Unveiling the association between angiogenic imbalance in the gingival crevicular fluid in maternal periodontitis and spontaneous preterm birth.

IF 1.8 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Frontiers in dental medicine Pub Date : 2025-07-29 eCollection Date: 2025-01-01 DOI:10.3389/fdmed.2025.1625995
Daniela Albers, María José Bendek, Marcela Hernández, Diego Prieto, Carolina Rojas, María Luisa Mizgier, Patricia Hernández, Sebastián E Illanes, Alejandra Chaparro
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引用次数: 0

Abstract

Background: Emerging evidence suggests that abnormal angiogenesis and imbalanced angiogenic factors may contribute to the development of spontaneous preterm birth (sPTB). In addition, pregnancy-related angiogenic changes and increased vascular permeability in periodontal tissues could amplify periodontal inflammation under hormonal influence.

Objectives: This study aimed to evaluate the association between gingival crevicular fluid (GCF) levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) and sPTB risk and to assess their correlation with periodontal disease severity during early pregnancy.

Materials and methods: A prospective cohort study was conducted involving 348 pregnant women, with obstetric, clinical, and periodontal parameter assessments performed at 11-14 weeks of gestation, including probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), periodontal inflamed surface area (PISA), and plaque index score (PI). GCF samples were collected, and PlGF and sFlt-1 levels were measured using Magpix-Luminex® multiplex technology.

Results: sPTB occurred in 3.45% (n = 12) of the participants. The women who had a sPTB had a significantly higher GCF PlGF/sFlt-1 ratio (p = 0.017) and lower sFlt-1 levels (p = 0.003) compared to those who had term pregnancies. A multivariate regression model combining the PlGF/sFlt-1 ratio, PI score, and first-trimester arterial blood pressure showed a predictive area under the curve of 0.78 (odds ratio 3.36, p = 0.008) for sPTB risk. Periodontal parameters, including PD sites >3 mm and PISA, were significantly worse in those with sPTB pregnancies (p = 0.032 and p = 0.047, respectively). Both PlGF and sFlt-1 levels were elevated in pregnant women with moderate to severe periodontitis compared to those with gingivitis or a healthy status (p < 0.0001), with significant positive correlations with inflammatory periodontal clinical parameters (p < 0.05).

Conclusion: An early pregnancy imbalance of angiogenic and antiangiogenic factors in the GCF is associated with increased sPTB risk and greater periodontal inflammation. These findings suggest that angiogenic factors in the GCF may serve as promising non-invasive biomarkers for identifying women at elevated risk for sPTB.

揭示母体牙周炎龈沟液血管生成失衡与自发性早产之间的关系。
背景:越来越多的证据表明,血管生成异常和血管生成因子失衡可能与自发性早产(sPTB)的发生有关。此外,妊娠相关的血管生成改变和牙周组织血管通透性增加可在激素的影响下放大牙周炎症。目的:本研究旨在评估妊娠早期龈沟液(GCF)中胎盘生长因子(PlGF)和可溶性膜样酪氨酸激酶-1 (sFlt-1)水平与sPTB风险之间的关系,并评估其与牙周病严重程度的相关性。材料和方法:对348名孕妇进行前瞻性队列研究,在妊娠11-14周进行产科、临床和牙周参数评估,包括探诊深度(PD)、临床附着丧失(CAL)、探诊出血(BOP)、牙周炎症表面积(PISA)和菌斑指数评分(PI)。收集GCF样品,使用Magpix-Luminex®多路复用技术测量PlGF和sFlt-1水平。结果:sPTB发生率为3.45% (n = 12)。与足月妊娠的妇女相比,患有sPTB的妇女GCF PlGF/sFlt-1的比值显著较高(p = 0.017), sFlt-1水平显著较低(p = 0.003)。结合PlGF/sFlt-1比值、PI评分和妊娠早期动脉血压的多元回归模型显示,sPTB风险的曲线下预测面积为0.78(优势比3.36,p = 0.008)。sPTB妊娠组的牙周参数,包括PD部位bbb30 mm和PISA,均显著差于对照组(p = 0.032和p = 0.047)。与牙龈炎或健康状态的孕妇相比,中度至重度牙周炎孕妇的PlGF和sFlt-1水平均升高(p结论:妊娠早期GCF中血管生成因子和抗血管生成因子的失衡与sPTB风险增加和牙周炎症加重有关。这些发现表明,GCF中的血管生成因子可能作为识别sPTB高风险女性的有希望的非侵入性生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
2.10
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