Impact of Periodontitis In Pregnancy

C-reactive protein (CRP) is a protein found in the blood, the levels of which rise in response to inflammation (i.e. C-reactive protein is an acute-phase protein). Its physiological role is to bind to phosphocholine expressed on the surface of dead or dying cells (and some types of bacteria) in order to activate the complement system via the C1Q complex.
 
CRP is synthesized by the liver in response to factors released by fat cells (adipocytes). It is a member of the pentraxin family of proteins. It is not related to C-peptide or protein C. C-reactive protein was the first pattern recognition receptor (PRR) to be identified.
 
CRP was so named because it was first discovered as a substance in the serum of patients with acute inflammation that reacted with the C- (capsular) polysaccharide of pneumococcus. Discovered by Tillett and Francis in 1930, it was initially thought that CRP might be a pathogenic secretion as it was elevated in people with a variety of illnesses including cancer, however, discovery of hepatic synthesis demonstrated that it is a native protein.
 
The CRP gene is located on the first chromosome (1q21-q23). CRP is a 224-residue protein with a monomer molar mass of 25106 Da. The protein is an annular pentameric disc in shape and a member of the small pentraxins family.
 
Researchers found that pregnant women with periodontitis had 65 percent higher C-reactive protein (CRP) levels compared to periodontally healthy women. This study appears in the May issue of the Journal of Periodontology (JOP). 
 
CRP levels are a marker of systemic inflammation and are associated with periodontal disease, a chronic bacterial infection found in the gums of the mouth. CRP has also been associated with adverse pregnancy outcomes, including preeclampsia and preterm delivery. 
 
"Elevated CRP may indeed be caused by periodontal infection and inflammation." said Dr. Waranuch Pitiphat, Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University, Thailand. "If this is the case, CRP could amplify the inflammatory response and ultimately cause adverse pregnancy outcomes. Alternatively, periodontal disease and CRP may share a common risk factor for predisposing individuals to a hyperinflammatory response. More research is clearly needed to further our understanding about the association between periodontal disease and adverse pregnancy outcomes." 
 
Past studies examining the relationship between periodontal disease and CRP found that often after standard non-surgical periodontal therapy, CRP levels decrease. 
 
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