The impact of Porphyromonas gingivalis and its virulence in cardiovascular diseases
Main Article Content
Aim: To describe the pathogenic mechanisms used by P. gingivalis to migrate to the heart and infect the heart valves.
Materials and methods: A systematic search of the information is carried out from the PRISMA Declaration to obtain sources of information, the MeSH health descriptors "Porphyromonas gingivalis", "Infection mechanisms" and "Valvular heart disease" are |obtained, which were combined through the boolean “AND” connector.
Results: Two types of searches were carried out, in which a total of 61 articles were analyzed, where four studies related to the chosen theme were found, including two original scientific research articles and two observational articles; a conventional PCR method was used to detect P. gingivalis in all the articles.
Conclusion: Several studies carried out in patients with periodontal disease with or without the presence of concomitant valvular disease have managed to isolate the periodontopathogen in heart valves, although its proportion is minimal compared to other pathogens, however, the pathogenic mechanism by which P. gingivalis infects heart valves has not been identified, and research is needed to obtain accurate information on the relationship between infection caused by P. gingivalis and valve disease.
Hajishengallis G. Periodontitis: From microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15(1):30-44. Doi: https://doi.org/10.1038/nri3785 DOI: https://doi.org/10.1038/nri3785
Calle CM, Ángel MP, Duque A, Giraldo A. Enfermedad periodontal y su relación con las enfermedades cardiovasculares. Rev. CES Odont. 2012;25(1) 82-91. In: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-971X2012000100008
Pardo Romero, FF, Hernández, LJ. Enfermedad periodontal: enfoques epidemiológicos para su análisis como problema de salud pública. Revista de salud pública. 2018; 20 (2), 258-264. Doi: https://doi.org/10.15446/rsap.v20n2.64654 DOI: https://doi.org/10.15446/rsap.v20n2.64654
Villines Z. Válvulas cardíacas: Tipos, función, enfermedades y más.. 2021 [citado el 27 de agosto de 2022]. In: https://www.medicalnewstoday.com/articles/es/valvulas-cardiacas
Urrútia G, Bonfill X. PRISMA declaration: A proposal to improve the publication of systematic reviews and meta-analyses. Med Clin (Barc). 2010;135(11):507-11. Doi: https://doi.org/10.1016/j.medcli.2010.01.015 DOI: https://doi.org/10.1016/j.medcli.2010.01.015
Moreno Sandra, Parra Beatriz, Botero Javier E., Moreno Freddy, Vásquez Daniel, Fernández Hugo et al . Microbiota periodontal y microorganismos aislados de válvulas cardiacas en pacientes sometidos a cirugía de reemplazo de válvulas en una clínica de Cali, Colombia. Biomédica . 2017 Dec [cited 2022 Oct 15] ; 37( 4 ): 516-525. http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-41572017000400516&lng=en. Doi: https://doi.org/10.7705/biomedica.v37i4.3232 DOI: https://doi.org/10.7705/biomedica.v37i4.3232
Raffaelli L, Santangelo R, Falchetti P, Galluccio F, Luciani N, Anselmi A, Nowzari H, Verdugo F, Fadda G, D'Addona A. Examination of periodontal pathogens in stenotic valve specimens and in whole blood samples in patients affected by aortic valve stenosis and chronic periodontitis. Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):561-6. Doi: https://doi.org/10.1177/039463201002300218
Ninomiya M, Hashimoto M, Yamanouchi K, Fukumura Y, Nagata T, Naruishi K. Relationship of oral conditions to the incidence of infective endocarditis in periodontitis patients with valvular heart disease: a cross-sectional study. Clin Oral Investig. 2020;24(2):833-40. Doi: https://doi.org/10.1007/s00784-019-02973-2 DOI: https://doi.org/10.1007/s00784-019-02973-2
Hanaoka, Y., Soejima, H., Yasuda, O. et al. Level of serum antibody against a periodontal pathogen is associated with atherosclerosis and hypertension. Hypertens Res 36, 829-833 (2013). Doi: https://doi.org/10.1038/hr.2013.46 DOI: https://doi.org/10.1038/hr.2013.46
Nezu T, Hosomi N, Aoki S, Nishi H, Nakamori M, Shiga Y, Imamura E, Shintani T, Kawaguchi H, Maruyama H. Assessment of Serum IgG Titers to Various Periodontal Pathogens Associated with Atrial Fibrillation in Acute Stroke Patients. J Stroke Cerebrovasc Dis. 2022 Mar;31(3):106301. Doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106301 DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106301
Leishman SJ, Ford PJ, Do HL, Palmer JE, Heng NC, West MJ, Seymour GJ, Cullinan MP. Periodontal pathogen load and increased antibody response to heat shock protein 60 in patients with cardiovascular disease. J Clin Periodontol. 2012 Oct;39(10):923-30. doi: 10.1111/j.1600-051X.2012.01934.x. Epub 2012 Aug 13. Doi: https://doi.org/10.1111/j.1600-051X.2012.01934.x DOI: https://doi.org/10.1111/j.1600-051X.2012.01934.x
Giles JT, Reinholdt J, Andrade F, Konig MF. Associations of Antibodies Targeting Periodontal Pathogens With Subclinical Coronary, Carotid, and Peripheral Arterial Atherosclerosis in Rheumatoid Arthritis. Arthritis Rheumatol. 2021 Apr;73(4):568-575. Epub 2021 Mar 3. PMID: 33205531; PMCID: PMC8005413. Doi: https://doi.org/10.1002/art.41572 DOI: https://doi.org/10.1002/art.41572
Berquist VL, Hearps AC, Ford P, Jaworowski A, Leishman SJ, Hoy JF, Trevillyan JM. Porphyromonas gingivalis antibody levels and diagnosis of coronary artery disease in HIV-positive individuals. J Periodontal Res. 2017 Oct;52(5):930-935. Epub 2017 Apr 10. PMID: 28397248. Doi:
https://doi.org/10.1111/jre.12460 DOI: https://doi.org/10.1111/jre.12460
Łysek RP, Szafraniec K, Polak M, Jankowski P, Micek A, Wolfshaut-Wolak R, Czarnecka D, Potempa J, Pająk A. Relationship between past myocardial infarction, periodontal disease and Porphyromonas gingivalis serum antibodies: A case-control study. Cardiol J. 2018;25(3):386-392. Epub 2017 Feb 2. Doi: https://doi.org/10.5603/CJ.a2017.0015 DOI: https://doi.org/10.5603/CJ.a2017.0015
de Boer SP, Cheng JM, Rangé H, Garcia-Garcia HM, Heo JH, Akkerhuis KM, Meilhac O, Cosler G, Pussinen PJ, van Geuns RJ, Serruys PW, Boersma E, Kardys I. Antibodies to periodontal pathogens are associated with coronary plaque remodeling but not with vulnerability or burden. Atherosclerosis. 2014 Nov;237(1):84-91. Epub 2014 Sep 6. PMID: 25233105. Doi: https://doi.org/10.1016/j.atherosclerosis.2014.08.050 DOI: https://doi.org/10.1016/j.atherosclerosis.2014.08.050
Díaz Zúñiga, J., Yáñez Figueroa, J., Melgar Rodríguez, S., Álvarez Rivas, C., Rojas Lagos, C., & Vernal Astudillo, R. (2012). Virulencia y variabilidad de Porphyromonas gingivalis y Aggregatibacter actinomycetemcomitans y su asociación a la periodontitis. Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral, 5(1), 40-45. Doi: https://doi.org/10.4067/S0719-01072012000100007 DOI: https://doi.org/10.1016/S0718-5391(12)70090-3
Gode S, Sarp TZ, Saribas S, Ergin S, Kasnak G, Dinc HO, Caliskan R, Akkus S, Tokman HB, Kocak BT, Demirci M, Gareayaghi N, Kirmusaoglu S, Tokman H, Kocazeybek B. The Prevalence of Periodontal Pathogenic Bacteria in Atherosclerotic Cardiovascular Disease. Clin Lab. 2020 May 1;66(5). Doi: https://doi.org/10.7754/Clin.Lab.2020.191146
Akhi, R., Wang, C., Nissinen, A. E., Kankaanpää, J., Bloigu, R., Paju, S., Mäntylä, P., Buhlin, K., Sinisalo, J., Pussinen, P. J., & Hörkkö, S. (2019). Salivary IgA to MAA-LDL and oral pathogens are linked to coronary disease. Journal of Dental Research, 98(3), 296-303. Doi: https://doi.org/10.1177/0022034518818445 DOI: https://doi.org/10.1177/0022034518818445
Orrego-Cardozo, M., Parra-Gil, M. A., Salgado-Morales, Y. P., Muñoz-Guarín, E., & Fandiño-Henao, V. (2015). Porphyromonas gingivalis y enfermedades sistémicas. CES odontologia, 28(1), 57-73. http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-971X2015000100006
Nakano K, Nemoto H, Nomura R, Inaba H, Yoshioka H, Taniguchi K, Amano A, Ooshima T. Detection of oral bacteria in cardiovascular specimens. Oral Microbiol Immunol. 2009 Feb;24(1):64-8. Doi: https://doi.org/10.1111/j.1399-302X.2008.00479.x DOI: https://doi.org/10.1111/j.1399-302X.2008.00479.x
Radwan-Oczko M, Jaworski A, Duś I, Plonek T, Szulc M, Kustrzycki W. Porphyromonas gingivalis in periodontal pockets and heart valves. Virulence. 2014 May 15;5(4):575-80. Doi: https://doi.org/10.4161/viru.28657 DOI: https://doi.org/10.4161/viru.28657
Mahendra J, Mahendra L, Nagarajan A, Mathew K. Prevalence of eight putative periodontal pathogens in atherosclerotic plaque of coronary artery disease patients and comparing them with noncardiac subjects: A case-control study. Indian J Dent Res. 2015 Mar-Apr;26(2):189-95. Doi: https://doi.org/10.4103/0970-9290.159164 DOI: https://doi.org/10.4103/0970-9290.159164
Gode S, Sarp TZ, Saribas S, Ergin S, Kasnak G, Dinc HO, Caliskan R, Akkus S, Tokman HB, Kocak BT, Demirci M, Gareayaghi N, Kirmusaoglu S, Tokman H, Kocazeybek B. The Prevalence of Periodontal Pathogenic Bacteria in Atherosclerotic Cardiovascular Disease. Clin Lab. 2020 May 1;66(5). Doi: https://doi.org/10.7754/Clin.Lab.2020.191146 DOI: https://doi.org/10.7754/Clin.Lab.2020.191146
Lee S-D, Wu C-C, Chang Y-C, Chang S-H, Wu C-H, Wu J-P, et al. Porphyromonas gingivalis-induced cellular hypertrophy and MMP-9 activity via different signaling pathways in H9c2 cardiomyoblast cells. J Periodontol. 2006;77(4):684-91. Doi: https://doi.org/10.1902/jop.2006.050070 DOI: https://doi.org/10.1902/jop.2006.050070
Joshi C, Bapat R, Anderson W, Dawson D, Hijazi K, Cherukara G. Detection of periodontal microorganisms in coronary atheromatous plaque specimens of myocardial infarction patients: A systematic review and meta-analysis. Trends Cardiovasc Med. 2021 Jan;31(1):69-82. Doi: https://doi.org/10.1016/j.tcm.2019.12.005 DOI: https://doi.org/10.1016/j.tcm.2019.12.005
Shanker J, Setty P, Arvind P, Nair J, Bhasker D, Balakrishna G, et al. Relationship between periodontal disease, Porphyromonas gingivalis, peripheral vascular resistance markers and coronary artery disease in Asian Indians. Thromb Res [Internet]. 2013;132(1):e8-14. Doi: https://doi.org/10.1016/j.thromres.2013.04.023 DOI: https://doi.org/10.1016/j.thromres.2013.04.023
Miyauchi S, Tokuyama T, Shintani T, Uotani Y, Miyamoto S, Ikeuchi Y, Okamura S, Okubo Y, Miyauchi M, Nakano Y. Porphyromonas gingivalis and left atrial appendage spontaneous echo contrast in atrial fibrillation ablation candidates. Heart Vessels. 2021 Nov;36(11):1721-1729. Epub 2021 May 21. PMID: 34021383. Doi: https://doi.org/10.1007/s00380-021-01851-w DOI: https://doi.org/10.1007/s00380-021-01851-w
Salminen A, Gursoy UK, Paju S, Hyvärinen K, Mäntylä P, Buhlin K, et al. Salivary biomarkers of bacterial burden, inflammatory response, and tissue destruction in periodontitis. J Clin Periodontol [Internet]. 2014;41(5):442-50. Doi: https://doi.org/10.1111/jcpe.12234 DOI: https://doi.org/10.1111/jcpe.12234
Nowzari, H., Verdugo, F., Fadda, G., & D'Addona, A. (2010). Examination of periodontal pathogens in stenotic valve specimens and in whole blood samples in patients affected by aortic valve stenosis and chronic periodontitis. International Journal of Immunopathology and Pharmacology, 23(2), 561-566. Doi: https://doi.org/10.1177/039463201002300218 DOI: https://doi.org/10.1177/039463201002300218
Socransky, S. S., Haffajee, A. D., Cugini, M. A., Smith, C., & Kent, R. L. (1998). Microbial complexes in subgingival plaque. Journal of Clinical Periodontology, 25(2), 134-144. Doi: https://doi.org/10.1111/j.1600-051X.1998.tb02419.x DOI: https://doi.org/10.1111/j.1600-051X.1998.tb02419.x
Oliveira FAF, Forte CPF, Silva PG de B, Lopes CB, Montenegro RC, Santos ÂKCRD, et al. Molecular analysis of oral bacteria in heart valve of patients with cardiovascular disease by real-time polymerase chain reaction. Medicine (Baltimore). 2015;94(47):e2067. Doi: https://doi.org/10.1097/MD.0000000000002067 DOI: https://doi.org/10.1097/MD.0000000000002067
Miyauchi S, Tokuyama T, Shintani T, Nishi H, Hamamoto Y, Ouhara K, et al. Periodontitis and the outcome of atrial fibrillation ablation: Porphyromonas gingivalis is related to atrial fibrillation recurrence. J Cardiovasc Electrophysiol [Internet]. 2021;32(5):1240-50. Doi: https://doi.org/10.1111/jce.14952 DOI: https://doi.org/10.1111/jce.14952
Suzuki J-I, Sato H, Kaneko M, Yoshida A, Aoyama N, Akimoto S, et al. Periodontitis and myocardial hypertrophy. Hypertens Res [Internet]. 2017;40(4):324-8. Doi: https://doi.org/10.1038/hr.2016.146 DOI: https://doi.org/10.1038/hr.2016.146
Accepted 2024-10-23
Published 2024-10-30
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