A Pilot Study to Evaluate the Oral Microbiome and Dental Health in Primary Open-Angle Glaucoma

Polla, Daniel J.; Astafurov, Konstantin; Hawy, Eman; Hyman, Leslie; Hou, Weikun; Danias, John

doi:10.1097/ijg.0000000000000465

Cited by 42 publications

(34 citation statements)

References 43 publications

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“…In our restricted analyses that included only Caucasians, the association with recent tooth loss was slightly attenuated, indicating there might be some differences by race. However, our results are consistent with the findings from studies of Astafurov et al 11 and Polla et al 12 conducted among African-Americans that implicated a role for oral health in POAG. More studies in women and other racial/ethnic groups may help to further shed light on this link, as prevalence of periodontal disease and dental problems differ by gender and race.…”

Section: Discussionsupporting

confidence: 93%

“…11, 26, 27 One clinic-based case-control study of 103 African-American subjects 11 observed that those with oral bacteria loads in the upper quartile were over three times more likely to have glaucoma and that glaucoma cases had significantly fewer teeth, especially in older persons. 12 In addition, they observed that in two glaucoma animal models 11 administration of low dose subcutaneous lipopolysaccharide to simulate the condition of chronic subclinical bacterial infection, exacerbated glaucomatous neurodegeneration. The possible mechanisms may be related to upregulation of complement system and toll-like receptor 4 signaling activity along with microglial activation in the optic nerve, 11 which occur early in the glaucomatous process.…”

Section: Discussionmentioning

confidence: 99%

“…In a clinic-based case-control study among African-Americans, 11 compared to 45 controls, 58 glaucoma cases showed significantly higher oral bacterial loads and significantly fewer teeth, especially in older persons. 12 The same research group 11 found that when glaucoma animal models were administered low-dose bacterial toxins, glaucomatous neurodegeneration ensued and was accompanied by microglial activation, upregulation of the complement system and toll-like receptor 4 signaling activity in the optic nerve. These results suggest that oral infections, particularly those that can lead to periodontal disease, may have systemic effects that can contribute to POAG.…”

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confidence: 99%

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Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men

et al. 2016

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Purpose Tooth loss or periodontal disease is associated with systemic endothelial dysfunction, which has been implicated in primary open-angle glaucoma (POAG). The relationship between oral health and POAG has received limited attention. Thus, we evaluated the association between oral health history and risk of POAG and POAG subtypes. Design Prospective cohort study Participants Health Professionals Follow-up Study participants (40,536 men) followed biennially from 1986 to 2012. At each 2-year risk period, eligible participants were 40+ years old, free of POAG, and reported eye examinations. Methods Using validated questions, we updated participants' status on number of natural teeth, teeth lost, periodontal disease with bone loss and root canal treatments. Main Outcome Measures During follow-up, 485 incident cases of POAG were confirmed with medical records and classified into subtypes defined by intraocular pressure (IOP) (≥ or < 22 mm Hg) or by visual field (VF) loss pattern at diagnosis (peripheral loss only or early paracentral loss). Multivariable relative risks (MVRR) and 95% confidence intervals (CIs) were estimated. Results Number of natural teeth, periodontal disease or root canal treatment were not associated with POAG. However, compared to no report of tooth loss, a report of losing teeth within the past 2 years was associated with a 1.45 fold increased risk of POAG (95% CI=1.06, 1.97); in particular, a report within the past 2 years of both losing teeth and having a prevalent diagnosis of periodontal disease was associated with 1.85 fold increased risk of POAG (95% CI=1.07, 3.18). The associations with recent tooth loss was not significantly different for the POAG subtypes (p for heterogeneity ≥ 0.36), although associations were strongest in relation to the POAG subtypes with IOP < 22 mm Hg (MVRR = 1.93, 95% CI=1.09, 3.43) and with early paracentral VF loss (MVRR = 2.27, 95% CI=1.32, 3.88). Conclusion While the number of natural teeth was not associated with risk of POAG, recent tooth loss was associated with an increased risk of POAG. Because these findings may be due to chance, they need confirmation in larger studies.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men

et al. 2016

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“…Neurotoxicity from some pathogenic species could be mediated by nitric oxide production through effects on microglia and astrocytes 27 . The localization of bacteria in these structures may not be necessary, and the bacterial products can initiate a local inflammatory response that leads to glaucomatous neurodegeneration 21 .…”

Section: Discussionmentioning

confidence: 99%

“…In fact, periodontitis increased the systemic inflammatory reaction, and glaucoma, as a neurodegenerative disease, could be exacerbated by the result of the chronic systemic inflammation 4 , 19 . In a case–control study including 119 POAG cases and 78 controls, Polla et al 21 reported that patients with POAG have fewer natural teeth and higher number of oral bacteria (Streptococci) than those without POAG. Pasquale et al 22 conducted a prospective study (40,536 men) showing a lack of association between POAG and tooth number, periodontal disease, or root canal treatment.…”

Section: Introductionmentioning

confidence: 99%

Periodontitis and the subsequent risk of glaucoma: results from the real-world practice

Sun

Shen

Chen

et al. 2020

Sci Rep

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Periodontitis is a multifactorial inflammatory disease that can cause tooth loss and contribute to systemic inflammation. It is suggested that periodontitis may be associated with the development of glaucoma. Based on data from Taiwan’s National Health Insurance Research Database, a retrospective cohort study was conducted to investigate the risk of developing glaucoma in patients with periodontitis. The periodontitis cohort consisted of newly diagnosed adult patients (n = 194,090, minimum age = 20 years) between 2000 and 2012. The comparison group included age-, gender-, and diagnosis date-matched people without periodontitis (n = 194,090, minimum age = 20 years). Incident glaucoma was monitored until the end of 2013. Hazard ratios (HRs) with confidence intervals (CIs) were established based on the Cox proportional hazard models. The risk of developing glaucoma was higher in patients with periodontitis than those without periodontitis (31.2 vs. 23.3 patients per 10,000 person-years, with an adjusted HR of 1.26 [95% CI 1.21–1.32]). A high risk was evident even after stratifying by age (adjusted HRs = 1.34 [1.26–1.44] for ages 20–49, 1.24 [1.13–1.36] for ages ≥ 65, and 1.20 [1.12–1.29] for ages 50–64 years), sex (adjusted HRs = 1.33 [1.24–1.41] and 1.21 [1.14–1.28] for men and women, respectively), presence of comorbidity (adjusted HRs = 1.38 [1.29–1.47] and 1.18 [1.12–1.25] for without and with comorbidity, respectively), and corticosteroid use (adjusted HRs = 1.27 [1.21–1.33] and 1.21 [1.08–1.35] for without and with corticosteroid use, respectively). Specifically, patients with periodontitis exhibited a significantly high risk of primary open-angle glaucoma (adjusted HR = 1.31 [1.21–1.32]) but not for primary closed-angle glaucoma (adjusted HR = 1.05 [0.94–1.17]). People with periodontitis are at a greater risk of glaucoma than individuals without periodontitis. Ocular health should be emphasized for such patients, and the underlying mechanisms need further investigation.

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Dysbiosis of gut microbiome contributes to glaucoma pathogenesis

Chen

Wang

Liu

et al. 2022

MedComm – Future Medicine

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Microbiome dysfunction is considered to contribute to the pathogenesis of many neurodegenerative diseases. However, the relationship between the gut microbiome and glaucoma, a neurodegenerative disorder remains largely unknown. Here, we identified that the gut microbiome of glaucoma patients were rich in Dysgonamonadaceae, along with a lower level of Barnesiellaceae by metagenomic sequencing. This microbiome pattern is shown to increased the production of short chain fatty acids (SCFAs) in the fecal and blood samples. Reducing these glaucoma-specific gut microbiome bacteria significantly reduced retinal ganglion cell (RGC) loss by alleviating the activation of retinal microglia cells and overproduction of inflammatory cytokines in acute glaucoma mouse model, whereas SCFAs treatment aggravated microglia activation. Mechanistically, reducing the glaucoma-specific gut microbiome bacteria decreased the retinal microRNA profile including MiR-122-5p, which led to neuroprotection through inhibition of retinal inflammation. We validated our results by showing that fecal microbiome transplantation from glaucoma patients significantly exacerbated retinal microglia activation and increased retinal inflammation. Our findings indicate that the change of gut MedComm -Future Medicine. 2022;e28.wileyonlinelibrary.com/journal/mef2

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A Pilot Study to Evaluate the Oral Microbiome and Dental Health in Primary Open-Angle Glaucoma

Cited by 42 publications

References 43 publications

Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men

Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men

Periodontitis and the subsequent risk of glaucoma: results from the real-world practice

Dysbiosis of gut microbiome contributes to glaucoma pathogenesis

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