Relationship between periodontitis-related antibody and frequent exacerbations in chronic obstructive pulmonary disease.
BACKGROUND
To identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to frequent exacerbations is important. Although periodontitis aggravated by poor oral hygiene might increase the risk of lower respiratory tract infection, the relationship between periodontitis and COPD exacerbations remains unknown. This prospective cohort study investigates the relationship between periodontitis-related antibody and exacerbation frequency over a one-year period.


METHODS
We assessed an IgG antibody titer against Porphyromonas gingivalis, which is a major pathogen of periodontitis, and then prospectively followed up 93 individuals over one year to detect exacerbations.


RESULTS
The numbers of exacerbations and the rate of individuals with frequent exacerbations (at least two per year) were significantly lower in patients with higher IgG titer than those with normal IgG titer (0.8 vs. 1.2 per year, p= 0.045 and 14.3 vs. 38.6%, p= 0.009, respectively). Multivariate logistic regression analysis showed that being normal-IgG titer for periodontitis-related antibody significantly increased the risk of frequent exacerbations (relative risk, 5.27, 95% confidence interval, 1.30-25.7; p = 0.019) after adjusting for other possible confounders, such as a history of exacerbations in the past year, disease severity, COPD medication and smoking status.


CONCLUSIONS
Normal-IgG titer for periodontitis-related antibody can be an independent predictor of frequent exacerbations. Measuring periodontitis-related antibody titers might be useful to identify patients with susceptibility to frequent exacerbations so that an aggressive prevention strategy can be designed.
Department of Respiratory Medicine, Kyoto University, Kyoto, Japan.
Tamaki
T
Takahashi
Shigeo
S
Muro
Naoya
N
Tanabe
Kunihiko
K
Terada
Hirofumi
H
Kiyokawa
Susumu
S
Sato
Yuma
Y
Hoshino
Emiko
E
Ogawa
Kazuko
K
Uno
Koji
K
Naruishi
Shogo
S
Takashiba
Michiaki
M
Mishima
D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology*; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood / Q000276:immunology; D018450:Disease Progression; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood / Q000276:immunology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications* / Q000276:immunology*; D016966:Porphyromonas gingivalis / Q000276:immunology; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000209:etiology*; D012307:Risk Factors
D000907:Antibodies, Bacterial; D016207:Cytokines; D007074:Immunoglobulin G; D018836:Inflammation Mediators