Relationship of Clinical and Microbiological Variables in Patients with Type 1 Diabetes Mellitus and Periodontitis

Background Oral manifestations are common in Crohn's disease (CD). Here we characterized the subgingival microbiota in pediatric CD patients initiating therapy and after 8 weeks to identify microbial community features associated with CD and therapy. Methods Pediatric CD patients were recruited from The Children's Hospital of Pennsylvania. Healthy control subjects were recruited from primary care or orthopedics clinic. Subgingival plaque samples were collected at initiation of therapy and after 8 weeks. Treatment exposures included 5-ASAs, immunomodualtors, steroids, and infliximab. The microbiota was characterized by 16S rRNA gene sequencing. The study was repeated in separate discovery (35 CD, 43 healthy) and validation cohorts (43 CD, 31 healthy). Results A majority of subjects in both cohorts demonstrated clinical response after 8 weeks of therapy (discovery cohort 88%, validation cohort 79%). At week 0, both antibiotic exposure and disease state were associated with differences in bacterial community composition. Seventeen genera were identified in the discovery cohort as candidate biomarkers, of which 11 were confirmed in the validation cohort. Capnocytophaga, Rothia, and TM7 were more abundant in CD relative to healthy controls. Other bacteria were reduced in abundance with antibiotic exposure among CD subjects. CD-associated genera were not enriched compared to healthy controls after 8 weeks of therapy. Conclusions Subgingival microbial community structure differed with CD and antibiotic use. Results in the discovery cohort were replicated in a separate validation cohort. Several potentially pathogenic bacterial lineages were associated with CD but were not diminished in abundance by antibiotic treatment, suggesting targets for additional surveillance.

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“…28 Additionally, it has been detected in higher abundance in patients with Type 1 diabetes mellitus. 29 …”

Section: Discussionmentioning

confidence: 99%

Alterations of the Subgingival Microbiota in Pediatric Crohnʼs Disease Studied Longitudinally in Discovery and Validation Cohorts

Kelsen

Bittinger²,

Pauly-Hubbard

et al. 2015

Inflammatory Bowel Diseases

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“…Recent studies based on PCR technology also show a shift in microbial composition in DM (Aemaimanan, Amimanan, & Taweechaisupapong, 2013;Castrillon et al, 2015;Demmer et al, 2015;Merchant et al, 2014;Sakalauskiene et al, 2014). Furthermore, three of these studies demonstrated this shift only in poorly controlled diabetic patients (Aemaimanan et al, 2013;Merchant et al, 2014;Sakalauskiene et al, 2014). Still, the above data do not provide solid evidence of causal relationship between poorly controlled DM and periodontal microbial dysbiosis, and the available date derived from cross-sectional studies.…”

Section: Biological Plausibility Of Increase In Severity Of Periodomentioning

confidence: 97%

“…Recent studies that explored the possible association between the compositions of the periodontal flora in patients with diabetes using 16S rRNA Sequencing (Casarin et al, 2013;Zhou et al, 2013) found evidence which may indicate a difference in microbial composition in patients with diabetes mellitus (DM). Recent studies based on PCR technology also show a shift in microbial composition in DM (Aemaimanan, Amimanan, & Taweechaisupapong, 2013;Castrillon et al, 2015;Demmer et al, 2015;Merchant et al, 2014;Sakalauskiene et al, 2014). Furthermore, three of these studies demonstrated this shift only in poorly controlled diabetic patients (Aemaimanan et al, 2013;Merchant et al, 2014;Sakalauskiene et al, 2014).…”

Section: Biological Plausibility Of Increase In Severity Of Periodomentioning

confidence: 98%

An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes

Polak

Shapira

2017

J Clinic Periodontology

296

234

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The elevated pro-inflammatory factors in the gingiva of patients with poorly controlled diabetes suggest a biological pathway that may aggravate periodontitis. Some evidence suggests that the systemic inflammatory burden in periodontitis has the potential to affect diabetes control, but no studies addressed the impact of successful periodontal therapy on the pathophysiological mechanisms involved in systemic complications of diabetes.

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“…E. corrodens , a Gram negative facultative anaerobic bacillus and allocated to the green complex, plays a presumably important role as an early colonizer as well [ 3 ]. It is also meant to be associated with the development of periodontitis [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

What is the influence of tonsillectomy on the level of periodontal pathogens on the tongue dorsum and in periodontal pockets

et al. 2018

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BackgroundFor periodontal treatment, the full mouth disinfection approach suggests disinfection of oral soft tissues, such as tongue and tonsils concomitant to scaling and root planning since patients might benefit from treatment of these oral niches either. Periodontopathogenes in tonsillar tissue support this hypothesis. This prospective controlled clinical study investigated the change in the oral flora of patients who underwent tonsillectomy. Pockets were tested for eleven bacterial species before and six weeks after the surgical intervention.MethodsFifty generally healthy adults were included in this study. The test group consisted of 25 patients with tonsillectomy. The control group included 25 patients with otorhinolarynologic surgery without involvement of the oral cavity. Clinical parameters such as probing pocket depth, bleeding-on-probing index and plaque index were registered the evening before surgery. Also bacterial samples from the gingival sulcus and dorsum linguae were taken, and an additional sample from the removed tonsils in the test group. Six weeks after the intervention microbial samples of pockets and tongue were taken again. Data were tested for significant differences using Wilcoxon rank and Whitney-u-test.ResultsNo relevant intra- or intergroup differences were found for the change of the eleven investigated species.ConclusionBased on the results of the present study, tonsillectomy does not seem to have an immediate relevant effect on the bacterial flora of tongue or periodontium. This study design was approved by the ethical committee of Zurich (KEK-ZH-Nr.2013–0419).Trial registrationThe trial was retrospectively registered in the German Clinical Trials Register (DRK00014077) on February 20, 2018.

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Relationship of Clinical and Microbiological Variables in Patients with Type 1 Diabetes Mellitus and Periodontitis

Cited by 24 publications

References 30 publications

Alterations of the Subgingival Microbiota in Pediatric Crohnʼs Disease Studied Longitudinally in Discovery and Validation Cohorts

Alterations of the Subgingival Microbiota in Pediatric Crohnʼs Disease Studied Longitudinally in Discovery and Validation Cohorts

An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes

What is the influence of tonsillectomy on the level of periodontal pathogens on the tongue dorsum and in periodontal pockets

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