Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 13;23(1):481.
doi: 10.1186/s12903-023-03183-9.

A systematic review of the impact of Porphyromonas gingivalis on foam cell formation: Implications for the role of periodontitis in atherosclerosis

Saeed Afzoon #  1 , Mohammad Amin Amiri #  2 , Mostafa Mohebbi  1 , Shahram Hamedani  3 , Nima Farshidfar  4
Affiliations

A systematic review of the impact of Porphyromonas gingivalis on foam cell formation: Implications for the role of periodontitis in atherosclerosis

Saeed Afzoon et al. BMC Oral Health. .

Abstract

Background: The current literature suggests the significant role of foam cells in the initiation of atherosclerosis through the formation of a necrotic core in atherosclerotic plaques. Moreover, an important periodontal pathogen called Porphyromonas gingivalis (P. gingivalis) is indicated to play a significant role in this regard. Thus, the aim of this systematic review was to comprehensively study the pathways by which P. gingivalis as a prominent bacterial species in periodontal disease, can induce foam cells that would initiate the process of atherosclerosis formation.

Methods: An electronic search was undertaken in three databases (Pubmed, Scopus, and Web of Science) to identify the studies published from January 2000 until March 2023. The risk of bias in each study was also assessed using the QUIN risk of bias assessment tool.

Results: After the completion of the screening process, 11 in-vitro studies met the inclusion criteria and were included for further assessments. Nine of these studies represented a medium risk of bias, while the other two had a high risk of bias. All of the studies have reported that P. gingivalis can significantly induce foam cell formation by infecting the macrophages and induction of oxidized low-density lipoprotein (oxLDL) uptake. This process is activated through various mediators and pathways. The most important factors in this regard are the lipopolysaccharide of P. gingivalis and its outer membrane vesicles, as well as the changes in the expression rate of transmembrane lipid transportation channels, including transient receptor potential channel of the vanilloid subfamily 4 (TRPV4), lysosomal integral protein 2 (LIMP2), CD36, etc. The identified molecular pathways involved in this process include but are not limited to NF-κB, ERK1/2, p65.

Conclusion: Based on the results of this study, it can be concluded that P. gingivalis can effectively promote foam cell formation through various pathogenic elements and this bacterial species can affect the expression rate of various genes and the function of specific receptors in the cellular and lysosomal membranes. However, due to the moderate to high level of risk of bias among the studies, further studies are required in this regard.

Keywords: Atherosclerosis; Chronic Periodontitis; Foam cells; Periodontitis; Porphyromonas Gingivalis.

PubMed Disclaimer

Conflict of interest statement

NF is the Editorial Board Member of BMC Oral Health. All other authors declares that they have no competing interest.

Figures

Fig. 1
Fig. 1
PRISMA chart 2020 representing the screening process undertaken in this study
Fig. 2
Fig. 2
Illustrates the process by which P. gingivalis can play a role in foam cell formation. The infection caused by periodontopathogens, especially P. gingivalis destructs periodontal tissue. The progression of this disease leads to the infiltration of P. gingivalis into blood vessels which by entering into the blood vessels intima, it can affect the macrophages in that layer and induce LDL endocytosis. This process eventually leads to foam cell formation
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Prim. 2017;3:17038. doi: 10.1038/nrdp.2017.38. - DOI - PubMed
    1. Dahlen G, Fejerskov O, Manji F. Current concepts and an alternative perspective on periodontal disease. BMC Oral Health. 2020;20:235. doi: 10.1186/s12903-020-01221-4. - DOI - PMC - PubMed
    1. Srimaneepong V, Heboyan A, Zafar MS, Khurshid Z, Marya A, Fernandes GVO, et al. Fixed prosthetic restorations and periodontal health: a narrative review. J Funct Biomater. 2022;13:15. doi: 10.3390/jfb13010015. - DOI - PMC - PubMed
    1. Yadalam PK, Sivasankari T, Rengaraj S, Mugri MH, Sayed M, Khan SS, et al. Gene interaction network analysis reveals IFI44L as a drug target in rheumatoid arthritis and periodontitis. Molecules. 2022;27:2749. doi: 10.3390/molecules27092749. - DOI - PMC - PubMed
    1. Barzegar PEF, Ranjbar R, Yazdanian M, Tahmasebi E, Alam M, Abbasi K et al. The current natural/chemical materials and innovative technologies in periodontal diseases therapy and regeneration: a narrative review. Mater Today Commun. 2022;:104099.

Publication types