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How Periodontal Disease and Presence of Nitric Oxide Reducing Oral Bacteria Can Affect Blood Pressure. Int J Mol Sci 2020; 21:ijms21207538. [PMID: 33066082 PMCID: PMC7589924 DOI: 10.3390/ijms21207538] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023] Open
Abstract
Nitric oxide (NO), a small gaseous and multifunctional signaling molecule, is involved in the maintenance of metabolic and cardiovascular homeostasis. It is endogenously produced in the vascular endothelium by specific enzymes known as NO synthases (NOSs). Subsequently, NO is readily oxidized to nitrite and nitrate. Nitrite is also derived from exogenous inorganic nitrate (NO3) contained in meat, vegetables, and drinking water, resulting in greater plasma NO2 concentration and major reduction in systemic blood pressure (BP). The recycling process of nitrate and nitrite to NO (nitrate-nitrite-NO pathway), known as the enterosalivary cycle of nitrate, is dependent upon oral commensal nitrate-reducing bacteria of the dorsal tongue. Veillonella, Actinomyces, Haemophilus, and Neisseria are the most copious among the nitrate-reducing bacteria. The use of chlorhexidine mouthwashes and tongue cleaning can mitigate the bacterial nitrate-related BP lowering effects. Imbalances in the oral reducing microbiota have been associated with a decrease of NO, promoting endothelial dysfunction, and increased cardiovascular risk. Although there is a relationship between periodontitis and hypertension (HT), the correlation between nitrate-reducing bacteria and HT has been poorly studied. Restoring the oral flora and NO activity by probiotics may be considered a potential therapeutic strategy to treat HT.
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Ferrer MD, López-López A, Nicolescu T, Perez-Vilaplana S, Boix-Amorós A, Dzidic M, Garcia S, Artacho A, Llena C, Mira A. Topic Application of the Probiotic Streptococcus dentisani Improves Clinical and Microbiological Parameters Associated With Oral Health. Front Cell Infect Microbiol 2020; 10:465. [PMID: 32984080 PMCID: PMC7488176 DOI: 10.3389/fcimb.2020.00465] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/28/2020] [Indexed: 01/04/2023] Open
Abstract
Streptococcus dentisani 7746, isolated from dental plaque of caries-free individuals, has been shown to have several beneficial effects in vitro which could contribute to promote oral health, including an antimicrobial activity against oral pathogens by the production of bacteriocins and a pH buffering capacity through ammonia production. Previous work has shown that S. dentisani was able to colonize the oral cavity for 2–4 weeks after application. The aim of the present work was to evaluate its clinical efficacy by a randomized, double-blind, placebo-controlled parallel group study. Fifty nine volunteers were enrolled in the study and randomly assigned to a treatment or placebo group. The treatment consisted of a bucco-adhesive gel application (2.5 109 cfu/dose) with a dental splint for 5 min every 48 h, for a period of 1 month (i.e., 14 doses). Dental plaque and saliva samples were collected at baseline, 15 and 30 days after first application, and 15 days after the end of treatment. At baseline, there was a significant correlation between S. dentisani levels and frequency of toothbrushing. Salivary flow, a major factor influencing oral health, was significantly higher in the probiotic group at day 15 compared with the placebo (4.4 and 3.4 ml/5 min, respectively). In the probiotic group, there was a decrease in the amount of dental plaque and in gingival inflammation, but no differences were observed in the placebo group. The probiotic group showed a significant increase in the levels of salivary ammonia and calcium. Finally, Illumina sequencing of plaque samples showed a beneficial shift in bacterial composition at day 30 relative to baseline, with a reduction of several cariogenic organisms and the key players in plaque formation, probably as a result of bacteriocins production. Only 58% of the participants in the probiotic group showed increased plaque levels of S. dentisani at day 30 and 71% by day 45, indicating that the benefits of S. dentisani application could be augmented by improving colonization efficiency. In conclusion, the application of S. dentisani 7746 improved several clinical and microbiological parameters associated with oral health, supporting its use as a probiotic to prevent tooth decay.
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Affiliation(s)
- María D Ferrer
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain
| | - Aranzazu López-López
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain
| | - Teodora Nicolescu
- Clínica Odontológica, Fundació Lluís Alcanyis, Universitat de València, Valencia, Spain
| | | | - Alba Boix-Amorós
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain
| | - Majda Dzidic
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain
| | - Sandra Garcia
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain
| | - Alejandro Artacho
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain
| | - Carmen Llena
- Clínica Odontológica, Fundació Lluís Alcanyis, Universitat de València, Valencia, Spain
| | - Alex Mira
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain
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53
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Rowland SN, Chessor R, French G, Robinson GP, O'Donnell E, James LJ, Bailey SJ. Oral nitrate reduction is not impaired after training in chlorinated swimming pool water in elite swimmers. Appl Physiol Nutr Metab 2020; 46:86-89. [PMID: 32835490 DOI: 10.1139/apnm-2020-0357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study tested the hypothesis that exposure to chlorine-sterilised pool water would impair oral nitrate reduction (ONR). ONR was assessed in elite swimmers before and after morning and afternoon pool-based training. Nonswimmers were only assessed in the morning. ONR was similar in swimmers and nonswimmers (P = 1.000) and unchanged before and after morning and afternoon training (P ≥ 0.341). Therefore, exposure to chlorinated pool water does not interfere with ONR. Novelty Exposure to chlorine-sterilised pool water does not impair oral nitrate reduction in elite swimmers.
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Affiliation(s)
- Samantha N Rowland
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Richard Chessor
- British Swimming, Loughborough University, Loughborough LE11 3TU, UK
| | - George French
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - George P Robinson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Emma O'Donnell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
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Kapil V, Khambata RS, Jones DA, Rathod K, Primus C, Massimo G, Fukuto JM, Ahluwalia A. The Noncanonical Pathway for In Vivo Nitric Oxide Generation: The Nitrate-Nitrite-Nitric Oxide Pathway. Pharmacol Rev 2020; 72:692-766. [DOI: 10.1124/pr.120.019240] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Bescos R, Ashworth A, Cutler C, Brookes ZL, Belfield L, Rodiles A, Casas-Agustench P, Farnham G, Liddle L, Burleigh M, White D, Easton C, Hickson M. Effects of Chlorhexidine mouthwash on the oral microbiome. Sci Rep 2020; 10:5254. [PMID: 32210245 PMCID: PMC7093448 DOI: 10.1038/s41598-020-61912-4] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/26/2020] [Indexed: 11/12/2022] Open
Abstract
Following a single blind, cross-over and non-randomized design we investigated the effect of 7-day use of chlorhexidine (CHX) mouthwash on the salivary microbiome as well as several saliva and plasma biomarkers in 36 healthy individuals. They rinsed their mouth (for 1 min) twice a day for seven days with a placebo mouthwash and then repeated this protocol with CHX mouthwash for a further seven days. Saliva and blood samples were taken at the end of each treatment to analyse the abundance and diversity of oral bacteria, and pH, lactate, glucose, nitrate and nitrite concentrations. CHX significantly increased the abundance of Firmicutes and Proteobacteria, and reduced the content of Bacteroidetes, TM7, SR1 and Fusobacteria. This shift was associated with a significant decrease in saliva pH and buffering capacity, accompanied by an increase in saliva lactate and glucose levels. Lower saliva and plasma nitrite concentrations were found after using CHX, followed by a trend of increased systolic blood pressure. Overall, this study demonstrates that mouthwash containing CHX is associated with a major shift in the salivary microbiome, leading to more acidic conditions and lower nitrite availability in healthy individuals.
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Affiliation(s)
- Raul Bescos
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK.
| | - Ann Ashworth
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Craig Cutler
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Zoe L Brookes
- Peninsula Dental School, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Louise Belfield
- Peninsula Dental School, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Ana Rodiles
- School of Biological and Marine Sciences, University of Plymouth, Plymouth, PL4 8AA, UK
| | | | - Garry Farnham
- Peninsula Medical School, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Luke Liddle
- School of Social Sciences, Bishop Grosseteste University, Lincolnshire, LN1 3DY, UK.,Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, G72 0LH, UK
| | - Mia Burleigh
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, G72 0LH, UK
| | - Desley White
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, G72 0LH, UK
| | - Mary Hickson
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
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Rocha BS, Laranjinha J. Nitrate from diet might fuel gut microbiota metabolism: Minding the gap between redox signaling and inter-kingdom communication. Free Radic Biol Med 2020; 149:37-43. [PMID: 32045656 DOI: 10.1016/j.freeradbiomed.2020.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/29/2020] [Accepted: 02/03/2020] [Indexed: 12/19/2022]
Abstract
The gut microbiota has been recently interpreted in terms of a metabolic organ that influences the host through reciprocal interactions, encompassing metabolic and immune pathways, genetic and epigenetic programming in host mammal tissues in a diet-depended manner, that shape virtually all aspects of host physiology. In this scenario, dietary nitrate, a major component of leafy green vegetables known for their health benefits, might fuel microbiota metabolism with ensued consequences for microbiota-host interaction. Cumulating evidence support that nitrate shapes oral microbiome communities with impact on the kinetics and systemic levels of both nitrate and nitrite. However, the impact of nitrate, which is steadily delivered into the lower gastrointestinal tract after a vegetable-rich meal, in the intestinal microbiome communities and their functional capacity remains largely elusive. Several mechanisms reinforce the notion that nitrate may be a nutrient for the lower microbiome and might participate in local redox interactions with relevance for bacteria-host interactions, among these nitric oxide-dependent mechanisms along the nitrate-nitrite-nitric oxide pathway. Also, by allowing bacteria to thrive, either by increasing microbial biomass or by acting as a respiratory substrate for the existing communities, nitrate ensures the production of bacterial metabolites (e.g., pathogen-associated molecular patterns, PAMP, short chain fatty acids, among other) that are recognised by host receptors (such as toll-like, TLR, and formyl peptide receptors, FPR) thereby activating local signalling pathways. Here, we elaborate on the notion that via modulation of intestinal microbiota metabolism, dietary nitrate impacts on host-microbiota metabolic and redox interactions, thereby contributing as an essential nutrient to optimal health.
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Affiliation(s)
- Bárbara S Rocha
- Faculty of Pharmacy and Center for Neuroscience and Cell Biology, University of Coimbra, Health Sciences Campus, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal.
| | - João Laranjinha
- Faculty of Pharmacy and Center for Neuroscience and Cell Biology, University of Coimbra, Health Sciences Campus, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal
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Goh CE, Trinh P, Colombo PC, Genkinger JM, Mathema B, Uhlemann AC, LeDuc C, Leibel R, Rosenbaum M, Paster BJ, Desvarieux M, Papapanou PN, Jacobs DR, Demmer RT. Association Between Nitrate-Reducing Oral Bacteria and Cardiometabolic Outcomes: Results From ORIGINS. J Am Heart Assoc 2019; 8:e013324. [PMID: 31766976 PMCID: PMC6912959 DOI: 10.1161/jaha.119.013324] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background The enterosalivary nitrate‐nitrite‐nitric oxide pathway is an alternative pathway of nitric oxide generation, potentially linking the oral microbiome to insulin resistance and blood pressure (BP). We hypothesized that increased abundance of nitrate‐reducing oral bacteria would be associated with lower levels of cardiometabolic risk cross‐sectionally. Methods and Results ORIGINS (Oral Infections, Glucose Intolerance, and Insulin Resistance Study) enrolled 300 diabetes mellitus–free adults aged 20 to 55 years (mean=34±10 years) (78% women). Microbial DNA was extracted from subgingival dental plaque (n=281) and V3–V4 regions of the 16S rRNA gene were sequenced to measure the relative abundances of 20 a priori–selected taxa with nitrate‐reducing capacity. Standardized scores of each taxon's relative abundance were summed, producing a nitrate‐reducing taxa summary score (NO3TSS) for each participant. Natural log‐transformed homeostatic model assessment of insulin resistance, plasma glucose, systolic BP, and diastolic BP were regressed on NO3TSS in multivariable linear regressions; prediabetes mellitus and hypertension prevalence were regressed on NO3TSS using modified Poisson regression models. Nitrate‐reducing bacterial species represented 20±16% of all measured taxa. After multivariable adjustment, a 1‐SD increase in NO3TSS, was associated with a −0.09 (95% CI, −0.15 to −0.03) and −1.03 mg/dL (95% CI, −1.903 to −0.16) lower natural log‐transformed homeostatic model assessment of insulin resistance and plasma glucose, respectively. NO3TSS was associated with systolic BP only among patients without hypertension; 1‐SD increase in NO3TSS was associated with −1.53 (95% CI, −2.82 to −0.24) mm Hg lower mean systolic BP. No associations were observed with prediabetes mellitus and hypertension. Conclusions A higher relative abundance of oral nitrate‐reducing bacteria was associated with lower insulin resistance and plasma glucose in the full cohort and with mean systolic BP in participants with normotension.
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Affiliation(s)
- Charlene E Goh
- Faculty of Dentistry National University of Singapore Singapore
| | - Pauline Trinh
- Department of Epidemiology Columbia University Mailman School of Public Health New York NY
| | - Paolo C Colombo
- Division of Cardiology Department of Medicine Columbia University New York NY
| | - Jeanine M Genkinger
- Department of Epidemiology Columbia University Mailman School of Public Health New York NY.,Herbert Irving Comprehensive Cancer Center Columbia University Irving Medical Center New York NY
| | - Barun Mathema
- Department of Epidemiology Columbia University Mailman School of Public Health New York NY
| | - Anne-Catrin Uhlemann
- Division of Infectious Diseases and Microbiome and Pathogen Genomics Core Department of Medicine Columbia University Irving Medical Center New York NY
| | - Charles LeDuc
- Division of Molecular Genetics Departments of Pediatrics and Medicine Columbia University New York NY
| | - Rudolph Leibel
- Division of Molecular Genetics Departments of Pediatrics and Medicine Columbia University New York NY
| | - Michael Rosenbaum
- Division of Molecular Genetics Departments of Pediatrics and Medicine Columbia University New York NY
| | - Bruce J Paster
- The Forsyth Institute Cambridge MA.,Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine Boston MA
| | - Moise Desvarieux
- Department of Epidemiology Columbia University Mailman School of Public Health New York NY.,INSERM UMR 1153 Centre de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS) METHODS Core Paris France
| | - Panos N Papapanou
- Division of Periodontics Section of Oral and Diagnostic Sciences College of Dental Medicine Columbia University New York NY
| | - David R Jacobs
- Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Ryan T Demmer
- Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
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58
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Senkus KE, Crowe-White KM. Influence of mouth rinse use on the enterosalivary pathway and blood pressure regulation: A systematic review. Crit Rev Food Sci Nutr 2019; 60:2874-2886. [DOI: 10.1080/10408398.2019.1665495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Katelyn E. Senkus
- Department of Human Nutrition, The University of Alabama, Tuscaloosa, Alabama, USA
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59
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Zhurakivska K, Troiano G, Caponio VCA, Dioguardi M, Laino L, Maffione AB, Lo Muzio L. Do Changes in Oral Microbiota Correlate With Plasma Nitrite Response? A Systematic Review. Front Physiol 2019; 10:1029. [PMID: 31456696 PMCID: PMC6700760 DOI: 10.3389/fphys.2019.01029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/25/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Nitric Oxide (NO) has a role in immunitary defense, regulation of mucosal blood flow and mucus production, regulation of smooth muscle contraction, cerebral blood flow, glucose regulation, and mitochondrial function. NO can be synthetized endogenously through the L-arginine-NO pathway or it can be absorbed by the human intestine through the dietary intake. Most of the ingested NO is in the form of nitrate (NO3−). NO3− is a substrate of oral and intestinal microbiota and, at the end of the catabolic pathway, NO is released. Using antibacterial mouthwashes leads to an alteration of salivary NO3− metabolism, however, with unclear consequences on the circulating NO levels. The aim of this study is to perform a systematic review in order to elucidate if the alterations of oral microbiota lead to modifications in plasma NO content. Methods: Electronic databases were screened, using the following terms: [“oral bacteria” and (nitrate OR nitrite OR nitric)]. Clinical studies reporting NO3− and NO2− measurements in blood and their correlation to oral microbiota variations were included. We focused on the correlation between the changes in oral microbiota and plasma concentrations of nitrites (primary outcome). Subsequently, we investigated if modifications in oral microbiota could lead to changes in blood pressure and salivary NO2− concentration (secondary outcome). Results: Six studies, for a total of 82 participants were included in this review. In four studies, the use of mouthwash correlated to a reduction of plasma nitrite concentration (p < 0.05); Two studies did not find any difference in plasma nitrate or nitrite concentration. In five studies, a correlation between blood pressure (BP) changes and antibacterial mouthwashing emerged. Anyway, only three studies suggested a significant increase of systolic BP following mouthwashing compared with controls. Conclusions: Although, the role of oral bacteria has been unequivocally demonstrated in the regulation of salivary NO3− metabolism, their influence on plasma concentration of NO species remains ambiguous. Further studies with larger sample size are required in order to demonstrate if an alteration in oral microbiota composition may influence the blood content of NO3−/NO2−/NO and all the linked biological processes.
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Affiliation(s)
- Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Angela Bruna Maffione
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Next Generation Sequencing Discoveries of the Nitrate-Responsive Oral Microbiome and Its Effect on Vascular Responses. J Clin Med 2019; 8:jcm8081110. [PMID: 31357429 PMCID: PMC6723919 DOI: 10.3390/jcm8081110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease is a worldwide human condition which has multiple underlying contributing factors: one of these is long-term increased blood pressure—hypertension. Nitric oxide (NO) is a small nitrogenous radical species that has a number of physiological functions including vasodilation. It can be produced enzymatically through host nitric oxide synthases and by an alternative nitrate–nitrite–NO pathway from ingested inorganic nitrate. It was discovered that this route relies on the ability of the oral microbiota to reduce nitrate to nitrite and NO. Next generation sequencing has been used over the past two decades to gain deeper insight into the microbes involved, their location and the effect of their removal from the oral cavity. This review article presents this research and comments briefly on future directions.
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