From oral infection to pulmonary inflammation: periodontal pathogens and their potential role in COPD susceptibility.

Background: Oral health significantly impacts overall health. Periodontal disease and chronic obstructive pulmonary disease (COPD) are prevalent chronic inflammatory conditions among older adults, but their causal link is not well-established. Methods: Multivariable logistic regression, including subgroup, sex-stratified, and interaction analyses, was used to investigate the link between self-reported periodontal disease and COPD. Two-sample Mendelian randomization (MR) was utilized to explore causality, primarily through inverse-variance weighting (IVW), and supported by four additional MR approaches. Sensitivity analyses were performed to evaluate pleiotropy and heterogeneity. Normal human bronchial epithelial cells were stimulated Results: Multivariable logistic regression revealed significant associations between self-reported periodontal disease, oral hygiene practices, and COPD. The self-reported periodontal disease-COPD association was moderated by hypertension and flossing behavior. Mendelian randomization studies provided suggestive, exploratory evidence that periodontal disease may be associated with a higher risk of COPD in European populations, although the association did not survive multiple-testing correction and was not observed in East Asian populations. Conclusion: Periodontal disease may promote COPD pathogenesis, with