Naqvi A Z, Hasturk H, Mu L, Phillips R S, Davis R B, Halem S, Campos H, Goodson J M, Van Dyke T E, Mukamal K J
Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Forsyth Institute, Cambridge, MA, USA.
J Dent Res. 2014 Aug;93(8):767-73. doi: 10.1177/0022034514541125. Epub 2014 Jun 26.
Periodontitis is a common chronic inflammatory disease initiated by bacteria, resulting in bone resorption, tooth loss, and systemic inflammation. Long-chain omega-3 fatty acids such as docosahexaenoic acid (DHA) reduce periodontitis in animals. We aimed to determine whether DHA supplementation with low-dose aspirin would reduce periodontitis in humans. We conducted a double-blind placebo-controlled parallel trial lasting 3 mo. Fifty-five adults with moderate periodontitis were randomized to 2,000 mg of DHA or identical soy/corn oil capsules. All participants received 81 mg of aspirin but received no other treatments. We analyzed the primary outcome of per-pocket change in pocket depth using mixed models among teeth with pocket depth ≥5 mm. Secondary outcomes assessed with generalized estimating equations included gingival index, plaque index, and bleeding on probing. Gingival crevicular fluid samples were analyzed for changes in high-sensitivity C-reactive protein (hsCRP) and interleukins 6 and 1β (IL-6 and IL-1β). Plasma was analyzed for changes in systemic inflammatory markers, including hsCRP. We confirmed adherence with erythrocyte fatty acid measurement. Forty-six participants completed the trial. While similar at baseline, the proportion of DHA in red blood cell plasma membranes increased from 3.6% ± 0.9% to 6.2% ± 1.6% in the intervention group but did not change among controls. DHA supplementation decreased mean pocket depth (-0.29 ± 0.13; p = .03) and gingival index (-0.26 ± 0.13; p = .04). Plaque index and bleeding on probing did not change. Significant adjusted differences were found between DHA and control for both gingival crevicular fluid hsCRP (-5.3 ng/mL, standard error [SE] = 2.4, p = .03) and IL-1β (-20.1 pg/mL, SE = 8.2, p = .02) but not IL-6 (0.02 pg/mL, SE = 0.71, p = .98) or systemic hsCRP (-1.19 mg/L, SE = 0.90, p = .20). In this randomized controlled trial, aspirin-triggered DHA supplementation significantly improved periodontal outcomes in people with periodontitis, indicating its potential therapeutic efficacy (clinicaltrials.gov NCT01976806).
牙周炎是一种由细菌引发的常见慢性炎症性疾病，会导致骨质吸收、牙齿脱落以及全身性炎症。长链ω-3脂肪酸，如二十二碳六烯酸（DHA），可减轻动物的牙周炎。我们旨在确定补充DHA并联合低剂量阿司匹林是否会减轻人类的牙周炎。我们开展了一项为期3个月的双盲安慰剂对照平行试验。55名患有中度牙周炎的成年人被随机分为两组，分别服用2000毫克DHA或相同的大豆/玉米油胶囊。所有参与者均服用81毫克阿司匹林，但未接受其他治疗。我们使用混合模型分析了牙周袋深度≥5毫米的牙齿中每个牙周袋深度变化的主要结局。用广义估计方程评估的次要结局包括牙龈指数、菌斑指数和探诊出血。分析龈沟液样本中高敏C反应蛋白（hsCRP）以及白细胞介素6和1β（IL-6和IL-1β）的变化。分析血浆中全身性炎症标志物的变化，包括hsCRP。我们通过红细胞脂肪酸测量确认了依从性。46名参与者完成了试验。虽然两组在基线时相似，但干预组红细胞质膜中DHA的比例从3.6%±0.9%增加到了6.2%±1.6%，而对照组则没有变化。补充DHA可降低平均牙周袋深度（-0.29±0.13；p = 0.03）和牙龈指数（-0.26±0.13；p = 0.04）。菌斑指数和探诊出血没有变化。在龈沟液hsCRP（-5.3纳克/毫升，标准误[SE]=2.4，p = 0.03）和IL-1β（-20.1皮克/毫升，SE = 8.2，p = 0.02）方面，DHA组与对照组之间存在显著的校正差异，但IL-6（0.02皮克/毫升，SE = 0.71，p = 0.98）或全身性hsCRP（-1.19毫克/升，SE = 0.90，p = 0.20）方面没有差异。在这项随机对照试验中，阿司匹林引发的DHA补充显著改善了牙周炎患者的牙周结局，表明其具有潜在的治疗效果（clinicaltrials.gov NCT01976806）。
