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Infection and inflammatory mechanisms. J Periodontol 2013;84 4 Suppl: S1-7. Champagne CM, Buchanan W, Reddy MS, Preisser JS, Beck JD, Offenbacher S. Potential for gingival crevice fluid measures as predictors of risk for periodontal diseases. Periodontol 2000 2003;31:167-80. Kinane DF, Preshaw PM, Loos BG; Working Group of Seventh European Workshop on Periodontology. Host-response: Understanding the cellular and molecular mechanisms of host-microbial interactions \u2013 Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol 2011;38 Suppl 11:44-8. Takeuchi H, Furuta N, Morisaki I, Amano A. Exit of intracellular Porphyromonas gingivalisfrom gingival epithelial cells is mediated by endocytic recycling pathway. Cell Microbiol 2011;13:677-91. Dietrich T, Sharma P, Walter C, Weston P, Beck J. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Clin Periodontol 2013;40 Suppl 14:S70-84. Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes \u2013 Systematic review. J Clin Periodontol 2013;40 Suppl 14:S181-94. Borgnakke WS, Yl\u00f6stalo PV, Taylor GW, Genco RJ. Effect of periodontal disease on diabetes: Systematic review of epidemiologic observational evidence. J Clin Periodontol 2013;40 Suppl 14:S135-52. Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: Review of the evidence. J Periodontol 2013;84 4 Suppl: S8-19. Schenkein HA, Loos BG. Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Periodontol 2013;84 4 Suppl: S51-69. Namiki M, Kawashima S, Yamashita T, Ozaki M, Hirase T, Ishida T, et al.Local overexpression of monocyte chemoattractant protein-1 at vessel wall induces infiltration of macrophages and formation of atherosclerotic lesion: Synergism with hypercholesterolemia. Arterioscler Thromb Vasc Biol 2002;22:115-20. Tanaka T, Nakamura Y, Nasuno A, Mezaki T, Higuchi K, Fukunaga H, et al.Plasma concentrations of monocyte chemoattractant protein 1 (MCP-1) and neopterin in the coronary circulation of patients with coronary artery disease. Circ J 2004;68:114-20. Gonzalez-Quesada C, Frangogiannis NG. Monocyte chemoattractant protein-1\/CCL2 as a biomarker in acute coronary syndromes. Curr Atheroscler Rep 2009;11:131-8. Sch\u00f6nbeck U, Libby P. The CD40\/CD154 receptor\/ligand dyad. Cell Mol Life Sci 2001;58:4-43. Phipps RP. Atherosclerosis: The emerging role of inflammation and the CD40-CD40 ligand system. Proc Natl Acad Sci U S A 2000;97:6930-2. Andr\u00e9 P, Nannizzi-Alaimo L, Prasad SK, Phillips DR. Platelet-derived CD40L: The switch-hitting player of cardiovascular disease. Circulation 2002;106:896-9. Heeschen C, Dimmeler S, Hamm CW, van den Brand MJ, Boersma E, Zeiher AM, et al.Soluble CD40 ligand in acute coronary syndromes. N Engl J Med 2003;348:1104-11. Sch\u00f6nbeck U, Varo N, Libby P, Buring J, Ridker PM. Soluble CD40L and cardiovascular risk in women. Circulation 2001;104:2266-8. Amar S, Gokce N, Morgan S, Loukideli M, Van Dyke TE, Vita JA. Periodontal disease is associated with brachial artery endothelial dysfunction and systemic inflammation. Arterioscler Thromb Vasc Biol 2003;23:1245-9. Nakajima T, Honda T, Domon H, Okui T, Kajita K, Ito H, et al.Periodontitis-associated up-regulation of systemic inflammatory mediator level may increase the risk of coronary heart disease. J Periodontal Res 2010;45:116-22. Gupta M, Chaturvedi R, Jain A. Role of monocyte chemoattractant protein-1 (MCP-1) as an immune-diagnostic biomarker in the pathogenesis of chronic periodontal disease. Cytokine 2013;61:892-7. Chaturvedi R, Gupta M, Jain A, Das T, Prashar S. Soluble CD40 ligand: A novel biomarker in the pathogenesis of periodontal disease. Clin Oral Investig 2015;19:45-52. Lievens D, Zernecke A, Seijkens T, Soehnlein O, Beckers L, Munnix IC, et al.Platelet CD40L mediates thrombotic and inflammatory processes in atherosclerosis. Blood 2010;116:4317-27. Aukrust P, M\u00fcller F, Ueland T, Berget T, Aaser E, Brunsvig A, et al.Enhanced levels of soluble and membrane-bound CD40 ligand in patients with unstable angina. Possible reflection of T lymphocyte and platelet involvement in the pathogenesis of acute coronary syndromes. Circulation 1999;100:614-20. Giannini S, Falcinelli E, Bury L, Guglielmini G, Rossi R, Momi S, et al.Interaction with damaged vessel wall in vivo in humans induces platelets to express CD40L resulting in endothelial activation with no effect of aspirin intake. Am J Physiol Heart Circ Physiol 2011;300:H2072-9. Dav\u00ec G, Tuttolomondo A, Santilli F, Basili S, Ferrante E, Di Raimondo D, et al.CD40 ligand and MCP-1 as predictors of cardiovascular events in diabetic patients with stroke. J Atheroscler Thromb 2009;16:707-13. Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol 2007;78 7 Suppl: 1387-99. Leishman SJ, Do HL, Ford PJ. Cardiovascular disease and the role of oral bacteria. J Oral Microbiol 2010;2:5781-93. Kozarov EV, Dorn BR, Shelburne CE, Dunn WA Jr, Progulske-Fox A. Human atherosclerotic plaque contains viable invasive Actinobacillus actinomycetemcomitansand Porphyromonas gingivalis. Arterioscler Thromb Vasc Biol 2005;25:e17-8. Mahendra J, Mahendra L, Kurian VM, Jaishankar K, Mythilli R. 16S rRNA-based detection of oral pathogens in coronary atherosclerotic plaque. Indian J Dent Res 2010;21:248-52. Packard RR, Libby P. Inflammation in atherosclerosis: From vascular biology to biomarker discovery and risk prediction. Clin Chem 2008;54:24-38. Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: A meta-analysis. Am Heart J 2007;154:830-7. Marcaccini AM, Meschiari CA, Sorgi CA, Saraiva MC, de Souza AM, Faccioli LH, et al.Circulating interleukin-6 and high-sensitivity C-reactive protein decrease after periodontal therapy in otherwise healthy subjects. J Periodontol 2009;80:594-602. Pradeep AR, Daisy H, Hadge P. Gingival crevicular fluid levels of monocyte chemoattractant protein-1 in periodontal health and disease. Arch Oral Biol 2009;54:503-9. Papapanagiotou D, Nicu EA, Bizzarro S, Gerdes VE, Meijers JC, Nieuwland R, et al.Periodontitis is associated with platelet activation. Atherosclerosis 2009;202:605-11. Pradeep AR, Daisy H, Hadge P. Serum levels of monocyte chemoattractant protein-1 in periodontal health and disease. Cytokine 2009;47:77-81. Kiener PA, Moran-Davis P, Rankin BM, Wahl AF, Aruffo A, Hollenbaugh D. Stimulation of CD40 with purified soluble gp39 induces proinflammatory responses in human monocytes. J Immunol 1995;155:4917-25. Stumpf C, Lehner C, Raaz D, Yilmaz A, Anger T, Daniel WG, et al.Platelets contribute to enhanced MCP-1 levels in patients with chronic heart failure. Heart 2008;94:65-9. Imamura T, Travis J, Potempa J. The biphasic virulence activities of gingipains: Activation and inactivation of host proteins. Curr Protein Pept Sci 2003;4:443-50. D'Aiuto F, Parkar M, Nibali L, Suvan J, Lessem J, Tonetti MS. Periodontal infections cause changes in traditional and novel cardiovascular risk factors: Results from a randomized controlled clinical trial. Am Heart J 2006;151:977-84. Tonetti MS, D'Aiuto F, Nibali L, Donald A, Storry C, Parkar M, et al.Treatment of periodontitis and endothelial function. N Engl J Med 2007;356:911-20. D'Aiuto F, Orlandi M, Gunsolley JC. Evidence that periodontal treatment improves biomarkers and CVD outcomes. 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