Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan.
Department of Neurology, Chikamori Hospital, Kochi, Japan.
Clin Exp Immunol. 2020 Jun;200(3):302-309. doi: 10.1111/cei.13430. Epub 2020 Mar 24.
Stroke can be a cause of death, while in non-fatal cases it is a common cause of various disabilities resulting from associated brain damage. However, whether a specific periodontal pathogen is associated with increased risk of unfavorable outcome after stroke remains unknown. We examined risk factors for unfavorable outcome following stroke occurrence, including serum antibody titers to periodontal pathogens. The enrolled cohort included 534 patients who had experienced an acute stroke, who were divided into favorable (n = 337) and unfavorable (n = 197) outcome groups according to modified ranking scale (mRS) score determined at 3 months after onset (favorable = score 0 or 1; unfavorable = score 2-6). The associations of risk factors with unfavorable outcome, including serum titers of IgG antibodies to 16 periodontal pathogens, were examined. Logistic regression analysis showed that the initial National Institutes of Health stroke scale score [odds ratio (OR) = 1·24, 95% confidence interval (CI) = 1·18-1·31, P < 0·001] and C-reactive protein (OR = 1·29, 95% CI = 1·10-1·51, P = 0·002) were independently associated with unfavorable outcome after stroke. Following adjustment with those, detection of the antibody for Fusobacterium nucleatum ATCC 10953 in serum remained an independent predictor of unfavorable outcome (OR = 3·12, 95% CI = 1·55-6·29, P = 0·002). Determination of the antibody titer to F. nucleatum ATCC 10953 in serum may be useful as a predictor of unfavorable outcome after stroke.
中风可能导致死亡,即使是非致命病例,它也是由相关脑损伤引起的各种残疾的常见原因。然而,特定的牙周病原体是否与中风后不良结局的风险增加有关仍不清楚。我们研究了中风发生后不良结局的危险因素,包括针对牙周病原体的血清抗体滴度。纳入的队列包括 534 名经历过急性中风的患者,根据发病后 3 个月的改良 Rankin 量表(mRS)评分将其分为预后良好(n=337)和预后不良(n=197)两组(预后良好=评分 0 或 1;预后不良=评分 2-6)。检查了包括针对 16 种牙周病原体 IgG 抗体滴度在内的危险因素与不良结局的关系。逻辑回归分析显示,初始国立卫生研究院卒中量表评分(比值比 [OR] = 1·24,95%置信区间 [CI] = 1·18-1·31,P < 0·001)和 C 反应蛋白(OR = 1·29,95%CI = 1·10-1·51,P = 0·002)与中风后不良结局独立相关。在调整这些因素后,血清中检测到核梭杆菌 ATCC 10953 的抗体仍然是不良结局的独立预测因素(OR = 3·12,95%CI = 1·55-6·29,P = 0·002)。血清中核梭杆菌 ATCC 10953 抗体滴度的测定可能有助于预测中风后的不良结局。