title: Systemic endotoxin levels in chronic indolent periodontal infections.
abstract: OBJECTIVE
  Periodontal disease has been linked with an increased risk of various systemic diseases. A plausible biologic explanation for this link includes the opportunity for oral pathogens to translocate to the circulation as a result of breakdown in integrity of the oral epithelium. This study refined a methodology used to detect endotoxin activity in the serum of subjects with indolent periodontal infections.
  
  
  METHODS
  The QCL Kinetic Chromogenic Assay (Cambrex) is a kinetic measure of endotoxin activity. Sera from 211 pregnant women with periodontitis enrolled in the Obstetrics and Periodontal Therapy Trial were used to develop the assay further and to evaluate the detection of endotoxin activity that might accompany a low-level bacteremia in chronic periodontitis.
  
  
  RESULTS
  We optimized the system to increase the sensitivity and reproducibility of the assay. The refined system was able to detect endotoxin activity in serum at > 0.0125 EU/mL. At baseline (13-16 wk of gestation), 35.5% of the women were positive for endotoxin activity (1.62 +/- 2.21; range: 0.38-15 EU/mL).
  
  
  CONCLUSIONS
  This report describes a sensitive measure of endotoxin activity in serum. The procedure allowed us to document levels of this microbial virulence factor in serum of individuals with indolent infections such as periodontal disease.
authors.affiliation: Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY 40536-0297, USA. jleber2@uky.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Ebersole
authors.forename: J
authors.initials: J
authors.lastname: Stevens
authors.forename: M J
authors.initials: MJ
authors.lastname: Steffen
authors.forename: D
authors.initials: D
authors.lastname: Dawson Iii
authors.forename: M J
authors.initials: MJ
authors.lastname: Novak
mesh_terms: D016470:Bacteremia / Q000097:blood; D002863:Chromogenic Compounds; D055113:Chronic Periodontitis / Q000097:blood* / Q000145:classification / Q000628:therapy; D004731:Endotoxins / Q000097:blood*; D004926:Escherichia coli; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000097:blood / Q000145:classification; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008033:Limulus Test; D017622:Periodontal Attachment Loss / Q000097:blood / Q000145:classification; D010514:Periodontal Pocket / Q000097:blood / Q000145:classification; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000145:classification / Q000628:therapy; D047928:Premature Birth; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D002863:Chromogenic Compounds; D004731:Endotoxins
references.citation: Lancet. 1986 Feb 8;1(8476):307-10
references.pmid: 2868172
references.citation: Circulation. 2005 Feb 8;111(5):576-82
references.pmid: 15699278
references.citation: Ann Periodontol. 2002 Dec;7(1):72-8
references.pmid: 16013219
references.citation: J Periodontol. 2005 Nov;76(11 Suppl):2106-15
references.pmid: 16277583
references.citation: Periodontol 2000. 2006;42:7-12
references.pmid: 16930302
references.citation: J Am Dent Assoc. 2002 Jun;133 Suppl:37S-44S
references.pmid: 12085723
references.citation: Periodontol 2000. 2005;38:72-122
references.pmid: 15853938
references.citation: Open Dent J. 2008;2:49-55
references.pmid: 19088882
references.citation: J Biol Chem. 2005 Jul 29;280(30):27949-59
references.pmid: 15923643
references.citation: Crit Rev Oral Biol Med. 2004 Nov 01;15(6):403-13
references.pmid: 15574681
references.citation: J Am Dent Assoc. 2006 Oct;137 Suppl:7S-13S
references.pmid: 17012730
references.citation: Ann Periodontol. 1998 Jul;3(1):108-20
references.pmid: 9722695
references.citation: Periodontol 2000. 1999 Jun;20:168-238
references.pmid: 10522227
references.citation: J Thromb Haemost. 2006 Oct;4(10):2256-61
references.pmid: 16856978
references.citation: Curr Pharm Des. 2006;12(32):4229-45
references.pmid: 17100625
references.citation: J Lab Clin Med. 2002 Oct;140(4):228-35
references.pmid: 12389020
references.citation: N Engl J Med. 2006 Nov 2;355(18):1885-94
references.pmid: 17079762
references.citation: J Clin Periodontol. 2005;32 Suppl 6:57-71
references.pmid: 16128830
references.citation: Int J Med Microbiol. 2005 Jan;294(7):465-70
references.pmid: 15715175
references.citation: Adv Exp Med Biol. 1997;433:23-35
references.pmid: 9561098
references.citation: Periodontol 2000. 2007;43:278-93
references.pmid: 17214845
references.citation: J Periodontol. 2005 Nov;76(11 Suppl):2085-8
references.pmid: 16277580
references.citation: Ann Periodontol. 2003 Dec;8(1):38-53
references.pmid: 14971247
references.citation: J Lab Clin Med. 2005 Sep;146(3):192-6
references.pmid: 16131459
references.citation: Ultrastruct Pathol. 2005 Mar-Apr;29(2):121-7
references.pmid: 16028668
references.citation: Med Princ Pract. 2006;15(1):77-9
references.pmid: 16340233
references.citation: Clin Microbiol Rev. 2000 Oct;13(4):547-58
references.pmid: 11023956
references.citation: Periodontol 2000. 2006;42:80-7
references.pmid: 16930307
references.citation: J Clin Periodontol. 2005 Jul;32(7):708-13
references.pmid: 15966875
references.citation: Biosens Bioelectron. 2006 Jun 15;21(12):2270-4
references.pmid: 16356707
references.citation: Microbes Infect. 2000 Jul;2(8):897-906
references.pmid: 10962273
references.citation: Periodontol 2000. 2005;38:135-87
references.pmid: 15853940
references.citation: Infect Immun. 2002 Feb;70(2):938-44
references.pmid: 11796629
references.citation: Dent Clin North Am. 2005 Jul;49(3):491-516, v
references.pmid: 15978238
references.citation: Microbes Infect. 2006 Mar;8(3):946-52
references.pmid: 16483818
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Oct;102(4):e21-3
references.pmid: 16997089
references.citation: Microbes Infect. 2004 Sep;6(11):990-5
references.pmid: 15345230
references.citation: Tissue Cell. 2000 Oct;32(5):437-45
references.pmid: 11201283
references.citation: J Dent Res. 2005 Jul;84(7):584-95
references.pmid: 15972584
references.citation: J Endotoxin Res. 2005;11(4):225-9
references.pmid: 16176659
references.citation: Gerodontology. 2006 Mar;23(1):3-16
references.pmid: 16433636
references.citation: J Int Acad Periodontol. 2005 Jan;7(1):3-7
references.pmid: 15736889
references.citation: J Biol Chem. 2006 Nov 10;281(45):33849-59
references.pmid: 16943191
references.citation: J Periodontol. 2004 Dec;75(12):1720-3
references.pmid: 15732877
references.citation: Oral Microbiol Immunol. 2005 Oct;20(5):317-21
references.pmid: 16101968
references.citation: Pediatr Dev Pathol. 2005 Jul-Aug;8(4):489-92
references.pmid: 16235131
references.citation: J Int Acad Periodontol. 2005 Apr;7(2):39-48
references.pmid: 15912923
references.citation: J Clin Microbiol. 2005 Aug;43(8):3944-55
references.pmid: 16081935
references.citation: Periodontol 2000. 2006;42:114-57
references.pmid: 16930309
references.citation: J Public Health Dent. 2006 Summer;66(3):163-8
references.pmid: 16913241
references.citation: J Immunol. 2004 Apr 1;172(7):4470-9
references.pmid: 15034063
references.citation: J Endotoxin Res. 2005;11(4):237-42
references.pmid: 16176661
references.citation: J Clin Periodontol. 2006 Jun;33(6):401-7
references.pmid: 16677328
references.citation: J Endotoxin Res. 2006;12(3):171-80
references.pmid: 16719988
references.citation: Nature. 1999 Oct 21;401(6755):755-6
references.pmid: 10548095
references.citation: Arch Pathol Lab Med. 2005 Jun;129(6):805-6
references.pmid: 15913436
references.citation: Surgery. 2000 Aug;128(2):339-44
references.pmid: 10923014
references.citation: Arterioscler Thromb Vasc Biol. 2004 Nov;24(11):2174-80
references.pmid: 15388525
references.citation: J Periodontol. 2006 Aug;77(8):1289-303
references.pmid: 16881798
references.citation: Oral Microbiol Immunol. 2006 Aug;21(4):231-7
references.pmid: 16842507
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Mar;99(3):292-8
references.pmid: 15716834
references.citation: J Infect Dis. 1989 Feb;159(2):195-204
references.pmid: 2492587
references.citation: J Lab Clin Med. 1994 Dec;124(6):813-20
references.pmid: 7798795
references.citation: Pak J Pharm Sci. 2004 Jan;17(1):89-94
references.pmid: 16414591