Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA.
Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA.
J Transl Med. 2023 Mar 4;21(1):172. doi: 10.1186/s12967-023-03997-9.
Suboptimal maternal oral health during pregnancy is potentially associated with adverse birth outcomes and increased dental caries risks in children. This study aimed to assess the oral microbiome and immune response following an innovative clinical regimen, Prenatal Total Oral Rehabilitation (PTOR), that fully restores women's oral health to a "disease-free status" before delivery.
This prospective cohort study assessed 15 pregnant women at baseline and 3 follow-up visits (1 week, 2 weeks, and 2 months) after receiving PTOR. The salivary and supragingival plaque microbiomes were analyzed using metagenomic sequencing. Multiplexed Luminex cytokine assays were performed to examine immune response following PTOR. The association between salivary immune markers and oral microbiome was further examined.
PTOR was associated with a reduction of periodontal pathogens in plaque, for instance, a lower relative abundance of Tannerella forsythia and Treponema denticola at 2 weeks compared to the baseline (p < 0.05). The alpha diversity of plaque microbial community was significantly reduced at the 1-week follow-up (p < 0.05). Furthermore, we observed significant changes in the Actinomyces defective-associated carbohydrate degradation pathway and Streptococcus Gordonii-associated fatty acid biosynthesis pathway. Two immune markers related to adverse birth outcomes significantly differed between baseline and follow-up. ITAC, negatively correlated with preeclampsia severity, significantly increased at 1-week follow-up; MCP-1, positively correlated with gestational age, was elevated at 1-week follow-up. Association modeling between immune markers and microbiome further revealed specific oral microorganisms that are potentially correlated with the host immune response.
PTOR is associated with alteration of the oral microbiome and immune response among a cohort of underserved US pregnant women. Future randomized clinical trials are warranted to comprehensively assess the impact of PTOR on maternal oral flora, birth outcomes, and their offspring's oral health.
孕妇口腔健康状况不佳可能与不良分娩结局和儿童龋齿风险增加有关。本研究旨在评估一种创新的临床方案——产前全面口腔康复（PTOR）后口腔微生物组和免疫反应，该方案可在分娩前将女性的口腔健康完全恢复到“无疾病状态”。
本前瞻性队列研究在基线时评估了 15 名孕妇，并在接受 PTOR 后进行了 3 次随访（1 周、2 周和 2 个月）。使用宏基因组测序分析唾液和龈上菌斑微生物组。通过多重 Luminex 细胞因子测定法检测 PTOR 后免疫反应。进一步检查唾液免疫标志物与口腔微生物组之间的关联。
PTOR 与菌斑中牙周病原体的减少有关，例如，与基线相比，2 周时坦纳拉福赛思氏菌和牙髓密螺旋体的相对丰度降低（p<0.05）。菌斑微生物群落的 alpha 多样性在 1 周随访时显著降低（p<0.05）。此外，我们观察到 Actinomyces defective 相关碳水化合物降解途径和 Streptococcus Gordonii 相关脂肪酸生物合成途径的显著变化。与不良分娩结局相关的两个免疫标志物在基线和随访之间有显著差异。与子痫前期严重程度呈负相关的 ITAC 在 1 周随访时显著增加；与胎龄呈正相关的 MCP-1 在 1 周随访时升高。免疫标志物与微生物组之间的关联模型进一步显示，特定的口腔微生物可能与宿主免疫反应相关。
PTOR 与美国未得到充分服务的孕妇队列的口腔微生物组和免疫反应改变有关。需要进行随机临床试验来全面评估 PTOR 对产妇口腔菌群、分娩结局及其后代口腔健康的影响。
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