Untersuchung zum Zusammenhang zwischen parodontaler Gesundheit sowie Anzahl der Restbezahnung und LBP (big42), CD14 und CD68 am humanen Ventrikelmyokard

Examination of coherence between the severity of both periodontal disease as well as the amount of missing teeth and the expression of different markers of inflammation, such as CD68, CD14 and LBP (big2) in human myocardial tissue

by Aline Duchatsch
Doctoral thesis
Date of Examination:2017-04-24
Date of issue:2017-02-24
Advisor:PD Dr. Dirk Ziebolz
Referee:Prof. Dr. Sabine Mihm
Referee:Prof. Dr. Rainer Mausberg
Persistent Address: http://dx.doi.org/10.53846/goediss-6150

 

 

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Abstract

English

The aim of this study was to detect coherence between the severity of both periodontal disease as well as the amount of missing teeth and the expression of different markers of inflammation, such as CD68, CD14 and LBP (big2) in human myocardial tissue. The study included 64 patients (f = 21, m = 43) at the age of 70 ±9 years, who suffered from valvular aortic stenosis, which gave the indication for aortic valve replacement, in some cases also for aortocoronary bypass. All patients underwent a dental examination, one day before surgery. Beforehand they were informed about the study and after written informed consent, their anamnestic history was recorded. One hour before the dental examination an endocarditis prophylaxis was given. The dental examination included DMF-T index and periodontal status, which should represent the periodontal health status by determining periodontal probing depth and clinical attachment loss. According to the severity of periodontitis all patients were divided into the groups PAR1 to 3 (PAR1: no/mild/moderate periodontitis; PAR2: severe periodontitis; PAR3: edentulous patients). Another classification was made due to the number of teeth missing and the M-T index (MT1: M-T = 0-7; MT2: M-T = 8-18; MT3: M-T = 19-28). During aortic valve replacement myocardial biopsy was taken. It was prepared for histology (H.E. staining) and immunohistochemistry analysis (LBP (big2), CD68, CD14). All samples were evaluated by a score from 0 - 3. According to immune-histochemistry of CD68 and CD14, all positive stained cells per field of vision on the microscope were counted. The scoring and enumeration of cells were related to the groups of PAR and MT and underwent statistical examination by Chi-Quadrat test and H-Test (Kruskal Wallis). The level of significance was defined ≤ 0,05. The study could include 43 male and 21 female patients. 36 suffered from severe periodontitis and 5 were edentulous. Smoking and BMI were not significantly distributed. The evaluation of histologic and immunohistochemical scores regarding MT1 - 3 was in no case below the level of significance, which shows that the grade of myocardial inflammation is not associated with the number of missing teeth. According to PAR1 - 3 the results for CD14 and LBP (big42) showed significance. CD14 and LBP (big42) can be detected more often in the myocardial tissue on patients who suffer from periodontitis. This fact leads to the conclusion that the presence of periodontitis is directly correlated to an inflammation of myocardial tissue and may be connected to the genesis of cardiac insufficiency. The results of the present study show, that lower grades of periodontitis are coherent to lower scores of the analyzed parameters in myocardial tissue. However, only the severity of periodontitis had an influence on higher scores, not the number of missing teeth. These results confirm the importance of cooperation of cardiologists and dentists regarding the prevention of cardiovascular diseases, especially heart insufficiency.
Keywords: Periodontitis; Heart disease
Schlagwörter: Parodontitis; Herzinsuffizienz
 
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