Prisustvo oralnih patogenih mikroorganizama u ateromu i trombu pacijenata sa aterosklerozom i infarktom miokarda

Periodontal pockets harbor more than 400 different bacterial species. The aims of this study were to establish new links between periodontitis and atherosclerosis by quantitative and qualitative assessment of periodontal pathogens Аggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythi (Tf) and Treponema denticola (Td) in patient’s mouth and blood vessel. Material and Methods: 100 patients with periodontitis and atherosclerosis were included in the study, divided into 6 groups according to the localization of atheromas and into 2 groups in relation to their age (below and over 60). 13 thrombi from patients with myocardial infarction were analyzed for the presence of oral bacteria and CMV. Pathogen presence and their total load were determined by PCR and real-time quantitative PCR, respectively, and statistically analyzed. Results: 91% of oral samples and 65% of samples of atherosclerotic plaques were positive for at least one of the tested microorganism. Decreasing frequencies of bacteria in oral vs. artery specimens were: Tf (76%:53%), Pi (71%:31%), Pg (60%:38%), Aa (39%:14%) and Td (21%:6%). and their ratio was as follows: Tf 1.4, Pg 1.6, Pi 2.3, Aa 2.8 and Td 3.5. Oral bacteria were the most frequent in coronary arteries. There was no statistical difference in the load of microorganisms between younger and older patients, but Pi and Aa were less frequent in older patients. CMV was more frequent in thrombi than in atheromas. Conclusion: Oral pathogens were found at high frequency in atheroma plaques and thrombi, with a slightly changed bacterial composition compared to oral biofilm. Patient’s age and the distance of a given blood vessel from the mouth influenced microbiological findings.Parodontalni džepovi sadrže više od 400 različitih bakterijskih vrsta i sa ovom studijom se želela ustanoviti nova veza između parodontopatije i ateroskleroze koristeći kvalitativno i kvantitativno određivanje prisustva parodontopatogena Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythi (Tf) i Trepondema denticola (Td) u usnoj duplji i krvnim sudovima pacijenata. Materijal i metode: U ispitivanje je bilo uključeno 100 pacijenata sa parodontopatijom i aterosklerozom, podeljenih u 6 grupa u skladu sa lokalizacijom ateroma i u 2 grupe u odnosu na starost pacijenata (ispod i iznad 60 godina). Analizirano je i 13 trombova od pacijenata sa infarktom miokarda na prisustvo oralnih bakterija i CMV. Detekcija patogena i ukupno opterećenje mikroorganizmima određeni su PCR-om (običnim, odnosno kvantitativnim) a dobijeni podaci su statistički obrađeni. Rezultati: Ispitani mikroorganizmi su bili visoko zastupljeni kako u gingivalnom tako i u aterosklerotskom plaku. Redosled opadajućih učestalosti bakterija u oralnim uzorcima nasuprot ateromima bio je: Tf (76%: 53%), Pi (71%: 31%), Pg (60%: 38%), Aa (39%: 14%) i Td (21%: 6%), a njihov odnos je bio sledeći: Tf 1,4, Pg 1,6, Pi 2,3, Aa 2,8 i Td 3,5. Oralni patogeni bili su najčešći u koronarnim arterijama. Nije bilo značajne razlike u ukupnom sadržaju mikroorganizama između mlađih i starijih pacijenata, ali Pi i Aa su bili češći kod mlađih pacijenata. CMV je bio češći u trombovima nego u ateromima. Zaključak: Oralni patogeni su bili učestali i u ateromima i u trombovima, sa blago izmenjenim sastavom bakterijske zajednice u odnosu na zajednicu u oralnom biofilmu. Mikrobiološki nalaz zavisio je od starosti pacijenta i udaljenosti krvnog suda od usne duplje