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Ibraheem WI, Bhati AK, Essa Ageeli FM, Sufyani RA, Ahmed Darraj M, Ageeli EO, Mobarki KM, Alhazmi MY, Mohamed Beshir SE. Association between asthma and periodontitis. Bioinformation 2024; 20:59-64. [PMID: 38352910 PMCID: PMC10859951 DOI: 10.6026/973206300200059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
The association between asthma and periodontitis is of interest. 20 periodontitis patients with asthma (asthma group) and 20 patients without asthma (non-asthma group) were included based on inclusion and inclusion criteria. Periodontitis was classified according to 2017 periodontal classification and periodontal parameters such as tooth loss, pocket depth, clinical attachment loss, alveolar bone loss, bone reduction index, plaque index, bleeding index and periodontal risk were assessed. Effect of anti-asthmatic drugs and asthma control on periodontal parameters was also assessed. Inter-group comparison of all the continuous variables was done using independent "t" test. Comparison of categorical variables was done using Chi-square test. P value <0.05 was considered statistically significant. Results showed greater severity and higher grade of periodontitis with asthma group as well as with patients on anti-asthmatic drugs and patients with poor controlled asthma. Hence, there is an association between asthma and periodontitis.
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Affiliation(s)
- Wael I Ibraheem
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Ashok Kumar Bhati
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | | | | | | | - Enas Omar Ageeli
- College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | | | | | - Saiid Elshafey Mohamed Beshir
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral and Maxillofacial Surgery, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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2
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Tamiya H, Abe M, Nagase T, Mitani A. The Link between Periodontal Disease and Asthma: How Do These Two Diseases Affect Each Other? J Clin Med 2023; 12:6747. [PMID: 37959214 PMCID: PMC10650117 DOI: 10.3390/jcm12216747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/03/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
A growing body of evidence suggests that the effects of poor oral hygiene extend beyond the oral cavity and are associated with a variety of systemic diseases, including asthma. Asthma, which results in symptoms of cough, wheezing, and dyspnoea, and is characterized by airflow limitation with variability and (partial or complete) reversibility, is amongst the most prevalent respiratory diseases with approximately 262 million patients worldwide, and its prevalence and disease burden is on the increase. While asthma can occur at a young age, it can also develop later in life and affects a variety of age groups. Both of these diseases have a chronic course, and various researchers have suggested a link between the two. In this article, we aim to provide a literature review focusing on the association between the two diseases. The results demonstrate that medications (primarily, inhaler medicine), hypoxia induced by asthma, and the breathing behaviour of patients potentially trigger periodontal disease. In contrast, oral periodontopathogenic microorganisms and the inflammatory mediators produced by them may be involved in the onset and/or exacerbation of asthma. Common contributing factors, such as smoking, gastro-oesophageal reflux, and type-2 inflammation, should also be considered when evaluating the relationship between the two diseases.
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Affiliation(s)
- Hiroyuki Tamiya
- Division for Health Service Promotion, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masanobu Abe
- Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Takahide Nagase
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akihisa Mitani
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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3
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Shi T, Wang J, Dong J, Hu P, Guo Q. Periodontopathogens Porphyromonas gingivalis and Fusobacterium nucleatum and Their Roles in the Progression of Respiratory Diseases. Pathogens 2023; 12:1110. [PMID: 37764918 PMCID: PMC10535846 DOI: 10.3390/pathogens12091110] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
The intricate interplay between oral microbiota and the human host extends beyond the confines of the oral cavity, profoundly impacting the general health status. Both periodontal diseases and respiratory diseases show high prevalence worldwide and have a marked influence on the quality of life for the patients. Accumulating studies are establishing a compelling association between periodontal diseases and respiratory diseases. Here, in this review, we specifically focus on the key periodontal pathogenic bacteria Porphyromonas gingivalis and Fusobacterium nucleatum and dissect their roles in the onset and course of respiratory diseases, mainly pneumonia, chronic obstructive pulmonary disease, lung cancer, and asthma. The mechanistic underpinnings and molecular processes on how P. gingivalis and F. nucleatum contribute to the progression of related respiratory diseases are further summarized and analyzed, including: induction of mucus hypersecretion and chronic airway inflammation; cytotoxic effects to disrupt the morphology and function of respiratory epithelial cells; synergistic pathogenic effects with respiratory pathogens like Streptococcus pneumoniae and Pseudomonas aeruginosa. By delving into the complex relationship to periodontal diseases and periodontopathogens, this review helps unearth novel insights into the etiopathogenesis of respiratory diseases and inspires the development of potential therapeutic avenues and preventive strategies.
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Affiliation(s)
- Tao Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiale Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiajia Dong
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Pingyue Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qiang Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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4
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Du M, Xu S, Qiu B, Hu S, Tjakkes GHE, Li A, Ge S. Serum antibodies to periodontal pathogens are related to allergic symptoms. J Periodontol 2023; 94:204-216. [PMID: 35960608 DOI: 10.1002/jper.22-0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The association between periodontitis and allergic symptoms has been investigated. However, the difference in immune signatures between them remains poorly understood. This cross-sectional study assessed the relationship between serum immunoglobulin G (IgG) antibodies to periodontal pathogens and allergic symptoms in a nationwide population cohort. METHODS Two phases of the Third National Health and Nutrition Examination Survey (NHANES III) were used as discovery dataset (n = 3700) and validation dataset (n = 4453), respectively. Based on the antibodies against 19 periodontal pathogens, we performed an unsupervised hierarchical clustering to categorize the population into three clusters. In the discovery dataset, cluster 1 (n = 2847) had the highest level of IgG antibodies, followed by clusters 2 (n = 588) and 3 (n = 265). Data on allergic symptoms (asthma, hay fever, and wheezing) were obtained using a self-reported questionnaire. Survey-weighted multivariable logistic regression evaluated the association between these clusters and allergic symptoms. RESULTS In the discovery dataset, the participants with lower levels of antibodies to periodontal pathogens exhibited a higher risk of asthma (odds ratio [OR]cluster 3 vs. cluster 1 = 1.820, 95% confidence interval [CI]: 1.153-2.873) and wheezing (ORcluster 3 vs. cluster 1 = 1.550, 95% CI: 1.095-2.194) compared to those with higher periodontal antibodies, but the non-significant association with hay fever. Consistent results were found in the validation dataset. CONCLUSIONS Serum IgG titers to periodontal pathogens were inversely associated with the risk of asthma and wheezing, suggesting the potentially protective role against allergic conditions.
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Affiliation(s)
- Mi Du
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration, Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Bingjiang Qiu
- Department of Radiology & Guangdong Cardiovascular Institute & Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Data Science Center in Health (DASH) & 3D Lab, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Shixian Hu
- Institute of Precision Medicine, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Gastroenterology and Hepatology, UMCG, University of Groningen, Groningen, The Netherlands
| | - Geerten-Has E Tjakkes
- Department of Periodontology, Center for Dentistry and Oral Hygiene, UMCG, University of Groningen, Groningen, The Netherlands
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China.,Department of Periodontology, Center for Dentistry and Oral Hygiene, UMCG, University of Groningen, Groningen, The Netherlands
| | - Shaohua Ge
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration, Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
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5
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Dong J, Li W, Wang Q, Chen J, Zu Y, Zhou X, Guo Q. Relationships Between Oral Microecosystem and Respiratory Diseases. Front Mol Biosci 2022; 8:718222. [PMID: 35071321 PMCID: PMC8767498 DOI: 10.3389/fmolb.2021.718222] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/09/2021] [Indexed: 02/05/2023] Open
Abstract
Oral microecosystem is a very complicated ecosystem that is located in the mouth and comprises oral microbiome, diverse anatomic structures of oral cavity, saliva and interactions between oral microbiota and between oral microbiota and the host. More and more evidence from studies of epidemiology, microbiology and molecular biology is establishing a significant link between oral microecosystem and respiratory diseases. Microbiota settling down in oral microecosystem is known as the main source of lung microbiome and has been associated with the occurrence and development of respiratory diseases like pneumonia, chronic obstructive pulmonary disease, lung cancer, cystic fibrosis lung disease and asthma. In fact, it is not only indigenous oral microbes promote or directly cause respiratory infection and inflammation when inhaled into the lower respiratory tract, but also internal environment of oral microecosystem serves as a reservoir for opportunistic respiratory pathogens. Moreover, poor oral health and oral diseases caused by oral microecological dysbiosis (especially periodontal disease) are related with risk of multiple respiratory diseases. Here, we review the research status on the respiratory diseases related with oral microecosystem. Potential mechanisms on how respiratory pathogens colonize oral microecosystem and the role of indigenous oral microbes in pathogenesis of respiratory diseases are also summarized and analyzed. Given the importance of oral plaque control and oral health interventions in controlling or preventing respiratory infection and diseases, we also summarize the oral health management measures and attentions, not only for populations susceptible to respiratory infection like the elderly and hospitalized patients, but also for dentist or oral hygienists who undertake oral health care. In conclusion, the relationship between respiratory diseases and oral microecosystem has been established and supported by growing body of literature. However, etiological evidence on the role of oral microecosystem in the development of respiratory diseases is still insufficient. Further detailed studies focusing on specific mechanisms on how oral microecosystem participate in the pathogenesis of respiratory diseases could be helpful to prevent and treat respiratory diseases.
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Affiliation(s)
- Jiajia Dong
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiahao Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Zu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qiang Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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6
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Lee DW, Kim JG, Yang YM. Influence of mouth breathing on atopic dermatitis risk and oral health in children: A population-based cross-sectional study. J Dent Sci 2020; 16:178-185. [PMID: 33384795 PMCID: PMC7770290 DOI: 10.1016/j.jds.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/15/2020] [Indexed: 11/29/2022] Open
Abstract
Background/purpose Previous studies have suggested that mouth breathing has harmful effects on atopic dermatitis (AD) and oral health in children, but the evidence has been insufficient. To investigate the association of mouth breathing with AD and oral health in Korean schoolchildren aged 8–11 years. Materials and methods Cross-sectional data were obtained from March to April 2016. A questionnaire was used to investigate children's mouth breathing habits and personal/family histories related to allergic disease. Oral health status was determined through a clinical oral examination. Data were analyzed with multivariable logistic regression. Results In total, 1507 children were included. A moderate relationship was observed between mouth breathing and AD (adjusted odds ratio, 1.05; 95% confidence interval, 1.00–1.10; p-value, 0.035), whereas no association was found between mouth breathing and dental caries in children. Mouth breathing during sleep (MBS) was closely related to allergic diseases and other respiratory diseases. Furthermore, mouth breathing was associated with child's tonsillitis and was identified as a possible risk factor for class II dental malocclusion. Conclusion We confirmed the positive association between mouth breathing (especially during sleep) and allergic diseases, including the AD in school-aged children. The influence of mouth breathing on dental caries remains uncertain. An intervention trial is required to evaluate whether the prevention of mouth breathing can reduce the risk of allergic diseases.
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Affiliation(s)
- Dae-Woo Lee
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Jae-Gon Kim
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Yeon-Mi Yang
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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7
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Nelwan SC, Nugraha RA, Endaryanto A, Dewi F, Nuraini P, Tedjosasongko U, Utomo DH. Effect of scaling and root planing on level of immunoglobulin E and immunoglobulin G 4 in children with gingivitis and house-dust mite allergy: A pilot randomised controlled trial. ACTA ACUST UNITED AC 2020; 39:21-31. [PMID: 32054426 DOI: 10.1142/s2214607519500020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background and Objective: There is a pressing need for developing innovative strategies to prevent allergic diseases among children. As house-dust mite (HDM) allergy is often seen in children with gingivitis, strategies should be derived from a conceptual framework of allergen elimination and pathogen eradication; one such strategy is dental scaling and root planing (SRP) to remove dental plaque and periodontal pathogens. The study aimed to evaluate the beneficial effects of comprehensive 6-months dental SRP to reduce the level of immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) in children with gingivitis and HDM allergy. IgE and IgG4, whose production is controlled mainly by Th-2 cells and B cells, are proven biomarkers for atopic inflammatory responses. Methods: The present study conducted a non-blinded randomised controlled trial with superiority design. A total of 10 subjects (age range 6-16 years) with gingivitis and positive skin-prick test to HDM from Pediatric Allergy Outpatient Clinic, Dr. Soetomo General Hospital were enrolled in the present study. Of the 10 subjects, only five received dental SRP. We further evaluated total serum IgE and IgG4 level before and 6 months after treatment. Results and Discussion: Subjects in the standard treatment group showed a slight decrease in the IgE level ([Formula: see text]) but no change in the IgG4 level ([Formula: see text]), while subjects in the intervention group showed a significant decrease in IgE ([Formula: see text]) and IgG4 levels ([Formula: see text]). Conclusion: The study results suggest that 6-month comprehensive dental scaling combined with root planing may help to reduce IgE and IgG4 levels in children with gingivitis and HDM allergy. Furthermore, untreated or undertreated gingivitis is often associated with worsening allergic manifestation and thus should be avoided. Trial Registration: ISRCTN31416107, retrospectively registered on 17 April 2018.
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Affiliation(s)
- Sindy Cornelia Nelwan
- Department of Pediatric Dentistry, Universitas Airlangga, Surabaya, 60135, Indonesia
| | | | - Anang Endaryanto
- Department of Child Health, Universitas Airlangga, Surabaya, 60135, Indonesia
| | - Frisma Dewi
- Department of Pediatric Dentistry, Universitas Airlangga, Surabaya, 60135, Indonesia
| | - Prawati Nuraini
- Department of Pediatric Dentistry, Universitas Airlangga, Surabaya, 60135, Indonesia
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8
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Lopes MP, Cruz ÁA, Xavier MT, Stöcker A, Carvalho-Filho P, Miranda PM, Meyer RJ, Soledade KR, Gomes-Filho IS, Trindade SC. Prevotella intermedia and periodontitis are associated with severe asthma. J Periodontol 2019; 91:46-54. [PMID: 31342509 DOI: 10.1002/jper.19-0065] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/24/2019] [Accepted: 05/27/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Periodontitis, an inflammatory disease of multibacterial etiology that affects the protective and supporting tissues surrounding teeth, can influence the course of respiratory diseases, such as asthma, due to epithelial alterations arising from inflammatory and immunological processes, bronchial remodeling, or by the aspiration of pathogenic colonizers found in periodontal pockets. This study evaluated the levels of periodontal pathogens Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans in the subgingival biofilm of individuals with and without severe asthma. METHODS A case-control study enrolling 457 individuals (220 with asthma and 237 without asthma) was conducted at the Program for Control of Asthma in Bahia (ProAR) Clinic located in Salvador, Bahia, Brazil. A structured questionnaire was used to obtain data on sociodemographic, health status, and lifestyle habits. A clinical periodontal assessment was performed, including bleeding on probing, probing depth, and clinical attachment level. Subgingival biofilm was collected at the deepest site of each sextant, and bacterial DNA was extracted. Quantitative real-time PCR analysis was performed to detect and relatively quantify periodontopathogens in the biofilm. RESULTS Statistically significant positive associations were found between periodontitis and severe asthma, (odds ratio [OR]adjusted] : 4.00; 95% confidence interval [CI]: 2.26 to 7.10). High levels of P. intermedia were found in association with the presence of severe asthma (ORadjusted : 2.64; 95% CI: 1.62 to 4.39; P < 0.01). CONCLUSIONS The present results suggest that periodontitis and P. intermedia are associated with severe asthma. However, the functional consequences of this dysbiosis upon asthma susceptibility and its phenotypes remain unclear.
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Affiliation(s)
- Mabel P Lopes
- Post-Graduation Program, Federal University of Bahia, Salvador, Brazil
| | - Álvaro A Cruz
- Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Márcia T Xavier
- Department of Biointeraction, Federal University of Bahia, Salvador, Brazil
| | - Andreas Stöcker
- Universitary Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | | | - Roberto J Meyer
- Department of Biointeraction, Federal University of Bahia, Salvador, Brazil
| | - Kaliane R Soledade
- Department of Biointeraction, Federal University of Bahia, Salvador, Brazil
| | - Isaac S Gomes-Filho
- Department of Health, Feira de Santana State University, Feira de Santana, Brazil
| | - Soraya C Trindade
- Post-Graduation Program, Federal University of Bahia, Salvador, Brazil.,Department of Health, Feira de Santana State University, Feira de Santana, Brazil
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9
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Hong M, Park JB, Kim YS, Lee DH, Kim H, Lee JI, Ahn HS, Sohn TS, Lee TK, Song JY, Jeong SC, Yeo CD, Chae HS, Do Han K, Vu D, Lee YB. Association between Cockroach-specific Immunoglobulin E and periodontitis in Korean male adults Based on Korean National Health and Nutrition Examination Survey. Sci Rep 2017; 7:46373. [PMID: 28401926 PMCID: PMC5388886 DOI: 10.1038/srep46373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/15/2017] [Indexed: 01/22/2023] Open
Abstract
Periodontitis is an inflammatory disease affecting the tooth supporting tissues (periodontium) and associated with chronic diseases such as cardiovascular disease and insulin resistance. However, there has been no nation-wide population based epidemiologic study regarding any association between periodontitis and serum IgE. Among the 8,958 participants in the 2010 Korean National Health and Nutrition Examination Survey (KNHANES V-1), 1,731 adults aged 19 to 64 who had measured serum IgE were included in the analysis. Dentists examined the periodontal status of the participants. Multiple logistic regression analyses were used to evaluate the odds ratio of periodontitis in association with total IgE and specific IgE to cockroach and house dust mite. In males, total IgE showed a positive correlation with the presence of periodontitis. The participants in the highest tertile of cockroach specific IgE (T3, >31.6 kU/L) had a significantly increased risk of periodontitis (OR = 2.108; 95% CI, 1.233–3.606). In females, the inverse association occurred between total IgE and periodontitis (OR = 0.409; 95% CI, 0.200–0.839). The present study firstly demonstrated the association between periodontitis and serum IgE, using the Korean nationwide, population-based, cross-sectional health examination and survey. This study suggested a positive correlation between periodontitis and cockroach-specific IgE in Korean male adults.
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Affiliation(s)
- Mihee Hong
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jun-Beom Park
- Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Soo Kim
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong-Hee Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - HeeYeon Kim
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae-Im Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyo-Suk Ahn
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Tae Seo Sohn
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Tae-Kyu Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Yen Song
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seong Cheol Jeong
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Dong Yeo
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hiun Suk Chae
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyung Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - David Vu
- Wing Dental Center, Alberta, Canada
| | - Young Bok Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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10
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Lee SW, Lim HJ, Lee E. Association Between Asthma and Periodontitis: Results From the Korean National Health and Nutrition Examination Survey. J Periodontol 2017; 88:575-581. [PMID: 28398111 DOI: 10.1902/jop.2017.160706] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The aim of this study is to examine the association between asthma and periodontitis in a representative sample of Korean adults from the Sixth Korean National Health and Nutrition Examination Survey (KNHANES) in 2014. METHODS This study conducts a cross-sectional evaluation using 2014 KNHANES data to describe the association between current asthma condition and chronic periodontitis while adjusting for sociodemographic characteristics and lifestyle factors. Presence of periodontitis is evaluated by community periodontal index defined by the World Health Organization, and current asthma condition is defined as "currently suffering from asthma condition." RESULTS The study population comprises a total of 5,976 patients aged 19 years and older, representing 40.7 million Koreans. A multivariable logistic regression analysis with weighted observations reveals patients with current asthma condition are ≈5 times more likely to be associated with periodontitis (adjusted odds ratio [OR]: 5.36; 95% confidence interval [95% CI]: 1.27 to 22.68). In addition, 83% of patients who regularly receive scheduled antiasthmatic medications are less likely to have a diagnosis of periodontitis than individuals who do not receive medication regularly (adjusted OR: 0.17; 95% CI: 0.05 to 0.57). However, the association is not significant if treatment with antiasthmatic medication is delivered on an "as-needed" basis (adjusted OR:1.80; 95% CI: 0.87 to 3.74). CONCLUSIONS Findings from the current study show a positive association between periodontitis and current asthma condition. In addition, patients taking scheduled antiasthmatic medications are less likely to be diagnosed with periodontitis. Due to limitations of study design and available data from the national survey, well-designed follow-up studies are needed to confirm these findings.
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Affiliation(s)
- Seok-Woo Lee
- Departments of Dental Education and Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Hoi-Jeong Lim
- Departments of Dental Education and Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea.,Department of Orthodontics, School of Dentistry, Chonnam National University
| | - Euni Lee
- Department of Pharmacy, College of Pharmacy, Seoul National University, Seoul, Korea
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Gomez-Rubio P, Zock JP, Rava M, Marquez M, Sharp L, Hidalgo M, Carrato A, Ilzarbe L, Michalski C, Molero X, Farré A, Perea J, Greenhalf W, O'Rorke M, Tardón A, Gress T, Barberà V, Crnogorac-Jurcevic T, Domínguez-Muñoz E, Muñoz-Bellvís L, Alvarez-Urturi C, Balcells J, Barneo L, Costello E, Guillén-Ponce C, Kleeff J, Kong B, Lawlor R, Löhr M, Mora J, Murray L, O'Driscoll D, Peláez P, Poves I, Scarpa A, Real FX, Malats N. Reduced risk of pancreatic cancer associated with asthma and nasal allergies. Gut 2017; 66:314-322. [PMID: 26628509 DOI: 10.1136/gutjnl-2015-310442] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Studies indicate an inverse association between ductal adenocarcinoma of the pancreas (PDAC) and nasal allergies. However, controversial findings are reported for the association with asthma. Understanding PDAC risk factors will help us to implement appropriate strategies to prevent, treat and diagnose this cancer. This study assessed and characterised the association between PDAC and asthma and corroborated existing reports regarding the association between allergies and PDAC risk. DESIGN Information about asthma and allergies was collated from 1297 PDAC cases and 1024 controls included in the PanGenEU case-control study. Associations between PDAC and atopic diseases were studied using multilevel logistic regression analysis. Meta-analyses of association studies on these diseases and PDAC risk were performed applying random-effects model. RESULTS Asthma was associated with lower risk of PDAC (OR 0.64, 95% CI 0.47 to 0.88), particularly long-standing asthma (>=17 years, OR 0.39, 95% CI 0.24 to 0.65). Meta-analysis of 10 case-control studies sustained our results (metaOR 0.73, 95% CI 0.59 to 0.89). Nasal allergies and related symptoms were associated with lower risk of PDAC (OR 0.66, 95% CI 0.52 to 0.83 and OR 0.59, 95% CI 0.46 to 0.77, respectively). These results were supported by a meta-analysis of nasal allergy studies (metaOR 0.6, 95% CI 0.5 to 0.72). Skin allergies were not associated with PDAC risk. CONCLUSIONS This study shows a consistent inverse association between PDAC and asthma and nasal allergies, supporting the notion that atopic diseases are associated with reduced cancer risk. These results point to the involvement of immune and/or inflammatory factors that may either foster or restrain pancreas carcinogenesis warranting further research to understand the molecular mechanisms driving this association.
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Affiliation(s)
- Paulina Gomez-Rubio
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Marta Rava
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Mirari Marquez
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Linda Sharp
- National Cancer Registry Ireland, Cork, Ireland, and Institute of Health & Society, Newcastle University, UK
| | | | - Alfredo Carrato
- Department of Oncology, Hospital Ramón y Cajal, Madrid, Spain
| | - Lucas Ilzarbe
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | | | - Xavier Molero
- Exocrine Pancreas Research Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antoni Farré
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José Perea
- Department of Surgery, 12 de Octubre University Hospital, Madrid, Spain
| | | | - Michael O'Rorke
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Adonina Tardón
- Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Thomas Gress
- Department of Gastroenterology, University Hospital Giessen and Marburg, Marburg, Germany
| | - Victor Barberà
- Laboratorio de Genética Molecular, Hospital General Universitario de Elche, Elche, Spain
| | | | | | - Luís Muñoz-Bellvís
- Cirugía General y del Aparato Digestivo, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | - Joaquim Balcells
- Exocrine Pancreas Research Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Luis Barneo
- Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | | | - Jörg Kleeff
- Technical University of Munich, Munich, Germany
| | - Bo Kong
- Technical University of Munich, Munich, Germany
| | - Rita Lawlor
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Matthias Löhr
- Gastrocentrum, Karolinska Institutet, Stockholm, Sweden
| | - Josefina Mora
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lim Murray
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Damian O'Driscoll
- National Cancer Registry Ireland, Cork, Ireland, and Institute of Health & Society, Newcastle University, UK
| | - Pablo Peláez
- Department of Surgery, 12 de Octubre University Hospital, Madrid, Spain
| | - Ignasi Poves
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - Aldo Scarpa
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Francisco X Real
- Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain
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Serum antibody levels against Porphyromonas gingivalis in patients with and without rheumatoid arthritis - a systematic review and meta-analysis. Clin Oral Investig 2016; 21:33-42. [PMID: 27561661 DOI: 10.1007/s00784-016-1938-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/08/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Since the peptidyl arginine deiminase of Porphyromonas gingivalis is able to citrullinate peptides and proteins, various studies have suggested the species as a possible link between periodontal disease (PD) and rheumatoid arthritis (RA). This systematic review including meta-analysis was aimed to evaluate whether differences in terms of antibody titers against P. gingivalis exist between RA patients and systemically healthy individuals with and without PD. MATERIALS AND METHODS The following focused question was addressed: Are the antibody titers against P. gingivalis of RA patients different from systemically healthy individuals with and without PD? A systematic data search was conducted in MEDLINE and EMBASE. The collected data underwent a meta-analysis to detect statistically significant differences in terms of antibody levels between the groups. RESULTS From 114 articles found by the search 13 articles met the inclusion criteria and provided data suitable for meta-analysis. After analyzing various levels of confinement the meta-analysis revealed a statistically significant higher antibody titer against P. gingivalis in patients suffering from RA in comparison with systemically and periodontally healthy controls (p < 0.01) and systemically healthy patients with PD (p < 0.01). CONCLUSION The present findings indicate that RA is often accompanied by the presence of an immune response against P. gingivalis. CLINICAL RELEVANCE The significantly higher antibody response to P. gingivalis in comparison to systemically healthy individuals supports the link between PD and RA by P. gingivalis. Screening of the regularly taken blood samples of RA patients for P. gingivalis antibodies may help to sensitize rheumatologists and RA patients for improving periodontal health.
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Rivera R, Andriankaja OM, Perez CM, Joshipura K. Relationship between periodontal disease and asthma among overweight/obese adults. J Clin Periodontol 2016; 43:566-71. [PMID: 27028763 PMCID: PMC4900929 DOI: 10.1111/jcpe.12553] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 12/20/2022]
Abstract
AIM To assess the relationship between oral health and asthma. METHODS Data from 1315 overweight or obese individuals, aged 40-65 years were used. Asthma was self-reported, whereas periodontitis, bleeding on probing (BOP) and plaque index were determined by clinical examinations. RESULTS Using logistic regression adjusting for gender, smoking status, age, body mass index, family history of asthma and income level, revealed that the odds ratio (OR) of asthma for a participant with severe periodontitis was 0.44 (95% confidence interval: 0.27, 0.70) that of a participant with none/mild periodontitis. On the other hand, proportion of BOP sites and plaque index were not statistically significant. For a participant with severe periodontitis, the OR of taking asthma medication was 0.20 (95% confidence interval: 0.09, 0.43) that of a participant with none/mild periodontitis. Moreover, proportion of BOP sites was statistically associated with use of asthma medication, whereas plaque index still remained non-significant. CONCLUSION Participants with severe periodontitis were less likely to have asthma. Stronger evidence of an inverse association was found when using asthma medication as outcome.
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Affiliation(s)
- Roberto Rivera
- College of Business, University of Puerto Rico, Mayaguez
| | | | - Cynthia M. Perez
- School of Public Health, University of Puerto Rico, Medical Science Campus
| | - Kaumudi Joshipura
- School of Dental Medicine, University of Puerto Rico, Medical Science Campus
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Hsieh VCR, Liu CC, Hsiao YC, Wu TN. Risk of Allergic Rhinitis, Allergic Conjunctivitis, and Eczema in Children Born to Mothers with Gum Inflammation during Pregnancy. PLoS One 2016; 11:e0156185. [PMID: 27224053 PMCID: PMC4880316 DOI: 10.1371/journal.pone.0156185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 05/10/2016] [Indexed: 12/13/2022] Open
Abstract
Purpose Despite links between maternal and child health status, evidence on the association between gum infection in pregnant mothers and childhood allergies is scarce. We aim to evaluate the risk of developing allergy in children born to periodontal mothers in a nationwide study. Methods We conducted a 9-year population-based, retrospective cohort study using Taiwan’s National Health Insurance database. A study cohort of 42,217 newborns born to mothers with periodontal disease during pregnancy was identified in 2001 and matched with 42,334 babies born to mothers without any infection (control) by mother’s age at delivery and baby sex. With a follow-up period from 2001 to 2010, we observed the incidence of allergic rhinitis (AR), allergic conjunctivitis (AC), and eczema in these children. Cox proportional hazards regression models were performed with premature deaths as competing risk for the estimation of allergic disease risks. Results Nine-year cumulative incidences were the highest among children born to periodontal mothers; they reached 46.8%, 24.2%, and 40.4% (vs. 39.5%, 18.3% and 34.8% in control) for AR, AC, and eczema, respectively. Our results showed moderately increased risks for the allergies in children born to periodontal mothers relative to their matched non-inflammatory control (adjusted HRs: 1.17, 95% CI: 1.15–1.20; 1.27, 1.24–1.31; 1.14, 1.12–1.17, respectively). Because the impact of food consumption and living environment cannot be considered using insurance data, we attempted to control it by adjusting for parental income and mother’s residential area. Conclusions Overall cumulative incidence and risks of children born to periodontal mothers for AR, AC, and eczema are significantly higher than those born to non-inflammatory mothers. Gum infection in women during pregnancy is an independent risk factor for allergic diseases in children, thus its intergenerational consequences should be considered in gestational care.
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Affiliation(s)
- Vivian Chia-Rong Hsieh
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chin-Chen Liu
- Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Yu-Chen Hsiao
- Center for General Education, Asia University, Wufeng, Taiwan
| | - Trong-Neng Wu
- Department of Nursing, College of Medicine and Nursing, Hungkuang University, Taichung, Taiwan
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Taiwan
- Department of Healthcare Administration, Asia University, Wufeng, Taiwan
- * E-mail:
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15
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Harper KN, Armelagos GJ. Genomics, the origins of agriculture, and our changing microbe-scape: time to revisit some old tales and tell some new ones. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 152 Suppl 57:135-52. [PMID: 24249593 PMCID: PMC7159788 DOI: 10.1002/ajpa.22396] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Though agriculture is often viewed as one of humanity's crowning achievements, skeletal evidence indicates that dependence on domesticated plants and animals was accompanied by an increase in infectious disease. Scientists have proposed that many important infections emerged in the period following the advent of agriculture, as a result of newly dense populations and novel proximity to domestic animals that served as reservoirs for novel pathogens. Here, we review genomic evidence regarding pathogen origins, analyzing these data using the epidemiological transition framework. Genetic information has forced us to reconsider how and when many important pathogens emerged; it appears that a number of infections thought to result from contact with domesticated animals arose much earlier than agriculture was adopted. We also consider the broader effect of agriculture upon the microbiome, exploring potential consequences for human health. We end by discussing the changes in the human microbe-scape we are likely to see in the future.
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Affiliation(s)
- Kristin N Harper
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032
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Reddy BVR, Chava VK, Nagarakanti S, Gunupati S, Samudrala P. Hygiene hypothesis and periodontitis--a possible association. Med Hypotheses 2013; 82:60-3. [PMID: 24268739 DOI: 10.1016/j.mehy.2013.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/06/2013] [Indexed: 01/22/2023]
Abstract
Hygiene hypothesis has been proposed more than two decades back to explain an increasing prevalence of allergic diseases and atopy. It states that, a lack of early childhood exposure to infectious agents increases susceptibility to allergic diseases and atopy later in life. The evidence in relation to hygiene hypothesis is controversial and inconclusive. Moreover, its underlying mechanisms are elusive and remain to be elucidated. Periodontitis is an inflammatory disease initiated by microorganisms present in the plaque biofilm. Association between periodontitis and various systemic diseases has already been established and is currently an area of interest particularly in periodontal research. Consistent with hygiene hypothesis, some researchers believed that pathogens associated with periodontal diseases might have a protective role in the development of asthma and other allergic diseases. Very few studies attempted to explore the concept of association between periodontitis, asthma and other respiratory allergic diseases which could neither support such a protective role for periodontal diseases nor reject such an association. This suggests a need for additional research to examine the relevance of hygiene hypothesis in periodontics. The purpose of the present article is to review the plausible scientific explanations available for hygiene hypothesis, to review some studies relating periodontitis, asthma and other respiratory allergic diseases and to stress the need for further research.
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Affiliation(s)
| | - Vijay Kumar Chava
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh 524002, India
| | - Sreenivas Nagarakanti
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh 524002, India
| | - Sumanth Gunupati
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh 524002, India
| | - Pramod Samudrala
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh 524002, India
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17
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Silverberg JI, Simpson EL. Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization. Pediatr Allergy Immunol 2013; 24:476-86. [PMID: 23773154 PMCID: PMC4397968 DOI: 10.1111/pai.12095] [Citation(s) in RCA: 217] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 01/25/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is associated with multiple comorbid conditions, such as asthma and food allergy. We sought to determine the impact of eczema severity on the development of these disorders and other non-atopic comorbidities in AD. METHODS We used the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children aged 0-17 yr. Prevalence and severity of eczema, asthma, hay fever and food allergy, sleep impairment, healthcare utilization, recurrent ear infections, and visual and dental problems were determined. RESULTS In general, more severe eczema is correlated with poorer overall health, impaired sleep, and increased healthcare utilization, including seeing a specialist, compared with children with mild or moderate disease (Rao-Scott chi-squared test, p < 0.0001). Severe eczema was associated with a higher prevalence of comorbid chronic health disorders, including asthma, hay fever, and food allergies (p < 0.0001). In addition, the severity of eczema was directly related to the severity of the comorbidities. These associations remained significant in multivariate logistic regression models that included age, sex, and race/ethnicity. Severe eczema was also associated with recent dental problems, including bleeding gums (p < 0.0001), toothache (p = 0.0004), but not broken teeth (p = 0.04) or tooth decay (p = 0.13). CONCLUSIONS These data indicate that severe eczema is associated with multiple comorbid chronic health disorders, impaired overall health, and increased healthcare utilization. Further, these data suggest that children with eczema are at risk of decreased oral health. Future studies are warranted to verify this novel association.
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Affiliation(s)
- Jonathan I Silverberg
- Department of Dermatology, Beth Israel Medical Center and St. Luke's-Roosevelt Hospital Center, New York, NY, USA.
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18
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Savage JH, Matsui EC, Wood RA, Keet CA. Urinary levels of triclosan and parabens are associated with aeroallergen and food sensitization. J Allergy Clin Immunol 2012; 130:453-60.e7. [PMID: 22704536 DOI: 10.1016/j.jaci.2012.05.006] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 04/17/2012] [Accepted: 05/04/2012] [Indexed: 12/29/2022]
Abstract
BACKGROUND Endocrine-disrupting compounds (EDCs) have immune-modulating effects. We were interested in determining their association with allergic sensitization. OBJECTIVE We sought to determine the association between EDCs and allergic sensitization and whether this relationship depends on the antimicrobial properties of the EDCs, sex, or both. METHODS Data were obtained from the 2005-2006 National Health and Nutrition Examination Survey in which urinary bisphenol A; triclosan; benzophenone-3; propyl, methyl, butyl, and ethyl parabens; and specific IgE levels were available for 860 children. Aeroallergen and food sensitizations were defined as having at least 1 positive (≥ 0.35 kU/L) specific IgE level to an aeroallergen or a food. Logistic regression was used to determine the association of EDCs and sensitization. Analyses were adjusted for urinary creatinine level, age, sex, ethnicity, and poverty index ratio. RESULTS The odds of aeroallergen sensitization significantly increased with the level of the antimicrobial EDCs triclosan and propyl and butyl parabens (P ≤ .04). The odds of food sensitization significantly increased with the level of urinary triclosan among male subjects (odds ratio for third vs first tertiles, 3.9; P= .02 for trend). There was a significant interaction between sex and triclosan level, with male subjects being more likely to be food sensitized with exposure (P= .03). Similar associations were not identified for the nonantimicrobial EDCs bisphenol A and benzophenone-3 (P > .2). CONCLUSIONS As a group, EDCs are not associated with allergen sensitization. However, levels of the antimicrobial EDCs triclosan and parabens were significantly associated with allergic sensitization. The potential role of antimicrobial EDCs in allergic disease warrants further study because they are commonly used in Western society.
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Affiliation(s)
- Jessica H Savage
- Johns Hopkins Division of Allergy and Clinical Immunology, Baltimore, MD 21224, USA.
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19
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Cabana MD. Early probiotic supplementation for the prevention of atopic disease in newborns-probiotics and the hygiene hypothesis-. Biosci Microflora 2011; 30:129-33. [PMID: 25045318 PMCID: PMC4103639 DOI: 10.12938/bifidus.30.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Indexed: 12/21/2022] Open
Abstract
Environmental factors during early infancy could theoretically affect immune system
development and subsequent risk of allergic disease. One potentially helpful exposure is
early infant supplementation with specific probiotic strains. Unlike other exposures,
probiotic supplementation is feasible and has a good safety profile. A review of recent
randomized, controlled trials suggests that the effect of supplementation with probiotics
on preventing the development of allergic disease is mixed. Further studies are needed to
define potential mechanisms of action, such as effects on infant microbiota, as well as
potential subgroups of patients that may benefit from these interventions.
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Affiliation(s)
- Michael D Cabana
- Department of Pediatrics, Epidemiology and Biostatistics and the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, USA
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López R, Loos BG, Baelum V. Hematological features in adolescents with periodontitis. Clin Oral Investig 2011; 16:1209-16. [DOI: 10.1007/s00784-011-0628-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 10/05/2011] [Indexed: 01/20/2023]
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Arbes SJ, Matsui EC. Can oral pathogens influence allergic disease? J Allergy Clin Immunol 2011; 127:1119-27. [PMID: 21531254 DOI: 10.1016/j.jaci.2011.03.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 03/11/2011] [Accepted: 03/15/2011] [Indexed: 01/29/2023]
Abstract
The hygiene hypothesis contends that fewer opportunities for infections and microbial exposures have resulted in more widespread asthma and atopic disease. Consistent with that hypothesis, decreases in infectious oral diseases over the past half century have coincided with increases in the prevalence of asthma and other allergic diseases. This observation has led some researchers to speculate that exposures to oral bacteria, including pathogens associated with periodontal diseases, such as gingivitis and periodontitis, might play a protective role in the development of asthma and allergy. Colonization of the oral cavity with bacteria, including some species of periodontal pathogens, begins shortly after birth, and the detection of serum antibodies to oral pathogens in early childhood provides evidence of an early immune response to these bacteria. Current knowledge of the immune response to oral bacteria and the immunologic pathogenesis of periodontal diseases suggests biologically plausible mechanisms by which oral pathogens could influence the risk of allergic disease. However, studies investigating the association between oral pathogen exposures and allergic disease are few in number and limited by cross-sectional or case-control design, exclusion of young children, and use of surrogate measures of oral bacterial colonization. Additional studies, particularly well-designed case-control studies among very young children and prospective birth cohort studies, are needed.
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da Fonseca DM, Trombone APF, Repeke CE, Avila-Campos MJ, Coelho-Castelo AAM, Silva JS, Campanelli AP, Deperon Bonato VL, Garlet GP. Functional interferences in host inflammatory immune response by airway allergic inflammation restrain experimental periodontitis development in mice. J Clin Periodontol 2010; 38:131-41. [DOI: 10.1111/j.1600-051x.2010.01660.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Modulation of allergic airway inflammation by the oral pathogen Porphyromonas gingivalis. Infect Immun 2010; 78:2488-96. [PMID: 20308298 DOI: 10.1128/iai.01270-09] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Accumulating evidence suggests that bacteria associated with periodontal disease may exert systemic immunomodulatory effects. Although the improvement in oral hygiene practices in recent decades correlates with the increased incidence of asthma in developed nations, it is not known whether diseases of the respiratory system might be influenced by the presence of oral pathogens. The present study sought to determine whether subcutaneous infection with the anaerobic oral pathogen Porphyromonas gingivalis exerts a regulatory effect on allergic airway inflammation. BALB/c mice sensitized and subsequently challenged with ovalbumin exhibited airway hyperresponsiveness to methacholine aerosol and increased airway inflammatory cell influx and Th2 cytokine (interleukin-4 [IL-4], IL-5, and IL-13) content relative to those in nonallergic controls. Airway inflammatory cell and cytokine contents were significantly reduced by establishment of a subcutaneous infection with P. gingivalis prior to allergen sensitization, whereas serum levels of ovalbumin-specific IgE and airway responsiveness were not altered. Conversely, subcutaneous infection initiated after allergen sensitization did not alter inflammatory end points but did reduce airway responsiveness in spite of increased serum IgE levels. These data provide the first direct evidence of a regulatory effect of an oral pathogen on allergic airway inflammation and responsiveness. Furthermore, a temporal importance of the establishment of infection relative to allergen sensitization is demonstrated for allergic outcomes.
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Hol J, de Jongste JC, Nieuwenhuis EE. Quoting a landmark paper on the beneficial effects of probiotics. J Allergy Clin Immunol 2010; 124:1354-6.e9. [PMID: 19818483 DOI: 10.1016/j.jaci.2009.07.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 07/21/2009] [Accepted: 07/23/2009] [Indexed: 02/06/2023]
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25
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Tanaka K, Miyake Y, Arakawa M, Sasaki S, Ohya Y. Dental caries and allergic disorders in Japanese children: the Ryukyus Child Health Study. J Asthma 2008; 45:795-9. [PMID: 18972298 DOI: 10.1080/02770900802252119] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dental caries is an infectious disease and is highly prevalent among children. In the etiology of allergic diseases, the hygiene hypothesis contends that infections might confer protection against the development of allergic diseases. The aim of this cross-sectional study was to investigate the association between dental caries and the prevalence of allergic disorders. METHODS Study subjects were 21,792 children 6 to 15 years of age in Okinawa, Japan. Outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Data on dental caries were obtained from school records. Children were classified as having dental caries if one or more teeth had decayed and/or had been filled. Adjustment was made for sex, age, region of residence, number of siblings, smoking in the household, paternal and maternal history of asthma, atopic eczema, or allergic rhinitis, and paternal and maternal educational level. RESULTS The prevalence of wheeze, asthma, atopic eczema, and allergic rhinoconjunctivitis in the previous 12 months was 10.8%, 7.6%, 6.8%, and 7.6%, respectively. In an overall analysis, no measurable relationship was found between dental caries and the prevalence of wheeze, asthma, atopic eczema, or allergic rhinoconjunctivitis. However, dental caries was significantly inversely associated with the prevalence of allergic rhinoconjunctivitis only among children with a positive parental allergic history: The adjusted odds ratio was 0.84 (95% confidence interval: 0.72, 0.99). CONCLUSIONS The present findings do not support the hypothesis that dental caries was protective against allergic diseases. However, a parental allergic history may affect the association between dental caries and allergic rhinoconjunctivitis.
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Affiliation(s)
- Keiko Tanaka
- Department of Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
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Hujoel PP, Cunha-Cruz J, Maupome G, Saver B. Long-term use of medications and destructive periodontal disease. J Periodontol 2008; 79:1330-8. [PMID: 18672981 DOI: 10.1902/jop.2008.070648] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Knowledge of typical medication use among patients with chronic periodontitis or destructive periodontal disease is limited. The aim of this study was to associate periodontitis severity with the use of different classes of medications. METHODS Patients (N=12,631) who had medical, dental, and pharmaceutical coverage with a health maintenance organization and whose severity of destructive periodontal disease was diagnosed by a dentist or specialist were included in the study. The rate of drug use over 7 years was related to the severity of destructive periodontal disease by means of Poisson regression models. RESULTS Individuals with moderate to advanced periodontitis had significantly lower fill rates for the respiratory agents (antihistamines: -23%, 95% confidence interval [CI]: -10% to -34%; decongestants: -24%, 95% CI: -13% to -34%; and cough/cold medications: -12%, 95% CI: -3% to -21%) and anti-infective agents (antibiotics: -12%, 95% confidence interval: -6% to -18%; urinary anti-infectives: -36%, 95% CI: -6% to -56%; and topical antibiotics: -18%, 95% CI: -5% to -29%). CONCLUSIONS More severe periodontitis was a marker for reduced medication use for allergies and infections. The associations between destructive periodontal disease, infections, allergies, and the hygiene hypothesis need further exploration.
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Affiliation(s)
- Philippe P Hujoel
- Department of Dental Public Health Sciences, University of Washington, Seattle, WA 98195-7475, USA.
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Glick M. The dirt on being clean: or, why more children develop asthma. J Am Dent Assoc 2007; 138:1188-9. [PMID: 17785377 DOI: 10.14219/jada.archive.2007.0333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Apter AJ. Advances in adult asthma 2006: its risk factors, course, and management. J Allergy Clin Immunol 2007; 119:563-6. [PMID: 17270262 DOI: 10.1016/j.jaci.2007.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 12/28/2006] [Accepted: 01/02/2007] [Indexed: 01/03/2023]
Abstract
This Advances article updates our understanding of risk factors for asthma and its course and management. Studies relevant to clinical practice are discussed, with special attention to their clinical research methods.
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Affiliation(s)
- Andrea J Apter
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USa.
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