Tongue coating microbiome regulates the changes in tongue texture and coating in patients with post-menopausal osteoporosis of Gan-shen deficiency syndrome type

Abstract

Tongue inspection is a unique and important method of diagnosis in traditional Chinese medicine (TCM). It is a diagnostic approach which involves observing the changes in the tongue proper and tongue coating in order to understand the physiological functions and pathological changes of the body. However, the biological basis of TCM tongue diagnosis remains to be poorly understood and lacks systematic investigation at the molecular level. In this study, we evaluated the effects of tongue coating microbiome on changes in the tongue texture and coating in patients with post-menopausal osteoporosis (PMO) of Gan‑shen deficiency syndrome type. Our aim was to delineate the mechanisms of tongue coating microbiome-induced changes in the tongue texture and coating by investigating the histomorphological changes and performing a bacterial analysis of the tongue coating. We found that the number of intermediate cells in the red tongue with a thin coating was higher, while the number of superficial cells in the red tongue with a thin coating was lower. The maturation value (MV) of tongue exfoliated cells in the red tongue with a thin coating decreased, compared with that in the pale red tongue with a thin white coating. Furthermore, the total bacterial count, oral streptococcus, Gram‑positive (G+) and Gram‑negative (G-) anaerobic bacteria in the red tongue with a thin coating was significantly decreased compared with the pale red tongue with a thin white coating. The results of ultrastructural examination demonstrated that the number of epithelial cells and bacteria in the red tongue with a thin coating decreased compared with that in the pale red tongue with a thin white coating. These observations indicate that the tongue coating microbiome may be an important factor contributing to changes in the tongue in patients with PMO of Gan‑shen deficiency syndrome type.

Bacillus as a potential diagnostic marker for yellow tongue coating

“…Furthermore, we detected decreased levels of Rothia, Granulicatella, Streptococcus, Fusobacterium, Gemella, Haemophilus, Neisseria, and Porphyromonas in CEG patients with YTC. All of these 8 genera have been described in normal populations of healthy oral microbiota45678910111213141516171819202122232425262728293031. An increasing trend in these bacteria was observed after therapy, albeit not statistically significant (Fig.…”

“…In the long history of traditional clinical practice in China and other Eastern countries, syndrome classification is often used as a guideline for disease classification in TCM practice, and tongue coating appearance is one of the major criteria for diagnosis21. It is known that the microbiota colonizing the surfaces of human oral cavity play an important role in human health and disease or is relevant to syndrome differentiation92223.…”

FTY720 enhances osteogenic differentiation of bone marrow mesenchymal stem cells in ovariectomized rats

“…Osteoporosis is characterized by decreased bone mineral density (BMD) and microarchitectural deterioration of bone, due to increased bone resorption compared with formation. Thus, osteoporosis has become one of the most prevalent and complex skeletal disorders for post-menopausal women, the aged and those with other associated medical conditions, or those who develop the condition as a result of certain therapeutic interventions (1,2).…”

Effect of serum from postmenopausal women with osteoporosis exhibiting the Kidney-Yang deficiency pattern on bone formation in an hFOB 1.19 human osteoblastic cell line

“…According to TCM theory, the kidney regulates bone formation and development. Kidney deficiency leading to bone loss is associated with the pathological process of PMO (17,20,21). Among all kidney deficiency patterns, the KYD pattern is a common clinical type of PMO; however, the precise mechanism behind its formation remains unclear.…”

“…Zheng is based on factors including pulse feeling and tongue appearance and can be used as a guideline in TCM disease classification; however, it is not simply a collection of disease symptoms but rather can be defined as the TCM theoretical abstraction of the symptom profiles of patients (14)(15)(16). The KYD pattern (Shen-Yang-Xu Zheng) is an important syndrome of PMO (17); while some postmenopausal women are prone to forming the KYD pattern of osteoporosis, others of the same age group exhibit no development of osteoporosis. The underlying mechanism of this phenomenon remains to be elucidated.…”