The effect of subantimicrobial-dosedoxycycline periodontal therapy on serum biomarkers of systemic inflammation

A randomized, double-masked, placebo-controlled clinical trial

Jeffrey B Payne, Lome M. Golub, Julie A. Stoner, Hsi Ming Lee, Richard A Reinhardt, Timo Sorsa, Marvin J. Slepian

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background. Periodontitis has been reported to be associated with coronary artery disease (CAD). Research is needed to determine if therapies that improve periodontal health also reduce systemic measures of inflammation associated with both diseases. Methods. The study registrar randomly assigned 128 eligible postmenopausal women with chronic periodontitis to a twice-daily regimen of subantimicrobialdose-doxycycline (SDD) or placebo tablets for two years as an adjunct to periodontal maintenance therapy. Through a supplement to the main trial, in which they investigated alveolar bone and clinical attachment level changes, the authors assayed inflammatory mediators and lipid profiles in baseline, one-year and two-year serum samples. The authors analyzed the data by using generalized estimating equations. Results. In the intent-to-treat analysis across two years, SDD treatment reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (primary outcome; P = .02) and reduced serum matrix metalloproteinase (MMP)-9 (92 kilodalton gelatinase; difference in mean scanning units, -28.44; P < .001), with no significant effect on serum lipids. However, in women more than five years postmenopausal, SDD elevated the level of high-density lipoprotein (HDL) cholesterol (difference in means [milligrams per deciliter], 5.99; P = .01). Conclusion. A two-year SDD regimen in postmenopausal women significantly reduced the serum inflammatory biomarkers hs-CRP and MMP-9 and, among women more than five years postmenopausal, increased the HDL cholesterol level. Clinical Implications. SDD significantly reduced the systemic inflammatory biomarkers hs-CRP and MMP-9. More research is needed to determine whether SDD has a role in managing the care of patients at risk of developing CAD.

Original languageEnglish (US)
Pages (from-to)262-273
Number of pages12
JournalJournal of the American Dental Association
Volume142
Issue number3
DOIs
StatePublished - Jan 1 2011

Fingerprint

Doxycycline
Controlled Clinical Trials
Biomarkers
Placebos
Inflammation
Matrix Metalloproteinase 9
Serum
C-Reactive Protein
HDL Cholesterol
Coronary Artery Disease
Therapeutics
Lipids
Chronic Periodontitis
Gelatinases
Periodontitis
Research
Tablets
Patient Care
Bone and Bones
Health

Keywords

  • C-reactive protein
  • Doxycycline
  • High-density lipoprotein cholesterol
  • Inflammation
  • Matrix metalloproteinases
  • Periodontitis
  • Serum inflammatory biomarkers

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

The effect of subantimicrobial-dosedoxycycline periodontal therapy on serum biomarkers of systemic inflammation : A randomized, double-masked, placebo-controlled clinical trial. / Payne, Jeffrey B; Golub, Lome M.; Stoner, Julie A.; Lee, Hsi Ming; Reinhardt, Richard A; Sorsa, Timo; Slepian, Marvin J.

In: Journal of the American Dental Association, Vol. 142, No. 3, 01.01.2011, p. 262-273.

Research output: Contribution to journalArticle

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abstract = "Background. Periodontitis has been reported to be associated with coronary artery disease (CAD). Research is needed to determine if therapies that improve periodontal health also reduce systemic measures of inflammation associated with both diseases. Methods. The study registrar randomly assigned 128 eligible postmenopausal women with chronic periodontitis to a twice-daily regimen of subantimicrobialdose-doxycycline (SDD) or placebo tablets for two years as an adjunct to periodontal maintenance therapy. Through a supplement to the main trial, in which they investigated alveolar bone and clinical attachment level changes, the authors assayed inflammatory mediators and lipid profiles in baseline, one-year and two-year serum samples. The authors analyzed the data by using generalized estimating equations. Results. In the intent-to-treat analysis across two years, SDD treatment reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (primary outcome; P = .02) and reduced serum matrix metalloproteinase (MMP)-9 (92 kilodalton gelatinase; difference in mean scanning units, -28.44; P < .001), with no significant effect on serum lipids. However, in women more than five years postmenopausal, SDD elevated the level of high-density lipoprotein (HDL) cholesterol (difference in means [milligrams per deciliter], 5.99; P = .01). Conclusion. A two-year SDD regimen in postmenopausal women significantly reduced the serum inflammatory biomarkers hs-CRP and MMP-9 and, among women more than five years postmenopausal, increased the HDL cholesterol level. Clinical Implications. SDD significantly reduced the systemic inflammatory biomarkers hs-CRP and MMP-9. More research is needed to determine whether SDD has a role in managing the care of patients at risk of developing CAD.",
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AB - Background. Periodontitis has been reported to be associated with coronary artery disease (CAD). Research is needed to determine if therapies that improve periodontal health also reduce systemic measures of inflammation associated with both diseases. Methods. The study registrar randomly assigned 128 eligible postmenopausal women with chronic periodontitis to a twice-daily regimen of subantimicrobialdose-doxycycline (SDD) or placebo tablets for two years as an adjunct to periodontal maintenance therapy. Through a supplement to the main trial, in which they investigated alveolar bone and clinical attachment level changes, the authors assayed inflammatory mediators and lipid profiles in baseline, one-year and two-year serum samples. The authors analyzed the data by using generalized estimating equations. Results. In the intent-to-treat analysis across two years, SDD treatment reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (primary outcome; P = .02) and reduced serum matrix metalloproteinase (MMP)-9 (92 kilodalton gelatinase; difference in mean scanning units, -28.44; P < .001), with no significant effect on serum lipids. However, in women more than five years postmenopausal, SDD elevated the level of high-density lipoprotein (HDL) cholesterol (difference in means [milligrams per deciliter], 5.99; P = .01). Conclusion. A two-year SDD regimen in postmenopausal women significantly reduced the serum inflammatory biomarkers hs-CRP and MMP-9 and, among women more than five years postmenopausal, increased the HDL cholesterol level. Clinical Implications. SDD significantly reduced the systemic inflammatory biomarkers hs-CRP and MMP-9. More research is needed to determine whether SDD has a role in managing the care of patients at risk of developing CAD.

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