Anti-Cardiolipin, Markers of Vascular Inflammation, and CRP In Aggressive Periodontitis

Objectives: A significant proportion of patients with periodontitis have elevated serum levels of β2-glycoprotein1-dependent anti-cardiolipin (anti-CL). These prothrombotic autoantibodies, commonly found to be elevated in patients with systemic lupus erythematosis and the antiphospholipid syndrome, are associated with adverse pregnancy outcomes and with cardiovascular sequelae. Anti-CL are known to promote vascular inflammation and thrombosis. Methods: We measured serum levels of markers of vascular inflammation, sICAM-1, sVCAM-1, and sE-selectin, in 280 subjects with generalized aggressive (GAgP) or chronic periodontitis (CP) and in periodontally healthy (NP) subjects. We also measured serum CRP levels in 57 patients with GAgP. All assays were performed using commercial ELISA kits. Anti-CL was considered elevated when serum concentration exceeded 15U/ml. Results: Mean levels of both sVCAM-1 and sE-selectin were significantly higher in those subjects with elevated anti-CL (>15 U/ml) than in those with normal anti-CL. This relationship was also observed in the never-smoker subset of subjects even after correction for demographic and periodontal variables. Within diagnostic categories, sICAM-1, sVCAM-1, and sE-selectin were significantly higher in GAgP patients who had elevated anti-CL compared to those with normal anti-CL, but not in CP or NP patients. Statistical correction for demographic (age, race, and sex) and periodontal (attachment loss, pocket depth, number of teeth) variables indicated that elevated anti-CL remained significantly associated with increased sVCAM-1 and sE-selectin in GAgP patients. Mean CRP levels were significantly higher in GAgP patients with elevated anti-CL than in those with normal anti-CL. Conclusions: Systemic markers of vascular inflammation and CRP in GAgP are associated with elevated anti-CL, and we hypothesize that this subset of aggressive periodontitis patients could represent a subgroup at increased risk for obstetrical and cardiovascular sequelae. Supported by grant DE 13102 from the NIDCR