Increased levels of circulating endothelial progenitor cells in subjects with moderate to severe chronic periodontitis

J Clin Periodontol. 2009 Nov;36(11):933-9. doi: 10.1111/j.1600-051X.2009.01481.x. Epub 2009 Oct 2.


Aim: Emerging evidence shows that periodontal disease is associated with endothelial dysfunction. The purpose of this study was to determine the association between chronic periodontitis (CP) and circulating endothelial progenitor cells (EPC).

Materials and methods: Eighty-six non-smoking subjects (36 males and 50 females, aged 35-80 years) were recruited, including 23 subjects with no or mild CP and 63 subjects with moderate to severe CP. The levels of circulating EPC were quantitatively determined by fluorescence-activated cell analysis, including CD34+/kinase insert domain-containing receptor (KDR)+ (more mature EPC) and CD133+/KDR+ (less mature EPC). Periodontal conditions, the intima-media thickness of carotid arteries and circulating biomarkers were examined.

Results: Subjects with moderate to severe CP exhibited an increased risk of high EPC count, compared with those with no or mild CP: CD34+/KDR+ EPC [odds ratio (OR)=9.5, 95% confidence interval (95% CI) 1.5-61.0, p=0.018; CD133+/KDR+ EPC, OR=4.6, 95% CI 1.1-19.5, p=0.039]. C-reactive protein was significantly associated with high CD34+/KDR+ EPC count and age was inversely related with high EPC count. Age, gender and CD34+/KDR+ EPC were independent variables of increased carotid intima-media thickness (p<0.05).

Conclusion: This study shows for the first time that moderate to severe CP is associated with an increased level of circulating EPC.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AC133 Antigen
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antigens, CD / blood
  • Antigens, CD34 / blood
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Carotid Arteries / pathology
  • Chronic Periodontitis / blood*
  • Educational Status
  • Endothelial Cells / pathology*
  • Female
  • Flow Cytometry
  • Gingival Hemorrhage / blood
  • Gingival Recession / blood
  • Glycoproteins / blood
  • Humans
  • Male
  • Middle Aged
  • Peptides / blood
  • Periodontal Attachment Loss / blood
  • Periodontal Pocket / blood
  • Sex Factors
  • Stem Cells / pathology*
  • Tunica Intima / pathology
  • Tunica Media / pathology
  • Vascular Endothelial Growth Factor Receptor-2 / blood
  • Waist-Hip Ratio


  • AC133 Antigen
  • Antigens, CD
  • Antigens, CD34
  • Biomarkers
  • Glycoproteins
  • PROM1 protein, human
  • Peptides
  • C-Reactive Protein
  • Vascular Endothelial Growth Factor Receptor-2