Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
Greater Manchester Comprehensive Stroke Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK.
Int J Stroke. 2020 Feb;15(2):175-187. doi: 10.1177/1747493019834191. Epub 2019 Feb 22.
Stroke is a major cause of disability and mortality. Poorer outcome after stroke is associated with concomitant inflammatory and infectious disease. Periodontitis is a chronic inflammatory disease of the dental supporting structures and is a prominent risk factor for many systemic disorders, including cardiovascular disease and stroke. While epidemiological studies suggest that periodontitis increases the likelihood of stroke, its impact on stroke severity is poorly understood. Here, we sought to determine the contribution of periodontitis to acute stroke pathology.
We characterized a murine ligature model of periodontitis for inflammatory responses that could potentially impact stroke outcome. We applied this model and then subjected mice to either transient or permanent middle cerebral artery occlusion. We also enhanced the periodontitis model with repeated intravenous administration of a periodontal-specific lipopolysaccharide to better mimic the clinical condition.
Ligature-induced periodontitis caused bone loss, bacterial growth, and increased local inflammatory cell trafficking. Systemically, periodontitis increased circulating levels of pro-inflammatory cytokines, and primed bone marrow monocytes to produce elevated tumour necrosis factor-alpha (TNFα). Despite these changes, periodontitis alone or in tandem with repeated lipopolysaccharide challenge did not alter infarct volume, blood-brain barrier breakdown, or systemic inflammation after experimental stroke.
Our data show that despite elevated systemic inflammation in periodontitis, oral inflammatory disease does not impact acute stroke pathology in terms of severity, determined primarily by infarct volume. This indicates that, at least in this experimental paradigm, periodontitis alone does not alter acute outcome after cerebral ischemia.
中风是残疾和死亡的主要原因。中风后较差的预后与同时存在的炎症和感染性疾病有关。牙周炎是一种牙齿支持组织的慢性炎症性疾病,是许多全身性疾病的重要危险因素,包括心血管疾病和中风。虽然流行病学研究表明牙周炎增加了中风的可能性,但它对中风严重程度的影响还不清楚。在这里,我们试图确定牙周炎对急性中风病理的影响。
我们对牙周炎的结扎模型进行了特征描述,以研究可能影响中风结果的炎症反应。我们应用了这种模型,然后让老鼠经历短暂或永久性的大脑中动脉闭塞。我们还通过重复静脉内给予牙周炎特异性脂多糖来增强牙周炎模型,以更好地模拟临床情况。
结扎诱导的牙周炎导致骨丢失、细菌生长和局部炎症细胞迁移增加。在系统水平上,牙周炎增加了循环中促炎细胞因子的水平,并使骨髓单核细胞产生更高水平的肿瘤坏死因子-α(TNFα)。尽管有这些变化,但牙周炎单独或与重复脂多糖挑战一起,并没有改变实验性中风后的梗死体积、血脑屏障破坏或全身炎症。
我们的数据表明,尽管牙周炎存在全身性炎症升高,但口腔炎症性疾病并不会影响中风严重程度,这主要由梗死体积来决定。这表明,至少在这个实验模型中,单独的牙周炎不会改变脑缺血后的急性结局。