Subgingival microbiota dysbiosis in systemic lupus erythematosus: association with periodontal status

Abstract

BackgroundPeriodontitis results from the interaction between a subgingival biofilm and host immune response. Changes in biofilm composition are thought to disrupt homeostasis between the host and subgingival bacteria resulting in periodontal damage. Chronic systemic inflammatory disorders have been shown to affect the subgingival microbiota and clinical periodontal status. However, this relationship has not been examined in subjects with systemic lupus erythematosus (SLE). The objective of our study was to investigate the influence of SLE on the subgingival microbiota and its connection with periodontal disease and SLE activity.MethodsWe evaluated 52 patients with SLE compared to 52 subjects without SLE (control group). Subjects were classified as without periodontitis and with periodontitis. Oral microbiota composition was assessed by amplifying the V4 region of 16S rRNA gene from subgingival dental plaque DNA extracts. These amplicons were examined by Illumina MiSeq sequencing.ResultsSLE patients exhibited higher prevalence of periodontitis which occurred at a younger age compared to subjects of the control group. More severe forms of periodontitis were found in SLE subjects that had higher bacterial loads and decreased microbial diversity. Bacterial species frequently detected in periodontal disease were observed in higher proportions in SLE patients, even in periodontal healthy sites such as Fretibacterium, Prevotella nigrescens, and Selenomonas. Changes in the oral microbiota were linked to increased local inflammation, as demonstrated by higher concentrations of IL-6, IL-17, and IL-33 in SLE patients with periodontitis.ConclusionsSLE is associated with differences in the composition of the microbiota, independently of periodontal status.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-017-0252-z) contains supplementary material, which is available to authorized users.

Analysis of Oral Microbiota Revealed High Abundance of Prevotella Intermedia in Gout Patients

“…Indeed, previous studies have provided critical insights into how abnormal compositions of oral microbiota may be related to oral and systemic diseases [17][18][19][20][21]. On the other hand, a recent study also showed that systemic diseases have significant influence on the oral microbiota [22]. Salivary urate is reported to be significantly increased in gout and higher concentrations may change the oral microenvironment, such as the pH of saliva [13], which has been demonstrated to be an important factor that affects the balance of oral microbial communities [23,24].…”

Differences in Gut Microbiota Profiles between Autoimmune Pancreatitis and Chronic Pancreatitis

“…For example, imbalance of gut microbiota, referred to as dysbiosis, is associated with multiple sclerosis, a chronic demyelinating disease triggered by an autoimmune mechanism (Yadav et al 2017). Subgingival dysbiosis has been reported in patients with systemic lupus erythematosus, another autoimmune disease (Correa et al 2017). In the field of gastroenterology, it has been recognized that alterations in gut microbiota have substantial roles in inflammatory bowel diseases (Alipour et al 2016).…”

Host-Microbial Interactions in Systemic Lupus Erythematosus and Periodontitis

“…Here, we show that proinflammatory cytokines MCP-1, IL-8, IP-10, and IL-6 were significantly elevated in SLE-I and SLE-A patients in comparison to non-SLE subjects 20 ( Figure 1A). Of this proinflammatory cytokines, IL-6, IL-17, TNF-α, and IFN-α suppression have been reported as therapeutic targets for clinical management of lupus and other chronic inflammatory diseases 4,[49][50][51] .…”

“…As part of the upper digestive tract, the oral cavity presents specific niches, such as gingival sulcus and gingival crevicular fluid (GCF), which in turn harbor commensal and pathogenic bacteria with potential impact to oral and systemic health. Through local activation of inflammation, oral pathogens have shown to worsen the burden of chronic diseases through time including, type 2 diabetes, premature labor, rheumatoid arthritis, systemic lupus erythematosus (SLE), Alzheimer's, cardiovascular conditions, and cancer [1][2][3][4] .…”

“…The heterogeneity of disease presentation and organ involvement contribute to clinical challenges for diagnosis and effective management 15 . While several studies reported associations among human oral microbiota compositions in SLE [16][17][18][19] , co-occurrences of specific periodontal pathogens and inflammatory cytokines important for low grade inflammation and chronic disease remains to be explored 4 .…”