Risk Factors and Immunoinflammatory Mechanisms Leading to Atherosclerosis: Focus on the Role of Oral Microbiota Dysbiosis

Cardiovascular diseases (CVD), including myocardial infarction and stroke, are currently
the leading cause of morbidity, disability and mortality worldwide. Recently, researchers have
focused their attention on the alterations of the gut and oral microbiota, investigating the possible role
of their dysbiosis in the pathogenesis and/or progression of CVD. In this regard, it has been shown
that endothelial dysfunction, a major feature of CVD, can also be induced by chronic periodontal
infection, due to a systemic pro-inflammatory condition, as suggested by increased plasma levels
of acute phase proteins, IL-6 and fibrinogen. Moreover, proatherogenic dysfunctions can also be
promoted by direct bacterial invasion of the endothelium. This review reports the current evidence
about the possible role of oral microbiota dysbiosis and the related immunoinflammatory components
in the pathophysiology of atherosclerosis and associated CVD. It is concluded that integration of oral
microbiota sampling into clinical practice may result in a more accurate assessment of CV risk in
patients and even modify their prognosis.