Oral Microbiome and Periodontitis: A Prospective Study in Postmenopausal Women

描述（由申请人提供）：牙周病是老年人最常见的疾病之一。牙周病的病因学涉及宿主对牙龈下损伤的免疫反应的改变，这是一种复杂的多微生物生物膜，目前还不完全清楚。下一代测序（NGS）使用不依赖培养的技术来鉴定16S rRNA基因，可以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。很少有研究描述了口腔微生物群及其与长期前瞻性老年人牙周炎的关系。我们提出了一项具有成本效益的研究，以解决这些问题，在一个大的现有的，特征明确的绝经后妇女队列。我们的综合假设是，口腔微生物组的组成是多种多样的，某些组成将与牙周病的患病率、严重程度和进展有关。这项拟议的研究建立在布法罗“骨手术研究”的现有数据基础上，这是一项妇女健康倡议的辅助研究。我们从基线（N=1000; 1997-2000）和基线后第5年（N=1000; 2002-2005）两次已经进行的OsteoPerio研究访问中收集和冷冻的牙龈下菌斑样本。还可获得标准化口腔检查的数据，包括探诊袋深度、临床附着水平和牙槽高度x线测量，以表征牙周病状况，以及关于个人因素（如吸烟、饮食摄入、肥胖、糖尿病、激素使用）和整体健康状况的广泛信息。在此，我们建议对其中600名妇女进行基线后第15年（2014-2017年）的复查，收集第三组样本、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。我们的研究目的是确定龈下微生物组在3个时间点的组成和多样性；确定口腔微生物组组成随时间变化的程度；确定哪些口腔微生物组组成物与牙周病的存在、严重程度和长期进展有关；确定关键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。这项提议的研究填补了我们对基因的作用的认识上的一个关键空白

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.