Diabetes reversal and the subgingival microbiota

项目概要 糖尿病增加了牙周病的患病率和严重程度。牙周炎 具有复杂的细菌病因学，以及细菌群落与糖尿病的关系 仍不清楚。牙周炎和糖尿病相互作用的一个潜在机制是 糖尿病由于以下因素的改变而导致致病性细菌负担增加： 促进某些细菌生长的底物，例如葡萄糖或炎症产物。 研究表明，糖尿病会增加病原菌感染的易感性 多个靶器官中的细菌，糖尿病会导致肠道微生物群的变化。是否 糖尿病创造了一个支持更多致病菌群落的环境 由于先前研究的技术限制，牙周病尚未得到解决。 随着复杂细菌群落动态研究方法的进步，现在 可以将健康个体与糖尿病患者的微生物群进行比较。我们计划获得 通过高通量 Illumina DNA-seq 分析逆转之前和之后的微生物概况 糖尿病并通过 RNA-Seq 检查功能性细菌差异。最近的一项进展是 提供了比较糖尿病和血糖正常相关龈下的机会 细菌群落。腹腔镜袖状胃切除手术可快速解决 大多数接受者患有糖尿病。糖尿病的逆转提供了对其影响的新见解 糖尿病对肠道微生物群的影响。我们将利用这个机会进行两项研究。 一种是横断面分析，比较糖尿病患者与非糖尿病患者的微生物组。的 第二是对同一受试者进行纵向比较，以检验逆转的效果 糖尿病。由于糖尿病的逆转很快，因此有利于因果关系的检查 关系。采取的两种方法（基线和纵向）各有不同的优势 因此我们可以确定糖尿病是否会改变龈下微生物群从而增加患糖尿病的风险 牙周炎。该项目汇集了天普大学两个领先的减肥手术项目 大学和宾夕法尼亚大学确保有足够的患者群体到达 计划的入学人数。它还汇集了天普大学的糖尿病专家 大学和宾夕法尼亚大学，以及口腔和口腔细菌方面的专家 宾夕法尼亚大学和俄亥俄州立大学。

Project Summary Diabetes mellitus increases the prevalence and severity of periodontal diseases. Periodontitis has a complex bacterial etiology, and the relationship of the bacterial community to diabetes remains unclear. A potential mechanism for the interaction of periodontitis and diabetes is that diabetes causes a shift to a more pathogenic bacterial burden as the result of alterations in substrates such as glucose or inflammatory products that promote growth of certain bacteria. Studies have established that diabetes enhances susceptibility to infection by pathogenic bacteria in several target organs, and that diabetes causes a shift in the gut microbiota. Whether diabetes creates an environment that supports a more pathogenic bacterial community in the periodontium has not been settled in part because of technical limitations of previous studies. With advances in approaches to study the dynamics of complex bacterial communities, it is now possible to compare the microbiota in healthy individuals to diabetics. We plan to obtain microbial profiles by high throughput Illumina DNA-seq analysis before and after reversal of diabetes and to examine functional bacterial differences by RNA-Seq. A recent development has provided an opportunity to compare diabetes and normoglycemia-associated subgingival bacterial communities. Laparoscopic sleeve gastrectomy surgery produces a rapid resolution of diabetes in most recipients. The reversal of diabetes has provided new insights into the impact of diabetes on the gut microbiome. We will advantage of this opportunity to conduct two studies. One is a cross-sectional analysis to compare the microbiome in diabetics with nondiabetics. The second is a longitudinal comparison in the same subjects to examine the effect of reversing diabetes. Because the reversal of diabetes is rapid it facilitates examination of cause and effect relationships. The two approaches taken (baseline and longitudinal) each has distinct strengths so we can determine whether diabetes alters the subgingival microbiome to enhance the risk of periodontitis. This project brings together two leading bariatric surgery programs at Temple University and the University of Pennsylvania to ensure an adequate patient population to reach the planned enrollment figures. It also brings together experts in diabetes from Temple University and University of Pennsylvania, and experts in the oral cavity and oral bacteria from Penn and Ohio State University.