Abstract
A relationship between IgA nephropathy (IgAN) and bacterial infection has been suspected. As IgAN is a chronic disease, bacteria that could cause chronic infection in oral areas might be pathogenetic bacteria candidates. Oral bacterial species related to dental caries and periodontitis should be candidates because these bacteria are well known to be pathogenic in chronic dental disease. Recently, several reports have indicated that collagen-binding protein (cnm)-(+) Streptococcs mutans is relate to the incidence of IgAN and the progression of IgAN. Among periodontal bacteria, Treponema denticola, Porphyromonas gingivalis and Campylobacte rectus were found to be related to the incidence of IgAN. These bacteria can cause IgAN-like histological findings in animal models. While the connection between oral bacterial infection, such as infection with S. mutans and periodontal bacteria, and the incidence of IgAN remains unclear, these bacterial infections might cause aberrantly glycosylated IgA1 in nasopharynx-associated lymphoid tissue, which has been reported to cause IgA deposition in mesangial areas in glomeruli, probably through the alteration of microRNAs related to the expression of glycosylation enzymes. The roles of other factors related to the incidence and progression of IgA, such as genes and cigarette smoking, can also be explained from the perspective of the relationship between these factors and oral bacteria. This review summarizes the relationship between IgAN and oral bacteria, such as cnm-(+) S. mutans and periodontal bacteria.
Highlights
Approximately two weeks after patients had group A beta-Streptococcus tonsillar infection as a preceding infection, patients presented with macrohematuria, proteinuria, hypertension, edema, and typical glomerular lesions, such as endocapillary proliferation and subepithelial hump, which can be proven by kidney biopsy
To investigate the pathogenesis of acute glomerulonephritis (AGN), a cultural method to diagnose Streptococcus infection using tonsillar swabs may work because Streptococcus belong to the aerobic bacteria
P. gingivalis colocalizes with C. rectus, an orange complex periodontal bacterium, and C. rectus has been reported to be highly detected in the tonsils of IgA nephropathy (IgAN) patients [112]; C. rectus has a relationship with the clinical remission rate after tonsillectomy [107], indicating that C. rectus infection might be accompanied by
Summary
The strongest candidate as this stimulator is chronic infection in the oral areas, such as bacterial species related to dental caries and periodontitis (see Figure 1). These bacterial species have been reported to have a strong relationship with many systemic diseases [11,12,13,14,15,16], and these bacteria participate in the pathogenesis of dental diseases, such as dental caries and periodontal disease. Several reports indicated that these bacterial species may be involved in the pathogenesis of IgAN as a stimulator of IgA production (see Figure 1). IgA production by NALT might be chronic oral area infections, such as bacteria related to dental caries and periodontal bacteria
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