Fan Tiantian, Guo Kaili, Cao Fengdi, Deng Zhuohang, Liu Bin, Shi Mingyue, Liu Yue, Ma Zhe
Department of Preventive Dentistry, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China.
J Periodontal Res. 2023 Jun;58(3):655-667. doi: 10.1111/jre.13128. Epub 2023 Apr 12.
Periodontitis is immune inflammatory disease, atherosclerosis (AS) and chronic kidney disease (CKD) are two common systemic diseases. Periodontitis promotes AS and CKD, and CKD interacts with AS. The objective of this animal study was to evaluate the changes of kidney when periodontitis and atherosclerosis exist separately and the degenerative effects of periodontitis on the kidney in atherosclerotic mice.
A total of 40 male Apoe-/- mice were randomly divided into four groups: control (NC), periodontitis (PD), AS and AS with PD (AS + PD). AS was induced by high-fat diet feeding, and PD was induced by injection of Porphyromonas gingivalis-Lipopolysaccharide (P.g-LPS) (endotoxin suspension) into the buccal side of mouse maxillary molars. The right maxilla of mice was scanned with micro-CT to evaluate alveolar bone loss; aortic tissue was stained with HE and Oil-Red O to evaluate arterial plaque formation; serum was collected to detect the changes of blood lipids and serum renal function parameters (blood urea nitrogen [BUN], serum creatinine [Scr]); renal histopathological changes were evaluated by HE staining (glomerular and tubular damage scores), PAS staining (glomerular Mesangial matrix index) and Masson staining (percentage of renal fibrosis area); qRT-PCR and ELISA were used to evaluate the expression of renal inflammatory cytokines (tumor necrosis factor-α, Interleukin-1β, neutrophil surface marker Ly6G).
The amount of alveolar bone loss: PD group was significantly higher than NC group (p < .05); AS + PD group was higher than PD group, the difference was not statistically significant. Atherosclerotic plaque formation and serum lipid changes: AS group were significantly worse than NC group (p < .05), and AS + PD group were worse than AS group. The results of the corresponding qualitative and quantitative analyses of kidney tissue in experimental animals gradually deteriorated in the NC group, PD group, AS group and AS + PD group and worsened sequentially. Renal function parameters: the content of BUN in AS group was higher than that in PD group, the difference was not statistically significant; Scr in AS group was significantly higher than that in PD group (p < .05); the contents of BUN and Scr in AS + PD group were higher than those in AS group, the difference was not statistically significant. Glomerular and tubular damage scores: AS group were higher than PD group, the difference was not statistically significant; AS + PD group were significantly higher than AS group (p < .001). The ratio of glomerular mesangial matrix to glomerular area and the percentage of renal fibrosis area: AS group were significantly higher than PD group (p < .001), and AS + PD group were significantly higher than AS group (p < .001). Expression of inflammatory cytokines: AS group was higher than PD group, the difference was not statistically significant; AS + PD group was significantly higher than AS group (p < .05).
Both PD and AS can aggravate the inflammatory stress of kidney tissue and cause the damage of kidney tissue, and the inflammatory increase and damage effect of AS is stronger; PD can promote kidney damage of atherosclerotic mice by aggravating the renal inflammation in atherosclerotic mice; renal function parameters were not completely synchronized with the changes of renal inflammation and histopathology in each group of mice; PD can promote AS, periodontal inflammation in mice with AS is more severe, and the special changes of blood lipids in mice with AS are closely related to the above results.
牙周炎是一种免疫炎症性疾病,动脉粥样硬化(AS)和慢性肾脏病(CKD)是两种常见的全身性疾病。牙周炎可促进AS和CKD的发生,且CKD与AS相互作用。本动物研究的目的是评估牙周炎和动脉粥样硬化单独存在时肾脏的变化,以及牙周炎对动脉粥样硬化小鼠肾脏的退行性影响。
将40只雄性Apoe-/-小鼠随机分为四组:对照组(NC)、牙周炎组(PD)、AS组和AS合并PD组(AS+PD)。通过高脂饮食诱导AS,通过将牙龈卟啉单胞菌脂多糖(P.g-LPS)(内毒素悬液)注射到小鼠上颌磨牙颊侧诱导PD。用微型CT扫描小鼠右上颌骨以评估牙槽骨吸收;主动脉组织进行HE和油红O染色以评估动脉斑块形成;收集血清检测血脂和血清肾功能参数(血尿素氮[BUN]、血清肌酐[Scr])的变化;通过HE染色(肾小球和肾小管损伤评分)、PAS染色(肾小球系膜基质指数)和Masson染色(肾纤维化面积百分比)评估肾脏组织病理学变化;采用qRT-PCR和ELISA评估肾脏炎症细胞因子(肿瘤坏死因子-α、白细胞介素-1β、中性粒细胞表面标志物Ly6G)的表达。
牙槽骨吸收量:PD组显著高于NC组(p<.05);AS+PD组高于PD组,差异无统计学意义。动脉粥样硬化斑块形成和血脂变化:AS组显著比NC组差(p<.05),AS+PD组比AS组差。实验动物肾脏组织相应的定性和定量分析结果在NC组、PD组、AS组和AS+PD组中逐渐恶化且依次加重。肾功能参数:AS组BUN含量高于PD组,差异无统计学意义;AS组Scr显著高于PD组(p<.05);AS+PD组BUN和Scr含量高于AS组,差异无统计学意义。肾小球和肾小管损伤评分:AS组高于PD组,差异无统计学意义;AS+PD组显著高于AS组(p<.001)。肾小球系膜基质与肾小球面积比值和肾纤维化面积百分比:AS组显著高于PD组(p<.001),AS+PD组显著高于AS组(p<.001)。炎症细胞因子表达:AS组高于PD组,差异无统计学意义;AS+PD组显著高于AS组(p<.05)。
PD和AS均可加重肾脏组织的炎症应激并导致肾脏组织损伤,且AS的炎症增加和损伤作用更强;PD可通过加重动脉粥样硬化小鼠的肾脏炎症促进其肾脏损伤;每组小鼠的肾功能参数与肾脏炎症和组织病理学变化不完全同步;PD可促进AS,AS小鼠的牙周炎症更严重,且AS小鼠血脂的特殊变化与上述结果密切相关。