Clinical periodontal and microbiologic parameters in patients with Crohn's disease with consideration of the CARD15 genotype.
BACKGROUND
Crohn's disease (CD) was reported to have oral manifestations. However, data on periodontal parameters and oral microbiology in CD are rare. Recent studies showed associations of variants in the caspase recruitment domain (CARD)15 gene with CD that are involved in the immune response toward bacterial products. Our aim is to investigate the periodontal status and prevalence of periodontal pathogens in patients with CD under consideration of the CARD15 polymorphism.


METHODS
Oral soft tissue alterations and periodontal parameters of 147 patients with CD were assessed. Subgingival plaque samples were analyzed for the periodontal pathogens Aggregatibacter actinomycetemcomitans (Aa; previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf; previously T. forsythensis), Prevotella intermedia (Pi), and Campylobacter rectus (Cr ) using dot-blot hybridization. CARD15 genotyping was performed with the a polymerase chain reaction (PCR) based assay.


RESULTS
A total of 36.7% of patients had oral manifestations predominated by gingival swellings (27.2%) and hyperplastic lesions of the buccal mucosa (20.4%). The mean probing depth and mean clinical attachment level were 3.6 and 3.8 mm, respectively. A total of 57.8% of the patients had a Community Periodontal Index of Treatment Needs (CPITN) score 3, and 31.3% of had a CPITN score 4. The prevalence of Aa, Pg, Pi, Tf, and Cr was 76.9%, 62.6%, 79.6%, 64.6%, and 94.6%, respectively. Pi was significantly less frequent in carriers of CARD15 mutations compared to the wild type (69.7% versus 87.7%; P = 0.008). All other pathogens and clinical periodontal parameters did not differ significantly as to the CARD15 polymorphism.


CONCLUSIONS
Our findings suggest that patients with CD have an increased prevalence and moderate severity of periodontitis. The colonization of periodontal pathogens, in particular Cr, might be of particular value for the periodontal manifestation of CD. Although a modulating impact on periodontal microbiota can be supposed, our data do not support the role of CARD15 in oral symptoms and periodontal lesions in patients with CD.
Stein
Jamal M
JM
Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany. jstein@ukaachen.de
Lammert
Frank
F
Zimmer
Vincent
V
Granzow
Marie
M
Reichert
Stefan
S
Schulz
Susanne
S
Ocklenburg
Christina
C
Conrads
Georg
G
D000293:Adolescent; D000328:Adult; D000483:Alleles; D001421:Bacteria, Anaerobic / Q000235:genetics; D016009:Chi-Square Distribution; D003424:Crohn Disease / Q000150:complications* / Q000235:genetics* / Q000382:microbiology; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053473:Nod2 Signaling Adaptor Protein / Q000235:genetics*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology; D010518:Periodontitis / Q000150:complications* / Q000235:genetics* / Q000382:microbiology; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide; D055815:Young Adult
D004269:DNA, Bacterial; C429018:NOD2 protein, human; D053473:Nod2 Signaling Adaptor Protein