Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
권호 표지

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

한국인에서 치주질환과 관상동맥질환의 관련성에 대한 염증표지자와 IL-1 유전자 다변성의 영향

  • Jeong, Ha-Na (Department of Periodontology, Chonnam National University) ;
  • Chung, Hyun-Ju (Department of Periodontology, Chonnam National University, Dental Science Research Institute, Chonnam National University) ;
  • Kim, Ok-Su (Department of Periodontology, Chonnam National University, Dental Science Research Institute, Chonnam National University) ;
  • Kim, Young-Joon (Department of Periodontology, Chonnam National University, Dental Science Research Institute, Chonnam National University) ;
  • Kim, Ju-Han (Department of cardiovascular Medicine, Chonnam National University) ;
  • Koh, Jung-Tae (Dental Science Research Institute, Chonnam National University)
  • 정하나 (전남대학교 치과대학 치주과학교실) ;
  • 정현주 (전남대학교 치과대학 치주과학교실, 전남대학교 치의학연구소) ;
  • 김옥수 (전남대학교 치과대학 치주과학교실, 전남대학교 치의학연구소) ;
  • 김영준 (전남대학교 치과대학 치주과학교실, 전남대학교 치의학연구소) ;
  • 김주한 (전남대학교 의과대학 순환기내과학교실) ;
  • 고정태 (전남대학교 치의학연구소)
  • Published : 2004.09.30
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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 ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). 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 $PGE_2$ 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 $PGE_2$. 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.

Keywords

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