title: The effect of subantimicrobial-dose-doxycycline periodontal therapy on serum biomarkers of systemic inflammation: a randomized, double-masked, placebo-controlled clinical trial.
abstract: BACKGROUND
  Periodontitis has been reported to be associated with coronary artery disease (CAD). Research is needed to determine if therapies that improve periodontal health also reduce systemic measures of inflammation associated with both diseases.
  
  
  METHODS
  The study registrar randomly assigned 128 eligible postmenopausal women with chronic periodontitis to a twice-daily regimen of subantimicrobial-dose-doxycycline (SDD) or placebo tablets for two years as an adjunct to periodontal maintenance therapy. Through a supplement to the main trial, in which they investigated alveolar bone and clinical attachment level changes, the authors assayed inflammatory mediators and lipid profiles in baseline, one-year and two-year serum samples. The authors analyzed the data by using generalized estimating equations.
  
  
  RESULTS
  In the intent-to-treat analysis across two years, SDD treatment reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (primary outcome; P = .02) and reduced serum matrix metalloproteinase (MMP)-9 (92 kilodalton gelatinase; difference in mean scanning units, -28.44; P < .001), with no significant effect on serum lipids. However, in women more than five years postmenopausal, SDD elevated the level of high-density lipoprotein (HDL) cholesterol (difference in means [milligrams per deciliter], 5.99; P = .01).
  
  
  CONCLUSIONS
  A two-year SDD regimen in postmenopausal women significantly reduced the serum inflammatory biomarkers hs-CRP and MMP-9 and, among women more than five years postmenopausal, increased the HDL cholesterol level.
  
  
  CONCLUSIONS
  SDD significantly reduced the systemic inflammatory biomarkers hs-CRP and MMP-9. More research is needed to determine whether SDD has a role in managing the care of patients at risk of developing CAD.
authors.affiliation: Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, Neb. 68583-0740, USA. jbpayne@unmc.edu
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Payne
authors.forename: Lorne M
authors.initials: LM
authors.lastname: Golub
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stoner
authors.forename: Hsi-Ming
authors.initials: HM
authors.lastname: Lee
authors.forename: Richard A
authors.initials: RA
authors.lastname: Reinhardt
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
authors.forename: Marvin J
authors.initials: MJ
authors.lastname: Slepian
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001851:Bone Diseases, Metabolic / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood*; D055113:Chronic Periodontitis / Q000097:blood* / Q000188:drug therapy*; D003327:Coronary Disease / Q000517:prevention & control; D004311:Double-Blind Method; D004318:Doxycycline / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents; D008076:Cholesterol, HDL; D018836:Inflammation Mediators; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9; D004318:Doxycycline