Biological foundation for periodontitis
as a potential risk factor for atherosclerosis
Yong-Hee P. Chun, Kyoung-Ryul J. Chun, De'Avlin Olguin, Hom-Lay
Wang
Objectives: Links between periodontal diseases and systemic diseases
have been well documented by epidemiological studies. Recently,
research has shifted to elucidating the biologic mechanism for
a causal relationship. One focus of interest is atherosclerosis,
the underlying event of cardiovascular diseases due to its serious
health impact. However, it is still not clear whether periodontopathic
pathogens are truly etiologic agents or ubiquitous bystanders.
This article reviews the current understanding about the molecular
biological interactions between periodontal disease and atherosclerosis
and the biological plausibility of periodontitis as a potential
risk factor for cardiovascular disease.
Materials and methods: The current literature regarding periodontal
diseases and atherosclerosis and coronary vascular disease was
searched using the Medline and PubMed databases.
Results: In vitro experiments and animal models are appropriate
tools to investigate the biological interactions between periodontal
disease and atherosclerosis at the cell molecular level. The concepts
linking both pathologies refer to inflammatory response, immune
responses, and hemostasis. In particular, Porphyromonas gingivalis
appears to have unique, versatile pathogenic properties. Whether
or not these findings from isolated cells or animal models are
applicable in humans with genetic and environmental variations
is yet to be determined. Likewise, the benefit from periodontal
therapy on the development of atherosclerosis is unclear. Approaches
targeting inflammatory and immune responses of periodontitis and
atherosclerosis simultaneously are very intriguing.
Conclusion: An emerging concept suggests that a pathogenic burden
from different sources might overcome an individual threshold
culminating in clinical sequela. P. gingivalis contributes directly
and indirectly to atherosclerosis.
Journal of Periodontal Research
Volume 40 Issue 1 Page 87 - February 2005
