Abstract
ObjectivesTo investigate if there is subspecies specific migration to the placenta by Fusobacterium nucleatum (Fn) and to determine whether experimentally induced periodontitis results in adverse pregnancy outcomes (APO) in mice.MethodsPeriodontitis was induced in pregnant mice using an inoculum of Fn and Porphyromonas gingivalis. In parallel, four sub-species of Fn were individually injected into the circulatory system. At day 18 of gestation, the placenta, liver, spleen and blood were harvested and litter size, number of viable fetuses and resorptions, maternal, fetal and placenta weights were recorded. For the direct inoculation group, some mice were allowed to deliver for assessment of length of gestation, litter size, maternal, placental and pup weight. The presence of Fn was assessed by PCR and inflammatory mediators were measured by ELISA or multiplex analysis.ResultsMice with alveolar bone loss, a marker of periodontitis, demonstrated significantly higher fetal weights (p = 0.015) and fetal/placental weight ratios (p = 0.030). PCR analysis of maternal organs did not identify Fn in any extracted tissues. In mice that received direct injection of Fn subspecies, varying degrees of APO were observed including preterm birth, intrauterine growth restriction, and fetal loss. Haematogenous spread of only Fn subsp. nucleatum to the placenta was confirmed. Litter size was significantly smaller (p = 0.023) and the number of resorptions was higher in inoculated versus control groups. Mice injected with subsp. nucleatum had significantly increased circulating CRP levels (p = 0.020) compared to controls while the mice with induced periodontitis had increased levels of IL-6 (p = 0.047) and IL-8 (p = 0.105).ConclusionsPeriodontitis in mice elevated fetal weight and the fetal weight/placental weight ratio. This study found that subsp. nucleatum migrated haematogenously to the placenta, leading to APO in mice. The study supports the potential role of Fn in the association between periodontitis and APO.
Highlights
Periodontal disease is the result of complex interactions between the host and certain microbial species residing in the sub-gingival environment
This study found that subsp. nucleatum migrated haematogenously to the placenta, leading to adverse pregnancy outcomes (APO) in mice
The study supports the potential role of Fusobacterium nucleatum (Fn) in the association between periodontitis and APO
Summary
Periodontal disease is the result of complex interactions between the host and certain microbial species residing in the sub-gingival environment. The host response is primarily protective, in conjunction with bacterial virulence factors it can result in the progressive destruction of the periodontal ligament, gingival recession, loss of alveolar bone, tooth mobility and tooth loss. It is a serious disease which potentially allows for oral bacteria to disseminate around the body and cause major complications to human health including adverse pregnancy outcomes (APO) [2,3]. Increased levels of oestrogen and progesterone increase the vascular permeability of the periodontium facilitating transmission to the feto-placental unit [4]
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