Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand.
Department of Otorhinolaryngology, Auckland City Hospital, Auckland, 1023, New Zealand.
Support Care Cancer. 2020 Jun;28(6):2683-2691. doi: 10.1007/s00520-019-05084-6. Epub 2019 Oct 25.
Oral mucositis (OM) remains a significant complication developed by many patients undergoing radiotherapy (RT) to the head and neck region. Emerging data suggest oral microbes may contribute to the onset and severity of this acute side effect.
In this study, saliva and oral swabs from head and neck cancer patients undergoing RT were collected. We employed molecular microbiological techniques to study the bacterial communities present in saliva, and both the bacterial and fungal communities present on the buccal mucosa and lateral tongue. Changes in microbiota composition with increasing radiation dose and the presence of mucositis were examined.
The data suggest that the salivary microbiota remain stable during RT and are consistently dominated by Streptococcus, Prevotella, Fusobacterium and Granulicatella. Obligate and facultative anaerobic Gram-negative bacilli (GNB) Bacteroidales G2, Capnocytophaga, Eikenella, Mycoplasma and Sneathia, as well as anaerobic GNB in the periopathogenic genera Porphyromonas and Tannerella, were all positively correlated with ≥ grade 2 OM. Significant increases in the relative abundances of Bacteroidales G2, Fusobacterium and Sneathia were identified in buccal mucosa swabs at sites of ≥ grade 2 OM (p < 0.05). Furthermore, the abundance of several GNB (Fusobacterium, Haemophilus, Tannerella, Porphyromonas and Eikenella) on the buccal mucosa may influence patient susceptibility to developing OM. Candida was widely detected in buccal mucosa swabs, regardless of mucositis status.
Our findings support previously hypothesized associations between oral health and the pathogenesis of OM, highlighting the importance of oral health interventions for head and neck cancer patients.
口腔黏膜炎（OM）仍然是头颈部接受放疗（RT）的许多患者发生的严重并发症。新出现的数据表明，口腔微生物可能有助于这种急性副作用的发生和严重程度。
本研究采集了头颈部癌症患者在接受 RT 时的唾液和口腔拭子。我们采用分子微生物学技术研究唾液中存在的细菌群落，以及颊黏膜和侧舌上存在的细菌和真菌群落。研究了随着辐射剂量的增加和黏膜炎的发生，微生物群落组成的变化。
数据表明，唾液微生物群在 RT 期间保持稳定，并且始终由链球菌、普雷沃氏菌、梭杆菌和颗粒杆菌主导。需氧和兼性厌氧革兰氏阴性杆菌（GNB）拟杆菌门 G2、卡他莫拉菌、爱肯菌、支原体和西尼西亚菌，以及围产期病原体卟啉单胞菌属和 Tannerella 属中的厌氧 GNB，均与≥2 级 OM 呈正相关。在≥2 级 OM 部位的颊黏膜拭子中，鉴定出拟杆菌门 G2、梭杆菌和西尼西亚菌的相对丰度显著增加（p<0.05）。此外，几种 GNB（梭杆菌、嗜血杆菌、Tannerella、卟啉单胞菌和爱肯菌）在颊黏膜上的丰度可能影响患者发生 OM 的易感性。无论黏膜炎状况如何，口腔黏膜拭子中均广泛检测到假丝酵母菌。
我们的研究结果支持先前假设的口腔健康与 OM 发病机制之间的关联，强调了对头颈部癌症患者进行口腔健康干预的重要性。
