Periodontal disease and its systemic associated diseases.

FERNÁNDEZ SOLARI JJ; BARRIONUEVO P; MASTRONARDI CA

MEDIATORS OF INFLAMMATION

HINDAWI PUBLISHING CORPORATION

Lugar: New York; Año: 2015

0962-9351

Inflammatory processes can underlie the etiology of several pathological conditions ranging from metabolic to infectious diseases. Periodontitis, a chronic oral infectious disease, appears to occur as a result of a dysregulated host immune response elicited by subgingival microorganisms occurring in the dental biofilm. Whereas the activity of periodontal pathogens is required, their presence is not sufficient to account for the initiation and progression of periodontal disease. Thus, the combination of the bacterial-elicited insults and the poorly regulated host immune response causes deleterious effects on dentition supporting structures including the periodontal ligament, alveolar bone, and gingival tissues. Furthermore, emerging evidence suggests that periodontal disease can impact on host susceptibility for acquiring other diseases. The relationship between periodontitis and other pathological conditions could be established by the immunogenic potential of host and/or bacterial products that reach the bloodstream and target distant organs and systems. For instance, lipopolysaccharide, a key component of the outer membrane of Gram-negative bacteria, stimulates host cells to produce a number of potent pro-inflammatory cytokines such as tumor necrosis factor alpha, interleukin-1, and interleukin-6. It also stimulates the production of other inflammatory mediators, such as prostaglandin E2 and nitric oxide. This inflammatory cascade promotes metalloproteinase matrix release from host tissues and causes deleterious effects in the extracellular matrix and alveolar bone. Thus, periodontitis could start as a local infection, but the triggering of a chronic inflammatory cascade could cause that oral bacteria, LPS, and/or several potent bacterial-induced proinflammatory molecules enters the bloodstream to increase the susceptibility of acquiring other infectious diseases and/or severe pathological conditions such as cardiovascular disease, cerebrovascular diseases, peripheral arterial disease, respiratory diseases, mental disorders (e.g. depression), diabetes, obesity, rheumatoid arthritis, osteoporosis and complications of pregnancy. Additionally, chronic environmental insults such as exposure to stress, cafeteria diet, smoking, alcoholism, and drugs of abuse could also predispose the host to acquire and/or exacerbate the deleterious effects of periodontal disease and other related conditions. Some of these insults may in turn exacerbate the severity and incidence of periodontal disease by increasing the susceptibility of an impaired host immune response to oral bacteria and their by-products. Indeed, emerging evidence supports the fact that a bi-directional relationship between periodontitis and systemic diseases exist. Since the understanding of the possible relationship between periodontitis and other systemic diseases still remains to be understood, we decided to edit this special issue on "Periodontal disease and its systemic associated diseases" to bring attention on the deleterious impact that this chronic condition could impose on the host. The contributions to this special issue reported on some pathogenic and diagnostic aspects of periodontal disease, and its putative systemic associated conditions.