Maternal microbiome – A pathway to preterm birth

Vinturache, Angela; Gyamfi-Bannerman, Cynthia; Hwang, Joseph; Mysorekar, Indira U.; Jacobsson, Bo

doi:10.1016/j.siny.2016.02.004

Cited by 114 publications

(66 citation statements)

References 50 publications

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“…Microbial niches in periodontal tissues may act as a reservoir for translocation of oral pathogens to distant organizations, such as the placenta, and the amount of bacteria or changes in their relative proportions can trigger an inflammatory cascade . Studies have shown that P. gingivalis may colonize gestational tissue including the placenta, umbilical cord, and amniotic cavity, and the presence of microbial invasion may contribute to PTB .…”

Section: Discussionmentioning

confidence: 99%

Periodontal infection with Porphyromonas gingivalis induces preterm birth and lower birth weight in rats

Liang

Ren²,

Guo

et al. 2018

Molecular Oral Microbiology

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Preterm birth (PTB), accompanied by low birth weight (LBW) or not, is a syndrome with tremendous risk factors and long-term health consequences for children. In recent decades, overwhelming studies have shown that periodontitis contributes to prematurity and LBW. This study was conducted to determine the link between maternal periodontitis and the pathogenesis of PTB and/or LBW through a rat infection model induced by Porphyromonas gingivalis, an important periodontopathic bacterium. The murine model was established by surgically ligating the left mandibular first molars and inoculating with P. gingivalis, and then all female rats initiated mating 6 weeks post infection. The gestational day and birth weight were recorded, and blood, amniotic fluid, and placental specimens were collected. Rats with a PTB and LBW newborns were observed in the P. gingivalis-infected group. Additionally, P. gingivalis infection significantly increased the maternal serum levels of interferon-γ and interleukin-1β, whereas no significant difference in the cytokine response was observed in the amniotic fluid. Moreover, with the translocation of P. gingivalis to placentas, remarkable changes in gestational tissues were found, followed by significantly enhanced expression of Toll-like receptor 2 (TLR2) as well as Fas and Fas ligand (FasL). These results support the concept that severe cases of periodontitis caused by P. gingivalis infection may be indicative of rats being more susceptible to PTB/LBW, probably through the activation of the TLR2 and Fas/FasL pathways within the placental tissues. This study gave us new insight into how maternal periodontopathogens might be linked to placental damage and premature pathogenesis.

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Section: Discussionmentioning

confidence: 99%

Periodontal infection with Porphyromonas gingivalis induces preterm birth and lower birth weight in rats

Liang

Ren²,

Guo

et al. 2018

Molecular Oral Microbiology

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“…However, various studies [modulo the usual issues of contamination (418)] have shown the presence of microbes in tissues including the placenta (400, 409, 419–432), vagina (393, 433–440), uterus (391, 441, 442), amniotic fluid (430, 443–448), and follicular fluid (449, 450), and how these may vary significantly in PE [we do not discuss other pregnancy disorders such as small for gestational age (SGA) and intrauterine growth restriction (IUGR)]. We list some of these in Table 3.…”

Section: Direct Evidence For a Role Of Infectious Agents In Pementioning

confidence: 99%

A Dormant Microbial Component in the Development of Preeclampsia

Kell

Kenny

2016

Front. Med.

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Preeclampsia (PE) is a complex, multisystem disorder that remains a leading cause of morbidity and mortality in pregnancy. Four main classes of dysregulation accompany PE and are widely considered to contribute to its severity. These are abnormal trophoblast invasion of the placenta, anti-angiogenic responses, oxidative stress, and inflammation. What is lacking, however, is an explanation of how these themselves are caused. We here develop the unifying idea, and the considerable evidence for it, that the originating cause of PE (and of the four classes of dysregulation) is, in fact, microbial infection, that most such microbes are dormant and hence resist detection by conventional (replication-dependent) microbiology, and that by occasional resuscitation and growth it is they that are responsible for all the observable sequelae, including the continuing, chronic inflammation. In particular, bacterial products such as lipopolysaccharide (LPS), also known as endotoxin, are well known as highly inflammagenic and stimulate an innate (and possibly trained) immune response that exacerbates the inflammation further. The known need of microbes for free iron can explain the iron dysregulation that accompanies PE. We describe the main routes of infection (gut, oral, and urinary tract infection) and the regularly observed presence of microbes in placental and other tissues in PE. Every known proteomic biomarker of “preeclampsia” that we assessed has, in fact, also been shown to be raised in response to infection. An infectious component to PE fulfills the Bradford Hill criteria for ascribing a disease to an environmental cause and suggests a number of treatments, some of which have, in fact, been shown to be successful. PE was classically referred to as endotoxemia or toxemia of pregnancy, and it is ironic that it seems that LPS and other microbial endotoxins really are involved. Overall, the recognition of an infectious component in the etiology of PE mirrors that for ulcers and other diseases that were previously considered to lack one.

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“…Also, recent studies described that placenta may harbour a unique microbiome (2,3), and apparently this microbiome is more similar to the oral cavity than to the vagina microbiome (2). In fact, it is known that microorganisms may reach the uterus through a haematogenous route (4,5) and that maternal microbiomes from different body sites, including oral, vaginal, gut, cervical, and even the placenta itself, may influence pregnancy outcomes (6). Also, several studies suggested that the presence of periodontal pathogenic microorganisms or their by-products in the intrauterine environment stimulate an foetal immune and inflammatory response that may be responsible for the increased risk of preterm birth and low birth weight (7-10).…”

Section: Introductionmentioning

confidence: 99%

Oral yeast colonization throughout pregnancy

Rio

Simões-Silva²,

Garro³

et al. 2017

Med Oral

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BackgroundRecent studies suggest that placenta may harbour a unique microbiome that may have origin in maternal oral microbiome. Although the major physiological and hormonal adjustments observed in pregnant women lead to biochemical and microbiological modifications of the oral environment, very few studies evaluated the changes suffered by the oral microbiota throughout pregnancy. So, the aim of our study was to evaluate oral yeast colonization throughout pregnancy and to compare it with non-pregnant women.Material and MethodsThe oral yeast colonization was assessed in saliva of 30 pregnant and non-pregnant women longitudinally over a 6-months period. Demographic information was collected, a non-invasive intra-oral examination was performed and saliva flow and pH were determined.ResultsPregnant and non-pregnant groups were similar regarding age and level of education. Saliva flow rate did not differ, but saliva pH was lower in pregnant than in non-pregnant women. Oral yeast prevalence was higher in pregnant than in non-pregnant women, either in the first or in the third trimester, but did not attain statistical significance. In individuals colonized with yeast, the total yeast quantification (Log10CFU/mL) increase from the 1st to the 3rd trimester in pregnant women, but not in non-pregnant women.ConclusionsPregnancy may favour oral yeast growth that may be associated with an acidic oral environment. Key words:Oral yeast, fungi, pregnancy, saliva pH.

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Maternal microbiome – A pathway to preterm birth

Cited by 114 publications

References 50 publications

Periodontal infection with Porphyromonas gingivalis induces preterm birth and lower birth weight in rats

Periodontal infection with Porphyromonas gingivalis induces preterm birth and lower birth weight in rats

A Dormant Microbial Component in the Development of Preeclampsia

Oral yeast colonization throughout pregnancy

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