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Nayak G, Dimitriadis K, Pyrpyris N, Manti M, Kamperidis N, Kamperidis V, Ziakas A, Tsioufis K. Gut Microbiome and Its Role in Valvular Heart Disease: Not a "Gutted" Relationship. Life (Basel) 2024; 14:527. [PMID: 38672797 PMCID: PMC11051562 DOI: 10.3390/life14040527] [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: 03/18/2024] [Revised: 04/07/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
The role of the gut microbiome (GM) and oral microbiome (OM) in cardiovascular disease (CVD) has been increasingly being understood in recent years. It is well known that GM is a risk factor for various CVD phenotypes, including hypertension, dyslipidemia, heart failure and atrial fibrillation. However, its role in valvular heart disease (VHD) is less well understood. Research shows that, direct, microbe-mediated and indirect, metabolite-mediated damage as a result of gut dysbiosis and environmental factors results in a subclinical, chronic, systemic inflammatory state, which promotes inflammatory cell infiltration in heart valves and subsequently, via pro-inflammatory molecules, initiates a cascade of reaction, resulting in valve calcification, fibrosis and dysfunction. This relationship between GM and VHD adds a pathophysiological link to the pathogenesis of VHD, which can be aimed therapeutically, in order to prevent or regress any risk for valvular pathologies. Therapeutic interventions include dietary modifications and lifestyle interventions, in order to influence environmental factors that can promote gut dysbiosis. Furthermore, the combination of probiotics and prebiotics, as well as fecal m transplantation and targeted treatment with inducers or inhibitors of microbial enzymes have showed promising results in animal and/or clinical studies, with the potential to reduce the inflammatory state and restore the normal gut flora in patients. This review, thus, is going to discuss the pathophysiological links behind the relationship of GM, CVD and VHD, as well as explore the recent data regarding the effect of GM-altering treatment in CVD, cardiac function and systemic inflammation.
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Affiliation(s)
- Gyanaranjan Nayak
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, Greece; (G.N.); (N.P.); (K.T.)
| | - Kyriakos Dimitriadis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, Greece; (G.N.); (N.P.); (K.T.)
| | - Nikolaos Pyrpyris
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, Greece; (G.N.); (N.P.); (K.T.)
| | - Magdalini Manti
- St Mark’s Hospital, Imperial College London, London HA1 3UJ, UK (N.K.)
| | | | - Vasileios Kamperidis
- First Cardiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54453 Thessaloniki, Greece; (V.K.); (A.Z.)
| | - Antonios Ziakas
- First Cardiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54453 Thessaloniki, Greece; (V.K.); (A.Z.)
| | - Konstantinos Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, Greece; (G.N.); (N.P.); (K.T.)
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Wang X, Gao J, Chen Y, Zhang X, Dai Z, Dai Q, Peng M, Xiao L, Jia X, Cai H, Mou T, Li X, Xu G. Detecting prokaryote-specific gene and other bacterial signatures in thrombi from patients with acute ischemic stroke. Thromb J 2024; 22:14. [PMID: 38263151 PMCID: PMC10807108 DOI: 10.1186/s12959-024-00583-x] [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: 07/30/2023] [Accepted: 01/13/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND AND PURPOSE Microbial infection has been associated with thrombogenesis. This study aimed to detect bacterium-specific genes and other signatures in thrombi from patients with acute ischemic stroke and to relate these signatures to clinical characteristics. METHODS Blood samples were collected before thrombectomy procedures, and thrombus samples were obtained during the procedure. Identification and classification of bacteria in the samples were accomplished using 16 S rRNA gene sequencing. Bacterium-specific structures were observed with transmission electron microscopy. Bacterium-specific biomarkers were detected through immunohistochemical staining. RESULTS 16 S rRNA gene was detected in 32.1% of the thrombus samples from 81 patients. Bacillus (0.04% vs. 0.00046%, p = 0.003), Parabacteroides (0.20% vs. 0.09%, p = 0.029), Prevotella (1.57% vs. 0.38%, p = 0.010), Streptococcus (1.53% vs. 0.29%, p = 0.001), Romboutsia (0.18% vs. 0.0070%, p = 0.029), Corynebacterium (1.61% vs. 1.26%, p = 0.026) and Roseburia (0.53% vs. 0.05%, p = 0.005) exhibited significantly higher abundance in thrombi compared to arterial blood. Bacteria-like structures were observed in 22 (27.1%), while whole bacteria-like structures were observed in 7 (8.6%) thrombi under transmission electron microscopy. Immunohistochemical staining detected bacterium-specific monocyte/macrophage markers in 51 (63.0%) out of 81 thrombi. Logistic regression analysis indicated that alcohol consumption was associated with a higher bacteria burden in thrombi (odds ratio = 3.19; 95% CI, 1.10-9.27; p = 0.033). CONCLUSION Bacterial signatures usually found in the oral cavity and digestive tract were detected in thrombi from patients with ischemic stroke. This suggests a potential involvement of bacterial infection in the development of thrombosis. Long-term alcohol consumption may potentially enhance this possibility.
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Affiliation(s)
- Xiaoke Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Jie Gao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Yantong Chen
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
- Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Xiaohao Zhang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Zhengze Dai
- Department of Neurology, Fourth Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiliang Dai
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Mengna Peng
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Lulu Xiao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Xuerong Jia
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Haodi Cai
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, Germany
| | - Tao Mou
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China
| | - Xiang Li
- Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Gelin Xu
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, 305# East Zhongshan Road, 210002, Nanjing, Jiangsu, China.
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China.
- Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.
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Neculae E, Gosav EM, Valasciuc E, Dima N, Floria M, Tanase DM. The Oral Microbiota in Valvular Heart Disease: Current Knowledge and Future Directions. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010182. [PMID: 36676130 PMCID: PMC9862471 DOI: 10.3390/life13010182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/31/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
Oral microbiota formation begins from birth, and everything from genetic components to the environment, alongside the host's behavior (such as diet, smoking, oral hygiene, and even physical activity), contributes to oral microbiota structure. Even though recent studies have focused on the gut microbiota's role in systemic diseases, the oral microbiome represents the second largest community of microorganisms, making it a new promising therapeutic target. Periodontitis and dental caries are considered the two main consequences of oral bacterial imbalance. Studies have shown that oral dysbiosis effects are not limited locally. Due to technological advancement, research identified oral bacterial species in heart valves. This evidence links oral dysbiosis with the development of valvular heart disease (VHD). This review focuses on describing the mechanism behind prolonged local inflammation and dysbiosis, that can induce bacteriemia by direct or immune-mediated mechanisms and finally VHD. Additionally, we highlight emerging therapies based on controlling oral dysbiosis, periodontal disease, and inflammation with immunological and systemic effects, that exert beneficial effects in VHD management.
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Affiliation(s)
- Ecaterina Neculae
- Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Institute of Gastroenterology and Hepatology, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Evelina Maria Gosav
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Emilia Valasciuc
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Nicoleta Dima
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Mariana Floria
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
- Correspondence:
| | - Daniela Maria Tanase
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
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Boukobza M, Raffoul R, Duval X, Laissy JP. [Not Available]. Ann Cardiol Angeiol (Paris) 2022; 71:240-242. [PMID: 35940971 DOI: 10.1016/j.ancard.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/27/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Prevotella species (i. e. P. intermedia, P. nigrescens, P. pallens, P. oris) are usually responsible for abscesses of head and neck spaces after dental procedures. P. intermedia - related infective endocarditis has never been reported. CASE REPORT A 22-year-old man, with a history of aortic valve replacement 6 years ago, presented with fever and persistent retrosternal chest pain. An empirical antibiotic therapy was started on (cefotaxime, 2gx3 - gentamicin, 5mg/kilo). Five blood cultures were positive at Prevotella Intermedia. Metronidazole was introduced (500mg X 3 by day).The oro-pharyngeal spaces were normal. The evolution was marked by a hypotension, a third degree atrio-ventricular block, and a rapidly growing aortic root abscess complicated this case of Prevotella Intermedia infective endocarditis (IE). Aortic valve redux surgery was performed at day 5 of admission. Post-operative course was unremarkable. CONCLUSION This first reported case of Prevotella Intermedia IE presented suggestive features of anaerobic IE as the patient developed both aortic-ring abscess, third degree atrio-ventricular block and hypotension.
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Affiliation(s)
- Monique Boukobza
- Department of Radiology, Bichat-Claude-Bernard Hospital, Assistance Publique-Hôpitaux de Paris, 46 rue Henri Huchard, 75018, Paris, FRANCE.
| | - Richard Raffoul
- Department of Cardiac Surgery, Bichat-Claude-Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier Duval
- Department of Infectious Diseases, Bichat-Claude-Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France ; INSERM Clinical Investigation Center 007, Paris, France ; INSERM U738, Paris, France ; Paris University, France
| | - Jean-Pierre Laissy
- Department of Radiology, Bichat-Claude-Bernard Hospital, Assistance Publique-Hôpitaux de Paris , Paris, France ; INSERM U1148, Paris, France ; Paris University, Paris, France
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Rughwani RR, Cholan PK, Victor DJ. Congenital Heart Diseases and Periodontal Diseases—Is There a Link? Front Cardiovasc Med 2022; 9:937480. [PMID: 35845078 PMCID: PMC9279652 DOI: 10.3389/fcvm.2022.937480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/30/2022] [Indexed: 11/14/2022] Open
Abstract
An understanding in the field of periodontal medicine explains the fact that the oral cavity serves as a niche for numerous pathogenic microorganisms. When these microorganisms or their by-products disseminate to the various parts of the body, they are capable of triggering diseases characterized by an altered host immune-inflammatory response in the anatomically distinct organ. This mechanism is reported in the propagation of cardiovascular diseases with respect to periodontal medicine. Abundant amount of literature suggests an association between atherosclerotic cardiovascular disease and periodontal diseases. However, there is very less data available to highlight the association between periodontal disease and non-atherosclerotic cardiovascular disease, such as congenital anomalies of the heart. This review outlines the relationship between periodontal diseases and congenital heart diseases and also helps us understand whether the presence of periodontal disease can worsen the preexisting congenital cardiac disease.
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Deppe H, Reitberger J, Behr AV, Vitanova K, Lange R, Wantia N, Wagenpfeil S, Sculean A, Ritschl LM. Oral bacteria in infective endocarditis requiring surgery: a retrospective analysis of 134 patients. Clin Oral Investig 2022; 26:4977-4985. [PMID: 35316412 PMCID: PMC9276723 DOI: 10.1007/s00784-022-04465-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/15/2022] [Indexed: 01/02/2023]
Abstract
Objectives It has been reported that bacteria associated with infective endocarditis originate from the oral cavity in 26–45% of cases. However, little is known on the counts and species of periodontal microbiota in infected heart valves. The aim of this study was to identify these aspects of periodontal microbiota in infective endocarditis and to potentially initiate a dental extraction concept for periodontally compromised teeth concerning patients requiring heart valve surgery. Materials and methods The retrospective study group consisted of tissue samples from infected heart valves of 683 patients who had undergone heart valve surgery. Before patients had undergone cardiac surgery, the following laboratory tests confirmed the occurrence of endocarditis in all patients: blood cultures, echocardiography, electrocardiography, chest X-ray, and electrophoresis of the serum proteins. The specimens were aseptically obtained and deep frozen immediately following surgery. Microbiological diagnosis included proof of germs (dichotomous), species of germs, and source of germs (oral versus other). Results Microbiota was detected in 134 (31.2%) out of 430 enrolled patients. Oral cavity was supposed to be the source in 10.4% of cases, whereas microbiota of the skin (57.5%) and gastrointestinal tract (GIT, 24.6%) were detected considerably more frequently. Moreover, periodontal bacteria belonged mostly to the Streptococci species and the yellow complex. None of the detected bacteria belonged to the red complex. Conclusion Most frequently, the skin and GIT represented the site of origin of the microbiota. Nevertheless, the oral cavity represented the source of IE in up to 10%. Consequently, it needs to be emphasized that a good level of oral hygiene is strongly recommended in all patients undergoing heart valve surgery in order to reduce the bacterial load in the oral cavity, thereby minimizing the hematogenous spread of oral microbiota. The prerequisites for conservative dental treatment versus radical tooth extraction must always be based on the patient’s cooperation, and the clinical intraoral status on a sense of proportion in view of the overall clinical situation due to the underlying cardiac disease. Clinical relevance The oral cavity is a source of oral microbiota on infected heart valves. Patients requiring heart valve surgery should always undergo a critical evaluation of dental treatment affecting periodontally compromised teeth, favoring a systematic, conservative-leaning recall.
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Affiliation(s)
- Herbert Deppe
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Hospital "Rechts Der Isar", Ismaninger Straße 22, 81675, Munich, Germany
| | - Julia Reitberger
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Hospital "Rechts Der Isar", Ismaninger Straße 22, 81675, Munich, Germany
| | - Alexandra V Behr
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Hospital "Rechts Der Isar", Ismaninger Straße 22, 81675, Munich, Germany
| | - Keti Vitanova
- Department of Cardiac Surgery, German Heart Center Munich, Technical University of Munich, Lazarettstraße 36, 80636, Munich, Germany
| | - Rüdiger Lange
- Department of Cardiac Surgery, German Heart Center Munich, Technical University of Munich, Lazarettstraße 36, 80636, Munich, Germany
| | - Nina Wantia
- Department of Microbiology, Technical University of Munich, Hospital "Rechts Der Isar", Ismaninger Straße 22, 81675, Munich, Germany
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, University of Saarland, Kirrbergerstraße Building 86, 66421, Homburg, Saar, Germany
| | - Anton Sculean
- Department of Periodontology, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Lucas M Ritschl
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Hospital "Rechts Der Isar", Ismaninger Straße 22, 81675, Munich, Germany.
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Fungi—A Component of the Oral Microbiome Involved in Periodontal Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:113-138. [DOI: 10.1007/978-3-030-96881-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Thomas C, Minty M, Vinel A, Canceill T, Loubières P, Burcelin R, Kaddech M, Blasco-Baque V, Laurencin-Dalicieux S. Oral Microbiota: A Major Player in the Diagnosis of Systemic Diseases. Diagnostics (Basel) 2021; 11:1376. [PMID: 34441309 PMCID: PMC8391932 DOI: 10.3390/diagnostics11081376] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
The oral cavity is host to a complex and diverse microbiota community which plays an important role in health and disease. Major oral infections, i.e., caries and periodontal diseases, are both responsible for and induced by oral microbiota dysbiosis. This dysbiosis is known to have an impact on other chronic systemic diseases, whether triggering or aggravating them, making the oral microbiota a novel target in diagnosing, following, and treating systemic diseases. In this review, we summarize the major roles that oral microbiota can play in systemic disease development and aggravation and also how novel tools can help investigate this complex ecosystem. Finally, we describe new therapeutic approaches based on oral bacterial recolonization or host modulation therapies. Collaboration in diagnosis and treatment between oral specialists and general health specialists is of key importance in bridging oral and systemic health and disease and improving patients' wellbeing.
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Affiliation(s)
- Charlotte Thomas
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Matthieu Minty
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Alexia Vinel
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Thibault Canceill
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- UMR CNRS 5085, Centre Interuniversitaire de Recherche et d’Ingénierie des Matériaux (CIRIMAT), Université Paul Sabatier, 35 Chemin des Maraichers, CEDEX 9, 31062 Toulouse, France
| | - Pascale Loubières
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
| | - Remy Burcelin
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
| | - Myriam Kaddech
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Vincent Blasco-Baque
- INSERM UMR 1297 Inserm, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Avenue Jean Poulhès 1, CEDEX 4, 31432 Toulouse, France; (A.V.); (P.L.); (R.B.); (V.B.-B.)
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
| | - Sara Laurencin-Dalicieux
- Faculté de Chirurgie Dentaire, Université Paul Sabatier III (UPS), 118 Route de Narbonne, CEDEX 9, 31062 Toulouse, France; (T.C.); (M.K.); (S.L.-D.)
- Service d’Odontologie Rangueil, CHU de Toulouse, 3 Chemin des Maraîchers, CEDEX 9, 31062 Toulouse, France
- INSERM UMR 1295, Centre d’Epidémiologie et de Recherche en Santé des Populations de Toulouse (CERPOP), Epidémiologie et Analyse en Santé Publique, Risques, Maladies Chroniques et Handicaps, 37 Allées Jules Guesdes, 31000 Toulouse, France
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Osako R, Matsuda Y, Itohara C, Sukegawa-Takahashi Y, Sukegawa S, Okuma S, Furuki Y, Kanno T. Relationship between Oral Bacterial Count and Postoperative Complications among Patients with Cardiovascular Disease Treated by Surgery: A Retrospective Cohort Study. Healthcare (Basel) 2021; 9:healthcare9070850. [PMID: 34356228 PMCID: PMC8304811 DOI: 10.3390/healthcare9070850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022] Open
Abstract
In this retrospective observational study, we evaluated the relationship between perioperative oral bacterial counts and postoperative complications in cardiovascular disease (CVD) patients. From April 2012 to December 2018, all patients scheduled for surgery received perioperative oral management (POM) by oral specialists at a single center. Tongue dorsum bacterial counts were measured on the pre-hospitalization day, preoperatively, and postoperatively. Background data were collected retrospectively. Among the 470 consecutive patients, the postoperative complication incidence rate was 10.4% (pericardial fluid storage, n = 21; postoperative pneumonia, n = 13; surgical site infection, n = 9; mediastinitis, n = 2; and seroma, postoperative infective endocarditis, lung torsion, and pericardial effusion, n = 1 each). Oral bacterial counts were significantly higher in the pre-hospitalization than in the pre- and postoperative samples (p < 0.05). Sex, cerebrovascular disease, and operation time differed significantly between complications and no-complications groups (p < 0.05). Multivariate analysis with propensity score adjustment showed a significant association between postoperative oral bacterial count and postoperative complications (odds ratio 1.26; 95% confidence interval, 1.00–1.60; p = 0.05). Since the development of cardiovascular complications is a multifactorial process, the present study cannot show that POM reduces complications but indicates POM may prevent complications in CVD patients.
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Affiliation(s)
- Rie Osako
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine & Oral Care Center, Shimane University Hospital, Izumo 693-8501, Japan; (R.O.); (Y.M.); (C.I.); (S.O.)
| | - Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine & Oral Care Center, Shimane University Hospital, Izumo 693-8501, Japan; (R.O.); (Y.M.); (C.I.); (S.O.)
| | - Chieko Itohara
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine & Oral Care Center, Shimane University Hospital, Izumo 693-8501, Japan; (R.O.); (Y.M.); (C.I.); (S.O.)
| | - Yuka Sukegawa-Takahashi
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu 760-8557, Japan; (Y.S.-T.); (S.S.); (Y.F.)
| | - Shintaro Sukegawa
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu 760-8557, Japan; (Y.S.-T.); (S.S.); (Y.F.)
| | - Satoe Okuma
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine & Oral Care Center, Shimane University Hospital, Izumo 693-8501, Japan; (R.O.); (Y.M.); (C.I.); (S.O.)
| | - Yoshihiko Furuki
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Takamatsu 760-8557, Japan; (Y.S.-T.); (S.S.); (Y.F.)
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine & Oral Care Center, Shimane University Hospital, Izumo 693-8501, Japan; (R.O.); (Y.M.); (C.I.); (S.O.)
- Correspondence: ; Tel.: +81-853-20-2301
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10
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Del Giudice C, Vaia E, Liccardo D, Marzano F, Valletta A, Spagnuolo G, Ferrara N, Rengo C, Cannavo A, Rengo G. Infective Endocarditis: A Focus on Oral Microbiota. Microorganisms 2021; 9:1218. [PMID: 34199916 PMCID: PMC8227130 DOI: 10.3390/microorganisms9061218] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/17/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023] Open
Abstract
Infective endocarditis (IE) is an inflammatory disease usually caused by bacteria entering the bloodstream and settling in the heart lining valves or blood vessels. Despite modern antimicrobial and surgical treatments, IE continues to cause substantial morbidity and mortality. Thus, primary prevention and enhanced diagnosis remain the most important strategies to fight this disease. In this regard, it is worth noting that for over 50 years, oral microbiota has been considered one of the significant risk factors for IE. Indeed, among the disparate recommendations from the American heart association and the European Society of Cardiology, there are good oral hygiene and prophylaxis for high-risk patients undergoing dental procedures. Thus, significant interest has grown in the role of oral microbiota and it continues to be a subject of research interest, especially if we consider that antimicrobial treatments can generate drug-resistant mutant bacteria, becoming a severe social problem. This review will describe the current knowledge about the relationship between oral microbiota, dental procedures, and IE. Further, it will discuss current methods used to prevent IE cases that originate from oral pathogens and how these should be focused on improving oral hygiene, which remains the significant persuasible way to prevent bacteremia and systemic disorders.
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Affiliation(s)
- Carmela Del Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (C.D.G.); (E.V.); (A.V.); (G.S.)
| | - Emanuele Vaia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (C.D.G.); (E.V.); (A.V.); (G.S.)
| | - Daniela Liccardo
- Department of Translational Medical Sciences, Medicine Federico II University of Naples, 80131 Naples, Italy; (D.L.); (N.F.); (G.R.)
| | - Federica Marzano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Alessandra Valletta
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (C.D.G.); (E.V.); (A.V.); (G.S.)
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (C.D.G.); (E.V.); (A.V.); (G.S.)
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Medicine Federico II University of Naples, 80131 Naples, Italy; (D.L.); (N.F.); (G.R.)
- Istituti Clinici Scientifici ICS-Maugeri, 82037 Telese Terme, Italy
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100 Siena, Italy;
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, Medicine Federico II University of Naples, 80131 Naples, Italy; (D.L.); (N.F.); (G.R.)
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Medicine Federico II University of Naples, 80131 Naples, Italy; (D.L.); (N.F.); (G.R.)
- Istituti Clinici Scientifici ICS-Maugeri, 82037 Telese Terme, Italy
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11
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Sia SK, Jan MS, Wang YH, Huang YF, Wei JCC. Periodontitis is associated with incidental valvular heart disease: A nationwide population-based cohort study. J Clin Periodontol 2021; 48:1085-1092. [PMID: 34060116 DOI: 10.1111/jcpe.13478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/18/2021] [Accepted: 04/10/2021] [Indexed: 12/15/2022]
Abstract
AIM Periodontitis and valvular heart disease (VHD) are common diseases. Both diseases are related to chronic inflammation and share many common risk factors. Previous periodontal studies had focused mainly on atherosclerotic cardiovascular disease. This study aimed to determine whether periodontitis is associated with the development of VHD. MATERIALS AND METHODS This was a retrospective nationwide cohort study using Taiwan's Longitudinal Health Insurance Database. Using ICD-9-CM coding, both the periodontitis and non-periodontitis groups were matched. RESULTS There were 8483 cases and 4919 cases of VHD diagnosed in the periodontitis group and non-periodontitis group, respectively. The cumulative incidence of VHD was significantly higher in the periodontitis group (log-rank test, p < .001), with the incidence density of 6.44 (95% CI, 6.31-6.58) per 1000 person-years in the periodontitis group compared to 4.65 (95% CI, 4.52-4.78) in the non-periodontitis group. The relative risk for VHD was 1.39 (95% CI, 1.34-1.44). After multivariate analysis, periodontitis was independently associated with a risk for VHD (HR, 1.38; 95% CI, 1.33-1.42, p < .001). Intensive treatment of periodontitis significantly lowered the risk for VHD (HR, 0.68; 95% CI, 0.60-0.77, p < .001). CONCLUSIONS Periodontitis was significantly associated with the development of VHD. Treatment of periodontitis reduced the risk for VHD.
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Affiliation(s)
- Sung-Kien Sia
- Division of cardiology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Shiou Jan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Feng Huang
- Department of stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,College of oral medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Division of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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12
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Wadhawan A, Reynolds MA, Makkar H, Scott AJ, Potocki E, Hoisington AJ, Brenner LA, Dagdag A, Lowry CA, Dwivedi Y, Postolache TT. Periodontal Pathogens and Neuropsychiatric Health. Curr Top Med Chem 2021; 20:1353-1397. [PMID: 31924157 DOI: 10.2174/1568026620666200110161105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 02/08/2023]
Abstract
Increasing evidence incriminates low-grade inflammation in cardiovascular, metabolic diseases, and neuropsychiatric clinical conditions, all important causes of morbidity and mortality. One of the upstream and modifiable precipitants and perpetrators of inflammation is chronic periodontitis, a polymicrobial infection with Porphyromonas gingivalis (P. gingivalis) playing a central role in the disease pathogenesis. We review the association between P. gingivalis and cardiovascular, metabolic, and neuropsychiatric illness, and the molecular mechanisms potentially implicated in immune upregulation as well as downregulation induced by the pathogen. In addition to inflammation, translocation of the pathogens to the coronary and peripheral arteries, including brain vasculature, and gut and liver vasculature has important pathophysiological consequences. Distant effects via translocation rely on virulence factors of P. gingivalis such as gingipains, on its synergistic interactions with other pathogens, and on its capability to manipulate the immune system via several mechanisms, including its capacity to induce production of immune-downregulating micro-RNAs. Possible targets for intervention and drug development to manage distal consequences of infection with P. gingivalis are also reviewed.
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Affiliation(s)
- Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Department of Psychiatry, Saint Elizabeths Hospital, Washington, D.C. 20032, United States
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore 21201, United States
| | - Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Alison J Scott
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, United States
| | - Eileen Potocki
- VA Maryland Healthcare System, Baltimore VA Medical Center, Baltimore, United States
| | - Andrew J Hoisington
- Air Force Institute of Technology, Wright-Patterson Air Force Base, United States
| | - Lisa A Brenner
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Christopher A Lowry
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Department of Integrative Physiology, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, United States
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Alabama, United States
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, United States
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13
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Farrugia C, Stafford GP, Potempa J, Wilkinson RN, Chen Y, Murdoch C, Widziolek M. Mechanisms of vascular damage by systemic dissemination of the oral pathogen Porphyromonas gingivalis. FEBS J 2021; 288:1479-1495. [PMID: 32681704 PMCID: PMC9994420 DOI: 10.1111/febs.15486] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/15/2020] [Accepted: 07/14/2020] [Indexed: 01/04/2023]
Abstract
Several studies have shown a clear association between periodontal disease and increased risk of cardiovascular disease. Porphyromonas gingivalis (Pg), a key oral pathogen, and its cell surface-expressed gingipains, induce oedema in a zebrafish larvae infection model although the mechanism of these vascular effects is unknown. Here, we aimed to determine whether Pg-induced vascular damage is mediated by gingipains. In vitro, human endothelial cells from different vascular beds were invaded by wild-type (W83) but not gingipain-deficient (ΔK/R-ab) Pg. W83 infection resulted in increased endothelial permeability as well as decreased cell surface abundance of endothelial adhesion molecules PECAM-1 and VE-cadherin compared to infection with ΔK/R-ab. In agreement, when transgenic zebrafish larvae expressing fluorescently labelled PECAM-1 or VE-cadherin were systemically infected with W83 or ΔK/R-ab, a significant reduction in adhesion molecule fluorescence was observed specifically in endothelium proximal to W83 bacteria through a gingipain-dependent mechanism. Furthermore, this was associated with increased vascular permeability in vivo when assessed by dextran leakage microangiography. These data are the first to show that Pg directly mediates vascular damage in vivo by degrading PECAM-1 and VE-cadherin. Our data provide a molecular mechanism by which Pg might contribute to cardiovascular disease.
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Affiliation(s)
- Cher Farrugia
- School of Clinical Dentistry, University of Sheffield, UK
| | | | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.,Department of Oral Immunity and Infectious Diseases, University of Louisville School of Dentistry, KY, USA
| | | | - Yan Chen
- Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, UK
| | - Craig Murdoch
- School of Clinical Dentistry, University of Sheffield, UK
| | - Magdalena Widziolek
- School of Clinical Dentistry, University of Sheffield, UK.,Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.,Department of Evolutionary Immunology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University, Kraków, Poland
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14
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Nishi H, Takahashi S, Ohta K, Takamoto M, Shigeishi H, Go S, Obayashi T, Yoshioka Y, Konishi M, Shimizu Y, Yano K, Miyagawa T, Kakimoto N, Ohge H, Kawaguchi H, Kurihara H. Effects of perioperative oral care on postoperative inflammation following heart valve surgery. Oral Dis 2020; 27:1542-1550. [PMID: 33067895 DOI: 10.1111/odi.13682] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/12/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Whether oral health care during the perioperative period can lead to a better outcome after heart valve surgery has not been adequately elucidated. We examined the effects of perioperative oral care on postoperative inflammation response in patients who underwent heart valve surgery. MATERIALS AND METHODS In this retrospective cohort study, 223 patients scheduled for single valve heart surgery were divided into the oral care, who underwent professional teeth cleaning or scaling within 3 days prior to surgery, and also following surgery at least twice a week (n = 111), and non-oral care (n = 112) groups. After propensity score matching, records of both groups (80:80) were examined after surgery to evaluate inflammation markers (white blood cell count [WBC], neutrophil/white blood cell ratio [NWR], C-reactive protein [CRP] level, body temperature [BT]). RESULTS WBC, NWR, CRP level, and BT were increased in both groups the day following surgery. Thereafter, CRP level, WBC, NWR, and BT on various days after surgery in the oral care group showed greater decreases as compared to the non-oral care group. CONCLUSIONS Perioperative oral health care can decrease postoperative inflammation in patients undergoing heart valve surgery and may be important to ensure a better outcome in those patients.
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Affiliation(s)
- Hiromi Nishi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Shinya Takahashi
- Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Megumi Takamoto
- Department of Dentistry and Oral Surgery, Shinshu University Hospital, Nagano, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seimei Go
- Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Taiji Obayashi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Yoshioka
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kanako Yano
- Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Tsuyoshi Miyagawa
- Center for Integrated Medical Research, Hiroshima University Hospital, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Hiroki Ohge
- Department of Infectious diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroyuki Kawaguchi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Hidemi Kurihara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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15
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Alushi B, Curini L, Christopher MR, Grubitzch H, Landmesser U, Amedei A, Lauten A. Calcific Aortic Valve Disease-Natural History and Future Therapeutic Strategies. Front Pharmacol 2020; 11:685. [PMID: 32477143 PMCID: PMC7237871 DOI: 10.3389/fphar.2020.00685] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/27/2020] [Indexed: 12/20/2022] Open
Abstract
Calcific aortic valve disease (CAVD) is the most frequent heart valve disorder. It is characterized by an active remodeling process accompanied with valve mineralization, that results in a progressive aortic valve narrowing, significant restriction of the valvular area, and impairment of blood flow.The pathophysiology of CAVD is a multifaceted process, involving genetic factors, chronic inflammation, lipid deposition, and valve mineralization. Mineralization is strictly related to the inflammatory process in which both, innate, and adaptive immunity are involved. The underlying pathophysiological pathways that go from inflammation to calcification and, finally lead to severe stenosis, remain, however, incompletely understood. Histopathological studies are limited to patients with severe CAVD and no samples are available for longitudinal studies of disease progression. Therefore, alternative routes should be explored to investigate the pathogenesis and progression of CAVD.Recently, increasing evidence suggests that epigenetic markers such as non-coding RNAs are implicated in the landscape of phenotypical changes occurring in CAVD. Furthermore, the microbiome, an essential player in several diseases, including the cardiovascular ones, has recently been linked to the inflammation process occurring in CAVD. In the present review, we analyze and discuss the CAVD pathophysiology and future therapeutic strategies, focusing on the real and putative role of inflammation, calcification, and microbiome.
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Affiliation(s)
- Brunilda Alushi
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Department of General and Interventional Cardiology, Helios Klinikum Erfurt, Erfurt, Germany
| | - Lavinia Curini
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Mary Roxana Christopher
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Herko Grubitzch
- Berlin Institute of Health, Berlin, Germany.,Department of Cardiology, German Heart Centre Berlin (DHZB), Berlin, Germany
| | - Ulf Landmesser
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.,Sod of Interdisciplinary Internal Medicine, Azienda Ospedaliera Universitaria Careggi (AOUC), Florence, Italy
| | - Alexander Lauten
- Department of Cardiology, Charite´ Universitätsmedizin Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Department of General and Interventional Cardiology, Helios Klinikum Erfurt, Erfurt, Germany
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16
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Javed F, Khan J, Youssef M, Divakar DD, Michelogiannakis D. Dental management of patients with congestive heart failure before and after implantation of ventricular assist devices: linking the missing protocol. SCAND CARDIOVASC J 2020; 54:206-211. [PMID: 32188268 DOI: 10.1080/14017431.2020.1742368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: There are no studies that have reviewed the pre- and post-operative dental protocols for the management of congestive heart failure (CHF) patients before and after implantation of the left ventricular assist device (LVAD). The aim of the present study was to review the pre- and post-operative dental protocols reported in indexed literature related to the management of CHF patients before and after implantation of ventricular assist devices (VAD). Design: The addressed focused question was "Is there a protocol for the dental management of end-stage CHF patients before and after VAD implantation?" Indexed databases were searched using various keywords. Letters to the Editor, review articles, and commentaries/expert opinions were excluded. Results: Seven studies were included and processed for data extraction. The number of participants ranged between 1 and 32 individuals, with age ranging between 14 and 66 years. Dental extractions were performed in 5 studies, and in 2 studies scaling and root planing was done for the treatment of periodontal diseases. One study assessed odontogenic infective foci and other lesions of the oral soft and hard tissues as a preoperative protocol. Six of the 7 studies did not report a dental therapeutic protocol, which was followed for the pre and/or post-LVAD implantation. Conclusions: It is recommended that standardized protocols should be adopted that allow the delivery of safe and effective pre- and postoperative dental care to VAD patients. Such protocols may help influence the morbidity and mortality rates and simultaneously improve the overall quality of life in vulnerable patients.
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Affiliation(s)
- Fawad Javed
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.,Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Junad Khan
- Department of Orofacial Pain, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Moustafa Youssef
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Dimitrios Michelogiannakis
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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17
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Zeng YM, Hu AK, Su HZ, Ko CY. A review of the association between oral bacterial flora and obstructive sleep apnea-hypopnea syndrome comorbid with cardiovascular disease. Sleep Breath 2019; 24:1261-1266. [PMID: 31758435 DOI: 10.1007/s11325-019-01962-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 09/29/2019] [Accepted: 10/11/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Obstructive sleep apnea-hypopnea syndrome (OSAHS), a common sleep disorder, has been shown to be an independent risk factor for cardiovascular disease (CVD). Recent studies have focused on the important roles of microorganisms in human health; for example, microorganisms are reportedly associated with obesity, metabolic disorders, and CVD. The number of oral bacteria in patients with OSAHS is considerably higher than that in healthy individuals, and infection with oral bacterial pathogens is associated with the development of CVD. However, whether changes in the oral microbiota mediate the development of OSAHS and CVD remains unknown. METHODS Therefore, we attempted to review the association between changes in oral microbiota in patients with OSAHS and the development of CVD. RESULTS Oral microbiota possibly acts via multiple pathways including direct invasion, platelet aggregation, immune response, inflammatory response, and oxidative stress response, leading to the development of CVD in patients with OSAHS. In particular, the strains Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia have demonstrated profound effects. OSAHS leads to changes in the oral bacterial flora and thus may facilitate the occurrence and development of CVD. CONCLUSION We propose that the underlying mechanism of CVDs resulting from oral microbiota in patients with OSAHS should be elucidated in further studies.
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Affiliation(s)
- Yi-Ming Zeng
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan N Rd, Licheng Qu, Quanzhou Shi, 362000, Fujian Province, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, 362000, China.,The Sleep Medicine Key Laboratory of Fujian Medical Universities, Fujian Province University, Quanzhou, 362000, China
| | - An-Ke Hu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan N Rd, Licheng Qu, Quanzhou Shi, 362000, Fujian Province, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, 362000, China.,The Sleep Medicine Key Laboratory of Fujian Medical Universities, Fujian Province University, Quanzhou, 362000, China
| | - Huan-Zhang Su
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan N Rd, Licheng Qu, Quanzhou Shi, 362000, Fujian Province, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, 362000, China.,The Sleep Medicine Key Laboratory of Fujian Medical Universities, Fujian Province University, Quanzhou, 362000, China
| | - Chih-Yuan Ko
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan N Rd, Licheng Qu, Quanzhou Shi, 362000, Fujian Province, China. .,Respiratory Medicine Center of Fujian Province, Quanzhou, 362000, China. .,The Sleep Medicine Key Laboratory of Fujian Medical Universities, Fujian Province University, Quanzhou, 362000, China. .,Department of Clinical Nutrition, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, China.
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18
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Oberbach A, Schlichting N, Friedrich M, Lehmann S, Kullnick Y, Pichlmaier M, Hagl C, Bagaev E. Quantification of Multiple Bacteria in Calcified Structural Valvular Heart Disease. Semin Thorac Cardiovasc Surg 2019; 32:255-263. [PMID: 31605771 DOI: 10.1053/j.semtcvs.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 11/11/2022]
Abstract
Genome studies of heart valve tissue (HVT) in patients with structural valvular heart disease (sVHD) and acute infective endocarditis (aIE) showed polymicrobial infections. Subject of this study is the quantification of bacterial DNA in HVT of sVHD in comparison to aIE. It will be examined whether the bacterial DNA concentration can be used as surrogate marker to differentiate chronic and acute infections. DNA was isolated from HVT of 100 patients with sVHD and 23 microbiologically positively tested patients with aIE. Selected pathogens (Cutibacterium acnes, Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus agalactiae, Clostridium difficile, and Klebsiella pneumoniae) were quantified using TaqMan-qPCR. Polymicrobial infiltration of HVT was investigated by immunohistologic methods. Of 100 sVHD patients, 94 tested positive for bacteria by 16S-rDNA and 72 by TaqMan-qPCR. In 29% of the sVHD cohort and in 70% of the aIE cohort, a coinfection with more than 2 bacteria was observed as indication of a polymicrobial infection. The most common pathogens in the sVHD patients were C. acnes (59%; 5-4074 pg/mL), E. faecalis (16%, 174-2781 pg/mL), and S. aureus (15%, 8-105 pg/mL). The DNA concentration of E. faecalis (P = 0.0285) and S. aureus (P = 0.0149) is significantly lower in the sVHD cohort than in the aIE cohort. sVHD is associated with bacterial infection and infiltration of the HVT in a majority of cases. TaqMan-qPCR is a valid instrument for the specific detection of bacteria in HVT and allows discrimination between sVHD and aIE for E. faecalis and S. aureus.
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Affiliation(s)
- Andreas Oberbach
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany; Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
| | - Nadine Schlichting
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Department of Visceral, Transplantation, Thoracic and Vascular Surgery, Leipzig University Hospital, Leipzig, Germany
| | - Maik Friedrich
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Stefanie Lehmann
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Department of Internal Medicine, University of Leipzig, Leipzig, Germany
| | - Yvonne Kullnick
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | | | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany; Munich Heart Alliance, Partner Site German Center for Cardiovascular Disease (DZHK), Munich, Germany
| | - Erik Bagaev
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
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- CardiOmics Group Including Vivek Kumbhari, MD, Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland
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- Clinical Microbiology Group Including Sandra Gräber and Arne C. Rodloff, MD, Institute for Medical Microbiology and Epidemiology of Infectious Diseases, Leipzig University Hospital, Leipzig, Germany
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- Clinical Management Group Including Maximilian Luehr, MD, Miriam Gruhle, Marion Alber, Sven Peters, MD, Felix Kur, MD, Gerd Juchem, MD, and Alexey Dashkevich, MD, Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
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19
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Suzuki H, Matsuo K, Okamoto M, Nakata H, Sakamoto H, Fujita M. Preoperative periodontal treatment and its effects on postoperative infection in cardiac valve surgery. Clin Exp Dent Res 2019; 5:485-490. [PMID: 31687181 PMCID: PMC6820569 DOI: 10.1002/cre2.212] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/02/2019] [Accepted: 06/04/2019] [Indexed: 11/09/2022] Open
Abstract
Objectives Oral infection control is important for patients undergoing cardiac valve replacement (CVR) as prophylaxis for postoperative complications. This study examined the changes in oral health status by preoperative periodontal treatment and its effects on postsurgical complications in CVR patients. Material and methods We recruited 64 patients undergoing CVR who received preoperative periodontal treatment at our hospital as the intervention group and retrospectively reviewed the medical records of 38 patients who had undergone CVR surgery without dental intervention as the control group. Oral health status was assessed at the first visit to our dental office, 1 day before surgery, and >7 days after surgery. Days of high fever, antibiotics use, and postoperative hospitalization were recorded for the intervention and control groups for statistical comparisons. Results In the intervention group, oral health status significantly improved from the initial visit to >7 days after surgery. There were significantly fewer days of high fever (>37.5°C) in the intervention group than in the control group, with comparable results for other events. Conclusions This study's findings suggest that preoperative periodontal treatment can improve oral health status surrounding CVR surgery and could be the contributor of the reduction in the risk of postoperative infection.
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Affiliation(s)
- Hitomi Suzuki
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
- Doctorate Course for Oral Health and WelfareNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
| | - Koichiro Matsuo
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
| | - Mieko Okamoto
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
| | - Haruka Nakata
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
- Doctorate Course for Oral Health and WelfareNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
| | - Hitomi Sakamoto
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
| | - Mirai Fujita
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
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20
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Oliveira FAF, Fernandes Forte CP, Silva PGDB, Lopes CDB, Montenegro RC, Dos Santos ÂKCR, Mota MRL, Sousa FB, Alves APNN. Relationship of Streptococcus mutans with valvar cardiac tissue: A molecular and immunohistochemical study. J Oral Pathol Med 2019; 48:745-753. [PMID: 31323147 DOI: 10.1111/jop.12929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 06/04/2019] [Accepted: 07/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The present study aimed to investigate the presence or absence of Streptococcus mutans in oral cavity and valvular samples associating with the histomorphologic alterations of calcified aortic stenosis. METHODOLOGY Dental plaque and cardiac valve samples were collected from 10 patients with calcified aortic stenosis for molecular analysis of S mutans by real-time polymerase chain reaction (PCR). Healthy valve tissue was also collected from five young cadavers and analyzed for S mutans. Moreover, fragments of all valvar specimens were submitted for histomorphological analysis and immunohistochemistry (anti-S mutans and anti-CD61). RESULTS Streptococcus mutans was present in 100% of the oral cavity samples from the patients with calcified aortic stenosis in the molecular analysis. The analysis by real-time PCR showed that S mutans presented the same proportion in healthy valves and those with calcified aortic stenosis (80%; P = 1.000). Conversely, the immunoexpression of S mutans was 37.40 (IC95% = 1.49-937.00) times superior in samples of patients with cardiac disease (P = .007). The immunoexpression analysis showed that CD61 was present in seven (70%) calcified aortic stenosis samples, all of which were also immunopositive for S mutans. CONCLUSIONS Streptococcus mutans was found in the oral cavity, healthy valve tissue, and calcified aortic stenosis samples. However, the microorganism was visualized by immunohistochemistry only in the calcified aortic stenosis samples, which may suggest viability and an increased bacterial density in this condition. The association of the presence of S mutans and positive CD61 immunoexpression suggests a probable relationship with calcified aortic stenosis.
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Affiliation(s)
- Francisco Artur Forte Oliveira
- Department of Stomatology and Oral Pathology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | | | - Camile de Barros Lopes
- Laboratory of Human and Medical Genetics, Graduate Program in Genetics and Molecular Biology, Federal University of Pará, Brazil
| | - Raquel Carvalho Montenegro
- Department of Human Cytogenetics, School of Biological Sciences, Federal University of Para, Belém, Pará, Brazil
| | | | - Mário Rogério Lima Mota
- Department of Stomatology and Oral Pathology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Department of Oral Pathology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Fabrício Bitu Sousa
- Department of Stomatology and Oral Pathology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Department of Oral Pathology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
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21
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Is Oral Health Maintenance/Promotion Crucial in Patients Treated With the Left Ventricular Assist Device? Am J Med Sci 2019; 358:168. [PMID: 31200921 DOI: 10.1016/j.amjms.2019.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 04/03/2019] [Indexed: 02/07/2023]
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22
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Ko CY, Hu AK, Chou D, Huang LM, Su HZ, Yan FR, Zhang XB, Zhang HP, Zeng YM. Analysis of oral microbiota in patients with obstructive sleep apnea-associated hypertension. Hypertens Res 2019; 42:1692-1700. [PMID: 30976074 PMCID: PMC8075895 DOI: 10.1038/s41440-019-0260-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/28/2019] [Accepted: 03/09/2019] [Indexed: 02/08/2023]
Abstract
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is an independent risk factor for hypertension (HTN). The oral microbiota plays a pathophysiological role in cardiovascular diseases; however, there are few reports directly investigating and identifying the organisms involved in OSAHS-related HTN. Therefore, this study aimed to identify those organisms. We obtained 139 oral samples and determined the microbiome composition using pyrosequencing and bioinformatic analyses of the 16S rRNA. We examined the fasting levels of cytokines and homocysteine in all participants and analyzed the correlations between the oral microbiota and homocysteine levels. We determined the molecular mechanism underlying HTN by investigating the genetic composition of the strains in the blood. We detected higher relative abundances of Porphyromonas and Aggregatibacter and elevated proinflammatory cytokines in patients with OSAHS of varying severity compared with individuals without OSAHS; however, the two organisms were not measured in the blood samples from all participants. High levels of specific Porphyromonas bacteria were detected in patients with OSAHS with and without HTN, whereas the relative abundance of Aggregatibacter was negatively correlated with the homocysteine level. The receiver operating characteristic curve analysis of controls and patients with OSAHS resulted in area under the curve values of 0.759 and 0.641 for patients with OSAHS with or without HTN, respectively. We found that the predictive function of oral microbiota was different in patients with OSAHS with and without HTN. However, there was no direct invasion by the two organisms causing endothelial cell injury, leading to speculation regarding the other mechanisms that may lead to HTN. Elucidating the differences in the oral microbiome will help us understand the pathogenesis of OSAHS-related HTN.
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Affiliation(s)
- Chih-Yuan Ko
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China. .,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China. .,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China. .,Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.
| | - An-Ke Hu
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Dylan Chou
- Zhuhai Campus of Zunyi Medical University, Zhuhai, 519090, Guangdong, China
| | - Li-Mei Huang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Huan-Zhang Su
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Fu-Rong Yan
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China.,Center for Molecular Diagnosis and Therapy, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China
| | - Xiao-Bin Zhang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China
| | - Hua-Ping Zhang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China. .,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China. .,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China.
| | - Yi-Ming Zeng
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China. .,Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China. .,Key Laboratory of Fujian Medical University, Fujian Province University, 362000, Quanzhou, China.
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23
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Nakata H, Matsuo K, Suzuki H, Yoshihara A. Perioperative changes in knowledge and attitude toward oral health by oral health education. Oral Dis 2019; 25:1214-1220. [PMID: 30701629 DOI: 10.1111/odi.13048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/15/2019] [Accepted: 01/22/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Perioperative oral health care can prevent postoperative complications, but it is also important to maintain oral health afterward to avoid later adverse events. This study examined (a) the relationship between knowledge and attitude toward oral health (KAOH) and oral/periodontal status (OPS) in patients receiving surgery, and (b) the changes in KAOH by perioperative oral health care and education. METHODS Patients receiving surgery who visited our hospital's dental clinic beforehand were prospectively recruited. All participants received oral health care and education. In questionnaires assessing KAOH before and after surgery, respondent answers were generally classified as positive or negative. OPS was assessed before surgery. Associations between KAOH and OPS and perioperative changes in KAOH were statistically tested. RESULTS A total of 507 patients answered the questionnaire before surgery, among whom 324 patients also completed it afterward. Preoperative OPS was significantly worse in the negative than in the positive KAOH group. Positive answers for KAOH increased significantly from 68.6% to 92.2% during the perioperative period. CONCLUSIONS We found that patients with poor KAOH also had poor OPS, but KAOH could be improved by perioperative oral health care and education, suggesting that perioperative oral health management could improve oral health knowledge and attitudes.
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Affiliation(s)
- Haruka Nakata
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan.,Doctorate Course for Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital, Toyoake, Japan
| | - Koichiro Matsuo
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitomi Suzuki
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan.,Doctorate Course for Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Niigata University, Niigata, Japan
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24
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Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, Rengo G. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci 2019; 20:ijms20061414. [PMID: 30897827 PMCID: PMC6470716 DOI: 10.3390/ijms20061414] [Citation(s) in RCA: 208] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease, initiated by the presence of a bacterial biofilm, called dental plaque, which affects both the periodontal ligaments and bone surrounding teeth. In the last decades, several lines of evidence have supported the existence of a relationship between periodontitis and systemic health. For instance, as periodontitis acts within the same chronic inflammatory model seen in cardiovascular disease (CVD), or other disorders, such as diabetes, several studies have suggested the existence of a bi-directional link between periodontal health and these pathologies. For instance, people with diabetes are more susceptible to infections and are more likely to suffer from periodontitis than people without this syndrome. Analogously, it is now evident that cardiac disorders are worsened by periodontitis, both experimentally and in humans. For all these reasons, it is very plausible that preventing periodontitis has an impact on the onset or progression of CVD and diabetes. On these grounds, in this review, we have provided an updated account on the current knowledge concerning periodontal disease and the adverse effects exerted on the cardiovascular system health and diabetes, informing readers on the most recent preclinical studies and epidemiological evidence.
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Affiliation(s)
- Daniela Liccardo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Center for Translational Medicine, Temple University, Philadelphia, PA 19140, USA.
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia.
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100 Siena, Italy.
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
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25
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Oberbach A, Friedrich M, Lehmann S, Schlichting N, Kullnick Y, Gräber S, Buschmann T, Hagl C, Bagaev E. Bacterial infiltration in structural heart valve disease. J Thorac Cardiovasc Surg 2019; 159:116-124.e4. [PMID: 30885626 DOI: 10.1016/j.jtcvs.2019.02.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The pathology of structural valvular heart disease (sVHD) ranges from basic diseases of rheumatologic origin to chronic degenerative remodeling processes after acute bacterial infections. Molecular genetic methods allow detection of the complete microbial spectrum in heart valve tissues independent of microbiological cultivation. In particular, whole-metagenome analysis is a sensitive and highly specific analytical method that allows a deeper insight into the pathogenicity of the diseases. In the present study we assessed the pathogen spectrum in heart valve tissue from 25 sVHD patients using molecular and microbiological methods. METHODS Twenty-five sVHD patients were selected randomly from an observational cohort study (March 2016 to January 2017). The explanted native heart valves were examined using microbiological methods and immunohistological structural analysis. In addition, the bacterial metagenome of the heart valve tissue was determined using next-generation sequencing. RESULTS The use of sonication as a pretreatment of valve tissue from 4 sVHD patients permitted successful detection of Clostridium difficile, Enterococcus faecalis, Staphylococcus saccharolyticus, and Staphylococcus haemolyticus using microbial cultivation. Histological staining revealed intramural localization. Metagenome analysis identified a higher rate of bacterial infiltration in 52% of cases. The pathogen spectrum included both gram-positive and gram-negative bacteria. CONCLUSIONS Microbiological and molecular biological studies are necessary to detect the spectrum of bacteria in a calcified heart valve. Metagenome analysis is a valid method to gain new insight into the polymicrobial pathophysiology of sVHD. Our results suggest that an undetected proportion of sVHD might be triggered by chronic inflammation or influenced by secondary bacterial infiltration.
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Affiliation(s)
- Andreas Oberbach
- Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany; Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Md.
| | - Maik Friedrich
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Stefanie Lehmann
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Department of Internal Medicine, University of Leipzig, Leipzig, Germany
| | - Nadine Schlichting
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany; Department of Visceral, Transplantation, Thoracic and Vascular Surgery, Leipzig University Hospital, Leipzig, Germany
| | - Yvonne Kullnick
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Sandra Gräber
- Institute for Medical Microbiology and Epidemiology of Infectious Diseases, Leipzig University Hospital, Leipzig, Germany
| | - Tilo Buschmann
- Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany; Munich Heart Alliance, Partner Site German Center for Cardiovascular Disease (DZHK), Munich, Germany
| | - Erik Bagaev
- Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany
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Suzuki H, Matsuo K, Okamoto M, Nakata H, Sakamoto H, Fujita M. Perioperative changes in oral bacteria number in patients undergoing cardiac valve surgery. J Oral Sci 2019; 61:526-528. [DOI: 10.2334/josnusd.18-0380] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Hitomi Suzuki
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University
- Division of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital
| | - Koichiro Matsuo
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University
| | - Mieko Okamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University
| | - Haruka Nakata
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University
- Division of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital
| | - Hitomi Sakamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital
| | - Mirai Fujita
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital
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27
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Periodontal bacteria DNA findings in human cardiac tissue - Is there a link of periodontitis to heart valve disease? Int J Cardiol 2018; 251:74-79. [PMID: 29197463 DOI: 10.1016/j.ijcard.2017.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/22/2017] [Accepted: 09/02/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND The aim of the study was to detect periodontal pathogens DNA in atrial and myocardial tissue, and to investigate periodontal status and their connection to cardiac tissue inflammation. METHODS In 30 patients, biopsy samples were taken from the atrium (A) and the ventricle myocardium (M) during aortic valve surgery. The dental examination included the dental and periodontal status (PS) and a collection of a microbiological sample. The detection of 11 periodontal pathogens DNA in oral and heart samples was carried out using PCR. The heart samples were prepared for detecting the LPS-binding protein (LBP), and for inflammation scoring on immunohistochemistry (IHC), comprising macrophages (CD68), LPS-binding protein receptor (CD14), and LBP (big42). RESULTS 28 (93%) patients showed moderate to severe periodontitis. The periodontal pathogens in the oral samples of all patients revealed a similar distribution (3-93%). To a lesser extent and with a different distribution, these bacteria DNA were also detected in atrium and myocardium (3-27%). The LBP was detected in higher amount in atrium (0.22±0.16) versus myocardium (0.13±0.13, p=0.001). IHC showed a higher inflammation score in atrial than myocardial tissue as well as for CD14, CD68 and for LBP. Additional, periodontal findings showed a significant correlation to CD14 and CD68. CONCLUSION The results provide evidence of the occurrence of oral bacteria DNA at the cardiac tissue, with a different impact on atrial and myocardial tissue inflammation. Influence of periodontal findings was identified, but their relevance is not yet distinct. Therefore further clinical investigations with long term implication are warranted.
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28
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Bacterial DNA detected on pathologically changed heart valves using 16S rRNA gene amplification. Folia Microbiol (Praha) 2018; 63:707-711. [DOI: 10.1007/s12223-018-0611-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 05/11/2018] [Indexed: 12/19/2022]
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29
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Rudick CP, Miyamoto T, Lang MS, Agrawal DK. Triggering receptor expressed on myeloid cells in the pathogenesis of periodontitis: potential novel treatment strategies. Expert Rev Clin Immunol 2017; 13:1189-1197. [PMID: 29027827 DOI: 10.1080/1744666x.2017.1392855] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Periodontal diseases are polymicrobial inflammatory disorders of the tissue, ligament, and bone structures supporting teeth. Periodontitis (inflammation with corresponding loss of attachment) affects 40-50% of adults. Recently, members of the Triggering Receptor on Myeloid Cell (TREM) family have been studied to determine their relationship to these diseases. Areas covered: TREM-1 is a receptor expressed on the surface of PMNs, monocytes, macrophages, dendritic cells, vascular smooth muscle cells, and keratinocytes upregulated in the presence of periodontal inflammation. TREM-1 expression can be upregulated by oral bacterium Porphyromonas gingivalis that can be abrogated by a sub-antimicrobial dose of doxycycline. When cleaved from the cell surface, a soluble form of TREM-1 (sTREM-1) can be used as a biomarker of inflammation and might also provide a link between oral and systemic inflammation. While less understood, TREM-2 has a role in osteoclastogenesis which could contribute to the alveolar bone destruction seen in more advanced periodontitis. Expert commentary: Additional studies to simulate biofilm microenvironment in TREM research are warranted. Longitudinal studies determining TREM-1, sTREM-1, and TREM-2 levels in tissues over time and progression of periodontal diseases would provide valuable information in the role of TREM receptors as indicators of or contributors to the disease process.
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Affiliation(s)
- Courtney P Rudick
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
| | - Takanari Miyamoto
- b Department of Periodontology , Creighton University School of Medicine , Omaha , NE , USA
| | - Melissa S Lang
- b Department of Periodontology , Creighton University School of Medicine , Omaha , NE , USA
| | - Devendra K Agrawal
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
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Aoyama N, Suzuki JI, Kumagai H, Ikeda Y, Akazawa H, Komuro I, Minabe M, Izumi Y, Isobe M. Specific periodontopathic bacterial infection affects hypertension in male cardiovascular disease patients. Heart Vessels 2017; 33:198-204. [DOI: 10.1007/s00380-017-1042-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/09/2017] [Indexed: 12/20/2022]
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Jurczak A, Kościelniak D, Skalniak A, Papież M, Vyhouskaya P, Krzyściak W. The role of the saliva antioxidant barrier to reactive oxygen species with regard to caries development. Redox Rep 2017; 22:524-533. [PMID: 28288542 DOI: 10.1080/13510002.2017.1301625] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the role of the antioxidant barrier in the saliva of children with caries, and its impact on the colonization of cariogenic bacteria. METHODS This is a cross-sectional study of 81 children aged 1-5 years. Antioxidant levels and salivary bacterial profiles were measured. Patients were divided into two groups as follows: initial stage decay, termed non-cavitated (1-2 in International Caries Detection and Assessment System (ICDAS)), and extensive decay, termed cavitated lesions (5-6 in ICDAS). The control group includes children without caries. RESULTS The linear regression model demonstrated that the GSH, GSSG, GSH/GSSG, and total antioxidant capacity levels are influenced (P < 0.05) by: the stage of caries and the dominant bacterial strain. Compared with the other groups (P < 0.001), the highest antioxidant parameters were recorded in the saliva of patients with cavitated lesions. DISCUSSION Our results indicate that the high levels of antioxidants in saliva increase significantly in children in line with the salivary cariogenic bacterial profiles and caries progression.
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Affiliation(s)
- A Jurczak
- a Department of Pediatric Dentistry, Institute of Dentistry , Jagiellonian University Medical College Krakow , Poland
| | - D Kościelniak
- a Department of Pediatric Dentistry, Institute of Dentistry , Jagiellonian University Medical College Krakow , Poland
| | - A Skalniak
- b Genetics Laboratory, Department of Endocrinology , Jagiellonian University Medical College Krakow , Poland
| | - M Papież
- c Department of Cytobiology, Faculty of Pharmacy , Jagiellonian University Medical College Krakow , Poland
| | - P Vyhouskaya
- d Department of Medical Diagnostics, Faculty of Pharmacy , Jagiellonian University Medical College Krakow , Poland
| | - W Krzyściak
- d Department of Medical Diagnostics, Faculty of Pharmacy , Jagiellonian University Medical College Krakow , Poland
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Freires IA, Avilés-Reyes A, Kitten T, Simpson-Haidaris PJ, Swartz M, Knight PA, Rosalen PL, Lemos JA, Abranches J. Heterologous expression of Streptococcus mutans Cnm in Lactococcus lactis promotes intracellular invasion, adhesion to human cardiac tissues and virulence. Virulence 2016; 8:18-29. [PMID: 27260618 DOI: 10.1080/21505594.2016.1195538] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In S. mutans, the expression of the surface glycoprotein Cnm mediates binding to extracellular matrix proteins, endothelial cell invasion and virulence in the Galleria mellonella invertebrate model. To further characterize Cnm as a virulence factor, the cnm gene from S. mutans strain OMZ175 was expressed in the non-pathogenic Lactococcus lactis NZ9800 using a nisin-inducible system. Despite the absence of the machinery necessary for Cnm glycosylation, Western blot and immunofluorescence microscopy analyses demonstrated that Cnm was effectively expressed and translocated to the cell wall of L. lactis. Similar to S. mutans, expression of Cnm in L. lactis enabled robust binding to collagen and laminin, invasion of human coronary artery endothelial cells and increased virulence in G. mellonella. Using an ex vivo human heart tissue colonization model, we showed that Cnm-positive strains of either S. mutans or L. lactis outcompete their Cnm-negative counterparts for tissue colonization. Finally, Cnm expression facilitated L. lactis adhesion and colonization in a rabbit model of infective endocarditis. Collectively, our results provide unequivocal evidence that binding to extracellular matrices mediated by Cnm is an important virulence attribute of S. mutans and confirm the usefulness of the L. lactis heterologous system for further characterization of bacterial virulence factors.
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Affiliation(s)
- Irlan A Freires
- a Department of Physiological Sciences , Piracicaba Dental School, University of Campinas , Piracicaba , SP , Brazil.,b Center for Oral Biology, University of Rochester Medical Center , Rochester , NY , USA
| | - Alejandro Avilés-Reyes
- c Department of Oral Biology , University of Florida College of Dentistry , Gainesville , FL , USA
| | - Todd Kitten
- d Philips Institute for Oral Health Research, Virginia Commonwealth University , Richmond , VA , USA
| | - P J Simpson-Haidaris
- e Department of Medicine/Hematology-Oncology Division and Department of Pathology and Laboratory Medicine , University of Rochester Medical Center , Rochester , NY , USA
| | - Michael Swartz
- f Department of Surgery , Cardiac Division, University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
| | - Peter A Knight
- f Department of Surgery , Cardiac Division, University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
| | - Pedro L Rosalen
- a Department of Physiological Sciences , Piracicaba Dental School, University of Campinas , Piracicaba , SP , Brazil
| | - José A Lemos
- c Department of Oral Biology , University of Florida College of Dentistry , Gainesville , FL , USA
| | - Jacqueline Abranches
- c Department of Oral Biology , University of Florida College of Dentistry , Gainesville , FL , USA
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Avilés-Reyes A, Miller JH, Lemos JA, Abranches J. Collagen-binding proteins of Streptococcus mutans and related streptococci. Mol Oral Microbiol 2016; 32:89-106. [PMID: 26991416 DOI: 10.1111/omi.12158] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2016] [Indexed: 12/13/2022]
Abstract
The ability of Streptococcus mutans to interact with collagen through the expression of collagen-binding proteins (CBPs) bestows this oral pathogen with an alternative to the sucrose-dependent mechanism of colonization classically attributed to caries development. Based on the abundance and distribution of collagen throughout the human body, stringent adherence to this molecule grants S. mutans with the opportunity to establish infection at different host sites. Surface proteins, such as SpaP, WapA, Cnm and Cbm, have been shown to bind collagen in vitro, and it has been suggested that these molecules play a role in colonization of oral and extra-oral tissues. However, robust collagen binding is not achieved by all strains of S. mutans, particularly those that lack Cnm or Cbm. These observations merit careful dissection of the contribution from these different CBPs towards tissue colonization and virulence. In this review, we will discuss the current understanding of mechanisms used by S. mutans and related streptococci to colonize collagenous tissues, and the possible contribution of CBPs to infections in different sites of the host.
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Affiliation(s)
- A Avilés-Reyes
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - J H Miller
- Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - J A Lemos
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - J Abranches
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
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How KY, Song KP, Chan KG. Porphyromonas gingivalis: An Overview of Periodontopathic Pathogen below the Gum Line. Front Microbiol 2016; 7:53. [PMID: 26903954 PMCID: PMC4746253 DOI: 10.3389/fmicb.2016.00053] [Citation(s) in RCA: 386] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/12/2016] [Indexed: 01/12/2023] Open
Abstract
Periodontal disease represents a group of oral inflammatory infections initiated by oral pathogens which exist as a complex biofilms on the tooth surface and cause destruction to tooth supporting tissues. The severity of this disease ranges from mild and reversible inflammation of the gingiva (gingivitis) to chronic destruction of connective tissues, the formation of periodontal pocket and ultimately result in loss of teeth. While human subgingival plaque harbors more than 500 bacterial species, considerable research has shown that Porphyromonas gingivalis, a Gram-negative anaerobic bacterium, is the major etiologic agent which contributes to chronic periodontitis. This black-pigmented bacterium produces a myriad of virulence factors that cause destruction to periodontal tissues either directly or indirectly by modulating the host inflammatory response. Here, this review provides an overview of P. gingivalis and how its virulence factors contribute to the pathogenesis with other microbiome consortium in oral cavity.
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Affiliation(s)
- Kah Yan How
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya Kuala Lumpur, Malaysia
| | - Keang Peng Song
- School of Science, Monash University Sunway Campus Subang Jaya, Malaysia
| | - Kok Gan Chan
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya Kuala Lumpur, Malaysia
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