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Gestational diabetes and the human salivary microbiota: a longitudinal study during pregnancy and postpartum

妊娠期糖尿病与人类唾液微生物群: 妊娠期和产后的纵向研究

  • 影响因子:2.4130
  • DOI:10.1186/s12884-020-2764-y
  • 作者列表:"Mie K. W. Crusell","Lærke R. Brink","Trine Nielsen","Kristine H. Allin","Torben Hansen","Peter Damm","Jeannet Lauenborg","Tue H. Hansen","Oluf Pedersen
  • 发表时间:2020-02-02

Abstract Background An aberrant composition of the salivary microbiota has been found in individuals with type 2 diabetes, and in pregnant women salivary microbiota composition has been associated with preeclampsia and pre-term birth. Pregnant women, who develop gestational diabetes (GDM), have a high risk of developing type 2 diabetes after pregnancy. In the present study we assessed whether GDM is linked to variation in the oral microbial community by examining the diversity and composition of the salivary microbiota. Method In this observational study the salivary microbiota of pregnant women with GDM (n = 50) and normal glucose regulation (n = 160) in third trimester and 9 months postpartum was assessed by 16S rRNA gene amplicon sequencing of the V1-V3 region. GDM was diagnosed in accordance with the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Cross-sectional difference in alpha diversity was assessed using Student’s t-test and longitudinal changes were assessed by mixed linear regression. Cross-sectional and longitudinal difference in beta diversity was assessed by permutational multivariate analyses of variance. Differentially abundant genera and OTUs were identified by negative binomial regression. Results In the third trimester, two species-level operational taxonomic units (OTUs), while eight OTUs postpartum were differentially abundant in women with GDM compared with normoglycaemic women. OTU richness, Shannon diversity and Pielou evenness decreased from late pregnancy to 9 months after delivery regardless of glycaemic status. Conclusion GDM is associated with a minor aberration of the salivary microbiota during late pregnancy and postpartum. For unknown reasons richness of the salivary microbiota decreased from late pregnancy to postpartum, which might be explained by the physiological changes of the immune system during human pregnancy.


摘要背景在 2 型糖尿病个体中发现了唾液微生物群的异常组成,在孕妇中,唾液微生物群组成与先兆子痫和早产有关。发生妊娠期糖尿病 (GDM) 的孕妇在怀孕后发生 2 型糖尿病的风险很高。在本研究中,我们通过检查唾液微生物群的多样性和组成,评估 GDM 是否与口腔微生物群落的变异有关。方法: 在这项观察性研究中,GDM (n = 50) 和糖调节正常 (n = 160) 孕妇的唾液微生物群。在妊娠晚期和产后 9 个月,通过 16 S rRNA 基因扩增子测序评估 V1-V3 区域。GDM 诊断符合国际糖尿病和妊娠研究组协会 (IADPSG) 标准。使用 Student t 检验评估 α 多样性的横断面差异,通过混合线性回归评估纵向变化。通过置换多变量方差分析评估 β 多样性的横断面和纵向差异。通过负二项回归鉴定差异丰富的属和 OTUs。结果在妊娠晚期,两个物种水平的操作分类学单位 (OTUs),而产后 8 个 OTUs 在 GDM 妇女中与血糖正常妇女相比差异较大。无论血糖状况如何,OTU 丰富度、 Shannon 多样性和 Pielou 均匀度从妊娠晚期到分娩后 9 个月均降低。结论 GDM 与妊娠晚期和产后唾液微生物群的轻微异常有关。由于未知的原因,唾液微生物群的丰富性从妊娠晚期到产后下降,这可能是由人类妊娠期间免疫系统的生理变化来解释的。



来源期刊:Acta Diabetologica
作者列表:["Benhalima, Katrien","Crombrugge, Paul","Moyson, Carolien","Verhaeghe, Johan","Vandeginste, Sofie","Verlaenen, Hilde","Vercammen, Chris","Maes, Toon","Dufraimont, Els","Block, Christophe","Jacquemyn, Yves","Mekahli, Farah","Clippel, Katrien","Den Bruel, Annick","Loccufier, Anne","Laenen, Annouschka","Minschart, Caro","Devlieger, Roland","Mathieu, Chantal"]

METHODS:Aims We aimed to develop a prediction model based on clinical and biochemical variables for gestational diabetes mellitus (GDM) based on the 2013 World Health Organization (WHO) criteria. Methods A total of 1843 women from a Belgian multi-centric prospective cohort study underwent universal screening for GDM. Using multivariable logistic regression analysis, a model to predict GDM was developed based on variables from early pregnancy. The performance of the model was assessed by receiver-operating characteristic (AUC) analysis. To account for over-optimism, an eightfold cross-validation was performed. The accuracy was compared with two validated models (van Leeuwen and Teede). Results A history with a first degree relative with diabetes, a history of smoking before pregnancy, a history of GDM, Asian origin, age, height and BMI were independent predictors for GDM with an AUC of 0.72 [95% confidence interval (CI) 0.69–0.76)]; after cross-validation, the AUC was 0.68 (95% CI 0.64–0.72). Adding biochemical variables, a history of a first degree relative with diabetes, a history of GDM, non-Caucasian origin, age, height, weight, fasting plasma glucose, triglycerides and HbA_1c were independent predictors for GDM, with an AUC of the model of 0.76 (95% CI 0.72–0.79); after cross-validation, the AUC was 0.72 (95% CI 0.66–0.78), compared to an AUC of 0.67 (95% CI 0.63–0.71) using the van Leeuwen model and an AUC of 0.66 (95% CI 0.62–0.70) using the Teede model. Conclusions A model based on easy to use variables in early pregnancy has a moderate accuracy to predict GDM based on the 2013 WHO criteria.

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来源期刊:Nature Medicine
作者列表:["Artzi, Nitzan Shalom","Shilo, Smadar","Hadar, Eran","Rossman, Hagai","Barbash-Hazan, Shiri","Ben-Haroush, Avi","Balicer, Ran D.","Feldman, Becca","Wiznitzer, Arnon","Segal, Eran"]

METHODS:Leveraging the availability of nationwide electronic health records from over 500,000 pregnancies in Israel, a machine-learning approach offers an alternative means of predicting gestational diabetes at high accuracy in the early stages of pregnancy. Gestational diabetes mellitus (GDM) poses increased risk of short- and long-term complications for mother and offspring^ 1 – 4 . GDM is typically diagnosed at 24–28 weeks of gestation, but earlier detection is desirable as this may prevent or considerably reduce the risk of adverse pregnancy outcomes^ 5 , 6 . Here we used a machine-learning approach to predict GDM on retrospective data of 588,622 pregnancies in Israel for which comprehensive electronic health records were available. Our models predict GDM with high accuracy even at pregnancy initiation (area under the receiver operating curve (auROC) = 0.85), substantially outperforming a baseline risk score (auROC = 0.68). We validated our results on both a future validation set and a geographical validation set from the most populated city in Israel, Jerusalem, thereby emulating real-world performance. Interrogating our model, we uncovered previously unreported risk factors, including results of previous pregnancy glucose challenge tests. Finally, we devised a simpler model based on just nine questions that a patient could answer, with only a modest reduction in accuracy (auROC = 0.80). Overall, our models may allow early-stage intervention in high-risk women, as well as a cost-effective screening approach that could avoid the need for glucose tolerance tests by identifying low-risk women. Future prospective studies and studies on additional populations are needed to assess the real-world clinical utility of the model.

关键词: 暂无
翻译标题与摘要 下载文献
作者列表:["Lowes DJ","Hevener KE","Peters BM"]

METHODS::Repurposing of currently approved medications is an attractive option for the development of novel treatment strategies against physiological and infectious diseases. The antidiabetic sulfonylurea glyburide has demonstrated off-target capacity to inhibit activation of the NLRP3 inflammasome in a variety of disease models, including vaginal candidiasis, caused primarily by the fungal pathogen Candida albicans Therefore, we sought to determine which of the currently approved sulfonylurea drugs prevent the release of interleukin 1β (IL-1β), a major inflammasome effector, during C. albicans challenge of the human macrophage-like THP1 cell line. Findings revealed that the second-generation antidiabetics (glyburide, glisoxepide, gliquidone, and glimepiride), which exhibit greater antidiabetic efficacy than prior iterations, demonstrated anti-inflammatory effects with various degrees of potency as determined by calculation of 50% inhibitory concentrations (IC50s). These same compounds were also effective in reducing IL-1β release during noninfectious inflammasome activation (e.g., induced by lipopolysaccharide [LPS] plus ATP), suggesting that their anti-inflammatory activity is not specific to C. albicans challenge. Moreover, treatment with sulfonylurea drugs did not impact C. albicans growth and filamentation or THP1 viability. Finally, the use of ECE1 and Candidalysin deletion mutants, along with isogenic NLRP3-/- cells, demonstrated that both Candidalysin and NLRP3 are required for IL-1β secretion, further confirming that sulfonylureas suppress inflammasome signaling. Moreover, challenge of THP1 cells with synthetic Candidalysin peptide demonstrated that this toxin is sufficient to activate the inflammasome. Treatment with the experimental inflammasome inhibitor MCC950 led to similar blockade of IL-1β release, suggesting that Candidalysin-mediated inflammasome activation can be inhibited independently of potassium efflux. Together, these results demonstrate that the second-generation antidiabetic sulfonylureas retain anti-inflammatory activity and may be considered for repurposing against immunopathological diseases, including vaginal candidiasis.