Introduction:
Previously we have shown that periodontal disease and systemic inflammation are related to intracranial atherosclerosis (ICAS) in Atherosclerosis Risk In Communities study (ARIC). In this study we evaluated the relationship between serum antibodies against periodontal pathogens and ICAS.
Methods:
In this ongoing, prospective, longitudinal community-based cohort study, participants were assessed for antibodies to periodontal organisms including Porphyrmonas
gingivalis
(PG), Prevotella
intermedia
(PI), Prevotella
nigrescens
(PN), Bacteriodes
forsythensis
(BF), Treponema
denticola
(TD), Actinobacillus
actinomycetemcomitans
(AA), Campylobacter
rectus
(CR), Eikenella
corrodens
(EC), Fusobacterium
nucleatum
(FN), Peptostreptococcus
micros
(PM), Selenomonas
noxia
(SN), Capnocytophaga
ochracea
(CO), Veillonella
parvula
(VP), Streptococcus
sanguinis
(SS), Streptococcus
intermedius
(SI), Streptococcus
oralis
(SO), Actinomycosis
viscosis
(AV) and Helicobacter
pylori
(HP). These participants underwent 3D time-of-flight magnetic resonance angiography (MRA) to evaluate ICAS. Log mean antibody (IgG), CRP and IL-6 levels were compared using t-test between groups with and without ≥50% ICAS.
Results:
In this ARIC cohort, 1066 participants were assessed by MRA for ICAS. Serum CRP and IL-6 data were available for all and IgG levels were available for 772 participants. The log mean IgG level was significantly lower for patients with ≥50% ICAS versus patients with <50% ICAS in four organisms: PN (1.69 vs 1.80,
p= 0.03
), BF (1.30 vs 1.38,
p=0.05
), CO (1.23 vs 1.33,
p= 0.04
), FN (0.87 vs 1.01,
p=0.02
). The log mean IgG was also lower for CR, EC, SN, VP, SI, SO and AV though not significant. Log mean CRP was higher in the ≥50% ICAS group versus the <50% ICAS group (0.58 vs. 0.47,
p < 0.001
). Log mean IL-6 levels were also higher but not significant (0. 17 vs. 0.11,
p= 0.07
).
Conclusion:
Higher levels of systemic inflammatory markers (CRP, IL-6) are associated with significant ICAS, but we report a significantly lower level of IgG antibodies to specific periodontal pathogens (PN, BF, CO and FN) in patients with ≥50% ICAS. This paradoxical finding may represent the effect of systemic inflammation and oxidative stress on IgG levels to periodontal bacteria.
Endotoxemia, Immune Response to Periodontal Pathogens, and Systemic Inflammation Associate With Incident Cardiovascular Disease Events
