By using NGS-sequencing libraries of DNA from periodontal swabs with primers specific to V6 region of 16S rDNA prevalence of bacterial genera and species in periodontal and colonic microbiota of patients with periodontitis of different severity and healthy donors was analyzed. Hyper-colonization of the colon with Akkermansia muciniphila was found to be the most important maker of negative predisposition to periodontitis (t=133,7 at р=10(-6)). This result is in a good agreement with communications about positive impact of hyper-colonization of the colon with this species on type 2 diabetes, obesity, atopic dermatitis, and antibiotic-induced diarrhea associated with Clostridium dificile. Analysis of the periodontal protectors at the periodontium elucidated a number of close taxonomic relatives of the periodontal pathogens by Socransky, e.g. Aggregatibacter segnis and Aggregatibacter aphrophilus are closely related to Aggregatibacter actinomycetemcomitans; Treponema vencentii is a relative of Treponema denticola; Prevotella baroniae, Prevotella salivae and Prevotella spp. are relatives of Prevotella intermedia; Campylobacter concisus is a relative of Campylobacter jejuni, causative agent of enterocolitis.
Патогенез пародонтита включает сложный иммунный воспалительный каскад, который инициируется бактериями биопленки, а восприимчивость или вероятность развития заболевания определяется реакцией организма человека, в частности, величиной воспалительного ответа и дифференциальной активацией иммунных путей. Цель исследования -разработать прогностическую модель для оценки риска развития тяжелой степени хронического генерализованного пародонтита в зависимости от содержания фактора некроза опухоли-α (ФНО-α) в экссудате пародонтального кармана (ПК) пациента. При клинико-инструментальном обследовании 537 пациентов с хроническим генерализованным пародонтитом и метаболическим синдромом установлено, что уровень повышения ФНО-α в содержимом ПК коррелировал со степенью тяжести хронического генерализованного пародонтита (ХГП): более высокие значения цитокина соответствовали более тяжелой степени. Разработанная в программе Statistica.10 прогностическая модель дала возможность использовать уровень ФНО-α в содержимом ПК пациента в качестве прогностического критерия течения ХГП. Определено критическое значение, при превышении которого с диагностической чувствительностью 91,2% и специфичностью 70,8% можно заключить о высоком риске развития тяжелой степени ХГП. Созданное окно в программе Microsoft Exсel 2010 позволяет автоматически рассчитывать риск развития тяжелой степени ХГП в зависимости от индивидуального значения концентрации ФНО-α в содержимом ПК пациента, что делает данную модель удобной для применения врачами-стоматологами.The pathogenesis of periodontitis involves a complex inflammatory cascade initiated by biofilm bacteria. The susceptibility to or the risk of developing the disease is determined by the body's response to the invasion, specifically, by the strength of the inflammatory response and the differential activation of immune pathways. In this paper, we propose a model for predicting the risk of severe chronic generalized periodontitis (GCP) in patients with metabolic syndrome based on the levels of tumor necrosis factor alpha (TNF-α) in the periodontal pocket exudate. The analysis of oral cavity cytokine profiles conducted in 537 patients with GCP and comorbid metabolic syndrome showed that increased TNF-α correlated with the severity of GCP: higher levels of TNF-α were observed in patients whose condition was more severe. The prognostic model built in Statistica. 10 allowed us to use TNF-α as a prognostic criterium for GCP severity. We determined the cut-off point above which a high risk of severe GCP can be concluded with 91.2% sensitivity and 70.8% specificity. The spreadsheet in Microsoft Exсel 2010 automatically computed the risk of severe GCP from a patient's TNF-α concentrations in the PP, which makes the model convenient for routine clinical use in dentistry.Ключевые слова: пародонтит, метаболический синдром, цитокины, фактор некроза опухоли, ФНО, прогностическая модель
By using NGS-sequencing libraries of DNA from periodontal swabs with primers specific to V6 region of 16S rDNA prevalence of bacterial genera and species in periodontal microbiota of patients with aggressive periodontitis and healthy donors was analyzed. Six genera of putative periodontal protectors and eight periodontal pathogens were identified with respect to aggressive (but not chronic) periodontitis. Statistically relevant over-colonization by general Porphyromonas, Treponema, Synergistes, Tannerella, Filifactor, Ruminococcus, Parvimonas and Mycoplasma was found to be associated with the condition. From these, only three genera Porphyromonas, Treponema and Tannerella are traditionally considered as periodontal pathogens. Statistically confidential over-colonization by genus Veillonella was found in healthy patients. This genus should be considered as a relevant marker of a healthy periodontium. Genera Streptococcus, Bergeyella, Granulicatella, Kingella and Corynebacterium may be considered as putative periodontal protectors. Comparison of data of NGS-sequencing and real-time PCR demonstrated a good agreement if different PCR efficiency using independent primer pairs is taken into account.
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