The Impact of Oral-Gut Inflammation in Cerebral Palsy

Abstract

Background: Oral-gut inflammation has an impact on overall health, placing subjects at risk to acquire chronic conditions and infections. Due to neuromotor disturbances, and medication intake, cerebral palsy (CP) subjects present intestinal constipation, impacting their quality of life (QOL), We aimed to investigate how oral inflammatory levels predicted gut phenotypes and response to therapy.Methods: A total of 93 subjects aging from 5 to 17 years were included in the study, and assigned into one of the 4 groups: CP with constipation (G1, n = 30), CP without constipation (G2, n = 33), and controls without CP with constipation (G3, n = 07) and without CP and without constipation (G4, n = 23). In addition to characterizing subjects' clinical demographics, medication intake, disease severity levels, salivary cytokine levels [TNF-α, interleukin (IL)-1β, IL-6, IL-8, IL-10], and Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). Statistical significance was evaluated by Shapiro-Wilks, Student's T-Test, ANOVA, and ANCOVA analysis.Results: Salivary proinflammatory cytokines were highly correlated with the severe form of gut constipation in G1 (P < 0.001), and out of all cytokines IL-1β levels demonstrated highest correlation with all gut constipation (P < 0.05). A significant relationship was found between the type of medication, in which subjects taking Gamma-Aminobutyric Acid (GABA) and GABA+ (GABA in association with other medication) were more likely to be constipated than the other groups (P < 0.01). Cleary salivary inflammatory levels and gut constipation were correlated, and impacted QOL of CP subjects. G1 presented a lower QOL mean score of CPCHILD (49.0 ± 13.1) compared to G2 (71.5 ± 16.7), when compared to G3 (88.9 ± 7.5), and G4 (95.5 ± 5.0) (P < 0.01). We accounted for gingival bleeding as a cofounder of oral inflammation, and here were no differences among groups regarding gender (P = 0.332) and age (P = 0.292).Conclusions: Collectively, the results suggest that saliva inflammatory levels were linked to gut constipation, and that the clinical impact of medications that controlled gut was reliably monitored via oral cytokine levels, providing reliable and non-invasive information in precision diagnostics.

Detection and quantification of pathogens in saliva of adolescents with cerebral palsy: a cross-sectional study

“…In order to analyze whether there is a change in the oral microbiota among adolescents who use antiepileptic drugs, we compared the abundance of bacteria (total bacteria) between groups of CP users and non-users of antiepileptic drugs and found a significant positive correlation (Pearson r: 0.3449; p = 0.0494). The highest value of the gingival index observed in our study group with gingivitis reflects the side effects of the use of antiepileptic drugs, corroborating the results found by Ferreira et al (32). The adolescents in the CP group with gingivitis in this study used polytherapy and had the highest gingival index values.…”

Bibliometric analysis of cerebral palsy and oral health in PubMed (1956-2021)

“…Despite the physical disability and comorbidities present in children and adolescents with cerebral palsy, many clinical studies have been carried out in this population (Rodrigues dos Santos et al 2003, Santos et al 2016, Yoshida et al2019, Ferreira et al, 2021. The design of a study is an important factor that links research to clinical practice.…”

From Mouth to Brain: Distinct Supragingival Plaque Microbiota Composition in Cerebral Palsy Children With Caries

“…Consequently, the anatomical communication ( Sansores-España et al, 2021 ) between the oral cavity and gut offers a new perspective in the well-established gut–brain axis that is associated with neuroinflammation, neurodegenerative diseases (e.g., impaired motor function or dementia), and neuropsychiatric disorders (e.g., depression, anxiety, bipolar disorder) ( Kelly et al., 2015 ; Lee et al., 2018 ; Mohajeri et al., 2018 ; Lee et al., 2019 ; Parker et al., 2020 ), specifically on how microbes in the oral cavity take part in the development of neurological/neurodegenerative disease via the oral–gut–brain axis. For the case of dental caries, a recently published scoping review ( Latti et al., 2018 ) indicated the lack of evidence from human studies to clearly explain the association of dental caries ( Ferreira et al., 2021a ) and systemic diseases, which constitutes a research gap ( Wu et al., 2016 ; Maitre et al., 2020 ; Orr et al., 2020 ). Understanding changes in the oral microbiota signatures, specifically dental caries as one of the most prevalent oral diseases, holds promise for better insight into the relationship of the oral–gut–brain axis.…”