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Association between periodontal disease due to Campylobacter rectus and cerebral microbleeds in acute stroke patients
Yuji Shiga1, Naohisa Hosomi2,3, Tomohisa Nezu1
1Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Abstract:
Oral health conditions and cerebral small vessel disease, such as white matter lesions or cerebral microbleeds (CMBs), are associated with the incidence of stroke. The purpose of this study was to examine the associations between oral health conditions (serum IgG titers of periodontal pathogens) with the presence or severity of CMBs in acute stroke patients. From January 2013 to April 2016, acute stroke patients were registered in two hospitals. Serum samples were evaluated for antibody titers against 9 periodontal pathogens using the ELISA method. The cut-off points for reactivity (the positive decision point) to each antigen were defined as more than a mean ELISA unit + 1 standard deviation (after logarithmic transformation) in all subjects. CMBs were evaluated on T2*-weighted MRI. In all, 639 patients were evaluated (ischemic, n = 533 and hemorrhagic, n = 106; 73.1 ± 12.9 years old). Among these patients, 627 were available for CMB evaluation. Among the 9 evaluated periodontal pathogens, only Campylobacter rectus (C. rectus) was associated with the presence of CMBs. the prevalence of positive serum antibody titers against C. rectus was higher among patients with CMBs than among those without CMBs (14.6% vs. 8.7%, P = 0.025). In addition, positive serum antibody titers against C. rectus remained one of the factors associated with the presence of CMBs in multivariate logistic analysis (odds ratio 2.03, 95% confidence interval 1.19-3.47, P = 0.010). A positive serum antibody titer against C. rectus was associated with the presence of CMBs in acute stroke patients.
Insights
Oral bacteria, specifically Campylobacter rectus, are linked to cerebral microbleeds (CMBs) in stroke patients. Higher antibody levels against C. rectus indicate an increased presence of these brain lesions.
Area of Science:
- Neurology
- Periodontology
- Vascular Biology
Background:
- Cerebral small vessel disease (CSVD), including white matter lesions and cerebral microbleeds (CMBs), is a known risk factor for stroke.
- Oral health conditions have been implicated in the incidence of stroke, but specific links to CSVD markers require further investigation.
Purpose of the Study:
- To investigate the association between specific oral health conditions, measured by serum IgG titers to periodontal pathogens, and the presence or severity of cerebral microbleeds (CMBs) in acute stroke patients.
Main Methods:
- Serum samples from 639 acute stroke patients were analyzed for antibody titers against nine periodontal pathogens using ELISA.
- Cerebral microbleeds (CMBs) were assessed using T2*-weighted MRI.
- Statistical analysis, including multivariate logistic regression, was employed to determine associations.
Main Results:
- A significant association was found between positive serum antibody titers against Campylobacter rectus (C. rectus) and the presence of CMBs.
- The prevalence of positive C. rectus antibody titers was higher in patients with CMBs (14.6%) compared to those without (8.7%).
- Positive C. rectus antibody titers remained a significant independent factor associated with CMBs in multivariate analysis (OR 2.03, P=0.010).
Conclusions:
- Elevated serum antibody titers against the periodontal pathogen Campylobacter rectus are associated with the presence of cerebral microbleeds in acute stroke patients.
- This finding suggests a potential link between specific oral infections and the pathophysiology of cerebral small vessel disease in stroke.
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