Understanding the Correlation Between Periodontal Disease and Other Inflammatory Comorbidities

Previous research has revealed that periodontitis (PD) is epidemiologically correlated with numerous other chronic inflammatory conditions, including cancer, autoimmune diseases, neurodegenerative disorders, and cardio-metabolic diseases.

According to a publication in the journal Nature Reviews Immunology, authors indicated that augmenting knowledge about the multifaceted correlations between periodontal disease (PD) and the manifestation and/or exacerbation of chronic inflammatory co-morbidities such as cardiovascular disease, type 2 diabetes, inflammatory bowel disease, Alzheimer’s disease, and rheumatoid arthritis could open up avenues for the development of novel targeted therapeutic options that may prevent and/or diminish the risk of periodontitis-associated inflammatory comorbidities.

With regard to the objective of this review, the authors wrote, “The Review aims to substantiate that the mouth–body link is not simply a consequence of common risk factors but is driven, in substantial part, by multiple microorganism-induced immunological mechanisms that converge to increase the susceptibility of patients with periodontitis to non-communicable chronic inflammatory diseases.”

The review provided information regarding the relationship between periodontitis and systemic inflammation. It noted that a possible contributory factor to the correlations could be that PD is known to cause low-grade systemic inflammation and, as a result, may impact the manifestation and degree of inflammatory co-morbidities. For example, PD is correlated with higher serum levels of triglycerides, low-density lipoproteins (LDL), and decreased values of high-density lipoproteins (HDL), and among patients with the abnormalities mentioned above, those who receive treatment for PD, data reveals that values of LDL and triglycerides are reduced, and HDL values are increased.

The authors also indicated that a plethora of clinical studies provide ample evidence demonstrating that PD has a negative impact on systematic health and certain medical conditions and that locally treating PD can diminish the serum levels of numerous inflammatory markers for various inflammatory co-morbidities. The authors also revealed that there is a deficiency of clear clinical evidence that successful treatment of PD can decrease the risk or prevalence of the conditions mentioned above, and more research is warranted.

The authors concluded, “We clearly need unifying frameworks, in which peripheral inflammatory and infectious stimuli (such as those associated with periodontitis) and multiple systemic risk factors (such as obesity, dyslipidemia, glycemic level, and aging) can be productively integrated to better understand the interconnected pathogenesis of distinct chronic inflammatory diseases and/or malignant disorders.”

Lastly, the authors indicated that greater knowledge of the correlation between PD and PD-associated systemic inflammation could provide the foundation for developing novel therapies to decrease the risk of PD-associated inflammatory conditions; however, more studies are warranted.

Reference

Hajishengallis, G., Chavakis, T. Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nat Rev Immunol 21, 426–440 (2021). https://doi.org/10.1038/s41577-020-00488-6.