Dysbiotic salivary microbiota in dry mouth and primary Sjögren's syndrome patients.

S Rusthen,H K Galtung,B É Petrovski,A K Kristoffersen,M Enersen,Ø Palm,J L Jensen,A Young,Silke Appel

doi:10.1371/journal.pone.0218319

Abstract

ObjectivesPrimary Sjögren’s syndrome (pSS) is an autoimmune disease characterized by reduced lacrimal and salivary secretion. Sicca symptoms together with fatigue and musculoskeletal pain can significantly reduce the patients’ quality of life. Furthermore, low salivary secretion may disrupt the oral microbial homeostasis. The aim of this study was to compare the salivary microbiota from pSS patients with patients with sicca symptoms not fulfilling the classification criteria for pSS (non-SS), and with healthy controls without sicca complaints.MethodsPellets from centrifuged chewing-stimulated whole saliva from pSS patients (n = 15), non-SS sicca patients (n = 15) and healthy controls (n = 15) were prepared. DNA was extracted and analyzed by 16S rRNA gene sequencing. The acquired sequencing data were performed using the human oral microbiome database (HOMD).ResultsWe detected 42, 45, and 34 bacterial genera in saliva samples from pSS patients, non-SS sicca patients, and healthy controls, respectively. The most abundant genera in all samples were Prevotella, Veillonella, Streptococcus, and Haemophilus. At species level Streptococcus intermedius, Prevotella intermedia, Fusobacterium nucleatum subsp. vincentii, Porphyromonas endodontalis, Prevotella nancensis, Tannerella spp., and Treponema spp. were detected in the samples from pSS and non-SS only, while Porphyromonas pasteri was mostly found among the healthy controls.ConclusionOur study indicated dysbiosis in the salivary microbiota from pSS and non-SS patients compared to healthy controls. Additionally, the results showed that the salivary microbiome in the pSS group differed significantly from the non-SS group.

Highlights

Sjogren’s syndrome (SS) is an autoimmune systemic inflammatory disease that affects exocrine glands, mainly the lacrimal and salivary glands
At species level Streptococcus intermedius, Prevotella intermedia, Fusobacterium nucleatum subsp. vincentii, Porphyromonas endodontalis, Prevotella nancensis, Tannerella spp., and Treponema spp. were detected in the samples from primary SS (pSS) and non-SS only, while Porphyromonas pasteri was mostly found among the healthy controls
Our study indicated dysbiosis in the salivary microbiota from pSS and non-SS patients compared to healthy controls

Summary

Introduction

Sjogren’s syndrome (SS) is an autoimmune systemic inflammatory disease that affects exocrine glands, mainly the lacrimal and salivary glands. Clinical manifestations of SS include the classical sicca symptoms of dry eyes and dry mouth, together with fatigue and musculoskeletal pain [2]. Sjogren’s syndrome may present itself as primary SS (pSS) or secondary SS (sSS) when a connective tissue disease has been diagnosed prior to the development of sicca symptoms. In 2002, the American-European Consensus Group (AECG) proposed a set of classification criteria for pSS [3,4], that includes dry mouth, dry eyes, reduced salivary secretion, reduced lacrimal secretion, presence of Ro/SSA and/or La/SSB autoantibodies, and lymphocyte infiltration in minor salivary glands. In order to be classified as pSS, four of the six criteria must be met, including a positive minor salivary gland biopsy or positive serum antibodies. The criteria from the AECG are well accepted and are often used in research and clinical practice [8]

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