title: Periodontal disease, Porphyromonas gingivalis serum antibody levels and orodigestive cancer mortality.
abstract: Periodontitis, the progressive loss of the alveolar bone around the teeth and the major cause of tooth loss in adults, is due to oral microorganisms, including Porphyromonas gingivalis. Periodontitis is associated with a local overly aggressive immune response and a spectrum of systemic effects, but the role of this condition in orodigestive cancers is unclear. We prospectively examined clinically ascertained periodontitis (N = 12,605) and serum IgG immune response to P.gingivalis (N = 7852) in relation to orodigestive cancer mortality among men and women in the National Health and Nutrition Examination Survey III. A detailed oral health exam was conducted from 1988 to 1994 in survey Phases I and II, whereas serum IgG for P.gingivalis was measured from 1991 to 1994 in Phase II only. One hundred and five orodigestive cancer deaths were ascertained through 31 December 2006. Periodontitis (moderate or severe) was associated with increased orodigestive cancer mortality [relative risks (RR) = 2.28, 95% confidence interval (CI) = 1.17-4.45]; mortality risks also increased with increasing severity of periodontal disease (P trend = 0.01). Periodontitis-associated mortality was in excess for colorectal (RR = 3.58; 95% CI = 1.15-11.16) and possibly for pancreatic cancer (RR = 4.56; 95% CI = 0.93-22.29). Greater serum P.gingivalis IgG tended to be associated overall with increased orodigestive cancer mortality (P trend = 0.06); P.gingivalis-associated excess orodigestive mortality was also found for healthy subjects not exhibiting overt periodontal disease (RR = 2.25; 95% CI = 1.23-4.14). Orodigestive cancer mortality is related to periodontitis and to the periodontal pathogen, P.gingivalis, independent of periodontal disease. Porphyromonas gingivalis is a biomarker for microbe-associated risk of death due to orodigestive cancer.
authors.affiliation: Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, 650 First Ave, New York, NY 10016, USA. Jiyoung.Ahn@nyumc.org
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Ahn
authors.forename: Stephanie
authors.initials: S
authors.lastname: Segers
authors.forename: Richard B
authors.initials: RB
authors.lastname: Hayes
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood* / Q000276:immunology; D016866:Bacteroidaceae Infections / Q000097:blood / Q000276:immunology; D004067:Digestive System Neoplasms / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000097:blood / Q000276:immunology*; D010510:Periodontal Diseases / Q000097:blood / Q000276:immunology*; D010518:Periodontitis / Q000097:blood / Q000276:immunology; D016966:Porphyromonas gingivalis / Q000276:immunology*; D011446:Prospective Studies
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G