Correlation Analysis And Mechanism Exploration Between Porphyromonas Gingivalis And Carotid Atherosclerotic Plaque Stability

BackgroundAbout 20% to 30% of ischemic strokes are secondary to carotid stenosis,and about90% of carotid stenosis is caused by atherosclerosis.At present,the main basis of guidelines for the diagnosis and treatment of carotid stenosis is still the degree of carotid stenosis,but also highlights the importance of carotid plaque stability.Carotid plaque stability has been shown to be a risk factor for carotid stenosis,affecting the risk assessment of stroke in patients with carotid stenosis,and thus has attracted more and more attention.Chronic periodontitis is a common oral infectious disease,which can increase the carotid intima-media thickness and promote the development of plaque.It has been proved to be an independent risk factor for cardiovascular disease,but the relationship between carotid plaque stability and chronic periodontitis has not been confirmed.Porphyromonas gingivalis is the main pathogen of chronic periodontitis and is increasingly used to study the relationship between chronic periodontitis and cardiovascular disease.ObjectiveThis research is to determine the relationship between Porphyromonas gingivalis and the stability of carotid atherosclerotic plaque,and to explore the possible pathways.It provides a theoretical basis for early oral intervention and stroke screening in patients with carotid stenosis complicated with chronic periodontitis.MethodThe effects of Porphyromonas gingivalis on the stability of carotid atherosclerotic plaques were determined from clinical sample studies and microbial diversity analysis.In the clinical sample study,the risk factors of carotid stenosis and plaque stability were analyzed first to determine the relationship between chronic periodontitis and carotid stenosis symptoms and plaque stability;then correlation analysis was performed between chronic periodontitis and carotid plaque stability to explore the mechanism of chronic periodontitis affecting the stability of carotid atherosclerotic plaque.The microbial diversity analysis mainly carried out differential analysis of microbial diversity,prediction of differential bacteria function,bacterial verification and matrixmetalloproteinase fluorescent staining,and explored the possible pathway mechanism of Porphyromonas gingivalis affecting the stability of carotid atherosclerotic plaque.ResultClinical sample study: Logistic regression analysis of carotid stenosis symptoms showed that LDL-C,unstable plaque and chronic periodontitis were risk factors for carotid stenosis,and activation of partial thromboplastin time was the protective factor,of which LDL-C(OR: 3.267,95% CI: 1.015-6.502)and chronic periodontitis(OR:2.756,95% CI: 1.168-10.515)were independent risk factors for carotid stenosis.Carotid plaque stability group,age,hyperlipidemia,LDL-C,D-dimer,fibrin degradation products,degree of stenosis,chronic periodontitis,plaque volume,and number of plaque calcifications Risk factors for arterial plaque stability,including LDL-C(OR: 3.119,95%CI: 1.172-8.302),fibrin degradation products(OR: 2.269,95% CI: 1.324-3.888),plaque volume(OR : 10.492,95% CI: 1.002-109.900)and the number of plaque calcifications(OR: 6.684,95% CI: 1.482-30.138)are independent risk factors for carotid atherosclerosis stability.In the correlation analysis of chronic periodontitis,the Kruskal-Wallis H test and the ?2 test were used to distinguish the measurement data from the count data.The results showed that the patient's age and plaque fiber cap thickness were statistically significant.Perioperative complications,length of surgery,intraoperative bleeding,postoperative hospital stay,and restenosis rate at 6 months after surgery were not significantly different between the carotid stability group and the chronic periodontitis severity group.Flora diversity analysis: At the genus level,the differential bacteria species were more in the unstable group and the relative abundance was higher;the relative abundance of the genus Porphyroms belonging to Porphyromonas gingivalis in different stable plaque groups There are significant differences between the two groups;the function of the flora indicates that the stable group seems to have more advantages in lipid metabolism,xenobiotic biodegradation,and metabolism and amino acid metabolism,while the unstable group affects the plaque by enhancing the efficiency of carbohydrate metabolism.Block stability.PCR results showed that the detection rate of Porphyromonas gingivalis in the unstable carotid plaque was higher(?2=5.714,p=0.017),and the detection rate of P.gingivalis progressed with chronic periodontitis.Significantly increased(?2=6.682,p=0.035).Immunofluorescence staining showed that matrixmetalloproteinase-2,-8 and carotid smooth muscle cells were different in chronic periodontitis group,while matrix metalloproteinase-9 showed no significant difference;matrix metalloproteinase-2,-8 and-9 can be secreted by macrophages in the plaque.ConclusionThe detection rate of Porphyromonas gingivalis varies with the severity of chronic periodontitis and can be considered as the main bacteria affecting plaque stability in chronic periodontitis.Chronic periodontitis is associated with carotid plaque stability.The mechanism of action may be through matrix metalloproteinases(MMP-2,-8)affecting plaque fibrous cap structure,which may affect plaque stability,or may affect lipids.The metabolic function plays a role,and the specific mechanism needs further exploration.