Short Communication| Volume 31, ISSUE 3, 106301, March 2022

Download started.


Assessment of Serum IgG Titers to Various Periodontal Pathogens Associated with Atrial Fibrillation in Acute Stroke Patients



      There is accumulating evidence that periodontal disease is associated with atrial fibrillation (AF) or stroke, but it is unclear which causative species of periodontal disease are present in stroke patients with AF. We aimed to investigate the associations between AF and specific periodontal pathogens using serum titers of IgG antibodies of bacteria in acute stroke patients.

      Materials and methods

      Acute stroke patients were registered at two hospitals. Serum samples were evaluated for titers of antibodies against 9 periodontal pathogens (16 genotypes) using ELISAs. We identified AF in patients according to the following criteria: (1) a history of sustained or paroxysmal AF or (2) AF detection upon arrival or during admission. We carried out propensity score matching to categorize the patients as those with AF and those without.


      Of the 664 acute stroke patients, 123 (18.5%) had AF. After propensity score matching, 234 patients were selected. Patients with AF had a higher prevalence of positive serum titers of antibodies against Porphyromonas gingivalis (FimA type III) and Porphyromonas gingivalis (FimA type V) than those without AF (59.0% vs. 39.3%, p=0.004 and 58.2% vs. 40.2%, p=0.009, respectively).


      Porphyromonas gingivalis, especially FimA type III and type V, might be associated with AF in stroke patients.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kim J
        • Amar S.
        Periodontal disease and systemic conditions: a bidirectional relationship.
        Odontology. 2006; 94: 10-21
        • Beck JD
        • Offenbacher S.
        Systemic effects of periodontitis: epidemiology of periodontal disease and cardiovascular disease.
        J Periodontol. 2005; 76: 2089-2100
        • Lafon A
        • Pereira B
        • Dufour T
        • Rigouby V
        • Giroud M
        • Béjot Y
        • Tubert-Jeannin S.
        Periodontal disease and stroke: a meta-analysis of cohort studies.
        Eur J Neurol. 2014; 21 (e1166-1157): 1155-1161
        • Chen DY
        • Lin CH
        • Chen YM
        • Chen HH.
        Risk of atrial fibrillation or flutter associated with periodontitis: a nationwide, population-based, cohort study.
        PLoS One. 2016; 11e0165601
        • Sen S
        • Redd K
        • Trivedi T
        • Moss K
        • Alonso A
        • Soliman EZ
        • Magnani JW
        • Chen LY
        • Gottesman RF
        • Rosamond W
        • et al.
        Periodontal disease, atrial fibrillation and stroke.
        Am Heart J. 2021; 235: 36-43
        • Howard KC
        • Gonzalez OA
        • Garneau-Tsodikova S.
        Porphyromonas gingivalis: where do we stand in our battle against this oral pathogen?.
        RSC Med Chem. 2021; 12: 666-704
        • Nishi H
        • Hosomi N
        • Ohta K
        • Aoki S
        • Nakamori M
        • Nezu T
        • Shigeishi H
        • Shintani T
        • Obayashi T
        • Ishikawa K
        • et al.
        Serum immunoglobulin G antibody titer to Fusobacterium nucleatum is associated with unfavorable outcome after stroke.
        Clin Exp Immunol. 2020; 200: 302-309
      1. Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III.
        Stroke. 1990; 21: 637-676
        • Nakahara T
        • Hyogo H
        • Ono A
        • Nagaoki Y
        • Kawaoka T
        • Miki D
        • Tsuge M
        • Hiraga N
        • Hayes CN
        • Hiramatsu A
        • et al.
        Involvement of Porphyromonas gingivalis in the progression of non-alcoholic fatty liver disease.
        J Gastroenterol. 2018; 53: 269-280
        • Socransky SS
        • Haffajee AD
        • Dzink JL.
        Relationship of subgingival microbial complexes to clinical features at the sampled sites.
        J Clin Periodontol. 1988; 15: 440-444
        • Hosomi N
        • Aoki S
        • Matsuo K
        • Deguchi K
        • Masugata H
        • Murao K
        • Ichihara N
        • Ohyama H
        • Dobashi H
        • Nezu T
        • et al.
        Association of serum anti-periodontal pathogen antibody with ischemic stroke.
        Cerebrovasc Dis. 2012; 34: 385-392
        • Nakamori M
        • Hosomi N
        • Nishi H
        • Aoki S
        • Nezu T
        • Shiga Y
        • Kinoshita N
        • Ishikawa K
        • Imamura E
        • Shintani T
        • et al.
        Serum IgG titers against periodontal pathogens are associated with cerebral hemorrhage growth and 3-month outcome.
        PLoS One. 2020; 15e0241205
        • Shiga Y
        • Hosomi N
        • Nezu T
        • Nishi H
        • Aoki S
        • Nakamori M
        • Ishikawa K
        • Kinoshita N
        • Imamura E
        • Ueno H
        • et al.
        Association between periodontal disease due to Campylobacter rectus and cerebral microbleeds in acute stroke patients.
        PLoS One. 2020; 15e0239773
        • Aoki S
        • Hosomi N
        • Nishi H
        • Nakamori M
        • Nezu T
        • Shiga Y
        • Kinoshita N
        • Ueno H
        • Ishikawa K
        • Imamura E
        • et al.
        Serum IgG titers to periodontal pathogens predict 3-month outcome in ischemic stroke patients.
        PLoS One. 2020; 15e0237185
        • Dickinson DP
        • Kubiniec MA
        • Yoshimura F
        • Genco RJ.
        Molecular cloning and sequencing of the gene encoding the fimbrial subunit protein of Bacteroides gingivalis.
        J Bacteriol. 1988; 170: 1658-1665
        • Wang H
        • Zhang W
        • Wang W
        • Zhang L.
        The prevalence of fimA genotypes of Porphyromonas gingivalis in patients with chronic periodontitis: A meta-analysis.
        PLoS One. 2020; 15e0240251
        • Nakano K
        • Inaba H
        • Nomura R
        • Nemoto H
        • Takeuchi H
        • Yoshioka H
        • Toda K
        • Taniguchi K
        • Amano A
        • Ooshima T.
        Distribution of Porphyromonas gingivalis fimA genotypes in cardiovascular specimens from Japanese patients.
        Oral Microbiol Immunol. 2008; 23: 170-172