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A potential pathogenic association between periodontal disease and Crohn’s disease
Jin Imai, … , Hidekazu Suzuki, Nobuhiko Kamada
Jin Imai, … , Hidekazu Suzuki, Nobuhiko Kamada
Published October 28, 2021
Citation Information: JCI Insight. 2021;6(23):e148543. https://doi.org/10.1172/jci.insight.148543.
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Research Article Gastroenterology Microbiology

A potential pathogenic association between periodontal disease and Crohn’s disease

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Abstract

Oral conditions are relatively common in patients with inflammatory bowel disease (IBD). However, the contribution of oral maladies to gut inflammation remains unexplored. Here, we investigated the effect of periodontitis on disease phenotypes of patients with IBD. In all, 60 patients with IBD (42 with ulcerative colitis [UC] and 18 with Crohn’s disease [CD]) and 45 healthy controls (HCs) without IBD were recruited for this clinical investigation. The effects of incipient periodontitis on the oral and gut microbiome as well as IBD characteristics were examined. In addition, patients were prospectively monitored for up to 12 months after enrollment. We found that, in both patients with UC and those with CD, the gut microbiome was significantly more similar to the oral microbiome than in HCs, suggesting that ectopic gut colonization by oral bacteria is increased in patients with IBD. Incipient periodontitis did not further enhance gut colonization by oral bacteria. The presence of incipient periodontitis did not significantly affect the clinical outcomes of patients with UC and CD. However, the short CD activity index increased in patients with CD with incipient periodontitis but declined or was unchanged during the study period in patients without periodontitis. Thus, early periodontitis may associate with worse clinically symptoms in some patients with CD.

Authors

Jin Imai, Hitoshi Ichikawa, Sho Kitamoto, Jonathan L. Golob, Motoki Kaneko, Junko Nagata, Miho Takahashi, Merritt G. Gillilland III, Rika Tanaka, Hiroko Nagao-Kitamoto, Atsushi Hayashi, Kohei Sugihara, Shrinivas Bishu, Shingo Tsuda, Hiroyuki Ito, Seiichiro Kojima, Kazunari Karakida, Masashi Matsushima, Takayoshi Suzuki, Katsuto Hozumi, Norihito Watanabe, William V. Giannobile, Takayuki Shirai, Hidekazu Suzuki, Nobuhiko Kamada

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Figure 4

UC characteristics in patients with or without incipient periodontitis.

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UC characteristics in patients with or without incipient periodontitis.
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(A) Age and disease duration at study entry. (B) Disease extent at diagnosis. E1, proctitis; E2, left sided; E3, extensive. (C) Disease activity. (D) Extraintestinal manifestations (EIM). (E) Response to steroid therapy. SR, steroid refractory; SD, steroid dependent; SF, steroid free. (F) The number of patients who received thiopurine or anti-TNF therapy. (A) Results are shown as mean ± SD. Dots indicate individual participants, as do numbers within bars. P values by Mann-Whitney U test (A) and Fisher exact test (B–F) are shown.

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