[論文レビュー] Unraveling the Link between Periodontitis and Inflammatory Bowel Disease: Challenges and Outlook

Himanshi Tanwar, Jeba Mercy Gnanasekaran+13 more|arXiv (Cornell University)|Aug 19, 2023

Oral microbiology and periodontitis research被引用数 9

ひとこと要約

この物語的レビューは、口腔-腸軸が歯周病とIBDを結びつけるエビデンスを総合し、共通の微生物学/免疫経路と多段階モデルを議論する。

ABSTRACT

Periodontitis and Inflammatory Bowel Disease (IBD) are chronic inflammatory conditions, characterized by microbial dysbiosis and hyper-immunoinflammatory responses. Growing evidence suggest an interconnection between periodontitis and IBD, implying a shift from the traditional concept of independent diseases to a complex, reciprocal cycle. This review outlines the evidence supporting an Oral-Gut axis, marked by a higher prevalence of periodontitis in IBD patients and vice versa. The specific mechanisms linking periodontitis and IBD remain to be fully elucidated, but emerging evidence points to the ectopic colonization of the gut by oral bacteria, which promote intestinal inflammation by activating host immune responses. This review presents an in-depth examination of the interconnection between periodontitis and IBD, highlighting the shared microbiological and immunological pathways, and proposing a multi-hit hypothesis in the pathogenesis of periodontitis-mediated intestinal inflammation. Furthermore, the review underscores the critical need for a collaborative approach between dentists and gastroenterologists to provide holistic oral-systemic healthcare.

研究の動機と目的

• To evaluate evidence for an interconnection between periodontitis and IBD via the oral-gut axis.
• To summarize shared microbiological and immunological pathways implicated in both conditions.
• To propose a multi-hit model describing how periodontitis may influence intestinal inflammation and IBD progression.
• To identify gaps and advocate for collaborative oral-systemic healthcare approaches.

提案手法

• Literature synthesis of epidemiological, microbiological, and immunological studies linking periodontitis and IBD.
• Analysis of oral and gut microbiome data to identify overlapping taxa and dysbiosis patterns.
• Discussion of immune pathways involving neutrophils, macrophages, dendritic cells, T and B cells in the context of both diseases.
• Proposal of a multi-hit conceptual framework for periodontitis-mediated intestinal inflammation.

実験結果

リサーチクエスチョン

• RQ1 Does periodontitis increase the risk or severity of IBD through an oral-gut axis?
• RQ2 What shared microbial signatures and immune pathways connect periodontitis and IBD?
• RQ3 Can therapies targeting periodontal inflammation influence IBD outcomes, and vice versa?
• RQ4 What mechanistic model best explains how oral pathogens translocate to the gut and promote intestinal inflammation?

主な発見

• There is evidence suggesting higher prevalence of periodontitis in IBD patients and vice versa.
• Oral bacteria can translocate to the gut and potentially exacerbate intestinal inflammation through immune activation.
• Shared immunoinflammatory pathways, including cytokines and Th17-mediated responses, link periodontal and intestinal tissues.
• IBD-associated oral manifestations may arise from immune cross-reactivity and dysregulated mucosal immunity.
• IBD treatments, notably anti-TNF and corticosteroids, may influence periodontal disease progression and treatment outcomes.