Periodontitis in COPD and alpha-1 antitypsin deficiency

Hobbins, Stephanie Ann (2018). Periodontitis in COPD and alpha-1 antitypsin deficiency. University of Birmingham. M.Sc.

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Abstract

This cross-sectional study reviews the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) by exploring epidemiological and pathological data from patients with both diseases and a cohort with alpha-one antitrypsin deficiency (AATD).

Diagnostic criteria for periodontitis is not well standardised in the literature and thus leads to diversity in reported prevalence. In this study, the prevalence in non-deficient COPD patients was found to be increased (1.2 – 97.6%) in comparison to AATD patients (0 – 88.2%) regardless of the definition of periodontitis used (p<0.001), and both groups had a significantly higher prevalence than the general UK population. Common risk factors to both diseases were associated with periodontitis but did not fully account for the increased prevalence. Periodontitis prevalence did not relate to respiratory physiology in non-deficient COPD, but correlations were seen in the AATD group.

As periodontitis, COPD and AATD are all destructive, neutrophilic inflammatory diseases; they likely share a common pathophysiology and the role of peripheral and salivary CRP and IL-8 was explored. Peripheral IL-8 and salivary and peripheral CRP levels were significantly higher in non-deficient COPD compared to AATD patients, but neither accounted for the increased prevalence of periodontitis in non-deficient COPD patients.

To conclude, the criterion used to diagnose periodontitis in epidemiological studies has a significant impact on the published prevalence and associations with other chronic lung disease. This data finds increased prevalence in non-deficient COPD compared to AATD but the association with the severity of pulmonary impairment is stronger in AATD suggesting the deficiency enhances periodontal damage irrespective of other demographic confounders. The pathophysiology underlying this requires further exploration.

Type of Work:

Thesis (Masters by Research > M.Sc.)

Award Type:

Masters by Research > M.Sc.

Supervisor(s):