Periodontal Disease Bacteria Specific to Tonsil in IgA Nephropathy Patients Predicts the Remission by the Treatment

Abstract

BackgroundImmunoglobulin (Ig)A nephropathy (IgAN) is the most common form of primary glomerulonephritis in the world. Some bacteria were reported to be the candidate of the antigen or the pathogenesis of IgAN, but systematic analysis of bacterial flora in tonsil with IgAN has not been reported. Moreover, these bacteria specific to IgAN might be candidate for the indicator which can predict the remission of IgAN treated by the combination of tonsillectomy and steroid pulse.Methods and FindingsWe made a comprehensive analysis of tonsil flora in 68 IgAN patients and 28 control patients using Denaturing gradient gel electrophoresis methods. We also analyzed the relationship between several bacteria specific to the IgAN and the prognosis of the IgAN. Treponema sp. were identified in 24% IgAN patients, while in 7% control patients (P = 0.062). Haemophilus segnis were detected in 53% IgAN patients, while in 25% control patients (P = 0.012). Campylobacter rectus were identified in 49% IgAN patients, while in 14% control patients (P = 0.002). Multiple Cox proportional-hazards model revealed that Treponema sp. or Campylobactor rectus are significant for the remission of proteinuria (Hazard ratio 2.35, p = 0.019). There was significant difference in remission rates between IgAN patients with Treponema sp. and those without the bacterium (p = 0.046), and in remission rates between IgAN patients with Campylobacter rectus and those without the bacterium (p = 0.037) by Kaplan-Meier analysis. Those bacteria are well known to be related with the periodontal disease. Periodontal bacteria has known to cause immune reaction and many diseases, and also might cause IgA nephropathy.ConclusionThis insight into IgAN might be useful for diagnosis of the IgAN patients and the decision of treatment of IgAN.

<b><i>Campylobacter rectus</i></b> in the Oral Cavity Correlates with Proteinuria in Immunoglobulin A Nephropathy Patients

“…The results of this analysis showed that C. rectus or T. denticola may be associated with IgAN [12]. Unfortunately, in the present study, we could not confirm the contribution of T. denticola to IgAN virulence because of the low positive rate of the limited number of saliva specimens.…”

“…Recently, we performed an analysis of tonsil flora in IgAN patients, which revealed that the periodontitis-related pathogens Campylobacter rectus and Treponema species were associated with IgAN [12]. We also found that the remission rates of proteinuria and haematuria were significantly related to the prevalence of infection with C. rectus and Treponema species.…”

Toll-Like Receptor 9 Stimulation Induces Aberrant Expression of a Proliferation-Inducing Ligand by Tonsillar Germinal Center B Cells in IgA Nephropathy

“…Our previous and recent studies regarding the involvement of TLR9 in the pathogenesis of human and murine IgAN indicate that specific antigens are not required for the development of IgAN. However, it seems that there is a biased bacterial flora in tonsil of human IgAN, 41 suggesting that actual exogenous antigens in the pathogenesis may be limited.…”

Comparison Study of Oropharyngeal Microbiota in Case of Bronchial Asthma and Chronic Obstructive Pulmonary Disease in Different Severity Levels

“…Бактерии рода Parvimonas являются условно-патогенными микроорганизмами, играющими роль в развитии агрессивного периодонтита [20]. Aggregatibacter segnis также относится к условно-патогенным микроорганизмам, вызывающим периодонтит [21]. Связь Aggregatibacter segnis с БА установлена впервые, однако из-вестно, что периодонтопатогенные бактерии играют роль в патогенезе ХОБЛ [22], что также показано нами далее.…”