Facultad de Odontología, Laboratorio de Odontología Traslacional, Dermoral, Universidad Andres Bello, Santiago, Chile.
Departamento de Dermatología, Centro Internacional de Estudios Clínicos (CIEC) Probity Medical Research, Santiago, Chile.
Front Immunol. 2024 Oct 24;15:1477587. doi: 10.3389/fimmu.2024.1477587. eCollection 2024.
Emerging evidence suggests that psoriasis and periodontitis are linked via systemic inflammation. However, the role of angiogenesis as an additional connecting mechanism between these diseases remains unclear.
This case control study explored the effect of psoriasis on the gingival crevicular fluid (GCF) levels of vascular endothelial growth factor A (VEGF-A) in patients with different stages of periodontitis. Thirty-one patients with psoriasis (P) and thirty healthy controls (C) underwent physical and intraoral evaluations, with diagnoses confirmed by dermatologists and periodontists. GCF VEGF-A was measured using a multiplex-bead immunoassay. Statistical analyses included Fisher exact tests, Student's T-tests, linear regression models, and mediation analyses.
Psoriasis patients had significantly lower GCF VEGF-A levels compared to controls (=0.008). Psoriasis was negatively associated with GCF VEGF-A (=0.006), while severe periodontitis was positively associated with GCF VEGF-A levels, regardless of tobacco use (=0.027). Further analyses revealed that severe periodontitis significantly increased GCF VEGF-A levels only in the C group (=0.038), but not in psoriasis patients (>0.610). Mediation analyses confirmed a significant direct and total effect of psoriasis on GCF VEGF-A (>0.002), with no significant indirect effect through periodontitis (=0.699).
Psoriasis and severe periodontitis are associated with GCF levels of VEGF-A in opposite and independent ways. In subjects with psoriasis, the impact of the dermatosis is direct with no mediation from periodontitis.
新出现的证据表明，银屑病和牙周炎通过全身炎症相关联。然而，血管生成作为连接这两种疾病的额外机制的作用尚不清楚。
本病例对照研究探讨了银屑病对不同牙周炎阶段患者牙龈沟液（GCF）中血管内皮生长因子 A（VEGF-A）水平的影响。31 名银屑病患者（P）和 30 名健康对照者（C）接受了身体和口腔评估，皮肤科医生和牙周病医生确诊。使用多重珠免疫测定法测量 GCF VEGF-A。统计分析包括 Fisher 确切检验、Student's T 检验、线性回归模型和中介分析。
银屑病患者的 GCF VEGF-A 水平明显低于对照组（=0.008）。银屑病与 GCF VEGF-A 呈负相关（=0.006），而重度牙周炎与 GCF VEGF-A 水平呈正相关，无论是否吸烟（=0.027）。进一步分析显示，重度牙周炎仅在 C 组显著增加 GCF VEGF-A 水平（=0.038），而在银屑病患者中则没有（>0.610）。中介分析证实了银屑病对 GCF VEGF-A 的直接和总效应显著（>0.002），且通过牙周炎的间接效应不显著（=0.699）。
银屑病和重度牙周炎与 GCF 中 VEGF-A 水平呈相反和独立的关系。在银屑病患者中，皮肤病的影响是直接的，不受牙周炎的影响。
