Anti-Porphyromonas gingivalis Antibody Levels in Patients With Stroke and Atrial Fibrillation: A Systematic Review and Meta-Analysis

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Clinical and Experimental Dental Research Pub Date : 2024-11-13 DOI:10.1002/cre2.70041

Alessandro Cannavo, Nastaran Babajani, Behrad Saeedian, Elina Ghondaghsaz, Sandro Rengo, Amirmohammad Khalaji, Amir Hossein Behnoush

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Abstract

Objectives

Atrial fibrillation (AF) and stroke are two highly related conditions, with periodontitis and periodontal pathogens, such as Porphyromonas gingivalis (Pg), appearing to be the most prominent common risk factors. In this study, we evaluated studies assessing Pg infection via serum/plasma anti-Pg antibodies in patients with AF and/or stroke.

Material and Methods

Online databases (PubMed, Scopus, Embase, and the Web of Science) were screened for studies showing the association between anti-Pg antibodies with stroke and/or AF. Relevant data were extracted, and a subsequent random-effects meta-analysis was performed to calculate the pooled odds ratio (OR) or standardized mean difference (SMD) and 95% confidence intervals (CIs) for Pg seropositivity or anti-Pg antibody levels in stroke patients compared to controls.

Results

Sixteen studies were included in the systematic review. Based on the meta-analysis performed, there was no significant difference in Pg IgA and IgG levels between patients with stroke and controls (IgA: SMD 0.11, 95% CI −0.02 to 0.25, p = 0.1; IgG: SMD −0.12, 95% CI −1.24 to 0.99, p = 0.83). Similarly, no difference was observed between these groups in terms of Pg IgA and IgG seropositivity (IgA: OR 1.63, 95% CI 1.06–2.50, p = 0.026; IgG: OR 2.30, 95% CI 1.39–3.78, p < 0.001). Subsequently, we reviewed the results of six articles investigating serum or plasma IgG antibodies against Pg in patients with AF. Our results revealed a strict association between Pg infection and AF, with AF patients exhibiting either higher anti-Pg antibody levels or a higher prevalence of positive serum Pg antibodies.

Conclusions

Our study supports the clinical utility of Pg infection assessment in patients with periodontitis and those with AF and solicits more focused studies to corroborate its use in clinical settings to enhance overall outcomes, reduce the risk of complications like stroke, and help fine-tune personalized therapies.

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中风和心房颤动患者的抗牙龈卟啉菌抗体水平：系统回顾与元分析》。

目的：心房颤动（AF）和中风是两种高度相关的疾病，牙周炎和牙周病原体（如牙龈卟啉单胞菌（Pg））似乎是最主要的常见风险因素。在本研究中，我们评估了通过心房颤动和/或中风患者血清/血浆抗 Pg 抗体评估 Pg 感染的研究：筛选在线数据库（PubMed、Scopus、Embase 和 Web of Science）中显示抗 Pg 抗体与中风和/或房颤相关的研究。提取了相关数据，随后进行了随机效应荟萃分析，计算了与对照组相比，中风患者Pg血清阳性或抗Pg抗体水平的合计几率比（OR）或标准化平均差（SMD）及95%置信区间（CIs）：系统综述共纳入 16 项研究。根据所进行的荟萃分析，脑卒中患者与对照组之间的 Pg IgA 和 IgG 水平无显著差异（IgA：SMD 0.11，95% CI -0.02~0.25，p = 0.1；IgG：SMD -0.12，95% CI -1.24~0.99，p = 0.83）。同样，在 Pg IgA 和 IgG 血清阳性率方面，这两组之间也未观察到差异（IgA：OR 1.63，95% CI 1.06-2.50，p = 0.026；IgG：OR 2.30，95% CI 1.39-3.78，p 结论：我们的研究支持 Pg IgA 和 IgG 血清阳性率的临床应用：我们的研究支持对牙周炎患者和房颤患者进行 Pg 感染评估的临床实用性，并要求进行更多的重点研究，以证实其在临床环境中的应用，从而提高总体疗效，降低中风等并发症的风险，并帮助微调个性化疗法。

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来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.