Harboring Cnm‐expressing <i>Streptococcus mutans</i> in the oral cavity relates to both deep and lobar cerebral microbleeds
Harboring Cnm‐expressing <i>Streptococcus mutans</i> in the oral cavity relates to both deep and lobar cerebral microbleeds
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口腔中表达 Cnm 的<i>变形链球菌</i>与深部和脑叶微出血有关
DOI：
10.1111/ene.15720
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发表时间：
2023
影响因子：
5.1
通讯作者：
Saito Satoshi...
中科院分区：
文献类型：
--
作者：
Ikeda Shuhei;Saito Satoshi...
背景脑微出血（CMB）影响中风患者的长期预后。表达胶原结合蛋白Cnm的变形链球菌可诱发脑血管炎症，损害血脑屏障完整性并导致脑出血。在这里，我们检查了 Cnm-positiveS 的关联。方法急性卒中患者选自单中心登记数据库。口腔携带 Cnm 阳性或 Cnm 阴性。使用聚合酶链式反应测定法测定变形链球菌。 Cnm-阳性的关联。分别使用准泊松模型和逻辑回归模型检查了具有 CMB 数量的变异病毒，特别是 >10 个 CMB 的存在。结果本研究包括 3154 名中风患者，其中 428 名患者（中位[四分位距]年龄，73.0 [63.0–81.0]岁；269 名男性 [62.9%]）接受了口腔细菌检查。总共有 326 名患者携带 S。突变体。在排除四名没有影像学数据的患者后，我们比较了 Cnm 阳性 (n=72) 和 Cnm 阴性 (n=250) 的患者。突变体。携带 Cnm 阳性 S。调整年龄、性别、高血压、中风后，mutans 与 >10 个 CMB（调整后比值比 2.20 [1.18–4.10]）和较高数量的深部和脑叶 CMB（调整后深部风险比 1.61 [1.14–2.27]；脑叶 5.14 [2.78–9.51]）独立相关，但与幕下 CMB 无关。类型、美国国立卫生研究院卒中量表评分和脑淀粉样血管病。结论：Cnm 阳性。 mutans 与深部和脑叶位置较多的 CMB 独立相关。减少 Cnm 阳性。口腔中的变形蛋白可能作为中风的新治疗方法。
BackgroundCerebral microbleeds (CMBs) influence long‐term prognoses of stroke patients.Streptococcus mutansexpressing the collagen‐binding protein Cnm induces cerebrovascular inflammation, impairing blood brain barrier integrity and causing cerebral bleeding. Here, we examine the association of Cnm‐positiveS. mutanswith CMBs.MethodsAcute stroke patients were selected from a single‐center registry database. Oral carriage of Cnm‐positive or Cnm‐negativeS. mutanswas determined using polymerase chain reaction assays. The associations of Cnm‐positiveS. mutanswith CMB number and specifically the presence of >10 CMBs were examined using quasi‐Poisson and logistic regression models, respectively.ResultsThis study included 3154 stroke patients, of which 428 patients (median [interquartile range] age, 73.0 [63.0–81.0] years; 269 men [62.9%]) underwent oral bacterial examinations. In total, 326 patients harboredS. mutans. After excluding four patients without imaging data, we compared patients with Cnm‐positive (n= 72) and Cnm‐negative (n= 250)S. mutans. Harboring Cnm‐positiveS. mutanswas independently associated with the presence of >10 CMBs (adjusted odds ratio 2.20 [1.18–4.10]) and higher numbers of deep and lobar CMBs (adjusted risk ratio 1.61 [1.14–2.27] for deep; 5.14 [2.78–9.51] for lobar), but not infratentorial CMBs, after adjusting for age, sex, hypertension, stroke type, National Institutes of Health Stroke Scale score, and cerebral amyloid angiopathy.ConclusionsHarboring Cnm‐positiveS. mutanswas independently associated with a higher number of CMBs in deep and lobar locations. Reducing Cnm‐positiveS. mutansin the oral cavity may serve as a novel therapeutic approach for stroke.