Oral microbiota disturbances in patients with bronchial asthma receiving inhaled glucocorticosteroids

Relevance. The microbiota of the oral cavity (MOC) plays an important role in maintaining local homeostasis. Currently, it is of interest to study MCI disorders (dysbiosis) in chronic somatic diseases such as bronchial asthma (BA). The processes of impaired immune response are essential in the pathogenesis of asthma, and inhaled glucocorticosteroids (IGCS) are widely used in the treatment of asthma. All of these factors can disrupt MCI, which, in turn, accelerates the development of caries and its complications (pulpitis and periodontitis), as well as periodontal diseases. Purpose. Improving the diagnosis of oral dysbiosis in patients with bronchial asthma receiving inhaled glucocorticosteroids. Material and methods. We conducted a study of the features of MCI disorders in patients suffering from asthma (n=30), in comparison with healthy volunteers (n=10), using gas chromatography – mass spectrometry (GCMS) saliva samples. To optimize statistical analysis, patients with asthma were divided into 3 groups, depending on the severity of bronchial asthma (mild, moderate and severe). Results. As a result of the study of microbial markers by gas chromatography-mass spectrometry (GCMS) of saliva samples in patients with severe bronchial asthma, a significant increase in the number of bacteria was revealed compared to patients in the control group: Hathewaya histolytica/Str. pneumoniae (478.4±460.3/70.6±31.7), Clostridium difficile (12.8±8.3/0), Clostridium propionicum (Anaerotignum propionicum) (687.1±307.3/310.2±176.6), Clostridium ramosum (Thomasclavelia ramosa) (1745.1±753.9/1009±472.2), Bifidobacterium spp. (157.9±74.5/35.5±25.8), Streptococcus mutans (307.8±106.6/138.6±41.6), Propionibacterium freudenreichii (408.4±147.1/129±45.2) (all p<0.05), while the composition of saliva samples from patients with mild and moderate bronchial asthma did not differ from that of healthy volunteers. Conclusion. Patients with asthma receiving inhaled glucocorticosteroids exhibit a disturbance in the composition of the oral microbiota (dysbiosis); these changes reach statistical significance in severe stages of the disease. Oral dysbiosis in severe asthma is characterized by an increase in opportunistic bacteria with proinflammatory potential (in particular, Streptococcus mutans, considered the main etiologic factor for dental caries), as well as bacteria producing short-chain fatty acids (SCFAs), which contribute to oral acidification. Our results complement existing literature on the characteristics of oral microbiota in patients with asthma.

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