PERİODONTAL DISEASE AND CARDIOVASCULAR DISEASES

Yıl 2021, Cilt: 8 Sayı: 1, 229 - 237, 30.04.2021

Siddika Selva Süme Keşir , Meltem Karşıyaka Hendek , Ebru Olgun

https://doi.org/10.15311/selcukdentj.439697

Öz

Inflammation
plays a role in the pathogenesis of periodontal and cardiovascular diseases.
Recent studies have indicated that periodontal disease may have an impact on
the development and progression of cardiovascular disease. Oral pathogens detected
in atheromatous lesions strengthen the possible link between the two diseases. Systemic
circulatory infiltration of periodontal pathogens through inflamed and
ulcerated gingival epithelium is considered to be a possible mechanism. Oral
pathogens affecting vascular tissues as a result of bacterial infiltration are
thought to progress in the systemic circulation and initiate destructive
reactions to the cardiovascular structures. Additionally, ulcerated gingival
epithelium is a source of proinflammatory cytokines/chemokines that may cause
the synthesis of acute phase
proteins. Chronic bacteriemia is able to stimulate the acquired immune
response.  Antibodies produced in
response to periodontal pathogens can stimulate cross-reaction between
endothelial cells and modified lipids. These reactions are believed to increase
the lipid concentration within the vessel wall. Moreover, it is discussed that
some antibodies and inflammatory cytokines increase the activation of
macrophages in the atheroma by stimulating T Helper-1 response. It is believed
that all these mechanisms contribute to the initiation and progression of
atherogenesis. These review focuses on the possible mechanisms between
periodontal disease and cardiovascular disease.

Anahtar Kelimeler

Periodontal disease, cardiovascular diseases, systemic inflammation, oral pathogens

PERİODONTAL HASTALIK VE KARDİYOVASKÜLER HASTALIKLAR

Öz

Periodontal ve kardiyovasküler hastalıklar patogenezinde
enflamasyonun rol oynadığı durumlardır. Yakın dönemde yapılan çalışmalar,
periodontal hastalığın kardiyovasküler hastalık oluşumu ve ilerlemesi üzerine
etkili olabileceğini ortaya koymuştur. Aterom lezyonlarında tespit edilen oral
patojenler iki hastalık arasındaki olası ilişkiyi kuvvetlendirmektedir. İltihaplı
ve ülsere dişeti epiteli yolu ile periodontal patojenlerin sistemik dolaşıma
infiltrasyonu olası mekanizma olarak kabul edilmektedir. Bakteriyel
infiltrasyon sonucunda vasküler dokuları etkileyen oral patojenlerin, sistemik
dolaşımda ilerleyerek kardiyovasküler sistem için zararlı reaksiyonları
başlattıkları düşünülmektedir. Ayrıca, ülsere dişetinden proenflamatuvar
sitokin/kemokin sızıntısı akut faz proteinlerinin sentezine neden
olabilir. Kronik bakteriyemi kazanılmış bağışıklık cevabını uyarabilmektedir.
Periodontal patojenlere cevap olarak üretilen antikorlar endotel hücreleri ve
modifiye lipidler arasındaki çapraz reaksiyonları uyarabilmektedir. Bu
reaksiyonların damar duvarında lipid yoğunluğunu arttırabileceği
düşünülmektedir. Bunlara ek olarak,  bazı
antikorların ve enflamatuvar sitokinlerin T Yardımcı Hücre-1 cevabını uyararak
aterom içindeki makrofajların aktivasyonunu arttırdıkları savunulmaktadır. Tüm bu
mekanizmaların aterogenezin başlamasına ve ilerlemesine katkıda bulunduğu
düşünülmektedir. Bu derleme, periodontal hastalık ve kardiyovasküler hastalık arasındaki
ilişkide olası mekanizmalara değinmektedir. 

Anahtar Kelimeler

Periodontal hastalık, kardiyovasküler hastalıklar, sistemik enflamasyon, oral patojenler

Kaynakça

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