Oral infections mainly affect oral health, but can also affect people's general health in several ways. This book gives an overview of the scientific evidence for linkages between oral infections and ...other systemic diseases. Much research has been carried out to find the most plausible reasons for associations and possible causal mechanisms in this regard. The last 20-30 years have opened up the field of the infection hypothesis in cardiovascular disease that was first introduced in the nineteenth century. The book also provides a short overview of oral infections and symptoms due to systemic diseases.
This study explores the risk for cancer by level of antibodies to the anaerobe oral bacteria of periodontitis Tannerella forsythia (TF), Porphyromonas gingivalis (PG), and Treponema denticola (TD) ...all three collectively termed the red complex, and the facultative anaerobe bacterium Aggregatibacter actinomycetemcomitans (AA). The prospective cohort, the Oslo II-study from 2000, the second screening of the Oslo study of 1972/73, has been followed for 17 ½ years with regard to cancer incidence and mortality. A random sample of 697 elderly men comprised the study cohort. The antibody results measured by enzyme linked immunosorbent assay (ELISA) were used in the Cox proportional hazards analyses, and quartile risk on cancer incidence in a 17 ½ years follow-up. Among the 621 participants with no prior cancer diagnoses, 221 men developed cancer. The incidence trend was inverse, and the results are shown as 1.sup.st quartile of highest value and 4.sup.th as lowest of antibody levels. The results of the Cox proportional regression analyses showed that TF inversely predicts bladder cancer (n = 22) by Hazard Ratio (HR) = 1.71 (95% CI: 1.12, 2.61). TD inversely predicts colon cancer (n = 26) by HR = 1.52 (95% CI: 1.06, 2.19) and bladder cancer (n = 22) by HR = 1.60 (95% CI: 1.05, 2.43). Antibodies to two oral bacteria, TF and TD, showed an inverse risk relationship with incidence of specific cancers: TF bladder cancer, TD bladder and colon cancer. Lowered immunological response to the oral infection, periodontitis, is shown to be a risk factor in terms of cancer aetiology.
This review explores the results of research on oral health concerning cardiovascular diseases and some forms of cancer and is based on results from published systematic reviews and some studies. The ...research results will have a strong focus on exploring the relationship between different aspects of oral infections. The relationship between oral health parameters, cardiovascular diseases (CVD), and certain cancers was examined from different angles, including prospective analyses, in a population-based health study in Oslo from the year 2000 (Oslo II study). A major finding was that low levels of antibodies to the oral anaerobe
predict both CVD mortality in men with a history of myocardial infarction and incidence of bladder cancer in a random sample of men in the study. Low levels of antibodies to
predict the incidence of bladder and colon cancer in a random sample of men in the study. Both anaerobe bacteria are part of the so-called red complex of bacteria in chronic periodontitis together with
. These three bacteria have different properties and are causal in chronic periodontitis. They migrate into the local tissues by adhering to the oral epithelium, break down soft and hard tissues, and spread via the circulation to organs distant from the mouth. This paper will give an overview of which oral health measures have been explored and associated with different CVD and cancer diagnoses and what scientific literature supports or contravenes our hypothesis. The oral microbiome is described with the most relevant bacteria related to microbiology, serum, autopsies, and associated causes such as alcohol. There will be a mention of the possibilities and limitations of different study designs. There seems to be a causal relationship between oral anaerobe bacteria and systemic diseases regulated by the immune system. This is seen alongside other well-known risk factors, especially for CVD. The prospective finding of a relation to the incidence of certain cancers and CVD is particularly intriguing. However, further research is needed to determine the biological mechanisms underpinning these associations.
This book provides a comprehensive overview of current knowledge about research in oral infections and their association with cardiovascular diseases. Several epidemiological, clinical and other ...scientific aspects are covered in this book through the work of medical experts. The detailed accounts in this book are of great value to readers in the scientific community, practitioners, teachers and students in relevant fields, and health-care planners.
Abstract
Background
Little is known about the association between bacterial DNA in human blood and the risk of cardiovascular disease (CVD) mortality.
Methods
A case-cohort study was performed based ...on a 9 ½ year follow-up of the Oslo II study from 2000. Eligible for this analysis were men born in 1923 and from 1926 to 1932. The cases were men (n = 227) who had died from CVD, and the controls were randomly selected participants from the same cohort (n = 178). Analysis of the bacterial microbiome was performed on stored frozen blood samples for both cases and controls. Association analyses for CVD mortality were performed by Cox proportional hazard regression adapted to the case-cohort design. We used the Bonferroni correction due to the many bacterial genera that were identified.
Results
Bacterial DNA was identified in 372 (82%) of the blood samples and included 78 bacterial genera from six phyla. Three genera were significantly associated with CVD mortality. The genera
Kocuria
(adjusted hazard ratio (HR) 8.50, 95% confidence interval (CI) (4.05, 17.84)) and
Enhydrobacter
(HR 3.30 (2.01, 5.57)) indicate an association with CVD mortality with increasing levels. The genera
Paracoccus
(HR 0.29 (0.15, 0.57)) was inversely related. Significant predictors of CVD mortality were: the feeling of bad health; and the consumption of more than three cups of coffee per day. The following registered factors were borderline significant, namely: a history of heart failure; increased systolic blood pressure; and currently taking antihypertensive drugs now, versus previously.
Conclusions
The increasing levels of two bacterial genera
Kocuria
(skin and oral) and
Enhydrobacter
(skin) and low levels of
Paracoccus
(soil) were associated with CVD mortality independent of known risk factors for CVD.
ObjectivesTo make a descriptive comparison of antibodies to four major periodontal bacteria and their relation to the respiratory diseases asthma and bronchitis/emphysema, and to cancer ...incidence.MethodsThe serum of a random sample of men with no history of cancer incidence (n=621) was analysed by the ELISA method for antibody levels of four periodontal bacteria; the anaerobes of the so-called red complex Tannerella forsythia (TF), Porphyromonas gingivalis (PG), and Treponema denticola (TD), and the facultative anaerobe Aggregatibacter actinomycetemcomitans (AA). The antibody readings were divided into quartiles and the distribution of cases of the relevant diseases as compared with the non-cases. Comparisons of the quartile distributions were by the Pearson χ2 test. Data and serum from the Oslo II study of Norwegian men from 2000 were used. The ELISA analyses were performed on thawed frozen serum. Cancer data from 17.5 years of follow-up were provided by the Norwegian Cancer Registry.ResultsIn all, 52 men had reported asthma and 23 men had bronchitis/emphysema at the health screening. Results on cancer incidence are given for all respiratory cancers, n=23, and bronchi and lung cancers separately, n=18. Stratified analyses were performed for the four endpoints showing significant association with low levels of TD antibodies for bronchitis; p=0.035. Both TF and TD were significant for low levels of antibodies among daily smokers; p=0.030 for TF and p<0.001 for TD in the analysis of the full study sample. For PG and AA, no such associations were observed. An association with respiratory cancers was not observed.ConclusionA low level of TD was associated with bronchitis/emphysema compared with the rest of the cohort. In the total study sample, low levels of antibodies to both TF and TD were associated with daily smoking.
Norway introduced 32 priority guidelines for elective health treatment in the specialist health service in the period 2008-9. The guidelines were intended to reduce large differences in waiting times ...among hospitals, streamline referrals and ensure that patients accessed the necessary healthcare to which they were entitled for certain conditions. Referral information guided the priorities. As the referral information was key to future evaluation of the guidelines, this study validates the referral information in hospital patient records against discharge diagnoses, because only the discharge diagnosis is recorded in the Norwegian Patient Register (NPR) database, which is used in the main evaluation.
Of the specific conditions from 10 priority guidelines, 20 were selected for review for the period 2008-9 at 4 hospitals in Norway. The ICD-10 diagnoses per disease or condition were given in retrospect by clinicians who participated in the expert groups developing the priority guidelines. Reasons for deviations between referral information and discharge diagnoses were coded into four categories, according to the degree of precision of the former compared with the latter.
In all, 1854 medical records were available for review. The diagnostic precision of the referrals differed significantly between hospitals, and across the 2 years 2008 and 2009. The overall sensitivity was 0.93 (95% confidence interval 0.92-0.94). For the separate conditions, sensitivity was in the range 0.60-1.00. Experience showed that it was necessary to pay careful attention to the selection of ICD-10 diagnoses for identifying patients. The medical records of psychiatry patients were unavailable in some cases and for certain conditions some were unavailable after use of our record extraction algorithm.
The sensitivity of the referral information on diagnosis or condition was high compared with the discharge diagnosis for the 20 selected conditions from the 10 priority guidelines. Although the review assessed a limited number of the total, we consider the results sufficiently representative and, hence, they will allow use of the NPR data for analyses of the introduction and follow-up of the 32 priority guidelines.
It is well known that the prevalence of asthma has been reported to increase in many places around the world during the last decades. Therefore, the aim of this study was to identify and review ...studies of asthma prevalence among children in China and address time trends and regional variation in asthma.
A systematic literature search was performed using PubMed and China National Knowledge Infrastructure (CNKI) databases. Selected articles had to describe an original study that showed the prevalence of asthma among children aged 0-14 years.
A total of 74 articles met the inclusion criteria. The lifetime prevalence of asthma varied between 1.1% in Lhasa (Tibet) and 11.0% in Hong Kong in studies following the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. The prevalence was 3% or lower in most articles following Chinese diagnostic criteria. One article reported the results from two national surveys and showed that the current average prevalence of asthma for the total study population had increased from 1990 to 2000 (0.9% to 1.5%). The lowest current prevalence was found in Lhasa (0.1% in 1990, 0.5% in 2000).
The prevalence of childhood asthma was generally low, both in studies following the ISAAC and Chinese diagnostic criteria. Assessment of time trends and regional variations in asthma prevalence was difficult due to insufficient data, variation in diagnostic criteria, difference in data collection methods, and uncertainty in prevalence measures. However, the findings from one large study of children from 27 different cities support an increase in current prevalence of childhood asthma from 1990 to 2000. The lowest current prevalence of childhood asthma was found in Tibet.
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