Arvanitidis Efthymios, Bizzarro Sergio, Alvarez Rodriguez Elena, Loos Bruno G, Nicu Elena A
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, Amsterdam, 1081LA The Netherlands.
Thromb J. 2017 Feb 6;15:5. doi: 10.1186/s12959-016-0125-x. eCollection 2017.
Platelets from untreated periodontitis patients are hyper-reactive and form more platelet-leukocyte complexes compared to cells from individuals without periodontitis. It is not known whether the improvement of the periodontal condition achievable by therapy has beneficial effects on the platelet function. We aimed to assess the effects of periodontal therapy on platelet reactivity.
Patients with periodontitis ( = 25) but unaffected by any other medical condition or medication were included and donated blood before and after periodontal therapy. Reactivity to ADP or oral bacteria was assessed by flow cytometric analysis of membrane markers (binding of PAC-1, P-selectin, CD63) and platelet-leukocyte complex formation. Reactivity values were expressed as ratio between the stimulated and unstimulated sample. Plasma levels of soluble (s) P-selectin were determined by enzyme-linked immunosorbent assay (ELISA).
Binding of PAC-1, the expression of P-selectin and CD63 in response to the oral bacterium were lower at recall (1.4 ± 1.1, 1.5 ± 1.2, and 1.0 ± 0.1) than at baseline (2.7 ± 4.1, = 0.026, 6.0 ± 12.5, = 0.045, and 2.7 ± 6.7, = 0.042, respectively). Formation of platelet-leukocyte complexes in response to was also reduced at recall compared to baseline (1.2 ± 0.7 vs. 11.4 ± 50.5, = 0.045). sP-selectin levels were significantly increased post-therapy.
In periodontitis patients, the improvement of the periodontal condition is paralleled by a reduction in platelet hyper-reactivity. We suggest that periodontal therapy, as an intervention for improved oral health, can facilitate the management of thrombotic risk, and on the long term can contribute to the prevention of cardiovascular events in patients at risk.
Current Controlled Trials identifier ISRCTN36043780. Retrospectively registered 25 September 2013.
与无牙周炎个体的细胞相比，未经治疗的牙周炎患者的血小板反应性过高，且形成更多的血小板 - 白细胞复合物。目前尚不清楚通过治疗实现的牙周状况改善是否对血小板功能有有益影响。我们旨在评估牙周治疗对血小板反应性的影响。
纳入25例患有牙周炎但未受任何其他疾病或药物影响的患者，在牙周治疗前后献血。通过对膜标志物（PAC - 1、P - 选择素、CD63的结合）进行流式细胞术分析以及血小板 - 白细胞复合物形成来评估对ADP或口腔细菌的反应性。反应性值表示为刺激样本与未刺激样本之间的比率。通过酶联免疫吸附测定（ELISA）测定血浆可溶性（s）P - 选择素水平。
复查时，对口腔细菌反应的PAC - 1结合、P - 选择素和CD63的表达（分别为1.4±1.1、1.5±1.2和1.0±0.1）低于基线水平（分别为2.7±4.1, P = 0.026；6.0±12.5, P = 0.045；2.7±6.7, P = 0.042）。与基线相比，复查时对口腔细菌反应的血小板 - 白细胞复合物形成也减少（1.2±0.7对11.4±50.5, P = 0.045）。治疗后sP - 选择素水平显著升高。
在牙周炎患者中，牙周状况的改善与血小板高反应性的降低同时出现。我们认为，作为改善口腔健康的一种干预措施，牙周治疗有助于管理血栓形成风险，从长远来看，有助于预防有风险患者的心血管事件。
当前对照试验标识符ISRCTN36043780。2013年9月25日追溯注册。
