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Urrutia‐Baca VH, Paz‐Michel BA, Calderon‐Porras AN, Valle JAJ, Alvarez‐Fernández WJ, Mervitch‐Sigal N, Rodríguez‐León MA, De La Garza‐Ramos MA. Oral Hygiene With Neutral Electrolyzed Water and Systemic Therapy Increases Gastric Helicobacter pylori Eradication and Reduces Recurrence. Clin Exp Dent Res 2024; 10:e927. [PMID: 38973212 PMCID: PMC11228356 DOI: 10.1002/cre2.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/31/2024] [Accepted: 06/15/2024] [Indexed: 07/09/2024] Open
Abstract
OBJECTIVES Helicobacter pylori gastric infection strongly correlates with gastric diseases such as chronic gastritis, functional dyspepsia, and complications such as peptic ulcers and gastric cancer. In developing countries, systemic therapies are not usually successful due to elevated antibiotic resistance. Additionally, oral H. pylori infection and periodontal disease correlate with gastric treatment failures. This study aimed to explore the effect of an integral therapy, comprising oral hygiene and concomitant systemic treatment, to increase the eradication of gastric infection and recurrences. MATERIALS AND METHODS A prospective, randomized, four-arm, parallel-group, open-label clinical trial was conducted to investigate the efficacy of integral therapy to eradicate gastric H. pylori infection and avoid recurrences in double-positive (real-time PCR oral and gastric infection) patients. Oral hygiene involved mouthwash with neutral electrolyzed water (NEW), with or without periodontal treatment. One hundred patients were equally distributed into four groups: NS, NS-PT, NEW, and NEW-PT. All patients had concomitant systemic therapy and additionally, the following oral treatments: mouthwash with normal saline (NS), periodontal treatment and mouthwash with normal saline (NS-PT), mouthwash with NEW (NEW), and periodontal treatment and mouthwash with NEW (NEW-PT). Gastric and oral infection and symptoms were evaluated one and four months after treatments. RESULTS Integral therapy with NEW-PT increased gastric eradication rates compared with NS or NS-PT (84%-96% vs. 20%-56%; p < 0.001). Even more, a protective effect of 81.2% (RR = 0.1877; 95% CI: 0.0658-0.5355; p = 0.0018) against recurrences and 76.6% (RR = 0.2439; 95% CI: 0.1380-0.4310; p < 0.001) against treatment failure (eradication of infection and associated symptoms) was observed in patients from the NEW and NEW-PT groups. CONCLUSIONS Implementation of oral hygiene and systemic treatment can increase the eradication of gastric infection, associated symptoms, and recurrences. NEW is recommended as an antiseptic mouthwash due to its efficacy and short- and long-term safety.
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Affiliation(s)
- Victor Hugo Urrutia‐Baca
- Facultad de Ciencias BiológicasUniversidad Autonoma de Nuevo LeonSan Nicolas de los GarzaNuevo LeonMexico
| | | | | | | | | | | | | | - Myriam Angelica De La Garza‐Ramos
- Facultad de Ciencias BiológicasUniversidad Autonoma de Nuevo LeonSan Nicolas de los GarzaNuevo LeonMexico
- Facultad de OdontologíaUniversidad Autonoma de Nuevo LeonMonterreyNuevo LeonMexico
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Mi S, Cai S, Lou G, Xue M. Two-sample Mendelian randomization analysis of the relationship between periodontitis and risk of upper gastrointestinal cancers. Postgrad Med J 2024:qgae069. [PMID: 38840504 DOI: 10.1093/postmj/qgae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/02/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE The aim of the present study is to explore the possible association between periodontitis and upper gastrointestinal (UGI) cancers, including esophageal and gastric cancers, utilizing the Mendelian randomization method. METHODS In this research, we utilized the Mendelian randomization method to examine the causal association between periodontitis and UGI cancers. Genome-wide association studies data for periodontitis were obtained from the Gene-Lifestyle Interactions in Dental Endpoints consortium, while UGI cancers' data were accessed from FinnGen's Biobank. After rigorously screening instrumental variables for periodontitis, we analyzed them with UGI cancers primarily using the inverse variance weighted. Finally, to identify outliers, the results were subjected to a leave-one-out sensitivity analysis. RESULTS Inverse variance weighted (fixed effect) results revealed that periodontitis is a risk factor for gastric cancer (OR = 1.7735, 95% CI: 1.1576 to 2.7170, P = 0.0085). As for esophageal cancer, no statistically significant correlation was observed. Furthermore, no outliers were detected in any of the results. CONCLUSION Our two-sample Mendelian randomization study obviously demonstrates a significant positive association between periodontitis and gastric cancer, while no statistically significant correlation was found for esophageal cancer.
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Affiliation(s)
- Shuyi Mi
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, Zhejiang, 310009, China
- Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Shangwen Cai
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, Zhejiang, 310009, China
- Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Guochun Lou
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, Zhejiang, 310009, China
- Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Meng Xue
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, Zhejiang, 310009, China
- Institute of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, 310009, China
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Lai Y, Dong X, Song Y, Zhao J, Du Y, Li Z. Novel MAXPOWER biological antibacterial liquid for eradicating oral Helicobacter pylori. BMC Infect Dis 2024; 24:540. [PMID: 38811871 PMCID: PMC11137934 DOI: 10.1186/s12879-024-09424-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Eradication of oral Helicobacter pylori (H. pylori) not only reduces the infection rate from the transmission route but also improves the success rate of intragastric eradication. MAXPOWER Biological Bacteriostatic Liquid, developed in our previous work, is a composite biological preparation with strong antibacterial ability and unique antibacterial mechanism. The present study evaluated the efficacy of the MAXPOWER biocontrol solution on H. pylori and its success rate in eradicating oral H. pylori in clinical patients. METHODS Live-dead cell staining and hemolysis test were used to evaluate the cellular safety of MAXPOWER biocontrol solution; plate spreading, live-dead bacterial staining, and scanning electron microscopy methods were used to evaluate its antimicrobial effect against H. pylori. Transcriptomics was used to analyze the changes in H. pylori genes before and after treatment. After seven days of gavage treatment, H&E staining and mice feces were collected for 16SrDNA sequencing to evaluate the animals' safety. Oral H. pylori-positive patients were randomized to be given a placebo and MAXPOWER Bio-Bacteriostatic Liquid gargle for seven days to evaluate the effect on oral H. pylori eradication. RESULTS In vitro tests demonstrated that this product has excellent biocompatibility and hemocompatibility and can effectively eradicate oral H. pylori. In vivo tests further showed that it has good biosafety and virtually no adverse effect on intestinal microflora. Transcriptomics analysis revealed that it kills H. pylori cells mainly by disrupting their cell membranes and metabolism. Additionally, the results of randomized controlled trials on humans disclosed that the oral H. pylori eradication rates achieved by MAXPOWER Biological Antibacterial Liquid were 71.4% and 78.9% according to the intention-to-treat and the per-protocol analysis, respectively. CONCLUSION MAXPOWER Biological Antibacterial Liquid is both safe and efficacious in the eradication of oral H. pylori. TRIAL REGISTRATION This study was retrospectively registered in the ClinicalTrials.gov Trial Registry on 21/09/2023 (NCT06045832).
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Affiliation(s)
- Yongkang Lai
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
- Department of Gastroenterology, Ganzhou People's Hospital Affiliated to Nanchang University, Ganzhou, 341000, China
| | - Xiaoyang Dong
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
| | - Yingxiao Song
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
| | - Jiulong Zhao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China.
- National Clinical Research Center for Digestive Diseases, Changhai Hospital, Naval Medical University, Shanghai, China.
- National key laboratory of Immunity and inflammation, Naval Medical University, Shanghai, China.
- Changhai Clinical Research Unit, Changhai hospital, Naval Medical University, Shanghai, China.
| | - Yiqi Du
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China.
- National Clinical Research Center for Digestive Diseases, Changhai Hospital, Naval Medical University, Shanghai, China.
- National key laboratory of Immunity and inflammation, Naval Medical University, Shanghai, China.
- Changhai Clinical Research Unit, Changhai hospital, Naval Medical University, Shanghai, China.
| | - Zhaoshen Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Yangp u District, Shanghai, 200433, China
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Baima G, Minoli M, Michaud DS, Aimetti M, Sanz M, Loos BG, Romandini M. Periodontitis and risk of cancer: Mechanistic evidence. Periodontol 2000 2023. [PMID: 38102837 DOI: 10.1111/prd.12540] [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: 09/06/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 12/17/2023]
Abstract
This review aims to critically analyze the pathways of interaction and the pathogenic mechanisms linking periodontitis and oral bacteria with the initiation/progression of cancer at different body compartments. A higher risk of head and neck cancer has been consistently associated with periodontitis. This relationship has been explained by the local promotion of dysbiosis, chronic inflammation, immune evasion, and direct (epi)genetic damage to epithelial cells by periodontal pathobionts and their toxins. Epidemiological reports have also studied a possible link between periodontitis and the incidence of other malignancies at distant sites, such as lung, breast, prostate, and digestive tract cancers. Mechanistically, different pathways have been involved, including the induction of a chronic systemic inflammatory state and the spreading of oral pathobionts with carcinogenic potential. Indeed, periodontitis may promote low-grade systemic inflammation and phenotypic changes in the mononuclear cells, leading to the release of free radicals and cytokines, as well as extracellular matrix degradation, which are all mechanisms involved in carcinogenic and metastatic processes. Moreover, the transient hematogenous spill out or micro-aspiration/swallowing of periodontal bacteria and their virulence factors (i.e., lipopolysaccharides, fimbriae), may lead to non-indigenous bacterial colonization of multiple microenvironments. These events may in turn replenish the tumor-associated microbiome and thus influence the molecular hallmarks of cancer. Particularly, specific strains of oral pathobionts (e.g., Porphyromonas gingivalis and Fusobacterium nucleatum) may translocate through the hematogenous and enteral routes, being implicated in esophageal, gastric, pancreatic, and colorectal tumorigenesis through the modulation of the gastrointestinal antitumor immune system (i.e., tumor-infiltrating T cells) and the increased expression of pro-inflammatory/oncogenic genes. Ultimately, the potential influence of common risk factors, relevant comorbidities, and upstream drivers, such as gerovulnerability to multiple diseases, in explaining the relationship cannot be disregarded. The evidence analyzed here emphasizes the possible relevance of periodontitis in cancer initiation/progression and stimulates future research endeavors.
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Affiliation(s)
- Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Margherita Minoli
- Department of Periodontology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Dominique S Michaud
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Mariano Sanz
- Faculty of Odontology, University Complutense, Madrid, Spain
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Bruno G Loos
- Department of Periodontology, ACTA - Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Tsimpiris A, Tsolianos I, Grigoriadis A, Moschos I, Goulis DG, Kouklakis G. Association of Chronic Periodontitis with Helicobacter pylori Infection in Stomach or Mouth: A Systematic Review and Meta-Analysis. Eur J Dent 2022. [DOI: 10.1055/s-0042-1756690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Helicobacter pylori (H. pylori) infection and periodontitis are both inflammatory conditions associated with systemic diseases. Researchers have attempted to investigate the correlation between them. This systematic review and meta-analyses were conducted to investigate the association of H. pylori infection in the stomach and/or in subgingival plaque and gingival crevicular fluid with chronic periodontitis. The protocol was created according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. The study was designed according to the Cochrane criteria. A comprehensive literature search was performed in MEDLINE, Scopus, and CENTRAL, combined with hand-searching and assessment of gray literature. The meta-analysis of the included studies was made by the Review Manager (RevMan) 5.4 software. The effect measure of the outcome was odds ratios with 95% confidence intervals. Heterogeneity was assessed by chi-square and I2. Four observational studies involving 818 subjects were included in this meta-analysis. The odds of oral H. pylori presence were higher in patients with chronic periodontitis, compared to healthy controls, with an odds ratio of 1.87 (95% confidence interval 0.85–4.10; p = 0.12). The odds of the presence of H. pylori in the stomach also were higher in patients with chronic periodontitis, with an odds ratio of 1.80 (95% confidence interval 0.82–3.95; p = 0.15). There is no evidence for an association between chronic periodontitis and the prevalence of H. pylori, detected either in subgingival plaque and gingival crevicular fluid or in the stomach.
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Affiliation(s)
- Athanasios Tsimpiris
- Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
- Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Ioannis Tsolianos
- Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Grigoriadis
- Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Moschos
- Department of Nursing, International Hellenic University, Thessaloniki, Greece
| | - Dimitrios G. Goulis
- 1st Department of Obstetrics and Gynecology, Unit of Reproductive Endocrinology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Kouklakis
- A΄ Department of Pathology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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6
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Zhang L, Chen X, Ren B, Zhou X, Cheng L. Helicobacter pylori in the Oral Cavity: Current Evidence and Potential Survival Strategies. Int J Mol Sci 2022; 23:ijms232113646. [PMID: 36362445 PMCID: PMC9657019 DOI: 10.3390/ijms232113646] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
Helicobacter pylori (H. pylori) is transmitted primarily through the oral–oral route and fecal–oral route. The oral cavity had therefore been hypothesized as an extragastric reservoir of H. pylori, owing to the presence of H. pylori DNA and particular antigens in distinct niches of the oral cavity. This bacterium in the oral cavity may contribute to the progression of periodontitis and is associated with a variety of oral diseases, gastric eradication failure, and reinfection. However, the conditions in the oral cavity do not appear to be ideal for H. pylori survival, and little is known about its biological function in the oral cavity. It is critical to clarify the survival strategies of H. pylori to better comprehend the role and function of this bacterium in the oral cavity. In this review, we attempt to analyze the evidence indicating the existence of living oral H. pylori, as well as potential survival strategies, including the formation of a favorable microenvironment, the interaction between H. pylori and oral microorganisms, and the transition to a non-growing state. Further research on oral H. pylori is necessary to develop improved therapies for the prevention and treatment of H. pylori infection.
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Affiliation(s)
- Lin Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xi Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Biao Ren
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence:
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7
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Alkhaldi NK, Alghamdi WK, Alharbi MH, Almutairi AS, Alghamdi FT. The Association Between Oral Helicobacter pylori and Gastric Complications: A Comprehensive Review. Cureus 2022; 14:e24703. [PMID: 35663643 PMCID: PMC9162906 DOI: 10.7759/cureus.24703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/13/2022] Open
Abstract
Helicobacter pylori (H. pylori) is linked to chronic gastritis, duodenal or gastric ulcers, and gastric cancer (GC). Because the oral cavity is the first component of the gastrointestinal tract (GIT) and the entrance point for H. pylori, it has been proposed as a possible reservoir of H. pylori. As a result, a putative oral-oral transmission pathway of H. pylori poses the possibility of whether personal contact, such as kissing or sharing a meal, might trigger H. pylori transmission. As a result, several investigations have been done on this issue using various approaches for detecting H. pylori in oral and stomach samples. Furthermore, the relationship between H. pylori and gastrointestinal disorders has yet to be studied. The evidence for the association between H. pylori and gastric diseases and their complications is still a controversial subject due to the existing literature in this review. The goal of this comprehensive review was to collect all available published articles and critically evaluate existing investigations looking into the relationship between oral H. pylori contamination and the danger of gastric complications. Few studies indicated an association between H. pylori and gastric diseases. Furthermore, more longitudinal randomized clinical studies to further investigate the association between H. pylori and gastric diseases are warranted.
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Affiliation(s)
- Njoud K Alkhaldi
- General Medicine and Surgery, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Waad K Alghamdi
- General Medicine and Surgery, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Maryam H Alharbi
- General Medicine and Surgery, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Albandri S Almutairi
- General Medicine and Surgery, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Faisal T Alghamdi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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8
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Sung CE, Lin FG, Huang RY, Fang WH, Cheng WC, Tsai YWC, Chen WL. Periodontitis, Helicobacter pylori infection, and gastrointestinal tract cancer mortality. J Clin Periodontol 2021; 49:210-220. [PMID: 34961943 DOI: 10.1111/jcpe.13590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 12/20/2022]
Abstract
AIM Periodontitis has been proposed to lead to Helicobacter pylori infection, which could cause many gastrointestinal tract cancers. This study aimed to determine the association or otherwise between periodontitis and survival outcomes in individuals with respect to H. pylori infection. MATERIALS AND METHODS The study population comprised 4955 subjects aged 20-90 who had received both periodontal examination and H. pylori serum test in the Third National Health and Nutrition Examination Survey (NHANES III) database. Logistic regression models were used to analyse the association between periodontitis and H. pylori seropositivity (H. pylori infection). Survival analysis was performed using the NHANES III linked to mortality data. Cox proportional hazard regression was carried out to investigate the association between periodontitis and gastrointestinal tract cancer mortality in individuals with/without H. pylori infection. RESULTS Compared to periodontal health, periodontitis was significantly associated with increased odds of H. pylori infection (OR = 1.271, 95% CI = 1.177-1.372). Periodontitis significantly increased the mortality risk from all causes (HR = 1.574, 95% CI = 1.327-1.866) and all cancers (HR = 1.948, 95% CI = 1.701-2.232), including gastrointestinal (GI) tract cancer (HR = 4.140, 95% CI = 3.656-4.687), gastric cancer (HR = 4.288, 95% CI = 3.969-4.632), and colorectal cancer (HR = 4.814, 95% CI = 3.849-6.020) in subjects with H. pylori infection after adjusting for health-related factors. Periodontitis was significantly related to the decreased survival time in subjects with GI tract (p = .001) or colorectal cancer (p = .002) and H. pylori infection. CONCLUSION Our study demonstrated that periodontitis was significantly associated with higher mortality risk of GI tract, gastric, and colorectal cancer in subjects with H. pylori infection. Owing to an interactive effect between periodontitis and H. pylori infection on cancer mortality, H. pylori infection has a significant moderating effect in regulating the association between periodontitis and mortality due to all cancers, including GI tract cancer and colorectal cancer.
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Affiliation(s)
- Cheng-En Sung
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Fu-Gong Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Optometry, University of Kang Ning, Tainan, Taiwan, Republic of China
| | - Ren-Yeong Huang
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wan-Chien Cheng
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yi-Wen Cathy Tsai
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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9
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Al-Zahrani MS, Alhassani AA, Zawawi KH. Clinical manifestations of gastrointestinal diseases in the oral cavity. Saudi Dent J 2021; 33:835-841. [PMID: 34938023 PMCID: PMC8665164 DOI: 10.1016/j.sdentj.2021.09.017] [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: 10/09/2020] [Revised: 04/03/2021] [Accepted: 09/05/2021] [Indexed: 02/07/2023] Open
Abstract
Aim In this review, several gastrointestinal diseases that dentists may encounter in practice are highlighted and discussed. Materials and methods Using MEDLINE (PubMed), a comprehensive review of gastrointestinal diseases and their oral cavity manifestations was performed. Results Many gastrointestinal diseases present with oral symptoms that are detectable by dentists and dental hygienists. Often, oral manifestations of the disease may appear before systemic signs and symptoms. Managing patients with these conditions requires dentists to adjust their treatment and/or involve other health professionals. Conclusion Care must be taken when providing periodontal therapy or dental implants to patients suffering gastrointestinal diseases who are at high risk of bleeding, infection, or malnutrition, for example. Also, pharmacological therapy for these patients may need to be customized.
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Affiliation(s)
- Mohammad S Al-Zahrani
- Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed A Alhassani
- Assistant Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid H Zawawi
- Professor, Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabi
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10
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Mirzaei A, Shahrestanaki E, Daneshzad E, Heshmati J, Djalalinia S, Asayesh H, Mahdavi-Gorabi A, Heshmat R, Qorbani M. Association of hyperglycaemia and periodontitis: an updated systematic review and meta-analysis. J Diabetes Metab Disord 2021; 20:1327-1336. [PMID: 34900784 DOI: 10.1007/s40200-021-00861-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
Purpose The aim of this updated systematic review and meta-analysis was the association between hyperglycemia and periodontitis. Methods We searched PubMed/MEDLINE, Web of Science, and Scopus until March 2021. The key search words were based on "periodontitis" and "hyperglycemia." We included cohort, case-control, and cross-sectional studies, restricted to publications in English. The quality assessment of included studies and data extraction were done by two independent reviewers. Meta-analysis was performed for cross-sectional studies using the random-effects model. Results The literature search yielded 340 studies, and finally, 19 and 11 studies were included in systematic review and meta-analysis, respectively. The total sample size of the eligible studies in the meta-analysis was 38,896 participants, of whom 33% were male with a mean age of 51.20 ± 14.0 years. According to a random-effect meta-analysis in cross-sectional studies, the pooled odds ratio (OR) for the association between hyperglycemia and periodontal indices was statistically significant (OR: 1.50, 95%CI: 1.11, 1.90). There was evidence of publication bias (coefficient: - 3.53, p-value = 0.014) which, after imputing missing studies, the pooled OR of the association between hyperglycemia and periodontitis change to 1.55 (95%CI: 1.20, 1.90). Conclusion Results of the present study show that hyperglycemia was positively associated with periodontitis. However, more cohort and prospective longitudinal studies should be conducted to find the exact association. Overall, it seems the management of hyperglycemia could be considered as a preventive strategy for periodontitis. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00861-9.
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Affiliation(s)
- Ahmadreza Mirzaei
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Ehsan Shahrestanaki
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Javad Heshmati
- Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Armita Mahdavi-Gorabi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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11
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Tsimpiris A, Grigoriadis A, Tsolianos I, Moschos I, Goulis DG, Kouklakis G. Periodontitis and Helicobacter pylori Infection: Eradication and Periodontal Therapy Combination. Eur J Dent 2021; 16:145-152. [PMID: 34598295 PMCID: PMC8890927 DOI: 10.1055/s-0041-1731928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objectives
This study was aimed to assess (1) the prevalence of salivary and gastric
Helicobacter pylori
(HP) infection in patients with and without periodontitis, (2) the prevalence of HP infection in patients with periodontitis according to its clinical classification, (3) the effect of periodontitis treatment in patients with or without gastric HP infection, and (4) if gastric HP eradication in combination with periodontitis treatment influences periodontitis clinical outcome.
Materials and Methods
Thirty-three adults with periodontitis treated by quadrant scaling and root planning (QSRP). The simplified plaque index (PI), bleeding on probing index (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed pretreatment and 3 months of posttreatment. The patients were tested for oral and gastric HP. Gastric HP (+) patients received eradication therapy. A control group of 32 periodontically healthy volunteers was tested for oral and gastric HP. Saliva samples were evaluated by real-time polymerase chain reaction (rtPCR); gastric HP was detected by urea breath test (UBT).
Statistical Analysis
Normality of variables assessed by the Kolmogorov–Smirnov test, while the differences of pre- and post-treatment were analyzed by paired samples
t
-test. Differences between subgroups were compared by a Student’s
t
-test or a Mann–Whitney
U
-test. Comparisons of nominal variables were made by Pearson’s Chi-square test.
Results
No saliva samples were positive for HP. Gastric HP was detected in six patients with periodontitis and seven controls (
p
> 0.05). HP infection affected patients with higher disease stages and grades. All HP (+) patients underwent successful eradication treatment. All clinical periodontitis indices improved following QSRP. HP (+) patients who received QSRP as adjunctive to eradication treatment showed improvement in BOP (
p
< 0.001), PI (
p
< 0.013), and CAL (
p
< 0.004) compared with HP (−) patients who received QSRP alone.
Conclusion
Periodontitis was not associated with gastric HP infection. Saliva was not a gastric HP supply reservoir. Gastric HP infection was associated with advanced stages and grades of periodontitis. Although all periodontal clinical markers improved after QSRP, BOP, PI, and CAL, they were further improved when combined with eradication treatment. Periodontal evaluation and treatment combined with HP eradication are recommended in patients with HP gastric infection.
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Affiliation(s)
- Athanasios Tsimpiris
- Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Andreas Grigoriadis
- Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece.,Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Tsolianos
- Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Moschos
- Department of Nursing, International Hellenic University, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Kouklakis
- A' Department of Pathology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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12
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Ozturk A. Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials. Int Dent J 2021; 71:188-196. [PMID: 34024329 PMCID: PMC9275331 DOI: 10.1111/idj.12616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives The efficacy of conventional systemic antibiotic therapy for eradication of Helicobacter pylori has been seriously challenged by antibiotic resistance. Identification of alternative therapeutic strategies might help to overcome this limitation. The aim of this study was to update previous meta-analyses that investigated the effect of periodontal treatment on gastric H. pylori eradication. Methods A systematic electronic search of the literature was conducted to identify all published clinical trials that compared the effect of adjunct periodontal treatment on conventional systemic H. pylori eradication therapy. Results The updated analysis (consisting of 541 participants representing six studies) demonstrated that, compared with conventional systemic eradication therapy alone, the addition of periodontal treatment resulted in improvements in gastric H. pylori eradication rates with OR 4.11 (P = 0.01). Moreover, not to lose any data, the previously presented Chinese results that could not be assessed by any available mechanism deduced from previously published meta-analysis and with other records were re-analysed. Similarly, the second meta-analysis adding up to a final cluster of 10 studies (909 participants) gives further credence to periodontal treatment as a useful concomitant therapy in the H. pylori eradication therapy (odds ratio [OR] = 2.65; P = 0.0002). Finally, the meta-analysis of four trials consisting of 177 cases and 161 controls showed that periodontal treatment also improved non-recurrence rates of gastric H. pylori infection, with an OR of 5.36 (P-value = 0.0002). Conclusion Although the inclusion of five additional clinical trials in this updated meta-analysis has not changed the result of the previous review, the current meta-analysis is superior for having removed one study involving the use of chlorhexidine, which did not meet appropriate criteria for inclusion. Our results strengthen the value of periodontal treatment as an adjunctive remedy. Consistency of these results suggests that the incorporation of professional periodontal treatment with systemic eradication therapy may be a wise strategy, enhancing the efficacy of H. pylori eradication therapy. Systematic review registration: in PROSPERO ID number: CRD42019119347.
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Affiliation(s)
- Ayla Ozturk
- Department of Periodontology, School of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
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13
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Analysis of the Relation between Periodontitis and Chronic Gastritis/Peptic Ulcer: A Cross-Sectional Study Using KoGES HEXA Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124387. [PMID: 32570864 PMCID: PMC7344436 DOI: 10.3390/ijerph17124387] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022]
Abstract
The aim of the present study was to investigate the association between periodontitis and chronic gastritis/peptic ulcer using a cross-sectional study design. The present prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study (KoGES) recorded from 2004 to 2016. Among 173,209 participants, 9983 with periodontitis and 125,336 with no periodontitis were selected. Histories of chronic gastritis and peptic ulcer between periodontitis and no periodontitis participants were analyzed. The participants were questioned around any history of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, ischemic heart disease, periodontitis, body mass index, smoking, alcohol consumption, nutritional intake, and financial income. Chi-square tests, independent t-tests, two-tailed analyses were used in statistical analysis of the data. The adjusted odds ratio of chronic gastritis was 2.22 (95% confidence interval [CI] = 2.10–2.34, p < 0.001) and that of peptic ulcer was 1.86 (95% CI = 1.74–1.98, p < 0.001) in model 2. This study demonstrated that periodontitis was associated with an increased risk of chronic gastritis/peptic ulcer. These findings provide additional evidence for an association between periodontitis and chronic gastritis/peptic ulcer.
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14
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Kashyap D, Baral B, Verma TP, Sonkar C, Chatterji D, Jain AK, Jha HC. Oral rinses in growth inhibition and treatment of Helicobacter pylori infection. BMC Microbiol 2020; 20:45. [PMID: 32131741 PMCID: PMC7055109 DOI: 10.1186/s12866-020-01728-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/14/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is well-known for its role in chronic gastritis and gastric cancer. Eradication of these carcinogenic bacteria from the gut is one of the challenges for clinicians. The complexity of treatment mainly owes to antibiotic resistance and relapse due to an additional reservoir in the oral cavity. Our study emphases the isolation of H. pylori from distinct habitats of the gut microenvironment (gastric biopsy and gastric juice) and its subsequent characterization. We have also evaluated the effect of various oral rinses on isolated H. pylori from different anatomical locations of included subjects. RESULTS The possible strains isolated from two different habitats of the same subject shows a striking difference in their growth pattern. Promisingly, some of the included oral rinses are efficient in growth inhibition as per recommended 30 s treatment. The subsequent evaluation shows that oral rinse B (among A-E) is most effective and down-regulates the expression of one of the potent H. pylori gene, CagA, in the infected gastric adenocarcinoma (AGS) cells. CONCLUSION Our study, for the first time, revealed that H. pylori, isolated from the different habitat of the same subject, show a different growth pattern. The expression of H. pylori pathogenic gene (CagA) was down-regulated by the use of oral rinses. Hence, oral rinses will reduce the H. pylori in the oral cavity and help to control its migration from oral to the gastric compartment and may be used as an adjuvant treatment option for its re-infection.
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Affiliation(s)
- Dharmendra Kashyap
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, 453552, Indore, Madhya Pradesh, India
| | - Budhadev Baral
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, 453552, Indore, Madhya Pradesh, India
| | - Tarun Prakash Verma
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, 453552, Indore, Madhya Pradesh, India
| | - Charu Sonkar
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, 453552, Indore, Madhya Pradesh, India
| | - Debi Chatterji
- Choithram Hospital and Research Centre, 452014, Indore, Madhya Pradesh, India
| | - Ajay Kumar Jain
- Choithram Hospital and Research Centre, 452014, Indore, Madhya Pradesh, India
| | - Hem C Jha
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, 453552, Indore, Madhya Pradesh, India.
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15
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Wei X, Zhao HQ, Ma C, Zhang AB, Feng H, Zhang D, Liu C. The association between chronic periodontitis and oral Helicobacter pylori: A meta-analysis. PLoS One 2019; 14:e0225247. [PMID: 31825954 PMCID: PMC6905540 DOI: 10.1371/journal.pone.0225247] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/31/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Epidemiological studies have shown that gastrointestinal Helicobacter pylori (H. pylori) infection is the main cause of chronic gastritis, but the relation between oral H. pylori and chronic periodontitis (CP) remains uncertain. A meta-analysis of published papers was performed to elucidate the correlation between oral H. pylori and CP. METHOD To perform this meta-analysis, we searched papers published from 2000 to 2018 on PubMed, OVID, Springer Link, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biology Medicine search engines. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for the correlation between H. pylori and CP were estimated. Heterogeneity, publication bias and subgroup analyses were also conducted. RESULTS A total of 918 papers on oral H. pylori and CP were collected, and 11 papers were in accordance with the inclusion criteria. Oral H. pylori was suggested to be correlated with CP. The results indicated that a H. pylori-positive state significantly increased the risk of CP 3.42 times (OR = 3.42; 95% CI = 2.71-4.31). A diagnostic test using polymerase chain reaction (PCR) showed a higher prevalence of H. pylori (OR = 3.70; 95% CI = 2.66-5.14) than did that using the rapid urease test (RUT) (OR = 3.13; 95% CI = 2.26-4.34). CONCLUSIONS This paper demonstrated that CP was potentially correlated with oral H. pylori in adults and that oral H. pylori may be a possible risk factor for CP.
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Affiliation(s)
- Xiang Wei
- Shandong Province Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Hua-Qiang Zhao
- Shandong Province Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Chuan Ma
- Shandong Province Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Ao-Bo Zhang
- Shandong Province Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong Province, China
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, Shandong Province, China
| | - Hao Feng
- School of Stomatology, West China Hospital of Sichuan University, Chengdu, China
| | - Dong Zhang
- Department of Oral and Maxillofacial Surgery, Qilu Hospital of Shandong University, Jinan, China
- Institute of Stomatology, Shandong University, Jinan, China
- Key Laboratory of Otolaryngology, NHFPC (Shandong University), Jinan, China
| | - Chao Liu
- Department of Oral and Maxillofacial Surgery, Qilu Hospital of Shandong University, Jinan, China
- Institute of Stomatology, Shandong University, Jinan, China
- Key Laboratory of Otolaryngology, NHFPC (Shandong University), Jinan, China
- * E-mail:
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16
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Yuksel Sert S, Ozturk A, Bektas A, Cengiz MI. Periodontal treatment is more effective in gastric Helicobacter pylori eradication in those patients who maintain good oral hygiene. Int Dent J 2019; 69:392-399. [DOI: 10.1111/idj.12484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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17
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Sun Y, Zhang J. Helicobacter pylori recrudescence and its influencing factors. J Cell Mol Med 2019; 23:7919-7925. [PMID: 31536675 PMCID: PMC6850920 DOI: 10.1111/jcmm.14682] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/21/2019] [Accepted: 08/25/2019] [Indexed: 12/12/2022] Open
Abstract
Helicobacter pylori (H pylori) is known as one of the most common infectious pathogens, with high infection and recurrence rates worldwide. The prevalence of H pylori is up to 90% in developing countries, while the annual recurrence rate is much higher than that in developed countries. Recurrence can occur either by recrudescence or reinfection. Compared with reinfection, the time window for recrudescence is generally shorter, followed by the recurrence of H pylori–associated diseases in the short‐term. Many factors are involved in the H pylori reinfection, such as the prevalence of H pylori infection, living conditions and economic development, health conditions and so forth. Previous studies focused less on H pylori recrudescence. Therefore, the influencing factors for H pylori recrudescence needed further exploration. This study reviewed the recrudescence of H pylori infection and its influencing factors.
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Affiliation(s)
- Yan Sun
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.,Department of Gastroenterology, Zhejiang Provincial People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Jun Zhang
- Department of Gastroenterology, Zhejiang Provincial People's Hospital of Hangzhou Medical College, Hangzhou, China
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18
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Tongtawee T, Wattanawongdon W, Simawaranon T. Effects of periodontal therapy on eradication and recurrence of Helicobacter pylori infection after successful treatment. J Int Med Res 2019; 47:875-883. [PMID: 30616462 PMCID: PMC6381484 DOI: 10.1177/0300060518816158] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the effects of periodontal therapy on the efficacy of Helicobacter pylori eradication and on the recurrence of infection after eradication. METHODS We conducted a prospective randomized trial on 698 gastric H. pylori-infected patients, of whom 347 received gastric H. pylori treatment alone and 342 received gastric H. pylori treatment plus periodontal therapy. The presence of H. pylori and associated virulence genes were detected by real-time polymerase chain reaction. RESULTS After eradication of gastric H. pylori infection, the recurrence of gastric H. pylori was significantly lower in the gastric H. pylori treatment plus periodontal therapy group than in the group receiving gastric H. pylori treatment alone (OR 0.67; 95% CI 0.45 to 0.99), whereas the eradication rate was not significantly different (OR 0.87; 95% CI 0.68 to 0.98). There was a close relationship between the presence of H. pylori in saliva and its presence in the stomach. CONCLUSIONS The oral cavity is an important reservoir for gastric H. pylori infection. Adjunctive periodontal therapy could enhance the efficiency of H. pylori treatment and reduce the recurrence of gastric H. pylori infection.
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Affiliation(s)
- Taweesak Tongtawee
- 1 Department of Surgery, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand.,2 Suranaree University of Technology Hospital, Nakhon Ratchasima, Thailand
| | - Wareeporn Wattanawongdon
- 1 Department of Surgery, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Theeraya Simawaranon
- 1 Department of Surgery, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
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19
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Shahbazi S, Vahdat Shariatpanahi Z. Comparison between daily single-dose triple therapy and conventional triple therapy on patient compliance and Helicobacter pylori eradication: A randomized controlled trial. Indian J Gastroenterol 2018; 37:550-554. [PMID: 30635887 DOI: 10.1007/s12664-018-0916-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 11/06/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The poor compliance to treatment of Helicobacter pylori-infected patients is well-known. We evaluated the efficacy of daily single-dose triple therapy as compared to conventional triple therapy on patient compliance and eradication of H. pylori infection. METHODS In the study group, 105 patients received esomeprazole 40 mg, tinidazole 1 g, and levofloxacin 500 mg once-daily for 14 days. One hundred and seven patients in the control group received lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg twice-daily for 14 days. Four weeks after completing therapy, urea breath test was performed to assess the eradication of H. pylori infection. RESULTS The eradication rates by intention-to-treat analysis were 86% and 90.2% and by per-protocol analyses were 90.5% and 95.3% in the control and study groups, respectively, with no significant differences. Drug compliance was significantly better in the study group compared to the control group (p = 0.04). Overall, 44.7% of the patients in the study and 47.6% in the control groups had at least one adverse event. The most common adverse event was the dysgeusia in both the groups. The occurrence of diarrhea, nausea and vomiting was significantly higher in the control group and that of arthralgia was higher in the study group. The presence of periodontal disease and drug compliance was independently associated with treatment failure. CONCLUSION The use of single-dose PPI-based triple therapy improves drug compliance and eradication rate to standard PPI-based triple therapy. Presence of periodontal disease and drug compliance had negative influence on the eradication rate. TRIAL REGISTRATION NCT02711176 ᅟ ᅟ.
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Affiliation(s)
- Shaahin Shahbazi
- Department of Internal Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
| | - Zahra Vahdat Shariatpanahi
- Department of Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Increased risk of periodontitis among patients with Crohn's disease: a population-based matched-cohort study. Int J Colorectal Dis 2018; 33:1437-1444. [PMID: 30003361 DOI: 10.1007/s00384-018-3117-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Periodontitis is a frequently cited extraintestinal manifestation of Crohn's disease (CD). Despite a plethora of investigations and a recent meta-analysis linking CD and periodontitis, no study has estimated the risk of periodontitis among CD patients with respect to a comparison group nor has any investigation analyzed the effect of CD-specific medications on the risk of periodontitis. The present cohort study compared CD patients and matched subjects without a history of inflammatory bowel disease (IBD) to estimate the effect of CD and CD-specific pharmaceutical prescriptions on the risk of developing periodontitis by leveraging a population-based dataset in Taiwan. METHODS We sourced 6657 CD patients and 26,628 comparison subjects without a history of IBD from the Taiwan National Health Insurance Database. Cox proportional hazards regressions were used to estimate the risk of subsequent periodontitis by CD status and pharmaceutical prescription during the follow-up period. RESULTS After adjusting for socioeconomic status (SES), urbanicity, selected medical co-morbidities, and CD-specific pharmaceutical prescriptions, the hazard ratio (HR) for subsequent periodontitis among patients with CD was 1.36 (95% CI = 1.25-1.48) that of comparison subjects. There was not a significant difference in risk between genders or across ages. Steroids (95% CI = 0.66-0.77) appeared to confer a protective effect and Aspirin, Plavix, and Licodin were marginally protective (95% CI = 0.76-0.95). CONCLUSION This is the first study to report an increased HR for subsequent periodontitis among CD patients when compared to matched comparison subjects without IBD. The protective effect of some pharmaceuticals may suggest that treatment of CD protects against periodontitis.
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21
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Ansari SA, Iqbal MUN, Khan TA, Kazmi SU. Association of oral Helicobacter pylori with gastric complications. Life Sci 2018; 205:125-130. [PMID: 29763614 DOI: 10.1016/j.lfs.2018.05.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/07/2018] [Accepted: 05/11/2018] [Indexed: 12/29/2022]
Abstract
AIM This study was aimed to identify the presence of Helicobacter pylori (H. pylori) genes in oral mucosa and find out their relationship between oral H. pylori infection and gastric complications. METHODS This study is a case control study consists of 567 subjects with periodontal infection (278 gastric complication cases and 289 controls normal gastric intestinal mucosa) with age range of 20-80 years. Oral health status was recorded by calculating oral hygiene index (OHI), probing depths (PD) and clinical attachment loss (CAL). Each participant provided gastric biopsy and plaque samples which were subjected to H. pylori detection. Polymerase chain reaction (PCR) with different primers specifically β globulin, 16SrRNA, babA, cagA, ureA, ureC and vacA gene was performed which were then analyzed using gel electrophoresis. RESULTS No significant differences (χ2 = 11.873, p value > 0.05) were observed between oral H. pylori and gastric infections/complications. However, H. pylori increase the risk of developing gastro-esophageal reflux grade II (OR = 1.458, 95%CI = 0.659-3.226), normal upper GIT mucosa with lax esophageal sphincters (OR = 1.215, 95%CI = 0.285-5.181) and duodenal ulcer/duodenitis (OR = 2.187, 95%CI = 0.225-21.278). This study also showed a significant increased risk of gastritis with babA gene. CONCLUSION Oral pathogenic H. pylori genes may enhance the severity of the gastric infection.
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Affiliation(s)
- Shazia A Ansari
- Department of Oral Pathology, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Taseer A Khan
- Department of Physiology, University of Karachi, Karachi, Pakistan
| | - Shahana U Kazmi
- Immunology and Infectious Diseases Research Laboratory, Department of Microbiology, University of Karachi, Karachi, Pakistan
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22
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Yu HC, Chen TP, Wei CY, Chang YC. Association between Peptic Ulcer Disease and Periodontitis: A Nationwide Population-Based Case-Control Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050912. [PMID: 29734656 PMCID: PMC5981951 DOI: 10.3390/ijerph15050912] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 04/28/2018] [Accepted: 04/29/2018] [Indexed: 12/25/2022]
Abstract
Previous studies have suggested that peptic ulcer disease (PUD) including stomach and duodenal ulcers might be associated with periodontitis (PD); however, no clear conclusions have been reached thus far. In this retrospective case-control study, we aimed to investigate the association between PUD and PD by using a large population-based dataset in Taiwan. A population-based retrospective case control study was conducted using the Longitudinal Health Insurance Database 2010 (LHID2010) derived from the National Health Insurance Research database (NHIRD) in Taiwan from 2000 to 2013. The case and control group were matched with gender, age, urbanization level, socioeconomic status, and Charlson comorbidity index (CCI) by using the propensity score method at a 1:1 ratio. A total of 177,240 cases and 177,240 control patients were included in this study, with an average age of 46.96 ± 11.76 years. The risk of PUD for patients diagnosed with PD was 1.15-fold when compared with those without PD (OR, 1.15; 95% CI, 1.12–1.18). This population-based case control study demonstrated a significantly positive association between PUD and PD in Taiwan.
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Affiliation(s)
- Hui-Chieh Yu
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Tsung-Po Chen
- Department of Family Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
| | - Chia-Yi Wei
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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23
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Lee JH, Choi JK, Jeong SN, Choi SH. Charlson comorbidity index as a predictor of periodontal disease in elderly participants. J Periodontal Implant Sci 2018; 48:92-102. [PMID: 29770238 PMCID: PMC5944227 DOI: 10.5051/jpis.2018.48.2.92] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/22/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods Nationwide representative samples of 149,785 adults aged ≥60 years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ≥2: HR, 1.12, P<0.001). Conclusions We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jung-Kyu Choi
- Department of Health Insurance Research, Ilsan Hospital, National Health Insurance Service, Goyang, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Yee JKC. Are the view of Helicobacter pylori colonized in the oral cavity an illusion? Exp Mol Med 2017; 49:e397. [PMID: 29170474 PMCID: PMC5704198 DOI: 10.1038/emm.2017.225] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/20/2017] [Accepted: 03/23/2017] [Indexed: 02/06/2023] Open
Abstract
Urea breath test (UBT), as a leading preferred non-invasive diagnostic technology, but may not be able to detect oral H. pylori. With negative results of UBT, the patient may have an oral infection. On the basis of the fact of success, eradication rate may increase by 21% in the 95% Cl range after the elimination of oral H. pylori, the author believes oral H. pylori does exist and the oral cavity is the second colonized site aside its primary site of the stomach. H. pylori migrated out of Africa along with its human host circa 60 000 years ago; they are not lives in stomach only. In this review article, evidence established in recent years studies with use more appropriate technology had been listed and discussed. The author considers the oral cavity is a black hole for H. pylori infection that significant effective on gastroenterology and another medical field. The role of the oral cavity as the source of H. pylori infection is so controvert in past years. It seems like a human being having a second-time face to discover H. pylori in the history.
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Affiliation(s)
- J K C Yee
- Research Lab of Oral H pylori, Everett, WA, USA
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Zahedi L, Jafari E, Torabi Parizi M, Shafieipour S, Hayat Bakhsh Abbasi M, Darvish Moghadam S, Zahedi MJ. The Association between Oral Hygiene and Gastric Pathology in Patients with Dyspepsia: a Cross-Sectional Study in Southeast Iran. Middle East J Dig Dis 2017; 9:33-38. [PMID: 28316764 PMCID: PMC5308132 DOI: 10.15171/mejdd.2016.49] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND
Many studies have reported an association between periodontal infections and some systemic diseases such as respiratory and cardiovascular diseases. Some studies found a direct association between chronic gastritis caused by Helicobacter pylori (HP) infection and poor periodontal health.
METHODS
In a cross-sectional study from November 2014 to December 2015 in Kerman, the largest province in southeast Iran, patients with dyspepsia who were candidate for diagnostic upper gastrointestinal (GI) endoscopy were included in our study. Decayed, Missing, and Filled Teeth (DMFT) index and Loe plaque index that are two popular indexes in dental epidemiology were used to assess the oral health by a dentist before the upper GI endoscopy. According to the Loe plaque index, score: 0= no plaque, score: 1= a film of plaque attaching to the free gingival border and near area of the tooth, score: 2= moderate reposition of deposits within the gingival pocket, score :3= plenty of soft matter within the gingival pocket±on the tooth and gingival border. Scores ≤1, 2 and 3 equal to good, moderate, and poor oral hygiene, respectively. During upper GI endoscopy a total of six biopsy samples were taken from fundus, body, and antrum. A pathologist reported these samples according to Sidney’s classification into superficial gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia.
RESULTS
According to Sidney’s classification 77 (89.5%) patients had superficial gastritis, 3 (3.5%) had atrophic gastritis, and 6 (7%) had intestinal metaplasia. HP was found in 80.2% of the gastric mucosal biopsy samples. There were not statistically significant relationship between Sidney’s classification, presence of HP in gastric mucosal biopsies, and hygiene indicators (p>0.05). No relation was found between the DMFT index and superficial gastritis, atrophic gastritis, and intestinal metaplasia (p>0.05). Gastric infection with HP was found in 70%, 75%, and 100% of patients with mild, moderate, and sever DMFT index, respectively.
CONCLUSION
Our study showed that there might be a relation between poor oral hygiene and gastric precancerous lesions. In addition, HP infection in gastric histopathology might be associated with periodontal disease.
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Affiliation(s)
- Leili Zahedi
- Researcher, Kerman Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Jafari
- Assistant Professor, Pathology and stem cells Research Center, Kerman University of Medical Science ,Kerman,Iran
| | - Molook Torabi Parizi
- Associate Professor, Kerman Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Shafieipour
- Assistant Professor of Internal Medicine, Digestive Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Hayat Bakhsh Abbasi
- Associate Professor of Internal Medicine, Digestive Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sodaif Darvish Moghadam
- Professor of Internal Medicine, Digestive Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Javad Zahedi
- Professor of Internal Medicine, Digestive Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Ren Q, Yan X, Zhou Y, Li WX. Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [PMID: 26852297 DOI: 10.1002/14651858.cd009477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Helicobacter pylori is estimated to affect about half the world's population and is considered as the main cause of chronic gastritis and peptic ulcer disease. Eradication of H. pylori infection accelerates ulcer healing and prevents relapse, reducing incidence of H. pylori-related gastric diseases. Numerous studies have provided evidence that the oral cavity could be a potential reservoir for H. pylori. The presence of oralH. pylori might affect the efficiency of eradication therapy and act as a causal force for its recurrence. Conversely, other investigators have indicated that the colonization and growth of H. pylori differs between the oral cavity and the stomach. Considering the open debate on the topic, it's necessary to clarify whether periodontal therapy is an effective adjunctive treatment for gastric H. pylori infection. OBJECTIVES To assess the effects of periodontal therapy plus eradication therapy versus eradication therapy alone for gastric H. pylori infection. The secondary objective is to compare the non-recurrence rate at long-term follow up in different treatment groups. SEARCH METHODS We identified randomized controlled trials (RCTs) by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 8), MEDLINE (1946 to August 2015), EMBASE (1980 to August 2015), and the Chinese Biomedical Database (1978 to August 2015). We also searched both ClinicalTrials.gov and the WHO ICTRP portal in October 2015. We handsearched the reference lists of included studies to identify relevant trials. SELECTION CRITERIA RCTs comparing periodontal therapy plus eradication treatment with eradication treatment alone, regardless of language of publication. DATA COLLECTION AND ANALYSIS Two reviewers selected the trials that met the inclusion criteria and extracted the details of each study independently. The data were pooled using both fixed-effect and random-effects models and results calculated as odds ratios (OR) with their 95% confidence intervals (CIs) based on an intention-to-treat analysis. However, because there was little difference in the results from these two models, we only reported the results from the fixed-effect model. MAIN RESULTS We included seven small RCTs involving 691 participants aged 17 to 78 years in our meta analyses. The primary result showed that periodontal therapy combined with H. pylori eradication treatment increased the eradication rate of gastric H. pylori compared with eradication treatment alone (OR 2.15; 95% CI 1.47 to 3.14; P < 0.0001) in people with H. pylori infection. In addition, periodontal therapy also had benefits on long-term gastric H. pylori eradication. After eradication of H. pylori, the non-recurrence rate of gastric H. pylori infection increased in participants treated with periodontal therapy compared with those who received eradication therapy alone (OR 3.60; 95% CI 2.11 to 6.15; P < 0.00001). According to the GRADE approach, the overall quality of the evidence was 'moderate' for eradication rate of gastric H.pylori and 'low' for non-recurrence rate of gastric H. pylori. AUTHORS' CONCLUSIONS Overall, periodontal therapy could increase the efficiency of H. pylori eradication and the non-recurrence rate of gastricH. pylori. In view of the limited number and quality of included studies, it will be necessary to conduct more well-designed, multicenter, and large-scale RCTs to determine the effects of periodontal therapy in eradicating gastric H. pylori and suppressing the recurrence of this bacterium in the stomach.
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Affiliation(s)
- Qian Ren
- Department of Gastroenterology, First Hospital of Lanzhou University, No. 1, Donggang West Road, Lanzhou City, Gansu, China, 730000
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Ren Q, Yan X, Zhou Y, Li WX. Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection. Cochrane Database Syst Rev 2016; 2:CD009477. [PMID: 26852297 PMCID: PMC8255095 DOI: 10.1002/14651858.cd009477.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Helicobacter pylori is estimated to affect about half the world's population and is considered as the main cause of chronic gastritis and peptic ulcer disease. Eradication of H. pylori infection accelerates ulcer healing and prevents relapse, reducing incidence of H. pylori-related gastric diseases. Numerous studies have provided evidence that the oral cavity could be a potential reservoir for H. pylori. The presence of oralH. pylori might affect the efficiency of eradication therapy and act as a causal force for its recurrence. Conversely, other investigators have indicated that the colonization and growth of H. pylori differs between the oral cavity and the stomach. Considering the open debate on the topic, it's necessary to clarify whether periodontal therapy is an effective adjunctive treatment for gastric H. pylori infection. OBJECTIVES To assess the effects of periodontal therapy plus eradication therapy versus eradication therapy alone for gastric H. pylori infection. The secondary objective is to compare the non-recurrence rate at long-term follow up in different treatment groups. SEARCH METHODS We identified randomized controlled trials (RCTs) by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 8), MEDLINE (1946 to August 2015), EMBASE (1980 to August 2015), and the Chinese Biomedical Database (1978 to August 2015). We also searched both ClinicalTrials.gov and the WHO ICTRP portal in October 2015. We handsearched the reference lists of included studies to identify relevant trials. SELECTION CRITERIA RCTs comparing periodontal therapy plus eradication treatment with eradication treatment alone, regardless of language of publication. DATA COLLECTION AND ANALYSIS Two reviewers selected the trials that met the inclusion criteria and extracted the details of each study independently. The data were pooled using both fixed-effect and random-effects models and results calculated as odds ratios (OR) with their 95% confidence intervals (CIs) based on an intention-to-treat analysis. However, because there was little difference in the results from these two models, we only reported the results from the fixed-effect model. MAIN RESULTS We included seven small RCTs involving 691 participants aged 17 to 78 years in our meta analyses. The primary result showed that periodontal therapy combined with H. pylori eradication treatment increased the eradication rate of gastric H. pylori compared with eradication treatment alone (OR 2.15; 95% CI 1.47 to 3.14; P < 0.0001) in people with H. pylori infection. In addition, periodontal therapy also had benefits on long-term gastric H. pylori eradication. After eradication of H. pylori, the non-recurrence rate of gastric H. pylori infection increased in participants treated with periodontal therapy compared with those who received eradication therapy alone (OR 3.60; 95% CI 2.11 to 6.15; P < 0.00001). According to the GRADE approach, the overall quality of the evidence was 'moderate' for eradication rate of gastric H.pylori and 'low' for non-recurrence rate of gastric H. pylori. AUTHORS' CONCLUSIONS Overall, periodontal therapy could increase the efficiency of H. pylori eradication and the non-recurrence rate of gastricH. pylori. In view of the limited number and quality of included studies, it will be necessary to conduct more well-designed, multicenter, and large-scale RCTs to determine the effects of periodontal therapy in eradicating gastric H. pylori and suppressing the recurrence of this bacterium in the stomach.
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Affiliation(s)
- Qian Ren
- First Hospital of Lanzhou UniversityDepartment of GastroenterologyNo. 1, Donggang West RoadLanzhou CityGansuChina730000
| | - Xiang Yan
- First Hospital of Lanzhou UniversityNo. 1, Donggang West RoadLanzhou CityGansuChina730000
| | - YongNing Zhou
- First Hospital of Lanzhou UniversityDepartment of GastroenterologyNo. 1, Donggang West RoadLanzhou CityGansuChina730000
| | - Wei Xin Li
- First Hospital of Lanzhou UniversityDivision of GeriatricsNo. 1, Donggang West RoadLanzhou CityGansuChina730000
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Bharath TS, Reddy MS, Dhanapal R, Raj Kumar NG, Neeladri Raju P, Saraswathi T. Molecular detection and corelation of Helicobacter pylori in dental plaque and gastric biopsies of dyspeptic patients. J Oral Maxillofac Pathol 2014; 18:19-24. [PMID: 24959032 PMCID: PMC4065441 DOI: 10.4103/0973-029x.131885] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
UNLABELLED Helicobacter pylori is a microaerophilic organism, which colonizes in the gastric mucosa. Its role in etiology and development of acute and chronic gastritis and peptic ulcer diseases is scientifically proved. Oral cavity especially supragingival, subgingival plaque and so forth simulate the same microaerophilic environment favorable for the growth of this bacterium. AIM Detection of H. pylori simultaneously in the oral cavity and gastric mucosa of patients suffering from gastric pathologies. OBJECTIVES To detect H. pylori in the oral cavity and gastric mucosa using endoscopy, urease test and real-time polymerase chain reaction (PCR) (urease A gene). Determining its association and corelation with patient demographics, oral hygiene maintenance and periodontal disease status. MATERIALS AND METHODS Endoscopic examination, oral findings oral hygiene index-simplified (OHI-S) and community periodontal index and treatment needs (CPITN) indices were recorded. Antral biopsies and supragingival plaque samples were taken from 56 dyspeptic adult patients. The collected samples were subjected to histological examination, urease broth test and urease A gene amplification using real-time PCR. RESULT H. pylori was detected in the supragingival plaque of individuals with H. pylori-induced gastric diseases using rapid urease test and real-time PCR analysis. Occurrence of same strain of H. pylori simultaneously in plaque and gastric mucosa was observed. Positive correlation was obtained between the collected indices and quantity of H. pylori colonization.
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Affiliation(s)
- T Sreenivasa Bharath
- Department of Oral Pathology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - M Sesha Reddy
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Raghu Dhanapal
- Department of Oral Pathology, Institute of Technology and Science Dental College, Ghaziabad, Uttar Pradesh, India
| | - N Govind Raj Kumar
- Department of Oral Pathology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Pv Neeladri Raju
- Gastroenterologist, Neeladri Institute of Gastroenterology, Bhimavaram, Andhra Pradesh, India
| | - Tr Saraswathi
- Department of Oral Pathology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Anand PS, Kamath KP, Anil S. Role of dental plaque, saliva and periodontal disease in Helicobacter pylori infection. World J Gastroenterol 2014; 20:5639-53. [PMID: 24914323 PMCID: PMC4024772 DOI: 10.3748/wjg.v20.i19.5639] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 01/19/2014] [Accepted: 03/06/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world's population, the mechanisms of transmission of the microorganism from individual to individual are not yet clear. Transmission of H. pylori could occur through iatrogenic, fecal-oral, and oral-oral routes, and through food and water. The microorganism may be transmitted orally and has been detected in dental plaque and saliva. However, the role of the oral cavity in the transmission and recurrence of H. pylori infection has been the subject of debate. A large number of studies investigating the role of oral hygiene and periodontal disease in H. pylori infection have varied significantly in terms of their methodology and sample population, resulting in a wide variation in the reported results. Nevertheless, recent studies have not only shown that the microorganism can be detected fairly consistently from the oral cavity but also demonstrated that the chances of recurrence of H. pylori infection is more likely among patients who harbor the organism in the oral cavity. Furthermore, initial results from clinical trials have shown that H. pylori-positive dyspeptic patients may benefit from periodontal therapy. This paper attempts to review the current body of evidence regarding the role of dental plaque, saliva, and periodontal disease in H. pylori infection.
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Li L, Gu H, Zhang G. Association between recurrent aphthous stomatitis and Helicobacter pylori infection: a meta-analysis. Clin Oral Investig 2014; 18:1553-60. [DOI: 10.1007/s00784-014-1230-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 03/14/2014] [Indexed: 01/26/2023]
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Oral Cavity as an Extragastric Reservoir of Helicobacter pylori. ISRN GASTROENTEROLOGY 2014; 2014:261369. [PMID: 24701355 PMCID: PMC3950549 DOI: 10.1155/2014/261369] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 12/24/2013] [Indexed: 12/11/2022]
Abstract
Background. Several studies were reported on the prevalence, and relationship between the existence of Helicobacter pylori (H. pylori) in oral cavity and in stomach of patients. The purpose of this study was to systematically review the existing literature on the presence of H. pylori in the oral cavity and its link to gastric infection, the existence of coinfection, and the impact of anti-H. pylori therapy on the dental plaque and vice versa. Method. Two authors independently searched the Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies. The articles were analyzed critically and all qualified studies were included. The search was carried out by using a combined text and the MeSH search strategies: using the key words Helicobacter, Helicobacter pylori, and H. pylori in combination with dental plaque, periodontitis, and oral hygiene. Results. The data was presented in 8 tables and each topic separately discussed. Conclusion. Based on the systematic review of the available literature on H. pylori infection and its presence in the oral cavity, it can be concluded that dental plaque can act as a reservoir, and proper oral hygiene maintenance is essential to prevent reinfection. Due to the diversified methods and population groups involved in the available literature, no concrete evidence can be laid down. Further studies are necessary to establish the role of H. pylori in the oral cavity and its eradication on preventing the gastroduodenal infection.
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Kariya S, Okano M, Nishizaki K. An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction? World J Gastroenterol 2014; 20:1470-1484. [PMID: 24587622 PMCID: PMC3925855 DOI: 10.3748/wjg.v20.i6.1470] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/03/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions.
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A prospective study of periodontal disease and risk of gastric and duodenal ulcer in male health professionals. Clin Transl Gastroenterol 2014; 5:e49. [PMID: 24522171 PMCID: PMC3940834 DOI: 10.1038/ctg.2013.14] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/13/2013] [Accepted: 09/09/2013] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Periodontal disease has been associated with higher circulating levels of inflammatory markers and conditions associated with chronic inflammation, including vascular disease, diabetes mellitus, and cancer. Limited data exist on the relationship between periodontal disease and gastric and duodenal ulcer. METHODS We conducted a prospective cohort study of 49,120 men in the Health Professionals Follow-up Study, aged 40-75 years at enrollment in 1986. Biennially, we assessed periodontal disease, tooth loss, and other risk factors for gastric and duodenal ulcer. We validated diagnoses of gastric and duodenal ulcer through medical record review. We used Cox proportional hazards modeling, adjusting for potential confounders, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS We documented 138 cases of gastric ulcer and 124 cases of duodenal ulcer with available information on Helicobacter pylori status over 24 years of follow-up. After adjustment for risk factors, including smoking and regular use of aspirin and non-steroidal anti-inflammatory drugs, men with periodontal disease with bone loss had a multivariate HR of ulcer of 1.62 (95% CI, 1.24-2.12). Periodontal disease appeared to be associated with a similar risk of developing ulcers that were H. pylori negative (HR 1.75; 95% CI, 1.26-2.43) than H. pylori positive (HR 1.40; 95% CI, 0.87-2.24), as well as ulcers in the stomach (HR 1.75; 95% CI, 1.21-2.53) than ulcers in the duodenum (HR 1.47; 95% CI, 0.98-2.19). CONCLUSIONS Periodontal disease is associated with an increased risk of incident gastric and duodenal ulcer. This relationship may be mediated by alterations in the oral and gastrointestinal microbiome and/or systemic inflammatory factors.
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Song HY, Li Y. Can eradication rate of gastric Helicobacter pylori be improved by killing oral Helicobacter pylori? World J Gastroenterol 2013; 19:6645-6650. [PMID: 24151394 PMCID: PMC3801381 DOI: 10.3748/wjg.v19.i39.6645] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 07/05/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the influence of oral Helicobacter pylori (H. pylori) on the success of eradication therapy against gastric H. pylori.
METHODS: A total of 391 patients with dyspepsia were examined for H. pylori using the saliva H. pylori antigen test (HPS), 13C-urea breath test (UBT), gastroscopy, and gastric mucosal histopathological detection. Another 40 volunteers without discomfort were subjected to HPS and 13C-UBT, and served as the control group. The 233 patients who were 13C-UBT+ were enrolled in this study and divided into 4 groups. Patients who were HPS- and 13C-UBT+ (n = 53) received triple therapy alone. Those who were both HPS+ and 13C-UBT+ (n = 180) were randomly divided into 3 groups: (1) the O+G+t group which received triple therapy alone (n = 53); (2) the O+G+tm group which received both triple therapy and mouthrinse treatment (n = 65); and (3) the O+G+tmp group which received triple therapy, mouthrinse, and periodontal treatment (n = 62). The HPS and 13C-UBT were continued for 4 wk after completion of treatment, and the eradication rate of gastric H. pylori and the prevalence of oral H. pylori in the 4 groups were then compared.
RESULTS: The eradication rates of gastric H. pylori in the O-G+t group, the O+G+tm group, and the O+G+tmp group were 93.3%, 90.0%, and 94.7% respectively; all of these rates were higher than that of the O+G+t group (78.4%) [O-G+t group vs O+G+t group (P = 0.039); O+G+tm group vs O+G+t group (P = 0.092); O+G+tmp group vs O+G+t group (P = 0.012); O+G+tm group vs O-G+t group (P = 0.546); O+G+tmp group vs O-G+t group (P = 0.765); O+G+tm group vs O+G+tmp group (P = 0.924)]. The eradication of gastric H. pylori was significantly improved using the combination of triple therapy, mouthrinse, and periodontal treatment. The eradication rates of gastric H. pylori in the peptic ulcer group, chronic atrophic gastritis group and control group were higher than in the duodenitis group and the superficial gastritis group. The prevalence rates of oral H. pylori in the O-G+t group, O+G+t group, O+G+tm group and O+G+tmp group following treatment were 0%, 76.5%, 53.3%, and 50.9%, respectively [O-G+t group vs O+G+t group (P < 0.0001); O+G+tm group vs O+G+t group (P = 0.011); O+G+tmp group vs O+G+t group (P = 0.006); O+G+tm group vs O-G+t group (P < 0.0001); O+G+tmp group vs O-G+t group (P < 0.0001); O+G+tm group vs the O+G+tmp group (P = 0.790)]. Both mouthrinse and periodontal treatment significantly reduced the prevalence of oral H. pylori.
CONCLUSION: Mouthrinse treatment alone or combined with periodontal treatment can, to some extent, reduce the prevalence of oral H. pylori and improve the eradication rate of gastric H. pylori.
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Bouziane A, Ahid S, Abouqal R, Ennibi O. Effect of periodontal therapy on prevention of gastric Helicobacter pylori recurrence: a systematic review and meta-analysis. J Clin Periodontol 2013; 39:1166-73. [PMID: 23151293 DOI: 10.1111/jcpe.12015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM The aim of this review is to assess the effect of dental plaque control and periodontal therapy on prevention of gastric Helicobacter pylori (H. pylori) recurrence. MATERIALS AND METHODS We conducted searches of electronic databases, and included controlled trials comparing periodontal treatment and eradication therapy of H. pylori with eradication therapy alone for prevention of recurrence of gastric H. pylori. We used the absence of recurrence of gastric H. pylori after the first 3 months as an outcome measure to determine relative risk of persistence of gastric H. pylori. We estimated the degree of heterogeneity among trial results using Q and I(2) statistics. RESULTS Three trials including 298 patients were eligible according to our inclusion criteria. As significant heterogeneity was indicated by the Q statistics (p = 0.04) and I(2) (69%), we used a random-effects model to combine the data. Compared with eradication therapy alone, the adjunction of periodontal therapy significantly reduced the relative risk of persistence of gastric H. pylori by 63% (0.37 [95% CI 0.21-0.64], p = 0.0004) in patients with gastric diseases. CONCLUSIONS The adjunction of periodontal treatment to eradication therapy appears to reduce gastric H. pylori recurrence compared with eradication therapy alone among patients with gastric diseases associated with H. pylori. The results of this meta-analysis should be taken with caution because of the limitations in the primary data.
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Affiliation(s)
- Amal Bouziane
- Department of periodontology,Biostatistical, Clinical and Epidemiological Research Laboratory, Mohammed the 5th Souissi University, Rabat, Morocco.
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36
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Oral Helicobacter pylori infection and the risk of oral cancer. Oral Oncol 2013; 49:e20-1. [PMID: 23481311 DOI: 10.1016/j.oraloncology.2013.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 02/11/2013] [Indexed: 01/13/2023]
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Furuta Y, Kobayashi I. Movement of DNA sequence recognition domains between non-orthologous proteins. Nucleic Acids Res 2012; 40:9218-32. [PMID: 22821560 PMCID: PMC3467074 DOI: 10.1093/nar/gks681] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Comparisons of proteins show that they evolve through the movement of domains. However, in many cases, the underlying mechanisms remain unclear. Here, we observed the movements of DNA recognition domains between non-orthologous proteins within a prokaryote genome. Restriction-modification (RM) systems, consisting of a sequence-specific DNA methyltransferase and a restriction enzyme, contribute to maintenance/evolution of genomes/epigenomes. RM systems limit horizontal gene transfer but are themselves mobile. We compared Type III RM systems in Helicobacter pylori genomes and found that target recognition domain (TRD) sequences are mobile, moving between different orthologous groups that occupy unique chromosomal locations. Sequence comparisons suggested that a likely underlying mechanism is movement through homologous recombination of similar DNA sequences that encode amino acid sequence motifs that are conserved among Type III DNA methyltransferases. Consistent with this movement, incongruence was observed between the phylogenetic trees of TRD regions and other regions in proteins. Horizontal acquisition of diverse TRD sequences was suggested by detection of homologs in other Helicobacter species and distantly related bacterial species. One of these RM systems in H. pylori was inactivated by insertion of another RM system that likely transferred from an oral bacterium. TRD movement represents a novel route for diversification of DNA-interacting proteins.
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Affiliation(s)
- Yoshikazu Furuta
- Department of Medical Genome Sciences, Graduate School of Frontier Sciences, University of Tokyo, Minato-ku, Tokyo, 108-8639, Japan
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Faust K, Sathirapongsasuti JF, Izard J, Segata N, Gevers D, Raes J, Huttenhower C. Microbial co-occurrence relationships in the human microbiome. PLoS Comput Biol 2012; 8:e1002606. [PMID: 22807668 PMCID: PMC3395616 DOI: 10.1371/journal.pcbi.1002606] [Citation(s) in RCA: 931] [Impact Index Per Article: 77.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 05/21/2012] [Indexed: 02/07/2023] Open
Abstract
The healthy microbiota show remarkable variability within and among individuals. In addition to external exposures, ecological relationships (both oppositional and symbiotic) between microbial inhabitants are important contributors to this variation. It is thus of interest to assess what relationships might exist among microbes and determine their underlying reasons. The initial Human Microbiome Project (HMP) cohort, comprising 239 individuals and 18 different microbial habitats, provides an unprecedented resource to detect, catalog, and analyze such relationships. Here, we applied an ensemble method based on multiple similarity measures in combination with generalized boosted linear models (GBLMs) to taxonomic marker (16S rRNA gene) profiles of this cohort, resulting in a global network of 3,005 significant co-occurrence and co-exclusion relationships between 197 clades occurring throughout the human microbiome. This network revealed strong niche specialization, with most microbial associations occurring within body sites and a number of accompanying inter-body site relationships. Microbial communities within the oropharynx grouped into three distinct habitats, which themselves showed no direct influence on the composition of the gut microbiota. Conversely, niches such as the vagina demonstrated little to no decomposition into region-specific interactions. Diverse mechanisms underlay individual interactions, with some such as the co-exclusion of Porphyromonaceae family members and Streptococcus in the subgingival plaque supported by known biochemical dependencies. These differences varied among broad phylogenetic groups as well, with the Bacilli and Fusobacteria, for example, both enriched for exclusion of taxa from other clades. Comparing phylogenetic versus functional similarities among bacteria, we show that dominant commensal taxa (such as Prevotellaceae and Bacteroides in the gut) often compete, while potential pathogens (e.g. Treponema and Prevotella in the dental plaque) are more likely to co-occur in complementary niches. This approach thus serves to open new opportunities for future targeted mechanistic studies of the microbial ecology of the human microbiome. The human body is a complex ecosystem where microbes compete, and cooperate. These interactions can support health or promote disease, e.g. in dental plaque formation. The Human Microbiome Project collected and sequenced ca. 5,000 samples from 18 different body sites, including the airways, gut, skin, oral cavity and vagina. These data allowed the first assessment of significant patterns of co-presence and exclusion among human-associated bacteria. We combined sparse regression with an ensemble of similarity measures to predict microbial relationships within and between body sites. This captured known relationships in the dental plaque, vagina, and gut, and also predicted novel interactions involving members of under-characterized phyla such as TM7. We detected relationships necessary for plaque formation and differences in community composition among dominant members of the gut and vaginal microbiomes. Most relationships were strongly niche-specific, with only a few hub microorganisms forming links across multiple body areas. We also found that phylogenetic distance had a strong impact on the interaction type: closely related microorganisms co-occurred within the same niche, whereas most exclusive relationships occurred between more distantly related microorganisms. This establishes both the specific organisms and general principles by which microbial communities associated with healthy humans are assembled and maintained.
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Affiliation(s)
- Karoline Faust
- Department of Structural Biology, VIB, Brussels, Belgium
- Department of Applied Biological Sciences (DBIT), Vrije Universiteit Brussel, Brussels, Belgium
| | - J. Fah Sathirapongsasuti
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Jacques Izard
- Department of Molecular Genetics, Forsyth Institute, Cambridge, Massachusetts, United States of America
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Nicola Segata
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Dirk Gevers
- Microbial Systems and Communities, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Jeroen Raes
- Department of Structural Biology, VIB, Brussels, Belgium
- Department of Applied Biological Sciences (DBIT), Vrije Universiteit Brussel, Brussels, Belgium
- * E-mail: (JR); (CH)
| | - Curtis Huttenhower
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Microbial Systems and Communities, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- * E-mail: (JR); (CH)
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Al-Ahmad A, Kürschner A, Weckesser S, Wittmer A, Rauberger H, Jakob T, Hellwig E, Kist M, Waidner B. Is Helicobacter pylori resident or transient in the human oral cavity? J Med Microbiol 2012; 61:1146-1152. [PMID: 22499779 DOI: 10.1099/jmm.0.043893-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Helicobacter pylori colonizes the stomachs of at least half of the world's human population. The role of the oral cavity in this colonization is not clear and there are, to date, no comprehensive data that clearly demonstrate the isolation of this bacterium from the oral cavity. The aim of this study was to evaluate the prevalence of H. pylori in the oral cavity of 15 patients who tested positive for H. pylori. A comprehensive dental examination of all patients was conducted. Samples were taken from supragingival and subgingival plaque, saliva, periapical exudates and tongue swabs. All samples were taken before the application of antibiotics. A total of 163 oral samples were investigated by PCR using two different H. pylori-specific primer pairs. A PCR inhibition control using a modified plasmid was always included for the most specific primer pair. In addition, a culture technique was used to confirm PCR results. Despite a PCR detection limit of 10(2) bacteria ml(-1), out of 14 patients, H. pylori could not be detected in any of the samples taken. In one patient, H. pylori-positive PCR signals were obtained in two samples using only one primer pair. H. pylori could not be cultivated from these two PCR-positive samples; therefore, no correlation to oral colonization status could be established. This study challenges the misleading preconception that H. pylori resides in the human oral cavity and suggests that this bacterium should be considered transient and independent of the oral status. To date, positive PCR results for H. pylori in the oral cavity have been overestimated and not critically interpreted in literature.
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Affiliation(s)
- A Al-Ahmad
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany
| | - A Kürschner
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany
| | - S Weckesser
- Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany
| | - A Wittmer
- Institute for Medical Microbiology and Hygiene, Albert-Ludwigs University, Freiburg, Germany
| | - H Rauberger
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany
| | - T Jakob
- Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany
| | - E Hellwig
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs University, Freiburg, Germany
| | - M Kist
- Institute for Medical Microbiology and Hygiene, Albert-Ludwigs University, Freiburg, Germany
| | - B Waidner
- Institute for Medical Microbiology and Hygiene, Albert-Ludwigs University, Freiburg, Germany
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Zaric SS, Coulter WA, Shelburne CE, Fulton CR, Zaric MS, Scott A, Lappin MJ, Fitzgerald DC, Irwin CR, Taggart CC. Altered Toll-like receptor 2-mediated endotoxin tolerance is related to diminished interferon beta production. J Biol Chem 2011; 286:29492-500. [PMID: 21705332 PMCID: PMC3190989 DOI: 10.1074/jbc.m111.252791] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 06/01/2011] [Indexed: 01/25/2023] Open
Abstract
Induction of endotoxin tolerance leads to a reduced inflammatory response after repeated challenge by LPS and is important for resolution of inflammation and prevention of tissue damage. Enterobacterial LPS is recognized by the TLR4 signaling complex, whereas LPS of some non-enterobacterial organisms is capable of signaling independently of TLR4 utilizing TLR2-mediated signal transduction instead. In this study we report that Porphyromonas gingivalis LPS, a TLR2 agonist, fails to induce a fully endotoxin tolerant state in a human monocytic cell line (THP-1) and mouse bone marrow-derived macrophages. In contrast to significantly decreased production of human IL-8 and TNF-α and, in mice, keratinocyte-derived cytokine (KC), macrophage inflammatory protein-2 (MIP-2), and TNF-α after repeated challenge with Escherichia coli LPS, cells repeatedly exposed to P. gingivalis LPS responded by producing less TNF-α but sustained elevated secretion of IL-8, KC, and MIP-2. Furthermore, in endotoxin-tolerant cells, production of IL-8 is controlled at the signaling level and correlates well with NF-κB activation, whereas TNF-α expression is blocked at the gene transcription level. Interferon β plays an important role in attenuation of chemokine expression in endotoxin-tolerized cells as shown in interferon regulatory factor-3 knock-out mice. In addition, human gingival fibroblasts, commonly known not to display LPS tolerance, were found to be tolerant to repeated challenge by LPS if pretreated with interferon β. The data suggest that the inability of the LPS-TLR2 complex to induce full endotoxin tolerance in monocytes/macrophages is related to diminished production of interferon β and may partly explain the involvement of these LPS isoforms in the pathogenesis of chronic inflammatory diseases.
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Affiliation(s)
- Svetislav S Zaric
- Centre for Infection and Immunity, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
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Abstract
PURPOSE OF REVIEW A multidisciplinary approach to the treatment and management of biofilms has resulted from the growing appreciation of the role that biofilms play in modern medicine. Conventional antimicrobial agents are generally ineffective against biofilms, and as a result novel laboratory-based and clinical strategies have emerged. The purpose of this review is to analyse the recent literature relating to novel treatment strategies targeting the growing spectrum of clinically relevant biofilms. RECENT FINDINGS Microscopy and molecular techniques have provided greater insights into identifying the key bacterial and fungal biofilm pathogens. Knowledge of these microorganisms has provided a foundation for the development of specific molecules, often microbial derived, with antimicrobial and/or biofilm disruptive properties, augmenting conventional antibiotics treatments. The validity of some such rationally designed therapeutics has been explored in clinical trials. SUMMARY Biofilms are inherently difficult to treat, and mechanical disruption is the mainstay of clinical management. With scientific progress in molecular microbiology, there is an abundance of newly discovered molecules and pathways, providing novel therapeutic and prophylactic targets.
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Krasteva A, Panov V, Krasteva A, Kisselova A. Oral Cavity and Systemic Diseases— Helicobacter Pyloriand Dentistry. BIOTECHNOL BIOTEC EQ 2011. [DOI: 10.5504/bbeq.2011.0078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Silva DG, Stevens RH, Macedo JMB, Albano RM, Falabella MEV, Fischer RG, Veerman EC, Tinoco EMB. Presence of Helicobacter pylori in supragingival dental plaque of individuals with periodontal disease and upper gastric diseases. Arch Oral Biol 2010; 55:896-901. [PMID: 20863482 DOI: 10.1016/j.archoralbio.2010.06.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 05/22/2010] [Accepted: 06/29/2010] [Indexed: 12/21/2022]
Abstract
BACKGROUND Helicobacter pylori is a Gram-negative microorganism which is able to colonize the gastric mucosa and is associated with peptic ulcer, gastric carcinoma, and gastric mucosa-associated lymphoid tissue lymphoma. Several studies have detected this bacterium in the oral cavity, suggesting it as a potential reservoir. The aim of this study was to investigate the presence of H. pylori in the oral cavity of individuals with periodontal disease and gastric diseases. METHODS 115 individuals, with mean age 49.6 (±5.8) years, were divided in 4 groups: (A) with gastric diseases and periodontal disease; (B) with gastric diseases and no periodontal disease; (C) without gastric diseases and without periodontal disease, (D) without gastric diseases and with periodontal disease. Supra and subgingival plaque samples were collected from posterior teeth of the individuals with sterile paper points, and prepared for Polymerase Chain Reaction analysis. Fisher's exact test was used for detecting statistical differences between groups (p<0.05). RESULTS H. pylori was detected in supragingival plaque of 9/36 (25%) of group A, 1/31 (0.3%) of group B, 0 (0%) of group C and 3/36 (8.3%) of group D. No subgingival samples were positive for H. pylori. There was a statistically higher prevalence of H. pylori in groups A and D when compared to B and C (p<0.05). CONCLUSION H. pylori was detected in the supragingival plaque, but not in the subgingival plaque, of individuals with periodontal disease and upper gastric diseases. There was an association between the supragingival colonization of H. pylori and oral hygiene parameters such as the presence of plaque and gingival bleeding.
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Affiliation(s)
- Denise G Silva
- Escola de Odontologia, UNIGRANRIO, Duque de Caxias, Brazil.
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Figura N, Franceschi F, Santucci A, Bernardini G, Gasbarrini G, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection. Helicobacter 2010; 15 Suppl 1:60-8. [PMID: 21054655 DOI: 10.1111/j.1523-5378.2010.00778.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The possible role of Helicobacter pylori as a trigger for some extragastric diseases has been largely investigated in the last year. There are, in fact, several studies concerning cardiovascular diseases, neurological disorders, diabetes mellitus, ear and eyes diseases, immunological and hematological disorders, liver and bile tract diseases, gynecological and respiratory tract pathologies. Among them, idiopathic sideropenic anemia and idiopathic thrombocytopenic purpura still remain the extragastric diseases showing the most convincing results. Concerning ischemic heart disease, there are new interesting data playing in favor of the association, even though there are still some open issues to be clarified. For the other diseases, more studies are needed to clarify the reality of the proposed association.
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Affiliation(s)
- Natale Figura
- Internal Medicine Department, University of Siena, Largo A. Gemelli 8, Rome, Italy
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Persson GR, Baumgartner S, Imfeld T, Schicht O, Rath C, Persson RE. Letter to the Editor: Authors' Response. J Periodontol 2010. [DOI: 10.1902/jop.2010.090750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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