Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Vic., Australia.
Centre for Biomedical Research, Burnet Institute, Melbourne, Vic., Australia.
J Periodontal Res. 2017 Oct;52(5):930-935. doi: 10.1111/jre.12460. Epub 2017 Apr 10.
Periodontal disease has been associated with cardiovascular disease in the general population. It is unknown whether IgG antibody levels for periodontal pathogens are associated with the diagnosis of coronary artery disease (CAD) in HIV-positive individuals.
Twenty-four HIV-positive individuals (cases) with stored plasma available in the 12 months before CAD diagnosis were age- and sex-matched 1:2 with 46 HIV-positive individuals without CAD (controls). Antibody levels to whole cell extracts from periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum, as well as markers of inflammation sCD14, CXCL10 and high-sensitivity C-reactive protein, were compared between cases and controls using enzyme-linked immunosorbent assays.
P. gingivalis-specific IgG levels (μg/mL) were significantly higher in individuals with CAD (median 1.48 [IQR 1.06-2.05]) compared to controls (0.70 [IQR 0.35-1.24], P<.001), and remained significantly higher following adjustment for traditional cardiovascular risk factors and HIV viral load (OR 21.6 [95% CI 3.73-125.63] P=.001). There was a borderline association between A. actinomycetemcomitans IgG antibody levels (cases, median 3.86 [IQR 3.19-4.72]; controls, 3.34 [IQR 2.59-4.07], P=.050) and no association found between F. nucleatum antibody levels and CAD. sCD14 levels (μg/mL) were higher in cases compared with controls (median 3.45 [IQR 3.03-4.11] vs 2.65 [IQR 2.32-2.99] P<.001), while CXCL10 (median 127 pg/mL [IQR 88-157] vs 153 [IQR 90-244] P=.321) and high-sensitivity C-reactive protein (median 3.44 mg/L [1.98-5.32] vs 1.85 [1.13-6.88] P=.203) levels were not different between cases and controls.
Periodontal bacteria may be contributing to CAD risk in HIV-positive individuals.
牙周病与普通人群的心血管疾病有关。尚不清楚针对牙周病原体的 IgG 抗体水平是否与 HIV 阳性个体的冠状动脉疾病 (CAD) 诊断相关。
在 CAD 诊断前 12 个月内，有 24 名 HIV 阳性个体（病例）的储存血浆可用，这些个体与 46 名没有 CAD 的 HIV 阳性个体（对照组）按年龄和性别 1:2 匹配。采用酶联免疫吸附试验比较病例组和对照组之间牙周病原体牙龈卟啉单胞菌、伴放线放线杆菌和核梭杆菌的全细胞提取物以及炎症标志物 sCD14、CXCL10 和高敏 C 反应蛋白的 IgG 抗体水平。
与对照组相比（中位数 0.70 [IQR 0.35-1.24]，P<.001），CAD 个体的牙龈卟啉单胞菌特异性 IgG 水平（μg/mL）明显更高（中位数 1.48 [IQR 1.06-2.05]），并且在调整传统心血管危险因素和 HIV 病毒载量后仍然明显更高（OR 21.6 [95%CI 3.73-125.63]，P=.001）。伴放线放线杆菌 IgG 抗体水平（病例组中位数 3.86 [IQR 3.19-4.72]；对照组中位数 3.34 [IQR 2.59-4.07]，P=.050）与 CAD 之间存在边界关联，而核梭杆菌抗体水平与 CAD 之间无关联。与对照组相比（中位数 3.45 [IQR 3.03-4.11] vs 2.65 [IQR 2.32-2.99]，P<.001），病例组的 sCD14 水平（μg/mL）更高，而 CXCL10（中位数 127 pg/mL [IQR 88-157] vs 153 [IQR 90-244]，P=.321）和高敏 C 反应蛋白（中位数 3.44 mg/L [1.98-5.32] vs 1.85 [1.13-6.88]，P=.203）水平在病例组和对照组之间无差异。
牙周细菌可能导致 HIV 阳性个体患 CAD 的风险增加。
