Understanding the link between gum disease and heart attacks: version1

• Research type

  Research Study

• Full title

  Acceleration of atherosclerosis by periodontal bacteria

• IRAS ID

  177794

• Contact name

  Sarah J George

• Contact email

  s.j.george@bristol.ac.uk

• Sponsor organisation

  University of Bristol

• Duration of Study in the UK

  4 years, 11 months, 31 days

• Research summary

  "Research Summary"
  Heart attacks are caused by the splitting of a diseased (blocked) artery within the heart. Gum disease (periodontitis) is known to be associated with heart attacks but the link is not fully understood. Both gum disease and heart attacks involve inflammation, and oral bacteria are even found in diseased arteries. However, the cellular and molecular mechanisms involved in this association are still unresolved. A greater understanding of these mechanisms may aid the development of new treatments.

  We propose that specific oral bacteria associated with gum disease activate cells in the blood that are responsible for arterial blockages, and that this promotes inflammation and the onset of heart attacks. To test this, blood will be taken from the forearm of healthy volunteers or patients with gum disease, and inflammatory blood cells (monocytes) will be purified using standard procedures. The behaviour of these blood cells will then be tested, including their interactions with blood vessel (endothelial) cells, to see if those cells taken from patients with gum disease behave differently to those taken from healthy volunteers. We will also take subgingival plaque samples from the gum disease patients and healthy volunteers to compare the microorganisms that they have in their mouths.

  "Summary of Results"
  Heart disease is predominantly caused by heart attacks and is a major killer in the UK. Heart attacks are caused by the rupture (splitting) of a diseased coronary artery within the heart, resulting in a blood clot. The clot may then block the supply of blood running through the coronary artery, triggering a heart attack. Gum disease (periodontitis) is known to be associated with heart attacks but how exactly they are linked is fully understood. Both gum disease and heart attacks involve inflammation. It has been shown that bacteria in the mouth are directly involved in the induction of inflammation and the acceleration of heart disease. In fact the oral bacteria are even found in the diseased arteries that cause heart attacks. The cellular and molecular mechanisms involved in this association are still unresolved and a greater understanding of these mechanisms may aid the development of new treatments.
  The blockage of arteries occurs due to damage to the innermost layer of the artery known as the endothelium, which permits the formation of blood clots and invasion of inflammatory cells. We have previously shown that cells within the blocked artery become active due to induction of a specific pathway, known as Wnt signalling. This pathway is activated by oral bacteria and promotes blood clotting and inflammation and therefore it may be the missing link between gum disease and heart attacks

  We determined whether specific oral bacteria lead to the activation of the Wnt pathway in the cells responsible for blood clot formation and inflammation (platelets, endothelium and monocyte/macrophages). We obtained blood cells from healthy volunteers and patients with gum disease. We compared the effects of specific bacteria on inflammation. Importantly, we showed that altering the Wnt pathway retarded inflammation. Moreover, we found evidence of direct association of bacteria with Wnt proteins.

  Heart disease and subsequent treatments have huge cost implications for the NHS and are major cause of morbidity and mortality in the UK. Consequently, the discovery and validation of novel treatments to retard heart disease is highly desirable. The findings from this study will highlighted the potential of novel selective treatments to retard the Wnt pathway and suppress the formation of blockages in arteries.

• REC name

  Wales REC 7

• REC reference

  15/WA/0209

• Date of REC Opinion

  4 Jun 2015

• REC opinion

  Favourable Opinion