Intraplaque hemorrhage, a potential consequence of periodontal bacteria gathering in human carotid atherothrombosis

Authors

  • Adrian Brun Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Descartes University – Sorbonne Paris Cité University; Department of Periodontology, Service of Odontology, Bretonneau Hospital, APHP;
  • Hélène Rangé Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Periodontology, Service of Odontology, Rothschild Hospital, APHP;
  • Bastien Prouvost Department of Periodontology, Service of Odontology, Rothschild Hospital, APHP;
  • Olivier Meilhac Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University;
  • Mikael Mazighi Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Neurology, Lariboisiere Hospital, APHP;
  • Pierre Amarenco Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Neurology and Stroke Centre, Bichat Hospital, APHP;
  • Guy Lesèche Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Vascular Surgery, Bichat Hospital, APHP;
  • Philippe Bouchard Paris Diderot University – Sorbonne Paris Cité University; Department of Periodontology, Service of Odontology, Rothschild Hospital, APHP; Orofacial Diseases, Imaging and Regeneration, EA2496, Paris Descartes University;
  • Jean-Baptiste Michel Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University;

Keywords:

Periodontal disease, periodontitis, keystone periodontal pathogens, carotid atherothrombosis, athrosclerosis, intraplaque hemorrhage

Abstract

Periodontal diseases are multifactorial inflammatory diseases, caused by a bacterial biofilm involving both innate and adaptative immunity, characterized by the destruction of tooth-supporting tissues. In the context of periodontitis, the spread of weak pathogenic bacteria into the bloodstream has been described. These bacteria will preferentially localize to existing clot within the circulation. Atherothrombosis of the carotid arteries is a local pathology and a common cause of cerebral infarction. Intraplaque hemorrhages render the lesion more prone to clinical complications such as stroke. The main objective of this study is to explore the biological relationship between carotid intraplaque hemorrhage and periodontal diseases.

This study included consecutive patients with symptomatic or asymptomatic carotid stenosis, admitted for endarterectomy surgical procedure (n=41). In conditioned media of the carotid samples collected, markers of neutrophil activation (myeloperoxidase or MPO, DNA-MPO complexes) and hemoglobin were quantified. To investigate the presence of DNA from periodontal bacteria in atherosclerotic plaque, PCR analysis using specific primers was performed.

Our preliminary results indicate an association between neutrophil activation and intraplaque hemorrhages, reflected by the release of MPO (p<0,01) and MPO-DNA complexes (p<0,05). Presence of DNA from periodontitis-associated bacteria was found in 32/41 (78%) atheromatous plaque samples. More specifically, DNA from Pg, Tf, Pi, Aa was found in 46%, 24%, 34% and 68% of the samples, respectively. Hemoglobin levels were higher in conditioned media in carotid samples where the bacteria were found, but this was not statistically significant.

Our data confirm the relationship between intraplaque hemorrhage and neutrophil activation. In addition, the presence of periodontal bacteria DNA in carotid atheromatous plaque, may contribute to this activation. Further analysis is needed to fully explore the raw data and specimens.

Author Biographies

Adrian Brun, Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Descartes University – Sorbonne Paris Cité University; Department of Periodontology, Service of Odontology, Bretonneau Hospital, APHP;

DDS

Hélène Rangé, Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Periodontology, Service of Odontology, Rothschild Hospital, APHP;

DDS

Bastien Prouvost, Department of Periodontology, Service of Odontology, Rothschild Hospital, APHP;

DDS

Olivier Meilhac, Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University;

PhD

Mikael Mazighi, Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Neurology, Lariboisiere Hospital, APHP;

MD, PhD

Pierre Amarenco, Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Neurology and Stroke Centre, Bichat Hospital, APHP;

MD, PhD

Guy Lesèche, Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University; Department of Vascular Surgery, Bichat Hospital, APHP;

MD, PhD

Philippe Bouchard, Paris Diderot University – Sorbonne Paris Cité University; Department of Periodontology, Service of Odontology, Rothschild Hospital, APHP; Orofacial Diseases, Imaging and Regeneration, EA2496, Paris Descartes University;

DDS, PhD

Jean-Baptiste Michel, Laboratory for Vascular Translational Science, Inserm UMR_S1148; Paris Diderot University – Sorbonne Paris Cité University;

MD, PhD

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Published

2016-06-28

Issue

Vol. 53 No. 1 (2016)

Section

Articles

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I hereby certify that the authors of the above manuscript have all:

1. Conceived, planned, and performed the work leading to the report, or interpreted the evidence presented, or both;

2. Written the report or reviewed successive versions and shared in their revisions; and

3. Approved the final version.

Further, I certify that:

1. This work has not been published elsewhere and is not under revision in another journal;

2. Humane procedures have been followed in the treatment of experimental animals (if applicable);

3. Investigations in humans was done in accordance with the ethical standards of the responsible committee on human experimentation or with the Helsinki Declaration (if applicable).

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