Sadeghi Fatemeh, Sohrabi Amir, Zagai Ulrika, Andreasson Anna, Vieth Michael, Talley Nicholas J, Agréus Lars, Ye Weimin
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
Am J Gastroenterol. 2024 Dec 31;120(9):2173-2185. doi: 10.14309/ajg.0000000000003279.
Oral microbiota may contribute to the development of upper gastrointestinal (UGI) disorders. In this study, we evaluated the association between microbiota of saliva, subgingival, and buccal mucosa and UGI disorders, particularly precancerous lesions. We also aimed to identify which oral site have the greatest potential as biomarkers for the development of UGI cancers.
In this population-based study, 388 adults underwent upper endoscopy with biopsies for histopathological analysis. UGI symptoms were assessed using a validated questionnaire, and 16S rRNA gene sequencing characterized the microbiota in 380 saliva, 200 subgingival, and 267 buccal mucosa samples collected during endoscopy.
Dysbiosis of the salivary microbiota was observed in subjects with gastroesophageal reflux symptoms (GERSs) alone, as well as in those with combined conditions such as GERS and esophagitis, or esophagitis and Barrett's esophagus. Significant microbial alterations were also found in individuals with several stomach disorders including Helicobacter pylori infection, chemical reactive gastritis, atrophic gastritis, and intestinal metaplasia. However, microbiota dissimilarity in subgingival and buccal mucosa samples was primarily associated with Barrett's esophagus or gastric atrophy. Among identified genera in saliva, the association between Prevotella and Fusabacterium and atrophic gastritis and intestinal metaplasia was notable. In subgingival samples, the link of Fretibacterium with Barrett's esophagus and Fusabacterium with gastric atrophy and intestinal metaplasia has also been found to be important.
Dysbiosis of saliva microbiota is linked to a broad spectrum of UGI disorders. However, microbiota dysbiosis in subgingival and buccal mucosa sites is specifically associated with the premalignant conditions such as Barrett's esophagus and gastric atrophy. Among oral sites, the subgingival microbiota shows more potential as a infectious biomarker for UGI cancers.
口腔微生物群可能对上消化道（UGI）疾病的发生发展产生影响。在本研究中，我们评估了唾液、龈下和颊黏膜微生物群与UGI疾病，特别是癌前病变之间的关联。我们还旨在确定哪个口腔部位作为UGI癌症发生发展的生物标志物具有最大潜力。
在这项基于人群的研究中，388名成年人接受了上消化道内镜检查并进行活检以进行组织病理学分析。使用经过验证的问卷评估UGI症状，并通过16S rRNA基因测序对在内镜检查期间收集的380份唾液、200份龈下和267份颊黏膜样本中的微生物群进行特征分析。
仅患有胃食管反流症状（GERS）的受试者，以及患有GERS和食管炎、或食管炎和巴雷特食管等合并症的受试者中，均观察到唾液微生物群失调。在患有多种胃部疾病的个体中也发现了显著的微生物改变，包括幽门螺杆菌感染、化学性反应性胃炎、萎缩性胃炎和肠化生。然而，龈下和颊黏膜样本中的微生物群差异主要与巴雷特食管或胃萎缩有关。在唾液中鉴定出的属中，普雷沃菌属和梭杆菌属与萎缩性胃炎和肠化生之间的关联值得注意。在龈下样本中，也发现Fretibacterium与巴雷特食管的联系以及梭杆菌属与胃萎缩和肠化生的联系很重要。
唾液微生物群失调与广泛的UGI疾病有关。然而，龈下和颊黏膜部位的微生物群失调与巴雷特食管和胃萎缩等癌前病变具体相关。在口腔部位中，龈下微生物群作为UGI癌症的感染生物标志物显示出更大的潜力。
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