Impact of periodontitis on circulating cell-free DNA levels as a measure of cardiovascular disease

Gaetano Isola; Alessandro Polizzi; Marco Mascitti; Simona Santonocito; Vincenzo Ronsivalle; Marco Cicciù; Paolo Pesce

doi:10.1007/s00784-023-05300-y

Impact of periodontitis on circulating cell-free DNA levels as a measure of cardiovascular disease

Clin Oral Investig. 2023 Nov;27(11):6855-6863. doi: 10.1007/s00784-023-05300-y. Epub 2023 Oct 10.

Authors

Gaetano Isola¹, Alessandro Polizzi², Marco Mascitti³, Simona Santonocito², Vincenzo Ronsivalle², Marco Cicciù², Paolo Pesce⁴

Affiliations

¹ Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Via S. Sofia 78, 95123, Catania, Italy. gaetano.isola@unict.it.
² Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
³ Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy.
⁴ Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.

Abstract

Objectives: The present study aims to assess the serum circulating cell-free (cfDNA) concentrations in patients with periodontitis and cardiovascular disease (CVD) and to evaluate the impact of periodontitis on circulating cfDNA levels and the confounding factors that might mediated the possible relationship.

Materials and methods: Healthy controls (n=30) and patients with CVD (n=31), periodontitis (n=31), and periodontitis + CVD (n=30) were enrolled in the present study. All subjects underwent regular periodontal examination and blood sampling and cfDNA evaluation. The analysis of the plasma cfDNA concentrations was performed using a dsDNA Assay Kit.

Results: In comparison with healthy controls and CVD patients, periodontitis and periodontitis+CVD exhibited significantly higher expression of circulating cfDNA (p<0.05). There was a positive correlation among plasma cfDNA and clinical attachment loss (CAL) (p=0.019), high sensitivity C-reactive protein (hs-CRP) (p=0.027), and periodontal inflamed surface area (PISA) (p=0.003). Furthermore, the multivariate regression analysis evidenced that PISA (p<0.001), hs-CRP (p=0.014), and full-mouth bleeding score (FMBS) (p=0.004) were significant predictors of circulating cfDNA concentrations.

Conclusions: The results of the study highlighted that the periodontitis and periodontitis + CVD group showed higher circulating cfDNA expression in comparison with healthy controls and CVD patients. Moreover, the extent of periodontitis was correlated with the increased cfDNA levels and represented a significant predictor of the increased circulating cfDNA concentrations.

Clinical relevance: Unbalanced circulating cfDNA concentrations have been indicated to represent a possible risk of CVD and endothelial dysfunction. Periodontitis and periodontitis + CVD patients showed higher circulating cfDNA expression; moreover, the extent of periodontitis significantly predicted higher circulating cfDNA concentrations, suggesting the potential increased risk of developing CVD in periodontitis patients.

Keywords: C-reactive protein; Cardiovascular disease; Circulating cfDNA; Clinical trial; Periodontal inflamed surface area; Periodontics; Periodontitis.

MeSH terms

C-Reactive Protein / analysis
Cardiovascular Diseases*
Cell-Free Nucleic Acids*
Humans
Multivariate Analysis
Periodontitis* / complications

Substances

C-Reactive Protein
Cell-Free Nucleic Acids