Inter-relação entre a periodontite apical e a aterosclerose. Análise metabólica, histológica e do perfil lipídico
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Data
2018-03-29
Autores
Conti, Leticia Citelli [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A aterosclerose é uma doença cardiovascular inflamatória crônica, caracterizada pelo acúmulo de placas de gordura nos vasos sanguíneos em consequência de danos no endotélio provocada por diversos fatores de risco, dentre eles o acúmulo de lipídeos. As infecções dentárias também são doenças de caráter inflamatório, dentre elas, está a infecção endodôntica que resulta no desenvolvimento da periodontite apical. Diante dos estudos apresentados na literatura especializada, dos quais os resultados ainda carecem de comprovação científica sobre possíveis correlações entre a periodontite apical com alterações sistêmicas, o objetivo deste trabalho foi avaliar a inter-relação entre a periodontite apical e a aterosclerose. Foram utilizados 40 ratos Wistar distribuídos em 4 grupos de 10 animais: ratos controle (C); ratos com periodontite apical (AP); ratos com aterosclerose (AT); ratos com periodontite apical e com aterosclerose (AP+AT). A aterosclerose foi induzida com a administração de uma dieta com alto teor lipídico, juntamente com um procedimento cirúrgico realizado na carótida comum direita associada a uma super dosagem de vitamina D3. A periodontite apical foi induzida 30 dias após a indução cirúrgica da aterosclerose, pela exposição da polpa dentária coronária ao meio bucal, dos primeiros e segundos molares superiores e inferiores direito. O peso corporal foi obtido aos 0, 15, 45 e 75 dias e o consumo de ração foi mensurado nos períodos de 7, 15, 45 e 75 dias. Aos 45 e 75 dias, foi realizada punção cardíaca para remoção do tecido hematológico e as concentrações séricas do perfil lipídico foram mensurados. Aos 75 dias, os ratos foram eutanasiados e os órgãos: cérebro, coração, pulmão, fígado, baço, rim e gônadas foram pesados individualmente. A maxila, a mandíbula e a carótida foram processadas para análise histológica (hematoxilina e eosina). Os resultados das diferentes análises e a relação entre os achados locais e sistêmicos foram tabulados e analisados por testes estatísticos específicos para cada caso (p<0,05). A aterosclerose foi capaz de induzir a perda de peso dos animais no período inicial do experimento, no entanto, ao final do experimento apenas o grupo AP+AT apresentou peso inferior quando comparado ao grupo controle. O consumo de ração foi semelhante entre todos os grupos. As concentrações séricas do colesterol total e do LDL-C foram, estatisticamente mais elevados nos grupos portadores de aterosclerose (AT e AP+AT) quando comparados aos outros grupos (p <0,05). Nos grupos AP e AT, a presença das doenças foram capazes de aumentar os níveis de triglicérides, comparados ao controle, sem diferença estatística entre si. (p <0,05). Já no grupo AP+AT os níveis de triglicérides foram superiores quando comparados aos grupos AP e AT. Houve aumento no peso do cérebro e redução no peso do pulmão nos grupos AP, AT, AP+AT quando comparados ao grupo C. O peso do baço no grupo AP apresentou-se elevado quando comparado aos demais grupos. Nas análises histológicas, o grupo AP+AT apresentou infiltrado inflamatório mais intenso e reabsorção óssea mais exacerbada quando comparada ao grupo AP. Foi possível detectar alterações morfológicas nas artérias carótidas dos animais portadores de aterosclerose. Conclui-se que a periodontite apical e a aterosclerose, isoladas ou associadas, influenciam no peso corporal, no metabolismo, no perfil lipídico, nas lesões periapicais e nas carótidas de ratos Wistar.
Atherosclerosis is a chronic inflammatory cardiovascular disease, characterized by the accumulation of lipid in the blood vessels, due to risk factors capable of causing injuries to the endothelium. Dental infections are also pathologies of inflammatory origin, among them is the endodontic infection that results in the development of apical periodontitis. In view of the studies presented in the specialized literature, of which the results still lack scientific evidence on possible correlations between apical periodontitis with systemic alterations, the objective of this study was to evaluate the possible interrelationship between apical periodontitis and atherosclerosis. Forty male Wistar rats were distributed in 4 groups of 10 animals: control rats (C); rats with apical periodontitis (AP); rats with atherosclerosis (AT); rats with AP and atherosclerosis (AP+AT). Atherosclerosis was induced by using a high-lipid diet together with right common carotid surgery and a super dosage of vitamin D3. Apical periodontitis was induced 30 days after the surgical induction of atherosclerosis, by exposure of the coronary tooth pulp to the oral environment, of the first and second molars, upper and lower right. Body weight was obtained at 0, 15, 45 and 75 days and food consumption was measured on 7, 15, 45, and 75 days. At 45 and 75 days, cardiac puncture was performed to remove hematological tissue and serum levels of the lipid profile were measured. At 75 days the rats were euthanized and the organs: brain, heart, lung, liver, spleen, kidney and gonads were weighed individually. The upper and lower jaws and carotid were processed for histological analysis (hematoxylin and eosin). The results of the different analyzes and the relation between the local and systemic findings were tabulated and analyzed by specific statistical tests for each case (p <0.05). Atherosclerosis induced the weight loss of the animals in the initial period of the experiment, however, at the end of the experiment only the AT+AP group presented lower weight when compared to group C. Feed consumption was similar among all groups. The levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) were statistically higher in the groups with atherosclerosis (AT and AP+AT) when compared to the other groups (p <0.05). In the AP and AT groups, the presence of infections were able to increase triglyceride levels, compared to control, with no statistical difference between them. (p <0.05). In the AT+AP group, the triglyceride levels were higher when compared to the AP and AT groups. There was an increase in brain weight and a reduction in lung weight in the AP, AT, AP+AT groups when compared to group C. The spleen weight in the AP group was elevated when compared to the other groups. In the histological analyzes, the AP+AT group presented more severe periapical inflammatory infiltrates and more exacerbated bone resorption when compared to the AP group. It was possible to detect morphological changes in the carotid arteries of animals with atherosclerosis. It is concluded that apical periodontitis and atherosclerosis, whether isolated or associated, influence body weight, metabolism, lipid profile, periapical lesions and in the carotids of Wistar rats.
Atherosclerosis is a chronic inflammatory cardiovascular disease, characterized by the accumulation of lipid in the blood vessels, due to risk factors capable of causing injuries to the endothelium. Dental infections are also pathologies of inflammatory origin, among them is the endodontic infection that results in the development of apical periodontitis. In view of the studies presented in the specialized literature, of which the results still lack scientific evidence on possible correlations between apical periodontitis with systemic alterations, the objective of this study was to evaluate the possible interrelationship between apical periodontitis and atherosclerosis. Forty male Wistar rats were distributed in 4 groups of 10 animals: control rats (C); rats with apical periodontitis (AP); rats with atherosclerosis (AT); rats with AP and atherosclerosis (AP+AT). Atherosclerosis was induced by using a high-lipid diet together with right common carotid surgery and a super dosage of vitamin D3. Apical periodontitis was induced 30 days after the surgical induction of atherosclerosis, by exposure of the coronary tooth pulp to the oral environment, of the first and second molars, upper and lower right. Body weight was obtained at 0, 15, 45 and 75 days and food consumption was measured on 7, 15, 45, and 75 days. At 45 and 75 days, cardiac puncture was performed to remove hematological tissue and serum levels of the lipid profile were measured. At 75 days the rats were euthanized and the organs: brain, heart, lung, liver, spleen, kidney and gonads were weighed individually. The upper and lower jaws and carotid were processed for histological analysis (hematoxylin and eosin). The results of the different analyzes and the relation between the local and systemic findings were tabulated and analyzed by specific statistical tests for each case (p <0.05). Atherosclerosis induced the weight loss of the animals in the initial period of the experiment, however, at the end of the experiment only the AT+AP group presented lower weight when compared to group C. Feed consumption was similar among all groups. The levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) were statistically higher in the groups with atherosclerosis (AT and AP+AT) when compared to the other groups (p <0.05). In the AP and AT groups, the presence of infections were able to increase triglyceride levels, compared to control, with no statistical difference between them. (p <0.05). In the AT+AP group, the triglyceride levels were higher when compared to the AP and AT groups. There was an increase in brain weight and a reduction in lung weight in the AP, AT, AP+AT groups when compared to group C. The spleen weight in the AP group was elevated when compared to the other groups. In the histological analyzes, the AP+AT group presented more severe periapical inflammatory infiltrates and more exacerbated bone resorption when compared to the AP group. It was possible to detect morphological changes in the carotid arteries of animals with atherosclerosis. It is concluded that apical periodontitis and atherosclerosis, whether isolated or associated, influence body weight, metabolism, lipid profile, periapical lesions and in the carotids of Wistar rats.
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Palavras-chave
Periodontite apical, Histologia, Colesterol, Aterosclerose, Apical periodontitis