Table 1.
Clinical studies suggesting the role of biomarkers and increased systemic mediators of inflammation in periodontitis as a link to inflammation in CVD
| Inflammatory Mediator or marker |
Association(s) with CVD | References |
|---|---|---|
| C-reactive protein | Serum levels increased in chronic periodontitis | Ebersole et al., 1997; Loos et al., 2000; Slade et al., 2000; Noack et al., 2001; Offenbacher, 2002; Ebersole et al., 2002; Buhlin et al., 2003; Beck and Slade et al., 2003; Amar et al., 2003; Yoshii et al., 2009; Gomes-Filho et al., 2011; Pejcic et al., 2011 |
| Serum levels increased in aggressive periodontitis | Salzberg et al., 2006; Sun et al., 2009 | |
| Serum levels increased in patients with CVD and chronic periodontitis compared to either condition alone | Glurich et al., 2002; Persson et al., 2005; Amabile et al., 2008; Malali et al., 2010; Liu et al., 2010 | |
| Serum levels decrease along with improvement in surrogate measures of cardiovascular health (brachial artery flow-mediated dilation (FMD), hypertension, Framingham Risk Score) following therapy | Seinost et al., 2005; D'Aiuto et al., 2006; Higashi et al., 2008; Higashi et al., 2009 | |
| C-reactive protein, fibrinogen, interleukin-6, and other markers | Serum levels decreased following therapy | Iwamoto et al., 2003; D'Aiuto et al., 2004; Montebugnoli et al., 2005; Taylor et al., 2006; Hussain Bokhari et al., 2009; Vidal et al., 2009; Nakajima et al., 2010 |
| Transient increase in serum levels shortly after therapy (24h) and impairment of FMD | Tonetti et al., 2007 | |
| Serum levels unchanged following therapy | Ide et al., 2003; Yamazaki et al., 2005 | |
| Interleukin-6 | Serum levels increased in chronic periodontitis | Buhlin et al., 2009 |
| Haptoglobin | ||
| Fibrinogen | ||
| Interleukin-18 | Serum levels decreased in chronic periodontitis | |
| Interleukin-4 | ||
| Serum amyloid A | Serum levels increased in patients with CVD and chronic periodontitis compared to periodontitis alone | Glurich et al., 2002 |
| Alpha 1 anti-chymotrypsin | ||
| Matrix metalloproteinase (MMP)-9 | Serum levels decreased following therapy; high levels associated with changes in carotid IMT in chronic periodontitis | Behle et al., 2009; Soder et al., 2009 |
| Platelet activating factor (PAF) and PAF-acetylhydrolase (AH) | PAF levels elevated in serum and gingiva, PAF-AH levels decrease following therapy | Noguchi et al., 1989; Losche et al., 2005; Zheng et al., 2006; Chen et al., 2010 |