Potential Association of the Oral Microbiome with Trimethylamine N-Oxide Quantification in Mexican Patients with Myocardial Infarction.

Many attempts have been proposed to evaluate the linkage between the oral-gut-liver axis and the mechanisms related to the diseases' establishment. One of them is the oral microbiota translocation into the bloodstream, liver, and gut, promoting a host dysbiosis and triggering the presence of some metabolites such as trimethylamine N-oxide (TMAO), known as a risk marker for cardiovascular disease, and especially the myocardial infarction (MI). In the present pilot study, the involvement of oral dysbiosis related to the presence of TMAO has been considered an independent component of the standard risk factors (SRs) in the development of MI, which has not been previously described in human cohorts. A positive and significant correlation of TMAO levels with Porphyromonas was identified; likewise, the increase of the genus Peptidiphaga in patients without SRs was observed. We determined that the presence of SRs does not influence the TMAO concentration in these patients. This report is the first study where the relationship between oral dysbiosis and TMAO is specified in the Mexican population. Our findings provide information on the possible contribution of the oral pathogens associated with gut dysbiosis in the development of MI, although further analysis should be performed.

Comparative characterization of inflammatory profile and oral microbiome according to an inflammation-based risk score in ST-segment elevation myocardial infarction.

Ischemic heart disease considers the myocardial infarction (MI), either non-ST-segment elevation (non-STEMI) or ST-segment elevation myocardial infarction (STEMI); this represents the main cause of mortality in Mexican population. Regarding to the inflammatory state, this is reported to be a major prognostic factor of mortality for patients with MI. One of the conditions capable of producing systemic inflammation is periodontal disease. It has been proposed that the oral microbiota is translocated through the bloodstream to the liver and intestine, generating intestinal dysbiosis. The aim of this protocol is to assess oral microbiota diversity and circulating inflammatory profile in STEMI patients stratified according to an inflammation-based risk scoring system. We found that Bacteriodetes phylum was the most abundant in STEMI patients, and Prevotella was the most abundant genus, with a higher proportion in periodontitis patients. In fact, Prevotella genus was found to correlate positively and significantly with elevated IL-6 concentration. Our study defined a non-causal association inferred between the cardiovascular risk of STEMI patients, determined by changes in the oral microbiota that influence the development of periodontal disease and its relationship with the exacerbation of the systemic inflammatory response.

Contribution of Trimethylamine N-Oxide (TMAO) to Chronic Inflammatory and Degenerative Diseases.

Trimethylamine N-oxide (TMAO) is a metabolite produced by the gut microbiota and has been mainly associated with an increased incidence of cardiovascular diseases (CVDs) in humans. There are factors that affect one's TMAO level, such as diet, drugs, age, and hormones, among others. Gut dysbiosis in the host has been studied recently as a new approach to understanding chronic inflammatory and degenerative diseases, including cardiovascular diseases, metabolic diseases, and Alzheimer's disease. These disease types as well as COVID-19 are known to modulate host immunity. Diabetic and obese patients have been observed to have an increase in their level of TMAO, which has a direct correlation with CVDs. This metabolite is attributed to enhancing the inflammatory pathways through cholesterol and bile acid dysregulation, promoting foam cell formation. Additionally, TMAO activates the transcription factor NF-κB, which, in turn, triggers cytokine production. The result can be an exaggerated inflammatory response capable of inducing endoplasmic reticulum stress, which is responsible for various diseases. Due to the deleterious effects that this metabolite causes in its host, it is important to search for new therapeutic agents that allow a reduction in the TMAO levels of patients and that, thus, allow patients to be able to avoid a severe cardiovascular event. The present review discussed the synthesis of TMAO and its contribution to the pathogenesis of various inflammatory diseases.

Cytokine and microbiota profiles in obesity-related hypertension patients.

Background: Systemic arterial hypertension is linked to a heightened risk of cardiovascular diseases on a global scale. In Mexico, nearly half of adults in vulnerable conditions experience hypertension. Imbalance in the oral and intestinal microbiota composition has been observed in patients with hypertension, documented by a decrease of bacteria producing short-chain fatty acids, which play a critical role in blood pressure regulation. Aim: To examine the cytokines' profile and assess the characteristics of oral and gut microbiota in obesity-related hypertension in Mexican patients. Methods: A cross-sectional, observational, and analytical study was carried out. Twenty-two patients were categorized by their body mass index (BMI) as overweight and obese, and the diagnosis of primary hypertension. DNA from supragingival dental plaque and feces samples was used to carry out 16S rRNA sequencing. Additionally, 13 cytokines were quantified. Results: In the oral microbiota, Kluyvera was found to be significantly enriched in obese compared to overweight patients. Instead, the gut microbiota was dominated by Firmicutes. However, the correlation between certain genera and proinflammatory cytokines was noted. Conclusion: This exploratory study provides insights into the complex relationship between the oral and gut microbiota and their association with systemic inflammation in obesity-related hypertension.

Relación entre la disbiosis de la microbiota oral y la enfermedad cardiovascular aterosclerótica / Relationship between oral microbiota dysbiosis and the atherosclerotic cardiovascular disease

Resumen Considerando la alta incidencia de las enfermedades cardiovasculares (ECV) en México y el mundo, la presente revisión proporciona un panorama general sobre la relación entre el desarrollo de periodontitis y la patogenia de estas enfermedades, describiendo aspectos sobre la alteración de la microbiota oral y los mecanismos asociados con el establecimiento de la respuesta inmunitaria local y sistémica en los pacientes con ECV. Además, proporciona las bases para considerar el análisis de la microbiota de la cavidad oral como un blanco terapéutico potencialmente útil en la regulación de la respuesta inmunitaria, lo que permitiría conseguir mejores pronósticos en pacientes con ECV.

Abstract Considering the high incidence of cardiovascular disease (CVD) worldwide, the present review provides a general panorama of the relation between the pathogenesis of these diseases and the development of periodontitis. Specific associations are described between an altered oral microbiota (and associated mechanisms) and the local and systemic immune response in patients with CVD. Additionally, the basis is established for considering an imbalance in the microbiota of the oral cavity as a potentially useful therapeutic target for the regulation of the immune response, which could possibly allow for better therapeutic outcomes in the case of patients with CVD.

Relación entre la disbiosis de la microbiota oral y la enfermedad cardiovascular aterosclerótica.

Considerando la alta incidencia de las enfermedades cardiovasculares (ECV) en México y el mundo, la presente revisión proporciona un panorama general sobre la relación entre el desarrollo de periodontitis y la patogenia de estas enfermedades, describiendo aspectos sobre la alteración de la microbiota oral y los mecanismos asociados con el establecimiento de la respuesta inmunitaria local y sistémica en los pacientes con ECV. Además, proporciona las bases para considerar el análisis de la microbiota de la cavidad oral como un blanco terapéutico potencialmente útil en la regulación de la respuesta inmunitaria, lo que permitiría conseguir mejores pronósticos en pacientes con ECV.Considering the high incidence of cardiovascular disease (CVD) worldwide, the present review provides a general panorama of the relation between the pathogenesis of these diseases and the development of periodontitis. Specific associations are described between an altered oral microbiota (and associated mechanisms) and the local and systemic immune response in patients with CVD. Additionally, the basis is established for considering an imbalance in the microbiota of the oral cavity as a potentially useful therapeutic target for the regulation of the immune response, which could possibly allow for better therapeutic outcomes in the case of patients with CVD.