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

基本信息

批准号：
10571699
负责人：
Donald Leslie Chi
金额：
$ 73.6万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
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/10571699
关键词：
Address Adolescence Adolescent and Young Adult Age Alabama Bacteria Behavior Behavioral Biological 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 Inflammatory Intake Intervention Life Life Expectancy Link Lung Lung diseases Measures Mechanical ventilation Medical Methods 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 Cystic Fibrosis Pulmonary Function Test/Forced Expiratory Volume 1 Quality of life Reflux Respiratory Tract Infections Risk Risk Factors Saliva Site Source Sputum Standardization Stomach Streptococcus mutans Time Universities Visit Weight age group aspirate autosome 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 randomized, clinical trials respiratory respiratory health

项目摘要

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）是白种人中最常见的限制生命的常染色体隐性遗传疾病。粘液纤毛清除功能使 CF 患者易患慢性呼吸道感染，从而导致进行性进展我们和其他人已经证明口腔细菌会感染个体的肺部。高浓度的 CF 与龋齿和牙龈炎有关。可吸入的牙菌斑菌群可引起致病性且通常促炎的口腔内细菌。考虑到更广泛的口腔呼吸证据，例如机械通气患者的肺炎。联系，令人惊讶的是，CF 中口腔疾病与呼吸系统健康之间的关联从未被研究过。尽管存在合理的微生物学机制，但该提案的总体假设仍然经过评估。被定义为龋齿和牙龈炎的口腔疾病是肺部疾病的潜在可改变因素在这个为期 5 年的观察性 U01 中，我们将招募 210 名年龄在 12 至 30 岁之间患有 CF 的青少年和年轻人。在 3 个地点工作多年：西雅图儿童医院、北卡罗来纳大学教堂山分校和北卡罗来纳大学阿拉巴马州伯明翰的研究将涉及 24 个月内的 3 次研究访问，我们将获得定量和结果。有关口腔疾病危险因素的定性数据；对龋齿和牙龈炎进行标准化评估；评估呼吸道健康结果；并收集痰液、唾液和菌斑进行微生物组分析。目的是： (1) 描述青少年口腔疾病的患病率和发病率患有 CF 的成人并确定相应的危险因素，重点是如何改善关键的口腔健康行为；（2）评估口腔疾病与健康行为之间的横向和纵向关联。呼吸系统结果；(3) 探索连接口腔和呼吸系统健康的微生物组途径。拟议的研究将是迄今为止最大的、第一个纵向 CF 口腔健康研究，也是第一个评估我们的长期目标是发展与 CF 口腔疾病相关的呼吸结局。针对患有 CF 的青少年和年轻人预防口腔疾病和保护的随机临床试验我们还试图阐明解释呼吸系统健康后果的机制。更广泛地说，我们的方法为改善口腔健康提供了一个框架。通过严格的流行病学调查和循证干预措施来帮助受影响的人群。