口腔微生物群落结构分析方法的研究进展

牙菌斑是口腔常见感染性疾病——龋病和牙周病的始动因子,主要由微生物构成。在口腔中发现的700余个种属或种系型的细菌中,有50%左右未获得培养。基于分子生物学的方法在口腔微生态和感染性疾病的病因研究中已经成为不可或缺的技术。近年来,以16S rRNA基因为基础建立的分子生物学技术正逐步广泛用于微生物群落的分析,跨越了传统的微生物培养,直接对不同生态系,包括人类口腔的微生物组成进行了研究。本文主要介绍16s rRNA基因的分子分析技术,以及它们在口腔微生物群落结构分析研究中的应用,另外还简要介绍了一些尚未应用于口腔的新技术。     

52例HIV／AIDS患者口腔念珠菌病的临床表型及病原学鉴定

目的：口腔念珠菌病（ oral candidiasis,OC）是HIV／AIDS患者中最常见的口腔疾病,研究其临床表型及病原学特点对AIDS相关性口腔念珠菌病的诊断和临床用药有重要的指导意义。方法将70例确诊为HIV／AIDS且初步诊断为AIDS相关性口腔念珠菌病患者使用棉拭子在其病损区取材,接种至科玛嘉念珠菌显色培养基检验。结果 HIV／AIDS患者念珠菌感染的病例为52例,临床表型以假膜型和红斑型为主,其中假膜型最为常见（56％）。 HIV／AIDS患者口腔念珠菌病各致病病原菌以白念珠菌的检出率最高（60．32％）,热带念珠菌次之（19．05％）,光滑念珠菌为（12．70％）,克柔念珠菌（7．94％）。有9例HIV／AIDS伴口腔念珠菌病患者,检测出病原菌的混合感染,其中2例为3种病原菌感染。结论 HIV／AIDS患者口腔念珠菌病临床表型复杂且可以伴发,单纯通过临床表现鉴别诊断常不准确,且病原菌的准确分型可以指导临床用药,降低耐药菌的产生。     

口腔未培养微生物分离培养策略的研究进展

口腔微生物是人体微生物组的重要组成部分,其群落组成丰富且独特。现有研究显示,口腔微生物与龋病、牙周炎等口腔健康问题有直接的联系,因而具有重要的研究价值。随着高通量测序技术的发展,人们对口腔中未培养微生物多样性的认识不断加深,这进一步催生对微生物分离培养技术需求的增加。为此,本文将围绕口腔未培养微生物及其分离培养策略的研究进展,首先介绍口腔中未培养微生物的研究现状;其次分析口腔微生物分离培养中可能的限制因素;最后综述微生物分离培养技术发展及其在口腔未培养微生物研究中的应用。全文旨在为口腔未培养微生物的分离培养提供思路和技术参考。     

口腔微生物群和人体健康

口腔微生物群作为人体微生物群的重要组成部分,其与人体健康之间的关系已成为各领域研究的焦点。口腔微生物群种类繁多、组成复杂,涵盖了细菌、真菌、古细菌和病毒等。近年来的研究显示,口腔微生物群的组成和比例与人体健康密切相关,会影响口腔疾病如龋齿、牙周病的发生。同时口腔微生物也是全身系统性疾病如肺炎、肿瘤和糖尿病等发生的危险因素之一。大量研究认为,口腔微生物群组成的改变、口腔微生物群之间的相互作用对疾病的发生有协同促进作用。本文聚焦于口腔微生物群的组成相关研究、口腔微生物组的最新进展,并对其与人体健康之间的关系进行综述。     

口腔微生物群与牙周病

口腔微生物群作为人体微生物群的重要组成部分,种类繁多、组成复杂,其组成和比例与各类口腔疾病密切相关。牙周炎是一种多微生物的复合感染,它由口腔内微生物群中潜在的致病微生物丰度增加引起,这些微生物通过介导炎症反应及调节口腔微生物群的基础营养环境而致病。本文综述了近年来口腔微生物群与牙周疾病之间的关系及相关影响因素,并分析了目前牙周病微生物群研究的挑战与瓶颈,为将微生物群作为预防、诊断和治疗牙周相关疾病的生物标记物并进一步应用于临床提供理论基础。     

口腔念珠菌病患者念珠菌分离株的菌种分布及流行趋势分析

目的回顾性分析我院近5年口腔黏膜科念珠菌病患者的念珠菌分布及流行趋势。方法对2015年至2019年到北京大学口腔医院黏膜科就诊的27 162例患者的唾液培养样本结果进行回顾性分析。将所有结果录入Excel表格后按照菌种、菌量、患者性别、患者年龄进行分组分析。结果在2015至2019年分离自口腔念珠菌病患者的所有念珠菌菌株中,白念珠菌所占的比例最高,热带念珠菌和其他念珠菌的阳性比例呈现逐年上升趋势。在白念珠菌、热带念珠菌、光滑念珠菌感染的样本中均以菌落数≥200 CFU/mL的菌株为主,而克柔念珠菌、其他念珠菌菌落数≥200 CFU/mL的菌株比例低于白念珠菌、热带念珠菌和光滑念珠菌,而菌落数≤30 CFU/mL的菌株比例明显高于白念珠菌、热带念珠菌和光滑念珠菌。统计分析结果显示,女性患者占比明显高于男性患者(P0.05)。口腔念珠菌各年龄段的占比总体随年龄的增长呈现升高趋势,且在41～50岁年龄段及其后升高明显。结论虽然白念珠菌感染仍然是口腔念珠菌感染的主要病原菌,但热带念珠菌和其他念珠菌的阳性比例近年来呈现逐年上升趋势。口腔念珠菌病患者菌株分布和流行趋势分析对于临床用药策略有指导意义。     

118株口腔致病念珠菌病原学特征及药敏结果分析

目的调查分析临床致病口腔念珠菌菌种分布及对氟康唑、伊曲康唑、制霉菌素、5-氟胞嘧啶和酮康唑的药物敏感性,以提供临床用药依据。方法收集口腔真菌感染患者标本,常规涂片镜检、培养,对酵母样生长菌落用生物梅里埃公司API20AUX进行菌种鉴定。对其中的念珠菌进行药敏分析。结果共收集141例临床口腔真菌病标本,其中118株念珠菌中,白念珠菌87株（73.7%）,热带念珠菌15株（12.7%）,高里念珠菌6株（5.1%）,光滑念珠菌4株,其他念珠菌6株。口腔念珠菌对氟康唑、伊曲康唑、制霉菌素、5-氟胞嘧啶和酮康唑的耐药率分别为5.1%、1.7%、0%、3.4%、5.1%。结论解放军324医院口腔真菌感染主要为长期应用抗生素的老年患者。口腔念珠菌病仍以白念珠菌为主,对常用抗真菌药物呈不同程度的耐药,应进行真菌常规菌种鉴定及药敏试验。     

口腔链球菌摄取生物素与口内白色念珠菌生长的关系

为了探讨口腔细菌生态平衡机制,本文体外检测了４株口腔链球菌（Ｓ．ｓａｌｉｖａｒｉｕｓ,Ｓ．ｓａｎｇｕｉｓ,Ｓ．ｍｕｔａｎｓ和Ｓ．ｍｉｔｉｏｒ）和白色念珠菌生长对生物素的依赖性。结果显示白色念珠菌和口腔链球菌的生长绝对依赖生物素,前者最大半数生长需要生物素约１０ｐＭｏｌ／Ｌ,其最大生长率所需生物素约为１００ｐＭｏｌ／Ｌ;而后者最大半数生长需生物素为５２５ｐＭｏｌ／Ｌ。正常人血清和唾液中生物素的含量约为２１２２９４ｐＭｏｌ／Ｌ。生物素饥饿状态下的白色念珠菌和口腔链球菌,以及唾液离心沉淀物（绝大多数为细菌）摄取生物素具温度依赖性,而代谢抑制剂（叠氮化合物、氰化物和醋酸碘）和某些抗生素（杆菌肽、短杆菌肽、万古霉素和二性霉素）具选择性抑制效应,提示生物素的摄取和跨膜转运是一依赖能量的主动过程。用唾液沉淀物和口腔链球菌吸收培养基中的生物素或与白色念珠菌共同培养,显著抑制白色念珠菌的生长。本文首次提供实验证据显示口腔优势菌可能通过竞争生物素等营养成份,抑制白色念珠菌生长,以维持口腔微生物之生态平衡。     

正畸治疗与口腔微生物群变化的相关性研究

随着口腔微生物群变化的研究不断深入，正畸治疗与口腔微生物群之间的关系逐渐显现。正畸治疗会对口腔微生物群甚至全身微生物群产生重要的影响。一般的正畸治疗主要是让患者佩戴牙齿矫正器，这会导致患者的口腔微生物群被破坏，从而引发一系列如龋齿、牙周炎、牙龈炎等口腔疾病，甚至会威胁到人体的其他器官，有研究表明口腔微生物群比例失衡会导致人体的肝脏等器官感染，从而诱发一系列人体疾病。所以，进行正畸治疗的患者要特别重视口腔健康，做好口腔清洁工作，防止口腔疾病的出现。     

口腔微生物多样性研究进展

口腔微生物多样性的改变是口腔常见感染性疾病的发病机制之一,随着分子生物学技术的普遍应用,研究者能够不通过纯培养技术即可对人类口腔不同生态系的微生物组成及变化进行研究。本文综述了当前口腔微生物多样性研究的常用方法及各自的特点,从而为口腔微生物生态方面的进一步深入研究提供参考。     

口腔微生物与全身健康研究进展

口腔微生物是定植于人体口腔的微生物集合。众多研究证实,口腔微生物与多种口腔感染性疾病及系统性疾病紧密相关。随着“人类微生物组计划”及其他微生物宏基因组学相关项目的开展,人们对口腔微生物群落的认识不断深入。本文基于最新研究进展,就口腔微生物的组成、演替特点、与口腔和全身系统性疾病的关系及与肠道微生物的交互作用进行综述。     

The oral microbiome of pregnant women facilitates gestational diabetes discrimination

The oral microbiota plays an important role in the development of various diseases,whereas its association with gestational diabetes mellitus (GDM) remains largely unclear.The aim of this study is to identify biomarkers from the oral microbiota of GDM patients by analyzing the microbiome of the saliva and dental plaque samples of 111 pregnant women.We find that the microbiota of both types of oral samples in GDM patients exhibits differences and significantly varies from that of patients with periodontitis or dental caries.Using bacterial biomarkers from the oral microbiota,GDM classification models based on support vector machine and random forest algorithms are constructed.The area under curve (AUC) value of the classification model constructed by combination of Lautropia and Neisseria in dental plaque and Streptococcus in saliva reaches 0.83,and the value achieves a maximum value of 0.89 by adding clinical features.These findings suggest that certain bacteria in either saliva or dental plaque can effectively distinguish women with GDM from healthy pregnant women,which provides evidence of oral microbiome as an informative source for developing noninvasive biomarkers of GDM.     

Molecular Identification of Candida Species in the Oral Microbiota of Individuals with Down Syndrome: A Case–Control Study

Mycopathologia - Candida species are common in the human oral microbiota and may cause oral candidiasis (OC) when the microbiota equilibrium is disturbed. Immunosuppressed individuals are...     

Cervicovaginal microbiome dynamics after taking oral probiotics

The vaginal microbiota is less complex than the gut microbiota, and the colonization of Lactobacillus in the female vagina is considered to be critical for reproductive health. Oral probiotics have been suggested as promising means to modulate vaginal homeostasis in the general population. In this study, 60 Chinese women were followed for over a year before, during, and after treatment with the probiotics Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Shotgun metagenomic data of 1334 samples from multiple body sites did not support a colonization route of the probiotics from the oral cavity to the intestinal tract and then to the vagina. Our analyses enable the classification of the cervicovaginal microbiome into a stable state and a state of dysbiosis. The microbiome in the stable group steadily maintained a relatively high abundance of Lactobacilli over one year, which was not affected by probiotic intake, whereas in the dysbiosis group, the microbiota was more diverse and changed markedly over time. Data from a subset of the dysbiosis group suggests this subgroup possibly benefited from supplementation with the probiotics,indicating that probiotics supplementation can be prescribed for women in a subclinical microbiome setting of dysbiosis, providing opportunities for targeted and personalized microbiome reconstitution.     

Environmental heavy metal as a potential risk factor for the progression of oral potentially malignant disorders in central Taiwan

ObjectiveOral cancer (OC) is a leading cause of death from cancer in men between the ages of 25 and 44 years in Taiwan. The overall 5-year survival rates for the four OC stages (I–IV) in Taiwan are approximately 70%, 30%, 20%, and 10%, respectively, indicating the importance of the early diagnosis of oral potentially malignant disorders (OPMDs). Previous studies indicated an association between the OC incidence and certain environmental heavy metal concentrations. If these associations do exist for OC, they may also be observed for OPMD. The purpose of this study is to explore the association between the development of OPMD to OC and environmental heavy metals. Oral submucous fibrosis (OSF) and oral leukoplakia (OL) are two major types of OPMD in Taiwan.Materials and methodsA retrospective cohort study was conducted by Changhua Christian Hospital, the sole medical center in Changhua County, where 2725 male adult patients diagnosed with either OSF or OL between 2000 and 2014 were recruited. Data were analyzed by Cox regression and adjusted for smoking and betel-quid chewing.Results and discussionOPMD patients who resided in areas with high nickel concentrations (polluted levels) exhibited hazard ratios of 1.8–2 for OC relative to those who lived in areas with low nickel levels (P < 0.01). Meanwhile, smokers with OPMDs had a hazard ratio of 2.8–2.9 relative to non-smokers. Betel-quid chewers had a 2.2–2.3 hazard ratio relative to non-chewers. Smoking, betel-quid chewing, and environmental nickel exposure are associated with an increased risk of OC development in OPMD patients. This study provides valuable findings on the environmental effects of heavy metals on human health. Enhanced surveillance of the condition of OPMD patients who have been exposed to high nickel concentrations may be crucial for OC prevention.     

口腔微生物与阿尔茨海默病相关性的研究进展

口腔微生物组是人体五大菌库之一,其微生态失衡不仅在牙周炎和龋齿等口腔疾病中发挥主要作用,还与全身诸多疾病紧密相关。阿尔茨海默病（Alzheimer′s disease,AD）是一种神经系统退行性疾病,随着社会人口老龄化的加剧,其防治已成为严重的公共卫生问题。大量研究表明,AD与某些口腔致病菌及其微生态失衡显著相关。本文就口腔微生物与AD的关系作一综述,总结了口腔微生物影响AD的可能机制,并在此基础上初步推测不同的微生物与AD间的潜在关系。为进一步治疗和预防AD,人们除了关注AD患者大脑的病理改变外,还应关注患者的口腔微生态平衡。

     

羊水菌群的研究进展

传统观念认为胎儿在宫内发育的过程是无菌的。随着研究方法的快速发展,针对于微生物的研究方法从传统的培养到现代分子生物学检测的进步,研究者已经认识到胎盘、羊水中具有微生物的存在。目前的研究尚不能明确胎儿宫内胎盘、羊水的菌群来源及菌群转移的具体途径,但已有的研究提示羊水菌群最可能来源为母亲肠道、生殖道以及口腔。本文综述了研究者对羊水菌群认识的转变、羊水菌群的来源以及羊水菌群与早产的相关性。     

Effects of menstrual cycle phase and oral contraceptive use on verbal memory

Surgical or pharmacological suppression of ovarian hormones leads to declines in verbal memory, and estrogen treatment reverses these deficits. In the current study, we investigated the effects of menstrual cycle phase and oral contraceptives on verbal memory, as measured by the California Verbal Learning Test, in two groups of premenopausal women — 16 naturally cycling women and 20 current users of estrogen-based oral contraceptives (OCs). Naturally cycling women were assessed twice — once during the early follicular phase (Days 2-4) and once during the midluteal phase (Days 20-22) of the menstrual cycle. OC users were tested on the same cycle days, corresponding to inactive and active pill phases, respectively. We predicted that naturally cycling women would show improved verbal memory during the midluteal phase, when estradiol levels are high, compared with the follicular phase, when estradiol levels are low. We also predicted that OC users, who show no change in endogenous estradiol across the cycle, would show no change in verbal memory. Contrary to predictions, naturally cycling women showed no changes in verbal memory across the cycle, whereas OC users showed enhanced memory during the active pill phase (p < .05). None of the secondary cognitive outcome measures varied with cycle phase or OC use including measures of visuospatial memory, verbal fluency, visuospatial abilities, and attention. Overall, these results suggest that verbal memory performance in premenopausal women varies across the cycle with OC use, but does not vary systematically with changes in endogenous estradiol.     

Assessment of DNA damage in women using oral contraceptives

The effect of the use of an oral contraceptive (OC) on the frequency of sister chromatid exchanges (SCEs) and on the response in the alkaline comet assay (single-cell gel electrophoresis (SCGE)) was investigated in 18 women taking contraceptive pills daily for 24 months. As controls, fertile women were included with regular menstrual cycles who received no OC drugs. A significant increase in the number of lymphocytes with DNA migration and an increased frequency of SCE per metaphase were observed in OC users as compared with their age-matched untreated controls (P<0.005). As higher incidences of spontaneous SCEs in peripheral blood lymphocytes have been reported to occur in females during pregnancy due to profound changes in the levels of certain sex hormones such as progesterone and estrogen, particularly during the last trimester, 17 pregnant women served as positive controls in this study in order to test the rate of genetic damage due to those changes. Higher frequencies of SCEs and comet responses were observed in pregnant women than in their matched controls. However, no statistically significant difference in DNA damage was observed between OC users and pregnant women (P>0.05). This study underscores the fact that prolonged and extensive use of these drugs in our daily life may be hazardous and also, that OC users should be aware of multifactorial risk factors (environmental, genetic and life style patterns) that may be responsible for additional DNA damage.