Unexpected lower level of oral periodontal pathogens in patients with high numbers of systemic diseases

PeerJ

article

Michael T. Shen¹  Betti Shahin²  Zhengjia Chen³  Guy R. Adami¹ 

[1] Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois Chicago;Restorative Dentistry, University of Illinois Chicago;Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago;Biostatistics Shared Resource Core, University of Illinois Cancer Center, University of Illinois Chicago;University of Illinois Cancer Center, University of Illinois Chicago

关键词: Poryphyromonas gingivalis;    Periodontal disease;    Multimorbidity;    Saliva microbiome;    Tannerella forsythia;    Fusobacterium;   

DOI  :  10.7717/peerj.15502

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundPeriodontal disease is associated with systemic conditions such as diabetes, arthritis, and cardiovascular disease, all diseases with large inflammatory components. Some, but not all, reports show periopathogens Porphyromonas gingivialis and Tannerella forsythia at higher levels orally in people with one of these chronic diseases and in people with more severe cases. These oral pathogens are thought to be positively associated with systemic inflammatory diseases through induction of oral inflammation that works to distort systemic inflammation or by directly inducing inflammation at distal sites in the body. This study aimed to determine if, among patients with severe periodontal disease, those with multi-morbidity (or many chronic diseases) showed higher levels of periodontal pathogens.MethodsA total of 201 adult subjects, including 84 with severe periodontal disease were recruited between 1/2017 and 6/2019 at a city dental clinic. Electronic charts supplied self-reported diseases and conditions which informed a morbidity index based on the number of chronic diseases and conditions present. Salivary composition was determined by 16S rRNA gene sequencing.ResultsAs expected, patients with severe periodontal disease showed higher levels of periodontal pathogens in their saliva. Also, those with severe periodontal disease showed higher levels of multiple chronic diseases (multimorbidity). An examination of the 84 patients with severe periodontal disease revealed some subjects despite being of advanced age were free or nearly free of systemic disease. Surprisingly, the salivary microbiota of the least healthy of these 84 subjects, defined here as those with maximal multimorbidity, showed significantly lower relative numbers of periodontal pathogens, including Porphyromonas gingivalis and Tannerella Forsythia, after controlling for active caries, tobacco usage, age, and gender. Analysis of a control group with none to moderate periodontal disease revealed no association of multimorbidity or numbers of medications used and specific oral bacteria, indicating the importance of severe periodontal disease as a variable of interest.ConclusionThe hypothesis that periodontal disease patients with higher levels of multimorbidity would have higher levels of oral periodontal pathogens is false. Multimorbidity is associated with a reduced relative number of periodontal pathogens Porphyromonas gingivalis and Tannerella forsythia.

【 授权许可】

CC BY