Virology & Mycology Infectious Diseases
 
   Publications A-Z
A
»Accounting & Marketing
» Addiction Research & Therapy
» Advanced Chemical Engineering
»Advances in Automobile Engineering
»Advances in Crop Science and Technology
»Advances in Dairy Research
»Advancements in Genetic Engineering
»Advances in Pharmacoepidemiology & Drug Safety
»Advances in Robotics & Automation
»Advanced Techniques in Biology & Medicine
»Advance Research in Meteorological Sciences
»Aeronautics & Aerospace Engineering
»Aging Science
»Agrotechnology
»AIDS & Clinical Research
»Alcoholism and Drug Dependence
»Allergy & Therapy
»Alternative & Integrative Medicine
»Air & Water borne Diseases
»Alzheimers Disease & Parkinsonism
»Analytical & Bioanalytical Techniques
»Anaplastology
»Anatomy & Physiology
»Ancient Diseases & Preventive Remedies
»Andrology-Open Access
»Anesthesia & Clinical Research
»Angiology: Open Access
»Antivirals & Antiretrovirals
»Anthropology
»Applied & Computational Mathematics
»Applied Mechanical Engineering
»Aquaculture Research & Development
» Arabian Journal Business and Management Review
»Architectural Engineering Technology
»Arthritis
»Arts and Social Sciences Journal
» Astrobiology & Outreach
»Astrophysics & Aerospace technology
»Autacoids
»Automatic Control of Physiological State and Function
»Autism-Open Access
  
B
»Bacteriology & Parasitology
»Bioanalysis & Biomedicine
»Bioceramics Development and Applications
»Biochemistry and Analytical Biochemistry
»Biochemistry & Pharmacology: Open Access
»Biochips & Tissue Chips
»Biodiversity & Endangered Species
»Bioenergetics: Open Access
»Bioengineering & Biomedical Science
»Bioequivalence & Bioavailability
»Biosafety & Health Education
»Biofertilizers & Biopesticides
»Biometrics & Biostatistics
»Biomimetics Biomaterials and Tissue Engineering
»Biomolecular Research & Therapeutics
» Biomusical Engineering
»Biochemistry & Physiology: Open Access
»Biological Systems- Open Access
»Biology and Medicine
»Bioprocessing & Biotechniques
»Bioremediation & Biodegradation
»Biosafety
»Biosensors & Bioelectronics
» Biosensors Journal
»Biotechnology & Biomaterials
»Bioterrorism & Biodefense
»Blood Disorders & Transfusion
»Blood & Lymph
»Bone Marrow Research
»Brain Disorders & Therapy
»Business and Economics Journal
»Business and Financial Affairs
  
C
»Cancer Science & Therapy
»Climatology & Weather forecasting
»Carcinogenesis & Mutagenesis
»Cardiovascular Diseases & Diagnosis
»Cardiovascular Pharmacology: Open Access
»Cell & Developmental Biology
»Cell Science & Therapy
»Chemical Engineering & Process Technology
»Chemical Sciences Journal
»Chemotherapy: Open Access
»Child and Adolescent Behavior
»Chromatography & Separation Techniques
»Civil & Environmental Engineering
»Civil & Legal Sciences
»Clinical & Cellular Immunology
»Clinical Case Reports
»Clinical & Experimental Cardiology
»Clinical & Experimental Dermatology Research
»Clinical & Experimental Ophthalmology
»Clinical & Experimental Pathology
»Clinical & Experimental Pharmacology
»Clinical Microbiology: Open Access
»Clinical Pharmacology & Biopharmaceutics
»Clinical Research & Bioethics
»Clinical Research on Foot & Ankle
»Clinical Toxicology
»Clinical Trials
»Clinics in Mother and Child Health
»Cloning & Transgenesis
»Community Medicine & Health Education
»Communication Disorders, Deaf Studies & Hearing Aids
»Computer Science & Systems Biology
» Current Synthetic & Systems Biology
»Cytology & Histology
D
»Data Mining in Genomics & Proteomics
»Defense Management
»Dentistry
»Depression and Anxiety
»Developing Drugs
»Diabetes & Metabolism
»Drug Designing
»Drug Metabolism & Toxicology
  
E
»Earth Science & Climatic Change
»Ecosystem & Ecography
»Endocrinology & Metabolic Syndrome
»Entomology, Ornithology & Herpetology
»Environmental & Analytical Toxicology
»Epidemiology: Open Access
»Emergency Medicine
»Ergonomics
»Electrical & Electronics
»Enzyme Engineering
»Entrepreneurship & Organization Management
  
F
»Family Medicine & Medical Science Research
»Fermentation Technology
»Fertilization: In Vitro - IVF-Worldwide
»Fisheries and Aquaculture Journal
»Fisheries & Livestock Production
»Food Processing & Technology
»Forensic Biomechanics
»Forensic Research
»Forest Research: Open Access
»Fundamentals of Renewable Energy and Applications
»Fungal Genomics & Biology
  
G
»Gastrointestinal & Digestive System
»Genetic Syndromes & Gene Therapy
»Gene Technology
»Generalized Lie Theory and Applications
»Glycobiology
»Glycomics & Lipidomics
»Gynecology& Obstetrics
»General Medicine
»General Practice
»Geography & Natural Disasters
»Geology & Geosciences
»Geophysics & Remote Sensing
»Gerontology & Geriatric Research
»Global Economics
»Global Journal of Technology and Optimization
  
H
»Hair : Therapy & Transplantation
»Hematology & Thromboembolic Diseases
»Health Care : Current Reviews
»Health & Medical Informatics
»Hereditary Genetics
»Homeopathy & Ayurvedic Medicine
»Horticulture
»Hotel & Business Management
»Human Genetics & Embryology
»Hydrology: Current Research
»Hypertension- Open Access
  
I
»Industrial Engineering & Management
»Irrigation and Drainage Systems Engineering
»Infectious Diseases and Therapy
»Information Technology & Software Engineering
»Intellectual Property Rights: Open Access
»Integrative Oncology
»Internal Medicine
»International Journal of Accounting Research
»International Journal of Advanced Innovations, Thoughts & Ideas
»International Journal of Biomedical Data Mining
»International Journal of Economics and Management Science
»International Journal of Sensor Networks and Data Communications
»International Journal of Swarm Intelligence and Evolutionary Computation
»International Journal of waste resources
»International Journal of Genomic Medicine
»International Journal of Physical Medicine & Rehabilitation
»Innovative Energy Policies
»Immunome Research
  
J
»JBR Journal of Interdisciplinary Medicine and Dental Science
»JBR Journal of Clinical Diagnosis and Research
»JBR Journal of Young Scientist
  
L
»Liver
» Leukemia
» Lovotics
  
M
»Marine Science: Research & Development
»Malaria Chemotherapy, Control & Elimination
»Mass Communication & Journalism
»Material Sciences & Engineering
»Medicinal Chemistry
»Medicinal & Aromatic Plants
»Medical Diagnostic Methods
»Medical Microbiology & Diagnosis
»Medical & Surgical Urology
»Membrane Science & Technology
»Metabolic Syndrome
»Metabolomics:Open Access
»Microbial & Biochemical Technology
»Modern Chemistry & Applications
»Molecular Biology
»Molecular Biomarkers & Diagnosis
»Molecular and Genetic Medicine
»Molecular Imaging & Dynamics
»Molecular Pharmaceutics & Organic Process Research
»Mycobacterial Diseases
N
»Natural Products Chemistry & Research
»Nanomedicine & Biotherapeutic Discovery
»Nanomedicine & Nanotechnology
»Neonatal Biology
»Nephrology & Therapeutics
»Neurology & Neurophysiology
»Neuroinfectious Diseases
»Neurological Disorders
»Novel Physiotherapies
»Nuclear Medicine & Radiation Therapy
»Nutrition & Food Sciences
»Nutritional Disorders & Therapy
»Nursing & Care
  
O
»Obesity & Weight Loss Therapy
»Oceanography-Open Access
»Occupational Medicine & Health Affairs
»OMICS Journal of Radiology
»Osteoporosis and Physical Activity
»Oral Health and Dental Management
»Oral Hygiene & Health
»Organic Chemistry: Current Research
»Orthopedic & Muscular System: Current Research
»Otolaryngology
  
P
»Pain & Relief
»Palliative Care & Medicine
»Pancreatic Disorders & Therapy
»Pediatrics & Therapeutics
»Petroleum & Environmental Biotechnology
»Pharmaceutica Analytica Acta
»Pharmaceutical Regulatory Affairs: Open Access
»Pharmacogenomics & Pharmacoproteomics
»Pharmacovigilance
»Physical Chemistry & Biophysics
»Physical Mathematics
»Plant Pathology & Microbiology
»Plant Biochemistry & Physiology
»Pollution Effects & Control
»political Sciences & public affairs
»Poultry, Fisheries & Wildlife Sciences
»Powder Metallurgy & Mining
»Primatology
»Primary Health Care: Open Access
»Probiotics & Health
» Phylogenetics & Evolutionary Biology
»Proteomics & Bioinformatics
»Phylogenetics & Evolutionary Biology
»Psychology & Psychotherapy
»Psychological Abnormalities in Children
»Pulmonary & Respiratory Medicine
  
R
»Reproductive System & Sexual Disorders
»Research and Development
»Review of Public Adminstration and Management
»Rheumatology: Current Research
»Rice Research: Open Access
  
S
» Single Cell Biology
»Sleep Disorders & Therapy
»Socialomics
»Sociology and Criminology-Open Access
»Sports Medicine & Doping Studies
»Spine
»Stem Cell Research & Therapy
»Steroids & Hormonal Science
»Stock & Forex Trading
»Surgery: Current Research
  
T
»Telecommunications System & Management
»Textile Science & Engineering
»Theoretical and Computational Chemistry:Open Access
»Thermodynamics & Catalysis
»Thyroid Disorders & Therapy
»Tissue Science & Engineering
»Translational Medicine
»Transplantation Technologies & Research
»Transcriptomics: Open Access
»Trauma & Treatment
»Tropical Diseases
»Tropical Medicine and Surgery
»Tourism & Hospitality
  
V
»Vaccines & Vaccination
»Vascular Medicine & surgery
»Veterinary Science & Technology
»Virology & Mycology
»Vitamins & Minerals
»Vortex Science and Technology
  
W
»Women's Health Care
  
Y
»Yoga & Physical Therapy
 
   Browse by Subjects
Clinical
» AIDS & Clinical Research
» Anesthesia & Clinical Research
» Angiology
» Cancer Science & Therapy
» Carcinogenesis & Mutagenesis
» Cell Science & Therapy
» Chemotherapy
» Child & Adolescent Behavior
» Clinical & Cellular Immunology
» Clinical Case Reports
» Clinical & Experimental Cardiology
» Clinical & Experimental Dermatology Research
» Clinical & Experimental Ophthalmology
» Clinical & Experimental Pharmacology
» Clinical & Experimental Pathology
» Clinical Microbiology: Open Access
» Clinical Research & Bioethics
» Clinical Research on Foot & Ankle
» Clinical Toxicology
» Clinical Trials
»Clinics in Mother and Child Health
» Communication Disorders, Deaf Studies & Hearing Aids
» Cytology & Histology
» Forensic Research
»Forensic Biomechanics
» Integrative Oncology
»Immunome Research
»JBR Journal of Clinical Diagnosis and Research
» Neurology & Neurophysiology
» Pulmonary & Respiratory Medicine
» Stem Cell Research & Therapy
» Transplantation Technologies & Research
   
Pharmaceutical Sciences
» Advances in Pharmacoepidemiology & Drug Safety
» Alcoholism and Drug Dependence
» Bioanalysis & Biomedicine
» Biochemical Pharmacology
» Bioequivalence & Bioavailability
» Cardiovascular Pharmacology: Open Access
» Clinical Pharmacology & Biopharmaceutics
» Developing Drugs
» Drug Designing
» Drug Metabolism & Toxicology
» Medicinal & Aromatic Plants
» Molecular Pharmaceutics & Organic Process Research
» Pharmaceutica Analytica Acta
» Pharmaceutical Regulatory Affairs
» Pharmacovigilance
» Vaccines & Vaccination
   
Chemistry
» Advanced Chemical Engineering
» Analytical & Bioanalytical Techniques
» Chemical Sciences Journal
» Chromatography & Separation Techniques
» Medicinal Chemistry
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» Natural Products Chemistry & Research
» Organic Chemistry
» Physical Chemistry & Biophysics
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» Thermodynamics & Catalysis
» Theoretical and Computational Chemistry:Open Access
   
Environmental
» Anthropology
» Aquaculture Research & Development
» Astrobiology & Outreach
» Biodiversity & Endangered Species
» Earth Science & Climatic Change
» Ecosystem & Ecography
» Environmental & Analytical Toxicology
» Fisheries & Livestock Production
»Fundamentals of Renewable Energy and Applications
» Geography & Natural Disasters
» Hydrology: Current Research
»Innovative Energy Policies
»International Journal of waste resources
» Oceanography-Open Access
» Petroleum & Environmental Biotechnology
» Pollution Effects & Control
» Poultry, Fisheries & Wildlife Sciences
   
Omics
» Data Mining in Genomics & Proteomics
»Ergonomics
» Glycomics & Lipidomics
» Health & Medical Informatics
»JBR Journal of Young Scientist
» Metabolomics:Open Access
» OMICS Journal of Radiology
» Pharmacogenomics & Pharmacoproteomics
» Phylogenetics & Evolutionary Biology
» Proteomics & Bioinformatics
» Transcriptomics
   
Life Sciences
» Advanced Techniques in Biology & Medicine
»Advancements in Genetic Engineering
»Advances in Crop Science and Technology
»Advances in Dairy Research
» Aging Science
» Agrotechnology
» Air & Water Borne Diseases
» Antivirals & Antiretrovirals
» Autism-Open Access
» Bacteriology & Parasitology
» Biochemistry & Physiology
» Biochemistry and Analytical Biochemistry
» Bioenergetics
» Bioengineering & Biomedical Science
» Biofertilizers & Biopesticides
» Biological Systems
» Biometrics & Biostatistics
»Biomimetics Biomaterials and Tissue Engineering
» Biomolecular Research & Therapeutics
» Bioremediation & Biodegradation
» Biosafety
» Biosafety & Health Education
» Biosensors & Bioelectronics
» Biosensors Journal
» Biotechnology & Biomaterials
» Bioterrorism & Biodefense
» Cell & Developmental Biology
» Current Synthetic & Systems Biology
» Entomology, Ornithology & Herpetology
» Enzyme Engineering
» Fermentation Technology
» Fertilization: In Vitro - IVF-Worldwide
» Fisheries and Aquaculture Journal
» Forest Research
» Fungal Genomics & Biology
» Gene Technology
» Glycobiology
» Horticulture
» Homeopathy & Ayurvedic Medicine
»International Journal of Swarm Intelligence and Evolutionary Computation
» Marine Science: Research & Development
» Membrane Science & Technology
» Microbial & Biochemical Technology
» Molecular Biology
» Molecular Imaging & Dynamics
» Nanomedicine & Biotherapeutic Discovery
» Nanomedicine & Nanotechnology
» Nutrition & Food Sciences
» Plant Pathology & Microbiology
» Primatology
» Probiotics & Health
» Rice Research: Open Access
» Single Cell Biology
» Sociology and Criminology-Open Access
» Tissue Science & Engineering
» Tropical Diseases
» Veterinary Science & Technology
» Vitamins & Minerals
»Virology & Mycology
   
Engineering
» Advances in Automobile Engineering
» Advances in Robotics & Automation
» Aeronautics & Aerospace Engineering
» Applied & Computational Mathematics
» Applied Mechanical Engineering
» Architectural Engineering Technology
» Astrophysics & Aerospace technology
» Biochips & Tissue Chips
» Bioprocessing & Biotechniques
» Chemical Engineering & Process Technology
» Civil & Environmental Engineering
» Computer Science & Systems Biology
» Electrical & Electronics
» Food Processing & Technology
» Geology and Geosciences
» Geophysics & Remote sensing
»Global Journal of Technology and Optimization
» Industrial Engineering & Management
» Information Technology & Software Engineering
» International Journal of Advance Innovations, Thoughts & Ideas
»International Journal of Sensor Networks and Data Communications
» Irrigation and Drainage Systems Engineering
»Generalized Lie Theory and Applications
» Lovotics
» Material Sciences & Engineering
»Physical Mathematics
» Powder Metallurgy & Mining
» Telecommunications System & Management
» Textile Science & Engineering
»Vortex Science and Technology
   
Medical Sciences
» Addiction Research & Therapy
» Allergy & Therapy
» Alternative & Integrative Medicine
» Alzheimers Disease & Parkinsonism
» Anaplastology
» Anatomy & Physiology
» Ancient Diseases & Preventive Remedies
» Andrology
» Arthritis
» Autacoids
»Automatic Control of Physiological State and Function
» Bioceramics Development and Applications
» Biology and Medicine
» Biomusical Engineering
» Blood & Lymph
» Blood Disorders & Transfusion
» Bone Marrow Research
» Brain Disorders & Therapy
» Cardiovascular Diseases & Diagnosis
» Cloning & Transgenesis
» Community Medicine & Health Education
» Dentistry
» Depression and Anxiety
» Diabetes & Metabolism
» Emergency Medicine
» Endocrinology & Metabolic Syndrome
» Epidemiology: Open Access
» Family Medicine & Medical Science Research
» Gastrointestinal & Digestive System
» General Medicine
» General Practice
» Genetic Syndromes & Gene Therapy
» Gynecology& Obstetrics
» Gerontology & Geriatrics Research
» Hematology & Thromboembolic Diseases
» Hair: Therapy & Transplantation
» Health Care : Current Reviews
» Hereditary Genetics
» Human Genetics & Embryology
» Hypertension-Open Access
» Infectious Diseases & Therapy
» International Journal of Genomic Medicine
» Internal Medicine
»International Journal of Biomedical Data Mining
» International Journal of Physical Medicine & Rehabilitation
»JBR Journal of Interdisciplinary Medicine and Dental Science
» Leukemia
» Liver
»Malaria Chemotherapy, Control & Elimination
» Medical & Surgical Urology
» Medical Diagnostic Methods
» Medical Microbiology & Diagnosis
» Metabolic Syndrome
» Molecular Biomarkers & Diagnosis
» Molecular and Genetic Medicine
» Mycobacterial Diseases
» Neonatal Biology
» Nephrology & Therapeutics
»Neuroinfectious Diseases
» Neurological Disorders
» Novel Physiotherapies
» Nuclear Medicine & Radiation Therapy
» Nursing & Care
» Nutritional Disorders & Therapy
» Obesity & Weight Loss Therapy
» Occupational Medicine & Health Affairs
» Oral Health and Dental Management
» Oral Hygiene & Health
» Orthopedic & Muscular System
» Osteoporosis & Physical Activity
» Otolaryngology
» Pain & Relief
» Palliative Care & Medicine
» Pancreatic Disorders & Therapy
» Pediatrics & Therapeutics
» Primary Health Care
» Psychological Abnormalities in Children
» Psychology & Psychotherapy
» Reproductive System & Sexual Disorders
»Research and Development
» Rheumatology: Current Research
» Sleep Disorders & Therapy
» Spine
» Sports Medicine & Doping Studies
» Steroids & Hormonal Science
» Surgery: Current Research
» Thyroid Disorders & Therapy
» Translational Medicine
» Trauma & Treatment
» Tropical Medicine and Surgery
» Vascular Medicine & surgery
» Women's Health Care
» Yoga & Physical Therapy
 
Management
» Accounting & Marketing
» Arabian Journal Business and Management Review
» Arts and Social Sciences Journal
» Business and Economics Journal
» Business and Financial Affairs
» Civil & Legal Sciences
» Defense Management
» Entrepreneurship & Organization Management
» Global Economics
» Hotel & Business Management
» Intellectual Property Rights: Open Access
»International Journal of Accounting Research
» International Journal of Economics & Management Sciences
» Mass Communication & Journalism
» political Sciences & public affairs
»Review of Public Adminstration and Management
» Socialomics
» Stock & Forex Trading
» Tourism & Hospitality
 
   Conferences
Upcoming Conferences
»3rd International Conference and Exhibition on Biosensors & Bioelectronics August 11-13, 2014 San Antonio, USA
»2nd World Associations Congress August 11-13, 2014 San Antonio, USA
»International Meeting on Space- Open Debate August 12-13, 2014 San Antonio, USA
»5th International Conference and Exhibition on Analytical & Bioanalytical Techniques August 18-20, 2014 Beijing, China
»2nd International Conference on Epidemiology and Evolutionary Genetics August 18-19, 2014 Beijing, China
»2nd International Conference and Exhibition on Pharmacognosy, Phytochemistry & Natural Products August 25-27, 2014 Beijing, China
»2nd International Conference and Exhibition on Traditional & Alternative Medicine August 25-26, 2014 Beijing, China
»2nd International Conference and Exhibition on Mechanical & Aerospace Engineering September 08-10, 2014 Philadelphia, USA
»2nd International Conference and Exhibition on Lasers, Optics & Photonics September 08-10, 2014 Philadelphia, USA
»3rd International Conference and Exhibition on Neurology & Therapeutics September 08-10, 2014 Philadelphia, USA
»4th International Conference on Pharmaceutical Regulatory Affairs September 08-10, 2014 Raleigh, USA
»2nd International Conference on Radiology and Imaging September 08-09, 2014 Raleigh, USA
»2nd International Conference on Genomics & PharmacogenomicsSeptember 08-09, 2014 Raleigh, USA
»2nd International Conference on Alzheimer's Disease and Dementia September 23-25, 2014 Valencia Convention Centre, Valencia, Spain
»3rd International Conference and Exhibition on Nutrition & Food Sciences September 23-25, 2014 Valencia, Spain
»3rd International Conference on Clinical Microbiology & Microbial Genomics September 24-26, 2014 Valencia, Spain
»3rd International Conference on Tissue Science & Regenerative Medicine September 24-26, 2014 Valencia, Spain
»4th International Conference on Vaccines & Vaccination September 24-26, 2014 Valencia, Spain
»3rd International Summit on GMP, GCP & Quality Control September 25-26, 2014 Valencia, Spain
»5th World Congress on Bioequivalence and Bioavailability: Pharmaceutical R&D Summit September 29-October 01, 2014 Baltimore, USA
»2nd International Conference on Hematology & Blood Disorders September 29-October 01, 2014 Baltimore, USA
»3rd International Conference and Exhibition on Clinical & Cellular Immunology September 29-October 01, 2014 Baltimore, USA
»3rd International Conference and Exhibition on Materials Science & Engineering October 06-08, 2014 San Antonio, USA
»3rd International Conference on Forensic Research and Technology October 06-08, 2014 San Antonio, USA
»4th World Congress on Virology October 06-08, 2014 San Antonio, USA
»2nd International Conference on Endocrinology October 20-22, 2014 Chicago, USA
»3rd 3rd International Summit on Toxicology & Applied Pharmacology October 20-22, 2014 Chicago, USA
»3rd 4th World Congress on Cancer Science and Therapy October 20-22, 2014 Chicago, USA
»3rd 3rd International Conference and Exhibition on Cell & Gene Therapy October 27-29, 2014 Las Vegas, USA
»2nd International Conference on HIV/AIDS, STDs & STIs October 27-29, 2014 Chicago, USA
»2nd World Congress on Petrochemistry and Chemical Engineering October 27-29, 2014 Las Vegas, USA
»3rd International Conference and Exhibition on Pharmacovigilance & Clinical Trials October 27-29, 2014 Hyderabad, India
»3rd International Conference and Exhibition on Biowaivers and Biosimilars October 27-29, 2014 Hyderabad, India
»3rd International Conference on Translational Medicine November 03-05, 2014 Las Vegas, USA
»2nd International Conference on Predictive, Preventive and Personalized Medicine & Molecular Diagnostics November 03-05, 2014 Las Vegas, USA
»5th International Conference on Diabetes & Metabolism November 03-05, 2014 Las Vegas, USA
»2nd International Congress on Bacteriology and Infectious Diseases November 17-19, 2014 Chicago, USA
»2nd International Conference on Nursing & Healthcare November 17-19, 2014 Chicago, USA
»3rd International Conference on Surgery and Anesthesia November 17-19, 2014 Chicago, USA
»4th International Conference on Nanotek & Expo December 01-03, 2014 San Francisco, USA
»3rd International Conference and Exhibition on Obesity & Weight Management December 01-03, 2014 San Francisco, USA
»2nd International Summit on Clinical PharmacyDecember 02-03, 2014 San Francisco, USA
»3rd International Conference on Medicinal Chemistry & Computer Aided Drug Designing December 08-10, 2014 San Francisco, USA
»3rd International Conference and Exhibition on Probiotics & Functional Foods December 08-10, 2014 San Francisco, USA
Previous Conferences Organized/Co-organized
»Health Informatics & Technology Conference July 28-29, 2014 Baltimore, USA
»3rd International Conference on Gastroenterology & Urology July 28-30, 2014 San Francisco, USA
»3rd International Conference on Earth Science & Climate Change July 28-30, 2014 San Francisco, USA
»3rd International Conference and Exhibition on Orthopedics & Rheumatology July 28-30, 2014 San Francisco, USA
»International Conference on Business Economics of Broadcasting Media & Film Industry July 28-30, 2014, Baltimore, USA
»4th International Conference on Proteomics & Bioinformatics August 04-06, 2014 Chicago, USA
»3rd International Conference and Exhibition on Addiction Research & Therapy August 04-06, 2014 Chicago, USA
»2nd International Conference on Integrative Biology Summit August 04-05, 2014 Chicago, USA
»3rd International Conference and Exhibition on Cosmetology & Trichology July 21-23, 2014 Las Vegas, USA
»3rd International Conference and Exhibition on Food Processing & Technology July 21-23, 2014 Las Vegas, USA
»2nd International Conference on Oceanography July 21-23 , 2014 Las Vegas USA
»4th International Conference on Clinical & Experimental Ophthalmology July 14-16, 2014 Baltimore, USA
»3rd International Conference & Exhibition on Biometrics & Biostatistics July 14-16, 2014 Baltimore, USA
»2nd International Conference and Exhibition on Physical Medicine & Rehabilitation July 14-16, 2014 Baltimore, USA
»International Conference on Geriatrics & Gerentology July 08-10, 2014 Chicago , USA
»International Conference on Women's Health, Gynecology & Obstetrics July 08-10, 2014 Chicago, USA
»International Conference on Computer Graphics and Media Design July 08-10, 2014 Chicago, USA
»4th International Conference on Clinical & Experimental Cardiology April 14-16, 2014 San Antonio, USA
»4th International Conference on Clinical & Experimental Dermatology April 14-16, 2014 San Antonio, USA
»3rd International Conference and Exhibition on Pathology April 14-16, 2014 San Antonio, USA
»5th International Conference on Biomarkers and Clinical Research April 15-17, 2014 University of Oxford, UK
»2nd International Conference on Business Economics and Management April 21-23, 2014 Dubai, UAE
»2nd International Conference on Dental and Oral Health April 21-23, 2014 Dubai, UAE
»4th World Congress on Cell Science & Stem Cell Research June 24-26, 2014 Valencia, Spain
»3rd International Conference on Biodiversity & Sustainable Energy Development June 24-26, 2014 Valencia, Spain
»3rd International Conference and Exhibition on Occupational Health & Safety June 24-25, 2014 Valencia, Spain
»5th World congress on Biotechnology June 25-27, 2014 Valencia, Spain
»3rd International Conference on Nephrology & Therapeutics June 26-27, 2014 Valencia, Spain
»2nd International Conference on Bioprocess and Engineering June 26-27, 2014 Valencia, Spain
»2nd International Conference on Dental and Oral Health April 21-23, 2014 Dubai, UAE
»5th International Conference on Biomarkers and Clinical Research April 15-17, 2014 University of Oxford, UK
»3rd International Conference and Exhibition on Pathology April 14-16, 2014 San Antonio, USA
»4th International Conference on Clinical & Experimental Dermatology April 14-16, 2014 San Antonio, USA
»4th International Conference on Clinical & Experimental Cardiology April 14-16, 2014 San Antonio, USA
»4th International Conference and Exhibition on Pharmaceutics & Novel Drug Delivery Systems March 24-26, 2014 San Antonio, USA
»3rd International Conference and Exhibition on Metabolomics & Systems Biology March 24-26, 2014 San Antonio, USA
»2nd International Conference on Agricultural & Horticultural Sciences, February 03-05, 2014 Hyderabad, India
»International Conference and Exhibition on Traditional & Alternative Medicine, December 09-11, 2013 Hyderabad, India
»2nd International Conference and Exhibition on Obesity & Weight Management, December 02-04, 2013 Las Vegas, USA
»International Conference on Nursing & Emergency Medicine, December 02-04, 2013 Las Vegas, USA
»3rd International Conference on Nanotek & Expo, December 02-04, 2013 Las Vegas, USA
»3rd World Congress on Virology, November, 20-22, 2013 Baltimore, USA
»International Congress on Bacteriology and Infectious diseases, November 20-22, 2013 Baltimore, USA
»3rd World Congress on Cell Science & Stem Cell Research, November 20-22, 2013 San Antonio, USA
»2nd International Conference and Exhibition on Pharmacovigilance & Clinical Trials, November 18-19, 2013 San Antonio, USA
»International Summit on Clinical Pharmacy & Dispensing, November 18-20, 2013 San Antonio, USA
»World Congress on Petrochemistry and Chemical Engineering, November 18-20, 2013 San Antonio, USA
»International Conference on Functional and Comparative Genomics & Pharmacogenomics, November 12-14, 2013 Chicago, USA
»2nd International Conference and Exhibition on Cosmetology & Trichology, November 12-14, 2013 Chicago, USA
»2nd International Summit on GMP, QA & QC, November 12-14, 2013 Chicago, USA
»2nd International Summit on GLP, GCP & Clinical Pharmacology, November 12-14, 2013 Chicago, USA
» International Conference on Fermentation Technology, Bioprocess and Cell Culture, October 28-30, 2013 Kansas City, USA
»2nd International Conference and Exhibition on Food Processing & Technology, October 28-30, 2013 Kansas City, USA
»International Conference on HIV/AIDS, STDs, & STIs, October 24-25, 2013 Orlando-FL, USA
»2nd International Conference and Exhibition on Cell & Gene Therapy, October 23-25, 2013 Orlando, USA
»2nd International Conference and Exhibition on Probiotics & Functional Foods, October 23-25, 2013 Orlando, USA
»International Conference and Exhibition on Pharmacognosy, Phytochemistry and Natural Products, October 21-23, 2013 Hyderabad, India
» 3rd World Congress on Cancer Science & Therapy, October 21-23, 2013 California, USA
»3rd International Conference on Pharmaceutical Regulatory Affairs, October 21-23, 2013 California, USA
»2nd International Conference on Clinical & Cellular Immunology, October 15-17, 2013 Las Vegas, USA
»2nd International Conference on Medicinal Chemistry & Computer Aided Drug Designing, October 15-17, 2013 Las Vegas, USA
»4th International Conference and Exhibition on Analytical & Bioanalytical Techniques, October 15-17, 2013 Las Vegas, USA
»2nd International Summit on Toxicology, October 07-09, 2013 Las Vegas, USA
»International Conference and Exhibition on Lasers, Optics & Photonics, October 7-9, 2013 San Antonio, USA
»2nd International Conference and Exhibition on Materials Science & Engineering, October 07-09, 2013 Las Vegas, USA
»2nd International Conference on Forensic Research & Technology, October 07-09, 2013 Las Vegas, USA
»International Conference and Exhibition on Biochemical & Molecular Engineering, October 07-08, 2013 San Antonio, USA
»International Conference on Psychology, Autism and Alzheimer's Disease, September 30-October 01, 2013 San Antonio, USA
»International Conference and Exhibition on Mechanical & Aerospace Engineering, September 30-October 02, 2013 San Antonio, USA
»2nd International Conference and Exhibition on Biowaivers & Biosimilars, September 23-25, 2013 Raleigh, USA
»4th World Congress on Biotechnology, September 23-25, 2013 Raliegh, USA
»International Conference on Hematology & Blood Disorders, September 23-25, 2013 Raliegh, USA
»2nd International Conference on Surgery and Anesthesia, September 16-18, 2013 Las Vegas, USA
»2nd International Conference on Clinical Microbiology & Microbial Genomics, September 16-18, 2013 Las Vegas, USA
» International Conference on Omics Studies, September 04-06, 2013 Orlando-FL, USA
»International Symposia on Entomology, September 04-06, 2013 Miami, USA
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Review Article Open Access
 
Periodontitis and Preterm Low Birth Weight: Is there any Association?
1Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia Trapezanlidis Michaela1*, 2Head of the Department of Dentistry, Slovak Medical University, Bratislava, Slovakia Straka Michal2 and 3Pavol Jozef Šafárik University in Košice, Košice, Slovakia Kotrán Milan3
 
Corresponding Author : Trapezanlidis Michaela
Faculty of Medicine
Comenius University in Bratislava
Bratislava, Slovakia
Email: trapezanlidismichaela@gmail.com
 
Received October 08, 2011; Accepted December 14, 2011; Published December 16, 2011
 
Citation: Michaela T, Michal S, Milan K (2011) Periodontitis and Preterm Low Birth Weight: Is there any Association? Reproductive Sys Sexual Disord S2:001. doi: 10.4172/2161-038X.S2-001
 
Copyright: © 2011 Sahli E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 
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Abstract
 

The aim of this paper is to indicate possible etiopathogenetic associations between destructive periodontitis in pregnant women and preterm low birth-weight deliveries. Strong pro-inflammatory potential of chronic periodontitis may attack the whole organism of the future mothers. The destructive inflammatory character of various forms of periodontitis with its bacterial, cytokinal and proteolytic expressions can raise the pro-inflammatory and proteolytic status in the fetoplacental unit and cause premature rupture of chorioplacental membranes. In our study, there are presented possible associations of both states manifested through bacterial, mediatory, genetic, proteolytic and oxidative mechanisms. The majority of other papers report associations of individual ethiopathogenetic mechanisms, by means of which chronic destructive inflammation of periodontium negatively afflicts the feto-placental structures. In spite of wide research in this field, causal associations have not yet been unanimously proven.

 
Introduction
 
There are two major types of periodontal diseases: gingivitis and periodontitis. While gingivitis is inflammation afflicting the gingival part of the periodontium, periodontitis is a bacterial disease manifested with presence of anti-inflammatory response; a reaction to the presence of periodontal pathogens in the periodontium. The antiinflammatory response of periodontal tissues can have an impact on other tissues and organs due to penetration of the microorganisms from the periodontium into the bloodstream; an inflammatory reaction in individuals with weakened immunity is stimulated. Temporary bacteraemia and penetration of various germs into the bloodstream can occur e.g. during medical examination with a periodontal probe, or during chewing, or simple dental hygiene procedures, such as tooth brushing, flossing, etc. [1-2]. Periodontitis is a serious inflammatory disease connected with osteolysis, destruction of periodontal ligaments and formation of periodontal pockets filled with anaerobic bacteria. For advanced stages and forms, penetration of the most virulent strains and bacteria into the periodontal structures is typical. Prolongation of the chronic process increases the total pro-inflammatory status of the organism and enables dissemination of bacteria, virulent components and other inflammatory mediators by blood. The surrounding tissues are often invaded with periodontal pathogens and bacteraemia is caused with hematogenous spreading of these pathogens into distal tissues and organisms [3]. Nowadays periodontitis is seen as a serious systemic disease. It afflicts pregnant women when the periodontal pathogens with their virulent toxins overcome fetoplacental barriers, attack the fetal membranes and cause a preterm labor [4,5].
 
Definition and Epidemiology
 
Preterm low birth weight (PLBW) children, preterm ruptures of membranes (PROM) and Intrauterine Growth Retardation Syndrome (IUGRS) are serious prenatal and perinatal complications that are sometimes hard to distinguish. According to a WHO report the incidence of preterm low birth weight infants varies from 8% in Europe up to 26.2 % in South-Eastern Asia [6]. PLBW children are designated as infants born before the 37th week of gestation with body weight less than 2500 g. Total morbidity in further development of these children is considerably higher and presents serious medical, social, and economic problems. A chronic oral infection is just one of the possible contributors to preterm low birth weight. Other risk factors can be infections of the urogenital tract, mainly bacterial vaginosis, chorioamniotitis, mother’s age, race, diabetes, high blood pressure, alcohol abuse, tobacco smoking, low socio-economic status, as well as previous deliveries of PLBW infants [4,5,7,8].
 
Besides increased mortality in neonatal and perinatal periods, total morbidity in further development of these children is a serious medical and social problem. Preservation of etiological factors, prevention, and introduction of new preventive and therapeutic programs can save society considerable financial resources [8]. It is necessary to mention that PLBW infants can suffer various psychomotor neurological disorders, damage of cognitive functions, congenital anomalies, respiratory diseases and overall retardation of the individual [6,9].
 
Ethiopathogenesis of PLBW Children
 
Nowadays etiopathogenic problems of PLBW and PROM are mostly considered to be a matter of infection and immunity, with destructive periodontitis during pregnancy seen as one of the possible ethiopathogenetic factors of its development. Increased numbers of preterm low birth weight children are connected in some epidemiological studies with the severity of destructive changes in the periodontium [10]. In other studies, periodontitis in future mothers is not considered to be a possible risk factor in development of preterm low birth weight infants [11]. During the last trimester of fetal development, the whole fetoplacental unit gets prepared for the coming labor. In fetal membranes, myometrium and amniotic space, competent immune cells and substances of catabolic character start to accumulate to induce uterine contractions and the right timing of rupture of chorioplacental membranes followed by definite expulsion of the fetus from the mother’s body. These mechanisms seem to be centrally controlled and timed by hormones and immunity. They are needed because the fetus disposes of half of the father’s proteins, which behave as antibodies with regard to developing HLA of the fetus. Delivery is the only effective mechanism able to solve this situation [3,7,12]. Immunologically and hormonally controlled proteolysis of the fetal membranes is caused by progressive accumulation of monocytes, fibroblasts and other pro-inflammatory altered imunocytes which increase production of pro-inflammatory mediators in the fetoplacental unit. These destructive and proteolytic substances mainly include the pro-inflammatory lipid mediators PGE2, TNF-alpha, IL- 1,-2 -6,-8 and others. Increased concentration of pro-inflammatory cells and substances stimulate formation of metalloproteinases, which catabolize extracellular matrix, collagen, elastin and other protein components of fetal membranes. The physiological proteolysis of fetal membranes, induced by destructive and altered remodeling, pushes these membranes to self-destruction leading to their rupture and subsequent delivery [12,13].
 
Periodontitis and its Effect on the Organism
 
Chronic periodontitis has a huge virulent and infectious potential due to periodontal pockets filled with anaerobic bacteria and their toxins. The walls of periodontal pockets are covered with a layer of subgingival biofilms formed by specially organized antibacterial substances. To destroy bacteria in subgingival biofilm, thousand times higher concentrations are needed. Due to these facts application of antibacterial medication requires subgingival mechanical depuration by means of professional dental hygiene [14,15]. It was detected that even during common mastication and oral hygiene, bacteria and their toxins and various pro-inflammatory substances and mediators penetrate into the bloodstream. In advanced and serious periodontitis, release of LPS endotoxins and prostaglandins is a serious and healththreatening issue [1-3,16-18].
 
The whole timing and destructive activity of several components leading to rupture of placental membranes is determined by the described mechanism. It is obvious that proteolysis of these membranes is strongly influenced by the pro-inflammatory activity of various cells, immunologically active substances arising mainly in the progressively changing fetoplacental unit. This mechanism can be stimulated and accelerated by existing infection [19-21].
 
Today there is enough evidence that historically understood dental (oral) focal infection presented in a form of transient bacteria has to be supplemented by new scientific knowledge which will confirm penetration of various bacterial products, pro-inflammatory mediators and substances into the bloodstream with their subsequent possible impact on other body structures and organs as well as their stimulation of a pro-inflammatory status of several tissues or even the whole organism. However it is obvious even today that these mechanisms cannot be unified and generalized because they undergo very complicated and individually modulated immunological processes with complicated genetic, epigenetic and environmental interactions. This complicated system is probably a reason why not all studies from this field bring equal results and confirm associations of these diseases in a positive way [22-25].
 
Periodontitis and its Possible Etiopathogenic Consequences on Preterm Deliveries
 
On the basis of given facts, the following etiopathogenic mechanisms (caused by oral infection and inducing increased prevalence of preterm born infants with low birth weight) are suggested:
 
Bacteria and their toxins (LPS-toxins) can penetrate into the fetoplacental unit
 
Where they form colonies, infect the fetoplacental structures, and induce inflammatory processes followed by a preterm delivery. As for periodontal bacterial pathogens participating in preterm deliveries, the Porphyromonas gingivalis are mostly associated. The immune homeostasis of the fetus, its environment and membranes can be altered through different mechanisms. The mentioned microbes were found in amniotic water of mothers in danger of preterm deliveries. The trophoblast infection /HTR-8/ was reported to be able to modulate production of cytokines via P. gingivalis and influence on the course of pregnancy [26]. Increased production of pro-inflammatory cytokines and restriction of fetal growth after infection was detected even in animal experiments [27]. Possible associations between preterm deliveries and periodontal pathogens, periodontal status and PGE2 concentration in crevicular fluid have long been reported [12].
 
The possible decreased expression of growth and development of determining genes and factors caused by Campylobacter rectus infection is reported in another study [28]. Other review studies see the results of associations between periodontal infection and preterm deliveries of low birth weight infants to be rather controversial and require further research [29].
 
Cytokines and other pro-inflammatory mediators
 
Increased serum concentrations of pro-inflammatory cytokines / IL-1-beta, PGE2/ in future mothers afflicted with periodontitis have been confirmed in several studies [13,14,27,30,31].
 
In some studies an increased concentration of cytokines in gingival crevicular fluid over a certain level is considered to be a limiting factor of association with these diseases [12]. However no significantly important associations in production of pro-inflammatory mediators and markers have been detected by some other authors [32].
 
Genetic polymorphisms of immunologically active substances
 
Some genetic polymorphisms of pro-inflammatory mediators can be associated with preterm low birth weight deliveries. It is supposed that identical or similar polymorphisms can induce periodontitis. These associations can be mainly in polymorph forms of interleukins-1 and their antagonists [33]. In similar correlations other immunological substances and their receptors are also tested. Research in this field is expected to make progress in the near future [34].
 
Increased oxidation and decreased concentrations of antioxidants in the last trimester
 
In women in the last trimester of pregnancy, a decreased concentration of antioxidants and higher systemic and crevicular levels of oxidative substances have been detected [35]. Destructive periodontitis is a rich source of strong oxidative substances, as their production is the basic antibacterial mechanism of destruction and elimination of periodontal bacteria. However, if this process is prolonged and is not stopped early by immune mechanisms, oxidants can destroy periodontal tissues and penetrate into the bloodstream and afflict distal organs and tissues [36].
 
Hormonal influences
 
An increased formation of progesterone and estrogens stimulates formation of prostaglandins, mainly PGE2, which have significant pro-inflammatory effects on periodontal tissues. The permeability and dilatation of vessels and their subsequent exudation is increased by these hormones. One result of hormonal changes is pregnancy gingivitis with prevalence from 37 to 100 per cent [37,38]. If the mentioned changes stimulated by hormones occur in pregnant women with incipient or already developed periodontitis, further deterioration of the disease is highly probable. No changes of bacterial profiles of periodontal bacterial pathogens in the last trimester of pregnancy have been confirmed [38,39].
 
Intracellular granulocyte infection
 
Interesting facts about intracellular granulatocyte infection induced by M-cells in Payer’s patches have been presented by Nishihara. According to him intracellular granulocytes can be contaminated with an intestinal non-pathogenic infection leading to functional damage of mitochondria and other specialized compartments. These immunological diseases can be diagnosed and listed under diseases of the autoimmune system. According to Nishihra, infection is spread to other tissues and organs with contaminated leukocytes. Production of CRP, anti-nuclear antigen and IgE is stimulated. An intracellular infection can be caused by eating food cooler than 37 degrees Celsius, or by mouth breathing. Such studies have to be further examined and verified [40,41].
 
Results and Comparisons of Epidemiologic Studies
 
At the beginning it should be noted that results of epidemiological studies dealing with associations between periodontitis in pregnant women and preterm low birth weight deliveries are not unanimous and neither positive nor negative associations have definitely been confirmed, although the number of positive studies is much higher. Positive studies state that future mothers suffering periodontitis run a statistically significantly higher risk of preterm low birth delivery. In some studies these states are divided into preterm deliveries, low birth weight deliveries and deliveries of infants with retarded growth [4,14,42].
 
However association between periodontitis in pregnant women and an increased prevalence of preterm deliveries is not unanimously confirmed in all studies. Some studies deny etiopathogenetic associations and require further long-term and sophisticated research [43-45].
 
Impact of Periodontal Therapy on Development of Preterm Deliveries of Infants
 
At present periodontal anaerobic infection during pregnancy is considered a possible risk factor in preterm deliveries of low birth weight infants. Chronic and destructive periodontitis is associated with increased levels of serum and local pro-inflammatory mediators as well as transient bacteraemias. Anaerobic infection and its toxins in periodontal pockets or already invaded bacteria and increased amounts of pro-inflammatory cytokines can penetrate into the bloodstream through damaged endothelium, ulcerated mucosa or during mastication and invade distal tissues of the organism [13,23,46].
 
In spite of dozens of various studies, it is still an open question to what extent periodontological therapy can influence the development and course of preterm deliveries with low birth weight infants. The protective effects of periodontal scaling on the prevalence of preterm deliveries are referred to in some studies [47-49]. A 3.8-fold reduction of preterm deliveries, a decreased amount of periodontal bacteria and a local decrease of IL-1-beta as well as decreased serum IL-6 concentrations are reported in another study [50]. Conventional periodontal scaling reduced preterm deliveries before the 37th week of gestation in 5 %; in a group of women treated with metronidazole, the reduction was only 3.3 % [47].
 
However not all studies have confirmed a beneficial effect of periodontal therapy on the development and course of preterm deliveries of low birth weight infants and values connected with them. There is high variability among the results. These associations are denied by other authors [51-53]. Similarly, from a statistical viewpoint some studies have not confirmed periodontitis as an important risk factor in the development of preterm low birth weight infants in pregnant women [54]. Nor has research of periodontitis progress unanimously confirmed an association between progress of periodontitis and an increased risk of preterm delivery of low birth weight, although other authors refer to this association as a positive one [21].
 
Heterogeneous results of studies can also be conditioned by the existence of several risk factors which have to be taken into consideration in their evaluation and which cannot always be eliminated. Among the most serious risk factors is infection of the lower part of the urogenital tract, mainly bacterial vaginosis, which can cause chorioamniotitis and subsequent rupture of amniotic membranes. Other possible factors contributing to increased prevalence of preterm low birth weight infants which have to be mentioned and in future studies taken into consideration is the age of mothers, previous preterm deliveries, as well as education.
 
Conclusion
 
In this review study possible etiopathogenetic associations between chronic periodontitis in pregnant women and preterm deliveries of low birth weight infants were outlined. It is obvious that destructive periodontitis is a serious inflammatory disease with impact on the whole organism. In spite of the fact that several etiopathogenetic associations between both examined diseases were confirmed, the exact cause has not definitely been proven. For evaluation of results stated in the studies it is necessary to establish unified diagnostic criteria of periodontitis as well as the grades and severity of periodontal diseases. These factors as well as adequate periodontological therapy have to be taken into consideration in the evaluation of individual studies and their results. The importance of appropriate research into this field with the application of multivariable statistic methods cannot be overlooked.
 
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