Circulating Antibody Levels Against PAMPs of Periodontopathogens Increase Cardiovascular Risk

Methods: The aim of the present study was to compare circulating antibody levels against outer membrane proteins (OMPs), peptidoglycan-associated lipoprotein (PAL) and lipopolysaccharide (LPS) of various serotypes of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis between periodontitis patients with (N=80) and without (N=80) acute myocardial infarction (AMI) and healthy subjects (N=15). In addition, demographic and life style variables were recorded and full-mouth periodontal status, medical status, serum/plasma inflammatory biomarkers, lipid profiles, and glucose levels were determined.

Results: IgG levels against A. actinomycetemcomitans and P. gingivalis LPS and OMPs were significantly higher but those against A. actinomycetemcomitans peptidoglycan-associated lipoprotein lower (AaPAL) in PER+AMI and PER-AMI than in healthy subjects. Severity of periodontitis was associated with IgG levels against OMPs and LPS in both species. CRP, glucose and triglyceride levels, white blood cell counts (WBC), BMI, smoking habit, socioeconomic status, dental plaque index, and number of teeth with deep pockets were significantly higher in PER+AMI than PER-AMI patients. Multiple logistic regression analysis identified besides CRP and total cholesterol levels and WBC also the serum IgG levels against A. actinomycetemcomitans and P. gingivalis LPS and OMPs as independent risk factors for AMI.

Conclusions: IgG levels to components of periodontal pathogens may represent an additional tool for evaluating host's specific reactivity to the infectious insult in periodontitis. Whether the targets, the conserved pathogen associated molecular patterns studied, were membrane bound, free soluble and/ or complexed needs further clarification.