Oral Health and the Oral Microbiome in Pancreatic Cancer

This systematic review aims to identify probiotics and prebiotics for modulating oral bacterial species associated with mental disorders. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline, we search the electronic MEDLINE database published till January 2021 to identify the studies on probiotics and/or prebiotics for preventing and treating major oral dysbiosis that provokes mental disorders. The outcome of the search produces 374 records. After excluding non-relevant studies, 38 papers were included in the present review. While many studies suggest the potential effects of the oral microbiota on the biochemical signalling events between the oral microbiota and central nervous system, our review highlights the limited development concerning the use of prebiotics and/or probiotics in modulating oral dysbiosis potentially involved in the development of mental disorders. However, the collected studies confirm prebiotics and/or probiotics interest for a global or targeted modulation of the oral microbiome in preventing or treating mental disorders. These outcomes also offer exciting prospects for improving the oral health of people with mental disorders in the future.

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The oral microbiome in relation to pancreatic cancer risk in African Americans

British Journal of Cancer ◽

10.1038/s41416-021-01578-5 ◽

2021 ◽

Author(s):

Jessica L. Petrick ◽

Jeremy E. Wilkinson ◽

Dominique S. Michaud ◽

Qiuyin Cai ◽

Hanna Gerlovin ◽

...

Keyword(s):

Pancreatic Cancer ◽

African Americans ◽

Cancer Risk ◽

Oral Microbiome ◽

Pancreatic Cancer Risk

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Human oral microbiome and prospective risk for pancreatic cancer: a population-based nested case-control study

Gut ◽

10.1136/gutjnl-2016-312580 ◽

2016 ◽

Vol 67 (1) ◽

pp. 120-127 ◽

Cited By ~ 177

Author(s):

Xiaozhou Fan ◽

Alexander V Alekseyenko ◽

Jing Wu ◽

Brandilyn A Peters ◽

Eric J Jacobs ◽

...

Keyword(s):

Pancreatic Cancer ◽

Case Control Study ◽

Case Control ◽

Oral Microbiome ◽

Rrna Gene ◽

Oral Microbiota ◽

Increased Risk ◽

Oral Pathogens ◽

Nested Case Control ◽

Control Study

ObjectiveA history of periodontal disease and the presence of circulating antibodies to selected oral pathogens have been associated with increased risk of pancreatic cancer; however, direct relationships of oral microbes with pancreatic cancer have not been evaluated in prospective studies. We examine the relationship of oral microbiota with subsequent risk of pancreatic cancer in a large nested case–control study.DesignWe selected 361 incident adenocarcinoma of pancreas and 371 matched controls from two prospective cohort studies, the American Cancer Society Cancer Prevention Study II and the National Cancer Institute Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. From pre-diagnostic oral wash samples, we characterised the composition of the oral microbiota using bacterial 16S ribosomal RNA (16S rRNA) gene sequencing. The associations between oral microbiota and risk of pancreatic cancer, controlling for the random effect of cohorts and other covariates, were examined using traditional and L1-penalised least absolute shrinkage and selection operator logistic regression.ResultsCarriage of oral pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, were associated with higher risk of pancreatic cancer (adjusted OR for presence vs absence=1.60 and 95% CI 1.15 to 2.22; OR=2.20 and 95% CI 1.16 to 4.18, respectively). Phylum Fusobacteria and its genus Leptotrichia were associated with decreased pancreatic cancer risk (OR per per cent increase of relative abundance=0.94 and 95% CI 0.89 to 0.99; OR=0.87 and 95% CI 0.79 to 0.95, respectively). Risks related to these phylotypes remained after exclusion of cases that developed within 2 years of sample collection, reducing the likelihood of reverse causation in this prospective study.ConclusionsThis study provides supportive evidence that oral microbiota may play a role in the aetiology of pancreatic cancer.

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Examining the association between oral health status and dementia: A nationwide nested case-controlled study

Experimental Biology and Medicine ◽

10.1177/1535370220904924 ◽

2020 ◽

Vol 245 (3) ◽

pp. 231-244 ◽

Cited By ~ 2

Author(s):

JW Lin ◽

CH Chang ◽

JL Caffrey

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Oral Health ◽

Dental Health ◽

Oral Microbiome ◽

Sporadic Alzheimer’S Disease ◽

Lower Odds ◽

National Insurance ◽

Dental Records ◽

Insurance Database

Alzheimer’s disease as a consequence of chronic brain inflammation mediated by infectious microbes including the oral microbiome continues to attract support. Taiwan’s National Insurance database was used to evaluate associations between dental health and Alzheimer’s disease; 209,112 new cases of Alzheimer’s disease were matched 1:4 with 836,448 dementia-free controls to test the hypothesis that better dental health would be associated with less occurrence of dementia. Ten year dental records and conditional logistic regression models were used to estimate the odds ratios associated with Alzheimer’s disease. Subgroup analyses compared vascular Alzheimer’s disease and sporadic Alzheimer’s disease. As the population aged, Alzheimer’s disease diagnoses were more frequent with a 10 fold upward inflection after 60. Nearly 56% of sporadic Alzheimer’s disease patients were women but less than 50% had vascular Alzheimer’s disease. Comorbidities were 10–20% higher in the Alzheimer’s disease patients than in controls, but stroke, chronic infection, and pneumonia were 40–45% more common in the vascular Alzheimer’s disease patients. Heart disease, hypertension, diabetes, stroke, peripheral artery disease, pneumonia, and herpetic disease (HSV) were all associated with higher odds of Alzheimer’s disease. HSV was not a factor in the vascular Alzheimer’s disease. Routine dental procedures tended to lower odds ratios. Root canals and extractions that restore oral homeostasis were associated with lower odds of dementia. However, when extractions exceeded four, the odds of Alzheimer’s disease rose. The fact that Alzheimer’s disease was not associated with periodontal procedures per se but with more frequent periodontal emergencies suggested again a chronic issue. Dental health costs suggest that good dental care was associated with lower odds of Alzheimer’s disease except for radiographic costs which were consistently associated with higher odds, independent of oral health. Common comorbid conditions were associated with higher odds of Alzheimer’s disease and oral health care was associated with lower odds, providing support for the hypothesis that the oral microbiome is a factor in the development of Alzheimer’s disease. Impact statement This study clearly demonstrates the power and value of a nationally applied digital medical record. Longitudinal studies of gradually developing pathologies like dementia have often been limited by sample size and narrow and incomplete medical histories. The Taiwan National Insurance database provides an unparalleled opportunity for detailed analyses of associations between current medical conditions and a spectrum of prior medical and dental events. The temporal impact of the database will only become more important as the past historical record progressively expands going forward. The inclusion of dental records in assessing the relationship with subsequent dementia is very important because this information is often unavailable or dependent on subject recall. This study clearly establishes associations between a variety of suspected cardiovascular and metabolic factors and the odds of dementia. A critical outcome should include the design of targeted interventions and the subsequent assessment of their efficacy.

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Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care: a systematic review

Age and Ageing ◽

10.1093/ageing/afaa102 ◽

2020 ◽

Author(s):

Sangeeta Khadka ◽

Shahrukh Khan ◽

Anna King ◽

Lynette R Goldberg ◽

Leonard Crocombe ◽

...

Keyword(s):

Oral Health ◽

Older People ◽

Aspiration Pneumonia ◽

Oral Hygiene ◽

Oral Care ◽

Aged Care ◽

Oral Microbiome ◽

Residential Aged Care ◽

Pathogenic Microorganisms ◽

Oral Microorganisms

Abstract Background aspiration pneumonia increases hospitalisation and mortality of older people in residential aged care. Objectives determine potentially pathogenic microorganisms in oral specimens of older people with aspiration pneumonia and the effect of professional oral care in reducing aspiration pneumonia risk. Data Sources PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science. Study Eligibility Criteria published between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment. Participants people 60 years and older in residential aged care. Study Appraisal and Synthesis Methods the Newcastle–Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist. Results twelve studies (four cross-sectional, five cohort and three intervention) reported colonisation of the oral cavity of older people by microorganisms commonly associated with respiratory infections. Aspiration pneumonia occurred less in people who received professional oral care compared with no such care. Isolation of Candida albicans, Staphylococcus aureus, methicillin-resistant S. aureus and Pseudomonas aeruginosa was related to mortality due to aspiration pneumonia. An interesting finding was isolation of Escherichia coli, a gut bacterium. Limitations more information may be present in publications about other co-morbidities that did not meet inclusion criteria. A high degree of heterogeneity prevented a meta-analysis. Issues included sampling size, no power and effect size calculations; different oral health assessments; how oral specimens were analysed and how aspiration pneumonia was diagnosed. Conclusions and Implications of Key Findings pathogenic microorganisms colonising the oral microbiome are associated with aspiration pneumonia in older people in residential care; professional oral hygiene care is useful in reducing aspiration pneumonia risk.

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Rapamycin rejuvenates oral health in aging mice

eLife ◽

10.7554/elife.54318 ◽

2020 ◽

Vol 9 ◽

Cited By ~ 3

Author(s):

Jonathan Y An ◽

Kristopher A Kerns ◽

Andrew Ouellette ◽

Laura Robinson ◽

H Douglas Morris ◽

...

Keyword(s):

Oral Health ◽

Periodontal Disease ◽

Tooth Extraction ◽

The Elderly ◽

Term Treatment ◽

Oral Microbiome ◽

Short Term ◽

Short Term Treatment ◽

Periodontal Bone Loss ◽

Bone Inflammation

Periodontal disease is an age-associated disorder clinically defined by periodontal bone loss, inflammation of the specialized tissues that surround and support the tooth, and microbiome dysbiosis. Currently, there is no therapy for reversing periodontal disease, and treatment is generally restricted to preventive measures or tooth extraction. The FDA-approved drug rapamycin slows aging and extends lifespan in multiple organisms, including mice. Here, we demonstrate that short-term treatment with rapamycin rejuvenates the aged oral cavity of elderly mice, including regeneration of periodontal bone, attenuation of gingival and periodontal bone inflammation, and revertive shift of the oral microbiome toward a more youthful composition. This provides a geroscience strategy to potentially rejuvenate oral health and reverse periodontal disease in the elderly.

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The Oral Microbiota: A Literature Review for Updating Professionals in Dentistry. Part I

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.2020.39178 ◽

2019 ◽

pp. 143-152

Author(s):

Cristina Barboza-Solís DDS, MSc, PhD ◽

Luis Alberto Acuña-Amador PhD

Keyword(s):

Oral Health ◽

Scientific Evidence ◽

Oral Microbiome ◽

Current Evidence ◽

Future Research ◽

Oral Microbiota ◽

Systemic Diseases ◽

Conceptual Background ◽

Keyword Searches

In recent decades, a body of literature examining the relationships between oral health and general health has rapidly developed. However, the biological mechanisms involved in explaining such relationships have not been fully described. Recent evidence has suggested that these relationships could be partially explained by the composition and interaction of the microbiome/microbiota between local and systemic body sites. For instance, it has been suggested that intestinal microbiota could have effects on non-communicable diseases, such as diabetes or cardiovascular diseases. The objective of this study is to explore current evidence of the link between oral and systemic diseases, to discuss whether oral microbiome/microbiota could represent an unexplored biological pathway partially explaining those relationships. A non-systematic review of the literature was carried out using keyword searches in Pubmed from February to May 2019. The ultimate goal was to present recent scientific evidence to update the general knowledge on this topic to professionals in dentistry. This review is divided in two parts for journal publication; however, it is intended to be used as one piece. In this first part, we will summarize the conceptual background of oral microbiome/microbiota, we will describe the main methods used in microbiology to characterize oral organisms, and will present the main composition of bacteria in oral microbiome/microbiota. The second part highlights the main evidence regarding the biological plausibility that links oral microbiome and systemic diseases and we will conclude with some future research recommendations. Taking into account the role of oral microbiota in the development of systemic diseases could change the main paradigm of how oral health is currently conceptualized by dental professionals.

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Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

Frontiers in Oral Health ◽

10.3389/froh.2021.697428 ◽

2021 ◽

Vol 2 ◽

Author(s):

Thais de Cássia Negrini ◽

Iracilda Zeppone Carlos ◽

Cristiane Duque ◽

Karina Sampaio Caiaffa ◽

Rodrigo Alex Arthur

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Immune Response ◽

Oral Health ◽

Inflammatory Response ◽

Oral Cavity ◽

Periodontal Disease ◽

Host Immune Response ◽

Oral Microbiome ◽

Associated Risk Factors

This comprehensive review of the literature aimed to investigate the interplay between the oral microbiome, oral cavity conditions, and host immune response in Diabetes mellitus (DM). Moreover, this review also aimed to investigate how DM related risk factors, such as advanced age, hyperglycemia, hyperlipidemia, obesity, hypertension and polycystic ovary syndrome (PCOS), act in promoting or modifying specific mechanisms that could potentially perpetuate both altered systemic and oral conditions. We found that poorly controlled glycemic index may exert a negative effect on the immune system of affected individuals, leading to a deficient immune response or to an exacerbation of the inflammatory response exacerbating DM-related complications. Hyperglycemia induces alterations in the oral microbiome since poor glycemic control is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of individuals with DM. A bidirectional relationship between periodontal diseases and DM has been suggested: DM patients may have an exaggerated inflammatory response, poor repair and bone resorption that aggravates periodontal disease whereas the increased levels of systemic pro-inflammatory mediators found in individuals affected with periodontal disease exacerbates insulin resistance. SARS-CoV-2 infection may represent an aggravating factor for individuals with DM. Individuals with DM tend to have low salivary flow and a high prevalence of xerostomia, but the association between prevalence/experience of dental caries and DM is still unclear. DM has also been associated to the development of lesions in the oral mucosa, especially potentially malignant ones and those associated with fungal infections. Obesity plays an important role in the induction and progression of DM. Co-affected obese and DM individuals tend to present worse oral health conditions. A decrease in HDL and, an increase in triglycerides bloodstream levels seem to be associated with an increase on the load of periodontopathogens on oral cavity. Moreover, DM may increase the likelihood of halitosis. Prevalence of impaired taste perception and impaired smell recognition tend to be greater in DM patients. An important interplay among oral cavity microbiome, DM, obesity and hypertension has been proposed as the reduction of nitrate into nitrite, in addition to contribute to lowering of blood pressure, reduces oxidative stress and increases insulin secretion, being these effects desirable for the control of obesity and DM. Women with PCOS tend to present a distinct oral microbial composition and an elevated systemic response to selective members of this microbial community, but the association between oral microbiome, PCOS are DM is still unknown. The results of the studies presented in this review suggest the interplay among the oral microbiome, oral cavity conditions, host immune response and DM and some of the DM associated risk factors exist. DM individuals need to be encouraged and motivated for an adequate oral health care. In addition, these results show the importance of adopting multidisciplinary management of DM and of strengthening physicians-dentists relationship focusing on both systemic and on oral cavity conditions of DM patients.

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The dynamics of the oral microbiome and oral health among patients receiving clear aligner orthodontic treatment

Oral Diseases ◽

10.1111/odi.13175 ◽

2020 ◽

Vol 26 (2) ◽

pp. 473-483 ◽

Cited By ~ 3

Author(s):

Rui Zhao ◽

Renhuan Huang ◽

Hu Long ◽

Yan Li ◽

Meiya Gao ◽

...

Keyword(s):

Oral Health ◽

Orthodontic Treatment ◽

Oral Microbiome ◽

Clear Aligner

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Intracellular Porphyromonas gingivalis Promotes the Tumorigenic Behavior of Pancreatic Carcinoma Cells

Cancers ◽

10.3390/cancers12082331 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2331 ◽

Cited By ~ 1

Author(s):

JebaMercy Gnanasekaran ◽

Adi Binder Gallimidi ◽

Elias Saba ◽

Karthikeyan Pandi ◽

Luba Eli Berchoer ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cancer Cells ◽

Cell Lines ◽

Porphyromonas Gingivalis ◽

Xenograft Model ◽

Oral Bacteria ◽

Oral Microbiome ◽

Human Pancreatic Cancer ◽

Pancreatic Cancer Cells ◽

Increased Risk

Porphyromonas gingivalis is a member of the dysbiotic oral microbiome associated with oral inflammation and periodontal disease. Intriguingly, epidemiological studies link P. gingivalis to an increased risk of pancreatic cancer. Given that oral bacteria are detected in human pancreatic cancer, and both mouse and human pancreata harbor microbiota, we explored the involvement of P. gingivalis in pancreatic tumorigenesis using cell lines and a xenograft model. Live P. gingivalis induced proliferation of pancreatic cancer cells; however, surprisingly, this effect was independent of Toll-like receptor 2, the innate immune receptor that is engaged in response to P. gingivalis on other cancer and immune cells, and is required for P. gingivalis to induce alveolar bone resorption. Instead, we found that P. gingivalis survives inside pancreatic cancer cells, a trait that can be enhanced in vitro and is increased by hypoxia, a central characteristic of pancreatic cancer. Increased tumor cell proliferation was related to the degree of intracellular persistence, and infection of tumor cells with P. gingivalis led to enhanced growth in vivo. To the best of our knowledge, this study is the first to demonstrate the direct effect of exposure to P. gingivalis on the tumorigenic behavior of pancreatic cancer cell lines. Our findings shed light on potential mechanisms underlying the pancreatic cancer–periodontitis link.

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