[The Relationship Between Oral Microbiota and Chronic Obstructive Pulmonary Disease].

Oral microbiota have a complex impact on the host's health and disease states. It has been found that the composition of lung flora bears a striking resemblance to the composition of oral flora. Moreover, oral pathogenic bacteria have been detected in the sputum and bronchoalveolar lavage fluid of patients with chronic obstructive pulmonary disease (COPD), suggesting that oral microbiota play an important role in the pathogenesis and development of COPD. Findings from lots of studies have shown that oral microbiota may participate in the pathogenesis and development of COPD through non-specific immune response, specific immune response, and the activities of protein hydrolase. Herein, we mainly summarized the available evidence on the relationship between oral microbiota and COPD. By examining the relationship between the two, we elaborated on the application of oral microbiota in the diagnosis and prevention of COPD, discussed possible directions for future research, and provided references for developing new therapeutic approaches.

[Salivary Peptide Profiling Analysis of Patients with Periodontitis and Chronic Obstructive Pulmonary Disease].

Objective: To analyze the salivary peptide profiles of patients with periodontitis (PD) and chronic obstructive pulmonary disease (COPD), to identify differentially expressed peptides that are associated with diseases, to explore for biomarkers with potential diagnostic significance, and to probe for new perspectives for the early prevention and treatment of COPD. Methods: A total of 10 PD patients (the PD group), 10 PD patients with COPD (the PD plus COPD group), and 8 healthy controls (the Control group) were selected for the study. The clinical data and saliva samples of the subjects were collected. Salivary supernatant samples were separated and purified with weak-cation-exchange magnetic bead-based (WCX-MB). With matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS), the biodata of the samples were obtained and differential salivary peptide profiling was conducted to screen for peptides exhibiting inter-group differences. In addition, all the differentially expressed peptides were examined and verified with liquid chromatography tandem mass spectrometry (LC-MS/MS). Result: An average of 77 peptide mass peaks were detected among three groups, the peaks intensities differed significantly for 10 peptides between PD patients and PD patients with COPD. Among them, eight peptides (1193.5, 1836.2, 1735.1, 1321.3, 1356.8, 2086.8, 1863.6, and 2230.9) showed increased expression and two peptides (1067.3 and 1124.4) showed decreased expression in the PD plus COPD group, in comparison with the PD group. Among the 10 differential peptides, 1193.5 and 1356.8 were identified as histidine-rich protein-1, submaxillary gland androgen-regulated protein 3B, and salivary acidic proline-rich protein 1/2. Conclusion: With WCX-MB and MALDI-TOF-MS, we have identified, from the saliva of patients with concomitant PD and COPD, differentially expressed salivary peptides that were associated with diseases. The differentially expressed peptides thus screened out show promises for being used as auxiliary biomarkers for early diagnosis of COPD.

[Systemic Influencing Factors of Dentition Defect in Type 2 Diabetes Mellitus Patients with Periodontitis].

Objective: To analyze the influencing factors of dentition defect in people with type 2 diabetes mellitus (T2DM) and periodontitis and to provide evidence-based support for improving the oral health and quality of life of T2DM patients. Methods: A total of 169 patients with T2DM and periodontitis were selected by convenience sampling. According to the number of remaining teeth, the subjects were divided into two groups, group A (number of remaining teeth in the mouth≥20, n=115) and group B (the number of remaining teeth in the mouth<20, n=54). Questionnaire surveys, systemic and oral examinations, and laboratory blood tests were performed. Systematic influencing factors of dentition defect in people with T2DM and periodontitis were analyzed with logistic regression. Results: Compared with patients in group A, patients in group B had higher findings in age, systolic blood pressure (SBP), prevalence of coronary heart disease and hyperlipidemia, glycosylated hemoglobin (HbA1c), periodontal probing depth (PD), and clinical attachment loss (CAL). Furthermore, their behaviors and awareness of oral health were not as good as those of patients in group A. Logistic regression showed that age, HbA1c, and SBP were independent risk factors for the number of remaining teeth in the mouth <20 among T2DM patients with periodontitis ( P<0.05). Conclusion: Increasing age, lower HbA1c, and increased SBP are the most important influencing factors for the number of remaining teeth in the mouth <20 in T2DM patients with periodontitis. Clinical practitioners should give more attention to the general health status of the patients and strengthen health education, thereby improving patients' quality.

Differential immune cell infiltrations between healthy periodontal and chronic periodontitis tissues.

BACKGROUND: Host immunity plays an important role against oral microorganisms in periodontitis. METHODS: This study assessed the infiltrating immune cell subtypes in 133 healthy periodontal and 210 chronic periodontitis tissues from Gene Expression Omnibus (GEO) datasets using the CIBERSORT gene signature files. RESULTS: Plasma cells, naive B cells and neutrophils were all elevated in periodontitis tissues, when compared to those in healthy controls. In contrast, memory B cells, resting dendritic, mast cells and CD4 memory cells, as well as activated mast cells, M1 and M2 macrophages, and follicular helper T cells, were mainly present in healthy periodontal tissues. Furthermore, these periodontitis tissues generally contained a higher proportion of activated CD4 memory T cells, while the other subtypes of T cells, including resting CD4 memory T cells, CD8 T cells, follicular helper T cells (TFH) and regulatory T cells (Tregs), were relatively lower in periodontitis tissues, when compared to healthy tissues. The ratio of dendritic and mast cells and macrophages was lower in periodontitis tissues, when compared to healthy tissues. In addition, there was a significant negative association of plasma cells with most of the other immune cells, such as plasma cells vs. memory B cells (γ = - 0.84), plasma cells vs. resting dendritic cells (γ = - 0.64), plasma cells vs. resting CD4 memory T cells (γ = 0.50), plasma cells versus activated dendritic cells (γ = - 0.46), plasma cells versus TFH (γ = - 0.46), plasma cells versus macrophage M2 cells (γ = - 0.43), or plasma cells versus macrophage M1 cells (γ = - 0.40), between healthy control and periodontitis tissues. CONCLUSION: Plasma cells, naive B cells and neutrophils were all elevated in periodontitis tissues. The infiltration of different immune cell subtypes in the periodontitis site could lead the host immunity against periodontitis.

Vitamin D reduces the serum levels of inflammatory cytokines in rat models of periodontitis and chronic obstructive pulmonary disease.

The purpose of this study was to investigate the effects of vitamin D in rat models of chronic obstructive pulmonary disease (COPD) and periodontitis. Animals with both periodontitis and COPD, or with periodontitis only, were established. Once the animal model was established, experimental groups received intraperitoneal injections of 25-hydroxyvitamin D3 (25-OHD3) for 8 weeks, while control groups received refined peanut oil. After sacrifice, inflammatory status was examined in terms of the serum levels of receptor activator of the nuclear factor κB ligand (RANKL), tumor necrosis factor alpha (TNF-α) and interleukins (IL-1 and IL-10), as well as alveolar bone loss, forced expiratory volume (0.20) (FEV 0.20), and the ratio of FEV0.2 to forced vital capacity. The results showed that 25-OHD3 treatment significantly alleviated inflammation by decreasing the serum levels of RANKL, TNF-α and IL-1 and increasing that of IL-10, while reducing alveolar bone loss and slightly improving lung function. These findings suggest that vitamin D supplementation could be a new clinical approach for the treatment of COPD and periodontitis.

Effects of Ginkgo biloba extract on periodontal pathogens and its clinical efficacy as adjuvant treatment.

OBJECTIVE: To determine the effects of Ginkgo biloba extract (EGB) on major periodontal pathogens in subgingival plaque. METHODS: Sixty patients with moderate to severe periodontitis were selected and randomly assigned to 3 groups: EGB group, a positive (periocline) and a negative control groups. Subgingival plaque samples were collected before treatment and 1 week, 2 months and 4 months after treatment. The detection rates of 4 major periodontal pathogens-Treponema denticola (Td), Tannerella forsythus (Tf), Prevotella intermedia (Pi), and Porphyromonas gingivalis (Pg)-were detected by polymerase chain reaction (PCR). Clinical indicators were examined before treatment, 3 and 6 months after treatment. RESULTS: EGB significantly decreased the detection rate of all the 4 pathogens 1 week after treatment, and then gradually increased at 2 and 4 months. EGB's inhibition effect was better than or comparable to periocline, except for Pg in short-term. The difference of plaque index (PLI) and bleeding index (BI) was not statistically significant among the groups, while for probing depth (PD) and attachment loss (AL), the difference was statistically significant between the EGB group and negative control group at 3 and 6 months after treatment. CONCLUSION: EGB significantly inhibited major periodontal pathogens and can be used as an adjuvant for periodontitis treatment.

[Establishment of chronic periodontitis and chronic obstructive pulmonary disease model in SD rat].

OBJECTIVE: To establish a model of chronic periodontitis (CP) accompanied with chronic obstructive pulmonary disease (COPD) in SD rats and investigate the relationship between chronic periodontitis and COPD. METHODS: Equal gender SD rats were randomly divided into 4 groups, A: control group, B: CP group, C: COPD group, D: COPD with CP group (n = 10, respectively). Each group was subjected to its predesigned intervention to establish a specific disease model. After 10 weeks, animals were sacrificed. The level of alveolar bone loss, lung function measurement, and the histopathological changes of periodontal and lung tissues were examined. The serum tumor necrosis factor (TNF)-α level was detected by enzyme-linked immunoabsorbent assay kits. RESULTS: Bleeding index (BI) levels of group A and C were (0.25 ± 0.04) and (1.30 ± 0.25), respectively. Attachment loss was (0.43 ± 0.02) and (0.51 ± 0.02) mm. BI levels in group B and D were significantly higher than those in group A and C. Forced expiratory volume in 0.2 second to forced vital capital ratio (FEV(0.2)/FVC) values in group B, C and D were significantly lower than that in group A. Pulmonary function were worse in group D than that in group C (P < 0.05). The levels of serum TNF-α, a sensitive indicator of both diseases, were increased in all test groups compared with the control, and increased most in group D. CONCLUSIONS: The chronic periodontitis and chronic obstructive pulmonary disease model was established in SD rat. The chronic periodontitis may be a risk factor for promoting and inducing COPD.

[Analysis on oral health care utilization and expenditure of residents in Beijing].

OBJECTIVE: To analyze the dental care utilization and expenditure of residents in Beijing, and to provide some basis on the policy of oral health insurance system. METHODS: A cross-sectional survey was conducted among 1,517 subjects (urban area) and 1,878 subjects (rural area) of all age groups in Beijing selected by stratified, clustering, random sampling. The data of oral health care utilization and expenditure were collected in their home. RESULTS: The number of the people who visited a dentist in a year were low both in urban area and in rural area, but the expenditure for oral health care per visit were quite high. The value of utilization of dental care in rural residents was 1/3 of that in urban residents, while the value of expenditure in rural people was about 1/2 of that in urban people. 2.07% incomes of rural residents were used for dental care per year, the corresponding value of urban residents was 1.77%. There was significant difference on the expenditure among those with different demographic, socio-economic backgrounds. CONCLUSIONS: The expenditure for oral health care was high in Beijing, which accounted for quite a lot in average incomes per year. The burden of expenditure for dental care on rural residents was heavier than that on urban residents. The level of expenditure for dental care could provide some references for oral health insurance system in Beijing.