Laboratory of Periodontology and Immunology, Department of Oral Health and Welfare, Niigata University Faculty of Dentistry, Niigata, Japan.
J Periodontal Res. 2010 Feb;45(1):116-22. doi: 10.1111/j.1600-0765.2009.01209.x. Epub 2009 Jul 8.
Although an elevation in the concentration of high-sensitivity C-reactive protein (hs-CRP) as a result of periodontal infection may account for an increased risk of developing coronary heart disease (CHD), the effect of periodontal infection on the level of hs-CRP in an otherwise healthy Japanese population has not yet been reported. The aim of the present study was to confirm, on a larger scale, our previous pilot study findings that both chronic periodontitis and subsequent periodontal treatment alter the serum levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha).
The concentrations of serum hs-CRP, IL-6 and TNF-alpha were measured in 78 periodontitis patients at baseline and at re-assessment, and in 40 periodontally healthy subjects at the time of examination.
The concentrations of hs-CRP and IL-6 in the sera of periodontitis patients were significantly higher than those in control subjects. By contrast, the concentration of TNF-alpha was significantly lower in periodontitis patients than in control subjects. Whereas periodontal treatment decreased the levels of serum hs-CRP and IL-6, no such effect was observed for TNF-alpha. When the patients were subdivided into four groups according to their initial concentration of hs-CRP, only the CRP and IL-6 concentrations of the highest quartile group showed a significant reduction following periodontal treatment. No significant difference in the initial clinical parameters was observed in any quartile.
Although periodontal infection does affect the concentration of hs-CRP and IL-6 in serum, a subgroup of patients exist who are highly susceptible to an increased risk of CHD associated with periodontitis, suggesting that there may be subjects who have an elevated risk of CHD independent of susceptibility to periodontal tissue destruction per se.
尽管牙周感染导致的高敏 C 反应蛋白(hs-CRP)浓度升高可能导致患冠心病(CHD)的风险增加,但牙周感染对健康日本人群中 hs-CRP 水平的影响尚未见报道。本研究旨在更大规模地证实我们之前的初步研究结果,即慢性牙周炎和随后的牙周治疗均会改变 C 反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的血清水平。
在基线和重新评估时测量了 78 例牙周炎患者和 40 例牙周健康受试者的血清 hs-CRP、IL-6 和 TNF-α 浓度。
牙周炎患者血清中 hs-CRP 和 IL-6 的浓度明显高于对照组。相比之下,牙周炎患者的 TNF-α 浓度明显低于对照组。牙周治疗降低了血清 hs-CRP 和 IL-6 的水平,但对 TNF-α 没有这种作用。将患者根据初始 hs-CRP 浓度分为四组后,只有 hs-CRP 和 IL-6 浓度最高四分位组在牙周治疗后显著降低。在任何四分位组中,初始临床参数均无显著差异。
尽管牙周感染确实会影响血清中 hs-CRP 和 IL-6 的浓度,但存在对牙周炎相关 CHD 风险增加高度敏感的亚组患者,这表明可能存在与牙周组织破坏本身的易感性无关的 CHD 风险升高的个体。