{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T08:34:56Z","timestamp":1791102896900,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2006,12,8]],"date-time":"2006-12-08T00:00:00Z","timestamp":1165536000000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2006,11]]},"abstract":"<jats:p><jats:bold><jats:sc>Abstract:\u2002<\/jats:sc><\/jats:bold>  <jats:bold>Increasing evidence implicates periodontitis, a chronic inflammatory disease of the tooth\u2010supporting structures, as a potential risk factor for increased morbidity or mortality for several systemic conditions including cardiovascular disease (atherosclerosis, heart attack, and stroke), pregnancy complications (spontaneous preterm birth [SPB]), and diabetes mellitus. Cross\u2010sectional, case\u2013control, and cohort studies indicate that periodontitis may confer two\u2010 and up to sevenfold increase in the risk for cardiovascular disease and premature birth, respectively. Given the recently acquired knowledge that systemic inflammation may contribute in the pathogenesis of atherosclerosis and may predispose to premature birth, research in the field of periodontics has focused on the potential of this chronic low\u2010grade inflammatory condition to contribute to the generation of a systemic inflammatory phenotype. Consistent with this hypothesis clinical studies demonstrate that periodontitis patients have elevated markers of systemic inflammation, such as C\u2010reactive protein (CRP), interleukin 6 (IL\u20106), haptoglobin, and fibrinogen. These are higher in periodontal patients with acute myocardial infarction (AMI) than in patients with AMI alone, supporting the notion that periodontal disease is an independent contributor to systemic inflammation. In the case of adverse pregnancy outcomes, studies on fetal cord blood from SBP babies indicate a strong <jats:italic>in utero<\/jats:italic> IgM antibody response specific to several oral periodontal pathogens, which induces an inflammatory response at the fetal\u2013placental unit, leading to prematurity. The importance of periodontal infections to systemic health is further strengthened by pilot intervention trials indicating that periodontal therapy may improve surrogate cardiovascular outcomes, such as endothelial function, and may reduce four\u2010 to fivefold the incidence of premature birth. Nevertheless, further research is needed to fully discern the underlying mechanisms by which local chronic infections can have an impact on systemic health, and in this endeavor periodontal disease may serve as an ideal disease model.<\/jats:bold> <\/jats:p>","DOI":"10.1196\/annals.1366.032","type":"journal-article","created":{"date-parts":[[2006,12,27]],"date-time":"2006-12-27T23:33:25Z","timestamp":1167262405000},"page":"251-264","source":"Crossref","is-referenced-by-count":249,"title":["Low\u2010Grade Inflammation in Chronic Infectious Diseases"],"prefix":"10.1111","volume":"1088","author":[{"given":"NIKI M.","family":"MOUTSOPOULOS","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PHOEBUS N.","family":"MADIANOS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,12,8]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra043430"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.grf.0000141894.85221.f7"},{"key":"e_1_2_7_4_2","first-page":"31","article-title":"Development of a classification system for periodontal diseases and conditions","volume":"79","author":"Armitage G.C.","year":"2000","journal-title":"Northwest Dent"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0757.2002.280102.x"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1998.tb02419.x"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.micro.54.1.413"},{"key":"e_1_2_7_8_2","first-page":"889","article-title":"T cell regulation of the immune response to infection in periodontal diseases","volume":"18","author":"Yamazaki K.","year":"2003","journal-title":"Histol. 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