title: Mechanism of increased mortality in hemodialysed patients with periodontitis.
abstract: Periodontitis significantly decreases survival in hemodialysed patients with end stage renal disease (ESRD). Periodontitis-related microorganisms spreading into the bloodstream are thought to impair blood rheological parameters - for example, increasing whole blood viscosity, aggregating blood elements, and decreasing blood flow - and thereby significantly accelerate systemic or local diseases, impairing survival. We discuss the ability of a prototypical pathogenic anaerobic polybacterial consortium to modulate and interfere with host immune responses and to enzymatically degrade host proteins, to bind to and cleave extracellular matrix proteins, to invade intercellularly as well as intracellularly, to promote vascular permeability, to disrupt polymorphonuclear leukocyte function, to cleave complement, and to degrade IgG heavy chains. To further elucidate these phenomena, studies involving detecting microorganism byproducts and monitoring blood rheological parameters are necessary.
authors: Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic. jirisedy@hotmail.com
authors: Jirí
authors: J
authors: Sedý
authors: Edita
authors: E
authors: Horká
authors: René
authors: R
authors: Foltán
authors: Jana
authors: J
authors: Spacková
authors: Jana
authors: J
authors: Dusková
mesh_terms: D001424:Bacterial Infections / Q000276:immunology* / Q000382:microbiology / Q000401:mortality*; D015897:Comorbidity; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology*; D018448:Models, Immunological; D009026:Mortality / Q000639:trends; D010518:Periodontitis / Q000276:immunology* / Q000382:microbiology / Q000401:mortality*; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate