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Saleh MHA, Decker AM, Kalani K, Hoang K, Mandil O, Gathalia P, Ray B, Lugogo N, Wang HL. Association between asthma and periodontitis: A case-control analysis of risk factors, related medications, and allergic responses. J Periodontal Res 2024. [PMID: 38853644 DOI: 10.1111/jre.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/11/2024]
Abstract
AIMS This study aimed to investigate the association between asthma, related allergies and medication use, and the presence and severity of periodontitis among individuals at the University of Michigan School of Dentistry. METHODS Employing a case-control design, the study analyzed data from 892 patients, half with asthma and half without asthma. Data collection included demographics, asthma history, medication use, allergies, and periodontal examination outcomes, including probing pocket depth (PPD), mobility, furcation involvement, and radiographic bone loss (RBL). Logistic regression models assessed the relationship between asthma and periodontitis, adjusting for confounders. RESULTS Asthmatic patients exhibited significantly lower odds of periodontitis (OR = 0.10, p < .001) and were less likely to present with advanced stages (OR = 0.23, p < .001) and grades of the disease (OR = 0.31, p < .001) compared to non-asthmatic patients. The study also found a higher proportion of females in the asthmatic group (67% vs. 51.8%, p < .001). Smoking was identified as a significant factor associated with periodontitis in patients with asthma, with former smokers at more than double the odds (OR = 2.28, p = .035) and current smokers at a slightly lower yet significant odds (OR = 1.87, p = .050). Additionally, asthmatic patients on adrenergic inhalers had an increased likelihood of developing periodontitis (OR = 1.76, p = .045). Allergies to codeine and latex were associated with higher odds of periodontitis, with ORs of 3.41 and 6.09, respectively. CONCLUSIONS Asthma was found to be associated with lower odds of periodontitis. However, this association appears to be modified by smoking habits and the use of certain asthma medications, which are related to an increased likelihood of periodontitis among asthmatic patients.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Ann M Decker
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Khushboo Kalani
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Khoa Hoang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Obada Mandil
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Parth Gathalia
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Bidisha Ray
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Njira Lugogo
- Division of Pulmonary & Critical Care Medicine, University of Michigan Health, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Jiao R, Li W, Song J, Chen Z. Causal association between asthma and periodontitis: A two-sample Mendelian randomization analysis. Oral Dis 2024; 30:1564-1572. [PMID: 36959704 DOI: 10.1111/odi.14565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/13/2023] [Accepted: 03/09/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND A unified view of whether asthma and periodontitis interact and the direction of action is not found in previous studies. Therefore, in this article, we will elucidate bidirectional causality by two-sample Mendelian randomization (MR). METHODS We obtained summary-level data for asthma and periodontitis from the massive GWAS databases of several publicly available. Meanwhile, it will ensure no confounders like smoking using the Phenoscanner website to have a search over each SNP. The F statistic value of each SNP is calculated as more significant than 10. This MR analysis mainly used five MR methods: MR-Egger, weighted median, inverse variance weighted (IVW), simple mode, and weighted mode. As a result, we performed heterogeneity and horizontal pleiotropy tests. RESULTS We have found supporting evidence to verify the hypothesis that asthma may be a protective factor for periodontitis (IVW OR = 0.34; 95% CI = [0.132,0.87]; p = 0.025). The consistent impact direction is shown when additional asthma GWAS dataset are used (MR-Egger OR = 0.118; 95%CI = [0.016,0.883]; p = 0.04). There is no evidence of a causal effect of periodontitis at the risk of asthma in the reverse analysis (p > 0.05). CONCLUSIONS Our analysis found that people with asthma may have a lower risk of periodontitis than those without. This MR analysis could have significant implications for the clinical process and future research.
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Affiliation(s)
- Ruofeng Jiao
- College of Stomatology, Zunyi Medical University, Zunyi, 563000, Guizhou, China
- Internal Medicine Department, Guiyang Hospital of Stomatology, Guiyang, 550002, Guizhou, China
| | - Wei Li
- Medical College, Guizhou University, Guiyang, 550002, Guizhou, China
| | - Jukun Song
- Oral & Maxillofacial Surgery Department, Guizhou Medical University, Guiyang, 550001, China
| | - Zhu Chen
- College of Stomatology, Zunyi Medical University, Zunyi, 563000, Guizhou, China
- Internal Medicine Department, Guiyang Hospital of Stomatology, Guiyang, 550002, Guizhou, China
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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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Tamiya H, Mitani A, Abe M, Nagase T. Putative Bidirectionality of Chronic Obstructive Pulmonary Disease and Periodontal Disease: A Review of the Literature. J Clin Med 2023; 12:5935. [PMID: 37762876 PMCID: PMC10531527 DOI: 10.3390/jcm12185935] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/24/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide and is currently the third leading cause of death globally. The long-term inhalation of toxic substances, mainly cigarette smoke, deteriorates pulmonary function over time, resulting in the development of COPD in adulthood. Periodontal disease is an inflammatory condition that affects most adults and is caused by the bacteria within dental plaque. These bacteria dissolve the gums around the teeth and the bone that supports them, ultimately leading to tooth loss. Periodontal disease and COPD share common risk factors, such as aging and smoking. Other similarities include local chronic inflammation and links with the onset and progression of systemic diseases such as ischemic heart disease and diabetes mellitus. Understanding whether interventions for periodontal disease improve the disease trajectory of COPD (and vice versa) is important, given our rapidly aging society. This review focuses on the putative relationship between COPD and periodontal disease while exploring current evidence and future research directions.
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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
| | - Akihisa Mitani
- 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 113-8654, Japan
| | - Takahide Nagase
- The Department of Respiratory Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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5
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Molina A, Huck O, Herrera D, Montero E. The association between respiratory diseases and periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2023; 50:842-887. [PMID: 36606394 DOI: 10.1111/jcpe.13767] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/26/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
AIM To evaluate (1) whether periodontitis has an influence on the prevalence/incidence of respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma, community-acquired pneumonia [CAP], obstructive sleep apnoea [OSA] and COVID-19), and (2) what is the impact of periodontal therapy on the onset or progression of respiratory diseases. MATERIALS AND METHODS An electronic search was performed on Pubmed, Cochrane Library and Scopus databases up to October 2021, to identify studies answering the PECOS and PICOS questions. RESULTS Seventy-five articles were selected. Meta-analyses identified statistically significant associations of periodontitis with COPD (nstudies = 12, odds ratio [OR] = 1.28, 95% confidence interval [CI] [1.16; 1.42], p < .001), and OSA (ns = 6, OR = 1.65, 95% CI [1.21; 2.25], p = .001), but not for asthma (ns = 9, OR = 1.53, 95% CI [0.82; 2.86], p = .181). For acute conditions, two studies were found for CAP, while for COVID-19, significant associations were found for the need of assisted ventilation (ns = 2, OR = 6.24, 95% CI [2.78; 13.99], p < .001) and COVID-related mortality (ns = 3, OR = 2.26, 95% CI [1.36, 3.77], p = .002). Only four intervention studies were found, showing positive effects of periodontal treatment on COPD, asthma and CAP. CONCLUSIONS A positive association between periodontitis and COPD, OSA and COVID-19 complications has been found, while there is a lack of intervention studies.
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Affiliation(s)
- Ana Molina
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Olivier Huck
- Dental Faculty Robert Franck, Université de Strasbourg, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Strasbourg, France
| | - David Herrera
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Eduardo Montero
- Etiology and Therapy of Periodontal and Peri-implant Diseases (ETEP) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
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Pacheco-Quito EM, Jaramillo J, Sarmiento-Ordoñez J, Cuenca-León K. Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health. Dent J (Basel) 2023; 11:dj11050113. [PMID: 37232764 DOI: 10.3390/dj11050113] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/16/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
Asthma is a chronic, heterogeneous respiratory pathology characterized by reversible airway inflammation. Therapeutics focus on symptom reduction and control, aimed at preserving normal pulmonary function and inducing bronchodilatation. The objective of this review is to describe the adverse effects produced by anti-asthmatic drugs on dental health, according to the reported scientific evidence. A bibliographic review was carried out on databases, such as Web of science, Scopus, and ScienceDirect. Most anti-asthmatic medications are administered using inhalers or nebulizers, making it impossible to avoid contact of the drug with hard dental tissues and oral mucosa, and thus promoting a greater risk of oral alterations, mainly due to decreases in the salivary flow and pH. Such changes can cause diseases, such as dental caries, dental erosion, tooth loss, periodontal disease, bone resorption, as well as fungal infections, such as oral candidiasis.
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Affiliation(s)
- Edisson-Mauricio Pacheco-Quito
- Academic Unit of Health and Wellness, Faculty of Dentistry, Catholic University of Cuenca, Cuenca 010105, Ecuador
- Innovation and Pharmaceutical Development in Dentistry Research Group, Faculty of Dentistry, Head of Research and Innovation, Catholic University of Cuenca, Cuenca 010105, Ecuador
| | | | - Jéssica Sarmiento-Ordoñez
- Academic Unit of Health and Wellness, Faculty of Dentistry, Catholic University of Cuenca, Cuenca 010105, Ecuador
- Innovation and Pharmaceutical Development in Dentistry Research Group, Faculty of Dentistry, Head of Research and Innovation, Catholic University of Cuenca, Cuenca 010105, Ecuador
| | - Katherine Cuenca-León
- Academic Unit of Health and Wellness, Faculty of Dentistry, Catholic University of Cuenca, Cuenca 010105, Ecuador
- Innovation and Pharmaceutical Development in Dentistry Research Group, Faculty of Dentistry, Head of Research and Innovation, Catholic University of Cuenca, Cuenca 010105, Ecuador
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7
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Moeintaghavi A, Akbari A, Rezaeetalab F. Association between periodontitis and periodontal indices in newly diagnosed bronchial asthma. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2022; 14:97-103. [PMID: 36714086 PMCID: PMC9871182 DOI: 10.34172/japid.2022.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/15/2022] [Indexed: 01/09/2023]
Abstract
Background. Periodontitis is an inflammatory disease of the tooth-supporting structures. Current data suggest that periodontal disease may be a risk factor for asthma. The present study aimed to assess the prevalence of periodontitis and its relationship with the severity of asthma in asthmatic patients. Methods. This study was conducted on 70 newly diagnosed asthmatic patients as the case group and 70 healthy subjects as the control group, aged 20‒50. The asthma was diagnosed by a pulmonologist according to Global Initiative for Asthma (GINA) guideline. All the participants underwent peri-odontal examinations, which included measuring the pocket depth (PD), attachment loss (AL), gingi-val index (GI), and plaque index (PI) in one tooth from each sextant, including the incisor/canine and left and right premolar/molar regions for both the maxillary and mandibular dental arches. Results. Periodontal disease was significantly more prevalent in newly diagnosed asthma patients. Patients with asthma had significantly higher PI, GI, PD, and AL scores (P<0.001). Furthermore, dry mouth in asthmatic patients with cough and mucosal changes in asthmatic patients with wheeze were significantly more common than in non-asthmatic patients (P<0.05). The median AL in wheezing patients and the median AL and PD in participants who had asthma attacks within the previous month were significantly higher than in other patients. Furthermore, there was a significant negative correlation between AL with Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and PD with FEV1 and FVC. Conclusion. Our results showed that periodontal diseases were more prevalent in newly diagnosed asthmatic patients, and asthma was more severe in periodontitis patients.
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Affiliation(s)
- Amir Moeintaghavi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afsaneh Akbari
- Department of Periodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author: Afsaneh Akbari. E-mail:
| | - Fariba Rezaeetalab
- Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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8
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Teles F, Collman RG, Mominkhan D, Wang Y. Viruses, periodontitis, and comorbidities. Periodontol 2000 2022; 89:190-206. [PMID: 35244970 DOI: 10.1111/prd.12435] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Seminal studies published in the 1990s and 2000s explored connections between periodontal diseases and systemic conditions, revealing potential contributions of periodontal diseases in the initiation or worsening of systemic conditions. The resulting field of periodontal medicine led to the publication of studies indicating that periodontal diseases can influence the risk of systemic conditions, including adverse pregnancy outcomes, cardiovascular and respiratory diseases, as well as Alzheimer disease and cancers. In general, these studies hypothesized that the periodontal bacterial insult and/or the associated proinflammatory cascade could contribute to the pathogenesis of these systemic diseases. While investigations of the biological basis of the connections between periodontal diseases and systemic conditions generally emphasized the bacteriome, it is also biologically plausible, under an analogous hypothesis, that other types of organisms may have a similar role. Human viruses would be logical "suspects" in this role, given their ubiquity in the oral cavity, association with periodontal diseases, and ability to elicit strong inflammatory response, compromise immune responses, and synergize with bacteria in favor of a more pathogenic microbial consortium. In this review, the current knowledge of the role of viruses in connecting periodontal diseases and systemic conditions is examined. We will also delve into the mechanistic basis for such connections and highlight the importance of those relationships in the management and treatment of patients.
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Affiliation(s)
- Flavia Teles
- Department of Basic and Translational Sciences, School of Dental Medicine, Center for Innovation & Precision Dentistry, School of Dental Medicine & School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ronald G Collman
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Dana Mominkhan
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yu Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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9
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Pulmonary disease and periodontal health: a meta-analysis. Sleep Breath 2022; 26:1857-1868. [PMID: 35122603 DOI: 10.1007/s11325-022-02577-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Research has shown a positive relationship between pulmonary and periodontal disease. However, the relationship remains unclear. The aim of this meta-analysis was to evaluate the associations between pulmonary disease and periodontal health. MATERIALS AND METHODS MEDLINE, PubMed, EMBASE, Web of Science, Science Citation Index, Wanfang, and CNKI were searched for all the relevant studies of relationship between pulmonary disease and periodontal health. Weighted mean difference (WMD)/odds ratio (OR) with 95% confidence interval (CI) was used to assess the strength of the association. RESULTS Thirty-seven studies were included in this meta-analysis. Pooled analysis showed a significant association between pulmonary and periodontal disease (adjusted OR, 1.93; 95%CI: 1.60-2.33; P < 0.05), and pooled adjusted OR was 1.64, 3.03, and 2.21 in COPD, asthma, and pneumonia, respectively. The pooled analysis also showed that patients with pulmonary disease suffered from worse periodontal health as most periodontal indexes in those patients were poorer. CONCLUSIONS There is a strong association between pulmonary disease and periodontal health. Clinical trials analyzing the causality and pathological basis of the association of these two diseases are needed.
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10
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Cai W, Marouf N, Said KN, Tamimi F. Nature of the Interplay Between Periodontal Diseases and COVID-19. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.735126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) is mostly a mild condition, however, in some patients, it could progress into a severe and even fatal disease. Recent studies have shown that COVID-19 infection and severity could be associated with the presence of periodontitis, one of the most prevalent chronic diseases. This association could be explained by the fact that periodontitis and COVID-19 share some common risk factors that included chronic diseases, such as diabetes and hypertension as well as conditions such as age, sex, and genetic variants. Another possible explanation could be the systemic inflammation and the aspiration of periodontopathogens seen in patients with periodontitis, which could have a synergism with the virus or compromise the reaction of the body against COVID-19. This narrative review explores the nature of these associations, the evidence behind them, and their implications.
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11
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Ikbariyeh B, Al Habashneh R, Khassawneh B, Alrawashdeh M, Elsalim L, Al-Nusair J. Clinical and Biological Indicators of Periodontal Disease in Obese and non-Obese adults with and without Bronchial Asthma. J Asthma 2021; 59:1758-1766. [PMID: 34324826 DOI: 10.1080/02770903.2021.1962907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: The present study aims to assess clinical and inflammatory parameters as indicators for periodontal disease in obese and non-obese adults with and without bronchial asthma (BA).Methods: 168 patients visiting the outpatient pulmonary clinics were divided into four groups according to BA and obesity. Obesity was defined by body mass index (BMI) and BA was diagnosed by a pulmonary consultant and being on inhaled asthma medication for at least 12 months. Participants were examined for clinical periodontal parameters and samples of gingival crevicular fluid (GCF) were taken and analyzed for the levels of 5 different inflammatory cytokines.Results: Compared with controls, obese asthmatic group had significant higher mean clinical attachment loss (CAL) (2.64 vs. 1.00, p<.001). Also, the occurrence of periodontitis was significantly higher among obese patients compared to non-obese patients (p = 0.003). Multivariate logistic regression model showed that age was the strongest predictor of periodontitis (aOR =1.23). The levels of IL-1β and IL-8 were significantly higher in the non-obese asthmatic group compared to the control group (p < 0.05). The level of IL-6 was significantly lower in the control group compared to the other groups (p < 0.001). Obese patients had significantly higher concentration of hsCRP compared to non-obese patients (p < 0.001). There was no significant difference in the level of TNF- α between groups.Conclusions: BA and obesity combined did not seem to be associated with a significant increased risk of having periodontitis. BA and obesity are associated with increased levels of some local proinflammatory cytokines which adds to the local and systemic inflammatory burden.
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Affiliation(s)
- Bader Ikbariyeh
- Faculty of Dentistry, Preventive Dentistry, Jordan University of Science & Technology, Irbid, Jordan
| | - Rola Al Habashneh
- Faculty of Dentistry, Preventive Dentistry, Jordan University of Science & Technology, Irbid, Jordan
| | - Basheer Khassawneh
- Faculty of Medicine, Internal Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammad Alrawashdeh
- Faculty of Nursing, Community and Mental Health Nursing, Jordan University of Science & Technology, Irbid, Jordan
| | - Lina Elsalim
- Faculty of Medicine, Department of Pharmacology, Jordan University of Science & Technology, Irbid, Jordan
| | - Jowan Al-Nusair
- Medical Student, College of Medicine, Jordan University of Science & Technology, Irbid, Jordan
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12
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Pathak JL, Yan Y, Zhang Q, Wang L, Ge L. The role of oral microbiome in respiratory health and diseases. Respir Med 2021; 185:106475. [PMID: 34049183 DOI: 10.1016/j.rmed.2021.106475] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 12/16/2022]
Abstract
The oral cavity (mouth) has various microbial habitats, including, teeth, gingival sulcus, gingiva, tongue, inner cheek, hard palate, and soft palate. The human oral cavity houses the second most diverse microbiome in the body harboring over 700 bacterial species. The fine-tuned equilibrium of the oral microbiome ecosystem maintains oral health. Oral dysbiosis caused by food habits and poor oral hygiene leads to various oral diseases such as periodontitis, caries, gingivitis, and oral cancer. Recent advances in technology have revealed the correlation between the oral microbiome and systemic diseases such as pulmonary diseases, cardiovascular diseases, rheumatoid arthritis, Alzheimer's disease, and other metabolic diseases. Since the oral cavity directly connects with the upper respiratory tract, the oral microbiome has easier access to the respiratory system compared to other organ systems. Direct aspiration of oral microflora in the respiratory system and oral dysbiosis-induced host immune reaction and inflammation are mainly responsible for various pulmonary complications. Numbers of literature have reported the correlation between oral diseases and pulmonary diseases, suggesting the possible role of the oral microbiome in respiratory diseases such as chronic obstructive pulmonary diseases, pneumonia, lung cancer, etc. This paper reviews the current evidence in establishing a link between the oral microbiome and pulmonary diseases. We also discuss future research directions focusing on the oral microbiome to unravel novel therapeutic approaches that could prevent or treat the various pulmonary complications.
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Affiliation(s)
- Janak L Pathak
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Yongyong Yan
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Qingbin Zhang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Liping Wang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
| | - Linhu Ge
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
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Gomes-Filho IS, Cruz SSD, Trindade SC, Passos-Soares JDS, Carvalho-Filho PC, Figueiredo ACMG, Lyrio AO, Hintz AM, Pereira MG, Scannapieco F. Periodontitis and respiratory diseases: A systematic review with meta-analysis. Oral Dis 2019; 26:439-446. [PMID: 31715080 DOI: 10.1111/odi.13228] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/08/2019] [Accepted: 10/27/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to evaluate the recent scientific literature addressing the association between periodontitis and asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. MATERIALS AND METHODS The search for studies was carried out using MEDLINE/PubMed, EMBASE, Lilacs, Web of Science, Scopus, and SciELO databases, including the gray literature (ProQuest). Reference lists of selected articles were also searched. Studies having varying epidemiological designs assessing the association between periodontitis and respiratory diseases in human subjects were eligible for inclusion. Three independent reviewers performed the selection of articles and data extraction. Fixed and random effects meta-analysis were performed for the calculation of the association measurements (Odds Ratio-OR) and 95% confidence intervals (95% CI). RESULTS A total of 3,234 records were identified in the database search, with only 13 studies meeting the eligibility criteria and 10 studies contributed data for meta-analysis. Using a random effects models periodontitis was associated with asthma: ORadjusted: 3.54 (95% CI: 2.47-5.07), I2 = 0%; with COPD: OR adjusted: 1.78 (95% CI: 1.04-3.05), I2 = 37.9%; and with pneumonia: OR adjusted: 3.21 (95% CI: 1.997-5.17), I2 = 0%. CONCLUSIONS The main findings of this systematic review validated an association between periodontitis and asthma, COPD and pneumonia.
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Affiliation(s)
| | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Bahia, Brazil.,Department of Epidemiology, Federal University of Recôncavo of Bahia, Bahia, Brazil
| | | | - Johelle de Santana Passos-Soares
- Department of Health, Feira de Santana State University, Bahia, Brazil.,Department of Preventive Dentistry, Federal University of Bahia, Salvador, Brazil
| | | | | | - Amanda Oliveira Lyrio
- Faculty of Health Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
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