口腔中携带cnm基因的变形链球菌，或可增加脑微出血风险 | 热心肠日报

口腔中携带cnm基因的变形链球菌与脑微出血发生率的增加有关

10.1161/STROKEAHA.120.029607

11-05, Article

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Background and Purpose: Cerebral microbleeds (CMB) are associated with stroke and cognitive impairment. We previously reported a high prevalence of CMB in people with Streptococcus mutans expressing Cnm, a collagen-binding protein in the oral cavity. S.mutans is a major pathogen responsible for dental caries. Repeated challenge with S.mutans harboring the cnm gene encoding Cnm induced cerebral bleeding in stroke-prone spontaneously hypertensive rats. The purpose of this longitudinal study is to examine the relationship of cnm-positive S.mutans to the development of CMB.
Methods: We retrospectively investigated patients with stroke receiving oral microbiological examination and head 3T magnetic resonance imaging evaluations twice in the period 2014 to 2019, allowing >180-day interval. Patients with cnm-positive S.mutans were compared with those without. Quasi-Poisson regression models were used to explore associations between cnm-positive S.mutans and the increase in number of CMB between the 2 magnetic resonance imaging scans.
Results: A total of 111 patients were identified; 21 (19%) with cnm-positive S.mutans and 90 (81%) without. Clinical history, including blood pressure and the use of antithrombotic agents, were comparable between the 2 groups. New CMB were more commonly observed in patients with cnm-positive S.mutans (52% versus 23%; P=0.008). The incidence of CMB was significantly higher in the group with cnm-positive S.mutans, especially in deep areas, (incidence rate ratios [95% CI], 5.1 [1.9–13.6] for CMB in any brain region; 15.0 [5.4–42.0] for deep CMB), which persisted after adjusting for age, sex, hypertension, and renal impairment (4.7 [1.8–11.9] for CMB in any brain region; 13.9 [4.3–44.5] for deep CMB).
Conclusions: This study demonstrates that cnm-positive S.mutans is associated with an increased incidence of CMB. Treatment for cnm-positive S.mutans infection may be a novel microbiota-based therapeutic approach for stroke and cognitive impairment.

First Authors:
Satoshi Hosoki

Correspondence Authors:
Satoshi Saito,Masafumi Ihara

All Authors:
Satoshi Hosoki,Satoshi Saito,Shuichi Tonomura,Hiroyuki Ishiyama,Takeshi Yoshimoto,Shuhei Ikeda,Hajime Ikenouchi,Yumi Yamamoto,Yorito Hattori,Kaori Miwa,Robert P Friedland,Roxana O Carare,Jin Nakahara,Norihiro Suzuki,Masatoshi Koga,Kazunori Toyoda,Ryota Nomura,Kazuhiko Nakano,Misa Takegami,Masafumi Ihara