The Clinical and Inflammatory Relationships between Periodontitis and Chronic Obstructive Pulmonary Disease.

AIM To investigate associations between Periodontitis, Chronic Obstructive Pulmonary Disease(COPD) with and without Alpha 1 Anti-trypsin Deficiency(AATD), including neutrophil functions implicated in tissue damage. METHODS The presence and severity of periodontitis (using two international criteria) and lung disease was assessed in 156 COPD patients with and without AATD accounting for common confounding factors. Saliva and systemic inflammatory markers were measured by ELISA together with neutrophil migration. RESULTS COPD and AATD patients exhibited higher prevalence of periodontitis (COPD 95%; AATD 88%) than reported in unselected community dwelling populations even when risk factors (age, smoking history, socioeconomic status, dental habits) were considered. Periodontitis severity associated with lung disease severity (AATD, Periodontitis vs no periodontitis; FEV1 = 56% vs 99% predicted; TLCO = 59% vs. 81% predicted, p<0.0001 for both). Neutrophil migratory accuracy declined in stages II-IV periodontitis patients with COPD or AATD compared to COPD or AATD with no or stage I periodontitis. Improved dental habits appeared to be associated with a reduction in exacerbation frequency in COPD. CONCLUSION The results support shared pathophysiology between periodontitis and COPD, especially when associated with AATD. This may reflect an amplification of neutrophilic inflammation and altered neutrophil functions, already described in periodontitis, COPD and AATD.