Abstract
Background: The present systematic review and meta-analysis assessed the strength of a reported association between elevated serum anti-periodontal bacterial antibody responses and an increased risk of coronary heart disease (CHD).
Review: Twenty original studies were identified after systematically searching five databases. The majority (n=11) compared serum anti-Porphyromonas gingivalis (Pg) and/or anti-Aggregatibacter actinomycetemcomitans (Aa) IgG antibody responses between CHD patients and control participants. The strength of the association between serum anti-Pg antibodies and CHD (n=10) and serum anti-Aa antibodies and CHD (n=6) was investigated using a meta-analysis approach separately.
Results: Most studies (61%) reported that the serum IgG antibody responses were elevated in CHD patients than in controls. The meta-analyses showed a significant association between elevated serum IgG antibody responses (anti-Pg and anti-Aa) and CHD risk, with pooled odds ratios of 1.23 (95% CI: 1.09-1.38, p=0.001) and 1.25 (95% CI: 1.04-1.47, p=0.0004), respectively.
Conclusion: A modest increase of CHD risk in individuals with higher serum anti-Pg and anti-Aa IgG antibody responses may support their use as potential biomarkers to detect and monitor at-risk populations. However, observed inconsistencies with the design and interpretation of immunoassays warrants standardisation of the immunoassays assessing antibody responses against periodontal bacteria.
Review: Twenty original studies were identified after systematically searching five databases. The majority (n=11) compared serum anti-Porphyromonas gingivalis (Pg) and/or anti-Aggregatibacter actinomycetemcomitans (Aa) IgG antibody responses between CHD patients and control participants. The strength of the association between serum anti-Pg antibodies and CHD (n=10) and serum anti-Aa antibodies and CHD (n=6) was investigated using a meta-analysis approach separately.
Results: Most studies (61%) reported that the serum IgG antibody responses were elevated in CHD patients than in controls. The meta-analyses showed a significant association between elevated serum IgG antibody responses (anti-Pg and anti-Aa) and CHD risk, with pooled odds ratios of 1.23 (95% CI: 1.09-1.38, p=0.001) and 1.25 (95% CI: 1.04-1.47, p=0.0004), respectively.
Conclusion: A modest increase of CHD risk in individuals with higher serum anti-Pg and anti-Aa IgG antibody responses may support their use as potential biomarkers to detect and monitor at-risk populations. However, observed inconsistencies with the design and interpretation of immunoassays warrants standardisation of the immunoassays assessing antibody responses against periodontal bacteria.
Original language | English |
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Pages (from-to) | 1570-1586 |
Number of pages | 17 |
Journal | Journal of Journal of Clinical Periodontology |
Volume | 48 |
Issue number | 12 |
Early online date | 1 Oct 2021 |
DOIs | |
Publication status | Published - 31 Dec 2021 |
Bibliographical note
Acknowledgements: The authors would like to thank Dr Neil Scott from the Medical Statistics Team, Division of Applied Health Sciences, the University of Aberdeen for providing statistical support and advice in conducting meta-analyses.Disclosures and funding note: There are no financial disclosures or conflicts of interest to declare for any of the authors. This project received no external funding
Keywords
- Myocardial Infarction
- Periodontitis
- Atherosclerosis
- Coronary Artery Disease
- Antibodies
- Immunoglobulin G
- Porphyromonas gingivalis
- Aggregatibacter actinomycetemcomitans