Abstract
Liver cirrhosis is a severe disease with major impact on the overall health of the patient including poor oral health. Lately, there has been increasing focus on oral diseases as cirrhosis-related complications due to the potential impact on systemic health and ultimately mortality. Periodontitis is one of the most common oral diseases in cirrhosis patients. However, no studies have investigated the composition of the subgingival microbiome in patients suffering from periodontitis and liver cirrhosis. We analysed the subgingival microbiome in 21 patients with periodontitis and cirrhosis using long-reads Illumina sequencing. The subgingival microbiota was dominated by bacteria belonging to the Firmicutes phylum and to a lesser extend the Actinobacteria and Bacteroidetes phyla. Bacteria usually considered periodontal pathogens, like Porhyromonas ginigivalis, Tannerella forsythia, Treponema denticola, generally showed low abundancy. Comparing the microbiota in our patients with that of periodontitis patients and healthy controls of three other studies revealed that the periodontitis-associated subgingival microbiota in cirrhosis patients is composed of a unique microbiota of bacteria not normally associated with periodontitis. We hypothesise that periodontitis in cirrhosis patients is a consequence of dysbiosis due to a compromised immune system that renders commensal bacteria pathogenic.
Highlights
Periodontitis is a bacterially induced inflammatory disease that affects the supporting tissues of teeth, characterized by loss of connective tissue and bone with ensuing deepening of the periodontal pockets
Some studies have shown that the dysbiosis of the gut microbiome in liver cirrhosis patients is mostly caused by increased abundancy of oral bacteria compared to healthy controls[24,25,26]
Our results show that the subgingival microbiota in liver cirrhosis patients with periodontitis is unique and that bacteria normally associated with periodontitis are found only in very low proportions
Summary
Periodontitis is a bacterially induced inflammatory disease that affects the supporting tissues of teeth, characterized by loss of connective tissue and bone with ensuing deepening of the periodontal pockets. Ensuing changes in the relative abundances of members of the complex microbiota that accumulate on the teeth toward pro-inflammatory species trigger a host response that includes release of inflammatory exudates, which further stimulate changes in the microbiota In some cases, this dysbiosis leads to a situation where a destructive inflammatory response results in degradation of connective tissue and periodontal bone[3,4,5]. Some studies have shown that the dysbiosis of the gut microbiome in liver cirrhosis patients is mostly caused by increased abundancy of oral bacteria compared to healthy controls[24,25,26]. Our results show that the subgingival microbiota in liver cirrhosis patients with periodontitis is unique and that bacteria normally associated with periodontitis are found only in very low proportions. We hypothesise that this may be due to an altered immune status in liver cirrhosis patients allowing bacteria not normally associated with periodontitis in otherwise healthy patients to induce periodontitis
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