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A tale of two risks: smoking, diabetes and the subgingival microbiome
Journal article   Open access   Peer reviewed

A tale of two risks: smoking, diabetes and the subgingival microbiome

Sukirth M Ganesan, Vinayak Joshi, Megan Fellows, Shareef M Dabdoub, Haikady N Nagaraja, Benjamin O'Donnell, Neeta Rohit Deshpande and Purnima S Kumar
The ISME Journal, Vol.11(9), pp.2075-2089
09/2017
DOI: 10.1038/ismej.2017.73
PMCID: PMC5563960
PMID: 28534880
url
https://doi.org/10.1038/ismej.2017.73View
Published (Version of record) Open Access

Abstract

Although smoking and diabetes have been established as the only two risk factors for periodontitis, their individual and synergistic impacts on the periodontal microbiome are not well studied. The present investigation analyzed 2.7 million 16S sequences from 175 non-smoking normoglycemic individuals (controls), smokers, diabetics and diabetic smokers with periodontitis as well as periodontally healthy controls, smokers and diabetics to assess subgingival bacterial biodiversity and co-occurrence patterns. The microbial signatures of periodontally healthy smokers, but not diabetics, were highly aligned with the disease-associated microbiomes of their respective cohorts. Diabetics were dominated by species belonging to Fusobacterium, Parvimonas, Peptostreptococcus, Gemella, Streptococcus, Leptotrichia, Filifactor, Veillonella, TM7 and Terrahemophilus. These microbiomes exhibited significant clustering based on HbA1c levels (pre-diabetic (<6.5%), diabetic (6.5-9.9%), diabetics >10%). Smokers with periodontitis evidenced a robust core microbiome (species identified in at least 80% of individuals) dominated by anaerobes, with inter-individual differences attributable largely to the 'rare biosphere'. Diabetics and diabetic smokers, on the other hand, were microbially heterogeneous and enriched for facultative species. In smokers, microbial co-occurrence networks were sparse and predominantly congeneric, while robust inter-generic networks were observed in diabetics and diabetic smokers. Smoking and hyperglycemia impact the subgingival microbiome in distinct ways, and when these perturbations intersect, their synergistic effect is greater than what would be expected from the sum of each effect separately. Thus, this study underscores the importance of early intervention strategies in maintaining health-compatible microbiomes in high-risk individuals, as well as the need to personalize these interventions based on the environmental perturbation.
Aged Bacteria - classification Bacteria - genetics Bacteria - isolation & purification Bacteria - metabolism Biodiversity Dental Plaque Diabetes Mellitus - microbiology Female Gingiva - microbiology Humans Male Microbiota Middle Aged Periodontitis - microbiology Phylogeny Smokers - statistics & numerical data Smoking - adverse effects

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