Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, 362000, Quanzhou, China.
Respiratory Medicine Center of Fujian Province, 362000, Quanzhou, China.
Hypertens Res. 2019 Nov;42(11):1692-1700. doi: 10.1038/s41440-019-0260-4. Epub 2019 Apr 11.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is an independent risk factor for hypertension (HTN). The oral microbiota plays a pathophysiological role in cardiovascular diseases; however, there are few reports directly investigating and identifying the organisms involved in OSAHS-related HTN. Therefore, this study aimed to identify those organisms. We obtained 139 oral samples and determined the microbiome composition using pyrosequencing and bioinformatic analyses of the 16S rRNA. We examined the fasting levels of cytokines and homocysteine in all participants and analyzed the correlations between the oral microbiota and homocysteine levels. We determined the molecular mechanism underlying HTN by investigating the genetic composition of the strains in the blood. We detected higher relative abundances of Porphyromonas and Aggregatibacter and elevated proinflammatory cytokines in patients with OSAHS of varying severity compared with individuals without OSAHS; however, the two organisms were not measured in the blood samples from all participants. High levels of specific Porphyromonas bacteria were detected in patients with OSAHS with and without HTN, whereas the relative abundance of Aggregatibacter was negatively correlated with the homocysteine level. The receiver operating characteristic curve analysis of controls and patients with OSAHS resulted in area under the curve values of 0.759 and 0.641 for patients with OSAHS with or without HTN, respectively. We found that the predictive function of oral microbiota was different in patients with OSAHS with and without HTN. However, there was no direct invasion by the two organisms causing endothelial cell injury, leading to speculation regarding the other mechanisms that may lead to HTN. Elucidating the differences in the oral microbiome will help us understand the pathogenesis of OSAHS-related HTN.
阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是高血压（HTN）的独立危险因素。口腔微生物群在心血管疾病中发挥着病理生理作用；然而，直接调查和识别与 OSAHS 相关的 HTN 相关生物体的报道很少。因此，本研究旨在确定这些生物体。我们获得了 139 个口腔样本，并通过焦磷酸测序和 16S rRNA 的生物信息学分析来确定微生物组组成。我们检查了所有参与者的空腹细胞因子和同型半胱氨酸水平，并分析了口腔微生物群与同型半胱氨酸水平之间的相关性。我们通过研究血液中菌株的遗传组成来确定 HTN 的分子机制。我们检测到患有 OSAHS 的患者中相对丰度较高的卟啉单胞菌和聚集性放线杆菌，以及不同严重程度的患者与无 OSAHS 的患者相比，促炎细胞因子水平升高；然而，这两种生物在所有参与者的血液样本中均未测量。在患有 OSAHS 的患者中，无论是否伴有 HTN，都检测到特定的卟啉单胞菌水平较高，而 Aggregatibacter 的相对丰度与同型半胱氨酸水平呈负相关。对照组和 OSAHS 患者的接收者操作特征曲线分析分别得出 OSAHS 患者伴或不伴 HTN 的曲线下面积值为 0.759 和 0.641。我们发现，伴有或不伴有 HTN 的 OSAHS 患者口腔微生物群的预测功能不同。然而，这两种生物并没有直接入侵导致内皮细胞损伤，因此推测可能存在其他导致 HTN 的机制。阐明口腔微生物组的差异将有助于我们了解 OSAHS 相关 HTN 的发病机制。
