Effects of oral flora on platelets: Possible consequences in cardiovascular disease

被引:156
作者
Herzberg, MC [1 ]
Meyer, MW [1 ]
机构
[1] UNIV MINNESOTA,SCH DENT,DEPT ORAL SCI,MINNEAPOLIS,MN 55455
关键词
coronary thrombosis etiology; myocardial infarction etiology; platelet aggregation; Streptococcus sanguis;
D O I
10.1902/jop.1996.67.10s.1138
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
DURING EPISODES OF DENTAL BACTEREMIA, viridans group streptococci encounter platelets. Among these microorganisms, certain Streptococcus sanguis induce human and rabbit platelets to aggregate in vitro. In experimental rabbits, circulating streptococci induced platelets to aggregate, triggering the accumulation of platelets and fibrin into the heart valve vegetations of endocarditis. At necropsy, affected rabbit hearts showed ischemic areas. We therefore hypothesized that circulating S. sanguis might cause coronary thrombosis and signs of myocardial infarction (MI). Signs of MI were monitored in rabbits after infusion with platelet-aggregating doses of 4 to 40 X 10(9) cells of S. sanguis 133-79. Infusion resulted in dose-dependent changes in electrocardiograms, blood pressure, heart rate, and cardiac contractility. These changes were consistent with the occurrence of MI. Platelets isolated from hyperlipidemic rabbits showed an accelerated in vitro aggregation response to strain 133-79. Cultured from immunosuppressed children with septic shock and signs of disseminated intravascular coagulation, more than 60% of isolates of viridans streptococci induced platelet aggregation when tested in vitro. The data are consistent with a thrombogenic role for S. sanguis in human disease, contributing to the development of the vegetative lesion in infective endocarditis and a thrombotic mechanism to explain the additional contributed risk of periodontitis to MI.
引用
收藏
页码:1138 / 1142
页数:5
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