We have observed that autoantibodies reactive with important phospholipid antigens are present in the sera and gingival crevicular fluids of patients with periodontitis. The antibodies are likely induced by commonly occuring plaque bacteria. Phosphorylcholine (PC) is a prevalent antigen found on 30-40% of plaque bacteria, and patients with periodontal attachment loss have significantly higher concentrations of IgG anti-PC than do individuals without attachment loss. Data indicate that these antibodies bind to and opsonize oral microorganisms such as Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) and further that they react with and opsonize modified low-density lipoproteins (LDL). Anti-β2-glycoprotein 1-dependent anti-cardiolipin (anti-CL), another antibody of interest, is found at elevated levels in 15-20% of patients with generalized periodontitis. In patients with systemic lupus erythemathosis (SLE) or the antiphospholipid syndrome (APS) elevated levels of these antibodies are associated with prothrombotic events such as stroke and myocardial infarction, early atherosclerosis, and pregnancy loss. A cross-reactive epitope of Porphyromas gingivalis (P. gingivalis) may be responsible for the induction of such antibodies in periodontitis.
Conclusions: Auto-anti-phospholipids may be important in both periodontal pathogensis and extra-oral conditions associated with periodontitis.
Keywords: periodontitis, autoantibody, phospholipid