A CUSTOMISED METHOD FOR TREATING GENERALISED PERIODONTITIS AND PREDICTING CARDIOVASCULAR PROBLEMS USING SALIVARY PROTEOMIC PROFILING

Аннотация

Chronic generalised periodontitis (CGP) is one recognised modifiable risk factor for cardiovascular diseases
(CVD). The use of oral fluid indicators for non-invasive monitoring of concurrent pathology is an intriguing direction in
personalised medicine.
Aim of the study. To develop and scientifically test a customised CGP therapy as well as an algorithm based on proteomic
profiling of the oral fluid for the early prediction of cardiovascular issues in patients with concomitant pathology.
Methods. There were 140 participants in all (the main group consisted of 65 patients with CGP and cardiovascular risk
who received individualised treatment; the comparator group consisted of 45 CGP patients receiving conventional medication;
and the control group consisted of 30 healthy individuals). A comprehensive dental, cardiological, and biochemical
examination was performed. The proteome profile of saliva (apolipoproteins A1, B, E, and cytokines) was evaluated
using ELISA and LC-MS/MS mass spectrometry. In R and Python environments, statistical analysis was performed using
LASSO regression and ROC analysis.
Results. The concept of the “salivary lipoprotein signature of periodontitis” (ApoB/ApoA1 ratio in saliva >1.3) as a marker
of disruption of systemic lipid homeostasis was validated for the first time. It was shown that the ApoE-ε4 isoform independently
predicted worse outcomes. The “PerioCardio-Risk” application incorporates a prognostic model (AUC >0.90).
Thanks to individualised care, the salivary profile reverted to normal in 75-85% of patients, and the periodontal pocket
depth decreased by 25-35%.
Conclusion. By incorporating salivary proteome profiling into an interdisciplinary approach, it is feasible to improve CGP
medication and predict cardiovascular risks two to five years before they manifest clinically