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Gaggi G, Di Credico A, D'Addazio G, Ghinassi B, Argentieri G, Caputi S, Di Baldassarre A, Sinjari B. Impact on peri-implant connective tissue of laser treated versus traditional healing abutments: a human clinical trials. BMC Oral Health 2023; 23:425. [PMID: 37370064 DOI: 10.1186/s12903-023-03148-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Dental implant is the principal treatment for edentulism and the healthiness of the peri-implant tissue has a pivotal role for its longterm success. In addition, it has been shown that also the topography of the healing abutment can influence the outcome of the restoration. The objective of this human clinical trial was to assess the impact of a novel laser-treated healing abutment on peri-implant connective tissue and extracellular matrix proteins compared to the conventional machined surface, which served as the control group. METHODS During second surgical stage a customized healing abutment were inserted on 30 single dental implants. Healing abutments were realized with two alternated different surface (two side laser-treated surfaces and two side machined surfaces) in order to be considered both as test and control on the same implant and reduce positioning bias. Following the soft tissue healing period (30 ± 7 days) a 5 mm circular biopsy was retrieved. Immuno-histochemical and quantitative real-time PCR (qPCR) analyses were performed on Collagen, Tenascin C, Fibrillin I, Metalloproteinases (MMPs) and their inhibitor (TIMPs). 15 were processed for qPCR, while the other 15 were processed for immunohistochemical analysis. Paired t-test between the two groups were performed. A value of p < 0.05 was considered statistically significant. RESULTS Results revealed that the connective tissue facing the laser-treated surface expressed statistically significant lower amount of MMPs (p < 0.05) and higher level of TIMPs 3 (p < 0.05), compared to the tissue surrounding the machined implant, which, in turn expressed also altered level of extracellular matrix protein (Tenascin C, Fibrillin I (p < 0.05)) and Collagen V, that are known to be altered also in peri-implantitis. CONCLUSIONS In conclusion, the laser-treated surface holds promise in positively influencing wound healing of peri-implant connective tissue. Results demonstrated that topographic nature of the healing abutments can positively influence mucosal wound healing and molecular expression. Previous studies have been demonstrated how laser treatment can rightly influence integrity and functionality of the gingiva epithelium and cell adhesion. Regarding connective tissue different molecular expression demonstrated a different inflammatory pattern between laser treated or machined surfaces where laser treated showed better response. Targeted interventions and preventive measures on peri- implant topography could effectively minimize the risk of peri-implant diseases contributing to the long-term success and durability of restoration. However, new studies are mandatory to better understand this phenomenon and the role of this surface in the peri-implantitis process. TRIAL REGISTRATION: This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970 ). Registered 06/03/2023, retrospectively registered.
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Affiliation(s)
- Giulia Gaggi
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Andrea Di Credico
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Gianmaria D'Addazio
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Barbara Ghinassi
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Giulio Argentieri
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Sergio Caputi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Angela Di Baldassarre
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy.
| | - Bruna Sinjari
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
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Woelber JP, Reichenbächer K, Groß T, Vach K, Ratka-Krüger P, Bartha V. Dietary and Nutraceutical Interventions as an Adjunct to Non-Surgical Periodontal Therapy-A Systematic Review. Nutrients 2023; 15:nu15061538. [PMID: 36986267 PMCID: PMC10052653 DOI: 10.3390/nu15061538] [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: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
The aim of this study was to conduct a systematic literature review on the influence of dietary and nutraceutical interventions as an adjunct to non-surgical periodontal therapy (NSPT). A literature search for randomized, controlled clinical trials (RCTs) was performed in PubMed, the Cochrane Library, and the Web of Science. Trial inclusion criteria included the application of a defined nutritional intervention (food, beverages, or supplements) adjunctive to NSPT compared to NSPT alone with at least one measured periodontal parameter (pocket probing depths (PPD) or clinical attachment level (CAL)). Of 462 search results, 20 clinical trials relating to periodontitis and nutritional interventions were identified, of which, in total, 14 studies could be included. Eleven studies examined supplements containing lycopene, folate, chicory extract, juice powder, micronutrients and plant extracts, omega-3 fatty acids, vitamin E, or vitamin D. Three studies examined food-based interventions (kiwifruit, green or oolong tea). Due to limited information on within-group differences in the studies, results were descriptively analyzed. A significant positive effect on periodontal parameters (PPD, bleeding on probing) was found for vitamin E, chicory extract, juice powder, green tea, and oolong tea. Heterogeneous effects were found for lycopene, folate, omega-3 fatty acids, and vitamin D. No effects on PPD were found for adjunct kiwifruit (in combination with NSPT). Risk of bias via RoB2 revealed a low risk of bias with some concerns. There was a high heterogeneity in the type of nutritional interventions. The adjunctive use of various supplements and green/oolong tea led to positive and significant effects of the nutritional interventions on clinical periodontal outcome parameters. In the context of non-surgical periodontal therapy, an adjunctive intake of micronutrients, omega-3 fatty acids, green/oolong tea, and polyphenols and flavonoids could be beneficial. Long-term clinical studies with full data reports (especially within-group differences) are needed for conducting a meta-analysis.
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Affiliation(s)
- Johan Peter Woelber
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Katharina Reichenbächer
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Tara Groß
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Zinkmattenstr. 6A, 79108 Freiburg, Germany
| | - Petra Ratka-Krüger
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Valentin Bartha
- Department for Conservative Dentistry, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Kurushima Y, Wells P, Bowyer R, Zoheir N, Doran S, Richardson J, Sprockett D, Relman D, Steves C, Nibali L. Host Genotype Links to Salivary and Gut Microbiota by Periodontal Status. J Dent Res 2023; 102:146-156. [PMID: 36214094 PMCID: PMC9986680 DOI: 10.1177/00220345221125402] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Limited evidence describing how host genetic variants affect the composition of the microbiota is currently available. The aim of this study was to assess the associations between a set of candidate host genetic variants and microbial composition in both saliva and gut in the TwinsUK registry. A total of 1,746 participants were included in this study and provided stool samples. A subset of 1,018 participants also provided self-reported periodontal data, and 396 of those participants provided a saliva sample. Host DNA was extracted from whole-blood samples and processed for Infinium Global screening array, focusing on 37 selected single-nucleotide polymorphisms (SNPs) previously associated with periodontitis. The gut and salivary microbiota of participants were profiled using 16S ribosomal RNA amplicon sequencing. Associations between genotype on the selected SNPs and microbial outcomes, including α diversity, β diversity, and amplicon sequence variants (ASVs), were investigated in a multivariate mixed model. Self-reported periodontal status was also compared with microbial outcomes. Downstream analyses in gut microbiota and salivary microbiota were carried out separately. IL10 rs6667202 and VDR 2228570 SNPs were associated with salivary α diversity, and SNPs in IL10, HSA21, UHRF2, and Fc-γR genes were associated with dissimilarity matrix generated from salivary β diversity. The SNP that was associated with the greatest number of salivary ASVs was VDR 2228570 followed by IL10 rs6667202, and that of gut ASVs was NPY rs2521364. There were 77 salivary ASVs and 39 gut ASVs differentially abundant in self-reported periodontal disease versus periodontal health. The dissimilarity between saliva and gut microbiota within individuals appeared significantly greater in self-reported periodontal cases compared to periodontal health. IL10 and VDR gene variants may affect salivary microbiota composition. Periodontal status may drive variations in the salivary microbiota and possibly, to a lesser extent, in the gut microbiota.
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Affiliation(s)
- Y. Kurushima
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
| | - P.M. Wells
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
| | - R.C.E. Bowyer
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
| | - N. Zoheir
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - S. Doran
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - J.P. Richardson
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - D.D. Sprockett
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
| | - D.A. Relman
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - C.J. Steves
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King’s College London, London, UK
| | - L. Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
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Santamaria P, Bowyer RC, Nibali L. Associations between host genetic variants and Herpes Simplex Labialis in the TwinsUK cohort. Arch Oral Biol 2022; 145:105587. [DOI: 10.1016/j.archoralbio.2022.105587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
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Davidovich NV, Galieva AS, Opravin AS, Gagarina TY, Malygina OG, Leikhter SN, Bashilova EN, Bazhukova TA. Correlation of marker periodontopathogenic bacteria with the immune component sCD 14 secretion level in inflammatory periodontal diseases. Klin Lab Diagn 2022; 67:471-475. [PMID: 36095084 DOI: 10.51620/0869-2084-2022-67-8-471-475] [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] [Indexed: 06/15/2023]
Abstract
Lipopolysaccharide of the cell wall of gram-negative bacteria is a highly active biological substance: its interaction with toll-like receptors-4 (TLR-4) of myeloid cells leads to the activation of a cascade of inflammatory reactions, which is accompanied by the release of the soluble CD14 receptor (sCD14), which can be considered not only as a marker of cell activation by endotoxin, but also as a marker of microbial translocation. The aim of the work was to assess the prognostic significance of the sCD14 level in the samples of the periodontal pocket in inflammatory periodontal diseases and the relationship of its secretion with marker periodontopathogens. For the study, washes were obtained from the periodontal pocket (88 samples in total) from patients with chronic periodontitis and intact periodontium. The sCD14 content was determined by ELISA; during real-time PCR, the marker periodontopathogens Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, and Candida albicans were isolated. The study revealed differences in the level of sCD14 secretion by groups: in chronic periodontitis, its content was 8,5 times higher than in the control group and amounted to 17,2±4,06 ng/ml (p=0,006). The frequency of detecting genes of periodontal pathogenic bacteria was 89,3% in patients with periodontitis and 31,25% in the group with intact periodontium. An interesting dependence of the detection of periodontal pathogenic bacteria in the group of patients with chronic periodontitis was established depending on the content of sCD14. Thus, at high concentrations of soluble coreceptor, a greater number of periodontopathogenic bacteria of the I and II orders were released. Thus, in inflammatory periodontal diseases, the processes of sCD14 synthesis change, which is probably due to the colonization of periodontal pathogenic bacteria and the action of their toxins and aggression factors. The relationship of marker periodontopathogens with the level of secretion of the immune component sCD14 and its effect on the structure of the periodontal index reflect shifts in the processes of reparative regeneration of the oral mucosa and the regulation of local immunity in response to microbial invasion.
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Affiliation(s)
| | - A S Galieva
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - A S Opravin
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - T Yu Gagarina
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - O G Malygina
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - S N Leikhter
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - E N Bashilova
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
| | - T A Bazhukova
- FSBEI HE Northern State Medical University (Arkhangelsk) of the Ministry of Health of the Russian Federation
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6
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Periodontal infectogenomics: a systematic review update of associations between host genetic variants and subgingival microbial detection. Clin Oral Investig 2022; 26:2209-2221. [PMID: 35122548 PMCID: PMC8898234 DOI: 10.1007/s00784-021-04233-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 10/16/2021] [Indexed: 12/20/2022]
Abstract
Objective The aim of this study was to systematically update the evidence for associations between host genetic variants and subgingival microbial detection and counts. Materials and methods Following a previous systematic review (Nibali et al. J Clin Periodontol 43(11): 889-900, 15), an update of a systematic search of the literature was conducted in Ovid Medline, Embase, LILACS, and Cochrane Library for studies reporting data on host genetic variants and detection of microbes subgingivally published in the last 6 years. Results A total of 19 studies were included in the review, from an initial search of 2797 titles. Studies consisted mainly of candidate gene studies and of one genome-wide analysis. A total of 62 studies were considered for summary findings, including 43 identified in the previous systematic review of studies published up to 2015. Meta-analyses were done when appropriate including both papers in the original review and in the update. Meta-analyses revealed lack of associations between IL1 composite genotype and subgingival detection of Aggregatibacter acinomycetemcomitans, Poprhyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia. Promising evidence is emerging from other genetic variants and from sub-analyses of data from genome-association studies. Among other studies with candidate-gene, target SNPs were mainly within the IL10, IL6, IL4, IL8, IL17A, and VDR gene. Conclusions IL1 composite genotype does not seem to be associated with subgingival microbial detection. Promising associations should be pursued by future studies, including studies employing -OMICS technologies. Clinical relevance A better knowledge of which host genetic variant predispose to subgingival microbial colonization and to the development of progression of periodontal disease could potentially help to better understand periodontal disease pathogenesis and help with its management. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04233-8.
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Montevecchi M, Valeriani L, Gatto MR, D'Alessandro G, Piana G. Subgingival pathogens in chronic periodontitis patients affected by type 2 diabetes mellitus: a retrospective case-control study. J Periodontal Implant Sci 2021; 51:409-421. [PMID: 34965620 PMCID: PMC8718332 DOI: 10.5051/jpis.2100180009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/20/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this study was to compare the prevalence and bacterial load of 6 main periodontal pathogens between pairs of periodontal patients with and without type 2 diabetes mellitus. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans genotypes were also investigated. Methods Twenty patients affected by chronic periodontitis and type 2 diabetes were retrospectively selected and matched to 20 patients without diabetes on the basis of the degree and severity of periodontal disease. Microbiological data of subgingival biofilms were analysed and compared for the examined pathogens: A. actinomycetemcomitans, P. gingivalis, Prevotella intermedia, Treponema denticola, Fusobacterium nucleatum, and Tannerella forsythia. Results The pairs were balanced in terms of demographic and clinical parameters, except for bleeding on probing and suppuration. In the microbiological test sites (4 for each patient), the mean probing pocket depth was 6.34±1.63 mm in patients with diabetes and 6.41±1.78 mm in patients without diabetes. No significant difference between pairs in the prevalence of P. gingivalis or the distribution of its genotypes was recorded. Patients with diabetes had a significantly greater amount of total bacterial load, P. gingivalis, T. denticola, T. forsythia, and F. nucleatum (P<0.05). Moreover, patients with diabetes had a higher number of sites with a greater cell count than patients without diabetes. When compared to the total bacterial load, only T. forsythia maintained its relative load in patients with diabetes (P=0.001). Conclusions This retrospective matched study supports the hypothesis that microbiological differences exist among periodontal patients with and without diabetes mellitus. Trial Registration ClinicalTrials.gov Identifier: NCT03786133
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Affiliation(s)
- Marco Montevecchi
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
| | - Leoluca Valeriani
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Maria Rosaria Gatto
- Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Giovanni D'Alessandro
- Dentistry Service for Patients with Special Needs, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Gabriela Piana
- Dentistry Service for Patients with Special Needs, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
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Nibali L, Sousa V, Davrandi M, Liu LS, Spratt D, Donos N. Patterns of subgingival microbiota in different periodontal phenotypes. J Dent 2021; 117:103912. [PMID: 34890714 DOI: 10.1016/j.jdent.2021.103912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To compare the subgingival microbiota of patients with aggressive (AgP) or chronic periodontitis (CP) to healthy (H), non-periodontitis patients as well as to explore their relevant associations to different host genetic variants. METHODS Following clinical examination, blood and subgingival plaque sampling of 471 study participants (125 AgP, 121 CP, 225 H), subgingival community analysis was performed by next generation sequencing of the 16S rRNA. Microbial data from 266 participants (75 AgP, 95 CP, 98 H) were available for analysis. SNPs in the IL6, IL6R and FTO gene were selected for genetic marker analyses. RESULTS Combined periodontitis patients (AgP + CP), particularly those classified with AgP, exhibited lower alpha- and beta- diversity. Several genera (including Peptostreptococcaceae, Filifactor, Desulfobulbus, Tannerella and Lachnospiracee) and species were over-abundant in combined periodontitis vs. healthy individuals, while other genera such as Prevotella or Dialister were found to be more abundant in healthy cases. The only genus with difference in abundance between AgP and CP was Granulicatella. No associations between IL6, IL6RA and FTO genetic variants and microbial findings were detected. CONCLUSION This study suggests that limited microbial differences existed between AgP and CP and challenges the current notion that periodontitis is associated with increased subgingival microbial diversity compared with periodontal health. CLINICAL SIGNIFICANCE The findings of this study cast some doubts on the notion that the dysbiosis characteristic of periodontal disease is expressed as increased microbial diversity.
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Affiliation(s)
- L Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Centre for Oral, London, United Kingdom; Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom.
| | - V Sousa
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Centre for Oral, London, United Kingdom; Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom
| | - M Davrandi
- Microbiology Department, University College London Eastman Dental Institute, London, UK
| | - L S Liu
- Periodontology Unit, University College London Eastman Dental Institute, London, UK
| | - D Spratt
- Microbiology Department, University College London Eastman Dental Institute, London, UK
| | - N Donos
- Centre for Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, United Kingdom
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Cugini C, Ramasubbu N, Tsiagbe VK, Fine DH. Dysbiosis From a Microbial and Host Perspective Relative to Oral Health and Disease. Front Microbiol 2021; 12:617485. [PMID: 33763040 PMCID: PMC7982844 DOI: 10.3389/fmicb.2021.617485] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
The significance of microbiology and immunology with regard to caries and periodontal disease gained substantial clinical or research consideration in the mid 1960's. This enhanced emphasis related to several simple but elegant experiments illustrating the relevance of bacteria to oral infections. Since that point, the understanding of oral diseases has become increasingly sophisticated and many of the original hypotheses related to disease causality have either been abandoned or amplified. The COVID pandemic has reminded us of the importance of history relative to infectious diseases and in the words of Churchill "those who fail to learn from history are condemned to repeat it." This review is designed to present an overview of broad general directions of research over the last 60 years in oral microbiology and immunology, reviewing significant contributions, indicating emerging foci of interest, and proposing future directions based on technical advances and new understandings. Our goal is to review this rich history (standard microbiology and immunology) and point to potential directions in the future (omics) that can lead to a better understanding of disease. Over the years, research scientists have moved from a position of downplaying the role of bacteria in oral disease to one implicating bacteria as true pathogens that cause disease. More recently it has been proposed that bacteria form the ecological first line of defense against "foreign" invaders and also serve to train the immune system as an acquired host defensive stimulus. While early immunological research was focused on immunological exposure as a modulator of disease, the "hygiene hypothesis," and now the "old friends hypothesis" suggest that the immune response could be trained by bacteria for long-term health. Advanced "omics" technologies are currently being used to address changes that occur in the host and the microbiome in oral disease. The "omics" methodologies have shaped the detection of quantifiable biomarkers to define human physiology and pathologies. In summary, this review will emphasize the role that commensals and pathobionts play in their interaction with the immune status of the host, with a prediction that current "omic" technologies will allow researchers to better understand disease in the future.
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Affiliation(s)
- Carla Cugini
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ, United States
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Pani P, Tsilioni I, McGlennen R, Brown CA, Hawley CE, Theoharides TC, Papathanasiou E. IL-1B(3954) polymorphism and red complex bacteria increase IL-1β (GCF) levels in periodontitis. J Periodontal Res 2021; 56:501-511. [PMID: 33638191 DOI: 10.1111/jre.12850] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/17/2020] [Accepted: 12/30/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to compare IL-1β levels in gingival crevicular fluid (GCF) from healthy and periodontitis sites of IL-1B(3954)-Single Nucleotide Polymorphism (SNP) positive and IL-1B(3954)-SNP negative periodontitis subjects in association with their bacterial profiles. BACKGROUND Susceptibility to periodontitis has been associated with several risk factors, including allelic variants at multiple gene loci. Variations in the IL-1 gene cluster have been linked with increased risk for periodontitis. IL-1B(3954)-SNP has been previously associated with increased levels of IL-1β in GCF or periodontal tissues in chronic periodontitis patients, as well as higher levels of specific periodontal pathogens. There is insufficient evidence to conclude if IL-1B gene polymorphisms affect the susceptibility to periodontitis by ultimately modulating the levels of IL-1β in GCF, the subgingival microbial profile or both. MATERIALS AND METHODS GCF, subgingival plaque, and buccal epithelial cells were collected from 32 individuals with periodontitis. GCF IL-1β levels were measured by an enzyme-linked immunosorbent assay (ELISA). Bacterial plaque samples were analyzed for 11 periodontal pathogens using polymerase chain reaction (PCR) analysis with specific primers for the 16SrRNA gene of each bacterium. IL-1B(3954)-SNP status was determined by identifying the carriers of the polymorphic T allele. RESULTS A significant association was shown between IL-1B(3954)-SNP and IL-1β GCF levels (amount and concentration). The concomitant presence of two or three red complex bacterial species was associated with increased IL-1β GCF levels in periodontitis sites (site-level analysis). The concurrent presence of all three red complex periodontal pathogens and IL-1B(3954)-SNP was associated with the highest IL-1β GCF levels in periodontitis sites. CONCLUSIONS Our results indicate an independent association of both IL-1B(3954)-SNP and red complex bacterial species with increased IL-1β levels in GCF of periodontitis sites. A better understanding of the interaction between genetics, bacteria, and inflammation is essential to develop more effective diagnostic, prognostic, and therapeutic tools for periodontitis.
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Affiliation(s)
- Pinelopi Pani
- Department of General Dentistry/Periodontology, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Irene Tsilioni
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Immunology, Tufts University School of Medicine, Boston, MA, USA
| | | | | | - Charles E Hawley
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Theoharis C Theoharides
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Immunology, Tufts University School of Medicine, Boston, MA, USA
| | - Evangelos Papathanasiou
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA.,Center for Clinical and Translational Research, Forsyth Institute, Cambridge, MA, USA
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11
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Teles F, Wang Y, Hajishengallis G, Hasturk H, Marchesan JT. Impact of systemic factors in shaping the periodontal microbiome. Periodontol 2000 2020; 85:126-160. [PMID: 33226693 DOI: 10.1111/prd.12356] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Since 2010, next-generation sequencing platforms have laid the foundation to an exciting phase of discovery in oral microbiology as it relates to oral and systemic health and disease. Next-generation sequencing has allowed large-scale oral microbial surveys, based on informative marker genes, such as 16S ribosomal RNA, community gene inventories (metagenomics), and functional analyses (metatranscriptomics), to be undertaken. More specifically, the availability of next-generation sequencing has also paved the way for studying, in greater depth and breadth, the effect of systemic factors on the periodontal microbiome. It was natural to investigate systemic diseases, such as diabetes, in such studies, along with systemic conditions or states, , pregnancy, menopause, stress, rheumatoid arthritis, and systemic lupus erythematosus. In addition, in recent years, the relevance of systemic "variables" (ie, factors that are not necessarily diseases or conditions, but may modulate the periodontal microbiome) has been explored in detail. These include ethnicity and genetics. In the present manuscript, we describe and elaborate on the new and confirmatory findings unveiled by next-generation sequencing as it pertains to systemic factors that may shape the periodontal microbiome. We also explore the systemic and mechanistic basis for such modulation and highlight the importance of those relationships in the management and treatment of patients.
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Affiliation(s)
- Flavia Teles
- Department of Basic and Translational Sciences, Center for Innovation & Precision Dentistry, School of Dental Medicine & School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Yu Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - George Hajishengallis
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hatice Hasturk
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Julie T Marchesan
- Department of Comprehensive Oral Health, Periodontology, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
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12
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Shaddox LM, Morford LA, Nibali L. Periodontal health and disease: The contribution of genetics. Periodontol 2000 2020; 85:161-181. [PMID: 33226705 DOI: 10.1111/prd.12357] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Periodontitis is an infectious, inflammatory disease that is associated with a complex interplay between specific bacteria, host response, and environmental factors. Because of its high degree of familial aggregation, specifically for the more aggressive forms of the disease, genetics factors have been implicated in disease pathogenesis for several decades. This review provides an overview of what we currently know regarding the genetic and epigenetic contributions to periodontal disease and discusses future opportunities in the field.
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Affiliation(s)
- Luciana Macchion Shaddox
- Division of Periodontology, Department of Oral Health Practice, University of Kentucky College of Dentistry, Lexington, Kentucky, USA
| | - Lorri Ann Morford
- Division of Orthodontics, Department of Oral Health Sciences, University of Kentucky College of Dentistry, Lexington, Kentucky, USA
| | - Luigi Nibali
- Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
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13
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Abstract
Periodontitis is a complex disease: (a) various causative factors play a role simultaneously and interact with each other; and (b) the disease is episodic in nature, and bursts of disease activity can be recognized, ie, the disease develops and cycles in a nonlinear fashion. We recognize that various causative factors determine the immune blueprint and, consequently, the immune fitness of a subject. Normally, the host lives in a state of homeostasis or symbiosis with the oral microbiome; however, disturbances in homeostatic balance can occur, because of an aberrant host response (inherited and/or acquired during life). This imbalance results from hyper- or hyporesponsiveness and/or lack of sufficient resolution of inflammation, which in turn is responsible for much of the disease destruction seen in periodontitis. The control of this destruction by anti-inflammatory processes and proresolution processes limits the destruction to the tissues surrounding the teeth. The local inflammatory processes can also become systemic, which in turn affect organs such as the heart. Gingival inflammation also elicits changes in the ecology of the subgingival environment providing optimal conditions for the outgrowth of gram-negative, anaerobic species, which become pathobionts and can propagate periodontal inflammation and can further negatively impact immune fitness. The factors that determine immune fitness are often the same factors that determine the response to the resident biofilm, and are clustered as follows: (a) genetic and epigenetic factors; (b) lifestyle factors, such as smoking, diet, and psychosocial conditions; (c) comorbidities, such as diabetes; and (d) local and dental factors, as well as randomly determined factors (stochasticity). Of critical importance are the pathobionts in a dysbiotic biofilm that drive the viscious cycle. Focusing on genetic factors, currently variants in at least 65 genes have been suggested as being associated with periodontitis based on genome-wide association studies and candidate gene case control studies. These studies have found pleiotropy between periodontitis and cardiovascular diseases. Most of these studies point to potential pathways in the pathogenesis of periodontal disease. Also, most contribute to a small portion of the total risk profile of periodontitis, often limited to specific racial and ethnic groups. To date, 4 genetic loci are shared between atherosclerotic cardiovascular diseases and periodontitis, ie, CDKN2B-AS1(ANRIL), a conserved noncoding element within CAMTA1 upstream of VAMP3, PLG, and a haplotype block at the VAMP8 locus. The shared genes suggest that periodontitis is not causally related to atherosclerotic diseases, but rather both conditions are sequelae of similar (the same?) aberrant inflammatory pathways. In addition to variations in genomic sequences, epigenetic modifications of DNA can affect the genetic blueprint of the host responses. This emerging field will yield new valuable information about susceptibility to periodontitis and subsequent persisting inflammatory reactions in periodontitis. Further studies are required to verify and expand our knowledge base before final cause and effect conclusions about the role of inflammation and genetic factors in periodontitis can be made.
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Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts, USA
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14
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Torrungruang K, Chantarangsu S, Sura T, Thienpramuk L. Interplay between vitamin D receptor FokI polymorphism and smoking influences Porphyromonas gingivalis proportions in subgingival plaque. J Clin Periodontol 2020; 47:912-920. [PMID: 32418218 DOI: 10.1111/jcpe.13307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/21/2020] [Accepted: 05/10/2020] [Indexed: 12/28/2022]
Abstract
AIM This cross-sectional study investigated the effect of the vitamin D receptor (VDR) FokI polymorphism and its interactions with smoking/drinking on the proportions of periodontal pathogens and periodontitis severity. MATERIALS AND METHODS FokI genotyping and bacterial quantification were performed using real-time polymerase chain reaction. Periodontitis severity was determined using mean clinical attachment level (CAL). Regression analyses examined the associations between the FokI polymorphism (rs2228570) and bacterial proportions or periodontitis severity. Effect modification by smoking or drinking was assessed. RESULTS The study population comprised 1,460 individuals, aged 39-66 years. After multivariable adjustment, the FokI risk genotypes (CC + CT) were associated with elevated Porphyromonas gingivalis proportions (regression coefficient (β) =0.294 ± 0.139; p = .034) and increased mean CAL (β = 0.130 ± 0.048; p = .007). The effect of the FokI polymorphism on P. gingivalis proportions was greater in smokers (β = 0.897 ± 0.328; p = .006) compared to non-smokers (β = 0.164 ± 0.153; p = .282) and in drinkers (β = 0.668 ± 0.242; p = .006) compared to non-drinkers (β = 0.114 ± 0.169; p = .500). The genotype*smoking interaction for P. gingivalis proportions was significant (p = .043), whereas the genotype*drinking interaction was not (p = .061). Similar results were found for the effect of the genotype*smoking/drinking interaction on mean CAL. CONCLUSIONS These findings suggest that the interplay between the host genotype and smoking is important in determining the subgingival microbial composition and periodontitis severity.
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Affiliation(s)
- Kitti Torrungruang
- Department of Microbiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Soranun Chantarangsu
- Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Thanyachai Sura
- Department of Internal Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Lalitsara Thienpramuk
- Health Division, Medical and Health Department, Electricity Generating Authority of Thailand, Nonthaburi, Thailand
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15
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Abstract
Biofilm bacteria co‐evolve and reach a symbiosis with the host on the gingival surface. The disruption of the homeostatic relationship between plaque bacteria and the host can initiate and promote periodontal disease progression. Recent advances in sequencing technologies allow researchers to profile disease‐associated microbial communities and quantify microbial metabolic activities and host transcriptional responses. In addition to confirming the findings from previous studies, new putative pathogens and novel genes that have not previously been associated with periodontitis, emerge. For example, multiple studies have reported that Synergistetes bacteria are associated with periodontitis. Genes involved in epithelial barrier defense were downregulated in periodontitis, while excessive expression of interleukin‐17 was associated with a hyperinflammatory response in periodontitis and with a unique microbial community. Bioinformatics‐enabled gene ontology pathway analyses provide a panoramic view of the bacterial and host activities as they shift from periodontal health to disease. Additionally, host innate factors, such as genetic variants identified by either a candidate‐gene approach or genome‐wide association analyses, have an impact on subgingival bacterial colonization. Transgenic mice carrying candidate genetic variants, or with the deletion of candidate genes mimicking the deleterious loss‐of‐function variant effect, provide experimental evidence validating the biologic relevance of the novel markers associated with the microbial phenotype identified through a statistical approach. Further refinement in bioinformatics, data management approaches, or statistical tools, are required to gain insight into host‐microbe interactions by harmonizing the multidimensional “big” data at the genomic, transcriptional, and proteomic levels.
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Affiliation(s)
- Shaoping Zhang
- Periodontics Department, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Ning Yu
- Applied Oral Science Department, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Roger M Arce
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
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16
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Nastych O, Goncharuk-Khomyn M, Foros A, Cavalcanti A, Yavuz I, Tsaryk V. Comparison of Bacterial Load Parameters in Subgingival Plaque during Peri-implantitis and Periodontitis Using the RT-PCR Method. Acta Stomatol Croat 2020; 54:32-43. [PMID: 32523155 PMCID: PMC7233121 DOI: 10.15644/asc54/1/4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective To estimate the actual parameters of bacterial load in subgingival plaque during periodontitis and peri-implantitis pathologies using the RT-PCR (real-time polymerase chain reaction) method and evaluate their associations with clinical periodontal indicators. Materials and Methods Five different groups of subjects were selected according to a formulated design of the study: with mild/moderate periodontitis, with severe periodontitis, with peri-implantitis, healthy periodontal group and healthy peri-implant group. Subgingival plaque samples were formed with paper points inserted in the pocket/sulcus area for 30 seconds. A standardized test the “ParodontoScreen” was provided for identification of target opportunistic pathogens (A. actinomycetemcomitans, P. gingivalis, T. forsythia, P. intermedia, T. denticola) by the RT-PCR. Results Bacterial load parameters demonstrated a significant tendency towards an increase within periodontitis progression and during the presence of peri-implantitis pathology. Each targeted mean bacterial load level was statistically associated with periodontitis or peri-implantitis pathology (p < 0, 05) according to the provided univariate analyses and upon condition that bacterial load parameters of healthy sites were used as reference for equiparation. The highest correlation values were found between periodontal probing depth and bacterial load parameters of A. actinomycetemcomitans (r=0, 37; p < 0, 05) and P. gingivalis (r=0, 28; p < 0, 05); and also between clinical attachment loss and bacterial load values of A. actinomycetemcomitans (r=0, 38; p < 0, 05) and P. gingivalis (r=0, 24; p < 0, 05). Conclusions Periodontitis and peri-implantitis are associated with the same microbial pathogens even though the distribution pattern of their bacterial load and detection frequency parameters registered with RT-PCR could be distinct and linked to the individual patient-related conditions and the severity stage of pathology.
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Affiliation(s)
- Oksana Nastych
- Medical Faculty, Pavol Jozef Šafárik University, Košice, Slovak Republic
| | | | - Anatoliy Foros
- Faculty of Dentistry, Uzhhorod National University, Uzhhorod, Ukraine
| | - Alessandro Cavalcanti
- Faculty of Dentistry, State University of Campina Grande-Paraiba, Campina Grande, Brazil
| | - Izzet Yavuz
- Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - Vladyslav Tsaryk
- Medical Faculty, Bogomolets National Medical University, Kyiv, Ukraine
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17
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Abstract
In this review we critically summarize the evidence base and the progress to date regarding the genomic basis of periodontal disease and tooth morbidity (ie, dental caries and tooth loss), and discuss future applications and research directions in the context of precision oral health and care. Evidence for these oral/dental traits from genome-wide association studies first emerged less than a decade ago. Basic and translational research activities in this domain are now under way by multiple groups around the world. Key departure points in the oral health genomics discourse are: (a) some heritable variation exists for periodontal and dental diseases; (b) the environmental component (eg, social determinants of health and behavioral risk factors) has a major influence on the population distribution but probably interacts with factors of innate susceptibility at the person-level; (c) sizeable, multi-ethnic, well-characterized samples or cohorts with high-quality measures on oral health outcomes and genomics information are required to make decisive discoveries; (d) challenges remain in the measurement of oral health and disease, with current periodontitis and dental caries traits capturing only a part of the health-disease continuum, and are little or not informed by the underlying biology; (e) the substantial individual heterogeneity that exists in the clinical presentation and lifetime trajectory of oral disease can be identified and leveraged in a precision medicine framework or, if unappreciated, can hamper translational efforts. In this review we discuss how composite or biologically informed traits may offer improvements over clinically defined ones for the genomic interrogation of oral diseases. We demonstrate the utility of the results of genome-wide association studies for the development and testing of a genetic risk score for severe periodontitis. We conclude that exciting opportunities lie ahead for improvements in the oral health of individual patients and populations via advances in our understanding of the genomic basis of oral health and disease. The pace of new discoveries and their equitable translation to practice will largely depend on investments in the education and training of the oral health care workforce, basic and population research, and sustained collaborative efforts..
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Affiliation(s)
- Thiago Morelli
- Department of PeriodontologySchool of DentistryUniversity of North Carolina at Chapel HillChapel HillNorth Carolina, USA
| | - Cary S. Agler
- Department of Oral and Craniofacial Health SciencesSchool of DentistryUniversity of North Carolina at Chapel HillChapel HillNorth Carolina, USA
| | - Kimon Divaris
- Department of Pediatric DentistrySchool of DentistryUniversity of North Carolina at Chapel HillChapel HillNorth Carolina, USA
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth Carolina, USA
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18
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Tran L, Nhu Y M, Le Ba Nghia T, Hendam A, Vuong NL, Alzalal E, Sayed AM, Hussain MM, Sharma A, Tieu T, Mathenge PG, Hirayama K, Alexander N, Huy NT. Frequent inappropriate use of unweighted summary statistics in systematic reviews of pathogen genotypes or genogroups. J Clin Epidemiol 2019; 119:26-35. [PMID: 31740320 DOI: 10.1016/j.jclinepi.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/11/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our study aimed to systematically assess and report the methodological quality used in epidemiological systematic reviews (SRs) and meta-analysis (MA) of pathogen genotypes/genogroups. STUDY DESIGN AND SETTING Nine electronic databases and manual search of reference lists were used to identify relevant studies. The method types were divided into three groups: 1) with weighted pooling analysis (which we call MA), (2) unweighted analysis of the study-level measures (which we call summary statistics), and (3) without any data pooling (which we call SR only). Characteristics were evaluated using Assessment of Multiple Systematic Reviews (AMSTAR), Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Risk Of Bias In Systematic reviews (ROBIS) tools. The protocol was registered in PROSPERO with CRD42017078146. RESULTS Among 36 included articles, 5 (14%) studies conducted SR only, 16 (44%) performed MA, and 15 (42%) used summary statistics. The univariable and multivariable linear regression of AMSTAR and PRISMA scores showed that MA had higher quality compared with those with summary statistics. The SR only and summary statistics groups had approximately equal scores among three scales of AMSTAR, PRISMA, and ROBIS. The methodological quality of epidemiological studies has improved from 1999 to 2017. CONCLUSION Despite the frequent use of unweighted summary statistics, MA remains the most suitable method for reaching rational conclusions in epidemiological studies of pathogen genotypes/genogroups.
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Affiliation(s)
- Linh Tran
- Institute of Research and Development, Duy Tan University, Danang 550000, Vietnam
| | - Mai Nhu Y
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Thai Le Ba Nghia
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Abdulrahman Hendam
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nguyen Lam Vuong
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ebrahim Alzalal
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
| | - Ahmed M Sayed
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mustafa Mushtaq Hussain
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Akash Sharma
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Thuan Tieu
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Peterson Gitonga Mathenge
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
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Lopez-Oliva I, de Pablo P, Dietrich T, Chapple I. Gums and joints: is there a connection? Part two: the biological link. Br Dent J 2019; 227:611-617. [PMID: 31605072 DOI: 10.1038/s41415-019-0723-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Rheumatoid arthritis (RA) and periodontitis (PD) are inflammatory diseases characterised by an exacerbated immune-inflammatory reaction that leads to the destruction of bone and other connective tissues that share numerous similarities. Although a significant and independent association between these two conditions has been described, the pathophysiological processes that may explain this relationship remain unknown and multiple theories have been proposed. This review presents the most important theories currently proposed to explain the biological link between RA and PD.
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Affiliation(s)
- Isabel Lopez-Oliva
- Periodontal Research Group, Birmingham Dental School, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK
| | - Paola de Pablo
- Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital, Birmingham, UK
| | - Thomas Dietrich
- Periodontal Research Group, Birmingham Dental School, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK
| | - Iain Chapple
- Periodontal Research Group, Birmingham Dental School, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK.
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Chemokine Receptor 2 ( CXCR2) Gene Variants and Their Association with Periodontal Bacteria in Patients with Chronic Periodontitis. Mediators Inflamm 2019; 2019:2061868. [PMID: 30863202 PMCID: PMC6378799 DOI: 10.1155/2019/2061868] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/22/2019] [Indexed: 11/18/2022] Open
Abstract
Periodontitis, an inflammatory disease caused by subgingival Gram-negative (G-) bacteria, is linked with loss of the connective tissue and destruction of the alveolar bone. In the regulation of inflammatory response, chemokine receptor 2 (CXCR2), a specific receptor for interleukin-8 and neutrophil chemoattractant, plays an important role. The first aim of this study was to investigate the CXCR2 gene variability in chronic periodontitis (CP) patients and healthy nonperiodontitis controls in the Czech population. The second aim was to find a relation between CXCR2 gene variants and the presence of periodontal bacteria. A total of 500 unrelated subjects participated in this case-control study. 329 CP patients and 171 healthy nonperiodontitis controls were analyzed using polymerase chain reaction techniques for three single-nucleotide polymorphisms (SNPs): +785C/T (rs2230054), +1208T/C (rs1126579), and +1440A/G (rs1126580). A DNA microarray detection kit was used for the investigation of the subgingival bacterial colonization, in a subgroup of CP subjects (N = 162). No significant differences in allele, genotype, haplotype, or haplogenotype frequencies of CXCR2 gene variants between patients with CP and healthy controls (P > 0.05) were determined. Nevertheless, Aggregatibacter actinomycetemcomitans was detected more frequently in men positive for the C allele of the CXCR2 +785C/T polymorphism (61.8% vs. 41.1%, P < 0.05; OR = 2.31, 95% CI = 1.03-5.20) and for the T allele of the CXCR2 +1208C/T variant (61.8% vs. 38.9%, P < 0.05; OR = 2.54, 95% CI = 1.13-5.71). In contrast, no statistically significant associations of CXCR2 variants with seven selected periodontal bacteria were found in women. Although none of the investigated SNPs in the CXCR2 gene was associated with CP, the CXCR2 gene variants can be associated with subgingival colonization of G- bacteria in men with CP in the Czech population.
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21
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Borilova Linhartova P, Kavrikova D, Tomandlova M, Poskerova H, Rehka V, Dušek L, Izakovicova Holla L. Differences in Interleukin-8 Plasma Levels between Diabetic Patients and Healthy Individuals Independently on Their Periodontal Status. Int J Mol Sci 2018; 19:E3214. [PMID: 30340321 PMCID: PMC6214016 DOI: 10.3390/ijms19103214] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/13/2022] Open
Abstract
Chronic periodontitis (CP) and diabetes mellitus (DM) involve several aspects of immune functions, including neutrophil activity and cytokine biology. Considering the critical function of chemokine interleukin-8 (IL-8) in the inflammatory process, the aims of this study were to determine: (i) IL-8 plasma levels; (ii) IL-8 (-251A/T, rs4073) and its receptor 2 (CXCR2, +1208C/T, rs1126579) polymorphisms, and (iii) the presence of the selected periodontal bacteria in types 1 and 2 DM patients (T1DM and T2DM) and systemically healthy controls (HC) with known periodontal status. This case⁻control study comprises of 153 unrelated individuals: 36/44 patients suffering from T1DM+CP/T2DM+CP and 32/41 from HC+CP/non-periodontitis HC. Both the clinical and biochemical parameters were monitored. The genotypes were determined using qPCR, IL-8 plasma levels were measured using an ELISA kit. Subgingival bacterial colonization was analyzed with a DNA microarray detection kit. The IL-8 plasma levels differed significantly between non-periodontitis HC and T1DM+CP/T2DM+CP patients (P < 0.01). Even in HC+CP, IL-8 concentrations were significantly lower than in T1DM+CP/T2DM+CP patients (P ≤ 0.05). No significant associations between the IL-8 plasma levels and the studied IL-8 and CXCR2 polymorphisms or the occurrence of selected periodontal bacteria (P > 0.05) were found. CP does not influence the circulating IL-8 levels. Patients with T1DM+CP/T2DM+CP had higher circulating IL-8 levels than HC+CP/non-periodontitis HC.
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Affiliation(s)
- Petra Borilova Linhartova
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic.
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic.
| | - Denisa Kavrikova
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic.
| | - Marie Tomandlova
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic.
| | - Hana Poskerova
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic.
| | - Vaclav Rehka
- Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic.
| | - Ladislav Dušek
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic.
| | - Lydie Izakovicova Holla
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Pekarska 664/53, 60200 Brno, Czech Republic.
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic.
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22
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Delatola C, Loos BG, Levin E, Laine ML. At least three phenotypes exist among periodontitis patients. J Clin Periodontol 2018; 44:1068-1076. [PMID: 28800144 DOI: 10.1111/jcpe.12797] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 12/18/2022]
Abstract
AIM To identify phenotypes of periodontitis patients by the use of an unsupervised modelling technique (clustering), based on pre-treatment radiographic and microbiological characteristics. MATERIALS AND METHODS This retrospective study included data from 392 untreated periodontitis patients. Co-regularized spectral clustering algorithm was used to cluster the patients. The resulting clusters were subsequently characterized based on their demographics, radiographic bone loss patterns and microbial data. RESULTS The vast majority of patients fitted into one of the three main clusters (accuracy 90%). Cluster A (n = 18) was characterized by high prevalence and high proportions of Aggregatibacter actinomycetemcomitans, a trend for a more localized pattern of alveolar bone loss and young individuals. Clusters B (n = 200) and C (n = 135) differed clearly in disease severity patterns and smoking habits, but not in microbiological characteristics. CONCLUSION On the basis of alveolar bone loss patterns and microbiological data, untreated periodontitis patients can be clustered into at least three phenotypes. These results should be validated in other cohorts, and the clinical utility needs to be explored on the basis of periodontal treatment outcomes and/or disease progression.
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Affiliation(s)
- Chryssa Delatola
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Evgeni Levin
- Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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23
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Genetic Association with Subgingival Bacterial Colonization in Chronic Periodontitis. Genes (Basel) 2018; 9:genes9060271. [PMID: 29882907 PMCID: PMC6027454 DOI: 10.3390/genes9060271] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/27/2022] Open
Abstract
Chronic periodontitis is the most prevalent form of inflammatory destructive bone disease and has been affecting humans since antiquity. Evidence suggest that genetic factors can highly influence periodontitis risk, modulating disease elements such as the susceptibility to microbial colonization and the nature of subsequent host-microbe interaction. Several single-nucleotide polymorphisms (SNPs) have been associated with the occurrence of periodontitis, but the full range of genetic influence in periodontitis outcomes remains to be determined. In this context, this study comprises an analysis of possible correlation between periodontitis-related genetic variants with changes in the subgingival microbiological pattern performed in a Brazilian population (n = 167, comprising 76 chronic periodontitis patients and 91 healthy subjects). For the genetic characterization, 19 candidate SNPs were selected based on the top hits of previous large genome wide association studies (GWAS), while the subgingival microbiota was characterized for the presence and relative quantity of 40 bacterial species by DNA-DNA checkerboard. The case/control association test did not demonstrate a significant effect of the target SNPs with the disease phenotype. The polymorphism rs2521634 proved significantly associated with Tannerella forsythia, Actinomyces gerencseriae, Fusobacterium periodonticum, and Prevotella nigrescens; rs10010758 and rs6667202 were associated with increased counts of Porphyromonas gingivalis; and rs10043775 proved significantly associated with decreased counts of Prevotella intermedia. In conclusion, we present strong evidence supporting a direct connection between the host’s genetic profile, specifically rs2521634, rs10010758, rs6667202, and rs10043775 polymorphisms, and the occurrence of chronic periodontitis-associated bacteria.
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24
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Kaur G, Grover V, Bhaskar N, Kaur RK, Jain A. Periodontal Infectogenomics. Inflamm Regen 2018; 38:8. [PMID: 29760828 PMCID: PMC5937045 DOI: 10.1186/s41232-018-0065-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/27/2018] [Indexed: 12/18/2022] Open
Abstract
Periodontal diseases are chronic infectious disease in which the pathogenic bacteria initiate the host immune response leading to the destruction of tooth supporting tissue and eventually result in the tooth loss. It has multifactorial etiological factors including local, systemic, environmental and genetic factors. The effect of genetic factors on periodontal disease is already under extensive research and has explained the role of polymorphisms of immune mediators affecting disease response. The role genetic factors in pathogens colonisation is emerged as a new field of research as "infectogenomics". It is a rapidly evolving and high-priority research area now days. It further elaborates the role of genetic factors in disease pathogenesis and help in the treatment, control and early prevention of infection. The aim of this review is to summarise the contemporary evidence available in the field of periodontal infectogenomics to draw some valuable conclusions to further elaborate its role in disease pathogenesis and its application in the clinical practice. This will open up opportunity for more extensive research in this field.
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Affiliation(s)
- Gurjeet Kaur
- Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Sector-25, Chandigarh, India
| | - Vishakha Grover
- Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Sector-25, Chandigarh, India
| | - Nandini Bhaskar
- Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Sector-25, Chandigarh, India
| | - Rose Kanwaljeet Kaur
- Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Sector-25, Chandigarh, India
| | - Ashish Jain
- Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Sector-25, Chandigarh, India
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25
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Zhou L, Dörfer CE, Chen L, Fawzy El-Sayed KM. Porphyromonas gingivalislipopolysaccharides affect gingival stem/progenitor cells attributes through NF-κB, but not Wnt/β-catenin, pathway. J Clin Periodontol 2017; 44:1112-1122. [DOI: 10.1111/jcpe.12777] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Lili Zhou
- Clinic of Conservative Dentistry and Periodontology; School of Dental Medicine; Christian-Albrechts Universität at Kiel; Kiel Germany
- Department of Oral Medicine; The Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Christof E. Dörfer
- Clinic of Conservative Dentistry and Periodontology; School of Dental Medicine; Christian-Albrechts Universität at Kiel; Kiel Germany
| | - Lili Chen
- Department of Oral Medicine; The Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Karim M. Fawzy El-Sayed
- Clinic of Conservative Dentistry and Periodontology; School of Dental Medicine; Christian-Albrechts Universität at Kiel; Kiel Germany
- Oral Medicine and Periodontology Department; Faculty of Oral and Dental Medicine; Cairo University; Cairo Egypt
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26
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Ebersole JL, Dawson D, Emecen-Huja P, Nagarajan R, Howard K, Grady ME, Thompson K, Peyyala R, Al-Attar A, Lethbridge K, Kirakodu S, Gonzalez OA. The periodontal war: microbes and immunity. Periodontol 2000 2017; 75:52-115. [DOI: 10.1111/prd.12222] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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27
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Cirelli T, Finoti LS, Corbi SCT, Anovazzi G, Nepomuceno R, Orrico SRP, Cirelli JA, Mayer MPA, Scarel-Caminaga RM. Absolute quantification of Aggregatibacter actinomycetemcomitans in patients carrying haplotypes associated with susceptibility to chronic periodontitis: multifaceted evaluation with periodontitis covariants. Pathog Dis 2017; 75:4056145. [DOI: 10.1093/femspd/ftx092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/27/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Thamiris Cirelli
- Department of Morphology, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
- Department of Oral Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
| | - Livia S. Finoti
- Department of Morphology, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
- Department of Oral Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
| | - Sâmia C. T. Corbi
- Department of Morphology, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
- Department of Oral Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
| | - Giovana Anovazzi
- Department of Morphology, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
- Department of Oral Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
| | - Rafael Nepomuceno
- Department of Morphology, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
- Department of Oral Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
| | - Silvana R. P. Orrico
- Department of Oral Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
| | - Joni A. Cirelli
- Department of Oral Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
| | - Márcia P. A. Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo (USP), CEP 05508-900, São Paulo, SP, Brazil
| | - Raquel M. Scarel-Caminaga
- Department of Morphology, São Paulo State University (UNESP), School of Dentistry, 14801903 Araraquara, SP, Brazil
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28
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Liljestrand JM, Paju S, Buhlin K, Persson GR, Sarna S, Nieminen MS, Sinisalo J, Mäntylä P, Pussinen PJ. Lipopolysaccharide, a possible molecular mediator between periodontitis and coronary artery disease. J Clin Periodontol 2017; 44:784-792. [PMID: 28556187 DOI: 10.1111/jcpe.12751] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2017] [Indexed: 12/11/2022]
Abstract
AIM We aimed to study how lipopolysaccharide (LPS) in saliva and serum associates with each other, periodontal microbial burden, periodontitis and coronary artery disease (CAD). MATERIALS AND METHODS The used Parogene cohort comprised N = 505 Finnish adults. Coronary diagnosis was acquired by coronary angiography, and the main outcomes were as follows: no significant CAD (n = 123), stable CAD (n = 184) and acute coronary syndrome (n = 169). Periodontitis was defined according to clinical and radiographic examinations. Levels for 75 strains of subgingival bacteria were determined by checkerboard DNA-DNA hybridization. Saliva and serum LPS activity was analysed by Limulus amebocyte lysate assay. RESULTS The level of 11 bacterial strains, which were mainly oral and respiratory Gram-negative species, associated with salivary LPS levels in an age- and gender-adjusted linear regression. A total of 4.9% of the serum LPS, that is endotoxemia, variation was explainable by saliva LPS among patients with periodontitis (n = 247, R2 = .049, Pearson's r = .222, p < .001). Endotoxemia associated with stable CAD in a confounder adjusted multinomial logistic regression model (OR 1.99, 95% CI 1.04-3.81, p = .039, 3rd tertile). CONCLUSIONS In particular in periodontitis patients, subgingival microbial burden contributes to endotoxemia. LPS is a possible molecular mediator between periodontitis and CAD.
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Affiliation(s)
- John M Liljestrand
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Susanna Paju
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kåre Buhlin
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - G Rutger Persson
- Departments of Oral Medicine and Periodontics, University of Washington, Seattle, WA, USA
| | - Seppo Sarna
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Markku S Nieminen
- Department of Cardiology, Heart and Lung Center, Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Juha Sinisalo
- Department of Cardiology, Heart and Lung Center, Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Päivi Mäntylä
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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29
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Chapple IL, Bouchard P, Cagetti MG, Campus G, Carra MC, Cocco F, Nibali L, Hujoel P, Laine ML, Lingström P, Manton DJ, Montero E, Pitts N, Rangé H, Schlueter N, Teughels W, Twetman S, Van Loveren C, Van der Weijden F, Vieira AR, Schulte AG. Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol 2017; 44 Suppl 18:S39-S51. [DOI: 10.1111/jcpe.12685] [Citation(s) in RCA: 223] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Iain L.C. Chapple
- Periodontal Research Group; The University of Birmingham; Birmingham UK
| | - Philippe Bouchard
- Department of Periodontology; Service of Odontology; Rothschild Hospital; AP-HP, Paris 7-Denis Diderot University; U.F.R. of Odontology; Paris France
- EA 2496; Paris 5-Descartes University; U.F.R. of Odontology; Paris France
| | | | - Guglielmo Campus
- WHO Collaboration Centre for Epidemiology and Community Dentistry; Milan Italy
- Department of Surgery, Microsurgery and Medicine Sciences; School of Dentistry; Universita degli Studi di Sassari; Sassari Italy
| | - Maria-Clotilde Carra
- Department of Periodontology; Service of Odontology; Rothschild Hospital; AP-HP, Paris 7-Denis Diderot University; U.F.R. of Odontology; Paris France
- INSERM; U1018; Villejuif; France
| | - Fabio Cocco
- Department of Surgery, Microsurgery and Medicine Sciences; School of Dentistry; Universita degli Studi di Sassari; Sassari Italy
| | - Luigi Nibali
- Centre for Oral Clinical Research; Institute of Dentistry; Barts and The London School of Medicine and Dentistry; Queen Mary University London (QMUL); London UK
| | - Philippe Hujoel
- Public Health Sciences; University of Washington; Seattle WA USA
| | - Marja L. Laine
- Department of Periodontology; Academic Centre for Dentistry in Amsterdam; Amsterdam the Netherlands
| | - Peter Lingström
- Department of Cariology; Institute of Odontology; Gothenburg Sweden
| | - David J. Manton
- Melbourne Dental School; University of Melbourne; Parkville Vic. Australia
| | - Eduardo Montero
- Faculty of Dentistry; Universidad Complutense de Madrid; Madrid Spain
| | - Nigel Pitts
- Dental Innovation and Translation Centre; Dental Institute; Kings College London; London UK
| | - Hélène Rangé
- Department of Periodontology; Service of Odontology; Rothschild Hospital; AP-HP, Paris 7-Denis Diderot University; U.F.R. of Odontology; Paris France
- EA 2496; Paris 5-Descartes University; U.F.R. of Odontology; Paris France
| | - Nadine Schlueter
- Division for Cariology; Department of Operative Dentistry and Periodontology; Center for Dental Medicine; University Medical Center; Albert-Ludwig-University; Freiburg Germany
| | | | - Svante Twetman
- Faculty of Health and Medical Sciences; School of Dentistry; Section of Cariology and Endodontics; University of Copenhagen; Copenhagen Denmark
| | - Cor Van Loveren
- Department of Cariology; Academic Centre for Dentistry Amsterdam; Amsterdam the Netherlands
| | - Fridus Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry in Amsterdam; Amsterdam the Netherlands
| | | | - Andreas G. Schulte
- Department of Special Care Dentistry; Dental School; Witten/Herdecke University; Witten Germany
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30
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Demmer RT, Breskin A, Rosenbaum M, Zuk A, LeDuc C, Leibel R, Paster B, Desvarieux M, Jacobs DR, Papapanou PN. The subgingival microbiome, systemic inflammation and insulin resistance: The Oral Infections, Glucose Intolerance and Insulin Resistance Study. J Clin Periodontol 2017; 44:255-265. [PMID: 27978598 DOI: 10.1111/jcpe.12664] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Inflammation might link microbial exposures to insulin resistance. We investigated the cross-sectional association between periodontal microbiota, inflammation and insulin resistance. METHODS The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS) enrolled 152 diabetes-free adults (77% female) aged 20-55 years (mean = 34 ± 10). Three hundred and four subgingival plaque samples were analysed using the Human Oral Microbe Identification Microarray to measure the relative abundances of 379 taxa. C-reactive protein, interleukin-6, tumour necrosis factor-α and adiponectin were assessed from venous blood and their z-scores were summed to create an inflammatory score (IS). Insulin resistance was defined via the HOMA-IR. Associations between the microbiota and both inflammation and HOMA-IR were explored using multivariable linear regressions; mediation analyses assessed the proportion of the association explained by inflammation. RESULTS The IS was inversely associated with Actinobacteria and Proteobacteria and positively associated with Firmicutes and TM7 (p-values < 0.05). Proteobacteria levels were associated with insulin resistance (p < 0.05). Inflammation explained 30-98% of the observed associations between levels of Actinobacteria, Proteobacteria or Firmicutes and insulin resistance (p-values < 0.05). Eighteen individual taxa were associated with inflammation (p < 0.05) and 22 with insulin resistance (p < 0.05). No findings for individual taxa met Bonferroni-adjusted statistical significance. CONCLUSION Bacterial measures were related to inflammation and insulin resistance among diabetes-free adults.
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Affiliation(s)
- Ryan T Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alexander Breskin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | - Aleksandra Zuk
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Charles LeDuc
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | - Rudolph Leibel
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | - Bruce Paster
- Department of Molecular Genetics, The Forsyth Institute, Cambridge, MA, USA.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Centre de recherche Epidémiologies et Biostatistique, INSERM U1153 Equipe: Méthodes en évaluation thérapeutique des maladies chroniques, Paris, France
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
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