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Vienna, Austria – 20 April 2018: Good oral hygiene may help recovery after acute cardiovascular events such as heart attacks and aortic dissection, according to research presented today at Frontiers in CardioVascular Biology (FCVB) 2018, a European Society of Cardiology congress.(1) The study in mice found that the bacteria that cause gum disease (periodontitis) also impair the healing of blood vessels.
Research on the prevention of cardiovascular disease, which remains the top killer worldwide despite improved treatments, has focused on conventional risk factors including hypertension, diabetes, and high cholesterol. The importance of oral health, which is often poor in people with other cardiovascular risk factors, has been neglected.
There is increasing evidence that gum disease increases the risk of cardiovascular disease and leads to worse outcomes in patients with atherosclerosis (clogged arteries).
Dr Sandrine Delbosc, author of the current study and associate investigator, Inserm Laboratory for Vascular Translational Science, Paris, France, said: “Our previous research in rats found periodontal bacteria in severely atherosclerotic arteries, suggesting that these bacteria may be the link between gum disease and cardiovascular disease.” (2)
The researchers hypothesised that periodontal bacteria enter the bloodstream through bleeding gums, a common symptom of gum disease. The bacteria then adhere to atherosclerotic lesions, which contain bacterial “food” such as protein, and impede healing of the lesions.
This hypothesis was tested in the current study using a mouse model of atherosclerosis complicated by aortic aneurysm. To mimic the repeated entry of periodontal bacteria into the blood that occurs in gum disease, the researchers injected Porphyromonas gingivalis, the main periodontal bacterium, into the bloodstream once a week for four weeks. A control group of mice was injected with saline solution.
The researchers found that a significantly higher proportion of the mice injected with bacteria died (23 out of 34; 68%) compared to the control mice (eight out of 23; 35%) (p<0.05). Death was caused by impaired aortic healing and a resulting rupture of the aorta. Mice injected with bacteria had Porphyromonas gingivalis at the site of aortic rupture.
A subsequent analysis in mouse cells showed that gingipaïn, an enzyme produced by Porphyromonas gingivalis, inhibits the repair function of immune cells.
Dr Delbosc said: “Our study shows that the bacteria that cause gum disease impair the healing and repair of arteries. This impaired healing may be due to an enzyme produced by the bacteria that stops the body’s immune cells from repairing the arteries.”
She continued: “Periodontitis can be prevented with flossing and brushing. Our study suggests that good oral health could significantly improve the outcome of patients who have an acute cardiovascular event.”
Dr Delbosc noted that the findings of the study need to be confirmed in patients. Her research group is designing a study to examine whether using non-surgical (scaling, root planing) and if necessary surgical periodontal treatments to stop the entry of periodontal bacteria into the bloodstream of patients with cardiovascular disease improves outcomes. The study will be conducted as part of the RHU iVASC (Innovations in Atherothrombosis Science; http://www.ivasc.eu) project funded by the French Government.
She concluded: “We hope that our experimental and clinical studies will promote the development of new recommendations for oral health care in patients with cardiovascular diseases.”
Authors: ESC Press Office
Tel: +33 (0)4 89 87 24 83
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SOURCES OF FUNDING: The study was sponsored by the RHU iVASC (Innovations in Atherothrombosis Science) [ANR/RHUS15/2016-260/iVASC] and the VIA (Vaccination in Atherosclerosis) consortium [FP7-HEALTH-2013-INNOVATION].
References and notes
(1) The abstract ‘Porphyromonas gingivalis bacteremia impairs arterial healing process in an experimental model of dissecting aneurysm’ will be presented during the Poster session: Basic Science – Vascular Biology and Physiology which takes place on 20 April from 08:30 to 16:30 CEST in the Poster Area.
(2) Delbosc S, Alsac JM, Journe C, et al. Porphyromonas gingivalis Participates in Pathogenesis of Human Abdominal Aortic Aneurysm by Neutrophil Activation. Proof of Concept in Rats. PLoS ONE. 2011;6(4):e18679. doi:10.1371/journal.pone.0018679
About Frontiers in CardioVascular Biology
Frontiers in CardioVascular Biology (FCVB) is a comprehensive basic science conference organised every two years by the ESC Council on Basic Cardiovascular Science, whose mission is to enhance the importance of basic science to clinical cardiology. FCVB is organised in collaboration with 12 European cardiovascular science societies.
About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
Information for journalists attending FCVB 2018
FCVB 2018 will be held from 20 to 22 April at the Austria Centre Vienna in Vienna, Austria. The full scientific programme is available here
Our mission: To reduce the burden of cardiovascular disease.
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