Understanding Oral Diseases in Cystic Fibrosis to Develop Tailored Preventive Dental Interventions

了解囊性纤维化中的口腔疾病以制定量身定制的预防性牙科干预措施

• 批准号: 10181640
• 负责人: Donald Leslie Chi
• 金额: $ 79.54万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-13 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10181640
• 关键词: Address; Adolescence; Adolescent and Young Adult; Age; Alabama; Aspirate substance; Bacteria; Behavior; Behavioral; Biological Factors; Carbohydrates; Caring; Cariogenic Diet; Caucasians; Cessation of life; Chronic; Clinical; Cystic Fibrosis; Data; Dental; Dental Hygiene; Dental Plaque; Dental caries; Dentistry; Dentists; Diagnostic; Disease; Enrollment; Environment; Epidemiology; Evidence based intervention; General Population; Gingivitis; Health; Health behavior; Impairment; Incidence; Intake; Intervention; Life; Life Expectancy; Link; Lung; Lung diseases; Measures; Mechanical ventilation; Medical; Methods; Microbiology; Modeling; Modernization; Mouth Diseases; Mucociliary Clearance; North Carolina; Obstructive Lung Diseases; Oral; Oral cavity; Oral health; Outcome; Pathogenicity; Pathway interactions; Patients; Pediatric Hospitals; Pneumonia; Population; Prevalence; Prevention; Preventive; Preventive dental care; Pulmonary Fibrosis; Pulmonary Function Test/Forced Expiratory Volume 1; Quality of life; Randomized Clinical Trials; Reflux; Respiratory Tract Infections; Risk; Risk Factors; Saliva; Site; Source; Sputum; Standardization; Stomach; Streptococcus mutans; Time; Universities; Visit; Weight; age group; base; children with cystic fibrosis; cohort; cystic fibrosis patients; disorder prevention; dysbiosis; early adolescence; functional decline; high risk; improved; loss of function; lung injury; lung microbiome; microbiome; microbiome analysis; oral bacteria; oral microbiome; pathogenic bacteria; peer; premature; prevent; preventive intervention; prospective; pulmonary function; pulmonary function decline; respiratory; respiratory health

Abstract Cystic fibrosis (CF) is the most common life-limiting autosomal recessive disease in Caucasians. Impaired mucociliary clearance predisposes individuals with CF to chronic respiratory infections, resulting in progressive lung damage and premature death. We and others have shown that oral bacteria infect the lungs in individuals with CF at high concentrations. Caries and gingivitis are associated with an increased abundance of pathogenic and often proinflammatory intraoral bacteria that can be aspirated. Dental plaque flora can cause pneumonia, for example in mechanically-ventilated patients. Given the broader evidence of oral-respiratory links, it is surprising that the association between oral diseases and respiratory health in CF has never been evaluated, even though there is a plausible microbiological mechanism. The overall hypothesis of this proposal is that oral diseases, defined as caries and gingivitis, are potentially modifiable contributors to lung disease in CF. In this 5-year observational U01, we will enroll 210 adolescents and young adults with CF ages 12 to 30 years at 3 sites: Seattle Children’s Hospital, the University of North Carolina Chapel Hill, and the University of Alabama at Birmingham. The study will involve 3 study visits over 24 months. We will obtain quantitative and qualitative data on risk factors for oral diseases; perform a standardized assessment of caries and gingivitis; evaluate respiratory health outcomes; and collect sputum, saliva, and plaque for microbiome analyses. The Aims are to: (1) Describe the prevalence and incidence of oral diseases in adolescents and young adults with CF and identify corresponding risk factors with an emphasis on how to improve key oral health behaviors; (2) Evaluate cross-sectional and longitudinal associations between oral diseases and respiratory outcomes; and (3) Explore microbiome pathways that link oral and respiratory health. The proposed study will be the largest and first longitudinal CF oral health study to date, and the first to evaluate respiratory outcomes associated with oral diseases in CF. Our long-term objective is to develop behavioral randomized clinical trials for adolescents and young adults with CF to prevent oral diseases and protect respiratory health. We also seek to elucidate mechanisms that explain the systemic health consequences of oral diseases. More broadly, our approach provides a framework for improving the oral health of medically compromised populations through critical epidemiologic inquiry and evidence-based interventions.

抽象的 囊性纤维化（CF）是高加索人中最常见的限制生命的常染色体隐性疾病。受损 或 肺部损伤和过早死亡。我们和其他人表明，口腔细菌感染了个体的肺 CF高浓度。龋齿和牙龈炎与丰度增加有关 可以吸出的致病性且经常促炎的口腔内细菌。牙菌斑菌群可能导致 肺炎，例如在机械通风的患者中。鉴于口腔呼吸器的更广泛的证据 链接，令人惊讶的是，CF的口腔疾病与呼吸健康之间的关联从未如此 评估，即使存在合理的微生物机制。该提议的总体假设 是口腔疾病，被定义为龋齿和牙龈炎，是导致肺部疾病的可改变的因素 参见在这个5年的观察性U01中，我们将招募210名青少年和12至30岁的年轻人 在3个地点：西雅图儿童医院，北卡罗来纳大学教堂山和大学 伯明翰的阿拉巴马州。该研究将在24个月内进行3次研究访问。我们将获得定量和 关于口腔疾病风险因素的定性数据；对龋齿和牙龈炎进行标准化评估； 评估呼吸健康结果；并收集痰，唾液和斑块进行微生物组分析。 目的是：（1）描述青少年和年轻人口腔疾病的患病率和发生率 患有CF的成年人并确定相应的风险因素，重点是如何改善钥匙口头 健康行为； （2）评估口腔疾病与 呼吸结局； （3）探索与口腔和呼吸健康联系的微生物组途径。这 拟议的研究将是迄今为止最大和第一个纵向CF口腔健康研究，也是第一个评估的研究 CF中与口腔疾病有关的呼吸结局。我们的长期目标是发展行为 青少年和患有CF年轻人的随机临床试验，以预防口腔疾病并保护 呼吸健康。我们还寻求阐明解释系统健康后果的机制 口腔疾病。更广泛地说，我们的方法为改善医学的口腔健康提供了一个框架 通过关键的流行病学探究和基于证据的干预措施损害了人群。