Abstract 1346: Modulation of Chronic Inflammation in Periodontal Disease Positively Alters Inflammatory and Lipid Risk Factors of Coronary Artery Disease
Background: An increasing link continues to emerge between Periodontal Disease (PD) and Coronary Artery Disease (CAD). Central to this link appears to be chronic inflammation associated with PD, with demonstrated increased serum inflammatory biomarkers, cytokines and proteases. In this study, we examined whether modulation of the host inflammatory response in PD patients, using subantimicrobial dose doxycycline (SDD), would positively alter serum profiles of inflammatory mediators and biomarkers of CAD.
Methods: Postmenopausal (PM) women with chronic periodontitis, but without known CAD or stroke, were randomly assigned to twice daily SDD or placebo for two years. In 113 subjects who completed the trial (SDD=51, placebo=62), serum collected at time 0, 1 yr and 2 yr was analyzed for hs-CRP, IL-6, and MMP-9, as well as serum lipids (Total cholesterol, LDL, VLDL, HDL and Triglycerides).
Results: At two years, SDD significantly reduced median hs-CRP by 18% compared to placebo (ratio of median values: 0.82, 95% CI: 0.70 to 0.97; p=0.02). No significant difference was detected between groups for IL-6 or serum lipids, except for HDL. SDD was associated with an elevation in mean HDL (difference in means [mg/dl; SDD minus placebo]: 5.99; 95% CI: 1.17 to 10.81, p=0.01) in women > 5yr PM. SDD also significantly reduced mean serum MMP-9 (difference in mean scanning units [SDD minus placebo]: −28.44; 95% CI: −40.17 to −16.72, p<0.0001).
Conclusion: SDD significantly reduced serum inflammatory mediator and biomarker profiles over a two-year period in PM women, while raising HDL. Utilization of such a host immuno-modulatory strategy, with agents such as SDD, may offer a valuable additional therapeutic method to reduce the inflammatory burden in populations at risk for CAD.
Supported by NIDCR (NIH) grant R01DE012872.