J Korean Acad Periodontol.  2004 Sep;34(3):607-622.

Association between Periodontitis and Coronary heart disease in Korea: Inflammatory markers and IL-1 gene polymorphism

• Jeong HN
• Chung HJ
• Kim OS
• Kim YJ
• Kim JH
• Koh JT

Abstract

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine (IL-1beta, IL-6, IL-1ra, tumor necrosis factor-alpha, and prostaglandin E2). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of PGE2 was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood PGE2. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15 % vs. 3.3 %, OR 5.118, p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

Keyword

Coronary heart disease; periodontitis; GCF cytokine; Inflammatory markers; IL-1 gene polymorphism

MeSH Terms

Alleles
Arteries
C-Reactive Protein
Cardiovascular Diseases
Constriction, Pathologic
Coronary Angiography
Coronary Disease*
Coronary Stenosis
Coronary Vessels
Cytokines
Dinoprostone
DNA
Epidemiologic Studies
Genotype
Gingival Crevicular Fluid
Gram-Negative Bacterial Infections
Hemorrhage
Humans
Inflammation
Interleukin 1 Receptor Antagonist Protein
Interleukin-1*
Interleukin-6
Korea*
Multigene Family
Periodontal Diseases
Periodontal Index
Periodontal Pocket
Periodontitis*
Polymerase Chain Reaction
Risk Factors
Tooth
Tumor Necrosis Factor-alpha
C-Reactive Protein
Cytokines
DNA
Dinoprostone
Interleukin 1 Receptor Antagonist Protein
Interleukin-1
Interleukin-6
Tumor Necrosis Factor-alpha