8/12/2016

mBiosphere:Scrapingawayatthecomplexmicrobialcommunitiesthatcauseperiodontaldisease

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08/12/2016

Scrapingawayatthecomplexmicrobialcommunitiesthatcauseperiodontaldisease
Thoughbothgingivitisandperiodontitisarediseasesofthegums,therelatedailmentsarenotsimplydifferentseveritiesof
thesamedisease,findsanewstudypublishedinAppliedandEnvironmentalMicrobiology.Researchersconfirmedthisby
investigatingthebacterialcompositionofthesupragingivalplaquethroughhighthroughputsequencing.
FirstauthorLiamShawandseniorauthorNigelKleinlookedatthesupragingival
plaque(plaqueonthetoothsurfaceabovethegumline)inalowincome
communitythatsufferspoororalhygieneandavarietyofgumdiseases.Poororal
hygieneistiedtoanumberofsystemichealthconditions,includingheartdisease,
sodiagnosingandtreatingthisrelativelysuperficialinfectioncanhavemajor
healthbenefits.
Gingivitis,inflammationofthegumssurroundingtheteeth,isalwaysafeatureof
periodontitis,whichoccurswhenthegumspullawayfromtheteethandopenup
pocketsinwhichbacteriacangrow.Inperiodontitis,inflamedgumsareaccompaniedbylooseteethandpainwhilechewing,
whichwilleventuallyculminateintoothlossifleftuntreated.Butdiagnosingperiodontitisvisuallyisimpossibleandit
doesntusuallygiveanysymptomsuntilithasdevelopedsofarthatteethbecomemobile,whichisverylateforany
treatment,saidstudycoauthorUllaHarjunmaa.
Further,gingivitisalwaysprecedesperiodontitisbutitdoesntalwaysprogresstothismoreseriousdisease.Thisfurther
complicatesdiagnoses.Thescientificteamwantedtoinvestigatewhetherthebacterialcommunitiesassociatedwith
supragingivalplaquecouldbeassociatedwithhealthygums,gingivitis,orperiodontitis.
Totestthisidea,theresearcherstestedplaquesamplesfromacohortofover900Malawianwomenwithvariousstagesoforal
health.Thebacterialcompositionoftheirplaquewasdeterminedusing16SrRNAgenesequencing.Sequencingfromsevere
gingivitisandperiodontitisshowedasignificantshiftinbacterialpopulationsfromtheplaqueofhealthygums.
Diseasetypeandseveritycorrelatedwiththesepopulationshifts.Themostsevere
gingivitiswasassociatedwiththepresenceofPeptostreptococcusstomatis,an
anaerobicGramnegativebacteriumthatoftenlivesaspartofthemicrobiota
withoutcausingdisease(seeGramstainedimage,left).Over75%ofplaque
samplesinmoderateandseveregingivitisshowedincreasesonP.stomatis
populations.
Periodontitiswas
associatedwithincreasesin
Lautropiamirabilis,
Rothiaaeria,Streptococcus
pyogenes,Streptococcusmutans,andsevenmembersof
Actinomyces.SequencingidentifiedredcomplexmemberTreponema
denticola,butnotPorphyromonasgingivalis,whichtheresearchers Cooccurrenceofperiodontalassociatedbacteriawith
speculatemaybeduetoprimermismatch.Treponema,Prevotella, periodontitissymptoms
andSelemonasgenerawereuniquelyseeninperiodontitispatients

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8/12/2016

mBiosphere:Scrapingawayatthecomplexmicrobialcommunitiesthatcauseperiodontaldisease

andnotpatientswithgingivitisorhealthygums.Theresearcherscouldthereforeusetheassociationoftheseperiodontitis
associatedbacteriatoidentifygingivitispatientslikelytoharborthismoredifficulttodiagnosedisease(seeright).
Theredcomplex,amicrobialgroupwhosemembersareassociatedwithsevereperiodontaldisease,wasdefinedinastudyof
subgingivalplaque(plaquebelowthegumline).Theseimportantstudieslookedatthesiteofperiodontitis,whichiswhen
periodontalpocketsofbacterialgrowthappearbelowthegumline.However,nostudyhaslookedatbacterialcompositionin
suchalargepatientcohort.Additionally,differentiatingbacterialcommunitiesofthemoreaccessiblesupragingivalplaque
couldallowdentiststoassessgumdiseaseprogressioninbothamorecosteffiencewayforlowresourceenvironmentsandan
easier,lesspainfulwayforpatients.
Thediscoveryofuniquebacterialcommunitycompositionsingingivitisversusperiodontitisconfirmthatperiodontitis
cannotbeconsideredsimplyanadvancedstangeofgingivitis,evenwhenonlyconsideringsupragingivalplaque,saidShaw.
Wherediseasescanhavemultipleseveritiesandclinicalfeaturesthatarealsofoundinnondisease(likebleedinggumsin
periodontitis),thiskindofmodelingwillbeincreasingimportantinmicrobiomeresearch.
JulieWolf
Photocredits:Plaqueschematic,PeptostreptococcusGramStain,FigurefromAppEnvMicroreport

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