Pathophysiological relationships between periodontitis and systemic disease: Recent concepts involving serum lipids

Periodontitis has been traditionally regarded as a chronic inflammatory ora l infection. However recent studies indicate that this oral disease may hav e profound effects on systemic health. The search for cellular/molecular me chanisms linking periodontitis to changes in systemic health and systemic p hysiology has resulted in the evolution of a new area of lipid research est ablishing linkages between existing multidisciplinary biomedical literature , recent observations concerning the effects of serum lipids on immune cell phenotype/function, and a heightened interest in systemic responses to chr onic localized infections. There appears to be more than a casual relations hip between serum lipid levels and systemic health (particularly cardiovasc ular disease, diabetes, tissue repair capacity, and immune cell function), susceptibility to periodontitis, and serum levels of pro-inflammatory cytok ines. In terms of the potential relationship between periodontitis and syst emic disease, it is possible that periodontitis-induced changes in immune c ell function cause metabolic dysregulation of lipid metabolism through mech anisms involving proinflammatory cytokines. Sustained elevations of serum l ipids and/or pro-inflammatory cytokines may have a serious negative impact on systemic health. The purpose of this paper is to present the background, supporting data, and hypotheses related to this concept. As active partici pants in this emerging and exciting area of investigation, we hope to stimu late interest and awareness among biomedical scientists and practitioners.