Oral and Gut Microbial Diversity and Immune Regulation in Patients with HIV on Antiretroviral Therapy

Study information

Reviewed Marked as Reviewed by Peace Sandy on 2024-2-15

study design

cross-sectional observational, not case-control

Citation

PMID PubMed identifier for scientific articles.

32024712

DOI Digital object identifier for electronic documents.

10.1128/mSphere.00798-19

URI

https://pubmed.ncbi.nlm.nih.gov/32024712/

Authors

Annavajhala MK, Khan SD, Sullivan SB, Shah J, Pass L, Kister K, Kunen H, Chiang V, Monnot GC, Ricupero CL, Mazur RA, Gordon P, de Jong A, Wadhwa S, Yin MT, Demmer RT, Uhlemann AC

Journal

mSphere

Year

2020

Keywords:

HIV, antiretroviral agents, antiretroviral therapy, immune dysfunction, immune system activation, mycobiome, oral microbiome

Despite evidence of a chronic inflammatory phenotype in people living with HIV (PLWH) on antiretroviral therapy (ART), the role of oral microbiota in chronic immune activation has not been fully explored. We aimed to determine the relationship between oral and gut microbiome diversity and chronic systemic inflammation in ART-treated PLWH with prevalent severe periodontitis, an inflammatory condition commonly associated with HIV infection. We assessed bacterial and fungal communities at oral and gastrointestinal sites in a cohort (n = 52) of primarily postmenopausal women on ART using 16S rRNA and internal transcribed spacer (ITS) sequencing and measured cellular and soluble markers of inflammation and immune dysfunction. Linear mixed-effect regression and differential abundance analyses were used to associate clinical characteristics and immunological markers with bacterial and fungal diversity and community composition. Bacterial α-diversity in plaque, saliva, and gut was associated with different immunological markers, while mycobial diversity was not associated with soluble or cellular biomarkers of immune stimulation or T cell dysfunction. Furthermore, lipopolysaccharide-positive (LPS+) bacteria previously linked to inflammatory outcomes were enriched at oral sites in patients with severe periodontitis. Fungal α-diversity was reduced in plaque from teeth with higher clinical attachment loss, a marker of periodontitis, and in saliva and plaque from patients with a history of AIDS. Our results show that both bacterial and fungal oral microbiome communities likely play a role in chronic systemic immune activation in PLWH. Thus, interventions targeting both inflammation and the microbiome, particularly in the oral cavity, may be necessary to reduce chronic immune dysregulation in patients with HIV.IMPORTANCE A feedback loop between dysbiotic gut microbiota, increased translocation of microbial products such as lipopolysaccharide, and inflammation has been hypothesized to cause immune system dysfunction in early HIV infection. However, despite evidence of a chronic inflammatory phenotype in patients on antiretroviral therapy (ART), the role of oral microbiota in systemic immune activation and the relationship between oral and gut bacterial and fungal diversity have not been explored. Our study suggests a crucial role for oral bacterial and fungal communities in long-term systemic immune activation in patients on ART, expanding the current paradigm focused on gut bacteria. Our results indicate that interventions targeting both inflammation and microbial diversity are needed to mitigate oral inflammation-related comorbidities, particularly in HIV-positive patients. More broadly, these findings can bolster general models of microbiome-mediated chronic systemic immune activation and aid the development of precise microbiota-targeted interventions to reverse chronic inflammation.

Experiment 1

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Curated date: 2021/12/21

Curator: Joyessa

Revision editor(s): WikiWorks, Joyessa, Jacquelynshevin, Peace Sandy, Victoria

Subjects

Location of subjects: United States of America

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: Oral cavity , Feces Bucca,Buccal cavity,Cavity of mouth,Oral cavity,oral cavity,Cow dung,Cow pat,Droppings,Dung,Excrement,Excreta,Faeces,Fecal material,Fecal matter,Fewmet,Frass,Guano,Matières fécales@fr,Merde@fr,Ordure,Partie de la merde@fr,Piece of shit,Porción de mierda@es,Portion of dung,Portion of excrement,Portion of faeces,Portion of fecal material,Portion of fecal matter,Portion of feces,Portion of guano,Portion of scat,Portionem cacas,Scat,Spoor,Spraint,Stool,Teil der fäkalien@de,Feces,feces

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

Group 0 name Corresponds to the control (unexposed) group for case-control studies: PLWH >50 years old with no/mild periodontitis

Group 1 name Corresponds to the case (exposed) group for case-control studies: PLWH >50 years old with severe periodontitis

Group 1 definition Diagnostic criteria applied to define the specific condition / phenotype represented in the case (exposed) group: Patients with severe periodontal disease

Group 0 sample size Number of subjects in the control (unexposed) group: 4

Group 1 sample size Number of subjects in the case (exposed) group: 22

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: DESeq2

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

Confounders controlled for Confounding factors that have been accounted for by stratification or model adjustment: age, race, sex

Alpha Diversity

Shannon Estimator of species richness and species evenness: more weight on species richness: unchanged

Chao1 Abundance-based estimator of species richness: decreased

Signature 1

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Reviewed Marked as Reviewed by Peace Sandy on 2024-2-15

Curated date: 2023/01/18

Curator: Jacquelynshevin

Revision editor(s): Jacquelynshevin, Peace Sandy, WikiWorks

Source: Table S5 and Table S6

Description: Differentially abundant fungal taxa in saliva and subgingival plaque from patients with severe vs. no/mild periodontal disease (DESeq2, p<0.05, padj (FDR)<0.05)

Abundance in Group 1: increased abundance in PLWH >50 years old with severe periodontitis

NCBI	Quality Control	Links
Candida albicans
Candida parapsilosis
Prevotella
Fusobacterium
Rothia
Kingella
Veillonella
Moryella
Streptococcus
Haemophilus

Revision editor(s): Jacquelynshevin, Peace Sandy, WikiWorks

Signature 2

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Your review change was submitted

Reviewed Marked as Reviewed by Peace Sandy on 2024-2-15

Curated date: 2023/01/24

Curator: Jacquelynshevin

Revision editor(s): Jacquelynshevin, Peace Sandy, WikiWorks

Source: Table S5 and Table S6

Description: Differentially abundant fungal taxa in saliva and subgingival plaque from patients with severe vs. no/mild periodontal disease (DESeq2, p<0.05, padj (FDR)<0.05)

Abundance in Group 1: decreased abundance in PLWH >50 years old with severe periodontitis

NCBI	Quality Control	Links
Candida dubliniensis
Debaryomyces hansenii
Exserohilum turcicum
Tausonia pullulans
Saccharomyces cerevisiae
Megasphaera
Veillonella

Revision editor(s): Jacquelynshevin, Peace Sandy, WikiWorks