Research on the Association Between Periodontitis and COPD

Abstract

Periodontitis is a common chronic bacteria-initiated inflammatory disease that is closely associated with various systemic diseases, including chronic obstructive pulmonary disease (COPD). Periodontitis and COPD share similar risk factors, pathology and microorganisms. Epidemiological and clinical research have shown positive correlation between the two diseases. Individuals with severe periodontitis had a higher risk of developing COPD. Moreover, the relative risk of COPD in severe periodontitis was much higher compared to people without periodontal disease and patients with mild to moderate periodontitis. COPD patients with periodontitis had a higher frequency of COPD exacerbation and periodontal treatment demonstrated some control of COPD. However, the nature of periodontitis affecting COPD still needs further exploration. Periodontitis caused microbial and immune imbalances of the lung through several aspects: (I) under periodontitis status, periodontal pathogens directly caused the lung inflammatory reaction after inhalation and colonization on the lung, (II) periodontitis status promoted the oral colonization of pneumonia-associated pathogens, (III) periodontitis status affected the respiratory epithelium structure and (IV) periodontitis status caused imbalances in neutrophils, macrophages and inflammatory cytokines. In this review, we conclude the association between periodontitis and COPD through several aspects and further discuss the potential mechanism by which periodontitis affects COPD.

Plain Language Summary

Epidemiological and clinical research have shown positive correlation between periodontitis and COPD. Individuals with severe periodontitis had a higher risk of developing COPD. COPD patients with periodontitis had a higher frequency of COPD exacerbation. Meanwhile, periodontal treatment demonstrated some control of COPD. In this review, we concluded the association between periodontitis and further summarized that periodontitis caused microbial and immune imbalances of the lung through several aspects: (I) under periodontitis status, periodontal pathogens directly caused the lung inflammatory reaction after inhalation and colonization on the lung, (II) periodontitis status promoted the oral colonization of pneumonia-associated pathogens, (III) periodontitis status affected the respiratory epithelium structure and (IV) periodontitis status caused imbalances in neutrophils, macrophages and inflammatory cytokines.

Keywords:

• COPD
• microorganism
• immune
• inflammation

Acknowledgments

Kaixin Xiong and Peng Yang are co-first authors for this study. This work was supported by Key Projects of Sichuan Provincial Department of Science and Technology (2020YFSY0008), Research and Develop Program, West China Hospital of Stomatology Sichuan University (RD-02-202112), Natural Science Foundation of Sichuan Province (2022NSFSC1507, 2023NSFSC1503).

Disclosure

The authors declare that they have no conflicts of interest in this work.