Serum Antibodies to Periodontal Pathogens and Markers of Systemic Inflammation

Objectives: We examined the relationship of serum antibodies against selected periodontal pathogens to plasma Fibrinogen and serum C-reactive protein (CRP) in a nationally representative sample.

Methods: Data on 5,752 participants' ≥40 years old from the third National Health and Nutrition Examination Survey (NHANES III, 1988-94) were used. Serum IgG antibody titers to 19 periodontal species were assessed by checkerboard immunoblotting. CRP was measured using a modified latex-enhanced CRP assay. Fibrinogen was measured by recording clotting time in comparison with that of a standardized fibrinogen preparation in an automated coagulation analyzer. Periodontitis was classified using three different definitions, based on combinations of pocket depth and attachment loss. Logistic regression models adjusting for demographic characteristics, diabetes, and presence of other inflammatory conditions were used.

Results: High fibrinogen (>400 mg/dl) was related to low antibody titers against Eubacterium nodatum (En), Actinomyces naeslundii (An), and Prevotella melaninogenica (Pm) for all three periodontitis definitions examined. Low Aggregatibacter actinomycetemcomitans titers were associated with high fibrinogen using two of the three disease definitions. In multivariable models accounting for demographic and other covariates, only low An titers were associated with high Fibrinogen. High CRP levels (>0.4 mg/dl) were related to elevated Porphyromonas gingivalis (Pg), and low En and Pm titers for all three disease definitions, whereas low An and Capnocytophaga ochracea titers were associated with high CRP using two of the three definitions. In multivariable models including demographic and other covariates, only low En titers were associated with high CRP.

Conclusions: Although our data corroborate earlier observations suggesting an association between high Pg titers and elevated serum CRP, adjusting for En titers eliminated the influence of Pg antibodies on CRP. These findings underscore the complex relationship between periodontal infections, antibody responses to established and putative periodontal pathogens, and systemic inflammation.

Supported by the American Heart Association (Grant-In-Aid #256205T).