Cavity-Causing Bacteria Linked To Endocarditis

We have long ago heard that gum disease may be linked to heart disease, but now due to recent discoveries made at the University of Rochester, there is even more evidence to shed light on why and how our oral health may affect the heart.

Thanks to the investigative work of Jacqueline Abranches, Ph.D. and her team at the University of Rochester’s Center for Oral Biology, we can now better understand why the cavity-inducing bacteria called Streptococcus mutans may be a leading cause of endocarditis, the potentially deadly inflammation of the heart valves. Infectious endocarditis can result in the destruction of heart valves and cardiac muscle, leading to “leaky heart valves” and heart failure.  Untreated or undertreated endocarditis is often fatal.

Dental plaque containing Streptococcus mutans, or S. mutans, can invade the bloodstream as a result of tooth brushing, flossing, and dental procedures such as tooth extraction and periodontal surgery. Most of the time, our body’s immune system is well capable of instantly destroying this bacterial invasion once they enter into the bloodstream. However, there are certain circumstances in which the strength of our immune systems alone is insufficient to prevent these bacteria from entering into our heart valve tissue.  Recent studies for instance identified S. mutans, the primary etiological agent of cavities, as the most prevalent bacterial species found in samples from patients who underwent heart valve and atheromatous plaque surgery.  Understanding the mechanisms by which S. mutans enter into the heart valve tissue was the motivation behind the work of Dr. Abranches; her findings, no doubt, will lead to important preventative protocols in the future.

Dr. Abranches and her team discovered that a collagen-binding protein known as CNM gives S. mutans its ability to successfully invade heart tissue.  Through a series of laboratory experiments, these microbiologists first discovered that S. mutans strains with CNM proteins were able to invade heart cells while strains without CNM proteins were not. Further research made very clear the role of CNM proteins as a mechanism of enabling heart tissue invasion. When Dr. Abranches and her team inactivated the gene for CNM from S. mutans strains with CNM proteins, these altered bacteria were no longer able to invade heart tissue.

Undoubtedly, these findings will one day lead to the development of biomarkers that will identify through screening patients colonized with S. mutans strains with CNM proteins. This will ensure that the appropriate prevention measures are taken prior to dental treatment. Similarly, these biomarkers may also be used to identify patients who may be at risk for endocarditis given the presence of S. mutans strains with CNM proteins.  More importantly, however, this work is a wake up call to all dental clinicians and cardiologists to the need for greater attention to be paid to the link between complex oral infections and overall patient well-being.  Through the work of Dr. Abranches and others, Streptococcus mutans have been linked to endocarditis, a serious condition involving inflammation of the inner lining of the heart.

Dr Abranches and her team presented their groundbreaking research at a recent conference on the “Oral Microbiome” hosted by the University of Rochester’s Center for Oral Biology, which is a part of the Medical Center’s Eastman Institute for Oral Health.

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