The Subgingival Microbiome in Non-Hispanic Black Women: Relationship to Periodontal Inflammation, Systemic Inflammation, and Preterm Birth

项目总结/摘要 早产发生在妊娠< 37周。它与一系列新生儿风险有关， 早产相关婴儿死亡的风险。美国在早产率方面领先于其他工业化国家 而且，由于未知的原因，美国非西班牙裔黑人妇女的早产率高出50 与全国总体流行率相比。目前的早产预防策略是有限的，由于缺乏 了解早产的潜在机制。子宫内膜异位症 感染和早产是公认的。新的研究表明，牙周病可能是 这种感染的病原学来源。牙周病是一种炎症性疾病， 免疫反应的微生物栖息在龈下生物膜。孕妇和种族/族裔 少数族裔特别容易患上牙周病。怀孕期间的牙龈炎症可能会导致 炎症产物进入循环系统和母胎单位，引发 炎症级联反应，这可能会增加早产的可能性。对于理解 牙周病和早产之间的联系，是对龈下微生物组的理解。 因此，本研究旨在： 1)表征龈下微生物组和怀孕的非西班牙裔黑人的结构和多样性 怀孕早期和晚期的妇女。 2)探讨龈下微生物群与局部炎症的关系。 3)探索局部和全身炎症与出生时胎龄之间的关系。 这项研究的结果将为牙周炎的评估和干预提供一种创新的方法。 作为早产的潜在可改变的目标风险因素，从而促进 产妇保健和防止对妇女及其新生儿产生不良生育结果。总体目标 K 01职业发展计划的重点是杨博士在三个领域的专业知识的发展： 微生物组数据分析、口腔健康研究和健康差异研究。拟议项目，在 结合结构化的指导和培训计划，其中包括教学课程，研讨会， 实践经验，旨在促进这一目标，以及杨博士的长期目标，发展一个 一个独立资助的生物行为研究项目，研究生理机制如何联合收割机 社会、行为和环境因素导致孕产妇健康差异。

Project Summary/Abstract Preterm birth occurs at < 37 weeks gestation. It is associated with a host of newborn risks that increase the risk of preterm related infant death. The United States leads other industrialized nations in preterm birth rate and, for reasons unknown, non-Hispanic Black women in the U.S. have a 50% higher preterm birth rate compared to the overall national prevalence. Current preterm prevention strategies are limited due to lack of understanding about the underlying mechanisms of preterm birth. The association between intrauterine infection and preterm birth is well-established. Emerging research suggests that periodontal disease may be an etiologic source of this infection. Periodontal disease is an inflammatory condition that begins as a direct immune response to microorganisms that inhabit the subgingival biofilm. Pregnant women and racial/ethnic minorities are particularly at risk for periodontal disease. Gingival inflammation during pregnancy may allow for the movement of inflammatory products into the circulatory system and to the maternal-fetal unit, triggering an inflammatory cascade which may increase the likelihood of preterm birth. Critical to understanding the association between periodontal disease and preterm birth, is an understanding of the subgingival microbiome. This study, therefore, aims to: 1) Characterize the structure and diversity of the subgingival microbiome and of pregnant non-Hispanic Black women in early and late pregnancy. 2) Explore the relationship between the subgingival microbiome and localized inflammation. 3) Explore associations between localized and systemic inflammation, and gestational age at birth. Results from this study will inform an innovative approach to the assessment and intervention of periodontal disease in pregnant women as a potential modifiable target risk factor for preterm birth, thereby promoting maternal health, and preventing adverse birth outcomes for women and their newborns. The overarching goal of this K01 career development proposal is the development of Dr. Yang’s expertise in three areas: microbiome data analysis, oral health research, and health disparities research. The proposed project, in conjunction with the structured mentoring and training plan which includes didactic courses, workshops, and hands-on experience, are designed to facilitate this goal, as well as Dr. Yang’s long-term goal of developing an independently-funded biobehavioral research program that investigates how physiologic mechanisms combine with social, behavioral and environmental factors to give rise to maternal health disparities.