The blood pressure lowering effect of beetroot juice is impaired in periodontitis and recovered after periodontal treatment

Study information

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study design

case-control

Citation

PMID PubMed identifier for scientific articles.

39788958

DOI Digital object identifier for electronic documents.

https://doi.org/10.1038/s41522-024-00622-5

URI

Authors

Sanchez-Orozco NY, Rosier BT, Ruiz-Gutierrez A, Marquez-Sandoval F, Artacho A, Carrera-Quintanar L, Mira A

Journal

NPJ biofilms and microbiomes

Year

2025

We have previously demonstrated that subgingival levels of nitrate-reducing bacteria, as well as the in vitro salivary nitrate reduction capacity (NRC), were diminished in periodontitis patients, increasing after periodontal treatment. However, it remains unclear if an impaired NRC in periodontitis can affect systemic health. To determine this, the effect of nitrate-rich beetroot juice (BRJ) on blood pressure was determined in 15 periodontitis patients before and 70 days after periodontal treatment (i.e., professional mechanical plaque removal, oral hygiene instruction, and subgingival instrumentation), as well as in a healthy control group of 15 individuals. Additionally, subgingival and tongue samples were taken to analyse the bacterial composition with Illumina sequencing of the 16S rRNA gene. In healthy individuals, the systolic and diastolic blood pressure (SBP and DPB) decreased significantly (both P < 0.01) 90 min after BRJ intake, but not in periodontitis patients. However, after periodontal treatment, this blood pressure-lowering effect was recovered (P < 0.05 for SBP; P < 0.01 for DBP). Lower levels of salivary nitrate after identical doses of BRJ intake indicated a potentially higher NRC in healthy individuals (P < 0.05). Periodontitis-associated bacteria decreased in tongue and subgingival samples after periodontal treatment (P < 0.01). In contrast, nitrate-reducing bacteria were associated with health in both habitats, but increased only in subgingival plaque after periodontal treatment (P < 0.001). This is the first study showing that periodontitis could limit the blood-pressure lowering effects of nitrate reduction by the oral microbiota. We propose that an impaired NRC represents a potential link between periodontitis and systemic conditions, which should be confirmed in future randomized controlled trials. Future work should also aim to determine if nitrate prebiotic supplementation and/or tongue cleaning could improve the treatment of periodontitis and its associated comorbidities.

Experiment 1

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Curated date: 2025/01/28

Curator: Miss Lulu

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Subjects

Location of subjects

Mexico

Spain

Host species Species from which microbiome was sampled. Contact us to have more species added.

Homo sapiens

Body site Anatomical site where microbial samples were extracted from according to the Uber Anatomy Ontology

Saliva Sailva normalis,Saliva atomaris,Saliva molecularis,Salivary gland secretion,Saliva,saliva

Condition The experimental condition / phenotype studied according to the Experimental Factor Ontology

Periodontitis chronic pericementitis,inflammation of periodontium,Pericementitides,Pericementitis,Periodontitides,periodontitis,Periodontitis (disorder),Periodontitis, NOS,periodontium inflammation,periodontosis,Periodontitis

Group 0 name Corresponds to the control (unexposed) group for case-control studies

Healthy controls

Group 1 name Corresponds to the case (exposed) group for case-control studies

Periodontitis for the subgingival plaque samples

Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group

To test the effect of periodontitis, before (BL) and after (D70) periodontal treatment, on the blood-pressure lowering effect of beetroot juice.

Group 0 sample size Number of subjects in the control (unexposed) group

13

Group 1 sample size Number of subjects in the case (exposed) group

13

Antibiotics exclusion Number of days without antibiotics usage (if applicable) and other antibiotics-related criteria used to exclude participants (if any)

3 months

Lab analysis

Sequencing type

16S

16S variable region One or more hypervariable region(s) of the bacterial 16S gene

V3-V4

Sequencing platform Manufacturer and experimental platform used for quantifying microbial abundance

Illumina

Statistical Analysis

Data transformation Data transformation applied to microbial abundance measurements prior to differential abundance testing (if any).

raw counts

Statistical test

ANCOM-BC

Significance threshold p-value or FDR threshold used for differential abundance testing (if any)

0.05

MHT correction Have statistical tests be corrected for multiple hypothesis testing (MHT)?

Yes

Matched on Factors on which subjects have been matched on in a case-control study

blood pressure

Alpha Diversity

Chao1 Abundance-based estimator of species richness

increased

Richness Number of species

increased

Signature 1

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Source: Supplementary Figure 2A and Figure 6A

Description: Bar graphs show comparisons between healthy individuals (H) and periodontitis patients at baseline (BL) in subgingival plaque

Abundance in Group 1: increased abundance in Periodontitis for the subgingival plaque samples

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Actinomyces
Actinomyces massiliensis
Actinomyces naeslundii
Actinomycetaceae
Bergeyella
Cardiobacterium
Cardiobacterium hominis
Corynebacterium
Gemella
Granulicatella
Haemophilus
Haemophilus sp.
Kingella
Kingella oralis
Propionibacterium
Rothia
Rothia dentocariosa

Revision editor(s): Miss Lulu

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Source: Supplementary Figure 2A and Figure 6A

Description: Bar graphs show comparisons between healthy individuals (H) and periodontitis patients at baseline (BL) in subgingival plaque

Abundance in Group 1: decreased abundance in Periodontitis for the subgingival plaque samples

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Alloprevotella
Alloprevotella tannerae
Filifactor
Lentimicrobium
Peptostreptococcus
Phocaeicola
Prevotella intermedia
Rikenellaceae
Veillonellaceae

Revision editor(s): Miss Lulu

Signature 3

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Source: Supplementary Figure 2B and Figure 6B

Description: Bar graphs show comparisons between periodontitis patients at baseline (BL) and 70 days after treatment (D70) in subgingival plaque

Abundance in Group 1: increased abundance in Periodontitis for the subgingival plaque samples

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Actinomyces
Actinomyces naeslundii
Actinomyces oris
Actinomycetes
Granulicatella
Haemophilus
Lautropia mirabilis
Rothia dentocariosa
Streptococcus

Revision editor(s): Miss Lulu

Signature 4

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Source: Supplementary Figure 2B and Figure 6B

Description: Bar graphs show comparisons between periodontitis patients at baseline (BL) and 70 days after treatment (D70) in subgingival plaque

Abundance in Group 1: decreased abundance in Periodontitis for the subgingival plaque samples

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Filifactor
Fretibacterium
Peptostreptococcus
Porphyromonas
Rikenellaceae
Tannerella forsythia

Revision editor(s): Miss Lulu

Experiment 2

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Differences from previous experiment shown

Subjects

Group 1 name Corresponds to the case (exposed) group for case-control studies

Periodontitis for the tongue samples

Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group

To test how nitrate-reducing bacteria on the tongue were affected by periodontitis(BL and D70)

Group 1 sample size Number of subjects in the case (exposed) group

14

Lab analysis

Statistical Analysis

Matched on Factors on which subjects have been matched on in a case-control study

Not specified

Alpha Diversity

Chao1 Abundance-based estimator of species richness

decreased

Richness Number of species

decreased

Signature 1

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Source: Supplementary Figure 2C and Figure 6C

Description: Bar graphs show comparisons between healthy individuals (H) and periodontitis patients at baseline (BL) in tongue coating.

Abundance in Group 1: increased abundance in Periodontitis for the tongue samples

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Actinobacillus
Cardiobacterium
Gemella
Gemella sanguinis
Haemophilus
Rothia dentocariosa
Veillonella
Veillonella rogosae

Revision editor(s): Miss Lulu

Signature 2

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Source: Supplementary Figure 2C and Figure 6C

Description: Bar graphs show comparisons between healthy individuals (H) and periodontitis patients at baseline (BL) in tongue coating.

Abundance in Group 1: decreased abundance in Periodontitis for the tongue samples

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Lachnospiraceae

Revision editor(s): Miss Lulu

Signature 3

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Source: Supplementary Figure 2D and Figure 6D

Description: Bar graphs show comparisons between D70 and BL in tongue coating

Abundance in Group 1: decreased abundance in Periodontitis for the tongue samples

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Filifactor
Porphyromonas gingivalis
Filifactor alocis

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Source: Supplementary Figure 2E and Figure 6E

Description: Bar graphs show comparisons between h and D70 in tongue coating

Abundance in Group 1: decreased abundance in Periodontitis for the tongue samples

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Actinobacillus
Leptotrichia
Actinobacillus pleuropneumoniae

Revision editor(s): Miss Lulu