Anti-cardiolipin and increased serum adhesion molecule levels in patients with aggressive periodontitis.
BACKGROUND
We observed that a significant proportion of patients with periodontitis have elevated serum levels of beta2-glycoprotein-I-dependent anti-cardiolipin (anti-CL). These prothrombotic autoantibodies, commonly found to be elevated in patients with systemic lupus erythematosus and the antiphospholipid syndrome, are associated with adverse pregnancy outcomes, such as fetal involution, prematurity, and low birth weight, and with cardiovascular sequelae, such as atherosclerosis, stroke, and myocardial infarction. Anti-CL is known to promote vascular inflammation and thrombosis.


METHODS
We measured serum levels of markers of vascular inflammation, including soluble intercellular adhesion molecule (sICAM)-1, soluble vascular cell adhesion molecule (sVCAM)-1, and sE-selectin, in 190 subjects with generalized aggressive or chronic periodontitis and in 90 periodontally healthy subjects.


RESULTS
sVCAM-1 and sE-selectin levels were significantly higher in patients with elevated anti-CL (>15 U/ml). This relationship also was observed in the never-smoker subset of subjects, even after correction for demographic and periodontal variables. Within the diagnostic categories, sICAM-1, sVCAM-1, and sE-selectin were significantly higher in generalized aggressive periodontitis patients who had elevated anti-CL compared to those with normal anti-CL. Statistical correction for demographic and periodontal variables indicated that elevated anti-CL remained significantly associated with increased sVCAM-1 and sE-selectin in generalized aggressive periodontitis patients.


CONCLUSIONS
Systemic markers of vascular inflammation in patients with aggressive periodontitis are associated with elevated levels of anti-CL. We hypothesize that a subset of periodontitis patients with elevated antiphospholipid antibodies could represent a subgroup at increased risk for obstetrical and cardiovascular sequelae.
Schenkein
Harvey A
HA
Clinical Research Center for Periodontal Disease, Virginia Commonwealth University School of Dentistry, Richmond, VA 23298, USA. haschenk@vcu.edu
Best
Al M
AM
Brooks
Carol N
CN
Burmeister
John A
JA
Arrowood
James A
JA
Kontos
Michael C
MC
Tew
John G
JG
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D015415:Biomarkers; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood*; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000097:blood* / Q000150:complications; D012044:Regression Analysis; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014657:Vasculitis / Q000097:blood / Q000209:etiology / Q000276:immunology
D017153:Antibodies, Anticardiolipin; D015415:Biomarkers; D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1