Periodontal disease–related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral‐liver axis

Abstract

Periodontal disease is a common chronic inflammatory and infectious disease that is caused by an oral biofilm-mediated microbial dysbiosis that is predominantly comprised of anaerobic gram-negative bacteria, namely periodontopathic bacteria. 1,2 These biofilms are a continually renewing storehouse of lipopolysaccharide and other microbial molecules that are derived from the resident gram-negative bacteria. Biofilm components have ready access to the periodontal tissues and host circulation. Microbial challengesThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Another Look at the Contribution of Oral Microbiota to the Pathogenesis of Rheumatoid Arthritis: A Narrative Review

“…The impairment of gut wall barrier function promotes the transfer of enterobacteria and hepatotoxins to the liver through the enterohepatic circulation [61], but some bacteria from microbiota can escape the liver firewall and reach the general circulation. Excessive enterohepatic circulation can cause a transient hepatic disease [62], a phenomenon commonly observed in patients with RA, especially following treatments such as methotrexate (which modify gut homeostasis [63], but cannot always restore gut impermeability).…”

Oral Health and Liver Disease: Bidirectional Associations—A Narrative Review

“…Associations between oral health and various systemic diseases are well described [ 1 ]. Recent studies have also linked oral diseases specifically with liver disease [ 2 , 3 , 4 ]. Such links can in part be explained by the many shared risk factors between oral disease and liver disease, such as diabetes, smoking and alcohol use [ 1 , 2 ].…”

“…Recent studies have also linked oral diseases specifically with liver disease [ 2 , 3 , 4 ]. Such links can in part be explained by the many shared risk factors between oral disease and liver disease, such as diabetes, smoking and alcohol use [ 1 , 2 ]. Moreover, there may be co-existent diseases; for instance, primary biliary cholangitis (PBC) often co-exists with Sjögren’s syndrome, which in turn is related to oral diseases [ 5 ].…”

“…Moreover, there may be co-existent diseases; for instance, primary biliary cholangitis (PBC) often co-exists with Sjögren’s syndrome, which in turn is related to oral diseases [ 5 ]. In addition to this, periodontitis has more recently also been suggested as a cause or co-factor in the onset and progression of liver disease [ 2 , 3 , 4 ].…”

“…Recent animal studies have demonstrated biologically plausible mechanisms whereby experimental periodontitis can induce liver injury [ 1 , 2 ]. Epidemiological studies have further supported this concept by reporting independent associations between periodontitis and liver disease even after adjusting for multiple confounders [ 16 ].…”