Chronic fatigue syndrome patients have alterations in their oral microbiome composition (PLoS ONE)

M Paine

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Chronic fatigue syndrome patients have alterations in their oral microbiome composition and function

(Link to Paper)

Abstract

Host–microbe interactions have been implicated in the pathogenesis of chronic fatigue syndrome (CFS), but whether the oral microbiome is altered in CFS patients is unknown. We explored alterations of the oral microbiome in Chinese Han CFS patients using 16S rRNA gene sequencing and alterations in the functional potential of the oral microbiome using PICRUSt. We found that Shannon and Simpson diversity indices were not different in CFS patients compared to healthy controls, but the overall oral microbiome composition was different (MANOVA, p < 0.01). CFS patients had a higher relative abundance of Fusobacteria compared with healthy controls. Further, the genera Leptotrichia, Prevotella, and Fusobacterium were enriched and Haemophilus, Veillonella, and Porphyromonas were depleted in CFS patients compared to healthy controls. Functional analysis from inferred metagenomes showed that bacterial genera altered in CFS patients were primarily associated with amino acid and energy metabolism. Our findings demonstrate that the oral microbiome in CFS patients is different from healthy controls, and these differences lead to shifts in functional pathways with implications for CFS pathogenesis. These findings increase our understanding of the relationship between the oral microbiota and CFS, which will advance our understanding of CFS pathogenesis and may contribute to future improvements in treatment and diagnosis.
 

ChrisD

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It's very interesting. I can't find any literature on it now but I have read about a connection between the mouth and gut (not by the digestive system before), it could be absolute nonsense but I have seen it recommended to swill probiotic yogurt at the back of the mouth so that bacteria can pass through a barrier of some kind.

Surely there findings are more a result of the illness rather than causal?

This study demonstrates that Oral microbiota may play a role in the development of Pancreatic cancer https://gut.bmj.com/content/gutjnl/67/1/120.full.pdf
 

Wishful

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I suppose we could experiment with mouthwash, herbal antibiotics held in the mouth, or whatever else we can come up with to alter the oral microbiome. If it was causal, I think someone would have noticed differences when changing diets, chewing gum vs not chewing gum, etc. Maybe there are some existing studies showing that immune activation or metabolic changes can alter the oral ecosystem.

Yes, a quick check found: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736563/ It concludes:

'Our comprehensive analysis of the oral microbiome in parallel with the gut microbiome supports the notion that metabolic disease can influence the non-gut human microbiome. Using rigorous analytical methods and a large sample size from a twin-family cohort, we demonstrated the use of local oral bacteria as potential biomarkers for systemic disease. Microbial biomarkers hold great potential as noninvasive diagnostic measures of systemic disease.'

I'm not in the mood for reading it in detail, but it seems pretty clear that they found that diseases alter the oral microbiome. I won't bother with mouthwash experiments.
 

M Paine

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They address the cause vs effect question in the paper, here's an excerpt:

CFS is an agnogenic disease, whose symptoms involve many systems[15] and systemic inflammatory factors[18]. Thus, CFS patient oral microbiome alterations may be only one clinical index of CFS pathogenesis. It may be that oral microbiome alterations increase the severity of symptoms and thus lead to or accelerate changes in inflammatory factors. Yet the reverse may also be true, CFS-induced oral symptoms may result in oral microbiome alterations. However, regardless of the causal relationship between oral microbiome alterations and oral CFS symptoms, these two features along with alterations in inflammatory factors[18, 19] are associated with infections. Thus, infections may also contribute to CFS symptoms, although further research is required to test this hypothesis.
My question would be, is the shift in the microbiome we see a result of altered metabolism, or of inflammatory processes?

Probably the answer is 'both'. Inflammation helps to drive some of the metabolic changes we know are occurring. The question ultimately is why it is happening. The root cause. They suggest infections as one answer... but at this point it seems unclear.
 
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sb4

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I am interested in this as my CFS started after tonsilitis. Perhaps this changed my mouth flora. I know poor dental health is associated with bad overal health but cause and effect is not clear. Some bacteria in mouth are associated with (the same?) bacteria in the heart causing heart disease.

I think it is Klinghardt who thinks dental problems / infection are a big deal because it is the easiest way for infections to get into your system (via nerves / blood supply to the teeth?).
 

HowToEscape?

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It is my understanding that sanitizing mouthwash can ruin the good bacteria in the gut as does hand sanitizer.
How would the mouthwash get all the way to your gut? You spit it out, then rinse, how far would any traces left behind get? I'm thinking to the stomach at most. I don't actually know the processes/pathways and mechanisms involved.
 

lafarfelue

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How would the mouthwash get all the way to your gut? You spit it out, then rinse, how far would any traces left behind get? I'm thinking to the stomach at most. I don't actually know the processes/pathways and mechanisms involved.
It'd be due to the delicate balance of the microbiome found in the mouth and further down in the gut. For those of us with very precariously balanced systems (eg. most pwME), even a little is likely to have an effect on one or the other microbiome.

This is an example of the discussion around hand sanitisers and microbiome (imagine the same being extrapolated to mouthwash, which is intended to kill oral bacteria): https://www.sciencealert.com/antiba...ly-quickly-mess-with-gut-bacteria-study-finds
 
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This is very timely. I include below an email I sent to Ken at CFS remission last month:

"I have written to you before about oral bacteria / bacteria as I was experiencing recurrent oral blood blisters.
As a severe M.E patient I suffer from very broken sleep – often waking over 10 times a night.

Over the last few months I have noticed that when I rinse for a minimum of 2 minutes with a certain mouth wash before bed then waking times seem to be reduced.

I have experimented with other brands with less success. I have also tried adding colloidal silver, although this did not enhance the effect.

I wonder whether this maybe affecting the mouth bacteria or that an ingredient of the product is having some sedative impact.

It is http://www.optimanaturals.net/en/products/aloe-dent/aloedent-mouthwash

I thought this perhaps is of some interest."

Ken suggested I also tried a neem mouthwash. I have done this and can confirm it has the same effect.

I must stress I have seen no other improvement in symptoms and my stomach / digestive issues are as troublesome as ever.
 

ChrisD

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HowToEscape?

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It'd be due to the delicate balance of the microbiome found in the mouth and further down in the gut. For those of us with very precariously balanced systems (eg. most pwME), even a little is likely to have an effect on one or the other microbiome.

This is an example of the discussion around hand sanitisers and microbiome (imagine the same being extrapolated to mouthwash, which is intended to kill oral bacteria): https://www.sciencealert.com/antiba...ly-quickly-mess-with-gut-bacteria-study-finds
our systems are easily thrown off. Ordinary things I had zero problem with before knock me down now. Wouldn't have believed it was possible until it happened to me.
 

HowToEscape?

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Thanks for catching that. Most of us have either too much brain fog or not enough science background to read and comprehend those papers. Many studies don't actually mean what people citing them on the internet or their blog etc say they mean.
 
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Could this be a reason I got periodontal disease and lost several healthy teeth because of it?

I had EBV as a teen and the dentist diagnosed the periodontal disease when I was about 27, about 10 years later.

I had good years, but never as much energy as my peers.
I am trying to put the pieces together in my mind.
I am beginning to suspect I have had partial remission for 20 years.
I have been disabled and have cervical spinal stenosis, and Fibromyalgia as well

These may seem silly questions, but I have never been of a scientific mind, more of an artist and communicator. I would appreciate any questions answered on the subject.

Thank you
 

Wishful

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I expect it's possible that chronic inflammation could effect on oral bacteria and thus cause periodontal problems. There was another paper mentioned somewhere here that claimed that tooth decay was not due to bacteria, but to dysfunctional transport of minerals in the teeth, which I suppose inflammation could also affect. Proving those things would be difficult.

I don't know about the rest of you, but I find myself continually tempted to blame problems and failures in my life on ME. No one can prove that they aren't due to ME, after all. :D Things before I got ME? Well, maybe they were due to the predisposition to ME. :D:D
 

kangaSue

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I seem to recall that there has been the odd mention by some here on PR that swirling a nitrate around the mouth has beneficial effects, just can't remember offhand what they were.

Interesting that this paper concludes that;
[Practicing good oral hygiene, maintaining a stable oral biofilm, and having an ample amount of NO-producing bacteria in the oral cavity may help ameliorate gastrointestinal disorders.]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104390/
 

kangaSue

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HowToEscape?

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I expect it's possible that chronic inflammation could effect on oral bacteria and thus cause periodontal problems. There was another paper mentioned somewhere here that claimed that tooth decay was not due to bacteria, but to dysfunctional transport of minerals in the teeth, which I suppose inflammation could also affect. Proving those things would be difficult.

I don't know about the rest of you, but I find myself continually tempted to blame problems and failures in my life on ME. No one can prove that they aren't due to ME, after all. :D Things before I got ME? Well, maybe they were due to the predisposition to ME. :D:D
it's a basic human tendency, and weakness, to assign all one's failures or disappointments to a single cause with a name, if that named cause is outside oneself. Stuff often happens after multiple, messy, unclear, icky, sticky, complicated causes which are too much to fully comprehend.