The study by Velsko and colleagues found a causal link between periodontitis and atherosclerosis [1]. As periodontitis is easier to recognize than is atherosclerosis, this finding opens the door to treatments that can reduce the risk of atherosclerosis.

Vitamin D has been found to reduce the risk of periodontitis [2-4]. The likely mechanism is through induction of cathelicidin (LL-37), which is an antimicrobial peptide [5,6]. LL-37 has been found to neutralize purified P. ginigivalis in laboratory experiments [7]. Smoking seems to reduce salivary levels of LL-37 [8], which may help explain why smokers have increased risk of periodontitis.

Vitamin D also reduces the risk of sepsis/septicemia [9,10], which implies that vitamin D, through induction of LL-37, can also provide antimicrobial actions against P. ginigivalis in the blood.

Vitamin D also reduces risk of atherosclerosis [11] and serum 25-hydroxyvitamin D levels are inversely correlated with incidence of cardiovascular disease in observational studies [12].

Thus, there seems to be sufficient evidence that vitamin D plays important roles in reducing risk of both periodontitis and atherosclerosis that those diagnosed with periodontitis could be advised to increase 25-hydroxyvitamin D levels to above 30-40 ng/mL (75-100 nmol/L) [13].

References

1. Velsko IM, Chukkapalli SS, Rivera MF, Lee JY, Chen H, et al. Active invasion of oral and aortic tissues by Porphyromonas gingivalis in mice causally links periodontitis and atherosclerosis. PLoS One. 2014;9(5):e97811.
2. Grant WB, Boucher BJ. Are Hill’s criteria for causality satisfied for vitamin D and periodontal disease? Dermatoendocrinol. 2010;2(1):30-36.
3. Alshouibi EN, Kaye EK, Cabral HJ, Leone CW, Garcia RI. Vitamin D and periodontal health in older men. J Dent Res. 2013;92(8):689-93.
4. Zhan Y, Samietz S, Holtfreter B, Hannemann A, Meisel P, et al. Prospective study of serum 25-hydroxy vitamin D and tooth loss. J Dent Res. 2014 May 14. pii: 0022034514534985. [Epub ahead of print]
5. Dixon BM, Barker T, McKinnon T, Cuomo J, Frei B, et al. Positive correlation between circulating cathelicidin antimicrobial peptide (hCAP18/LL-37) and 25-hydroxyvitamin D levels in healthy adults. BMC Res Notes. 2012;5:575.
6. Borella E, Nesher G, Israeli E, Shoenfeld Y. Vitamin D: a new anti-infective agent? Ann N Y Acad Sci. 2014 Mar 4.
7. Walters SM, Dubey VS, Jeffrey NR, Dixon DR. Antibiotic-induced Porphyromonas gingivalis LPS release and inhibition of LPS-stimulated cytokines by antimicrobial peptides. Peptides. 2010;31(9):1649-53.
8. Takeuchi Y, Nagasawa T, Katagiri S, Kitagawara S, Kobayashi H, et al. Salivary levels of antibacterial peptide (LL-37/hCAP-18) and cotinine in patients with chronic periodontitis. J Periodontol. 2012;83(6):766-72.
9. Grant WB. Solar ultraviolet-B irradiance and vitamin D may reduce the risk of septicemia. Dermatoendocrinol. 2009;1(1):37-42.
10. Moromizato T, Litonjua AA, Braun AB, Gibbons FK, Giovannucci E, et al. Association of low serum 25-hydroxyvitamin D levels and sepsis in the critically ill. Crit Care Med. 2014;42(1):97-107
11. Hao Y, Ma X, Luo Y, Ni J, Dou J, et al. Additional role of serum 25-hydroxyvitamin D3 levels in atherosclerosis in Chinese middle-aged and elderly men. Clin Exp Pharmacol Physiol. 2014;41(3):174-9.
12. Wang L, Song Y, Manson JE, Pilz S, März W, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: A meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012;5(6):819-29.
13. Hossein-Nezhad A, Holick MF. Vitamin D for health: A global perspective. Mayo Clin Proc. 2013;88(7):720-55.