title: Biomarkers of periodontitis and inflammation in ischemic stroke: A case-control study.
abstract: Periodontitis is a common infectious disease associated with increased risk for ischemic stroke though presently unclear mechanisms. In a case-control study, we investigated salivary levels of four periodontal pathogens, as well as systemic and local inflammatory markers. The population comprised 98 patients with acute ischemic stroke (mean ± SD, 68.2 ± 9.7 yrs; 45.9% women) and 100 healthy controls (69.1 ± 5.2 yrs; 47.0% women). Patients were more often edentulous and had fewer teeth than controls (13.8 ± 10.8 versus 16.6 ± 10.1). After adjusting for stroke risk factors and number of teeth, controls had higher saliva matrix metalloproteinase-8 (MMP-8), myeloperoxidase (MPO), IL-1β, Aggregatibacter actinomycetemcomitans, and serum LPS activity levels. Patients had higher serum MMP-8 and MPO, and they were more often qPCR-positive for A. actinomycetemcomitans (37.9% versus 19.0%) and for ≥3 periodontopathic species combined (50.0% versus 33.0%). We conclude that controls more often had evidence of current periodontal infection with higher periodontal pathogen amount, endotoxemia, local inflammation and tissue destruction. Stroke patients more often had evidence of end-stage periodontitis with edentulism and missing teeth. They were more often carriers of several periodontopathic pathogens in saliva, especially A. actinomycetemcomitans. Additionally, inflammatory burden may contribute to high systemic inflammation associated with elevated stroke susceptibility.
authors.affiliation: Department of Neurology, Klinikum Ludwigshafen, Germany palmf@klilu.de.
authors.forename: Frederick
authors.initials: F
authors.lastname: Palm
authors.affiliation: Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Lahdentausta
authors.affiliation: Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
authors.affiliation: Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Tervahartiala
authors.affiliation: Department of Neurology, Klinikum Ludwigshafen, Germany.
authors.forename: Pia
authors.initials: P
authors.lastname: Gokel
authors.affiliation: Department of Neurology, Klinikum Ludwigshafen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Buggle
authors.affiliation: Institute of Public Health, University of Heidelberg, Germany.
authors.forename: Anton
authors.initials: A
authors.lastname: Safer
authors.affiliation: Institute of Public Health, University of Heidelberg, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
authors.affiliation: Department of Neurology, Klinikum Ludwigshafen, Germany.
authors.forename: Armin J
authors.initials: AJ
authors.lastname: Grau
authors.affiliation: Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Pirkko
authors.initials: P
authors.lastname: Pussinen
mesh_terms: D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000737:chemistry; D015415:Biomarkers / Q000032:analysis*; D002545:Brain Ischemia / Q000276:immunology* / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D053583:Interleukin-1beta / Q000032:analysis; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000032:analysis; D009066:Mouth, Edentulous; D010518:Periodontitis / Q000473:pathology*; D009195:Peroxidase / Q000032:analysis; D016966:Porphyromonas gingivalis / Q000737:chemistry; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry; D020521:Stroke / Q000276:immunology* / Q000378:metabolism
chemical_list: D015415:Biomarkers; C508585:IL1B protein, human; D053583:Interleukin-1beta; D009195:Peroxidase; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8
keywords: Ischemic stroke; inflammation; periodontitis