The immunopathology of periodontal disease: links with atherosclerosis?

Abstract

Chronic inflammatory periodontal disease occurs as a result of an inflammatory response in the periodontium which is elicited by bacteria present in dental plaque. The specific cytokines and chemokines produced by this initial response cause a T cell/macrophage dominated inflammatory infiltrate to develop in the connective tissues. If this cell-mediated immune response does not control the bacterial challenge, progression to a B cell/plasma cell lesion occurs (reviewed in Gemmell et al. 20021). A component of the specific T cell and antibody response elicited by these bacteria however, has been implicated in a cross-reactive immune response targeting host antigens on systemic endothelial cells. This crossreactivity has been proposed to be involved in the pathogenesis of atherosclerosis.