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Hu Y, Ren B, Cheng L, Deng S, Chen Q. Candida species in periodontitis: A new villain or a new target? J Dent 2024; 148:105138. [PMID: 38906455 DOI: 10.1016/j.jdent.2024.105138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/24/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024] Open
Abstract
OBJECTIVES Recent research indicated that fungi might have a role in periodontitis alongside traditional periodontal pathogens. This state-of-the-art narrative review explores current concepts on the involvement of Candida species in periodontitis, and suggests the potential for ecological management of this disease. DATA, SOURCES AND STUDY SELECTION A literature search was conducted for a narrative review on Web of Science, PubMed, Medline and Scopus about periodontitis associated with Candida species. Published articles, including case reports, case series, observational and interventional clinical trials, and critical appraisals of the literature were retrieved and reviewed. CONCLUSIONS Several factors predispose individuals to periodontitis associated with Candida species. These include systemic diseases that lead to immunosuppression and oral environment changes such as cigarette smoking. While a consistent significant increase in the detection rate of Candida species in patients with periodontitis has not been universally observed, there is evidence linking Candida species to the severity of periodontitis and their potential to worsen the condition. Candida species may participate in the development of periodontitis in various ways, including cross-kingdom interactions with periodontal pathogens, changes in the local or systemic environment favoring the virulence of Candida species, and interactions between Candida-bacteria and host immunity. CLINICAL SIGNIFICANCE Mechanical plaque control is the most common treatment for periodontitis, but its effectiveness may be limited, particularly when dealing with systemic risk factors. Understanding the specific role of Candida in periodontitis illuminates innovative approaches for managing the ecological balance in periodontal health.
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Affiliation(s)
- Yao Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China; State Key Laboratory of Oral Diseases & West China School of Stomatology & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Biao Ren
- State Key Laboratory of Oral Diseases & West China School of Stomatology & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & West China School of Stomatology & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China.
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China; State Key Laboratory of Oral Diseases & West China School of Stomatology & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.
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Chen YY, Tan L, Su XL, Chen NX, Liu Q, Feng YZ, Guo Y. NOD2 contributes to Parvimonas micra-induced bone resorption in diabetic rats with experimental periodontitis. Mol Oral Microbiol 2024. [PMID: 38757737 DOI: 10.1111/omi.12467] [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: 02/15/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) may affect the oral microbial community, exacerbating periodontal inflammation; however, its pathogenic mechanisms remain unclear. As nucleotide-binding oligomerization domain 2 (NOD2) plays a crucial role in the activation during periodontitis (PD), it is hypothesized that changes in the oral microbial community due to diabetes enhance periodontal inflammation through the activation of NOD2. METHODS We collected subgingival plaque from 180 subjects who were categorized into two groups based on the presence or absence of T2DM. The composition of oral microbiota was detected by 16S rRNA high-throughput sequencing. In animal models of PD with or without T2DM, we assessed alveolar bone resorption by micro-computerized tomography and used immunohistochemistry to detect NOD2 expression in alveolar bone. Primary osteoblasts were cultured in osteogenic induction medium with high or normal glucose and treated with inactivated bacteria. After 24 h of inactivated bacteria intervention, the osteogenic differentiation ability was detected by alkaline phosphatase (ALP) staining, and the expressions of NOD2 and interleukin-12 (IL-6) were detected by western blot. RESULTS The relative abundance of Parvimonas and Filifactor in the T2DM group was increased compared to the group without T2DM. In animal models, alveolar bone mass was decreased in PD, particularly in T2DM with PD (DMPD) group, compared to controls. Immunohistochemistry revealed NOD2 in osteoblasts from the alveolar bone in both the PD group and DMPD group, especially in the DMPD group. In vitro, intervention with inactivated Parvimonas significantly reduced ALP secretion of primary osteoblasts in high glucose medium, accompanied by increased expression of NOD2 and IL-6. CONCLUSIONS The results suggest that T2DM leading to PD may be associated with the activation of NOD2 by Parvimonas.
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Affiliation(s)
- Ying-Yi Chen
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Stomatology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences(Qingdao Central Hospital), Qingdao, China
| | - Li Tan
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Lin Su
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ning-Xin Chen
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiong Liu
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yun-Zhi Feng
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yue Guo
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
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Gancz AS, Wright SL, Weyrich LS. Ancient human dental calculus metadata collection and sampling strategies: Recommendations for best practices. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 183:e24871. [PMID: 37994571 DOI: 10.1002/ajpa.24871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/26/2023] [Accepted: 10/18/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES Ancient human dental calculus is a unique, nonrenewable biological resource encapsulating key information about the diets, lifestyles, and health conditions of past individuals and populations. With compounding calls its destructive analysis, it is imperative to refine the ways in which the scientific community documents, samples, and analyzes dental calculus so as to maximize its utility to the public and scientific community. MATERIALS AND METHODS Our research team conducted an IRB-approved survey of dental calculus researchers with diverse academic backgrounds, research foci, and analytical specializations. RESULTS This survey reveals variation in how metadata is collected and utilized across different subdisciplines and highlights how these differences have profound implications for dental calculus research. Moreover, the survey suggests the need for more communication between those who excavate, curate, and analyze biomolecular data from dental calculus. DISCUSSION Challenges in cross-disciplinary communication limit researchers' ability to effectively utilize samples in rigorous and reproducible ways. Specifically, the lack of standardized skeletal and dental metadata recording and contamination avoidance procedures hinder downstream anthropological applications, as well as the pursuit of broader paleodemographic and paleoepidemiological inquiries that rely on more complete information about the individuals sampled. To provide a path forward toward more ethical and standardized dental calculus sampling and documentation approaches, we review the current methods by which skeletal and dental metadata are recorded. We also describe trends in sampling and contamination-control approaches. Finally, we use that information to suggest new guidelines for ancient dental calculus documentation and sampling strategies that will improve research practices in the future.
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Affiliation(s)
- Abigail S Gancz
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
- One Health Microbiome Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Sterling L Wright
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
- One Health Microbiome Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Laura S Weyrich
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA
- One Health Microbiome Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
- School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Agarwal J, Pandey P, Saxena SK, Kumar S. Comparative analysis of salivary microbiota in diabetic and non-diabetic individuals of North India using metagenomics. J Oral Biol Craniofac Res 2024; 14:22-26. [PMID: 38130425 PMCID: PMC10733697 DOI: 10.1016/j.jobcr.2023.12.003] [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: 05/01/2023] [Revised: 10/28/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Background Saliva, an oral secretion is considered an essential biological modulator involved in maintaining oral homeostasis. Increased glucose levels in diabetic patients' saliva may have an impact on diversity of microbes. Comparing the salivary microflora of diabetic and non-diabetic cohorts will help in diagnosis and risk assessment of oral health complications. This will provide greater knowledge about the contribution of oral microbes to the development of oral illnesses. The association between salivary microbiota and diabetic state is less explored in the North Indian population, hence current observational study was performed to analyze the salivary microflora of diabetic and non-diabetic individuals using metagenomic analysis. Materials and methods This single-center non-randomized observational trial was conducted in Uttar Pradesh, India. Participants were enrolled into either diabetic (n = 68) or non-diabetic groups (n = 68) based on their diabetes status. Following saliva collection, DNA was extracted and metagenomic sequencing was performed. Results Phylum Bacteroidetes and Fusobacteria were significantly abundant in diabetic individuals (p < 0.0001), while Proteobacteria was significantly higher among non-diabetic individuals (p < 0.0001). No statistical difference in phylum Actinobacteria and Firmicutes among diabetics and non-diabetics. Veillonella, Prevotella, Porphyromonas, Leptotrichia, Lactobacillus, and Streptococcus were greater in diabetics whereas the abundance of Capnocytophaga and Neisseria was more among non-diabetics (p < 0.05). Conclusions The genera Veillonella, Prevotella, Porphyromonas, Leptotrichia, Lactobacillus, and Streptococcus were comparatively over the odds with the diabetics in India. The association between microbiota in diabetic population and risk related to increase in occurrence of caries, gingivitis, and periodontitis in diabetic population prevalence should be investigated.
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Affiliation(s)
- Jyotsana Agarwal
- Department of Conservative Dentistry & Endodontics, King George's Medical University, Lucknow, India
| | - Pragya Pandey
- Department of Conservative Dentistry & Endodontics, King George's Medical University, Lucknow, India
| | | | - Swatantra Kumar
- Centre for Advanced Research, King George's Medical University, Lucknow, India
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5
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Chen S, Zhang Y. Mechanism and application of Lactobacillus in type 2 diabetes-associated periodontitis. Front Public Health 2023; 11:1248518. [PMID: 38098816 PMCID: PMC10720667 DOI: 10.3389/fpubh.2023.1248518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) accelerates the progression of periodontitis through diverse pathways. Abnormal immune responses, excessive activation of inflammation, increased levels of advanced glycation end products, and oxidative stress have defined roles in the pathophysiological process of T2DM-associated periodontitis. Furthermore, in the periodontium of diabetic individuals, there are high levels of advanced glycation end-products and glucose. Meanwhile, progress in microbiomics has revealed that dysbacteriosis caused by T2DM also contributes to the progression of periodontitis. Lactobacillus, owing to its fine-tuning function in the local microbiota, has sparked tremendous interest in this field. Accumulating research on Lactobacillus has detailed its beneficial role in both diabetes and oral diseases. In this study, we summarize the newly discovered mechanisms underlying Lactobacillus-mediated improvement of T2DM-associated periodontitis and propose the application of Lactobacillus in the clinic.
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Affiliation(s)
- Sisi Chen
- Chongqing Three Gorges Medical College, Chongqing, China
- Chongqing Medical University, Chongqing, China
| | - Yuhan Zhang
- Chongqing Three Gorges Medical College, Chongqing, China
- Chongqing Medical University, Chongqing, China
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6
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Duarte PM, Felix E, Santos VR, Figueiredo LC, da Silva HDP, Mendes JAV, Feres M, Miranda TS. Patients with type 2 diabetes and severe periodontitis harbor a less pathogenic subgingival biofilm than normoglycemic individuals with severe periodontitis. J Periodontol 2023; 94:1210-1219. [PMID: 37133975 DOI: 10.1002/jper.22-0657] [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: 11/09/2022] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Whether, and to what extent, diabetes mellitus (DM) can affect the subgingival biofilm composition remains controversial. Thus, the aim of this study was to compare the composition of the subgingival microbiota of non-diabetic and type 2 diabetic patients with periodontitis using 40 "biomarker bacterial species." METHODS Biofilm samples of shallow (probing depth [PD] and clinical attachment level [CAL] ≤3 mm without bleeding) and deep sites (PD and CAL ≥5 mm with bleeding) of patients with or without type 2 DM were evaluated for levels/proportions of 40 bacterial species by checkerboard DNA-DNA hybridization. RESULTS A total of 828 subgingival biofilm samples from 207 patients with periodontitis (118 normoglycemic and 89 with type 2 DM) were analyzed. The levels of most of the bacterial species evaluated were reduced in the diabetic compared with the normoglycemic group, both in shallow and in deep sites. The shallow and deep sites of patients with type 2 DM presented higher proportions of Actinomyces species, purple and green complexes, and lower proportions of red complex pathogens than those of normoglycemic patients (P < 0.05). CONCLUSIONS Patients with type 2 DM have a less dysbiotic subgingival microbial profile than normoglycemic patients, including lower levels/proportions of pathogens and higher levels/proportions of host-compatible species. Thus, type 2 diabetic patients seem to require less remarkable changes in biofilm composition than non-diabetic patients to develop the same pattern of periodontitis.
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Affiliation(s)
- Poliana M Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Edcarlos Felix
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Vanessa R Santos
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Luciene C Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Hélio D P da Silva
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Juliana A V Mendes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Tamires S Miranda
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
- Department of Periodontology, College of Dentistry, São Judas Tadeu University, São Paulo, SP, Brazil
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Mosaddad SA, Mahootchi P, Safari S, Rahimi H, Aghili SS. Interactions between systemic diseases and oral microbiota shifts in the aging community: A narrative review. J Basic Microbiol 2023. [PMID: 37173818 DOI: 10.1002/jobm.202300141] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/23/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
As a gateway to general health and a diverse microbial habitat, the oral cavity is colonized by numerous microorganisms such as bacteria, fungi, viruses, and archaea. Oral microbiota plays an essential role in preserving oral health. Besides, the oral cavity also significantly contributes to systemic health. Physiological aging influences all body systems, including the oral microbial inhabitants. The cited effect can cause diseases by forming dysbiotic communities. Since it has been demonstrated that microbial dysbiosis could disturb the symbiosis state between the host and the resident microorganism, shifting the condition toward a more pathogenic one, this study investigated how the oral microbial shifts in aging could associate with the development or progression of systemic diseases in older adults. The current study focused on the interactions between variations in the oral microbiome and prevalent diseases in older adults, including diabetes mellitus, Sjögren's syndrome, rheumatoid arthritis, pulmonary diseases, cardiovascular diseases, oral candidiasis, Parkinson's disease, Alzheimer's disease, and glaucoma. Underlying diseases can dynamically modify the oral ecology and the composition of its resident oral microbiome. Clinical, experimental, and epidemiological research suggests the associations of systemic disorders with bacteremia and inflammation after oral microbial changes in older adults.
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Affiliation(s)
- Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pegah Mahootchi
- Department of Oral and Maxillofacial Diseases, School of Dentistry, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Sajedeh Safari
- Department of Prosthodontics, Islamic Azad University, Tehran, Iran
| | - Hussein Rahimi
- Student Research Committee, School of Dentistry, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Cena JA, Reis LG, de Lima AKA, Vieira Lima CP, Stefani CM, Dame-Teixeira N. Enrichment of Acid-Associated Microbiota in the Saliva of Type 2 Diabetes Mellitus Adults: A Systematic Review. Pathogens 2023; 12:pathogens12030404. [PMID: 36986326 PMCID: PMC10051551 DOI: 10.3390/pathogens12030404] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/25/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
It could conceivably be hypothesized that a link exists between an altered microbiota due to local hyperglycemia and the increased risk of caries in diabetes mellitus (DM). This systematic review aimed to perform a cross-study comparison into the salivary microbiota of adults with type 2 diabetes mellitus (T2D) compared to adults without T2D, particularly focusing on the abundance of acid-associated bacteria. This report follows PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Studies using next-generation sequencing and other molecular techniques are included. The methodological quality of individual studies was assessed using appropriate Joanna Briggs Institute tools. The certainty of the evidence considering the effect direction was evaluated using the GRADE approach. From 2060 titles retrieved, 12 were included in the data synthesis, totalling 873 individuals with T2D and controls evaluated across the literature. Weighted averages of blood glucose levels (HbA1c—fasting blood glucose) were 8.21%—172.14 mg/dL and 5.12%—84.53 mg/dL for T2D and controls, respectively. In most studies, the relative abundance of acidogenic and aciduric bacteria was higher in diabetics when compared to their normoglycaemic controls. Whilst the evidence certainty was very low, there was a consistent Proteobacteria depletion and Firmicutes enrichment in T2D. As for the acid-associated genera, there was consistent enrichment of Lactobacillus and Veillonela for T2D. Tannerella/T. forsythia was enriched in T2D saliva, but the certainty is low. Further well-designed cohorts are needed to clarify the distribution of acid-associated microorganisms in the saliva of adults with T2D and how this can be clinically manifested (PROSPERO = CRD42021264350).
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Affiliation(s)
- Jéssica Alves Cena
- Department of Dentistry, School of Health Sciences, University of Brasília, Federal District, Brasília 70910-900, Brazil
| | - Letícia Gonçalves Reis
- Department of Dentistry, School of Health Sciences, University of Brasília, Federal District, Brasília 70910-900, Brazil
| | - Ana Karolina Almeida de Lima
- Department of Dentistry, School of Health Sciences, University of Brasília, Federal District, Brasília 70910-900, Brazil
| | - Camilla Pedrosa Vieira Lima
- Department of Dentistry, School of Health Sciences, University of Brasília, Federal District, Brasília 70910-900, Brazil
| | - Cristine Miron Stefani
- Department of Dentistry, School of Health Sciences, University of Brasília, Federal District, Brasília 70910-900, Brazil
| | - Naile Dame-Teixeira
- Department of Dentistry, School of Health Sciences, University of Brasília, Federal District, Brasília 70910-900, Brazil
- Division of Oral Biology, School of Dentistry, University of Leeds, Leeds LS9 7TF, UK
- Correspondence: ; Tel.: +55-(61)-31071802
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Nakade Y, Iwata Y, Sakai N, Mita M, Nakane M, Hamase K, Suda W, Toyama T, Kitajima S, Hara A, Shimizu M, Ogushi C, Furuichi K, Koshino Y, Morita H, Hattori M, Wada T. Increased levels of oral Streptococcus-derived D-alanine in patients with chronic kidney disease and diabetes mellitus. Sci Rep 2022; 12:21773. [PMID: 36526888 PMCID: PMC9758232 DOI: 10.1038/s41598-022-26175-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
The number of patients on hemodialysis is increasing globally; diabetes mellitus (DM) complications is the major cause of hemodialysis in patients with chronic kidney disease (CKD). The D-amino acid (AA) profile is altered in patients with CKD; however, it has not been studied in patients with CKD and DM. Furthermore, bacteria responsible for altering the D-AA profile are not well understood. Therefore, we examined the D-AA profiles and associated bacteria in patients with CKD, with and without DM. We enrolled 12 healthy controls and 54 patients with CKD, with and without DM, and determined their salivary, stool, plasma, and urine chiral AA levels using two-dimensional high-performance liquid chromatography. We performed 16S rRNA gene sequencing analysis of the oral and gut microbiota to determine the association between the abundance of bacterial species and D-AA levels. Plasma D-alanine and D-serine levels were higher in patients with CKD than in healthy adults (p < 0.01), and plasma D-alanine levels were higher in patients with CKD and DM than in those without DM. The abundance of salivary Streptococcus, which produced D-alanine, increased in patients with CKD and DM and was positively correlated with plasma D-alanine levels. Patients with CKD and DM had unique oral microbiota and D-alanine profiles. Plasma D-alanine is a potential biomarker for patients with CKD and DM.
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Affiliation(s)
- Yusuke Nakade
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan ,grid.9707.90000 0001 2308 3329Department of Clinical Laboratory, Kanazawa University, 13-1 Takara-machi, Kanazawa, Japan
| | - Yasunori Iwata
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan ,grid.9707.90000 0001 2308 3329Division of Infection Control, Kanazawa University, 13-1 Takara-machi, Kanazawa, Japan
| | - Norihiko Sakai
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan ,grid.9707.90000 0001 2308 3329Division of Blood Purification, Kanazawa University, 13-1 Takara-machi, Kanazawa, Japan
| | - Masashi Mita
- grid.511730.1KAGAMI Co., Ltd., 7-18 Saitobaiohiruzu Center 308, Ibaragi, Osaka Japan
| | - Maiko Nakane
- grid.511730.1KAGAMI Co., Ltd., 7-18 Saitobaiohiruzu Center 308, Ibaragi, Osaka Japan
| | - Kenji Hamase
- grid.177174.30000 0001 2242 4849Graduate School of Pharmaceutical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan
| | - Wataru Suda
- grid.509459.40000 0004 0472 0267RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa Japan ,grid.26999.3d0000 0001 2151 536XGraduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba Japan
| | - Tadashi Toyama
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan
| | - Shinji Kitajima
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan
| | - Akinori Hara
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan
| | - Miho Shimizu
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan
| | - Chikako Ogushi
- grid.9707.90000 0001 2308 3329Department of Clinical Laboratory, Kanazawa University, 13-1 Takara-machi, Kanazawa, Japan
| | - Kengo Furuichi
- grid.411998.c0000 0001 0265 5359Department of Nephrology, Kanazawa Medical University, 1-1 Uchinada, Kahoku, Ishikawa Japan
| | - Yoshitaka Koshino
- Department of Internal Medicine, Mizuho Hospital, 422-1 Tsubata, Kahoku, Ishikawa Japan
| | - Hidetoshi Morita
- grid.261356.50000 0001 1302 4472Graduate School of Environmental and Life Science, Okayama University, 1-1-1 Tsushima-naka, Okayama, Japan
| | - Masahira Hattori
- grid.509459.40000 0004 0472 0267RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa Japan ,grid.26999.3d0000 0001 2151 536XGraduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba Japan
| | - Takashi Wada
- grid.9707.90000 0001 2308 3329Department of Nephrology and Laboratory Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641 Japan
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Grisi DC, Vieira IV, de Almeida Lima AK, de Oliveira Mattos MC, Damé-Teixeira N, Salles LP, de Oliveira LA, Stefani C, do Carmo Machado Guimarães M. The Complex Interrelationship between Diabetes Mellitus, Oral Diseases and General Health. Curr Diabetes Rev 2022; 18:e220321192408. [PMID: 34225632 DOI: 10.2174/1573399817666210322153210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/20/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022]
Abstract
There is emerging evidence that several oral diseases and conditions can be associated with DM. Dental caries, hyposalivation, fungal diseases and endodontics lesions may represent potential oral complications that can be aggravated by chronic hyperglycemia. Individuals with DM have a low perception of oral diseases which can lead to clinically important oral and systemic complications. This review aims to provide data on the most common oral signs and symptoms related to DM and to explore the mechanisms that might explain associations between DM and oral diseases in order to clarify the risks posed by poor oral health in DM. Since the linkage between oral diseases and DM is part of multifactorial aspects related to chronic hyperglycemic status and several common conditions affecting the whole body, both require rigorous self-control from patients and attention from medical and dental professionals.
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Affiliation(s)
- Daniela Corrêa Grisi
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
| | | | | | | | - Nailê Damé-Teixeira
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
| | - Loise Pedrosa Salles
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
| | | | - Cristine Stefani
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília-DF, Brazil
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11
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Huang Q, Meng L, Li H, Xiong N, Zeng L, Wang G, Zhang P, Zhao H, Liu D. Huoxue Jiangtang Decoction Alleviates Type 2 Diabetes Mellitus by Regulating the Oral Microbiota and Food Preferences. Diabetes Metab Syndr Obes 2022; 15:3739-3751. [PMID: 36474726 PMCID: PMC9719691 DOI: 10.2147/dmso.s391226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE As a formula of traditional Chinese medicine (TCM), Huoxue Jiangtang Decoction (HJD) has positive effects on diabetes mellitus (DM) through improving of the metabolism of glycolipid and the function of β-cell. Hence, this research aims to explore the potential therapeutic effects of HJD on diabetes and reveal its underlying mechanisms. METHODS Diabetic rat models induced by high-fat diet (HFD) and streptozotocin (STZ) were included in this study. Following successful modeling, diabetic rats were treated with HJD, and then its therapeutic effects in eight weeks were evaluated. In addition to biochemical indicators, two-bottle preference tests were carried out to examine the rats' preferences for fat and sugar, and 16S rRNA gene sequencing was performed to disclose the differences of oral microbiota among groups. Finally, Pearson correlation coefficient was used to explore the correlation between oral microbiota and the preferences for fat and sugar. RESULTS It was found that HJD significantly improved the levels of fasting blood glucose (FBG), glucose tolerance, and dyslipidemia. Additionally, HJD contributed to decreasing preferences for fat and sugar in diabetic rats, which plays an important role in food intake. Furthermore, HJD regulated the abundance, distribution, and structure of oral microbiota in diabetic rats, serving as one of the underlying mechanisms of its antidiabetic effects. CONCLUSION Taken with other formulas, HJD functions to improve the metabolism of glycolipid and the function of β-cell by inhibiting preferences for fat and sugar, as well as regulating the oral microbiota of diabetic rats. Furthermore, a potential correlation between the oral micro-environment and preferences for fat and sugar in STZ-induced diabetic rats is likely to exist.
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Affiliation(s)
- Qian Huang
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of China
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
| | - Lu Meng
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of China
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
| | - Huilin Li
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
| | - Ni Xiong
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of China
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
| | - Lin Zeng
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of China
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
| | - Gaoxiang Wang
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
- Shenzhen Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Shenzhen, People’s Republic of China
| | - Pengxiang Zhang
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of China
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
| | - Hengxia Zhao
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
| | - Deliang Liu
- Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China
- Correspondence: Deliang Liu, Department of Endocrinology, Shenzhen Traditional Chinese Medicine Hospital, 1# Fuhua Road, Futian District, Shenzhen, 518033, People’s Republic of China, Tel +86 13924610289, Fax +86 755-88358328-3319, Email
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12
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Cheng X, Zhou X, Liu C, Xu X. Oral Osteomicrobiology: The Role of Oral Microbiota in Alveolar Bone Homeostasis. Front Cell Infect Microbiol 2021; 11:751503. [PMID: 34869060 PMCID: PMC8635720 DOI: 10.3389/fcimb.2021.751503] [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: 08/01/2021] [Accepted: 10/29/2021] [Indexed: 02/05/2023] Open
Abstract
Osteomicrobiology is a new research field in which the aim is to explore the role of microbiota in bone homeostasis. The alveolar bone is that part of the maxilla and mandible that supports the teeth. It is now evident that naturally occurring alveolar bone loss is considerably stunted in germ-free mice compared with specific-pathogen-free mice. Recently, the roles of oral microbiota in modulating host defense systems and alveolar bone homeostasis have attracted increasing attention. Moreover, the mechanistic understanding of oral microbiota in mediating alveolar bone remodeling processes is undergoing rapid progress due to the advancement in technology. In this review, to provide insight into the role of oral microbiota in alveolar bone homeostasis, we introduced the term “oral osteomicrobiology.” We discussed regulation of alveolar bone development and bone loss by oral microbiota under physiological and pathological conditions. We also focused on the signaling pathways involved in oral osteomicrobiology and discussed the bridging role of osteoimmunity and influencing factors in this process. Finally, the critical techniques for osteomicrobiological investigations were introduced.
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Affiliation(s)
- Xingqun Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chengcheng Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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13
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Effects of type 2 diabetes and metformin on salivary microbiota in patients with chronic periodontitis. Microb Pathog 2021; 161:105277. [PMID: 34740808 DOI: 10.1016/j.micpath.2021.105277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/11/2021] [Accepted: 11/01/2021] [Indexed: 12/28/2022]
Abstract
Diabetes is closely associated with periodontitis, however, the effects of type 2 diabetes and metformin treatment on the salivary microbiota in chronic periodontitis patients are still insufficiently studied. Saliva was collected from ten patients with moderate to severe chronic periodontitis (CP group) and 20 patients with type 2 diabetes mellitus (T2DM) and moderate to severe chronic periodontitis (ten patients were newly diagnosed with diabetes without drug treatment (DM group), and ten patients were treated with metformin (CP-DM-MET group)). Total DNA was extracted. DNA amplicons of the V3-V4 hypervariable regions of the 16S rRNA gene were generated and subjected to high-throughput sequencing. There was no significant difference in the alpha diversity of the salivary microbiota (Observed_Species, Shannon, Simpson, ACE, Chao1 index) among the three groups. The dominant phyla with relative abundances greater than 1% were Firmicutes, Proteobacteria, Bacteroidota, Actinobacteriota, Fusobacteriota, and Spirochaetota, and no significant difference was found among the three groups. Compared with the CP group, the relative abundance of twelve genera was found changed in CP-DM group, for example, Aggregatibacter, Unclassified_f_Neisseriaceae, Parvimonas, Erysipelotrichace_UCG-006, Atopobium, and Endomicrobium et al. Metformin treatment could partly restore the abundance of several genera in CP-DM, such as Acholeplasma and Comamonas. Compared with the CP group, genus Lactobacillus, Parvimonas, Norank_f_norank_o_Absconditabacteriales_SR1, and Acholeplasma changed significantly in CP-DM-MET group. Plaque index (PLI) was positively correlated with Prevotella and Lactobacillus but negatively correlated with Haemophilus, Lautropia, Unclassified_f_Pasteurellaceae, and TM7x. In conclusion, there was a significant difference in the salivary microbiota of patients with chronic periodontitis complicated by T2DM. Treatment with metformin partially alleviated the alteration in salivary microbiota caused by T2DM.
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Oral Bacterial Microbiomes in Association with Potential Prediabetes Using Different Criteria of Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147436. [PMID: 34299886 PMCID: PMC8307246 DOI: 10.3390/ijerph18147436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/22/2022]
Abstract
This study aimed to find a potential biomarker that can be used to diagnose prediabetic condition by comparing the salivary bacterial microbiomes between Thai dental patients with normoglycemia (NG) and those with potential prediabetes (PPG) conditions. Thirty-three subjects were randomly recruited. Demographic data were collected along with oral examination and unstimulated salivary collections. The salivary bacterial microbiomes were identified by high-throughput sequencing on the V3–V4 region of the bacterial 16S rRNA gene. Microbiomes in this study were composed of 12 phyla, 19 classes, 29 orders, 56 families, 81 genera, and 184 species. To check the validity of the selection criterion for prediabetes, we adopted two separate criteria to divide samples into PPG and NG groups using glycated hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG) levels. Using the HbA1c level resulted in the significant reduction of Alloprevotella, Neisseria, Rothia, and Streptococcus abundances in PPG compared with those in NG (p-value < 0.05). On the other hand, the abundance of Absconditabacteriales was significantly reduced whereas Leptotrichia, Stomatobaculum, and Ruminococcaceae increased in the PPG group when the samples were classified by the FPG level (p-value < 0.05). It is implied that the group classifying criterion should be carefully concerned when investigating relative abundances between groups. However, regardless of the criteria, Rothia is significantly dominant in the NG groups, suggesting that Rothia might be a potential prediabetic biomarker. Due to the small sample size of this study, further investigation with a larger sample size is necessary to ensure that Rothia can be a potential biomarker for prediabetes in Thai people.
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15
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Akherati M, Shafaei E, Salehiniya H, Abbaszadeh H. Comparison of the frequency of periodontal pathogenic species of diabetics and non-diabetics and its relation to periodontitis severity, glycemic control and body mass index. Clin Exp Dent Res 2021; 7:1080-1088. [PMID: 34041870 PMCID: PMC8638284 DOI: 10.1002/cre2.453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives To investigate common pathogenic bacteria of periodontal diseases (PD) in patients with type 2 diabetes mellitus (T2DM) and its relationship with PD severity, glycemic control and body mass index (BMI). Material and Methods This case–control study consisted of 55 patients with T2DM and 55 individuals as control. Samples were collected from periodontal pockets. After DNA extraction, using 16srRNA‐specific primers, the presence of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Prevotella intermedia (Pi), and Fusobacterium nucleatum (Fn) were examined based on polymerase chain reaction method. Results Aa frequency was significantly higher in in T2DM group than control. There were no significant differences in the frequencies of Pg, Tf, Pi, and Fn between studied groups. There were no significant differences between frequencies of studied bacteria in different severities of periodontitis in T2DM group. Prevalence of Tf in T2DM patients with moderate periodontitis was significantly higher than non‐diabetics with moderate periodontitis. There was no significant difference between the frequency of bacteria in diabetics with good and poor glycemic control. There was a significant difference between the frequencies of Pg in T2DM individuals with different BMI levels. Conclusions A higher frequency of detection of Aa was found in diabetic when compared to non‐diabetics. Glycemic control did not affect the frequency distribution of studied bacteria in T2DM. Pg was identified in higher frequency in overweight T2DM patients.
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Affiliation(s)
- Mojtaba Akherati
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Ebrahim Shafaei
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamid Abbaszadeh
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
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16
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Radaic A, Kapila YL. The oralome and its dysbiosis: New insights into oral microbiome-host interactions. Comput Struct Biotechnol J 2021; 19:1335-1360. [PMID: 33777334 PMCID: PMC7960681 DOI: 10.1016/j.csbj.2021.02.010] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023] Open
Abstract
The oralome is the summary of the dynamic interactions orchestrated between the ecological community of oral microorganisms (comprised of up to approximately 1000 species of bacteria, fungi, viruses, archaea and protozoa - the oral microbiome) that live in the oral cavity and the host. These microorganisms form a complex ecosystem that thrive in the dynamic oral environment in a symbiotic relationship with the human host. However, the microbial composition is significantly affected by interspecies and host-microbial interactions, which in turn, can impact the health and disease status of the host. In this review, we discuss the composition of the oralome and inter-species and host-microbial interactions that take place in the oral cavity and examine how these interactions change from healthy (eubiotic) to disease (dysbiotic) states. We further discuss the dysbiotic signatures associated with periodontitis and caries and their sequalae, (e.g., tooth/bone loss and pulpitis), and the systemic diseases associated with these oral diseases, such as infective endocarditis, atherosclerosis, diabetes, Alzheimer's disease and head and neck/oral cancer. We then discuss current computational techniques to assess dysbiotic oral microbiome changes. Lastly, we discuss current and novel techniques for modulation of the dysbiotic oral microbiome that may help in disease prevention and treatment, including standard hygiene methods, prebiotics, probiotics, use of nano-sized drug delivery systems (nano-DDS), extracellular polymeric matrix (EPM) disruption, and host response modulators.
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Affiliation(s)
- Allan Radaic
- Kapila Laboratory, Orofacial Sciences Department, School of Dentistry, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Yvonne L. Kapila
- Kapila Laboratory, Orofacial Sciences Department, School of Dentistry, University of California, San Francisco (UCSF), San Francisco, CA, USA
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17
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Bachtiar BM, Theodorea CF, Tahapary DL, Astrella C, n/a N, Bachtiar EW. A pilot study of red complex and three genera subgingival microbiome in periodontitis subjects with and without diabetes, evaluated by MinION platform. F1000Res 2021; 10:79. [PMID: 34249333 PMCID: PMC8261760 DOI: 10.12688/f1000research.28216.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Subgingival niche is one biofilm habitat containing rich microbiota, which plays an active role in maintaining the health of periodontal tissue and determining host response. As such, a study of changing subgingival biofilms is important for understanding the effect of a systemic condition. In this study, we compared the occurrence of six bacteria cohabiting in the subgingival area of periodontitis subjects, with (DP, n = 8) and without (NDP, n = 4) diabetes. Methods: The six genus and species of targeted bacteria were confirmed by 16S rRNA amplicon sequencing on MinION nanopore platform. Descriptive statistic was used to describe the obtained data. Results: We found that the six genus and species of targeted bacteria were detected but in different quantities in either group's periodontal pocket. Our data showed that Tannerella forsythia was the most abundant species in subgingival biofilms of the DP group of the red complex bacteria. In contrast, Aggregatibacter sp., which belongs to the phylum of proteobacteria, was present at a relatively lower level. In contrast, Fusobacterium sp., which belongs to orange complex bacteria, showed relative similarities in subgingival biofilms of both groups tested, while Veillonella sp., were abundant in the DP groups. Conclusions: Our data show that the diversity of classic periodontopathogens increased in the subgingival niche of periodontitis subjects with diabetes. It is the first study in Indonesia to apply MinION-based, full-length 16S rRNA amplicon sequencing in periodontitis patients with and without diabetes.
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Affiliation(s)
- Boy M Bachtiar
- Department of Oral Biology and Oral Science Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Citra F Theodorea
- Department of Oral Biology and Oral Science Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Dicky L Tahapary
- Division of Endocrinology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia.,Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Cindy Astrella
- Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia.,Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Natalina n/a
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Endang W Bachtiar
- Department of Oral Biology and Oral Science Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
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Zhao F, Dong T, Yuan KY, Wang NJ, Xia FZ, Liu D, Wang ZM, Ma R, Lu YL, Huang ZW. Shifts in the Bacterial Community of Supragingival Plaque Associated With Metabolic-Associated Fatty Liver Disease. Front Cell Infect Microbiol 2020; 10:581888. [PMID: 33384967 PMCID: PMC7770214 DOI: 10.3389/fcimb.2020.581888] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/05/2020] [Indexed: 11/13/2022] Open
Abstract
Metabolic-associated fatty liver disease (MAFLD), also known as the hepatic manifestation of metabolic disorders, has become one of the most common chronic liver diseases worldwide. The associations between some oral resident microbes and MAFLD have been described. However, changes to the oral microbial community in patients with MAFLD remain unknown. In this study, variations to the supragingival microbiota of MAFLD patients were identified. The microbial genetic profile of supragingival plaque samples from 24 MAFLD patients and 22 healthy participants were analyzed by 16S rDNA sequencing and bioinformatics analysis. Clinical variables, including indicators of insulin resistance, obesity, blood lipids, and hepatocellular damage, were evaluated with laboratory tests and physical examinations. The results showed that the diversity of the supragingival microbiota in MAFLD patients was significantly higher than that in healthy individuals. Weighted UniFrac principal coordinates analysis and partial least squares discriminant analysis showed that the samples from the MAFLD and control groups formed separate clusters (Adonis, P = 0.0120). There were 27 taxa with differential distributions (linear discriminant analysis, LDA>2.0) between two groups, among which Actinomyces spp. and Prevotella 2 spp. were over-represented in the MAFLD group with highest LDA score, while Neisseria spp. and Bergeyella spp. were more abundant in the control group. Co-occurrence networks of the top 50 abundant genera in the two groups suggested that the inter-genera relationships were also altered in the supragingival plaque of MAFLD patients. In addition, in genus level, as risk factors for the development of MAFLD, insulin resistance was positively correlated with the abundances of Granulicatella, Veillonella, Streptococcus, and Scardovia, while obesity was positively correlated to the abundances of Streptococcus, Oslenella, Scardovia, and Selenomonas. Metagenomic predictions based on Phylogenetic Investigation of Communities by Reconstruction of Unobserved States revealed that pathways related to sugar (mainly free sugar) metabolism were enriched in the supragingival plaque of the MAFLD group. In conclusion, as compared to healthy individuals, component and interactional dysbioses were observed in the supragingival microbiota of the MAFLD group.
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Affiliation(s)
- Fen Zhao
- Department of Endodontics, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ting Dong
- Department of Endodontics, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ke-Yong Yuan
- Department of Endodontics, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ning-Jian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang-Zhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Liu
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Zhi-Min Wang
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, Chinese National Human Genome Center, Shanghai, China
| | - Rui Ma
- Department of Endodontics, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ying-Li Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng-Wei Huang
- Department of Endodontics, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Alteration of salivary microbiome in periodontitis with or without type-2 diabetes mellitus and metformin treatment. Sci Rep 2020; 10:15363. [PMID: 32958790 PMCID: PMC7506544 DOI: 10.1038/s41598-020-72035-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/10/2020] [Indexed: 01/12/2023] Open
Abstract
We aimed to explore the effects of type-2 diabetes mellitus (T2DM) and hypoglycemic therapy on the salivary microbiome in periodontitis patients and identify the potential salivary micro-biomarker for the early warning of T2DM. Saliva samples were collected from healthy individuals (Health), periodontitis patients (P), T2DM patients, periodontitis patients with T2DM (DAP), and DAP patients treated with Metformin (Met). Samples were determined by16S rRNA gene sequencing. 29 phyla, 322 genera, and 333 species of salivary microbiome were annotated. Compared to the Health group, the P and DAP group showed a significantly higher diversity of saliva microbiota, while the T2DM and Met group had no significant difference in microbial abundance but showed a trend of increasing diversity. Other than well-known periodontitis-inducing pathogens, the proportion of Prevotella copri, Alloprevotella rava, and Ralstonia pickettii, etc. were also significantly increased in periodontitis patients with or without T2DM. After effective glycemic control, the abundance of Prevotella copri, Alloprevotella rava, Ralstonia pickettii, etc. decreased in periodontitis patients with companion T2DM. The accuracies of the classification models in differentiating Health-vs.-P, DAP-vs.-P, and T2DM-vs.-P were 100%, 96.3%, and 98.1%, respectively. Hypoglycemic therapy could reconstruct the saliva microbiota and hence improve the localized conditions of diabetes patients with periodontitis.
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Diabetes mellitus and poor glycemic control increase the occurrence of coronal and root caries: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:3801-3812. [DOI: 10.1007/s00784-020-03531-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/14/2020] [Indexed: 12/22/2022]
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Eidt G, Waltermann EDM, Hilgert JB, Arthur RA. Candida and dental caries in children, adolescents and adults: A systematic review and meta-analysis. Arch Oral Biol 2020; 119:104876. [PMID: 32905885 DOI: 10.1016/j.archoralbio.2020.104876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/10/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to investigate whether the presence of fungi of the genus Candida in oral cavity is associated with dental caries in children and adolescents (from 6 to 18 years) or in adults (older than 18 years). DESIGN Electronic search was carried out in MEDLINE, EMBASE and LILACS databases. Studies that evaluated the presence of Candida spp. and dental caries on those individuals were included. Data extraction and evidence quality assessment were performed by two independent investigators. Prevalence ratio (PR) was calculated considering 95 % confidence interval (CI). Meta-analysis was performed using random effect Mantel-Haenszel model. RESULTS Thirty out of 123 publications selected for full-reading were included in the systematic review. Prevalence of Candida spp. in the oral cavity ranged from 7.7 % to 78 %. Prevalence of dental caries in individuals harbouring Candida spp. ranged from 27.2%-100% and was higher than in individuals not harbouring Candida spp. (PR = 1.72 [1.46-2.02]). Prevalence of dental caries was 2.3 times higher in individuals harbouring Candida spp. in mucosa. Moreover, dental caries prevalence was 80 % and 48 % higher in children/adolescents and adults harbouring Candida spp., respectively (95 % CI [1.44-2.25] and [1.20-1.83]). The quality of evidence of most studies (n = 21) was graded as fair. CONCLUSIONS These results suggest that, regardless of age or sample site, individuals with the presence of Candida spp. have a higher prevalence of dental caries when compared to individuals without these microorganisms in the oral cavity.
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Affiliation(s)
- Gustavo Eidt
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
| | - Elen Darlise Marques Waltermann
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
| | - Juliana Balbinot Hilgert
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
| | - Rodrigo Alex Arthur
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
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22
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Almusawi MA, Gosadi I, Abidia R, Almasawi M, Alrashood ST, Ekhzaimy A, Alhomida AS, Khan HA. Association between salivary factors and cariogenic bacteria in type-2 diabetes patients. JOURNAL OF KING SAUD UNIVERSITY - SCIENCE 2020. [DOI: 10.1016/j.jksus.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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23
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Effect of diode laser application as an adjunct to nonsurgical periodontal therapy on the reduction of red complex microorganisms in type 2 diabetics with chronic periodontitis. Lasers Med Sci 2020; 35:1403-1410. [PMID: 32193820 DOI: 10.1007/s10103-020-02997-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
Bactericidal and detoxification effects of diode laser (DL) have been reported in periodontal treatment. The objective of this study was investigating the additional effect of DL with nonsurgical periodontal treatment on the red complex bacteria in type 2 diabetes mellitus (DM) patients with chronic periodontitis (CP). Sixty type 2 DM patients with chronic periodontitis (CP) were randomly assigned in two parallel groups to receive scaling root planning (SRP, n = 30) or SRP followed by DL periodontal pocket irradiation (SRP + DL, n = 30). Recording of clinical parameters and subgingival plaque sampling were performed at baseline, and post therapy (1 and 3 months after treatment). Amounts of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia were evaluated with quantitative RT-PCR. Significant reductions for numbers of all three bacterial species were observed at 1 and 3 months compared with baseline for both treatments (p < 0.001), but no significant differences were found between two groups regarding bacterial reductions at these follow-up time points. No additional benefit of DL as an adjunct to nonsurgical periodontal therapy was recognized in the reduction of P. gingivalis, T. denticola, and T. forsythia for type 2 DM patients with CP. Further studies are required to clarify the effects of diode laser on the other periodontopathogens.
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24
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Bartnicka D, Gonzalez-Gonzalez M, Sykut J, Koziel J, Ciaston I, Adamowicz K, Bras G, Zawrotniak M, Karkowska-Kuleta J, Satala D, Kozik A, Zyla E, Gawron K, Lazarz-Bartyzel K, Chomyszyn-Gajewska M, Rapala-Kozik M. Candida albicans Shields the Periodontal Killer Porphyromonas gingivalis from Recognition by the Host Immune System and Supports the Bacterial Infection of Gingival Tissue. Int J Mol Sci 2020; 21:E1984. [PMID: 32183255 PMCID: PMC7139284 DOI: 10.3390/ijms21061984] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/07/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
Candida albicans is a pathogenic fungus capable of switching its morphology between yeast-like cells and filamentous hyphae and can associate with bacteria to form mixed biofilms resistant to antibiotics. In these structures, the fungal milieu can play a protective function for bacteria as has recently been reported for C. albicans and a periodontal pathogen-Porphyromonas gingivalis. Our current study aimed to determine how this type of mutual microbe protection within the mixed biofilm affects the contacting host cells. To analyze C. albicans and P. gingivalis persistence and host infection, several models for host-biofilm interactions were developed, including microbial exposure to a representative monocyte cell line (THP1) and gingival fibroblasts isolated from periodontitis patients. For in vivo experiments, a mouse subcutaneous chamber model was utilized. The persistence of P. gingivalis cells was observed within mixed biofilm with C. albicans. This microbial co-existence influenced host immunity by attenuating macrophage and fibroblast responses. Cytokine and chemokine production decreased compared to pure bacterial infection. The fibroblasts isolated from patients with severe periodontitis were less susceptible to fungal colonization, indicating a modulation of the host environment by the dominating bacterial infection. The results obtained for the mouse model in which a sequential infection was initiated by the fungus showed that this host colonization induced a milder inflammation, leading to a significant reduction in mouse mortality. Moreover, high bacterial counts in animal organisms were noted on a longer time scale in the presence of C. albicans, suggesting the chronic nature of the dual-species infection.
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Affiliation(s)
- Dominika Bartnicka
- Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.B.); (M.G.-G.); (J.S.); (G.B.); (M.Z.); (J.K.-K.)
| | - Miriam Gonzalez-Gonzalez
- Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.B.); (M.G.-G.); (J.S.); (G.B.); (M.Z.); (J.K.-K.)
| | - Joanna Sykut
- Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.B.); (M.G.-G.); (J.S.); (G.B.); (M.Z.); (J.K.-K.)
| | - Joanna Koziel
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (J.K.); (I.C.); (K.A.)
| | - Izabela Ciaston
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (J.K.); (I.C.); (K.A.)
| | - Karina Adamowicz
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (J.K.); (I.C.); (K.A.)
| | - Grazyna Bras
- Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.B.); (M.G.-G.); (J.S.); (G.B.); (M.Z.); (J.K.-K.)
| | - Marcin Zawrotniak
- Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.B.); (M.G.-G.); (J.S.); (G.B.); (M.Z.); (J.K.-K.)
| | - Justyna Karkowska-Kuleta
- Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.B.); (M.G.-G.); (J.S.); (G.B.); (M.Z.); (J.K.-K.)
| | - Dorota Satala
- Department of Analytical Biochemistry, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.S.); (A.K.)
| | - Andrzej Kozik
- Department of Analytical Biochemistry, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.S.); (A.K.)
| | - Edyta Zyla
- Department of Cell Biochemistry, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland;
| | - Katarzyna Gawron
- Department of Molecular Biology and Genetics, School of Medicine in Katowice, Medical University of Silesia, Medykow 18, 40-752 Katowice, Poland;
| | - Katarzyna Lazarz-Bartyzel
- Department of Periodontology and Oral Medicine, Faculty of Medicine, Jagiellonian University, Medical College, 31-155 Krakow, Poland; (K.L.-B.); (M.C.-G.)
| | - Maria Chomyszyn-Gajewska
- Department of Periodontology and Oral Medicine, Faculty of Medicine, Jagiellonian University, Medical College, 31-155 Krakow, Poland; (K.L.-B.); (M.C.-G.)
| | - Maria Rapala-Kozik
- Department of Comparative Biochemistry and Bioanalytics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University in Krakow, 30-387 Krakow, Poland; (D.B.); (M.G.-G.); (J.S.); (G.B.); (M.Z.); (J.K.-K.)
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Al-Badr AH, AlJameel AH, Halawany HS, Al-Jazairy YH, Alhadlaq MK, Al-Maflehi NS, Al-Sharif JA, Jacob V, Abraham N. Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh, Kingdom of Saudi Arabia compared to non-diabetic children. Saudi Dent J 2020; 33:276-282. [PMID: 34194191 PMCID: PMC8236546 DOI: 10.1016/j.sdentj.2020.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. Methods The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. Results The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). Conclusion The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of “critical” pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.
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Affiliation(s)
- Abid Hamoud Al-Badr
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Albandary Hassan AlJameel
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hassan Suliman Halawany
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Yousra Hussein Al-Jazairy
- Department of Restorative Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad Khalid Alhadlaq
- Department of Paediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nassr Saleh Al-Maflehi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Vimal Jacob
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nimmi Abraham
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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26
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Wei YS, Hsiao YC, Su GW, Chang YR, Lin HP, Wang YS, Tsai YT, Liao EC, Chen HY, Chou HC, Ko ML, Kuo WH, Chang SJ, Cheng WC, Chan HL. Identification of hyperglycemia-associated microbiota alterations in saliva and gingival sulcus. Arch Biochem Biophys 2020; 682:108278. [DOI: 10.1016/j.abb.2020.108278] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/27/2019] [Accepted: 01/20/2020] [Indexed: 01/15/2023]
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27
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Crusell MKW, Brink LR, Nielsen T, Allin KH, Hansen T, Damm P, Lauenborg J, Hansen TH, Pedersen O. Gestational diabetes and the human salivary microbiota: a longitudinal study during pregnancy and postpartum. BMC Pregnancy Childbirth 2020; 20:69. [PMID: 32005194 PMCID: PMC6995204 DOI: 10.1186/s12884-020-2764-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 01/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background An aberrant composition of the salivary microbiota has been found in individuals with type 2 diabetes, and in pregnant women salivary microbiota composition has been associated with preeclampsia and pre-term birth. Pregnant women, who develop gestational diabetes (GDM), have a high risk of developing type 2 diabetes after pregnancy. In the present study we assessed whether GDM is linked to variation in the oral microbial community by examining the diversity and composition of the salivary microbiota. Method In this observational study the salivary microbiota of pregnant women with GDM (n = 50) and normal glucose regulation (n = 160) in third trimester and 9 months postpartum was assessed by 16S rRNA gene amplicon sequencing of the V1-V3 region. GDM was diagnosed in accordance with the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Cross-sectional difference in alpha diversity was assessed using Student’s t-test and longitudinal changes were assessed by mixed linear regression. Cross-sectional and longitudinal difference in beta diversity was assessed by permutational multivariate analyses of variance. Differentially abundant genera and OTUs were identified by negative binomial regression. Results In the third trimester, two species-level operational taxonomic units (OTUs), while eight OTUs postpartum were differentially abundant in women with GDM compared with normoglycaemic women. OTU richness, Shannon diversity and Pielou evenness decreased from late pregnancy to 9 months after delivery regardless of glycaemic status. Conclusion GDM is associated with a minor aberration of the salivary microbiota during late pregnancy and postpartum. For unknown reasons richness of the salivary microbiota decreased from late pregnancy to postpartum, which might be explained by the physiological changes of the immune system during human pregnancy.
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Affiliation(s)
- Mie K W Crusell
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Blegdamsvej 3B 8th floor, 2200, Copenhagen N, Denmark. .,Department of Gynecology and Obstetrics, Hvidovre University Hospital, Kettegaardsvej 30, 2650, Hvidovre, Denmark.
| | - Lærke R Brink
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Blegdamsvej 3B 8th floor, 2200, Copenhagen N, Denmark
| | - Trine Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Blegdamsvej 3B 8th floor, 2200, Copenhagen N, Denmark
| | - Kristine H Allin
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Blegdamsvej 3B 8th floor, 2200, Copenhagen N, Denmark.,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, the Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Blegdamsvej 3B 8th floor, 2200, Copenhagen N, Denmark
| | - Peter Damm
- Department of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet University Hospital, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamdsvej 3B, 2200, Copenhagen N, Denmark
| | - Jeannet Lauenborg
- Department for Gynecology and Obstetrics, Herlev University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Tue H Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Blegdamsvej 3B 8th floor, 2200, Copenhagen N, Denmark.,Department of Cardiology and Endocrinology, Slagelse Hospital, Ingemannsvej 30, 4200, Slagelse, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Blegdamsvej 3B 8th floor, 2200, Copenhagen N, Denmark
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28
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Coelho AS, Amaro IF, Caramelo F, Paula A, Marto CM, Ferreira MM, Botelho MF, Carrilho EV. Dental caries, diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2020; 32:291-309. [PMID: 31912978 DOI: 10.1111/jerd.12562] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/04/2019] [Accepted: 12/17/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To analyze articles aimed at evaluating the association between diabetes, metabolic control, diabetes duration, and dental caries. OVERVIEW A systematic search in PubMed, Cochrane Library, Embase, and Web of Science was conducted to retrieve papers in English, Portuguese, and Spanish, up to April 2019. The research strategy was constructed considering the "PECO" strategy. Only quantitative observational studies were analyzed. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. The meta-analyses were performed based on random-effects models using the statistical platform R. A total of 69 articles was included in the systematic review and 40 in the meta-analysis. Type 1 diabetics have a significantly higher DMFT compared to controls. No significant differences were found between type 2 diabetics and controls and between well-controlled and poorly controlled diabetics. Concerning diabetes duration, all authors failed to find differences between groups. CONCLUSION Although there is still a need for longitudinal studies, the meta-analysis proved that type 1 diabetics have a high dental caries risk. CLINICAL SIGNIFICANCE It is necessary to be aware of all risk factors for dental caries that may be associated with these patients, making it possible to include them into an individualized prevention program.
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Affiliation(s)
- Ana Sofia Coelho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Inês Flores Amaro
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal
| | - Francisco Caramelo
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Laboratory of Biostatistics and Medical Informatics, University of Coimbra, Coimbra, Portugal
| | - Anabela Paula
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Carlos Miguel Marto
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Experimental Pathology Institute, University of Coimbra, Coimbra, Portugal
| | - Manuel Marques Ferreira
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Institute of Endodontics, University of Coimbra, Coimbra, Portugal
| | - Maria Filomena Botelho
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Eunice Virgínia Carrilho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
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Microbiota, type 2 diabetes and non-alcoholic fatty liver disease: protocol of an observational study. J Transl Med 2019; 17:408. [PMID: 31801616 PMCID: PMC6891972 DOI: 10.1186/s12967-019-02130-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/07/2019] [Indexed: 02/07/2023] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is characterized by triglyceride accumulation in the hepatocytes in the absence of alcohol overconsumption, commonly associated with insulin resistance and obesity. Both NAFLD and type 2 diabetes (T2D) are characterized by an altered microbiota composition, however the role of the microbiota in NAFLD and T2D is not well understood. To assess the relationship between alteration in the microbiota and NAFLD while dissecting the role of T2D, we established a nested study on T2D and non-T2D individuals within the Cooperative Health Research In South Tyrol (CHRIS) study, called the CHRIS-NAFLD study. Here, we present the study protocol along with baseline and follow-up characteristics of study participants. Methods Among the first 4979 CHRIS study participants, 227 individuals with T2D were identified and recalled, along with 227 age- and sex-matched non-T2D individuals. Participants underwent ultrasound and transient elastography examination to evaluate the presence of hepatic steatosis and liver stiffness. Additionally, sampling of saliva and faeces, biochemical measurements and clinical interviews were carried out. Results We recruited 173 T2D and 183 non-T2D participants (78% overall response rate). Hepatic steatosis was more common in T2D (63.7%) than non-T2D (36.3%) participants. T2D participants also had higher levels of liver stiffness (median 4.8 kPa, interquartile range (IQR) 3.7, 5.9) than non-T2D participants (median 3.9 kPa, IQR 3.3, 5.1). The non-invasive scoring systems like the NAFLD fibrosis score (NFS) suggests an increased liver fibrosis in T2D (mean − 0.55, standard deviation, SD, 1.30) than non-T2D participants (mean − 1.30, SD, 1.17). Discussion Given the comprehensive biochemical and clinical characterization of study participants, once the bioinformatics classification of the microbiota will be completed, the CHRIS-NAFLD study will become a useful resource to further our understanding of the relationship between microbiota, T2D and NAFLD.
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30
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Liu YK, Xu X, Zhou XD. [Potential application of human microbiomes in the diagnosis and treatment of type 2 diabetes mellitus]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:556-562. [PMID: 31721508 DOI: 10.7518/hxkq.2019.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Human microbiome refers to the total microorganism genetic information of human body surface and internal, which is closely related to human health and disease. Oral and gut microbiomes are the most diverse microbial communities, which can interact and play a role in the development of the disease, and can reflect the health and disease state in real time. Type 2 diabetes mellitus is a metabolic disorder caused by both genetic and environmental factors. Recent research has shown a link between microbes and diabetes. This article reviewed the latest research on the changes of oral and gut microbiomes in type 2 diabetes mellitus patients, which expects to provide a reference for exploring the development of the disease model for prediction, diagnosis and prognosis of type 2 diabetes mellitus based on human microbiome characteristics.
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Affiliation(s)
- Yun-Kun Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xue-Dong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Rodríguez-Hernández AP, Márquez-Corona MDL, Pontigo-Loyola AP, Medina-Solís CE, Ximenez-Fyvie LA. Subgingival Microbiota of Mexicans with Type 2 Diabetes with Different Periodontal and Metabolic Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3184. [PMID: 31480468 PMCID: PMC6751498 DOI: 10.3390/ijerph16173184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Type-2-Diabetes (T2D) and Periodontitis are major inflammatory diseases. However, not much is known about the specific subgingival microbiota in Mexicans with diabetes and metabolic dysbiosis. The aim of this study was to describe the subgingival microbiota of Mexicans with T2D and the different periodontal and metabolic conditions, through "Checkerboard" DNA-DNA hybridization. METHODS Subjects were divided into two groups-periodontal-health (PH) (PH_non-T2D; n = 59, PH_T2D; n = 14) and generalized-periodontitis (GP) (GP_non-T2D; n = 67, GP_T2D; n = 38). Obesity (BMI ≥ 30 kg/m2) and serum levels of glycated-hemoglobin (HbA1c), total-lipids, triglycerides, total-cholesterol, high-density-lipids, and low-density-lipids were measured for the T2D individuals. Subgingival microbial identification was processed for 40 species through DNA-probes. RESULTS Subjects with T2D harbored significantly higher mean total levels (PH: p < 0.001, and GP_NS), a lower proportion of "red" complex (GP: p < 0.01), a higher proportion of "yellow" (GP; p < 0.001), and "orange" (GP; p < 0.01) complex than the non-T2D. GP_T2D individuals exhibited a greater proportion of putative-species-Campylobacter gracilis and S. constellatus (p < 0.001), and Parvimonas micra and Prevotella nigrescens (p < 0.01), than GP_non-T2D. T2D individuals with HbA1c > 8% had presented significantly higher mean pocket-depth and higher levels of G. morbillorum (p < 0.05) and those with obesity or dyslipidemia harbored higher levels, prevalence, or proportion of Streptococcus sp., Actinomyces sp., and Capnocytophaga sp. CONCLUSIONS T2D individuals harbored a particular microbial profile different to non-T2D microbiota. Metabolic control was related to dysbiosis of microbiota-HbA1c>8% related to periodontitis and obesity or dyslipidemia with the predominance of saccharolytic bacteria, irrespective of their periodontal condition.
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Affiliation(s)
| | - María de Lourdes Márquez-Corona
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico
| | - América Patricia Pontigo-Loyola
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico
| | - Carlo Eduardo Medina-Solís
- The Academic Area of Dentistry in the Health Sciences Institute, the Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico.
| | - Laurie-Ann Ximenez-Fyvie
- Laboratory of Molecular Genetics, School of Dentistry, National Autonomous University of Mexico (UNAM), Mexico City 04360, Mexico.
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Mahalakshmi K, Arangannal P, Santoshkumari. Frequency of putative periodontal pathogens among type 1 diabetes mellitus: a case-control study. BMC Res Notes 2019; 12:328. [PMID: 31182149 PMCID: PMC6558758 DOI: 10.1186/s13104-019-4364-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/05/2019] [Indexed: 12/30/2022] Open
Abstract
Objective The aim of the present study is to compare and assess the risk of periodontitis due to the presence of four putative periodontopathic bacteria viz., Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens. To fulfil the above objective, polymerase Chain reaction using the primers targeting 16S rRNA gene of the bacterial species was performed with the subgingival plaque collected from the permanent first molars of type 1 diabetic children and age matched healthy children. Results The prevalence of periodontal pathogens in diabetic and healthy children was 6% and 16% for E. corrodens, 18% and 36% for C. rectus, 2% and 2% for P. intermedia, 4% and 0%, for P. nigrescens respectively. Statistically, significant difference was not observed for the prevalence of all the four periodontal pathogens between type 1 diabetic and healthy children (P = 1.00). The results of the present study thus reveal a negative correlation of type I diabetes to periodontitis in association to Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens.
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Affiliation(s)
- Krishnan Mahalakshmi
- Department of Microbiology/Research Lab for Oral-Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Velachery - Tambaram Road, Chennai, Tamilnadu, 600100, India.
| | - Ponnudurai Arangannal
- Department of Paedodontics and Preventive Dentistry, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Velachery - Tambaram Road, Chennai, 600100, India
| | - Santoshkumari
- Department of Paedodontics and Preventive Dentistry, Sri Venkateswara Dental College and Hospital, Thalambur, Chennai, India
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Aggregatibacter actinomycetemcomitans mediates protection of Porphyromonas gingivalis from Streptococcus sanguinis hydrogen peroxide production in multi-species biofilms. Sci Rep 2019; 9:4944. [PMID: 30894650 PMCID: PMC6426879 DOI: 10.1038/s41598-019-41467-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/06/2019] [Indexed: 01/10/2023] Open
Abstract
Mixed species biofilms are shaped and influenced by interactions between species. In the oral cavity, dysbiosis of the microbiome leads to diseases such as periodontitis. Porphyromonas gingivalis is a keystone pathogen of periodontitis. In this study, we showed that polymicrobial biofilm formation promoted the tolerance of Porphyromonas gingivalis to oxidative stress under micro-aerobic conditions. The presence of Streptococcus sanguinis, an oral commensal bacterium, inhibited the survival of P. gingivalis in dual-species biofilms via the secretion of hydrogen peroxide (H2O2). Interestingly, this repression could be attenuated by the presence of Aggregatibacter actinomycetemcomitans in tri-species biofilms. It was also shown that the katA gene, encoding a cytoplasmic catalase in A. actinomycetemcomitans, was responsible for the reduction of H2O2 produced by S. sanguinis, which consequently increased the biomass of P. gingivalis in tri-species biofilms. Collectively, these findings reveal that polymicrobial interactions play important roles in shaping bacterial community in biofilm. The existence of catalase producers may support the colonization of pathogens vulnerable to H2O2, in the oral cavity. The catalase may be a potential drug target to aid in the prevention of periodontitis.
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Matic Petrovic S, Radunovic M, Barac M, Kuzmanovic Pficer J, Pavlica D, Arsic Arsenijevic V, Pucar A. Subgingival areas as potential reservoirs of different Candida spp in type 2 diabetes patients and healthy subjects. PLoS One 2019; 14:e0210527. [PMID: 30629672 PMCID: PMC6328191 DOI: 10.1371/journal.pone.0210527] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 12/26/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The aim of this cross-sectional observational study was to compare the prevalence of different oral Candida spp. in patients with Type 2 Diabetes and chronic periodontitis in two oral sites: dorsal surface of the tongue and subgingival area. In order to determine subgingival areas as potential reservoirs of yeasts, this study aimed to find differences in the yeasts' detection between the dorsum of the tongue, as the oral site most commonly inhabited with microorganisms, and subgingival samples. Additionally, potential predictors for the yeasts prevalence were determined. MATERIAL AND METHODS Subjects (N = 146) were divided into four groups: group A- healthy individuals without periodontitis, group B- healthy individuals with chronic periodontitis, group C- Type 2 Diabetes patients with good glycoregulation and Chronic periodontitis and group D- Type 2 Diabetes patients with poor glycoregulation and Chronic periodontitis. Samples were obtained from the tongue by swabbing. Subgingival plaque samples were taken by paper points and periodontal curette. Isolation and identification of different Candida spp. was done using ChromAgar medium. In addition, germ-tube production and carbohydrate assimilation tests were performed. RESULTS The prevalence of Candida spp. was higher in diabetics with poor glycoregulation. The most frequently isolated species was Candida albicans followed by Candida glabrata and Candida tropicalis. In 15.6% of cases, Candida spp. was present in the subgingival area while absent on the tongue. Multivariate regression model showed that HbA1c was Candida spp. predictor for both locations. CONCLUSIONS Our results confirmed that there are Candida spp. carriers among subjects with clinically healthy oral mucosa. Also, this study identified subgingival areas as potential reservoirs of these pathogenic species. Glycoregulation has been recognized as a positive predictor factor of Candida spp.
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Affiliation(s)
- Sanja Matic Petrovic
- Department of Oral Medicine and Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena Radunovic
- Department of Microbiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
- * E-mail: (AP); (MR)
| | - Milena Barac
- Department of Oral Medicine and Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Kuzmanovic Pficer
- Department for Medical Statistics and Informatics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Dusan Pavlica
- Department of Microbiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Ana Pucar
- Department of Oral Medicine and Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
- * E-mail: (AP); (MR)
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Cariogenicity of Candida albicans of distinct genotypes among 3-5-year-old Uygur children in Kashgar, China- a case-control study. BMC Oral Health 2018; 18:203. [PMID: 30518349 PMCID: PMC6282366 DOI: 10.1186/s12903-018-0658-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/08/2018] [Indexed: 01/11/2023] Open
Abstract
Background In recent years, the opportunistic fungus C.albicans has been linked to ECC.It is important to investigate the relationship between the distribution of C.albicans and early childhood caries (ECC) in 3–5-year-old Uygur and Han children in Kashgar, and the role of C.albicans of distinct genotypes in caries. Methods Two hundred fifty-six Uygur and 141 Han children were enrolled in the study. The identified C.albicans isolates were genotyped based on 25S rDNA Polymerase Chain Reaction(PCR) amplification, and their acidogenicity, aciduricity, and adhesiveness were examined. Moreover, secreted aspartic protease (Sap) activity and SAP1–5 transcriptional levels were compared in the ECC and caries-free (CF) groups of Uygur children. Results C.albicans detection rate was significantly higher in Uygur children than in Han children (44. 5% vs. 31. 2%; χ2= 6.739, P = 0.009);the A genotype was dominant in Uygur and Han children with ECC, the C genotype was dominant in Uygur CF children(P = 0.022). C.albicans acidogenicity and growth were more pronounced in the Uygur ECC group than in CF group, especially at pH 4.0 and 4. 5(pH 4.0, P = 0.012; pH 4. 5, P = 0.029); the average ratios of glass-wall adhesion and the Sap activity was higher in ECC group than in CF group(P < 0.01), and SAP2(P < 0.001) and SAP5(P = 0.001) were expressed more robustly in ECC group. Conclusions The strong acidogenicity and aciduricity, Sap activity, and high SAP2 and SAP5 expression might be closely associated with ECC. C.albicans potentially plays a key role in the progression of caries, which most readily affects genotype A carriers and could be attributed to person-to-person environmental variation.
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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Zhu B, Macleod LC, Kitten T, Xu P. Streptococcus sanguinis biofilm formation & interaction with oral pathogens. Future Microbiol 2018; 13:915-932. [PMID: 29882414 PMCID: PMC6060398 DOI: 10.2217/fmb-2018-0043] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Caries and periodontitis are the two most common human dental diseases and are caused by dysbiosis of oral flora. Although commensal microorganisms have been demonstrated to protect against pathogens and promote oral health, most previous studies have addressed pathogenesis rather than commensalism. Streptococcus sanguinis is a commensal bacterium that is abundant in the oral biofilm and whose presence is correlated with health. Here, we focus on the mechanism of biofilm formation in S. sanguinis and the interaction of S. sanguinis with caries- and periodontitis-associated pathogens. In addition, since S. sanguinis is well known as a cause of infective endocarditis, we discuss the relationship between S. sanguinis biofilm formation and its pathogenicity in endocarditis.
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Affiliation(s)
- Bin Zhu
- Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Lorna C Macleod
- Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Todd Kitten
- Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, VA 23298, USA.,Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Ping Xu
- Philips Institute for Oral Health Research, Virginia Commonwealth University, Richmond, VA 23298, USA.,Department of Microbiology & Immunology, Virginia Commonwealth University, Richmond, VA 23298, USA.,Center for the Study of Biological Complexity, Virginia Commonwealth University, Richmond, VA 23298, USA
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Predictors for Gingival Index in Middle-Aged Asian Indians with Type 2 Diabetes from South India: A Cross-Sectional Observational Study. ScientificWorldJournal 2018; 2018:9081572. [PMID: 29479293 PMCID: PMC5816844 DOI: 10.1155/2018/9081572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/02/2017] [Accepted: 11/19/2017] [Indexed: 12/25/2022] Open
Abstract
Asian Indians develop type 2 diabetes mellitus (T2DM) much earlier as compared to White Caucasians, due to unique phenotypic and genetic architecture. Periodontitis in T2DM patients is often a neglected clinical feature. This study was conducted to derive predictor variables for gingival index in middle-aged Asian Indians with T2DM in a semiurban population of Dravidian ethnicity from Tamil Nadu, India. T2DM patients (n = 232, mean age: 50.6 ± 10.4 years) with periodontitis (n = 123, mean age: 54.3 ± 2.4 years) and without periodontitis (n = 109, mean age: 55.2 ± 3.1 years) were recruited between 2014 and 2016 by purposive sampling method. Dental examinations for pocket depth (PD) and clinical attachment level (CAL) were performed and gingival index was calculated. Fasting venous blood samples were analysed for measures of glycaemia and cholesterol. Significant positive correlation (p < 0.01) was observed for gingival index with glycosylated haemoglobin (HbA1c), pocket depth, presence of T2DM, and clinical attachment level. Stepwise multiple linear regression analysis derived increased pocket depth (p < 0.01), elevated HbA1c (p < 0.01), clinical attachment level (p < 0.01), and presence of diabetes (p < 0.01) as significant predictors (r2 value = 0.67) for increased gingival index in middle aged patients with T2DM. These variables significantly (p < 0.01) predispose middle-aged T2DM patients to increased gingival index, thus warranting appropriate intervention.
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Zhang Y, Wang X, Li H, Ni C, Du Z, Yan F. Human oral microbiota and its modulation for oral health. Biomed Pharmacother 2018; 99:883-893. [PMID: 29710488 DOI: 10.1016/j.biopha.2018.01.146] [Citation(s) in RCA: 250] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/04/2018] [Accepted: 01/29/2018] [Indexed: 02/07/2023] Open
Abstract
The oral microbiome is an important part of the human microbiome. The oral cavity contains several significantly different niches with distinct microbial communities. A wide range of microorganisms inhabit the human oral cavity, including bacteria, fungi, viruses, archaea and protozoa. These microorganisms form a complex ecological community that influences oral and systemic health. The most prevalent oral diseases, dental caries and periodontal diseases, are microbiota-associated diseases. Moreover, increasing evidences have supported that many systemic diseases are associated with disturbances in the oral ecosystem, such as diabetes, cardiovascular diseases and tumors. The current control of dental plaque-related diseases is nonspecific and is centered on the removal of plaque by mechanical means. Due to this realization about the oral microbiome, several new methods based on the modulation of the microbiome that aim at maintaining and reestablishing a healthy oral ecosystem have been developed.
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Affiliation(s)
- Yangheng Zhang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Xiang Wang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Houxuan Li
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Can Ni
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Zhibin Du
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia.
| | - Fuhua Yan
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
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Joaquim CR, Miranda TS, Marins LM, Silva HDP, Feres M, Figueiredo LC, Duarte PM. The combined and individual impact of diabetes and smoking on key subgingival periodontal pathogens in patients with chronic periodontitis. J Periodontal Res 2017; 53:315-323. [PMID: 29110296 DOI: 10.1111/jre.12516] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Comprehension of the similarities and differences in the composition of the subgingival microbiota of patients with diabetes mellitus (DM), smokers or smokers with DM is an important step in developing therapies specific for these groups at risk for periodontitis. Therefore, the aim of this study was to compare the combined and individual effects of DM and smoking on the levels and prevalence of key subgingival periodontal pathogens in patients with chronic periodontitis. MATERIAL AND METHODS One hundred patients with generalized chronic periodontitis were allocated into one of the following groups: DM (n = 25, non-smokers with type 2 DM); S (n = 25, non-diabetic smokers); SDM (n = 25, smokers with type 2 DM); and control (n = 25, non-diabetic non-smokers). Two subgingival biofilm samples from healthy sites (probing depth and clinical attachment level ≤3 mm and no bleeding) and 2 from diseased sites (probing depth and clinical attachment level ≥5 mm and bleeding on probing) were analyzed by quantitative polymerase chain reaction for Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimonas micra, Fusobacterium nucleatum ssp. and Prevotella intermedia. RESULTS There were no differences among groups in the mean counts of the bacterial species studied, considering all sampled sites (healthy plus diseased sites). There were also no differences among groups regarding the prevalence of any bacteria species in healthy and diseased sites (P > .05). The mean P. micra count was significantly higher in the healthy sites of both smoking groups, than in those of the control group (P < .05). CONCLUSION The subgingival levels and prevalence of the bacterial species studied are not significantly different in subjects with chronic periodontitis presenting DM, smokers or smokers with DM. In addition, DM and smoking, jointly and individually, do not considerably affect the subgingival levels of target periodontal pathogens in patients with chronic periodontitis.
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Affiliation(s)
- C R Joaquim
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - T S Miranda
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - L M Marins
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - H D P Silva
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - M Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - L C Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - P M Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
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Cabral DJ, Wurster JI, Flokas ME, Alevizakos M, Zabat M, Korry BJ, Rowan AD, Sano WH, Andreatos N, Ducharme RB, Chan PA, Mylonakis E, Fuchs BB, Belenky P. The salivary microbiome is consistent between subjects and resistant to impacts of short-term hospitalization. Sci Rep 2017; 7:11040. [PMID: 28887570 PMCID: PMC5591268 DOI: 10.1038/s41598-017-11427-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/24/2017] [Indexed: 01/20/2023] Open
Abstract
In recent years, a growing amount of research has begun to focus on the oral microbiome due to its links with health and systemic disease. The oral microbiome has numerous advantages that make it particularly useful for clinical studies, including non-invasive collection, temporal stability, and lower complexity relative to other niches, such as the gut. Despite recent discoveries made in this area, it is unknown how the oral microbiome responds to short-term hospitalization. Previous studies have demonstrated that the gut microbiome is extremely sensitive to short-term hospitalization and that these changes are associated with significant morbidity and mortality. Here, we present a comprehensive pipeline for reliable bedside collection, sequencing, and analysis of the human salivary microbiome. We also develop a novel oral-specific mock community for pipeline validation. Using our methodology, we analyzed the salivary microbiomes of patients before and during hospitalization or azithromycin treatment to profile impacts on this community. Our findings indicate that azithromycin alters the diversity and taxonomic composition of the salivary microbiome; however, we also found that short-term hospitalization does not impact the richness or structure of this community, suggesting that the oral cavity may be less susceptible to dysbiosis during short-term hospitalization.
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Affiliation(s)
- Damien J Cabral
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, 02912, USA
| | - Jenna I Wurster
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, 02912, USA
| | - Myrto E Flokas
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School and Brown University, Providence, RI, 02903, USA
| | - Michail Alevizakos
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School and Brown University, Providence, RI, 02903, USA
| | - Michelle Zabat
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, 02912, USA
| | - Benjamin J Korry
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, 02912, USA
| | - Aislinn D Rowan
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, 02912, USA
| | - William H Sano
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, 02912, USA
| | - Nikolaos Andreatos
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School and Brown University, Providence, RI, 02903, USA
| | - R Bobby Ducharme
- Department of Medicine, Brown University, Providence, RI, 02903, USA
| | - Philip A Chan
- Department of Medicine, Brown University, Providence, RI, 02903, USA
| | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School and Brown University, Providence, RI, 02903, USA
| | - Beth Burgwyn Fuchs
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School and Brown University, Providence, RI, 02903, USA
| | - Peter Belenky
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, 02912, USA.
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Kapadia J, Dodamani A, Baviskar P, Karibasappa GN, Pathak P, Bezalwar A. Effect of Sugar-Free and Regular Toothpaste on Salivary Glucose and pH among Type 2 Diabetes- A Randomized Crossover Trial. J Clin Diagn Res 2017; 11:ZC71-ZC75. [PMID: 28893048 PMCID: PMC5583924 DOI: 10.7860/jcdr/2017/25580.10250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/03/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diabetes is one of the most prevalent diseases of mankind having general as well as oral health manifestations. Also, there is an increase of salivary glucose level in diabetic, inducing saccharolytic bacteria in saliva which can have adverse effects on oral tissue. AIM To assess and compare the effect of sugar-free toothpaste on salivary glucose and pH among Type 2 diabetic and non-diabetic individuals. MATERIALS AND METHODS A randomized controlled-crossover study was carried out on 30 Type 2 diabetic (Group A) and 45 non-diabetic (Group B) subjects. In first half of study, subjects in Group A and Group B were intervened with sugar-free and regular toothpaste respectively. Salivary glucose and pH was assessed before and after brushing at interval of one week for a period of four weeks. In second half, toothpastes were switched over between the groups, after sufficient washout period. Salivary glucose and pH were assessed again in the same manner for both the groups. The data was subjected to paired t-test and unpaired t-test for intragroup and intergroup comparison respectively. RESULTS Salivary glucose level was significantly reduced and salivary pH was increased significantly (p<0.001) in both groups with sugar free toothpaste when compared to regular toothpaste. CONCLUSION Sugar free toothpaste showed beneficial effect on salivary glucose level and salivary pH level on diabetes and non-diabetes population.
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Affiliation(s)
- Junaid Kapadia
- Assistant Professor, Department of Public Health Dentisry, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Arun Dodamani
- Professor and Head, Department of Public Health Dentisry, ACPM Dental College and Hospital, Dhule, Maharashtra, India
| | - Priya Baviskar
- Assistant Professor, Department of Public Health Dentisry, SMBT Dental College, Ghoti, Maharashtra, India
| | - GN Karibasappa
- Professor, Department of Oral and Maxillofacial Surgery, Sihagad Dental College, Pune, Maharashtra, India
| | - Parag Pathak
- Assistant Professor, Department of Oral Pathology, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Abhishek Bezalwar
- Assistant Professor, Department of Oral and Maxillofacial Surgery, SMBT Dental College, Ghoti, Maharashtra, India
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Yonekura S, Usui M, Murano S. Association between numbers of decayed teeth and HbA1c in Japanese patients with type 2 diabetes mellitus. Ups J Med Sci 2017; 122:108-113. [PMID: 28276781 PMCID: PMC5441370 DOI: 10.1080/03009734.2017.1285838] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/03/2016] [Accepted: 01/19/2017] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Dental caries (DC) are more prevalent in individuals with diabetes than in healthy individuals. However, the association between glycaemic control and DC has not been well characterized in patients with type 2 diabetes mellitus (T2DM). We therefore assessed the association between glycated haemoglobin (HbA1c) serum concentrations and the prevalence of DC in patients with T2DM. METHODS Retrospective analyses of data pertaining to 108 Japanese patients with T2DM hospitalized because of poor or worsened glycaemic control were included. We divided the patients based on HbA1c into two groups: HbA1c level ≥75 mmol/mol (9.0%) as poorly controlled T2DM, and HbA1c level <75 mmol/mol (9.0%) as a control group. We compared the association of lifestyle factors, dental caries, and periodontal health between patients with poorly controlled T2DM and controls. Stepwise multiple regression analyses were performed to evaluate the association between HbA1c, the absolute number of decayed teeth (DT), the sum of decayed, missing, and filled teeth, and the Met Need Index (MNI). RESULTS DT was higher and MNI was lower in patients with poorly controlled T2DM as compared to that in controls (P = 0.006 and P = 0.004, respectively). Multiple regression analyses revealed a significant association between HbA1c levels and DT (adjusted β = 0.039, 95% confidence interval [CI], 0.005 to 0.072, P = 0.025) and the MNI (adjusted β = -0.216, 95% CI -0.374 to -0.058, P = 0.008). CONCLUSIONS DT and MNI were associated with HbA1c in T2DM patients.
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Affiliation(s)
- Satoru Yonekura
- Department of Endocrinology, Tochigi Medical Center, Shimotsuga, Ohira-machi Kawatsure 420-1, Tochigi City, Tochigi, Japan
| | - Masato Usui
- Usui Dental Office, 12-14 Numawada-machi, Tochigi City, Tochigi, Japan
| | - Shunichi Murano
- Department of Endocrinology, Tochigi Medical Center, Shimotsuga, Ohira-machi Kawatsure 420-1, Tochigi City, Tochigi, Japan
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Ganesan SM, Joshi V, Fellows M, Dabdoub SM, Nagaraja HN, O'Donnell B, Deshpande NR, Kumar PS. A tale of two risks: smoking, diabetes and the subgingival microbiome. ISME JOURNAL 2017; 11:2075-2089. [PMID: 28534880 PMCID: PMC5563960 DOI: 10.1038/ismej.2017.73] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/06/2017] [Accepted: 03/22/2017] [Indexed: 01/08/2023]
Abstract
Although smoking and diabetes have been established as the only two risk factors for periodontitis, their individual and synergistic impacts on the periodontal microbiome are not well studied. The present investigation analyzed 2.7 million 16S sequences from 175 non-smoking normoglycemic individuals (controls), smokers, diabetics and diabetic smokers with periodontitis as well as periodontally healthy controls, smokers and diabetics to assess subgingival bacterial biodiversity and co-occurrence patterns. The microbial signatures of periodontally healthy smokers, but not diabetics, were highly aligned with the disease-associated microbiomes of their respective cohorts. Diabetics were dominated by species belonging to Fusobacterium, Parvimonas, Peptostreptococcus, Gemella, Streptococcus, Leptotrichia, Filifactor, Veillonella, TM7 and Terrahemophilus. These microbiomes exhibited significant clustering based on HbA1c levels (pre-diabetic (<6.5%), diabetic (6.5–9.9%), diabetics >10%). Smokers with periodontitis evidenced a robust core microbiome (species identified in at least 80% of individuals) dominated by anaerobes, with inter-individual differences attributable largely to the ‘rare biosphere’. Diabetics and diabetic smokers, on the other hand, were microbially heterogeneous and enriched for facultative species. In smokers, microbial co-occurrence networks were sparse and predominantly congeneric, while robust inter-generic networks were observed in diabetics and diabetic smokers. Smoking and hyperglycemia impact the subgingival microbiome in distinct ways, and when these perturbations intersect, their synergistic effect is greater than what would be expected from the sum of each effect separately. Thus, this study underscores the importance of early intervention strategies in maintaining health-compatible microbiomes in high-risk individuals, as well as the need to personalize these interventions based on the environmental perturbation.
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Affiliation(s)
- Sukirth M Ganesan
- Division of Periodontology, College of Dentistry, The Ohio State University, Coloumbus, OH, USA
| | - Vinayak Joshi
- Maratha Mandal's NathajiRao G. Halgekar Institute of Dental Sciences and Research Center, Rajiv Gandhi University, Belgaum, India
| | - Megan Fellows
- Division of Periodontology, College of Dentistry, The Ohio State University, Coloumbus, OH, USA
| | - Shareef M Dabdoub
- Division of Periodontology, College of Dentistry, The Ohio State University, Coloumbus, OH, USA
| | | | - Benjamin O'Donnell
- Division of Endocrinology, Diabetes and Metabolism, The Wexner Medical Center, The Ohio State University, Coloumbus, OH, USA
| | - Neeta Rohit Deshpande
- Department of General Medicine, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences &Research Centre, Rajiv Gandhi University, Belgaum, India
| | - Purnima S Kumar
- Division of Periodontology, College of Dentistry, The Ohio State University, Coloumbus, OH, USA
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Nitta H, Katagiri S, Nagasawa T, Izumi Y, Ishikawa I, Izumiyama H, Uchimura I, Kanazawa M, Chiba H, Matsuo A, Utsunomiya K, Tanabe H, Takei I, Asanami S, Kajio H, Ono T, Hayashi Y, Ueki K, Tsuji M, Kurachi Y, Yamanouchi T, Ichinokawa Y, Inokuchi T, Fukui A, Miyazaki S, Miyauchi T, Kawahara R, Ogiuchi H, Yoshioka N, Negishi J, Mori M, Mogi K, Saito Y, Tanzawa H, Nishikawa T, Takada N, Nanjo K, Morita N, Nakamura N, Kanamura N, Makino H, Nishimura F, Kobayashi K, Higuchi Y, Sakata T, Yanagisawa S, Tei C, Ando Y, Hanada N, Inoue S. The number of microvascular complications is associated with an increased risk for severity of periodontitis in type 2 diabetes patients: Results of a multicenter hospital-based cross-sectional study. J Diabetes Investig 2017; 8:677-686. [PMID: 28129466 PMCID: PMC5583958 DOI: 10.1111/jdi.12633] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 11/25/2016] [Accepted: 01/18/2017] [Indexed: 01/06/2023] Open
Abstract
Aims/Introduction To explore the relationships between periodontitis and microvascular complications as well as glycemic control in type 2 diabetes patients. Materials and Methods This multicenter, hospital‐based, cross‐sectional study included 620 patients with type 2 diabetes. We compared the prevalence and severity of periodontitis between patients with ≥1 microvascular complication and those without microvascular complications. We also compared the prevalence and severity of periodontitis among patients with different degrees of glycemic control. Results After adjusting for confounding factors, multiple logistic regression analysis showed that the severity of periodontitis was significantly associated with the number of microvascular complications (odds ratio 1.3, 95% confidence interval 1.1–1.6), glycated hemoglobin ≥8.0% (64 mmol/mol; odds ratio 1.6; 95% confidence interval 1.1–2.3), and older age (≥50 years; odds ratio 1.7; 95% confidence interval 1.1–2.6). However, the prevalence of periodontitis was not significantly associated with the number of microvascular complications, but was associated with male sex, high glycated hemoglobin (≥8.0% [64 mmol/mol]), older age (≥40 years), longer duration of diabetes (≥15 years) and fewer teeth (≤25). Furthermore, propensity score matching for age, sex, diabetes duration and glycated hemoglobin showed that the incidence of severe periodontitis was significantly higher among patients with microvascular complications than among those without microvascular complications (P < 0.05). Conclusions The number of microvascular complications is a risk factor for more severe periodontitis in patients with type 2 diabetes, whereas poor glycemic control is a risk factor for increased prevalence and severity of periodontitis.
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Affiliation(s)
- Hiroshi Nitta
- Medical and Dental Hospitals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sayaka Katagiri
- Medical and Dental Hospitals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshiyuki Nagasawa
- Medical and Dental Hospitals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Izumi
- Kagoshima University Medical and Dental Hospital, Kagoshima, Japan
| | - Isao Ishikawa
- Medical and Dental Hospitals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Izumiyama
- Medical and Dental Hospitals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Isao Uchimura
- Medical and Dental Hospitals, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | | | | | | | | | | | - Hiroshi Kajio
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Toaki Ono
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Kiichi Ueki
- Nihon University Itabashi Hospital, Tokyo, Japan
| | | | | | | | | | | | - Akiko Fukui
- Toho University Omori Hospital, Tokyo, Japan
| | | | | | | | | | | | - Jun Negishi
- Hokkaido University Hospital, Sapporo, Japan
| | | | - Kenji Mogi
- Gunma University Hospital, Maebashi, Japan
| | | | | | | | | | - Kishio Nanjo
- Wakayama Medical University Hospital, Wakayama, Japan
| | - Nobuo Morita
- Wakayama Medical University Hospital, Wakayama, Japan
| | - Naoto Nakamura
- University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Narisato Kanamura
- University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hirofumi Makino
- University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | - Yoshinori Higuchi
- National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan
| | | | | | - Chuwa Tei
- Kagoshima University Medical and Dental Hospital, Kagoshima, Japan
| | - Yuichi Ando
- Department of Oral Science, National Institute of Infectious Diseases, Japan
| | - Nobuhiro Hanada
- Department of Oral Science, National Institute of Infectious Diseases, Japan
| | - Shuji Inoue
- Department of Nutrition and Physiology, Faculty of Home Economics, Kyoritsu Women's University, Tokyo, Japan
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Goodson JM, Hartman ML, Shi P, Hasturk H, Yaskell T, Vargas J, Song X, Cugini M, Barake R, Alsmadi O, Al-Mutawa S, Ariga J, Soparkar P, Behbehani J, Behbehani K. The salivary microbiome is altered in the presence of a high salivary glucose concentration. PLoS One 2017; 12:e0170437. [PMID: 28249034 PMCID: PMC5331956 DOI: 10.1371/journal.pone.0170437] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/04/2017] [Indexed: 01/30/2023] Open
Abstract
Background Type II diabetes (T2D) has been associated with changes in oral bacterial diversity and frequency. It is not known whether these changes are part of the etiology of T2D, or one of its effects. Methods We measured the glucose concentration, bacterial counts, and relative frequencies of 42 bacterial species in whole saliva samples from 8,173 Kuwaiti adolescents (mean age 10.00 ± 0.67 years) using DNA probe analysis. In addition, clinical data related to obesity, dental caries, and gingivitis were collected. Data were compared between adolescents with high salivary glucose (HSG; glucose concentration ≥ 1.0 mg/d, n = 175) and those with low salivary glucose (LSG, glucose concentration < 0.1 mg/dL n = 2,537). Results HSG was associated with dental caries and gingivitis in the study population. The overall salivary bacterial load in saliva decreased with increasing salivary glucose concentration. Under HSG conditions, the bacterial count for 35 (83%) of 42 species was significantly reduced, and relative bacterial frequencies in 27 species (64%) were altered, as compared with LSG conditions. These alterations were stronger predictors of high salivary glucose than measures of oral disease, obesity, sleep or fitness. Conclusions HSG was associated with a reduction in overall bacterial load and alterations to many relative bacterial frequencies in saliva when compared with LSG in samples from adolescents. We propose that hyperglycemia due to obesity and/or T2D results in HSG and subsequent acidification of the oral environment, leading to a generalized perturbation in the oral microbiome. This suggests a basis for the observation that hyperglycemia is associated with an increased risk of dental erosion, dental caries, and gingivitis. We conclude that HSG in adolescents may be predicted from salivary microbial diversity or frequency, and that the changes in the oral microbial composition seen in adolescents with developing metabolic disease may the consequence of hyperglycemia.
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Affiliation(s)
- J. Max Goodson
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Mor-Li Hartman
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Ping Shi
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Hatice Hasturk
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Tina Yaskell
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Jorel Vargas
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Xiaoqing Song
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Maryann Cugini
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Roula Barake
- The Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | | | | | - Pramod Soparkar
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Jawad Behbehani
- Kuwait University, Faculty of Dentistry, Kuwait City, Kuwait
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Krishnan M, Krishnan P, Chandrasekaran SC. Detection of Porphyromonas gingivalis fimA Type I Genotype in Gingivitis by Real-Time PCR-A Pilot Study. J Clin Diagn Res 2016; 10:ZC32-5. [PMID: 27504406 DOI: 10.7860/jcdr/2016/17938.7979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/23/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Published literature till date reveals a high prevalence of Porphyromonas gingivalis fimA type I genotype among healthy subjects. Quite a few studies have reported its prevalence also in periodontitis patients. Nevertheless incidence of this genotype in gingivitis is lacking in adult population. AIM The present study was chosen to detect P. gingivalis fimA type I genotype among chronic gingivitis patients. MATERIALS AND METHODS A total of 46 subgingival plaque samples collected from chronic marginal gingivitis (n=23) and chronic periodontitis subjects (control group) (n=23) were subjected to Real-Time Polymerase Chain Reaction to detect the P. gingivalis fimA type I gene. Statistical analysis was performed using chi-square test. RESULTS Prevalence of P. gingivalis fimA type I gene among chronic periodontitis and chronic gingivitis patients were 8.7% and 30.4% respectively. P. gingivalis fimA type I genotype prevalence was found to be statistically insignificant between the two study groups (p=0.135). CONCLUSION The avirulent P. gingivalis fimA type I genotype, occurred in high prevalence among chronic gingivitis patients, while its presence was low in chronic periodontitis patients. Presence of this avirulent genotype in chronic marginal gingivitis signifies its reversible condition.
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Affiliation(s)
- Mahalakshmi Krishnan
- Professor and Head, Department of Microbiology/Director, Research Lab for Oral-Systemic Health, Sree Balaji Dental College and Hospital, BIHER , Velachery - Tambaram Road, Chennai, India
| | - Padma Krishnan
- Assistant Professor, Department of Microbiology, Dr. ALM PGIBMS, University of Madras , Chennai, India
| | - S C Chandrasekaran
- Professor and Head, Department of Periodontics and Implantology, Sree Balaji Dental College and Hospital, BIHER , Velachery - Tambaram Road, Chennai, India
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Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 2016; 40 Suppl 14:S113-34. [PMID: 23627323 DOI: 10.1111/jcpe.12059] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/16/2022]
Abstract
AIMS To review the evidence for the molecular and cellular processes that may potentially link periodontal disease and diabetes. The pathogenic roles of cytokines and metabolic molecules (e.g. glucose, lipids) are explored and the role of periodontal bacteria is also addressed. Paradigms for bidirectional relationships between periodontitis and diabetes are discussed and opportunities for elaborating these models are considered. METHODS Database searches were performed using MeSH terms, keywords, and title words. Studies were evaluated and summarized in a narrative review. RESULTS Periodontal microbiota appears unaltered by diabetes and there is little evidence that it may influence glycaemic control. Small-scale clinical studies and experiments in animal models suggest that IL-1β, TNF-α, IL-6, OPG and RANKL may mediate periodontitis in diabetes. The AGE-RAGE axis is likely an important pathway of tissue destruction and impaired repair in diabetes-associated periodontitis. A role for locally activated pro-inflammatory factors in the periodontium, which subsequently impact on diabetes, remains speculative. CONCLUSION There is substantial information on potential mechanistic pathways which support a close association between diabetes and periodontitis, but there is a real need for longitudinal clinical studies using larger patient groups, integrated with studies of animal models and cells/tissues in vitro.
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Affiliation(s)
- John J Taylor
- Centre for Oral Health Research and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
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Miklossy J, McGeer PL. Common mechanisms involved in Alzheimer's disease and type 2 diabetes: a key role of chronic bacterial infection and inflammation. Aging (Albany NY) 2016; 8:575-88. [PMID: 26961231 PMCID: PMC4925815 DOI: 10.18632/aging.100921] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 02/20/2016] [Indexed: 12/30/2022]
Abstract
Strong epidemiologic evidence and common molecular mechanisms support an association between Alzheimer's disease (AD) and type 2-diabetes. Local inflammation and amyloidosis occur in both diseases and are associated with periodontitis and various infectious agents. This article reviews the evidence for the presence of local inflammation and bacteria in type 2 diabetes and discusses host pathogen interactions in chronic inflammatory disorders. Chlamydophyla pneumoniae, Helicobacter pylori and spirochetes are demonstrated in association with dementia and brain lesions in AD and islet lesions in type 2 diabetes. The presence of pathogens in host tissues activates immune responses through Toll-like receptor signaling pathways. Evasion of pathogens from complement-mediated attack results in persistent infection, inflammation and amyloidosis. Amyloid beta and the pancreatic amyloid called amylin bind to lipid bilayers and produce Ca(2+) influx and bacteriolysis. Similarly to AD, accumulation of amylin deposits in type 2 diabetes may result from an innate immune response to chronic bacterial infections, which are known to be associated with amyloidosis. Further research based on an infectious origin of both AD and type 2 diabetes may lead to novel treatment strategies.
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Affiliation(s)
- Judith Miklossy
- International Alzheimer Research Centre, Prevention Alzheimer International Foundation, Martigny-Croix, Switzerland
| | - Patrick L. McGeer
- Kinsmen Laboratory of Neurological Research, The University of British Columbia, Vancouver, B.C, Canada
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De-la-Torre J, Marichalar-Mendia X, Varona-Barquin A, Marcos-Arias C, Eraso E, Aguirre-Urizar JM, Quindós G. Caries andCandidacolonisation in adult patients in Basque Country (Spain). Mycoses 2016; 59:234-240. [DOI: 10.1111/myc.12453] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 11/20/2015] [Accepted: 12/03/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Janire De-la-Torre
- Departamento de Inmunología; Microbiología y Parasitología; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
- Departamento de Estomatología II; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
| | - Xabier Marichalar-Mendia
- Departamento de Estomatología II; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
| | - Aketza Varona-Barquin
- Departamento de Inmunología; Microbiología y Parasitología; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
| | - Cristina Marcos-Arias
- Departamento de Inmunología; Microbiología y Parasitología; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
| | - Elena Eraso
- Departamento de Inmunología; Microbiología y Parasitología; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
| | - José Manuel Aguirre-Urizar
- Departamento de Estomatología II; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
| | - Guillermo Quindós
- Departamento de Inmunología; Microbiología y Parasitología; Unidad de Formación e Investigación multidisciplinar «Microbios y Salud» (UFI 11/25); Facultad de Medicina y Odontología; Universidad del País Vasco/Euskal Herriko Unibertsitatea; Bilbao Spain
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