title: Periodontal bacteria in human carotid atherothrombosis as a potential trigger for neutrophil activation.
abstract: OBJECTIVE
  Epidemiological, biological and clinical links between periodontal and cardiovascular diseases are now well established. Several human studies have detected bacterial DNA corresponding to periodontal pathogens in cardiovascular samples. Intraplaque hemorrhage has been associated with a higher risk of atherosclerotic plaque rupture, potentially mediated by neutrophil activation. In this study, we hypothesized that plaque composition may be related to periodontal pathogens.
  
  
  METHODS
  Carotid culprit plaque samples were collected from 157 patients. Macroscopic characterization was performed at the time of collection: presence of blood, lipid core, calcification and fibrosis. Markers of neutrophil activation released by carotid samples were quantified (myeloperoxidase or MPO, cell-free DNA and DNA-MPO complexes). PCR analysis using specific primers for Porphyromonas gingivalis, Aggregatibacter actinomycetemcommitans, Treponema denticola, Prevotella intermedia and Tannerella forsythia was used to detect DNA from periodontal pathogens in carotid tissues. In addition, bacterial lipopolysaccharide (LPS) and Immunoglobulins G against T. forsythia were quantified in atherosclerotic carotid conditioned medium.
  
  
  RESULTS
  Intraplaque hemorrhage was present in 73/157 carotid samples and was associated with neutrophil activation, reflected by the release of MPO, cell-free DNA and MPO-DNA complexes. LPS levels were also linked to intraplaque hemorrhage but not with the neutrophil activation markers. Seventy-three percent of the carotid samples were positive for periodontal bacterial DNA. Furthermore, hemoglobin levels were associated with the detection of T. forsythia and neutrophil activation/inflammation markers.
  
  
  CONCLUSIONS
  This study suggests a potential role of periodontal microorganisms, especially T. forsythia, in neutrophil activation within hemorrhagic atherosclerotic carotid plaques.
authors.affiliation: Inserm U1148, CHU X. Bichat, APHP, 46 Rue Henri Huchard, 75018 Paris, France; Département de Parodontologie, Hôpital Rothschild, APHP, 5 Rue Santerre, 75012 Paris, France; Université Paris Diderot, UFR d'Odontologie, 5 Rue Garancière, 75006 Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Rangé
authors.affiliation: Inserm U1148, CHU X. Bichat, APHP, 46 Rue Henri Huchard, 75018 Paris, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Labreuche
authors.affiliation: Inserm U1148, CHU X. Bichat, APHP, 46 Rue Henri Huchard, 75018 Paris, France.
authors.forename: Liliane
authors.initials: L
authors.lastname: Louedec
authors.affiliation: Université de La Réunion, 15, Avenue René Cassin, 97744 Saint-Denis, Ile de La Réunion, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rondeau
authors.affiliation: Université de La Réunion, 15, Avenue René Cassin, 97744 Saint-Denis, Ile de La Réunion, France.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Planesse
authors.affiliation: Centre Cardiologique du Nord, 36 Rue des Moulins Gémeaux, 93200 Saint-Denis, France.
authors.forename: Uriel
authors.initials: U
authors.lastname: Sebbag
authors.affiliation: Université de La Réunion, 15, Avenue René Cassin, 97744 Saint-Denis, Ile de La Réunion, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bourdon
authors.affiliation: Inserm U1148, CHU X. Bichat, APHP, 46 Rue Henri Huchard, 75018 Paris, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Michel
authors.affiliation: Département de Parodontologie, Hôpital Rothschild, APHP, 5 Rue Santerre, 75012 Paris, France; Université Paris Diderot, UFR d'Odontologie, 5 Rue Garancière, 75006 Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bouchard
authors.affiliation: Inserm U1148, CHU X. Bichat, APHP, 46 Rue Henri Huchard, 75018 Paris, France; CHU de La Réunion, Saint Denis, Ile de La Réunion, France. Electronic address: olivier.meilhac@inserm.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Meilhac
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000032:analysis; D001438:Bacteroidaceae / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D002340:Carotid Artery Diseases / Q000150:complications / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D002341:Carotid Artery Thrombosis / Q000150:complications / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D004269:DNA, Bacterial / Q000097:blood; D003773:Dental Plaque / Q000382:microbiology*; D016894:Endarterectomy, Carotid; D065206:Extracellular Traps; D005260:Female; D005337:Fibrin / Q000032:analysis; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism; D020556:Neutrophil Infiltration; D009504:Neutrophils / Q000502:physiology*; D010518:Periodontitis / Q000150:complications / Q000382:microbiology*; D009195:Peroxidase / Q000032:analysis; D058226:Plaque, Atherosclerotic / Q000737:chemistry; D016897:Respiratory Burst
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D008055:Lipids; D016328:NF-kappa B; D005337:Fibrin; D009195:Peroxidase
keywords: Atherosclerosis; Atherothrombosis; Intraplaque hemorrhage; Periodontal bacteria; Periodontal disease; Periodontitis; Tannerella forsythia