Periodontal inflammation is associated with increased circulating levels of endothelial progenitor cells: a retrospective cohort study in a high vascular risk population

María Vázquez-Reza; Antía Custodia; Iria López-Dequidt; Marta Aramburu-Núñez; Daniel Romaus-Sanjurjo; Alberto Ouro; João Botelho; Vanessa Machado; Ramón Iglesias-Rey; Juan Manuel Pías-Peleteiro; Rogelio Leira; Juan Blanco; José Castillo; Tomás Sobrino; Yago Leira

doi:10.1177/20406223231178276

Periodontal inflammation is associated with increased circulating levels of endothelial progenitor cells: a retrospective cohort study in a high vascular risk population

Ther Adv Chronic Dis. 2023 Jun 13:14:20406223231178276. doi: 10.1177/20406223231178276. eCollection 2023.

Authors

María Vázquez-Reza¹, Antía Custodia², Iria López-Dequidt³, Marta Aramburu-Núñez², Daniel Romaus-Sanjurjo², Alberto Ouro², João Botelho⁴, Vanessa Machado⁴, Ramón Iglesias-Rey⁵, Juan Manuel Pías-Peleteiro², Rogelio Leira³, Juan Blanco¹, José Castillo⁵, Tomás Sobrino⁶, Yago Leira^{6

1}

Affiliations

¹ Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.
² NeuroAging Laboratory (NEURAL) Group, Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain.
³ Neurology Department, University Clinical Hospital, Santiago de Compostela, Spain.
⁴ Periodontology Department and Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal.
⁵ Neuroimaging and Biotechnology Laboratory (NOBEL) Group, Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Santiago de Compostela, Spain.
⁶ NeuroAging Laboratory (NEURAL) Group, Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital, Travesía da Choupana S/N, 15706 Santiago de Compostela, Spain.

Abstract

Background: One of the main biological mechanisms behind the link between periodontitis and atherosclerotic vascular diseases is vascular endothelial dysfunction. Particularly, circulating endothelial progenitor cells (EPCs) have been considered a biomarker of altered vascular endothelial function.

Objectives: The aim of this study was to investigate relationship between periodontal inflammation and increased number of circulating EPCs.

Design: This is retrospective cohort study.

Methods: In this study, 85 elderly patients with a previous history of hypertension were followed up to 12 months. A baseline full-mouth periodontal assessment was carried out, and the amount of periodontal tissue inflamed per subject was calculated as a proxy of periodontal inflammation [periodontal inflamed surface area (PISA)]. The number of circulating EPCs (CD34⁺/CD133⁺/KDR⁺) was determined by flow cytometry from peripheral blood samples collected at baseline and 12 months.

Results: Mean concentrations of CD34⁺/CD133⁺/KDR⁺ progenitor cells were higher in periodontitis patients than in those without periodontitis at baseline [55.4, 95% confidence interval (CI) = 20.8 to 90.0 versus 27.2, 95% CI = 13.6 to 40.8, p = 0.008] and 12 months (114.6, 95% CI = 53.5 to 175.7 versus 19.1, 95% CI = 10.8 to 27.4, p = 0.003). A significant increase over the follow-up was noticed in the group of subjects with periodontitis (p = 0.049) but not in the nonperiodontitis group (p = 0.819). PISA was independently associated with CD34⁺/CD133⁺/KDR⁺ EPCs at baseline (B coefficient = 0.031, 95% CI = 0.005 to 0.058; p = 0.021). The relationship between PISA and CD34⁺/CD133⁺/KDR⁺ EPCs at 12 months was confounded by increased baseline body mass index (B coefficient = 0.064, 95% CI = -0.005 to 0.132; p = 0.066).

Conclusion: Periodontal inflammation is associated with high number of CD34⁺/CD133⁺/KDR⁺ EPCs, thus supporting a potential link between periodontitis and endothelial dysfunction.

Keywords: biomarker; endothelial function; endothelial progenitor cells; inflammation; periodontitis.