Association between circulating tumor necrosis factor receptors and oral bacterium in patients receiving hemodialysis: a
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ORIGINAL ARTICLE
Association between circulating tumor necrosis factor receptors and oral bacterium in patients receiving hemodialysis: a cross‑sectional study Risako Mikami1 · Koji Mizutani1 · Tomohito Gohda2 · Hiromichi Gotoh3 · Yusuke Matsuyama4 · Norio Aoyama5 · Takanori Matsuura1 · Daisuke Kido1 · Kohei Takeda1 · Yuichi Izumi1,6 · Takeo Fujiwara4 · Takanori Iwata1 Received: 22 April 2020 / Accepted: 3 August 2020 © Japanese Society of Nephrology 2020
Abstract Background High levels of tumor necrosis factor (TNF) receptors (TNFRs; TNFR1 and TNFR2), markers of inflammation, have been reported as significant predictors of mortality in hemodialysis patients. Porphyromonas gingivalis is a major pathogenic bacterium involved in periodontitis, which induces systemic inflammation. We investigated the association between the abundance of P. gingivalis in saliva and serum TNFR levels in hemodialysis patients. Methods A cross-sectional study was conducted on 121 hemodialysis patients visiting a clinic in the Tokyo metropolitan area. Medical interviews and examinations, comprehensive dental examinations, bacterial examinations for P. gingivalis in saliva, and measurements of circulating TNFR levels were conducted. Multiple linear regression analysis was performed to evaluate the association between the number of P. gingivalis and circulating TNFR levels. Results TNFR1 and TNFR2 were positively correlated with high-sensitivity C-reactive protein (hsCRP). Severe periodontitis was significantly associated with the number of P. gingivalis in saliva but not serum TNFR levels. The number of P. gingivalis was significantly associated with both TNFR1 and TNFR2 levels in sera after adjusting for age, sex, body mass index, smoking status, history of diabetes, prior cardiovascular disease events, serum levels of hsCRP and albumin, and severity of periodontitis [for TNFR1: coefficient 0.76, 95% confidence interval (CI) 0.14–1.37, p = 0.02; for TNFR2: coefficient 0.95, 95% CI 0.09–1.80, p = 0.03]. Conclusion Circulating TNFR levels are associated with the number of P. gingivalis in saliva after adjusting for relevant clinical factors. Keywords TNF receptor · P. gingivalis · Chronic kidney disease · Periodontitis · Hemodialysis
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10157-020-01952-2) contains supplementary material, which is available to authorized users. * Tomohito Gohda [email protected] 1
Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
2
Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
3
Department of Internal Medicine, Saiyu Soka Hospital, Saitama, Japan
Chronic kidney disease has become more common globally, and death related to end-stage renal disease (ESRD) is a serious problem [1]. Patients with ESRD undergoing 4
Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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