Systemic antibiotics increase microbiota pathogenicity and oral bone loss

Abstract

Periodontitis is the most widespread oral disease and is closely related to the oral microbiota. The oral microbiota is adversely affected by some pharmacologic treatments. Systemic antibiotics are widely used for infectious diseases but can lead to gut dysbiosis, causing negative effects on the human body. Whether systemic antibiotic-induced gut dysbiosis can affect the oral microbiota or even periodontitis has not yet been addressed. In this research, mice were exposed to drinking water containing a cocktail of four antibiotics to explore how systemic antibiotics affect microbiota pathogenicity and oral bone loss. The results demonstrated, for the first time, that gut dysbiosis caused by long-term use of antibiotics can disturb the oral microbiota and aggravate periodontitis. Moreover, the expression of cytokines related to Th17 was increased while transcription factors and cytokines related to Treg were decreased in the periodontal tissue. Fecal microbiota transplantation with normal mice feces restored the gut microbiota and barrier, decreased the pathogenicity of the oral microbiota, reversed the Th17/Treg imbalance in periodontal tissue, and alleviated alveolar bone loss. This study highlights the potential adverse effects of long-term systemic antibiotics-induced gut dysbiosis on the oral microbiota and periodontitis. A Th17/Treg imbalance might be related to this relationship. Importantly, these results reveal that the periodontal condition of patients should be assessed regularly when using systemic antibiotics in clinical practice.

The effect of the “Oral-Gut” axis on periodontitis in inflammatory bowel disease: A review of microbe and immune mechanism associations

“…Dysbiosis of the gut flora not only damages the intestinal barrier, but also disrupts the oral microbiota and exacerbates bone resorption in periodontitis through Th17/Treg imbalance. Yuan et al found that long-term antibiotic use led to gut ecological dysbiosis, which increased periodontitis-associated pathogens in the oral cavity and decreased oral microbiota probiotics associated with periodontal health, while Th17 cellassociated pro-inflammatory cytokine (IL-17A, IL-6) expression was upregulated and Treg cell-associated cytokine (Foxp3 and IL-10) expression was decreased in periodontal tissues; in contrast, the use of fecal microbiota transplantation (FMT) not only restored the intestinal microbiota of the mice, but even reversed the Th17/Treg imbalance in periodontal tissue and alleviated periodontitis (Yuan et al, 2023). Katarzyna et al found elevated levels of IL-1b, IL-6 and TNF by measuring salivary inflammatory markers in patients with IBD, with elevated levels of TNF-a and IL-6 being strongly associated with the development of periodontitis (Szczeklik et al, 2012); in the Figueredo team's study, inflammation scores in gingival tissue were significantly higher in patients with active IBD (including four cytokines, IL-1b, IL-6, IL-21 and sCD40L) (Figueredo et al, 2017); nevertheless, anti-inflammatory factors such as IL-4 decrease with increasing levels of inflammation, and IL-4 levels were found to be significantly lower in the gingival sulcus of IBD patients with periodontitis (de Mello-Neto et al, 2021).…”

Platelet Membrane‐Enclosed Bioorthogonal Catalysis for Combating Dental Caries

“…Such infectious diseases affect over 2.3 billion people worldwide, particularly those who are impoverished or have compromised health. [6][7][8][9] The existing treatment methods are inadequate for vulnerable populations, particularly in severe cases where cariogenic biofilms develop quickly owing to sugary diets and poor oral hygiene, leading to caries that are difficult to manage. [6,10] The antimicrobial treatments currently available are limited to broad-spectrum agents that lack efficacy and specificity against cariogenic biofilms and are minimally effective against dental caries.…”

Scalable Fabrication of Polymeric Composite Microspheres to Inhibit Oral Pathogens and Promote Osteogenic Differentiation of Periodontal Membrane Stem Cells

“…Mechanical debridement (scaling and root planning) removes inflammation but cannot properly recover the periodontium . Antibiotics can be used to treat periodontal infections, but they have risks of several side effects and bacterial resistance. , Guided tissue regeneration surgery does not quite fit to the arbitrary architecture of the periodontium. , Therefore, it is imperative to explore an effective strategy to inhibit pathogenic microorganisms and promote periodontal regeneration.…”