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Treatment of periodontal disease results in improvements in endothelial dysfunction and reduction of the carotid intima-media thickness

Stefania Piconi^*,1, Daria Trabattoni^||,1, Cristina Luraghi, Edoardo Perilli, Manuela Borelli^||, Michela Pacei^||, Giuliano Rizzardini^*, Antonella Lattuada, Dorothy H. Bray^#, Mariella Catalano, Antonella Sparaco and Mario Clerici^¶,**,2

^* Infectious Diseases Unit,

Odontoiatric Unit,

Research Center on Vascular Diseases and Angiology Unit, and

Haematology Unit, Hospital Luigi Sacco, Milan, Italy;

^|| Department of Preclinical Sciences LITA Vialba and

^¶ Department of Biomedical Sciences and Technologies, University of Milan, Milan, Italy;

^# Immunoclin Limited, London, UK; and

^** Don C. Gnocchi Foundation, Istituto Di Ricovero e Cura a Carattere Scientifico, Milan, Italy

²Correspondence: Department of Biomedical Sciences and Technologies, University of Milano, Via F.lli Cervi 93; 20090 Segrate (Milan), Italy. E-mail: mario.clerici{at}unimi.it

Several cohort studies reported a relation of cardiovascular events and periodontal disease. In particular, Porphyromonas gingivalis is associated with the development of atherosclerotic plaques. We verified in a longitudinal study whether inflammation biomarkers, endothelial adhesion molecules, leukocyte activation markers, and intima-media thickness could be beneficially modified by periodontal treatment alone. Thirty-five otherwise healthy individuals affected by mild to moderate parodontopathy were enrolled in the study. Echo-Doppler cardiography of the carotid artery, fluorescence-activated cell sorting analyses on lymphocytes and monocytes, and plasma inflammatory indices were evaluated at baseline and at multiple time points after the periodontal treatment. Results showed that inflammation biomarkers were abnormally increased at baseline. Periodontal treatment resulted in a significant reduction of the total oral bacterial load that was associated with a significant amelioration of inflammation biomarkers and of adhesion and activation proteins. Notably, intima-media thickness was significantly diminished after treatment. Inflammatory alterations associated with the genesis of atherosclerotic plaques are detected in otherwise healthy individuals affected by parodontopathy and are positively influenced by periodontal treatment. Reduction of oral bacterial load results in a modification of an anatomical parameter directly responsible for atherosclerosis. These results shed light on the pathogenesis of atherosclerosis and could have practical implications for public health.—Piconi, S., Trabattoni, D., Luraghi, C., Perilli, E., Borelli, M., Pacei, M., Rizzardini, G., Lattuada, A., Bray, D. H., Catalano, M., Sparaco, A., Clerici, M. Treatment of periodontal disease results in improvements of endothelial dysfunction and reduction of the carotid intima-media thickness.

Key Words: leukocyte activation • inflammation • T lymphocytes • ultrasound measurement