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Park J, Yamamoto Y, Hidaka K, Wada-Takahashi S, Takahashi SS, Morozumi T, Kubota N, Saita M, Saruta J, Sakaguchi W, To M, Shimizu T, Mikuni-Takagaki Y, Tsukinoki K. Effects of Diabetes and Voluntary Exercise on IgA Concentration and Polymeric Immunoglobulin Receptor Expression in the Submandibular Gland of Rats. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040789. [PMID: 37109747 PMCID: PMC10144866 DOI: 10.3390/medicina59040789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: Patients with diabetes are more susceptible to upper respiratory tract infections (URTIs) because they are easily infected. Salivary IgA (sali-IgA) levels play a major role in transmitting URTIs. Sali-IgA levels are determined by salivary gland IgA production and polymeric immunoglobulin receptor (poly-IgR) expression. However, it is unknown whether salivary gland IgA production and poly-IgR expression are decreased in patients with diabetes. While exercise is reported to increase or decrease the sali-IgA levels, it is unclear how exercise affects the salivary glands of patients with diabetes. This study aimed to determine the effects of diabetes and voluntary exercise on IgA production and poly-IgR expression in the salivary glands of diabetic rats. Materials and Methods: Ten spontaneously diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats (eight-week-old) were divided into two groups of five rats each: a non-exercise group (OLETF-C) and a voluntary wheel-running group (OLETF-E). Five Long-Evans Tokushima Otsuka (LETO) rats without diabetes were bred under the same conditions as the OLETF-C. Sixteen weeks after the study began, the submandibular glands (SGs) were collected and analyzed for IgA and poly-IgR expression levels. Results: IgA concentrations and poly-IgR expression levels in SGs were lower in OLETF-C and OLETF-E than in LETO (p < 0.05). These values did not differ between the OLETF-C and OLETF-E. Conclusions: Diabetes decreases IgA production and poly-IgR expression in the salivary glands of rats. Moreover, voluntary exercise increases sali-IgA levels but does not increase IgA production and poly-IgR expression in the salivary glands of diabetic rats. Increasing IgA production and poly-IgR expression in the salivary glands, which is reduced in diabetes, might require slightly higher-intensity exercise than voluntary exercise under the supervision of a doctor.
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Affiliation(s)
- Jaebum Park
- Department of Environmental Pathology, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Yuko Yamamoto
- Department of Dental Hygiene, Kanagawa Dental University, Junior College, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Kouki Hidaka
- Department of Restorative Dentistry, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Satoko Wada-Takahashi
- Department of Oral Physiology, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Shun-Suke Takahashi
- Department of Pharmacology, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Toshiya Morozumi
- Department of Endodontics, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata 9518580, Niigata, Japan
| | - Nobuhisa Kubota
- Department of Diagnostic Pathology, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Makiko Saita
- Department of Fixed Prosthodontics, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Juri Saruta
- Department of Education Planning, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Wakako Sakaguchi
- Department of Environmental Pathology, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Masahiro To
- Department of Clinical Oral Anatomy, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
| | - Tomoko Shimizu
- Department of Implantology and Periodontology, Kanagawa Dental University, 3-31-6 Tsuruya, Kanagawa-ku, Yokohama 2210835, Kanagawa, Japan
| | | | - Keiichi Tsukinoki
- Department of Environmental Pathology, Kanagawa Dental University, 82 Inaoka, Yokosuka 2388580, Kanagawa, Japan
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Bartolomé F, Rosa L, Valenti P, Lopera F, Hernández-Gallego J, Cantero JL, Orive G, Carro E. Lactoferrin as Immune-Enhancement Strategy for SARS-CoV-2 Infection in Alzheimer's Disease Patients. Front Immunol 2022; 13:878201. [PMID: 35547737 PMCID: PMC9083828 DOI: 10.3389/fimmu.2022.878201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/28/2022] [Indexed: 12/25/2022] Open
Abstract
Coronavirus 2 (SARS-CoV2) (COVID-19) causes severe acute respiratory syndrome. Severe illness of COVID-19 largely occurs in older people and recent evidence indicates that demented patients have higher risk for COVID-19. Additionally, COVID-19 further enhances the vulnerability of older adults with cognitive damage. A balance between the immune and inflammatory response is necessary to control the infection. Thus, antimicrobial and anti-inflammatory drugs are hopeful therapeutic agents for the treatment of COVID-19. Accumulating evidence suggests that lactoferrin (Lf) is active against SARS-CoV-2, likely due to its potent antiviral and anti-inflammatory actions that ultimately improves immune system responses. Remarkably, salivary Lf levels are significantly reduced in different Alzheimer's disease (AD) stages, which may reflect AD-related immunological disturbances, leading to reduced defense mechanisms against viral pathogens and an increase of the COVID-19 susceptibility. Overall, there is an urgent necessity to protect AD patients against COVID-19, decreasing the risk of viral infections. In this context, we propose bovine Lf (bLf) as a promising preventive therapeutic tool to minimize COVID-19 risk in patients with dementia or AD.
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Affiliation(s)
- Fernando Bartolomé
- Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), Madrid, Spain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Luigi Rosa
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, Rome, Italy
| | - Piera Valenti
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, Rome, Italy
| | - Francisco Lopera
- Neuroscience Group of Antioquia, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Jesús Hernández-Gallego
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - José Luis Cantero
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
| | - Gorka Orive
- Laboratory of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of the Basque Country, Vitoria, Spain
- Bioaraba, NanoBioCel Research Group, Vitoria-Gasteiz, Spain
- Networked Center for Biomedical Research in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Eva Carro
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Neurobiology of Alzheimer’s Disease Unit, Chronic Disease Programme, Instituto de Salud Carlos III, Madrid, Spain
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3
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Du Y, Li D, Chen J, Li YH, Zhang Z, Hidayat K, Wan Z, Xu JY, Qin LQ. Lactoferrin improves hepatic insulin resistance and pancreatic dysfunctions in high-fat diet and streptozotocin-induced diabetic mice. Nutr Res 2022; 103:47-58. [DOI: 10.1016/j.nutres.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/16/2022] [Accepted: 03/20/2022] [Indexed: 11/28/2022]
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Cydejko A, Kusiak A, Grzybowska ME, Kochańska B, Ochocińska J, Maj A, Świetlik D. Selected Physicochemical Properties of Saliva in Menopausal Women-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2604. [PMID: 32290275 PMCID: PMC7177701 DOI: 10.3390/ijerph17072604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 12/24/2022]
Abstract
The aim of this study was to estimate differences in selected physicochemical properties of saliva between menopausal and premenopausal women. METHODS The study population consisted of 9 menopausal women and 15 women of the control group. Laboratory tests included the determination of pH saliva, salivary flow rate, and concentrations of lactoferrin, lysozyme, immunoglobulin A, and ionized calcium. RESULTS Among menopausal women, statistically significant differences were observed in values of salivary flow rate and lysozyme and ionized calcium concentrations; however, no statistically significant differences for pH and concentrations of lactoferrin and immunoglobulin A were found. The salivary flow rate in the study group was significantly lower compared to that in premenopausal women. In relation to lysozyme, statistically significant differences were found between control group and menopausal women to the disadvantage of the latter. However, the concentration of ionized calcium in the saliva of menopausal women was distinctly higher than in the saliva of the control group. CONCLUSION The saliva of menopausal women appeared significantly different from that of the control group. Differences in physicochemical parameters such as salivary flow rate and lysozyme and ionized calcium concentrations were observed. These differences in saliva properties observed in menopause can potentially affect the oral environment of women in this particular period, possibly increasing the risk of some pathological changes in the oral cavity and consequently indicating the need to take special care of this group of female patients in order to help them maintain proper oral health. Dentists and gynecologists should be aware of the problems associated with menopause and need to provide these women complete health care, including dental care as an integral part.
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Affiliation(s)
- Aleksandra Cydejko
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdansk, Orzeszkowej 18 St, 80-204 Gdansk, Poland; (A.C.); (A.M.)
| | - Aida Kusiak
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdansk, Orzeszkowej 18 St, 80-204 Gdansk, Poland; (A.C.); (A.M.)
| | - Magdalena Emilia Grzybowska
- Department of Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Barbara Kochańska
- Department of Conservative Dentistry, Medical University of Gdansk, 80-208 Gdansk, Poland; (B.K.); (J.O.)
| | - Jolanta Ochocińska
- Department of Conservative Dentistry, Medical University of Gdansk, 80-208 Gdansk, Poland; (B.K.); (J.O.)
| | - Adrian Maj
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Gdansk, Orzeszkowej 18 St, 80-204 Gdansk, Poland; (A.C.); (A.M.)
| | - Dariusz Świetlik
- Department of Biostatistics and Neural Networks, Medical University of Gdansk, 80-211 Gdansk, Poland;
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Rosa L, Lepanto MS, Cutone A, Ianiro G, Pernarella S, Sangermano R, Musci G, Ottolenghi L, Valenti P. Lactoferrin and oral pathologies: a therapeutic treatment. Biochem Cell Biol 2020; 99:81-90. [PMID: 32213143 DOI: 10.1139/bcb-2020-0052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The oral cavity is a non-uniform, extraordinary environment characterized by mucosal, epithelial, abiotic surfaces and secretions as saliva. Aerobic and anaerobic commensal and pathogenic microorganisms colonize the tongue, teeth, jowl, gingiva, and periodontium. Commensals exert an important role in host defenses, while pathogenic microorganisms can nullify this protective function causing oral and systemic diseases. Every day, 750-1000 mL of saliva, containing several host defense constituents including lactoferrin (Lf), are secreted and swallowed. Lf is a multifunctional iron-chelating cationic glycoprotein of innate immunity. Depending on, or regardless of its iron-binding ability, Lf exerts bacteriostatic, bactericidal, antibiofilm, antioxidant, antiadhesive, anti-invasive, and anti-inflammatory activities. Here, we report the protective role of Lf in different oral pathologies, such as xerostomia, halitosis, alveolar or maxillary bone damage, gingivitis, periodontitis, and black stain. Unlike antibiotic therapy, which is ineffective against bacteria that are within a biofilm, adherent, or intracellular, the topical administration of Lf, through its simultaneous activity against microbial replication, biofilms, adhesion, and invasiveness, as well as inflammation, has been proven to be efficient in the treatment of all known oral pathologies without any adverse effects.
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Affiliation(s)
- Luigi Rosa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | | | - Antimo Cutone
- Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Giusi Ianiro
- Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Stefania Pernarella
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Riccardo Sangermano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Giovanni Musci
- Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Livia Ottolenghi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Piera Valenti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Techatanawat S, Surarit R, Chairatvit K, Roytrakul S, Khovidhunkit W, Thanakun S, Izumi Y, Khovidhunkit SOP. Salivary and serum cystatin SA levels in patients with type 2 diabetes mellitus or diabetic nephropathy. Arch Oral Biol 2019; 104:67-75. [PMID: 31174096 DOI: 10.1016/j.archoralbio.2019.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/07/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate putative salivary biomarkers for screening and diagnosis of type 2 diabetes mellitus and diabetic nephropathy. DESIGN Saliva and serum samples were collected from 29 patients with type 2 diabetes, 20 patients with diabetic nephropathy, eight patients with non-diabetic induced nephropathy, and 25 healthy subjects. Initially, pooled unstimulated saliva samples from six sex- and age-matched healthy subjects and six patients with type 2 diabetes were subjected to two-dimensional gel electrophoresis, followed by mass spectrometry. Protein expression of cystatin SA in the saliva of patients with type 2 diabetes was further examined in saliva and serum using enzyme-linked immunosorbent assay (ELISA). RESULTS Two-dimensional gel electrophoresis revealed upregulation of salivary cystatin SA in patients with type 2 diabetes. ELISA showed a weak trend of increasing salivary cystatin SA levels in patients with type 2 diabetes, compared with those levels in healthy subjects. When patients were stratified according to periodontal status, linear regression analyses revealed that salivary cystatin SA levels were associated with Periodontal Screening and Recording (PSR) index (β = 0.297, p < 0.05) when the analysis was adjusted for age, sex, HbA1C, estimated glomerular filtration rate (eGFR), and number of teeth. Serum cystatin SA levels were negatively associated with eGFR (β = -0.534, p < 0.0001) when the analysis was adjusted for age, sex, HbA1C, number of teeth, and PSR index. CONCLUSIONS Salivary cystatin SA was associated with periodontal disease severity; moreover, serum cystatin SA levels could reflect kidney function.
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Affiliation(s)
- Suteera Techatanawat
- Ph.D. program in Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand; Department of General Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Rudee Surarit
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kongthawat Chairatvit
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Sittiruk Roytrakul
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Weerapan Khovidhunkit
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Supanee Thanakun
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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7
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Naseri R, Mozaffari HR, Ramezani M, Sadeghi M. Effect of diabetes mellitus type 2 on salivary glucose, immunoglobulin A, total protein, and amylase levels in adults: A systematic review and meta-analysis of case-control studies. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:89. [PMID: 30505327 PMCID: PMC6225459 DOI: 10.4103/jrms.jrms_135_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/05/2018] [Accepted: 07/09/2018] [Indexed: 11/21/2022]
Abstract
Background: Saliva is a fluid with the complex compound which can be used as diagnostic markers for type 2 diabetes (T2D). This meta-analysis evaluated salivary glucose, immunoglobulin A (IgA), total protein, and amylase levels in adult T2D compared with the controls as well as the correlation of salivary glucose levels with serum glucose and hemoglobin A1C (HbA1c) levels in both groups. Materials and Methods: Web of Science, Scopus, PubMed, and Cochrane Library databases were searched up to July 2017. A random-effects analysis was performed using the mean difference (MD) and 95% confidence intervals. The search terms were “T2D, IgA, amylase, total protein, or glucose” combination with “saliva.” The studied variables were the sample size, the percentage of male, the mean age, the condition of saliva sampling, and the salivary levels of mentioned factors. Results: A total of 25 studies were included in this meta-analysis with 1432 and 900 diabetic patients and healthy controls, respectively. MD of salivary glucose level in patients with T2D, compared with the healthy controls, in fasting and nonfasting conditions were 6.23 mg/dL (P = 0.0002) and 6.70 mg/dL (P < 0.00001), respectively. Furthermore, the fasting salivary total protein in the patients was significantly higher than the controls (MD = 167.96 mg/dL; P = 0.03). Non-fasting salivary amylase and secretory IgA levels were significantly lower in the patients (MD = −48.61 IU/mL; P < 0.00001) than in the controls (MD = −9.42 IU/mL; P = 0.0006), respectively. The pooled estimate showed a significant correlation between salivary and serum glucose in the patients (r = 0.765; P < 0.001) and the controls (r = 0.646; P < 0.001) and between salivary glucose and serum glycated hemoglobin in the patients (r = 0.721; P < 0.001). Conclusion: Measurement of these salivary factors can be helpful for diagnostic and monitoring purposes of T2D. In addition, salivary glucose as a diagnostic tool can evaluate serum glucose and HbA1c levels in the diabetic patients.
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Affiliation(s)
- Rozita Naseri
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mazaher Ramezani
- Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Kodukula K, Faller DV, Harpp DN, Kanara I, Pernokas J, Pernokas M, Powers WR, Soukos NS, Steliou K, Moos WH. Gut Microbiota and Salivary Diagnostics: The Mouth Is Salivating to Tell Us Something. Biores Open Access 2017; 6:123-132. [PMID: 29098118 PMCID: PMC5665491 DOI: 10.1089/biores.2017.0020] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The microbiome of the human body represents a symbiosis of microbial networks spanning multiple organ systems. Bacteria predominantly represent the diversity of human microbiota, but not to be forgotten are fungi, viruses, and protists. Mounting evidence points to the fact that the "microbial signature" is host-specific and relatively stable over time. As our understanding of the human microbiome and its relationship to the health of the host increases, it is becoming clear that many and perhaps most chronic conditions have a microbial involvement. The oral and gastrointestinal tract microbiome constitutes the bulk of the overall human microbial load, and thus presents unique opportunities for advancing human health prognosis, diagnosis, and therapy development. This review is an attempt to catalog a broad diversity of recent evidence and focus it toward opportunities for prevention and treatment of debilitating illnesses.
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Affiliation(s)
- Krishna Kodukula
- Bridgewater College, Bridgewater, Virginia
- ShangPharma Innovation, Inc., South San Francisco, California
- PhenoMatriX, Inc., Natick, Massachusetts
| | - Douglas V. Faller
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- Cancer Research Center, Boston University School of Medicine, Boston, Massachusetts
| | - David N. Harpp
- Department of Chemistry, McGill University, Montreal, Canada
| | | | - Julie Pernokas
- Advanced Dental Associates of New England, Woburn, Massachusetts
| | - Mark Pernokas
- Advanced Dental Associates of New England, Woburn, Massachusetts
| | - Whitney R. Powers
- Department of Health Sciences, Boston University, Boston, Massachusetts
- Department of Anatomy, Boston University School of Medicine, Boston, Massachusetts
| | - Nikolaos S. Soukos
- Dana Research Center, Department of Physics, Northeastern University, Boston, Massachusetts
| | - Kosta Steliou
- PhenoMatriX, Inc., Natick, Massachusetts
- Cancer Research Center, Boston University School of Medicine, Boston, Massachusetts
| | - Walter H. Moos
- ShangPharma Innovation, Inc., South San Francisco, California
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of California San Francisco, San Francisco, California
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