Autonomic modulation - sympathy and parasympathic in: chronic Periodontitis investigated by variations in cardiac frequency

• Grant number: 22/05983-1
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• Start date: September 01, 2022
• End date: April 30, 2026
• Field of knowledge: Health Sciences - Dentistry - Periodontology
• Principal Investigator: Michel Reis Messora
• Grantee: Juliane Gonçalves da Fonseca
• Host Institution: Faculdade de Odontologia de Ribeirão Preto (FORP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated research grant: 20/06043-7 - Autonomic (sympathetic and parasympathetic) modulation of cardiovascular and inflammatory responses under physiopathological clinical and experimental conditions, AP.TEM

Abstract

Periodontitis is an infectious and inflammatory disease affecting 30%-60% of the population globally. Besides its local inflammatory characteristics, periodontitis may affect other organs and tissues distant from the oral cavity due to its systemic inflammatory impact, being associated with vascular dysfunction, hypertension, and gut inflammatory disease, among others. Heart Rate Variability (HRV) is a valuable tool to study the cardiac neuro-humoral modulation, with implications in the predictability of morbidity and mortality associated with several diseases, including the inflammatory ones, such as chronic Periodontitis. However, until now, HRV has not been investigated in chronic Periodontitis patients as a predictive tool of systemic conditions and its deterioration.Objective. To examine the HRV in chronic Periodontitis patients by electrocardiography to determine a possible autonomic imbalance (sympathovagal) associated, or not, with alterations in blood pressure and pro- and anti-inflammatory cytokines.Methods. It will be invited to participate in this study individuals diagnosed with moderate to severe chronic Periodontitis, determined by the presence of 2 interproximal sites with clinical attachment level (CAL) e 4 mm and e 1 site with Probing Depth (PD) e 5 mm. Participants will be recruited in The Periodontics Clinic, School of Dentistry at Bauru - USP and will be examined according to PD, gingival recession (REC) or hyperplasia (HP), CAL, and full-mouth gingival bleeding index (GBI) and plaque index (IPl). Interproximal bone level (IBL) will be composed of periodontally healthy individuals recruited from the Screening Section of School of Dentistry at Bauru - USP, paired to test group according to gender and age. Participants will be submitted to non-invasive electrocardiography (Holter) and blood pressure measurement (sphygmomanometry). Blood samples (1mL) will be obtained by puncture of a peripheral vein for the dosage of pro- (IL-1a, IL-1b, TNF-a, IL-6 e IL-17) and anti-inflammatory (IL-10) cytokines, besides C reactive protein.At the end of the protocol the patients will be submitted to the evaluation of the cardiac function through Echocardiography, as well as to the evaluation of the sympathetic activity on the heart by using the [123 I] meta-iodobenzylguanidine (MIBG).Data will be compared between groups by parametric tests (t - test) for linear measurements and non-parametric tests (Kruskal Wallis) for non-linear measurements. The association between cardiac and periodontal parameters and cytokines plasma levels will be analyzed by Chi-square and Fischer exact test, adopting at all tests a 5% significance level. (AU)