Abstract
Systemic inflammation induced by periodontitis is suggested to be the link between periodontitis and cardiovascular disease. The aim of this work was to explore the oral microbiome in periodontitis in relation to disease severity and systemic inflammation. The saliva and subgingival microbiome from periodontal pocket samples of patients with severe (n = 12) and mild periodontitis (n = 13) were analyzed using metagenomic shotgun sequencing. The taxa and pathways abundances were quantified. The diversity was assessed and the abundances to phenotype associations were performed using ANCOM and linear regression. A panel of inflammatory markers was measured in blood and was associated with taxa abundance. The microbial diversity and species richness did not differ between severe and mild periodontitis in either saliva or periodontal pockets. However, there were significant differences in the microbial composition between severe and mild periodontitis in the subgingival microbiome (i.e., pocket samples) and, in a lower grade, in saliva, and this is positively associated with systemic inflammatory markers. The “red complex” and “cluster B” abundances in periodontal pockets were strongly associated with inflammatory markers interleukin-6 and the white blood cell count. Our data suggest that systemic inflammation in severe periodontitis may be driven by the oral microbiome and may support the indirect (inflammatory) mechanism for the association between periodontitis and cardiovascular disease.
Highlights
Introduction published maps and institutional affilClinical research has identified an association between periodontal disease (PD) and cardiovascular disease (CVD)
There were no significant differences in the CVD risk factors, namely BMI, hypertension, and smoking status, between the groups
We found out that microbial diversity and species richness do not differ between severe PD and mild PD in either saliva or periodontal pockets
Summary
Introduction published maps and institutional affilClinical research has identified an association between periodontal disease (PD) and cardiovascular disease (CVD). The main suspected mechanisms driving this association are infectious (direct effect) and inflammatory (indirect effect) [1,2]. The indirect mechanism suggests that periodontal inflammation caused by oral bacteria induces the production of inflammatory mediators in the systemic circulation. The association between the oral microbiome and systemic inflammation has not been extensively investigated. It is unknown whether oral bacteria that may cause systemic inflammation are part of the saliva, subgingival periodontal pocket communities, or both. Most periodontal studies have been performed only on the subgingival microbiome and have yielded contradictory results. The subgingival bacterial burden of 11 species was not found to be associated with white blood cell counts or C-reactive protein (CRP) [3]. In another study [4], the phyla Firmicutes and TM 7, along with 18 other individual taxa, iations
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