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早产和低出生体重风险孕妇胎盘、唾液和龈下菌斑中的牙周病致病菌:一项日本孕妇的纵向研究。

The periodontopathic bacteria in placenta, saliva and subgingival plaque of threatened preterm labor and preterm low birth weight cases: a longitudinal study in Japanese pregnant women.

机构信息

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.

出版信息

Clin Oral Investig. 2020 Dec;24(12):4261-4270. doi: 10.1007/s00784-020-03287-4. Epub 2020 Apr 24.

Abstract

OBJECTIVES

This study determined the quantity of periodontopathic bacteria in saliva, subgingival plaque, and placenta on the threatened preterm labor (TPL) and preterm low birth weight (PLBW) subjects in order to identify specific periodontal pathogens with high association to adverse pregnancy outcomes.

METHODS

We used real-time PCR with TaqMan probe and ELISA to detect the amount of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, and Prevotella intermedia in subgingival plaque, saliva, and placenta tissue, in addition to serum IgG titers against these bacteria in 28 patients with TPL and 36 healthy pregnant women.

RESULTS

Thirteen of 64 births delivered PLBW infants. All 6 periodontopathic bacteria were detected in the placenta samples. The amount of F. nucleatum and detection frequency of T. denticola in placental samples was significantly higher in the TPL group than in the healthy group. Meanwhile, the age, anti-P. gingival IgG in serum, amount of P. gingivalis and T. forsythia in plaque samples, detection frequency of P. intermedia in saliva, and percentage of pocket probing depth ≥ 5 mm were higher in TPL-PLBW births than those in TPL-Healthy delivery (HD) group and/or in H-HD group. Ordinal logistic regression analysis revealed that the presence of F. nucleatum in placental tissues was significantly associated with TPL, while the maternal age was significantly associated with PLBW in TPL.

CONCLUSION

Our findings suggested all 6 bacteria may access the placenta. The increased presence of F. nucleatum in placenta might be related to TPL, while advanced maternal age might be associated with PLBW in TPL.

CLINICAL RELEVANCE

Periodontal therapy should be applied to reduce the deep periodontal pocket sites and the colonization of periodontal pathogens in high-risk population.

摘要

目的

本研究旨在确定唾液、龈下菌斑和胎盘中牙周病致病菌的数量,以确定与不良妊娠结局高度相关的特定牙周病原体。

方法

我们使用实时 PCR 与 TaqMan 探针和 ELISA 检测龈下菌斑、唾液和胎盘组织中伴放线聚集杆菌、牙龈卟啉单胞菌、福赛斯坦纳菌、牙髓卟啉单胞菌、核梭杆菌和中间普氏菌的数量,以及 28 例 TPL 患者和 36 例健康孕妇血清中针对这些细菌的 IgG 滴度。

结果

64 例分娩中有 13 例婴儿出生体重偏低。所有 6 种牙周病致病菌均在胎盘样本中检测到。TPL 组胎盘样本中 F. nucleatum 的数量和 T. denticola 的检出率明显高于健康组。同时,TPL-PLBW 分娩的产妇年龄、血清抗 P. gingival IgG、龈下菌斑中 P. gingivalis 和 T. forsythia 的数量、唾液中 P. intermedia 的检出率以及口袋探诊深度≥5mm 的比例均高于 TPL-健康分娩(HD)组和/或 H-HD 组。有序逻辑回归分析显示,胎盘组织中 F. nucleatum 的存在与 TPL 显著相关,而产妇年龄与 TPL 中的 PLBW 显著相关。

结论

我们的研究结果表明,这 6 种细菌都可能进入胎盘。胎盘中 F. nucleatum 的存在增加可能与 TPL 有关,而产妇年龄较大可能与 TPL 中的 PLBW 有关。

临床意义

牙周治疗应应用于减少高危人群深牙周袋部位和牙周致病菌的定植。

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