pathogens from periodontal pockets may also enter into the connective tissues, endothelial cells, and the bloodstream and thus could lead to the formation of thrombus by platelet aggregation degrading collagen [51–53]. Chronic periodontal infections can contribute to atherogenesis either directly by triggering the platelet aggregation and invasion causing damage to endothelial cells or indirectly by stimulating the synthesis of intracellular adhesion molecules and production of antibodies against bacterial LPS thereby causing a discrepancy of the immune system [54, 55]. Moreover, P. gingivalis and A. actinomycetemcomitans have also been detected in atheromatous plaques of CVD patients, indicating a connection between periodontal infections and the formation of atherogenic lesions [56–59]. A recent systematic meta-analysis of epidemiologic literature has also suggested that periodontal infection could be an independent risk factor for CHD (although relatively weak) and that various measures of periodontal infections could explicate 30% increase in risk of CHD [60].

Bottom Line: However, despite a significant increase in the prevalence of periodontal infections and systemic diseases in the past few decades, the fundamental biological mechanisms of connection between these ailments are still not fully explicated.Consequently, the mechanisms by which this bidirectional damage occurs are being explored with a concentric vision to develop strategies that could prevent or control the complications of these ailments.This paper attempts to summarize and hypothesize the diverse mechanisms that hint to a certain connection between the two prevalent chronic situations.

View Article: PubMed Central - PubMed

Affiliation: Probiotics Research Laboratory, Graduate School of Medicine, Juntendo University, Tokyo 113-0033, Japan.

ABSTRACT
Oral cavity that harbors diverse bacterial populations could also act as a site of origin for spread of pathogenic microorganisms to different body sites, particularly in immunocompromised hosts, patients, the elderly, or the underprivileged. A number of recent publications have advocated that patients with periodontal diseases are more susceptible to metabolic endotoxemia, inflammation, obesity, type 2 diabetes, and other related systemic complications, concluding that periodontal diseases could be a potential contributing risk factor for a wide array of clinically important systemic diseases. However, despite a significant increase in the prevalence of periodontal infections and systemic diseases in the past few decades, the fundamental biological mechanisms of connection between these ailments are still not fully explicated. Consequently, the mechanisms by which this bidirectional damage occurs are being explored with a concentric vision to develop strategies that could prevent or control the complications of these ailments. This paper attempts to summarize and hypothesize the diverse mechanisms that hint to a certain connection between the two prevalent chronic situations.

No MeSH data available.


Related in: MedlinePlus