Emerging perspectives on the influence of oral biofilm on systemic diseases and clinical implications: beyond oral hygiene
DOI:
https://doi.org/10.34119/bjhrv8n4-051Keywords:
microbiome, microenvironments, extracellular polymeric matrix, antibiofilm, pathologiesAbstract
The objective of this review was to evaluate current evidence linking oral biofilm composition and dynamics to the pathogenesis and progression of systemic diseases. We conducted a comprehensive literature search in PubMed, Scopus, Web of Science and the Virtual Health Library, using the terms “oral microbiome,” “biofilm” and “systemic disease” (including diabetes, cardiovascular disease, autoimmune disorders, cancer and neurodegeneration). From 759 retrieved records, 132 high-quality studies were selected for integrative analysis. Our synthesis demonstrates that dysbiotic oral biofilms harboring periodontopathogens such as Porphyromonas gingivalis, Fusobacterium nucleatum and Streptococcus mutans can translocate to distant sites, instigate chronic inflammation, endothelial dysfunction and immune dysregulation. Key mechanisms include lipopolysaccharide-induced cytokine release, quorum-sensing-mediated virulence activation and biofilm-associated evasion of host defenses. Epidemiological and experimental data reveal associations between oral dysbiosis and impaired glycemic control in diabetes, accelerated atherogenesis, exacerbated autoimmune activity, increased risk of head and neck and colorectal cancers, and neuroinflammatory pathways implicated in Alzheimer’s disease. We discuss emerging diagnostic and therapeutic strategies such as metagenomic saliva profiling, targeted antimicrobial peptides, probiotics and host-modulation agents that aim to restore biofilm homeostasis. Integrating oral microbiome assessment into multidisciplinary clinical protocols may enable early identification of at-risk individuals and personalized preventive measures. Further interventional trials are warranted to confirm causality and refine biofilm-focused treatments to enhance both oral and systemic health.
References
ABDELMASSIH, A. et al. The forgotten oral microbial transplantation for improving the outcomes of COVID-19. New Microbes and New Infections, 2021.
ALEKSIJEVIĆ, Lorena Horvat et al. Porphyromonas gingivalis virulence factors and clinical significance in periodontal disease and coronary artery diseases. Pathogens, 2022.
ANDERSON, Annette Carola et al. Long-term fluctuation of oral biofilm microbiota following different dietary phases. Applied and Environmental Microbiology, v. 86, n. 20, 2020.
ARWEILER, Nicole B. et al. Dental biofilm and saliva microbiome and its interplay with pediatric allergies. Microorganisms, v. 9, n. 6, 2021.
BACALI, Cecilia et al. Oral microbiome: getting to know and befriend neighbors, a biological approach. Biomedicines, 2022.
BESSA, Lucinda J. et al. managing oral health in the context of antimicrobial resistance. International Journal of Environmental Research and Public Health, 2022.
BISCHOFF, Stephan C. et al. Intestinal permeability - a new target for disease prevention and therapy. BMC Gastroenterology, 2014.
CAI, Liuyang et al. Integrative analysis reveals associations between oral microbiota dysbiosis and host genetic and epigenetic aberrations in oral cavity squamous cell carcinoma. npj Biofilms and Microbiomes, v. 10, n. 1, p. 39, 8 abr. 2024.
CHATZIGIANNIDOU, Ioanna et al. Oral biofilms exposure to chlorhexidine results in altered microbial composition and metabolic profile. npj Biofilms and Microbiomes, v. 6, n. 1, 2020.
CORNEJO ULLOA, Pilar et al. The effect of sex steroid hormones on the ecology of in vitro oral biofilms. Biofilm, v. 6, 2023.
CUADRA, Giancarlo A. et al. A comparison of flavorless electronic cigarette-generated aerosol and conventional cigarette smoke on the survival and growth of common oral commensal streptococci. International Journal of Environmental Research and Public Health, v. 16, n. 10, 2019.
DOBON, Begoña et al. The making of the oral microbiome in Agta hunter-gatherers. Evolutionary Human Sciences, v. 5, 2023.
DOMINY, Stephen S. et al. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science Advances, v. 5, n. 1, 2019.
DONG, Jiajia et al. Relationships between oral microecosystem and respiratory diseases. Frontiers in Molecular Biosciences, 2022.
FIORILLO, Luca. We do not eat alone: Formation and maturation of the oral microbiota. Biology, 2020.
FLEMMIG, Thomas F.; BEIKLER, Thomas. Control of oral biofilms. Periodontology 2000, v. 55, n. 1, p. 9–15, 1 fev. 2011.
GHOSH, Soumi et al. Human oral lectin ZG16B acts as a cell wall polysaccharide probe to decode host–microbe interactions with oral commensals. Proceedings of the National Academy of Sciences of the United States of America, v. 120, n. 22, 2023.
GUALTERO, Diego F. et al. Oral microbiome mediated inflammation, a potential inductor of vascular diseases: a comprehensive review. Frontiers in Cardiovascular Medicine, 2023.
HEIDRICH, Vitor et al. Longitudinal analysis at three oral sites links oral microbiota to clinical outcomes in allogeneic hematopoietic stem-cell transplant. Microbiology Spectrum, v. 11, n. 6, 2023.
HMPDACC. NIH Human Microbiome Project.
HOFMANN, Maria et al. The bacterial oral microbiome in children with congenital heart disease: an extensive review. Pathogens, 2023.
HUANG, Yi et al. Metagenomic and metatranscriptomic insight into oral biofilms in periodontitis and related systemic diseases. Frontiers in Microbiology, 2021.
IMAI, Kenichi; IINUMA, Toshimitsu; SATO, Shuichi. Relationship between the oral cavity and respiratory diseases: aspiration of oral bacteria possibly contributes to the progression of lower airway inflammation. Japanese Dental Science Review, 2021.
JENKINSON, Howard F.; LAMONT, Richard J. Oral microbial communities in sickness and in health. Trends in Microbiology, 2005.
KUMAR, Sangeetha Senthil et al. Oral streptococci S. anginosus and S. mitis induce distinct morphological, inflammatory, and metabolic signatures in macrophages. Infection and Immunity, v. 92, n. 3, 2024.
LIU, Yiran et al. Roles of the gut microbiota in severe SARS-CoV-2 infection. Cytokine & Growth Factor Reviews, v. 63, p. 98–107, fev. 2022.
NARENGAOWA et al. The Oral-Gut-Brain AXIS: The Influence of Microbes in Alzheimer’s Disease. Frontiers in Cellular Neuroscience, 2021.
ODENWALD, Matthew A.; TURNER, Jerrold R. The intestinal epithelial barrier: A therapeutic target? Nature Reviews Gastroenterology and Hepatology, 2017.
OSIAK, Joanna et al. Oral microbial dysbiosis in cardiovascular diseases. Journal of Education, Health and Sport, v. 41, n. 1, 2023.
PATHAK, Janak L. et al. The role of oral microbiome in respiratory health and diseases. Respiratory Medicine, 2021.
PENG, Xian et al. Oral microbiota in human systematic diseases. International Journal of Oral Science, 2022.
PESSOA, Larissa et al. Host-microbial interactions in systemic lupus erythematosus and periodontitis. Frontiers in Immunology, v. 10, 2019.
SANTONOCITO, Simona et al. A cross-talk between diet and the oral microbiome: balance of nutrition on inflammation and immune system’s response during periodontitis. Nutrients, 2022.
SCANNAPIECO, Frank A.; DONGARI-BAGTZOGLOU, Anna. Dysbiosis revisited: Understanding the role of the oral microbiome in the pathogenesis of gingivitis and periodontitis: A critical assessment. Journal of Periodontology, 2021.
SEDGHI, Lea et al. The oral microbiome: Role of key organisms and complex networks in oral health and disease. Periodontology 2000, 2021.
SHIGEMATSU, Yasuyuki et al. Fusobacterium nucleatum , immune responses, and metastatic organ diversity in colorectal cancer liver metastasis. Cancer Science, v. 115, n. 10, p. 3248–3255, 14 out. 2024.
SOTOZONO, Maki et al. Impact of sleep on the microbiome of oral biofilms. PLoS ONE, v. 16, n. 12 December, 2021.
SUDHAKARA, Preethi; SELLAMUTHU, Iyappan; ARUNI, A. Wilson. Bacterial Sialoglycosidases in Virulence and Pathogenesis. Pathogens, 2019.
THOMAS, Scott C. et al. Electronic Cigarette Use Promotes a Unique Periodontal Microbiome. mBio, v. 13, n. 1, 2022.
TSAI, Ming Shao et al. Streptococcus mutans promotes tumor progression in oral squamous cell carcinoma. Journal of Cancer, v. 13, n. 12, 2022.
YU, Xiaoyun et al. Microbial dysbiosis in oral squamous cell carcinoma: A systematic review and meta-analysis. Heliyon, 2023.
ZHENG, Sherry et al. Implication of Surface Properties, Bacterial Motility, and Hydrodynamic Conditions on Bacterial Surface Sensing and Their Initial Adhesion. Frontiers in Bioengineering and Biotechnology, 2021.
