Oral Microbiome and Periodontitis: A Prospective Study in Postmenopausal Women

描述(申请人提供)：牙周病是老年人最常见的疾病之一。牙周病的病因学涉及到宿主对一种复杂的多菌生物膜所引起的龈下侮辱的免疫反应的改变，目前尚不完全清楚。下一代测序(NGS)使用与培养无关的技术来识别16S rRNA基因，允许更完整和详细地表征人类口腔微生物组的复杂组成和多样性。很少有研究描述口腔微生物群及其与牙周炎的关系，在很长一段时间内，大量的老年人预期队列。我们建议进行一项具有成本效益的研究，在一大群现有的、特征良好的绝经后妇女中解决这些问题。我们的综合假设是，口腔微生物组的组成是多样化的，某些组成将与牙周病的患病率、严重性和进展随着时间的推移有关。这项拟议的研究建立在水牛城“OsteoPerio研究”的现有数据基础上，该研究是妇女健康倡议的辅助研究。我们以前收集并冷冻了两次已经进行的OsteoPerio研究访问的牙龈下菌斑样本，分别是基线(N=1000；1997-2000年)和基线后第5年(N=1000；2002-2005)。还可以获得标准化口腔检查的数据，包括探查牙袋深度、临床附着水平和放射牙槽高度测量，以表征牙周病状况，以及有关个人因素(例如，吸烟、饮食摄入量、肥胖、糖尿病、激素使用)和整体健康状况的广泛信息。我们建议在其中600名女性中增加一次基线后15年(2014-2017)的复查，以收集第三套样本、口腔测量和个人数据，以探索口腔微生物组组成与牙周病之间的长期关系。本研究的目的是确定3个时间点的龈下微生物组的组成和多样性；确定口腔微生物组的组成随时间的变化程度；确定哪些口腔微生物组的组成与牙周病的存在、严重程度和进展有关；以及确定关键的个人特征对口腔微生物组组成的影响及其与牙周病状态和进展的关系。这项拟议的研究填补了我们对 牙周疾病严重程度与老年人牙周疾病进展的关系。据我们所知，没有其他前瞻性流行病学研究如此庞大和丰富的数据资源，以解决我们在此提出的关于口腔微生物组及其在绝经后妇女牙周病中的作用的前沿问题。

DESCRIPTION (provided by applicant): Periodontal Disease is one of the most common diseases in older adults. Periodontal disease etiology involves altered host immune responses to subgingival insult by a complex polymicrobial biofilm that is not completely understood. Next Generation Sequencing (NGS) using culture- independent techniques to identify 16S rRNA genes, allows for more complete and detailed characterization of the complex composition and diversity of the human oral microbiome. Few studies have characterized the oral microbiome and its relation to periodontitis in large prospective cohorts of older adults over long time periods. We propose a cost-effective study to address these issues in a large existing, well-characterized cohort of postmenopausal women. Our omnibus hypothesis is that the oral microbiome composition is diverse, and that certain compositions will be associated with periodontal disease prevalence, severity and progression over time. This proposed study builds on existing data from the Buffalo "OsteoPerio Study", an ancillary study to the Women's Health Initiative. We have available previously collected and frozen subgingival plaque samples from two already conducted OsteoPerio study visits at Baseline (N=1000; 1997-2000) and Year-5 post-Baseline (N=1000; 2002-2005). Also available are data from standardized oral exams including probing pocket depth, clinical attachment level and radiographic alveolar height measurements to characterize periodontal disease status, and extensive information on personal factors (e.g., smoking, dietary intake, obesity, diabetes, hormone use) and overall health status. We propose here to add a Year-15 post-Baseline re-examination (2014-2017) in 600 of these women to collect a 3rd set of samples, oral measures and personal data to explore the longer-term relationship between the oral microbiome composition and periodontal disease. Our study aims are to determine the composition and diversity of the subgingival microbiome at 3 times points; determine the extent to which the oral microbiome composition changes over time; identify which oral microbiome compositions are associated with periodontal disease presence, severity and progression over time; and determine the influence of key personal characteristics on the oral microbiome composition and its relation with periodontal disease status and progression. The proposed study fills a critical gap in our knowledge of the role of the subgingival microbiome in periodontal disease severity and progression at older ages. To our knowledge, there is no other prospective epidemiologic study as large and rich with data resources to address the cutting edge questions we propose here on the oral microbiome and its role in periodontal disease in postmenopausal women.