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Knecht KT, Chiriac G, Guan HD. The potential impact of a vegetarian diet on glaucoma. Surv Ophthalmol 2024:S0039-6257(24)00048-1. [PMID: 38768761 DOI: 10.1016/j.survophthal.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
Treatment of primary open-angle glaucoma has centered on the lowering of intraocular pressure that damages the optic nerve; however, this strategy is not uniformly successful, especially in normal tension glaucoma, and there is interest in antioxidant, anti-inflammatory, and other neuroprotective strategies. Vegetarian diets are known to be rich in antioxidant and anti-inflammatory components and have a number of established health benefits. Thus, it would be reasonable to assume that vegetarian diets would be beneficial in glaucoma, but this approach has not been well studied. We examine the possible role of vegetarian diets and their components in the incidence and progression of glaucoma.
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Affiliation(s)
- Kathryn T Knecht
- Loma Linda University School of Pharmacy, Loma Linda, California, USA
| | - Gabriela Chiriac
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Howard D Guan
- Loma Linda University Eye Institute, Loma Linda, California, USA.
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2
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Paiva B, Laranjinha J, Rocha BS. Do oral and gut microbiota communicate through redox pathways? A novel asset of the nitrate-nitrite-NO pathway. FEBS Lett 2024. [PMID: 38523057 DOI: 10.1002/1873-3468.14859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/16/2024] [Accepted: 02/29/2024] [Indexed: 03/26/2024]
Abstract
Nitrate may act as a regulator of •NO bioavailability via sequential reduction along the nitrate-nitrite-NO pathway with widespread health benefits, including a eubiotic effect on the oral and gut microbiota. Here, we discuss the molecular mechanisms of microbiota-host communication through redox pathways, via the production of •NO and oxidants by the family of NADPH oxidases, namely hydrogen peroxide (via Duox2), superoxide radical (via Nox1 and Nox2) and peroxynitrite, which leads to downstream activation of stress responses (Nrf2 and NFkB pathways) in the host mucosa. The activation of Nox2 by microbial metabolites is also discussed. Finally, we propose a new perspective in which both oral and gut microbiota communicate through redox pathways, with nitrate as the pivot linking both ecosystems.
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Affiliation(s)
- Beatriz Paiva
- Faculty of Pharmacy, University of Coimbra, Portugal
| | - João Laranjinha
- Faculty of Pharmacy, University of Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, Portugal
| | - Bárbara S Rocha
- Faculty of Pharmacy, University of Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, Portugal
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3
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Moran SP, Rosier BT, Henriquez FL, Burleigh MC. The effects of nitrate on the oral microbiome: a systematic review investigating prebiotic potential. J Oral Microbiol 2024; 16:2322228. [PMID: 38420038 PMCID: PMC10901185 DOI: 10.1080/20002297.2024.2322228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Background Nitrate (NO3-) has been suggested as a prebiotic for oral health. Evidence indicates dietary nitrate and nitrate supplements can increase the proportion of bacterial genera associated with positive oral health whilst reducing bacteria implicated in oral disease(s). In contrast, chlorhexidine-containing mouthwashes, which are commonly used to treat oral infections, promote dysbiosis of the natural microflora and may induce antimicrobial resistance. Methods A systematic review of the literature was undertaken, surrounding the effects of nitrate on the oral microbiota. Results Overall, n = 12 in vivo and in vitro studies found acute and chronic nitrate exposure increased (representatives of) health-associated Neisseria and Rothia (67% and 58% of studies, respectively) whilst reducing periodontal disease-associated Prevotella (33%). Additionally, caries-associated Veillonella and Streptococcus decreased (25% for both genera). Nitrate also altered oral microbiome metabolism, causing an increase in pH levels (n = 5), which is beneficial to limit caries development. Secondary findings highlighted the benefits of nitrate for systemic health (n = 5). Conclusions More clinical trials are required to confirm the impact of nitrate on oral communities. However, these findings support the hypothesis that nitrate could be used as an oral health prebiotic. Future studies should investigate whether chlorhexidine-containing mouthwashes could be replaced or complemented by a nitrate-rich diet or nitrate supplementation.
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Affiliation(s)
- Siobhan P. Moran
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, UK
| | - Bob T. Rosier
- Department of Health and Genomics, Center for Advanced Research in Public Health, FISABIO Foundation, Valencia, Spain
| | - Fiona L. Henriquez
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, UK
| | - Mia C. Burleigh
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, UK
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4
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Cato LE, McKay AKA, L’Heureux JE, Vanhatalo A, Jones AM, Askew CD, Slater GJ, Burke LM. Low Carbohydrate, High Fat Diet Alters the Oral Microbiome without Negating the Nitrite Response to Beetroot Juice Supplementation. Nutrients 2023; 15:5123. [PMID: 38140382 PMCID: PMC10745889 DOI: 10.3390/nu15245123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
A low carbohydrate, high fat (LCHF) diet in athletes increases fat oxidation but impairs sports performance, potentially due to impaired exercise economy. Dietary nitrate supplementation can improve exercise economy via an increase in nitric oxide production, which is initiated by the reduction of nitrate to nitrite within the oral cavity. This reaction is dependent on the presence of nitrate-reducing oral bacteria, which can potentially be altered by dietary changes, including a LCHF diet. This study explored the effect of a LCHF diet on the oral microbiome and subsequent changes to plasma nitrite concentration following nitrate supplementation. Following five days of LCHF or high carbohydrate (HCHO) control dietary intervention, highly trained male race walkers consumed 140 mL beetroot juice containing 8.4 mmol nitrate; they then provided (a) blood samples for plasma nitrate and nitrite analysis and (b) saliva samples for 16S rRNA sequencing of the oral microbiome. The LCHF diet (n = 13) reduced oral bacterial diversity and changed the relative abundance of the genera Neisseria (+10%), Fusobacteria (+3%), Prevotella (-9%), and Veillonella (-4%), with no significant changes observed following the HCHO diet (n = 11). Following beetroot juice ingestion, plasma nitrite concentrations were higher for the LCHF diet compared to the HCHO diet (p = 0.04). However, the absence of an interaction with the trial (pre-post) (p = 0.71) suggests that this difference was not due to the dietary intervention. In summary, we found an increase in plasma nitrate and nitrite concentrations in response to nitrate supplementation independent of diet. This suggests the oral microbiome is adaptive to dietary changes and can maintain a nitrate reduction capacity despite a decrease in bacterial diversity following the LCHF diet.
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Affiliation(s)
- Louise E. Cato
- School of Health, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia; (C.D.A.); (G.J.S.)
| | - Alannah K. A. McKay
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.K.A.M.); (L.M.B.)
| | - Joanna E. L’Heureux
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK; (J.E.L.); (A.V.); (A.M.J.)
| | - Anni Vanhatalo
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK; (J.E.L.); (A.V.); (A.M.J.)
| | - Andrew M. Jones
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK; (J.E.L.); (A.V.); (A.M.J.)
| | - Christopher D. Askew
- School of Health, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia; (C.D.A.); (G.J.S.)
| | - Gary J. Slater
- School of Health, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia; (C.D.A.); (G.J.S.)
| | - Louise M. Burke
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.K.A.M.); (L.M.B.)
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5
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Liu H, Huang Y, Huang M, Wang M, Ming Y, Chen W, Chen Y, Tang Z, Jia B. From nitrate to NO: potential effects of nitrate-reducing bacteria on systemic health and disease. Eur J Med Res 2023; 28:425. [PMID: 37821966 PMCID: PMC10566198 DOI: 10.1186/s40001-023-01413-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
Current research has described improving multisystem disease and organ function through dietary nitrate (DN) supplementation. They have provided some evidence that these floras with nitrate (NO3-) reductase are mediators of the underlying mechanism. Symbiotic bacteria with nitrate reductase activity (NRA) are found in the human digestive tract, including the mouth, esophagus and gastrointestinal tract (GT). Nitrate in food can be converted to nitrite under the tongue or in the stomach by these symbiotic bacteria. Then, nitrite is transformed to nitric oxide (NO) by non-enzymatic synthesis. NO is currently recognized as a potent bioactive agent with biological activities, such as vasodilation, regulation of cardiomyocyte function, neurotransmission, suppression of platelet agglutination, and prevention of vascular smooth muscle cell proliferation. NO also can be produced through the conventional L-arginine-NO synthase (L-NOS) pathway, whereas endogenous NO production by L-arginine is inhibited under hypoxia-ischemia or disease conditions. In contrast, exogenous NO3-/NO2-/NO activity is enhanced and becomes a practical supplemental pathway for NO in the body, playing an essential role in various physiological activities. Moreover, many diseases (such as metabolic or geriatric diseases) are primarily associated with disorders of endogenous NO synthesis, and NO generation from the exogenous NO3-/NO2-/NO route can partially alleviate the disease progression. The imbalance of NO in the body may be one of the potential mechanisms of disease development. Therefore, the impact of these floras with nitrate reductase on host systemic health through exogenous NO3-/NO2-/NO pathway production of NO or direct regulation of floras ecological balance is essential (e.g., regulation of body homeostasis, amelioration of diseases, etc.). This review summarizes the bacteria with nitrate reductase in humans, emphasizing the relationship between the metabolic processes of this microflora and host systemic health and disease. The potential effects of nitrate reduction bacteria on human health and disease were also highlighted in disease models from different human systems, including digestive, cardiovascular, endocrine, nervous, respiratory, and urinary systems, providing innovative ideas for future disease diagnosis and treatment based on nitrate reduction bacteria.
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Affiliation(s)
- Hongyu Liu
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yisheng Huang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Mingshu Huang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Min Wang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yue Ming
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Weixing Chen
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yuanxin Chen
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Zhengming Tang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Bo Jia
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China.
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6
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Janket SJ, Lee C, Surakka M, Jangam TG, Van Dyke TE, Baird AE, Meurman JH. Oral hygiene, mouthwash usage and cardiovascular mortality during 18.8 years of follow-up. Br Dent J 2023:10.1038/s41415-023-5507-4. [PMID: 36737459 PMCID: PMC9897600 DOI: 10.1038/s41415-023-5507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/01/2022] [Indexed: 02/05/2023]
Abstract
Aim(s) We tested the following hypotheses: would better oral hygiene self-care (OHS) influence cardiovascular (CVD) mortality? Will using mouthwash in addition to OHS affect CVD mortality? How does mouthwash usage impact the oral microbes?Design and methods Among 354 dentate subjects from the Kuopio Oral Health and Heart study, the association of OHS with CVD mortality was assessed using Cox regression analyses, adjusting for age, sex, smoking, dyslipidemia, diabetes, hypertension and education. Additionally, whether using mouthwash would affect this relationship was evaluated.Results In the multivariable-adjusted models, OHS was associated with a 51% reduction in the risk of CVD mortality (hazard ratio [HR] 0.49 [0.28-0.85]; p = 0.01). Even those who had coronary artery disease at baseline showed a marginally significant benefit (0.50 [0.24-1.06]; p = 0.07). However, mouthwash usage did not change OHS effects (HR = 0.49 [0.27-0.87]; p = 0.01), indicating no additional benefits nor detriments. All tested microbes trended to decrease with mouthwash usage in the short term, but none were statistically significant.Conclusion Good OHS significantly lowered the risk of CVD mortality relative to poor OHS. Mouthwash usage did not show any long-term harm or benefit on CVD mortality beyond the benefits rendered by brushing and flossing.
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Affiliation(s)
- Sok-Ja Janket
- The Forsyth Institute, Centre for Clinical and Translational Research, Cambridge, Massachusetts, USA.
| | - Caitlyn Lee
- Boston University Externship, Wheeler High School, Providence, Rhode Island, USA
| | - Markku Surakka
- Department of Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | | | - Thomas E Van Dyke
- The Forsyth Institute, Centre for Clinical and Translational Research, Cambridge, Massachusetts, USA
| | - Alison E Baird
- Department of Neurology, SUNY Downstate Medical Centre, Brooklyn, New York, USA
| | - Jukka H Meurman
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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7
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McMahon NF, Brooker PG, Pavey TG, Leveritt MD. Nitrate, nitrite and nitrosamines in the global food supply. Crit Rev Food Sci Nutr 2022; 64:2673-2694. [PMID: 36168920 DOI: 10.1080/10408398.2022.2124949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Inorganic nitrate provided by either nitrate salts or food supplements may improve cardiometabolic health. However, current methods to assess dietary nitrate, nitrite and nitrosamine consumption are inadequate. The purpose of this study was to develop a reference database to estimate the levels of nitrate, nitrite and nitrosamines in the global food supply. A systematic literature search was undertaken; of the 5,747 articles screened, 448 met the inclusion criteria. The final database included data for 1,980 food and beverages from 65 different countries. There were 5,105 unique records for nitrate, 2,707 for nitrite, and 954 for nitrosamine. For ease of use, data were sorted into 12 categories; regarding nitrate and nitrite concentrations in food and beverages, 'vegetables and herbs' were most reported in the literature (n = 3,268 and n = 1,200, respectively). For nitrosamines, 'protein foods of animal origin' were most reported (n = 398 records). This database will allow researchers and practitioners to confidently estimate dietary intake of nitrate, nitrite and nitrosamines. When paired with health data, our database can be used to investigate associations between nitrate intake and health outcomes, and/or exercise performance and could support the development of key dietary nitrate intake guidelines.
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Affiliation(s)
- Nicholas F McMahon
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Paige G Brooker
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Toby G Pavey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
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8
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Giordano-Kelhoffer B, Lorca C, March Llanes J, Rábano A, del Ser T, Serra A, Gallart-Palau X. Oral Microbiota, Its Equilibrium and Implications in the Pathophysiology of Human Diseases: A Systematic Review. Biomedicines 2022; 10:biomedicines10081803. [PMID: 36009350 PMCID: PMC9405223 DOI: 10.3390/biomedicines10081803] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 02/06/2023] Open
Abstract
Imbalances of the oral microbiota and dysbiosis have traditionally been linked to the occurrence of teeth and oral diseases. However, recent findings indicate that this microbiota exerts relevant influence in systemic health. Dysbiosis of the oral microbiota is implicated in the apparition and progression of cardiovascular, neurodegenerative and other major human diseases. In fact, the oral microbiota are the second most diverse and largely populated microbiota of the human body and its relationships with systemic health, although widely explored, they still lack of proper integration. The purpose of this systematic review is thus to widely examine the implications of oral microbiota in oral, cardiovascular and neurodegenerative diseases to offer integrative and up-to-date interpretations. To achieve that aim, we identified a total of 121 studies curated in PUBMED from the time interval January 2003–April 2022, which after careful screening resulted in 79 studies included. The reviewed scientific literature provides plausible vias of implication of dysbiotic oral microbiota in systemic human diseases, and encourages further research to continue elucidating the highly relevant and still poorly understood implications of this niche microbiota in systemic health. PROSPERO Registration Number: CRD42022299692. This systematic review follows relevant PRISMA guidelines.
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Affiliation(s)
- Barbara Giordano-Kelhoffer
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain;
- Bioengineering Institute of Technology, Faculty of Health Sciences, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
| | - Cristina Lorca
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
- IMDEA—Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, 8 Crta. Canto Blanco, 28049 Madrid, Spain
| | - Jaume March Llanes
- NeuroPGA Research Group—Psychology Department, University of Lleida (UdL), 25001 Lleida, Spain;
| | - Alberto Rábano
- Alzheimer’s Centre Reina Sofia—CIEN Foundation, 28031 Madrid, Spain; (A.R.); (T.d.S.)
| | - Teodoro del Ser
- Alzheimer’s Centre Reina Sofia—CIEN Foundation, 28031 Madrid, Spain; (A.R.); (T.d.S.)
| | - Aida Serra
- IMDEA—Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, 8 Crta. Canto Blanco, 28049 Madrid, Spain
- Correspondence: (A.S.); (X.G.-P.); Tel.: +34-91-7278-100 (A.S.); +34-97-3702-224 (X.G.-P.)
| | - Xavier Gallart-Palau
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida), Neuroscience Area, +Pec Proteomics Research Group (+PPRG), University Hospital Arnau de Vilanova (HUAV), 25198 Lleida, Spain;
- Psychology Department, University of Lleida (UdL), 25001 Lleida, Spain
- Correspondence: (A.S.); (X.G.-P.); Tel.: +34-91-7278-100 (A.S.); +34-97-3702-224 (X.G.-P.)
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9
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Quantifying the Impact of Algae Supplement on Blood Pressure: Systematic Review and Meta-analysis of Randomized Controlled Trials. Curr Probl Cardiol 2022; 47:101336. [PMID: 35870546 DOI: 10.1016/j.cpcardiol.2022.101336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/17/2022] [Indexed: 11/20/2022]
Abstract
The impact of Algae supplements and its extract on blood pressure has not concluded yet. The aim of this systematic review meta-analysis is to evaluate the antihypertensive activity of this group marine organism on human. Alga was used in some studies as capsules (from 500 mg to 8 g) and the follow-up duration changed from 17 days to 9 months. The difference in standardized mean and its corresponding 95% confidence interval (CI) was applied as the effect size of algae supplementation on systolic and diastolic blood pressure. Based on the results, a meta-analysis of 10 studies with baseline effect control demonstrated that there was no difference in the mean systolic blood pressure in the two groups SMD (95%CI): -1.05 (-2.85,0.76), but a significant difference in the mean diastolic blood pressure was observed and showed that the mean diastolic blood pressure in the treatment group was lower than the control group SMD(95%CI): -2.23 (-4.35,-0.11). A meta-analysis of 4 studies with no baseline control effect did not show significant results on both blood pressure. The evidence to support this systematic review meta-analysis requires more investigation and future large scale RCT clinical trial to confirm the results.
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10
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Goh CE, Bohn B, Marotz C, Molinsky R, Roy S, Paster BJ, Chen C, Rosenbaum M, Yuzefpolskaya M, Colombo PC, Desvarieux M, Papapanou PN, Jacobs DR, Knight R, Demmer RT. Nitrite Generating and Depleting Capacity of the Oral Microbiome and Cardiometabolic Risk: Results from ORIGINS. J Am Heart Assoc 2022; 11:e023038. [PMID: 35574962 PMCID: PMC9238569 DOI: 10.1161/jaha.121.023038] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background
The enterosalivary nitrate–nitrite–nitric oxide (NO
3
–NO
2
–NO) pathway generates NO following oral microbiota‐mediated production of salivary nitrite, potentially linking the oral microbiota to reduced cardiometabolic risk. Nitrite depletion by oral bacteria may also be important for determining the net nitrite available systemically. We examine if higher abundance of oral microbial genes favoring increased oral nitrite generation and decreased nitrite depletion is associated with a better cardiometabolic profile cross‐sectionally.
Methods and Results
This study includes 764 adults (mean [SD] age 32 [9] years, 71% women) enrolled in ORIGINS (Oral Infections, Glucose Intolerance, and Insulin Resistance Study). Microbial DNA from subgingival dental plaques underwent 16S rRNA gene sequencing; PICRUSt2 was used to estimate functional gene profiles. To represent the different components and pathways of nitrogen metabolism in bacteria, predicted gene abundances were operationalized to create summary scores by (1) bacterial nitrogen metabolic pathway or (2) biochemical product (NO
2
, NO, or ammonia [NH
3
]) formed by the action of the bacterial reductases encoded. Finally, nitrite generation‐to‐depletion ratios of gene abundances were created from the above summary scores. A composite cardiometabolic
Z
score was created from cardiometabolic risk variables, with higher scores associated with worse cardiometabolic health. We performed multivariable linear regression analysis with cardiometabolic
Z
score as the outcome and the gene abundance summary scores and ratios as predictor variables, adjusting for sex, age, race, and ethnicity in the simple adjusted model. A 1 SD higher NO versus NH
3
summary ratio was inversely associated with a −0.10 (false discovery rate
q
=0.003) lower composite cardiometabolic
Z
score in simple adjusted models. Higher NH
3
summary score (suggestive of nitrite depletion) was associated with higher cardiometabolic risk, with a 0.06 (false discovery rate
q
=0.04) higher composite cardiometabolic
Z
score.
Conclusions
Increased net capacity for nitrite generation versus depletion by oral bacteria, assessed through a metagenome estimation approach, is associated with lower levels of cardiometabolic risk.
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Affiliation(s)
- Charlene E. Goh
- Faculty of DentistryNational University of SingaporeSingapore
| | - Bruno Bohn
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | - Clarisse Marotz
- Department of PediatricsUniversity of California San DiegoLa JollaCA
| | - Rebecca Molinsky
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | - Sumith Roy
- Department of EpidemiologyMailman School of Public HealthColumbia UniversityNew YorkNY
| | - Bruce J. Paster
- The Forsyth InstituteCambridgeMA
- Department of Oral Medicine, Infection, and ImmunityHarvard School of Dental MedicineBostonMA
| | - Ching‐Yuan Chen
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesCollege of Dental MedicineColumbia UniversityNew YorkNY
| | - Michael Rosenbaum
- Division of Molecular GeneticsDepartments of Pediatrics and MedicineColumbia UniversityNew YorkNY
| | - Melana Yuzefpolskaya
- Division of CardiologyDepartment of MedicineNew York Presbyterian HospitalColumbia UniversityNew YorkNY
| | - Paolo C. Colombo
- Division of CardiologyDepartment of MedicineNew York Presbyterian HospitalColumbia UniversityNew YorkNY
| | - Moïse Desvarieux
- Department of EpidemiologyMailman School of Public HealthColumbia UniversityNew YorkNY
- INSERM UMR 1153Centre de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS)METHODS CoreParisFrance
| | - Panos N. Papapanou
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesCollege of Dental MedicineColumbia UniversityNew YorkNY
| | - David R. Jacobs
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | - Rob Knight
- Department of Computer Science & EngineeringJacobs School of EngineeringUniversity of California San DiegoLa JollaCA
- Department of BioengineeringUniversity of California San DiegoLa JollaCA
- Center for Microbiome InnovationUniversity of California San DiegoLa JollaCA
| | - Ryan T. Demmer
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
- Department of EpidemiologyMailman School of Public HealthColumbia UniversityNew YorkNY
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11
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Irwin SV, Deardorff LM, Deng Y, Fisher P, Gould M, June J, Kent RS, Qin Y, Yadao F. Sulfite preservatives effects on the mouth microbiome: Changes in viability, diversity and composition of microbiota. PLoS One 2022; 17:e0265249. [PMID: 35390016 PMCID: PMC8989357 DOI: 10.1371/journal.pone.0265249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/25/2022] [Indexed: 11/26/2022] Open
Abstract
OVERVIEW Processed foods make up about 70 percent of the North American diet. Sulfites and other food preservatives are added to these foods largely to limit bacterial contamination. The mouth microbiota and its associated enzymes are the first to encounter food and therefore likely to be the most affected. METHODS Eight saliva samples from ten individuals were exposed to two sulfite preservatives, sodium sulfite and sodium bisulfite. One sample set was evaluated for bacteria composition utilizing 16s rRNA sequencing, and the number of viable cells in all sample sets was determined utilizing ATP assays at 10 and 40-minute exposure times. All untreated samples were analyzed for baseline lysozyme activity, and possible correlations between the number of viable cells and lysozyme activity. RESULTS Sequencing indicated significant increases in alpha diversity with sodium bisulfite exposure and changes in relative abundance of 3 amplicon sequence variants (ASV). Sodium sulfite treated samples showed a significant decrease in the Firmicutes/Bacteroidetes ratio, a marginally significant change in alpha diversity, and a significant change in the relative abundance for Proteobacteria, Firmicutes, Bacteroidetes, and for 6 ASVs. Beta diversity didn't show separation between groups, however, all but one sample set was observed to be moving in the same direction under sodium sulfite treatment. ATP assays indicated a significant and consistent average decrease in activity ranging from 24-46% at both exposure times with both sulfites. Average initial rates of lysozyme activity between all individuals ranged from +/- 76% compared to individual variations of +/- 10-34%. No consistent, significant correlation was found between ATP and lysozyme activity in any sample sets. CONCLUSIONS Sulfite preservatives, at concentrations regarded as safe by the FDA, alter the relative abundance and richness of the microbiota found in saliva, and decrease the number of viable cells, within 10 minutes of exposure.
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Affiliation(s)
- Sally V. Irwin
- Department of Science, Technology, Engineering and Mathematics, University of Hawai’i Maui College, Kahului, Hawai’i, United States of America
| | - Luz Maria Deardorff
- Department of Natural Sciences, University of Hawai’i at Manoa, Honolulu, Hawai’i, United States of America
| | - Youping Deng
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawai’I, United States of America
| | - Peter Fisher
- Department of Science, Technology, Engineering and Mathematics, University of Hawai’i Maui College, Kahului, Hawai’i, United States of America
| | - Michelle Gould
- Department of Science, Technology, Engineering and Mathematics, University of Hawai’i Maui College, Kahului, Hawai’i, United States of America
| | - Junnie June
- Department of Science, Technology, Engineering and Mathematics, University of Hawai’i Maui College, Kahului, Hawai’i, United States of America
| | - Rachael S. Kent
- Department of Science, Technology, Engineering and Mathematics, University of Hawai’i Maui College, Kahului, Hawai’i, United States of America
| | - Yujia Qin
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawai’I, United States of America
| | - Fracesca Yadao
- Department of Science, Technology, Engineering and Mathematics, University of Hawai’i Maui College, Kahului, Hawai’i, United States of America
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12
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Morou-Bermúdez E, Torres-Colón JE, Bermúdez NS, Patel RP, Joshipura KJ. Pathways Linking Oral Bacteria, Nitric Oxide Metabolism, and Health. J Dent Res 2022; 101:623-631. [PMID: 35081826 DOI: 10.1177/00220345211064571] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Nitrate-reducing oral bacteria have gained a lot of interest due to their involvement in nitric oxide (NO) synthesis and its important cardiometabolic outcomes. Consortia of nitrate-metabolizing oral bacteria associated with cardiometabolic health and cognitive function have been recently identified. Longitudinal studies and clinical trials have shown that chronic mouthwash use is associated with increased blood pressure and increased risk for prediabetes/diabetes and hypertension. Concurrently, recent studies are beginning to shed some light on the complexity of nitrate reduction pathways of oral bacteria, such as dissimilatory nitrate reduction to ammonium (DNRA), which converts nitrite into ammonium, and denitrification, which converts nitrite to NO, nitrous oxide, and dinitrogen. These pathways can affect the composition and metabolism of the oral microbiome; consequently, salivary nitrate and nitrite metabolism have been proposed as targets for probiotics and oral health. These pathways could also affect systemic NO levels because NO generated through denitrification can be oxidized back to nitrite in the saliva, thus facilitating flux along the NO3--NO2--NO pathway, while DNRA converts nitrite to ammonium, leading to reduced NO. It is, therefore, important to understand which pathway predominates under different oral environmental conditions, since the clinical consequences could be different for oral and systemic health. Recent studies show that oral hygiene measures such as tongue cleaning and dietary nitrate are likely to favor denitrifying bacteria such as Neisseria, which are linked with better cardiometabolic health. A vast body of literature demonstrates that redox potential, carbon-to-nitrate ratio, and nitrate-to-nitrite ratio are key environmental drivers of the competing denitrification and DNRA pathways in various natural and artificial ecosystems. Based on this information, a novel behavioral and microbial model for nitric oxide metabolism and health is proposed, which links lifestyle factors with oral and systemic health through NO metabolism.
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Affiliation(s)
- E Morou-Bermúdez
- University of Puerto Rico Medical Sciences Campus, School of Dental Medicine, San Juan, Puerto Rico
| | - J E Torres-Colón
- University of Puerto Rico Medical Sciences Campus, School of Dental Medicine, San Juan, Puerto Rico
| | - N S Bermúdez
- Department of Linguistics, Harvard University, Cambridge, MA, USA
| | - R P Patel
- Department of Pathology, University of Alabama at Birmingham and Center for Free Radical Biology, AL, USA
| | - K J Joshipura
- University of Puerto Rico Medical Sciences Campus, School of Dental Medicine, San Juan, Puerto Rico.,T. H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
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13
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Daniele S, Scarfò G, Ceccarelli L, Fusi J, Zappelli E, Biagini D, Lomonaco T, Di Francesco F, Franzoni F, Martini C. The Mediterranean Diet Positively Affects Resting Metabolic Rate and Salivary Microbiota in Human Subjects: A Comparison with the Vegan Regimen. BIOLOGY 2021; 10:biology10121292. [PMID: 34943207 PMCID: PMC8699008 DOI: 10.3390/biology10121292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 01/02/2023]
Abstract
Simple Summary Salivary microbiota has been shown to be individualized and influenced by genetic and environmental factors, including macronutrient intake and lifestyle. Herein, the effect of two long-term dietary patterns, the Mediterranean and the vegan diet, was analyzed on oral microbiota composition and metabolic profile of human subjects. Moreover, we correlated microbial species to metabolic parameters. Subjects following the Mediterranean diet had a wider spectrum of oral bacteria and a better metabolic profile compared to the vegan diet, confirming the positive effects of a Mediterranean diet. Abstract Salivary microbiota, comprising bacteria shed from oral surfaces, has been shown to be individualized, temporally stable, and influenced by macronutrient intake and lifestyle. Nevertheless, the effect of long-term dietary patterns on oral microbiota composition and the relationship between oral microbiota composition and metabolic rate remains to be examined. Herein, salivary microbiota composition and metabolic profile were analyzed in human subjects with vegan (VEG) or Mediterranean (MED) long-term dietary patterns. MED subjects presented significantly higher percentages of Subflava and Prevotella species as compared to VEG ones. Moreover, MED subjects showed a lower carbohydrate and a higher lipid consumption than VEG subjects, and, accordingly, a significantly higher basal metabolic rate (BMR) and a lower respiratory quotient (RQ). Prevotella abundance was demonstrated to be inversely related to RQ and carbohydrate consumption, whereas Subflava percentages were demonstrated to be positively correlated to BMR. Lactobacillus abundance, which was inversely related to Subflava presence in MED subjects, was associated with decreased BMR (Harris–Benedict) values. Overall, our data evidence the influence of macronutrient intake on metabolic profile and oral microbiota and confirm the positive effects of the Mediterranean diet on BMR and on the abundance of microbial species associated with a better macronutrient metabolism.
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Affiliation(s)
- Simona Daniele
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (S.D.); (L.C.); (E.Z.); (C.M.)
| | - Giorgia Scarfò
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126 Pisa, Italy; (G.S.); (J.F.)
| | - Lorenzo Ceccarelli
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (S.D.); (L.C.); (E.Z.); (C.M.)
- Department of Biotechnology, Chemistry, and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Jonathan Fusi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126 Pisa, Italy; (G.S.); (J.F.)
| | - Elisa Zappelli
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (S.D.); (L.C.); (E.Z.); (C.M.)
| | - Denise Biagini
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi 13, 56126 Pisa, Italy; (D.B.); (T.L.); (F.D.F.)
| | - Tommaso Lomonaco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi 13, 56126 Pisa, Italy; (D.B.); (T.L.); (F.D.F.)
| | - Fabio Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi 13, 56126 Pisa, Italy; (D.B.); (T.L.); (F.D.F.)
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126 Pisa, Italy; (G.S.); (J.F.)
- Correspondence: ; Tel.: +39-050-2211857; Fax: +39-050-40834
| | - Claudia Martini
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; (S.D.); (L.C.); (E.Z.); (C.M.)
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14
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Brookes ZLS, Belfield LA, Ashworth A, Casas-Agustench P, Raja M, Pollard AJ, Bescos R. Effects of chlorhexidine mouthwash on the oral microbiome. J Dent 2021; 113:103768. [PMID: 34418463 DOI: 10.1016/j.jdent.2021.103768] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/11/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION/OBJECTIVES Chlorhexidine (CHX) is a commonly used mouthwash with potent anti-microbial effects useful for the management of oral disease. However, we are moving away from the view of simply 'killing' bacteria, towards managing oral microbial ecosystems (oral microbiome), as an integrated system, to promote oral and systemic health. Here, we aimed to review the effects of CHX mouthwash on the balance of microbial communities in the mouth in vivo in oral health and disease. SOURCES AND STUDY SECTION The hierarchy of evidence was applied, with systematic reviews and randomised controlled trials consulted where available and case controlled studies being described thereafter. Search terms for each subject category were entered into MEDLINE, PubMed, Google Scholar and the Cochrane database. Focussing on metagenomics studies provides unique overview of the oral microbiome as an integrated system. DATA Evidence was limited, but several next generation sequencing case-controlled studies suggested that in an integrated system, CHX may cause a shift towards lower bacterial diversity and abundance, in particular nitrate-reducing bacteria in vivo. CHX also appeared to alter salivary pH, lactate, nitrate and nitrite concentrations in saliva. Evidence regarding the effects of CHX on the oral microbiome during oral disease is still emerging. CONCLUSIONS CHX alters the composition the oral microbiome. However, as CHX use remains widespread in dentistry to manage oral disease, urgent research using metagenomics studies of microbial communities in vivo are still needed to determine CHX mouthwash is 'good', 'bad' or otherwise for bacteria, in the context of oral and systemic health.
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Affiliation(s)
- Zoë L S Brookes
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, PL4 8AA, United Kingdom.
| | - Louise A Belfield
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, PL4 8AA, United Kingdom
| | - Ann Ashworth
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, United Kingdom
| | - Patricia Casas-Agustench
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, PL4 8AA, United Kingdom; Department of Health Sciences, Open University of Catalonia, Barcelona, Spain
| | | | - Alexander J Pollard
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, PL4 8AA, United Kingdom; Bristol Dental School, University of Bristol, Bristol BS1 2LY, United Kingdom
| | - Raul Bescos
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, PL4 8AA, United Kingdom.
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15
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Bahrami LS, Arabi SM, Feizy Z, Rezvani R. The effect of beetroot inorganic nitrate supplementation on cardiovascular risk factors: A systematic review and meta-regression of randomized controlled trials. Nitric Oxide 2021; 115:8-22. [PMID: 34119659 DOI: 10.1016/j.niox.2021.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/18/2021] [Accepted: 06/07/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Inorganic nitrate is one of the most effective compounds in beetroot for improving cardiovascular function due to its conversion to nitric oxide in the body. This review and meta-analysis aimed to investigate the role of beetroot inorganic nitrate supplementation on adults' cardiovascular risk factors. METHODS We conducted a systematic literature review of articles published without time limitation until November 2020 in PubMed, Embase, ISI Web of Science, Scopus, Cochrane Library, and gray literature databases. We included the original randomized clinical trials (RCTs) in which the effect of beetroot inorganic nitrate supplementation on endothelial function, arterial stiffness, and blood pressure was studied. RESULTS 43 studies were included for qualitative synthesis, out of which 27 were eligible for meta-analysis. Beetroot inorganic nitrate supplementation significantly decreased Arterial Stiffness (Pulse Wave Velocity (-0.27 m/s, p = 0.04)) and increased Endothelial function (Flow Mediated Dilation: 0.62%, p = 0.002) but did not change other parameters (p > 0.05). CONCLUSION Beetroot inorganic nitrate supplementation might have a beneficial effect on cardiovascular risk factors. Further high-quality investigations will be needed to provide sufficient evidence.
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Affiliation(s)
- Leila Sadat Bahrami
- Metabolic Syndrome Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyyed Mostafa Arabi
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran.
| | - Zahra Feizy
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX79414, USA.
| | - Reza Rezvani
- Metabolic Syndrome Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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16
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Muñoz Aguilera E, Leira Y, Miró Catalina Q, Orlandi M, Czesnikiewicz-Guzik M, Guzik TJ, Hingorani AD, Nart J, D'Aiuto F. Is systemic inflammation a missing link between periodontitis and hypertension? Results from two large population-based surveys. J Intern Med 2021; 289:532-546. [PMID: 32969093 DOI: 10.1111/joim.13180] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/13/2020] [Accepted: 09/02/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The primary objective was to investigate the relationship between periodontitis and hypertension in two independent large surveys. The secondary objective was to ascertain whether systemic inflammation had a mediation effect in the association. METHODS This cross-sectional study analysed representative samples of the US (n = 3460; NHANES 2009/10) and Korean (n = 4539; 2015 KNHANES VI-3) populations. The association between periodontitis (exposure), hypertension (outcome) and inflammatory markers [C-reactive protein (CRP) and white blood cell counts (WBC)] (mediators) was assessed using multivariate linear and logistic regression models and mediation analysis. RESULTS Participants with periodontitis were more likely to have hypertension (NHANES: OR = 1.3, 95% CI: 1.0-1.6, P = 0.025; KNHANES: OR = 1.2, 95% CI: 1.0-1.4, P = 0.041) and actual systolic blood pressure ≥ 140 mmHg (NHANES: OR = 1.6, 95% CI: 1.1-2.3, P < 0.001; KNHANES: OR = 1.3, 95% CI :1.0-1.6, P < 0.031) than those without the disease. These associations were independent of age, gender, BMI, education level, smoking, alcohol consumption, creatinine, physical activity, presence of other comorbidities and confirmed in participants not taking antihypertensive medications. Diagnosis of periodontitis was directly associated with WBC (in both surveys: NHANES: β ± SE = 0.3 ± 0.1, P < 0.004; KNHANES: β ± SE = 0.3 ± 0.1, P < 0.001) and with CRP levels (in one survey: NHANES: β ± SE = 0.1 ± 0.03, P < 0.007; KNHANES: β ± SE = 0.1 ± 0.04, P > 0.213). Mediation analyses confirmed that CRP acted as a mediator in the association between periodontitis and hypertension in both populations (mediated effect: NHANES: β ± SE = 0.010 ± 0.003, P < 0.001; KNHANES: β ± SE = 0.003 ± 0.001, P = 0.015). WBC acted as a mediator in the KNHANES (mediated effect: β ± SE = 0.004 ± 0.001, P = 0.004) whilst in the NHANES, its effect was dependent of CRP inclusion in the model (mediated effect WBC + CRP: β ± SE = 0.002 ± 0.001, P = 0.001). CONCLUSIONS These findings suggest that periodontitis is closely linked to hypertension and systemic inflammation is, in part, a mediator of this association.
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Affiliation(s)
- E Muñoz Aguilera
- From the, Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK.,Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Y Leira
- From the, Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK.,Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Q Miró Catalina
- Department of Statistics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - M Orlandi
- From the, Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - M Czesnikiewicz-Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow, UK.,Department of Experimental Dentistry and Dental Prophylaxis, Jagiellonian University, Krakow, Poland
| | - T J Guzik
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Department of Internal and Agricultural Medicine, Jagiellonian University, Krakow, Poland
| | - A D Hingorani
- Genetic Epidemiology, Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | - J Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - F D'Aiuto
- From the, Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
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17
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Ahmed KA, Kim K, Ricart K, Van Der Pol W, Qi X, Bamman MM, Behrens C, Fisher G, Boulton ME, Morrow C, O'Neal PV, Patel RP. Potential role for age as a modulator of oral nitrate reductase activity. Nitric Oxide 2021; 108:1-7. [PMID: 33321206 PMCID: PMC8085911 DOI: 10.1016/j.niox.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023]
Abstract
Reduction of salivary nitrate to nitrite by oral nitrate reductase (NR) expressing bacteria has emerged as an integral pathway in regulating nitric oxide (NO) homeostasis and signaling. The oral microbiome is critical for this pathway. Variations in this pathway may underlie variable responses in the magnitude by which dietary or therapeutic nitrate modulates NO-signaling. The relationships between oral microbes and NR activity, and the factors that affect this relationship remain unclear however. Using a cross-sectional study design, the objective of this study was to determine the relationships between oral microbes and oral NR activity using a protocol that directly measures initial NR activity. Tongue swabs were collected from 28 subjects ranging in age from 21 to 73y. Initial NR activity showed a bell-shaped dependence with age, with activity peaking at ~40-50y and being lower but similar between younger (20-30y) and older (51-73) individuals. Microbiome relative abundance and diversity analyses, using 16s sequencing, demonstrated differences across age and identified both NR expressing and non-expressing bacteria in modulating initial NR activity. Finally, initial NR activity was measured in 3mo and 13mo old C57BL/6J mice. No differences in bacterial number were observed. However initial NR activity was significantly (80%) lower in 13mo old mice. Collectively, these data suggest that age is a variable in NR activity and may modulate responsiveness to dietary nitrate.
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Affiliation(s)
- Khandaker Ahtesham Ahmed
- Department of Pathology and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kiyoung Kim
- Department of Pathology and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Pharmacology & Experimental Therapeutics and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - Karina Ricart
- Department of Pathology and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William Van Der Pol
- Center for Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, USA
| | - Xiaoping Qi
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcas M Bamman
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christian Behrens
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gordon Fisher
- Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael E Boulton
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Casey Morrow
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pamela V O'Neal
- College of Nursing, University of Alabama in Huntsville, Huntsville, AL, USA
| | - Rakesh P Patel
- Department of Pathology and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA.
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18
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Jones AM, Vanhatalo A, Seals DR, Rossman MJ, Piknova B, Jonvik KL. Dietary Nitrate and Nitric Oxide Metabolism: Mouth, Circulation, Skeletal Muscle, and Exercise Performance. Med Sci Sports Exerc 2021; 53:280-294. [PMID: 32735111 DOI: 10.1249/mss.0000000000002470] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Nitric oxide (NO) is a gaseous signaling molecule that plays an important role in myriad physiological processes, including the regulation of vascular tone, neurotransmission, mitochondrial respiration, and skeletal muscle contractile function. NO may be produced via the canonical NO synthase-catalyzed oxidation of l-arginine and also by the sequential reduction of nitrate to nitrite and then NO. The body's nitrate stores can be augmented by the ingestion of nitrate-rich foods (primarily green leafy vegetables). NO bioavailability is greatly enhanced by the activity of bacteria residing in the mouth, which reduce nitrate to nitrite, thereby increasing the concentration of circulating nitrite, which can be reduced further to NO in regions of low oxygen availability. Recent investigations have focused on promoting this nitrate-nitrite-NO pathway to positively affect indices of cardiovascular health and exercise tolerance. It has been reported that dietary nitrate supplementation with beetroot juice lowers blood pressure in hypertensive patients, and sodium nitrite supplementation improves vascular endothelial function and reduces the stiffening of large elastic arteries in older humans. Nitrate supplementation has also been shown to enhance skeletal muscle function and to improve exercise performance in some circumstances. Recently, it has been established that nitrate concentration in skeletal muscle is much higher than that in blood and that muscle nitrate stores are exquisitely sensitive to dietary nitrate supplementation and deprivation. In this review, we consider the possibility that nitrate represents an essential storage form of NO and discuss the integrated function of the oral microbiome, circulation, and skeletal muscle in nitrate-nitrite-NO metabolism, as well as the practical relevance for health and performance.
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Affiliation(s)
- Andrew M Jones
- Department of Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Anni Vanhatalo
- Department of Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Barbora Piknova
- Molecular Medicine Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
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19
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Bescos R, Brookes ZL, Belfield LA, Fernandez-Sanjurjo M, Casas-Agustench P. Modulation of oral microbiota: A new frontier in exercise supplementation. PHARMANUTRITION 2020. [DOI: 10.1016/j.phanu.2020.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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González-Soltero R, Bailén M, de Lucas B, Ramírez-Goercke MI, Pareja-Galeano H, Larrosa M. Role of Oral and Gut Microbiota in Dietary Nitrate Metabolism and Its Impact on Sports Performance. Nutrients 2020; 12:E3611. [PMID: 33255362 PMCID: PMC7760746 DOI: 10.3390/nu12123611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/30/2020] [Accepted: 11/20/2020] [Indexed: 12/20/2022] Open
Abstract
Nitrate supplementation is an effective, evidence-based dietary strategy for enhancing sports performance. The effects of dietary nitrate seem to be mediated by the ability of oral bacteria to reduce nitrate to nitrite, thus increasing the levels of nitrite in circulation that may be further reduced to nitric oxide in the body. The gut microbiota has been recently implicated in sports performance by improving muscle function through the supply of certain metabolites. In this line, skeletal muscle can also serve as a reservoir of nitrate. Here we review the bacteria of the oral cavity involved in the reduction of nitrate to nitrite and the possible changes induced by nitrite and their effect on gastrointestinal balance and gut microbiota homeostasis. The potential role of gut bacteria in the reduction of nitrate to nitrite and as a supplier of the signaling molecule nitric oxide to the blood circulation and muscles has not been explored in any great detail.
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Affiliation(s)
- Rocío González-Soltero
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.B.); (M.I.R.-G.)
| | - María Bailén
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.B.); (M.I.R.-G.)
| | - Beatriz de Lucas
- Faculty of Sports Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (B.d.L.); (H.P.-G.); (M.L.)
| | - Maria Isabel Ramírez-Goercke
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.B.); (M.I.R.-G.)
| | - Helios Pareja-Galeano
- Faculty of Sports Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (B.d.L.); (H.P.-G.); (M.L.)
| | - Mar Larrosa
- Faculty of Sports Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (B.d.L.); (H.P.-G.); (M.L.)
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Fernández-Elías V, Courel-Ibáñez J, Pérez-López A, Jodra P, Moreno-Pérez V, Coso JD, López-Samanes Á. Acute Beetroot Juice Supplementation Does Not Improve Match-Play Activity in Professional Tennis Players. J Am Coll Nutr 2020; 41:30-37. [PMID: 33180007 DOI: 10.1080/07315724.2020.1835585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Beetroot juice is a source of dietary nitrate (NO3-) recognized as a potential ergogenic aid to enhance tolerance during endurance exercise of submaximal-to-maximal intensity. However, little is known about the effects of beetroot juice on exercise performance in intermittent sports such as tennis. The present study aimed to determine the effect of acute beetroot juice supplementation on movement patterns during a competitive tennis match in professional players. METHODS In a double-blind and randomized experiment, nine professional tennis players performed two experimental trials 3 h after ingesting either 70 mL of a commercially-available concentrated beetroot juice (6.4 mmol NO3-) or placebo (0.005 mmol NO3-). In each experimental trial, players completed a 3-set tennis match and two performance tests (i.e., serve speed and isometric handgrip strength) before and after the match. Match-play running performance was recorded using wearable GPS and accelerometer units. RESULTS In comparison to the placebo trial, the acute beetroot juice supplementation did not modify any match-play running performance (p = 0.178 to 0.997, d = 0.01 to 0.42). Furthermore, beetroot juice supplementation did not alter the pre-to-post match change in serve speed (p = 0.663, ηp2 = 0.03) or isometric handgrip strength (p = 0.219, ηp2 = 0.18). CONCLUSIONS The current results indicated that acute ingestion of a commercialized shot of nitrate-rich beetroot juice (70 mL containing 6.4 mmol of NO3-) did not produce any performance benefit on tennis matchplay. Thus, acute beetroot juice supplementation seems an ergogenic aid with little value to enhance physical performance in professional tennis players.
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Affiliation(s)
| | | | - Alberto Pérez-López
- Department of Biomedical Sciences, Area of Sport and Physical Education, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - Pablo Jodra
- Department of Education Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Victor Moreno-Pérez
- Department of Pathology and Surgery, Center for Translational Research in Physiotherapy, Universidad Miguel Hernández, San Juan, Spain
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain
| | - Álvaro López-Samanes
- School of Physiotherapy, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
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22
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Rowland SN, Chessor R, French G, Robinson GP, O'Donnell E, James LJ, Bailey SJ. Oral nitrate reduction is not impaired after training in chlorinated swimming pool water in elite swimmers. Appl Physiol Nutr Metab 2020; 46:86-89. [PMID: 32835490 DOI: 10.1139/apnm-2020-0357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study tested the hypothesis that exposure to chlorine-sterilised pool water would impair oral nitrate reduction (ONR). ONR was assessed in elite swimmers before and after morning and afternoon pool-based training. Nonswimmers were only assessed in the morning. ONR was similar in swimmers and nonswimmers (P = 1.000) and unchanged before and after morning and afternoon training (P ≥ 0.341). Therefore, exposure to chlorinated pool water does not interfere with ONR. Novelty Exposure to chlorine-sterilised pool water does not impair oral nitrate reduction in elite swimmers.
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Affiliation(s)
- Samantha N Rowland
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Richard Chessor
- British Swimming, Loughborough University, Loughborough LE11 3TU, UK
| | - George French
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - George P Robinson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Emma O'Donnell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
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23
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Bescos R, Ashworth A, Cutler C, Brookes ZL, Belfield L, Rodiles A, Casas-Agustench P, Farnham G, Liddle L, Burleigh M, White D, Easton C, Hickson M. Effects of Chlorhexidine mouthwash on the oral microbiome. Sci Rep 2020; 10:5254. [PMID: 32210245 PMCID: PMC7093448 DOI: 10.1038/s41598-020-61912-4] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/26/2020] [Indexed: 11/12/2022] Open
Abstract
Following a single blind, cross-over and non-randomized design we investigated the effect of 7-day use of chlorhexidine (CHX) mouthwash on the salivary microbiome as well as several saliva and plasma biomarkers in 36 healthy individuals. They rinsed their mouth (for 1 min) twice a day for seven days with a placebo mouthwash and then repeated this protocol with CHX mouthwash for a further seven days. Saliva and blood samples were taken at the end of each treatment to analyse the abundance and diversity of oral bacteria, and pH, lactate, glucose, nitrate and nitrite concentrations. CHX significantly increased the abundance of Firmicutes and Proteobacteria, and reduced the content of Bacteroidetes, TM7, SR1 and Fusobacteria. This shift was associated with a significant decrease in saliva pH and buffering capacity, accompanied by an increase in saliva lactate and glucose levels. Lower saliva and plasma nitrite concentrations were found after using CHX, followed by a trend of increased systolic blood pressure. Overall, this study demonstrates that mouthwash containing CHX is associated with a major shift in the salivary microbiome, leading to more acidic conditions and lower nitrite availability in healthy individuals.
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Affiliation(s)
- Raul Bescos
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK.
| | - Ann Ashworth
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Craig Cutler
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Zoe L Brookes
- Peninsula Dental School, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Louise Belfield
- Peninsula Dental School, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Ana Rodiles
- School of Biological and Marine Sciences, University of Plymouth, Plymouth, PL4 8AA, UK
| | | | - Garry Farnham
- Peninsula Medical School, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Luke Liddle
- School of Social Sciences, Bishop Grosseteste University, Lincolnshire, LN1 3DY, UK.,Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, G72 0LH, UK
| | - Mia Burleigh
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, G72 0LH, UK
| | - Desley White
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, G72 0LH, UK
| | - Mary Hickson
- Institute of Health & Community, University of Plymouth, Plymouth, PL4 8AA, UK
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24
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Cutler C, Kiernan M, Willis JR, Gallardo-Alfaro L, Casas-Agustench P, White D, Hickson M, Gabaldon T, Bescos R. Post-exercise hypotension and skeletal muscle oxygenation is regulated by nitrate-reducing activity of oral bacteria. Free Radic Biol Med 2019; 143:252-259. [PMID: 31369841 DOI: 10.1016/j.freeradbiomed.2019.07.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/04/2019] [Accepted: 07/28/2019] [Indexed: 12/11/2022]
Abstract
Post-exercise hypotension (PEH) is a common physiological phenomenon leading to lower blood pressure after acute exercise, but it is not fully understood how this intriguing response occurs. This study investigated whether the nitrate-reducing activity of oral bacteria is a key mechanism to trigger PEH. Following a randomized, double blind and crossover design, twenty-three healthy individuals (15 males/8 females) completed two treadmill trials at moderate intensity. After exercise, participants rinsed their mouth with antibacterial mouthwash to inhibit the activity of oral bacteria or a placebo mouthwash. Blood pressure was measured before, 1h and 2 h after exercise. The microvascular response to a reactive hyperaemia test, as well as blood and salivary samples were taken before and 2 h after exercise to analyse nitrate and nitrite concentrations and the oral microbiome. As expected, systolic blood pressure (SBP) was lower (1 h: -5.2 ± 1.0 mmHg; P < 0.001); 2 h: -3.8 ± 1.1 mmHg, P = 0.005) after exercise compared to baseline in the placebo condition. This was accompanied by an increase of circulatory nitrite 2 h after exercise (2h: 100 ± 13 nM) compared to baseline (59 ± 9 nM; P = 0.013). Additionally, an increase in the peak of the tissue oxygenation index (TOI) during the reactive hyperaemia response was observed after exercise (86.1 ± 0.6%) compared to baseline levels (84.8 ± 0.5%; P = 0.010) in the placebo condition. On the other hand, the SBP-lowering effect of exercise was attenuated by 61% at 1 h in the recovery period, and it was fully attenuated 2 h after exercise with antibacterial mouthwash. This was associated with a lack of changes in circulatory nitrite (P > 0.05), and impaired microvascular response (peak TOI baseline: 85.1 ± 3.1%; peak TOI post-exercise: 84.6 ± 3.2%; P > 0.05). Diversity of oral bacteria did not change after exercise in any treatment. These findings show that nitrite synthesis by oral commensal bacteria is a key mechanism to induce the vascular response to exercise over the first period of recovery thereby promoting lower blood pressure and greater muscle oxygenation.
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Affiliation(s)
- C Cutler
- Institute of Health & Community, University of Plymouth, Plymouth, UK
| | - M Kiernan
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | - J R Willis
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science & Technology, Barcelona, Spain
| | - L Gallardo-Alfaro
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & CIBEROBN (CB12/03/30038), Palma de Mallorca, Spain
| | - P Casas-Agustench
- Institute of Health & Community, University of Plymouth, Plymouth, UK
| | - D White
- Institute of Health & Community, University of Plymouth, Plymouth, UK
| | - M Hickson
- Institute of Health & Community, University of Plymouth, Plymouth, UK
| | - T Gabaldon
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science & Technology, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Institució Catalana de Recerca I Estudis Avançats (ICREA), Barcelona, Spain
| | - R Bescos
- Institute of Health & Community, University of Plymouth, Plymouth, UK.
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25
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Next Generation Sequencing Discoveries of the Nitrate-Responsive Oral Microbiome and Its Effect on Vascular Responses. J Clin Med 2019; 8:jcm8081110. [PMID: 31357429 PMCID: PMC6723919 DOI: 10.3390/jcm8081110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease is a worldwide human condition which has multiple underlying contributing factors: one of these is long-term increased blood pressure—hypertension. Nitric oxide (NO) is a small nitrogenous radical species that has a number of physiological functions including vasodilation. It can be produced enzymatically through host nitric oxide synthases and by an alternative nitrate–nitrite–NO pathway from ingested inorganic nitrate. It was discovered that this route relies on the ability of the oral microbiota to reduce nitrate to nitrite and NO. Next generation sequencing has been used over the past two decades to gain deeper insight into the microbes involved, their location and the effect of their removal from the oral cavity. This review article presents this research and comments briefly on future directions.
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