Periodontitis and Endothelial Dysfunction: Periodontal Clinical Parameters and Levels of Salivary Markers Interleukin-1β, Tumor Necrosis Factor-α, Matrix Metalloproteinase-2, Tissue Inhibitor of Metalloproteinases-2 Complex, and Nitric Oxide

Abstract

Background: Periodontitis has been associated with a greater risk for atherosclerotic cardiovascular disease (ACD). Endothelial dysfunction (ED) is a parameter of early ACD, and its association with periodontitis has rarely been investigated to date. The objective of this study is to evaluate the association between periodontitis and ED by means of periodontal clinical parameters and salivary markers interleukin (IL)-1β, tumor necrosis factor (TNF)-α, nitric oxide (NO), and matrix metalloproteinase (MMP)-2 and tissue inhibitor of metalloproteinases (TIMP)-2 complex.

Methods: Forty-seven individuals were divided into two groups: 1) 24 individuals with chronic periodontitis (CP); and 2) 23 individuals without CP. Periodontal examinations of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were performed. ED was evaluated by means of flow-mediated dilatation (FMD) of the brachial artery. Salivary concentrations of IL-1β, TNF-α, and MMP-2/TIMP-2 complex were assessed using enzyme-linked immunosorbent assay. NO determination was based on the reaction of Griess.

Results: Individuals with CP presented higher occurrence of ED than individuals without CP (P = 0.03 after reactive hyperemia; P = 0.05 after sublingual nitrate). A significant association among the production of MMP-2/TIMP-2 complex with the presence of CP (P = 0.008) and periodontal parameters PD, CAL, and BOP was identified. Concentration of salivary markers IL-1β, TNF-α, and NO was similar in individuals with and without CP. A significant positive correlation between NO and ED was also identified.

Conclusions: Periodontitis was positively associated with ED, expressed by a smaller percentage of FMD of the brachial artery and higher salivary levels of MMP-2/TIMP-2 complex. Additionally, salivary levels of NO were significantly associated with better functioning of the vascular endothelium.

Keywords: Cardiovascular diseases; cytokines; endothelium, vascular; periodontitis.