title: Systemic antibodies to the leukotoxin of the oral pathogen Actinobacillus actinomycetemcomitans correlate negatively with stroke in women.
abstract: BACKGROUND
  Chronic infections and associated inflammatory markers are suggested risk factors for cardiovascular diseases (CVD) and stroke. The proinflammatory cytokine interleukin (IL)-1beta is suggested to play a role in the regulation of local inflammatory responses in both CVD and periodontitis. The leukotoxin from the periodontal pathogen Actinobacillus actinomycetemcomitans has recently been shown to cause abundant secretion of IL-1beta from macrophages. The aim of the present study was to compare the prevalence of systemic antibodies to A. actinomycetemcomitans leukotoxin in stroke cases (n = 273) and matched controls (n = 546) in an incident case-control study nested within the Northern Sweden MONICA and Vasterbotten Intervention cohorts.
  
  
  METHODS
  Antibodies to A. actinomycetemcomitans leukotoxin were analyzed in a bioassay with HL-60 cells (leukocytes), purified A. actinomycetemcomitans leukotoxin, and plasma. Plasma samples which inhibited lactate dehydrogenase release from leukotoxin-lysed cells by > or =50% were classified as antibody positive.
  
  
  RESULTS
  Antibodies to A. actinomycetemcomitans leukotoxin were detected in 18.8% of the women and 15.2% of the men. Women with those antibodies had a significantly decreased risk for stroke (OR = 0.28, 95% CI: 0.13-0.59), but not men (OR = 0.88, 95% CI: 0.52-1.51).
  
  
  CONCLUSIONS
  The immunoreactivity to A. actinomycetemcomitans leukotoxin correlates negatively with a future stroke in woman, but not in men. Further studies are needed to explain the underlying mechanisms, as well as the biological relevance of this finding.
authors.affiliation: Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden. anders.johansson@odont.umu.se
authors.forename: A
authors.initials: A
authors.lastname: Johansson
authors.forename: I
authors.initials: I
authors.lastname: Johansson
authors.forename: M
authors.initials: M
authors.lastname: Eriksson
authors.forename: A-M
authors.initials: AM
authors.lastname: Ahrén
authors.forename: G
authors.initials: G
authors.lastname: Hallmans
authors.forename: B
authors.initials: B
authors.lastname: Stegmayr
mesh_terms: D000189:Actinobacillus Infections / Q000453:epidemiology* / Q000276:immunology*; D016976:Aggregatibacter actinomycetemcomitans / Q000276:immunology*; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D005098:Exotoxins / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000276:immunology / Q000382:microbiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology* / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D005098:Exotoxins; C018579:leukotoxin