Lauritano D, Sbordone L, Nardone M, Iapichino A, Scapoli L, Carinci F
Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy.
Oral Implantol (Rome). 2017 Nov 30;10(3):229-233. doi: 10.11138/orl/2017.10.3.229. eCollection 2017 Jul-Sep.
Diagnosis of focal disease, the theory that the human oral microbial (HOM) could affect the onset and development of systemic diseases, was very popular in the past, but the lack of scientific evidence has led to the abandonment of this idea. Interestingly, increasing evidence over the past 3 or so decades suggests that HOM can indeed serve as a reservoir for systemic dissemination of pathogenic bacteria and their toxins in distant body sites, favouring the developments of malignant tumours. Malignant tumours are complex communities of oncogenically transformed cells with aberrant genomes, associated non-neoplastic cells including immune and stromal cells, and sometimes HOM, including bacteria and viruses. Recent data suggest that HOM and periodontal disease play an active role in the pathogenesis of colorectal cancer, in fact HOM has been found within the colorectal cancer microenvironment, and the composition of the HOM was different from that of adjacent non-neoplastic tissue. An association of fusobacterium nucleatum with the colonic mucosa of colorectal cancer has been proven. Several questions thus arise. Is periodontal disease a risk factor for colorectal carcinoma? Given the connectivity of the digestive tract, could fusubacterium nucleatum or other HOM be involved in additional gastrointestinal disorders? Furthermore, based on the "mobility" of Fusubacterium nucleatum and the omnipresence of cadherins, could this organism be involved in cancers beyond the gastrointestinal tract? Answers to these questions will shed new lights on the role of the HOM in onset of diseases.
局灶性疾病的诊断，即人类口腔微生物（HOM）可影响全身性疾病的发生和发展这一理论，在过去曾非常流行，但由于缺乏科学证据，这一观点已被摒弃。有趣的是，过去三十多年来越来越多的证据表明，HOM确实可作为病原菌及其毒素在远处身体部位进行全身播散的储存库，从而促进恶性肿瘤的发展。恶性肿瘤是由具有异常基因组的致癌转化细胞、包括免疫细胞和基质细胞在内的相关非肿瘤细胞，有时还包括HOM（包括细菌和病毒）组成的复杂群落。最近的数据表明，HOM和牙周疾病在结直肠癌的发病机制中发挥着积极作用，事实上，已在结直肠癌微环境中发现了HOM，而且HOM的组成与相邻非肿瘤组织不同。具核梭杆菌与结直肠癌的结肠黏膜之间的关联已得到证实。由此产生了几个问题。牙周疾病是结直肠癌的危险因素吗？鉴于消化道的连通性，具核梭杆菌或其他HOM会参与其他胃肠道疾病吗？此外，基于具核梭杆菌的“移动性”和钙黏蛋白的普遍存在，这种微生物会参与胃肠道以外的癌症吗？这些问题的答案将为HOM在疾病发生中的作用带来新的启示。
