Wang Chen-Ying, Chyuan I-Tsu, Wang Ya-Li, Kuo Mark Yen-Ping, Chang Ching-Wen, Wu King-Jean, Hsu Ping-Ning, Nagasawa Toshiyuki, Wara-aswapati Nawarat, Chen Yi-Wen
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan.
J Periodontol. 2015 Aug;86(8):995-1004. doi: 10.1902/jop.2015.140664. Epub 2015 Mar 30.
It was reported that patients with systemic lupus erythematosus (SLE) exhibited increased levels of anticardiolipin (anti-CL) antibodies, a class of antiphospholipid antibodies associated with thrombosis. β2-glycoprotein I (β2GPI) has been considered as the actual target antigen for anti-CL antibodies. This study investigates the association of periodontal infection with anti-CL antibodies in patients with SLE.
Fifty-three SLE female patients and 56 healthy female volunteers were recruited in this case-control study. All participants received periodontal examinations. The presence of Porphyromonas gingivalis and Treponema denticola in saliva and plaque samples was detected by polymerase chain reaction. Levels of serum anti-CL and anti-β2GPI antibodies were examined using enzyme-linked immunosorbent assay.
Patients with SLE exhibited more periodontal attachment loss and increased titers of serum anti-CL and anti-β2GPI antibodies compared with healthy controls. Patients with active SLE who harbored P. gingivalis or P. gingivalis together with T. denticola intraorally exhibited significantly higher anti-CL and anti-β2GPI antibodies than those without these bacteria. Anti-CL and anti-β2GPI antibody levels correlated positively with clinical attachment level. Furthermore, increased anti-β2GPI antibody levels were significantly associated with C-reactive protein and erythrocyte sedimentation rate.
Elevated anti-CL and anti-β2GPI antibody levels were associated with periodontopathic bacteria and periodontal breakdown in patients with SLE. Periodontitis might be a modifiable risk factor for SLE.
据报道，系统性红斑狼疮（SLE）患者体内抗心磷脂（anti-CL）抗体水平升高，这是一类与血栓形成相关的抗磷脂抗体。β2-糖蛋白I（β2GPI）被认为是anti-CL抗体的实际靶抗原。本研究调查了SLE患者牙周感染与anti-CL抗体之间的关联。
本病例对照研究招募了53名SLE女性患者和56名健康女性志愿者。所有参与者均接受了牙周检查。通过聚合酶链反应检测唾液和菌斑样本中牙龈卟啉单胞菌和齿垢密螺旋体的存在情况。采用酶联免疫吸附测定法检测血清anti-CL和抗β2GPI抗体水平。
与健康对照组相比，SLE患者表现出更多的牙周附着丧失，血清anti-CL和抗β2GPI抗体滴度升高。口腔内携带牙龈卟啉单胞菌或牙龈卟啉单胞菌与齿垢密螺旋体共存的活动期SLE患者，其anti-CL和抗β2GPI抗体水平显著高于未感染这些细菌的患者。anti-CL和抗β2GPI抗体水平与临床附着水平呈正相关。此外，抗β2GPI抗体水平升高与C反应蛋白和红细胞沉降率显著相关。
SLE患者anti-CL和抗β2GPI抗体水平升高与牙周病原菌和牙周破坏有关。牙周炎可能是SLE的一个可改变的危险因素。
