College of Dental Medicine (E.V.K.), Nova Southeastern University, Fort Lauderdale, Fla; Center for Molecular Microbiology (E.V.K., B.R.D., W.A.D., A.P.-F.), Department of Oral Biology and the Periodontal Disease Research Center, College of Dentistry (E.V.K., B.R.D., A.P.-F.), and Department of Anatomy and Cell Biology, College of Medicine (W.A.D.), University of Florida, Gainesville; and University of Michigan School of Dentistry (C.E.S.), Ann Arbor., B.R.D. is currently affiliated with Merchant & Gould, P.C., Minneapolis, Minn.

To the Editor:

Because epidemiological evidence supports an association between cardiovascular and periodontal disease, we assessed whether periodontal pathogens were present in atherosclerotic lesions. To detect invasive bacteria, the natural tropism of the bacteria toward human tissues was exploited. Further, bacterial presence was demonstrated using quantitative polymerase chain reaction (Q-PCR). This confirms the presence of periodontal pathogens in atherosclerotic lesions, whereby the bacteria could contribute to the vascular pathology either directly through their cytotoxicity or indirectly by inducing or exacerbating inflammation.

Cardiovascular disease (CVD) is the leading cause of death in the in the United States.¹ According to the American Heart Association’s statistics from 2003, there were no previous symptoms in 50% of men and 63% of women who died suddenly from CHD. In a 10-year follow-up study, 25% of coronary deaths in males and 15% in females occurred in persons in the lowest two quintiles of the multivariate Framingham Heart Study risk scores.² This and other data have led to an emerging paradigm shift from coronary heart disease having a purely hereditary/nutritional causation to possibly having an infectious component.³

Many epidemiological studies strongly suggest that periodontitis may be a risk factor for coronary heart disease (CHD).⁴ Serologically, edentulousness and serum IgG-antibodies to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in 1163 men were recently shown to be associated with CHD.⁵ In a larger prospective study of 6950 subjects, the same authors provide serological evidence that an infection caused by major periodontal pathogens is associated with future stroke.⁶ Previous studies have identified 16S rRNA of oral microbial pathogens, including P gingivalis and A actinomycetemcomitans, in atherosclerotic plaques using PCR.⁷ However, none of these studies provide evidence that the oral pathogens were viable at the vascular sites.

^{Full Article:
http://atvb.ahajournals.org/cgi/content/full/25/3/e17}