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ID 115292
タイトル別表記
重症歯周病に起因する血中蛋白分解酵素とその阻害因子の不均衡はヒトの脳動脈瘤破裂に関与する
RUPTURED CEREBRAL ANEURYSMS AND SEVERE PD
著者
𠮷岡, 正太郎 徳島大学大学院医科学教育部(医学専攻)
Shikata, Eiji Tokushima University
Yamaguchi, Tadashi Tokushima University
高麗, 雅章 Tokushima University
Okayama, Yoshihiro Tokushima University
Kitazato, Keiko T. Tokushima University
キーワード
gingival bleeding
intracranial aneurysm
matrix metalloproteinase 9
periodontal disease
procollagen type I
Subarachnoid hemorrhage
Tissue inhibitor of metalloproteinase 2
資料タイプ
学位論文
抄録
BACKGROUND: The pathophysiology of subarachnoid hemorrhages (SAHs) due to ruptured intracranial aneurysms (IAs) remains unclear.Although a relationship between SAHs and periodontal disease (PD) has been suggested, the mechanism requires clarification.
OBJECTIVE: To evaluate the relationship between PD and SAHs and to identify periodontal pathogens associated with SAHs.
METHODS: This prospective study included consecutive patients with ruptured (n = 11) and unruptured (n = 14) IAs and healthy controls (n = 8). The plasma and plaque subgingival bacterial deoxyribonucleic acid (DNA) levels in PD were evaluated by a dentist using the Community Periodontal Index of Treatment Needs (CPITN). Plasma levels of matrix metalloproteinase (MMP-9), tissue inhibitors of matrix metalloproteinase (TIMP2), and procollagen I were analyzed.
RESULTS: Patients with ruptured IAs, had significantly higher CPITN scores than the controls, suggesting that ruptured IAs were associated with severe PD. Although no rupture-specific bacteria were identified, the positive rate of plaque subgingival bacterial DNA was significantly higher in patients with severe PD than in those without severe PD. Multivariate logistic regression analysis indicated that bleeding on probing (BOP)was associated with ruptured IAs (odds ratio, 1.10; 95% confidence interval 1.04–1.20; P = .0001). BOP was positively associated with plasma MMP-9 levels and a disequilibrium in the MMP-9/TIMP2 ratio. BOP was negatively correlated with plasma procollagen I levels (P < .05, for each). This suggested that local inflammation with severe PD might have systemic effects and lead to ruptured IAs.
CONCLUSION: Disequilibrium of plasma protease/anti-protease associated with a high BOP rate in severe PD may be attributable to IA rupture.
掲載誌名
Neurosurgery Open
ISSN
26330873
出版者
Oxford University Press|Congress of Neurological Surgeons
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3
開始ページ
okaa007
発行日
2020-07-17
備考
内容要旨・審査要旨・論文本文の公開
本論文は,著者Shotaro Yoshiokaの学位論文として提出され,学位審査・授与の対象となっている。
権利情報
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3431号
学位記番号
甲医第1461号
学位授与年月日
2020-09-10
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系