TY - JOUR
T1 - The effect of subantimicrobial-dosedoxycycline periodontal therapy on serum biomarkers of systemic inflammation
T2 - A randomized, double-masked, placebo-controlled clinical trial
AU - Payne, Jeffrey B.
AU - Golub, Lome M.
AU - Stoner, Julie A.
AU - Lee, Hsi Ming
AU - Reinhardt, Richard A.
AU - Sorsa, Timo
AU - Slepian, Marvin J.
N1 - Funding Information:
The project was supported by grant R01DE012872 from the National Institute of Dental and Craniofacial Research to Dr. Jeffrey B. Payne, principal investigator, and Dr. Lorne M. Golub, co-principal investigator. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Dental and Craniofacial Research or the National Institutes of Health. Dr. Sorsa was supported by grants from the Academy of Finland and the Helsinki University Central Hospital Research Foundation.
PY - 2011/3
Y1 - 2011/3
N2 - Background. Periodontitis has been reported to be associated with coronary artery disease (CAD). Research is needed to determine if therapies that improve periodontal health also reduce systemic measures of inflammation associated with both diseases. Methods. The study registrar randomly assigned 128 eligible postmenopausal women with chronic periodontitis to a twice-daily regimen of subantimicrobialdose-doxycycline (SDD) or placebo tablets for two years as an adjunct to periodontal maintenance therapy. Through a supplement to the main trial, in which they investigated alveolar bone and clinical attachment level changes, the authors assayed inflammatory mediators and lipid profiles in baseline, one-year and two-year serum samples. The authors analyzed the data by using generalized estimating equations. Results. In the intent-to-treat analysis across two years, SDD treatment reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (primary outcome; P = .02) and reduced serum matrix metalloproteinase (MMP)-9 (92 kilodalton gelatinase; difference in mean scanning units, -28.44; P < .001), with no significant effect on serum lipids. However, in women more than five years postmenopausal, SDD elevated the level of high-density lipoprotein (HDL) cholesterol (difference in means [milligrams per deciliter], 5.99; P = .01). Conclusion. A two-year SDD regimen in postmenopausal women significantly reduced the serum inflammatory biomarkers hs-CRP and MMP-9 and, among women more than five years postmenopausal, increased the HDL cholesterol level. Clinical Implications. SDD significantly reduced the systemic inflammatory biomarkers hs-CRP and MMP-9. More research is needed to determine whether SDD has a role in managing the care of patients at risk of developing CAD.
AB - Background. Periodontitis has been reported to be associated with coronary artery disease (CAD). Research is needed to determine if therapies that improve periodontal health also reduce systemic measures of inflammation associated with both diseases. Methods. The study registrar randomly assigned 128 eligible postmenopausal women with chronic periodontitis to a twice-daily regimen of subantimicrobialdose-doxycycline (SDD) or placebo tablets for two years as an adjunct to periodontal maintenance therapy. Through a supplement to the main trial, in which they investigated alveolar bone and clinical attachment level changes, the authors assayed inflammatory mediators and lipid profiles in baseline, one-year and two-year serum samples. The authors analyzed the data by using generalized estimating equations. Results. In the intent-to-treat analysis across two years, SDD treatment reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (primary outcome; P = .02) and reduced serum matrix metalloproteinase (MMP)-9 (92 kilodalton gelatinase; difference in mean scanning units, -28.44; P < .001), with no significant effect on serum lipids. However, in women more than five years postmenopausal, SDD elevated the level of high-density lipoprotein (HDL) cholesterol (difference in means [milligrams per deciliter], 5.99; P = .01). Conclusion. A two-year SDD regimen in postmenopausal women significantly reduced the serum inflammatory biomarkers hs-CRP and MMP-9 and, among women more than five years postmenopausal, increased the HDL cholesterol level. Clinical Implications. SDD significantly reduced the systemic inflammatory biomarkers hs-CRP and MMP-9. More research is needed to determine whether SDD has a role in managing the care of patients at risk of developing CAD.
KW - C-reactive protein
KW - Doxycycline
KW - High-density lipoprotein cholesterol
KW - Inflammation
KW - Matrix metalloproteinases
KW - Periodontitis
KW - Serum inflammatory biomarkers
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U2 - 10.14219/jada.archive.2011.0165
DO - 10.14219/jada.archive.2011.0165
M3 - Article
C2 - 21357860
AN - SCOPUS:79953861737
SN - 0002-8177
VL - 142
SP - 262
EP - 273
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
IS - 3
ER -