Association between Selected Oral Pathogens and Gastric Precancerous Lesions

Abstract

We examined whether colonization of selected oral pathogens is associated with gastric precancerous lesions in a cross-sectional study. A total of 119 participants were included, of which 37 were cases of chronic atrophic gastritis, intestinal metaplasia, or dysplasia. An oral examination was performed to measure periodontal indices. Plaque and saliva samples were tested with real-time quantitative PCR for DNA levels of pathogens related to periodontal disease (Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Actinobacillus actinomycetemcomitans) and dental caries (Streptococcus mutans and S. sobrinus). There were no consistent associations between DNA levels of selected bacterial species and gastric precancerous lesions, although an elevated but non-significant odds ratio (OR) for gastric precancerous lesions was observed in relation to increasing colonization of A. actinomycetemcomitans (OR = 1.36 for one standard deviation increase, 95% Confidence Interval = 0.87–2.12), P. gingivalis (OR = 1.12, 0.67–1.88) and T. denticola (OR = 1.34, 0.83–2.12) measured in plaque. To assess the influence of specific long-term infection, stratified analyses by levels of periodontal indices were conducted. A. actinomycetemcomitans was significantly associated with gastric precancerous lesions (OR = 2.51, 1.13–5.56) among those with ≥ median of percent tooth sites with PD≥3 mm, compared with no association among those below the median (OR = 0.86, 0.43–1.72). A significantly stronger relationship was observed between the cumulative bacterial burden score of periodontal disease-related pathogens and gastric precancerous lesions among those with higher versus lower levels of periodontal disease indices (p-values for interactions: 0.03–0.06). Among individuals with periodontal disease, high levels of colonization of periodontal pathogens are associated with an increased risk of gastric precancerous lesions.

Looking in the Porphyromonas gingivalis cabinet of curiosities: the microbium, the host and cancer association

“…Individuals with high levels of antibodies against P. gingivalis ATTC 53978 had a two-fold higher risk of pancreatic cancer than individuals with lower levels of anti-P. gingivalis antibodies (Michaud et al, 2012). A year later in a clinical study involving 37 cases of chronic atrophic gastritis, intestinal metaplasia, or dysplasia, DNA levels of periodontopathic bacteria, including P. gingivalis, were measured in plaque and saliva samples by real-time quantitative PCR (Salazar et al, 2013). An elevated but not statistically significant odds ratio for gastric precancerous lesions was observed in relation to increasing colonization with P. gingivalis, Aggregatibacter actinomycetemcomitans and Treponema denticola measured in plaque, and so the study associated high levels of periodontal-pathogen colonization with an increased risk of gastric precancerous lesions in individuals with periodontal disease (Salazar et al, 2013).…”

“…A year later in a clinical study involving 37 cases of chronic atrophic gastritis, intestinal metaplasia, or dysplasia, DNA levels of periodontopathic bacteria, including P. gingivalis, were measured in plaque and saliva samples by real-time quantitative PCR (Salazar et al, 2013). An elevated but not statistically significant odds ratio for gastric precancerous lesions was observed in relation to increasing colonization with P. gingivalis, Aggregatibacter actinomycetemcomitans and Treponema denticola measured in plaque, and so the study associated high levels of periodontal-pathogen colonization with an increased risk of gastric precancerous lesions in individuals with periodontal disease (Salazar et al, 2013). A recent case-control study examined the fecal microbiome changes of 19 colorectal cancer patients in comparison to 20 healthy people using 16S rRNA pyro-sequencing .…”

Periodontal Disease and Incident Cancer Risk among Postmenopausal Women: Results from the Women's Health Initiative Observational Cohort

“…These pathogens could also permeate through diseased periodontal tissues into the systemic circulation to reach distant sites (11). There are numerous scientific reports of periodontal pathogen isolates in various organ systems including lymph nodes (12), arteries (13,14), lung aspirates (9,10), precancerous gastric (15) and colon lesions (16), and esophageal (17) and colorectal cancers (18,19). At the target site, periodontopathogens may promote a permissive microenvironment conducive to cancer progression (8,16,20).…”

The Presence of Periodontal Pathogens in Gastric Cancer

“…Periodontal and CRC pathogens. It has been reported that among patients with periodontal disease, high levels of colonization of periodontal pathogens are associated with an increased risk of gastric precancerous lesions [Salazar et al 2013]. We found the periodontal pathogens F. nucleatum, P. micra and P. stomatis to be commensal but also associated with tumor status and in direct interaction in several data sets.…”