title: Quantification of periodontal pathogens in vascular, blood, and subgingival samples from patients with peripheral arterial disease or abdominal aortic aneurysms.
abstract: BACKGROUND
  The aim of this investigation is to quantify periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, and Tannerella forsythia) in vascular, blood, and subgingival samples. As a secondary objective, two molecular bacterial identification methods (nested polymerase chain reaction [PCR] and quantitative PCR [qPCR]) are compared.
  
  
  METHODS
  Seventy consecutive patients provided a vascular lesion, a blood sample, and 36 subgingival samples. Bacterial DNA was extracted, and qPCR was used to determine the prevalence and amounts of the target pathogens in each sample. Nested PCR was performed only in the samples from vascular lesions. Periodontal examination was performed in 42 patients. Mann-Whitney U or χ(2) tests were used to compare microbiologic results according to periodontal diagnosis.
  
  
  RESULTS
  All targeted periodontal pathogens (A. actinomycetemcomitans, P. gingivalis, T. forsythia, or C. rectus) were detected in subgingival samples, with a prevalence rate of 72.2%, 47.2%, 74.3%, and 82.9%, respectively. In 7.1% and 11.4% of vascular and blood samples, bacterial DNA was detected. One patient was positive for A. actinomycetemcomitans in the three types of samples. No differences were found in the levels of targeted bacteria when comparing patients with and without periodontitis. Prevalence rates obtained with nested PCR were significantly higher than those obtained with qPCR.
  
  
  CONCLUSIONS
  The presence of A. actinomycetemcomitans was demonstrated in vascular, blood, and subgingival samples in one of 36 patients. These results, although with a very low frequency, may support the hypothesis of a translocation of periodontal pathogens from subgingival microbiota to the bloodstream and then to atheromatous plaques in carotid or other peripheral arteries. Nested PCR is not an adequate method for identifying DNA of periodontal pathogens in low quantities because of the high number of false-negative results.
authors: Oral Research Laboratory, Faculty of Odontology, University Complutense, Madrid, Spain.
authors: Elena
authors: E
authors: Figuero
authors: Christeel
authors: C
authors: Lindahl
authors: María José
authors: MJ
authors: Marín
authors: Stefan
authors: S
authors: Renvert
authors: David
authors: D
authors: Herrera
authors: Ola
authors: O
authors: Ohlsson
authors: Thomas
authors: T
authors: Wetterling
authors: Mariano
authors: M
authors: Sanz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D017544:Aortic Aneurysm, Abdominal / Q000382:microbiology*; D016470:Bacteremia / Q000382:microbiology*; D058491:Bacterial Load; D001439:Bacteroides / Q000302:isolation & purification; D018441:Biofilms; D001808:Blood Vessels / Q000382:microbiology*; D044883:Campylobacter rectus / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000032:analysis; D003773:Dental Plaque / Q000382:microbiology; D005260:Female; D017823:Furcation Defects / Q000382:microbiology; D005881:Gingiva / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology; D010518:Periodontitis / Q000382:microbiology; D058729:Peripheral Arterial Disease / Q000382:microbiology*; D058226:Plaque, Atherosclerotic / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods; D016966:Porphyromonas gingivalis / Q000302:isolation & purification
chemical_list: D004269:DNA, Bacterial
keywords: Aggregatibacter actinomycetemcomitans; Porphyromonas gingivalis; Tannerella forsythia; cardiovascular diseases; periodontal diseases; real-time polymerase chain reaction