Is periodontitis a risk indicator for gastrointestinal cancers? A meta‐analysis of cohort studies

Zhang, Yun; Sun, Chenyu; Song, E; Liang, Mingming; Shi, Tingting; Min, Min; Sun, Yehuan

doi:10.1111/jcpe.13217

Cited by 19 publications

(30 citation statements)

References 64 publications

(130 reference statements)

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“…Surprisingly, the oral microbiome is also associated with PDAC pathogenesis. Based on meta-epidemiological studies, periodontitis, a major oral dysbiotic disease, can significantly increase the risk and mortality of PDAC [ 193 , 194 ]. In consistent, carriage of its key pathogen, P. gingivalis, positively correlates to higher risk and mortality in PDAC patients [ 145 , 195 , 196 ].…”

Section: Oral–gut Microbiome Axis In Human Gi Diseases and Cancersmentioning

confidence: 99%

“…Collectively, the bidirectional crosstalk between oral and gut microbiomes can develop the oral-gut microbiome axis, which plays a crucial role in regulating pathogenesis of various human diseases, primarily in the GI system (see Tables 1-3). [85,188,190,191] Gut-pancreatic microbiome axis • Concomitant shifts in the gut, pancreatic, and tumor microbiomes of PDAC patients [188,190,191] • Overlap between gut and pancreatic microbiomes [85] Association with oral microbiome • Altered oral microbiome in PDAC patients [196,199] • Concomitant shifts in the oral, gut, and pancreatic microbiomes of PDAC patients [76] • Periodontitis was associated with increased PDAC risk and mortality [193,194] • Carriage of P. gingivalis was associated with increased PDAC risk and mortality [145,195,196] • Oral administration of P. gingivalis accelerated progression of PDAC in mice [197] Prevalence of oral microbiota • Fusobacterium in the gut, pancreatic, and tumor microbiomes of PDAC patients [85,196,200] It is noteworthy that the oral-gut microbiome axis improves prediction of pathogenesis and prognosis in the GI system. The meta-analysis has shown that oral microbiome changes are associated with the risk of GI cancer, including CRC, PDAC, and HCC, which can be a potential index for early detection [203].…”

Section: Perspectivesmentioning

confidence: 99%

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Oral–Gut Microbiome Axis in Gastrointestinal Disease and Cancer

Park

Hwang

Lim

et al. 2021

Cancers

122

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It is well-known that microbiota dysbiosis is closely associated with numerous diseases in the human body. The oral cavity and gut are the two largest microbial habitats, playing a major role in microbiome-associated diseases. Even though the oral cavity and gut are continuous regions connected through the gastrointestinal tract, the oral and gut microbiome profiles are well-segregated due to the oral–gut barrier. However, the oral microbiota can translocate to the intestinal mucosa in conditions of the oral–gut barrier dysfunction. Inversely, the gut-to-oral microbial transmission occurs as well in inter- and intrapersonal manners. Recently, it has been reported that oral and gut microbiomes interdependently regulate physiological functions and pathological processes. Oral-to-gut and gut-to-oral microbial transmissions can shape and/or reshape the microbial ecosystem in both habitats, eventually modulating pathogenesis of disease. However, the oral–gut microbial interaction in pathogenesis has been underappreciated to date. Here, we will highlight the oral–gut microbiome crosstalk and its implications in the pathogenesis of the gastrointestinal disease and cancer. Better understanding the role of the oral–gut microbiome axis in pathogenesis will be advantageous for precise diagnosis/prognosis and effective treatment.

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Section: Oral–gut Microbiome Axis In Human Gi Diseases and Cancersmentioning

confidence: 99%

Section: Perspectivesmentioning

confidence: 99%

Oral–Gut Microbiome Axis in Gastrointestinal Disease and Cancer

Park

Hwang

Lim

et al. 2021

Cancers

122

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“…The results showed that periodontal disease increased the risk of colorectal cancer incidence by 21% (95%CI, [1.06, 1.38]). In comparison to a previous meta‐analysis of periodontitis and gastrointestinal cancers that found no association between periodontitis and colorectal cancer incidence risk, 43 we included more studies and conducted comprehensive subgroup analyses and concluded that periodontal disease was associated with colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Is periodontal disease associated with increased risk of colorectal cancer? A meta‐analysis

Xuan

Jha

Zhao

et al. 2020

Int J Dental Hygiene

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Objective Colorectal cancer (CRC) is a commonly diagnosed cancer. Previous studies investigating the relationship between periodontal disease (PD) and CRC showed controversial conclusions. This meta‐analysis is to explore the association between PD and CRC. Methods Observational studies that explore the association between CRC and PD were included in this meta‐analysis. A comprehensive literature search in 7 electronic databases to identify all relevant studies published prior to February 2020. The Newcastle‐Ottawa Quality Assessment Scale was used to evaluate the quality each study. The pooled relative risk (RR) and 95% confidence interval (CI) were used to estimate the association between the PD and CRC risk. Results A total of 838 articles were obtained from database searching and 4 articles were obtained from other sources, and 13 articles with 14 studies involving 634,744 participants were included. An association between PD and increased CRC incidence was found, periodontal disease patients were 21% (95%CI, [1.06, 1.38], I2=83.9%) more likely to develop colorectal cancer than people with healthy oral cavity. But there is no significant association between PD and CRC mortality. The heterogeneity of this meta‐analysis was relatively high, I2 was 83.9% (95%CI, [72.7%, 90.5%]), chi‐squared of Q test was 62.18, but sensitivity analysis confirmed the stability of the result. Funnel plot, Eggerʼs test and Beggʼs test found no publication bias of analysis. Conclusion The current meta‐analysis demonstrates an association between PD and CRC, indicating that early CRC screening is necessary for people with poor oral health, and oral health improvement might be beneficial for reducing CRC risk.

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“…Recently, Zhang et al 158 Another meta-analysis 159 showed that patients with lost teeth, a marker for severe periodontitis, have increased risk for gastric cancer. Unfortunately, lost teeth are not a unique marker for periodontitis; thus, these specific data must be taken carefully.…”

Section: Gastrointestinal Cancermentioning

confidence: 99%

Paradigm shift in the pathogenesis and treatment of oral cancer and other cancers focused on the oralome and antimicrobial‐based therapeutics

Radaic

Ganther

Kamarajan

et al. 2021

Periodontology 2000

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The oral cavity contains up to 1000 microbial species in total, comprised of bacteria, fungi, viral, archaea, and protozoan species that thrive in a very dynamic microenviroment. [1][2][3][4][5] All of these microorganisms form a complex relationship among themselves, establishing a unique microbiome, known as the oral microbiome. Interestingly, the oral microbiome forms a close symbiotic relationship with human host cells in the oral cavity. Thus, the term oralome was coined to encompass not only the oral microbiome but also the host-microbial interactions that take place in the human oral cavity. 5 In this sense, healthy symbiotic host-microbiome interactions between humans and these microorganisms are known as eubiosis. [5][6][7] The microbial composition can be dramatically affected by interspecies and host-microbial interactions. These microbial changes can impact the health and disease status of the host, since eubiosis plays an essential role both in the development of natural oral physiology and host defense mechanisms. 5,8,9 Although the oral microbiome can compensate for most overall perturbations, 5,10 some changes can profoundly affect its composition, impacting the oral commensal populations and causing an unbalanced state known as dysbiosis. 5,11 | Periodontitis and oral microbiome dysbiosisDysbiosis is an unbalanced microbiome state that is caused by internal and/or external microbial-ecologic changes to the oral microbiome. 5 This specific state has been described as capable of promoting diseases in the host. 12,13 Since periodontitis is considered an inflammatory disease that is initiated by pathogenic bacteria, the most accepted hypothesis for periodontitis initiation and progression is that there is a dysbiotic shift in the oral microbiome. 5,14 This shift is driven by an enrichment of Prevotella intermedia, Fusobacterium nucleatum, Porphyromonas gingivalis, Tannarella forsythia, and Treponema denticola species in the microbiome. [14][15][16] Specifically, a dysbiotic oral biofilm infiltrates the gingival pocket, which then triggers the host immune response. This reaction leads to gingival tissue inflammation (gingivitis) and, ultimately, tissue degradation and periodontitis. 14 Oral dysbiosis has been associated with a variety of systemic diseases and conditions, including Alzheimer's disease, diabetes, adverse pregnancy complications, and several types of cancer, including oral, gastrointestinal, lung, breast, prostate, and uterine cancer. 5,[17][18][19][20] Thus, the objective of this research is to (1) evaluate the epidemiologic evidence linking periodontitis to these types of cancer, (2) provide insights into the mechanisms by which oral microbial dysbiosis can cause these cancers, and (3) summarize the evolving evidence supporting the use of probiotics and related moleculesThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use...

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Is periodontitis a risk indicator for gastrointestinal cancers? A meta‐analysis of cohort studies

Cited by 19 publications

References 64 publications

Oral–Gut Microbiome Axis in Gastrointestinal Disease and Cancer

Oral–Gut Microbiome Axis in Gastrointestinal Disease and Cancer

Is periodontal disease associated with increased risk of colorectal cancer? A meta‐analysis

Paradigm shift in the pathogenesis and treatment of oral cancer and other cancers focused on the oralome and antimicrobial‐based therapeutics

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