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Soffritti I, D’Accolti M, Fabbri C, Passaro A, Manfredini R, Zuliani G, Libanore M, Franchi M, Contini C, Caselli E. Oral Microbiome Dysbiosis Is Associated With Symptoms Severity and Local Immune/Inflammatory Response in COVID-19 Patients: A Cross-Sectional Study. Front Microbiol 2021; 12:687513. [PMID: 34248910 PMCID: PMC8261071 DOI: 10.3389/fmicb.2021.687513] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022] Open
Abstract
The human oral microbiome (HOM) is the second largest microbial community after the gut and can impact the onset and progression of several localized and systemic diseases, including those of viral origin, especially for viruses entering the body via the oropharynx. However, this important aspect has not been clarified for the new pandemic human coronavirus SARS-CoV-2, causing COVID-19 disease, despite it being one of the many respiratory viruses having the oropharynx as the primary site of replication. In particular, no data are available about the non-bacterial components of the HOM (fungi, viruses), which instead has been shown to be crucial for other diseases. Consistent with this, this study aimed to define the HOM in COVID-19 patients, to evidence any association between its profile and the clinical disease. Seventy-five oral rinse samples were analyzed by Whole Genome Sequencing (WGS) to simultaneously identify oral bacteria, fungi, and viruses. To correlate the HOM profile with local virus replication, the SARS-CoV-2 amount in the oral cavity was quantified by digital droplet PCR. Moreover, local inflammation and secretory immune response were also assessed, respectively by measuring the local release of pro-inflammatory cytokines (L-6, IL-17, TNFα, and GM-CSF) and the production of secretory immunoglobulins A (sIgA). The results showed the presence of oral dysbiosis in COVID-19 patients compared to matched controls, with significantly decreased alpha-diversity value and lower species richness in COVID-19 subjects. Notably, oral dysbiosis correlated with symptom severity (p = 0.006), and increased local inflammation (p < 0.01). In parallel, a decreased mucosal sIgA response was observed in more severely symptomatic patients (p = 0.02), suggesting that local immune response is important in the early control of virus infection and that its correct development is influenced by the HOM profile. In conclusion, the data presented here suggest that the HOM profile may be important in defining the individual susceptibility to SARS-CoV-2 infection, facilitating inflammation and virus replication, or rather, inducing a protective IgA response. Although it is not possible to determine whether the alteration in the microbial community is the cause or effect of the SARS-CoV-2 replication, these parameters may be considered as markers for personalized therapy and vaccine development.
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Affiliation(s)
- Irene Soffritti
- Section of Microbiology, CIAS Research Center and LTTA, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria D’Accolti
- Section of Microbiology, CIAS Research Center and LTTA, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Chiara Fabbri
- Section of Dentistry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Angela Passaro
- Unit of Internal Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Roberto Manfredini
- Medical Clinic Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Zuliani
- Unit of Internal Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Marco Libanore
- Unit of Infectious Diseases, University Hospital of Ferrara, Ferrara, Italy
| | - Maurizio Franchi
- Section of Dentistry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Carlo Contini
- Section of Infectious Diseases and Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Elisabetta Caselli
- Section of Microbiology, CIAS Research Center and LTTA, Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
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Ramburrun P, Pringle NA, Dube A, Adam RZ, D'Souza S, Aucamp M. Recent Advances in the Development of Antimicrobial and Antifouling Biocompatible Materials for Dental Applications. Materials (Basel) 2021; 14:3167. [PMID: 34207552 PMCID: PMC8229368 DOI: 10.3390/ma14123167] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022]
Abstract
The risk of secondary bacterial infections resulting from dental procedures has driven the design of antimicrobial and antifouling dental materials to curb pathogenic microbial growth, biofilm formation and subsequent oral and dental diseases. Studies have investigated approaches based primarily on contact-killing or release-killing materials. These materials are designed for addition into dental resins, adhesives and fillings or as immobilized coatings on tooth surfaces, titanium implants and dental prosthetics. This review discusses the recent developments in the different classes of biomaterials for antimicrobial and antifouling dental applications: polymeric drug-releasing materials, polymeric and metallic nanoparticles, polymeric biocides and antimicrobial peptides. With modifications to improve cytotoxicity and mechanical properties, contact-killing and anti-adhesion materials show potential for incorporation into dental materials for long-term clinical use as opposed to short-lived antimicrobial release-based coatings. However, extended durations of biocompatibility testing, and adjustment of essential biomaterial features to enhance material longevity in the oral cavity require further investigations to confirm suitability and safety of these materials in the clinical setting. The continuous exposure of dental restorative and regenerative materials to pathogenic microbes necessitates the implementation of antimicrobial and antifouling materials to either replace antibiotics or improve its rational use, especially in the day and age of the ever-increasing problem of antimicrobial resistance.
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Affiliation(s)
- Poornima Ramburrun
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Nadine A Pringle
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Admire Dube
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Razia Z Adam
- Department of Restorative Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town 7505, South Africa
| | - Sarah D'Souza
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Marique Aucamp
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
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