Reverse causal relationship between periodontitis and shortened telomere length: Bidirectional two-sample Mendelian random analysis.

Background: Observational studies have demonstrated a link between shortened telomere lengths(TL) and chronic periodontitis. However, whether the shortened TL is the cause or the result of periodontitis is unknown.Therefore, our objective was to investigate a bidirectional causal relationship between periodontitis and TL using a two-sample Mendel randomized (MR) study. Methods: A two-sample bidirectional MR analysis using publicly available genome-wide association study (GWAS) data was used. As the primary analysis, inverse variance weighting (IVW) was employed. To identify pleiotropy, we used leave-one-out analysis, MR-Egger, Weighted median, Simple mode, Weighted mode, and MR pleiotropy residual sum and outlier (MR-PRESSO). Results: In reverse MR results, a genetic prediction of short TL was causally associated with a higher risk of periodontitis (IVW: odds ratio [OR]: 1.0601, 95% confidence interval [CI]: 1.0213 to 1.1002; P =0.0021) and other complementary MR methods. In the forward MR analysis, periodontitis was shown to have no significant effect on TL (IVW: p = 0.7242), with consistent results for the remaining complementary MR. No pleiotropy was detected in sensitivity analysis (all P>0.05). Conclusion: Our MR studies showed a reverse causal relationship, with shorten TL being linked to a higher risk of periodontitis, rather than periodontitis shorten that TL. Future research is needed to investigate the relationship between cell senescence and the disease.

Meta-analysis and systematic review of procalcitonin-guided treatment in acute exacerbation of chronic obstructive pulmonary disease.

INTRODUCTION: To evaluate the method of procalcitonin (PCT)-guided treatment on antibiotics in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Database including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trails were searched to find relevant trails. Randomized and quasi-randomized trials of PCT-guided treatment in adult patients with AECOPD were included. Effects on primary outcome (i.e., antibiotic prescriptions, mortality, and clinical success) were accessed in this meta-analysis. RESULTS: Four trials involving 679 patients were included. PCT-guided treatment significantly reduced antibiotic use (OR 0.26, 95% CI 0.14-0.50, P < 0.0001) in comparison to standard treatment, without increasing clinical failure (OR 1.10, 95% CI 0.70-1.74, P = 0.68; I2 = 0%) and mortality (OR 0.86, 95% CI 0.44-1.68, P = 0.66). The rate of readmission and exacerbation at follow-up period was similar in both groups. CONCLUSION: Results from this meta-analysis suggest PCT-guided treatment can safely reduce antibiotic overuse in patients with AECOPD.