Association between polycystic ovary syndrome, oral microbiota and systemic antibody responses

Abstract

Polycystic ovary syndrome (PCOS) is a hormonal disorder of women that not only is the leading cause of infertility but also shows a reciprocal link with oral health. This study aimed to investigate the hypothesis that the levels of putative periodontal pathogens in saliva and their antibody response in serum are elevated in PCOS, compared to systemic health. A total of 125 women were included in four groups; 45 women with PCOS and healthy periodontium, 35 women with PCOS and gingivitis, 25 systemically and periodontally healthy women, 20 systemically healthy women with gingivitis. Salivary levels of seven putative periodontal pathogens were analyzed by quantitative real-time polymerase chain reaction and serum antibody levels were analyzed by ELISA. In women with PCOS, salivary Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus oralis and Tannerella forsythia levels were higher than matched systemically healthy women, particularly in the case of gingivitis. Aggregatibacter actinomycetemcomitans and Treponema denticola levels were similar among study groups. The presence of PCOS also enhanced P. gingivalis, Prevotella intermedia and S. oralis serum antibody levels, when gingivitis was also present. Gingival inflammation correlated positively with levels of the studied taxa in saliva, particularly in PCOS. The presence of P. gingivalis and F. nucleatum in saliva also exhibited a strong positive correlation with the corresponding serum antibody levels. In conclusion, as an underlying systemic endocrine condition, PCOS may quantitatively affect the composition of oral microbiota and the raised systemic response to selective members of this microbial community, exerting a confounding role in resultant gingival inflammation and periodontal health. The most consistent effect appeared to be exerted on P. gingivalis.

Figure 1. Levels of detection of different species in saliva.

Levels of detection of different species in saliva from PCOS with periodontal health (ph) (n = 45); PCOS with gingivitis (pg) (n = 35); systemically healthy with periodontal health (hh) (n = 25); systemically healthy with gingivitis (hg) (n = 20). The individual values represent bacterial counts in saliva (A); Total bacterial counts (B); A. actinomycetemcomitans, (C); T. denticola, (D); P. gingivalis, (E); F. nucleatum, (F); P. intermedia, (G); T. forsythia, and (H); S. oralis in both groups. The horizontal lines in the boxplots represent the median values and the whiskers represent the 5–95 percentiles. Values below and above the whiskers are drawn as individual dots. *p<0.05, **p<0.01, ***p<0.001.

Figure 2. Antibody levels of different species in serum.

Antibody levels of different species in serum from PCOS with periodontal health (ph) (n = 45); PCOS with gingivitis (pg) (n = 35); systemically healthy with periodontal health (hh) (n = 24); systemically healthy with gingivitis (hg) (n = 20). The individual values represent antibody levels in serum (A); P. gingivalis, (B); T. denticola, (C); T. forsythia, (D); A. actinomycetemcomitans, (E); F. nucleatum, (F); P. intermedia, and (G); S. oralis in both groups. The horizontal line indicates the study groups. The horizontal lines in the boxplots represent the median values and the whiskers represent the 5–95 percentiles. Values below and above the whiskers are drawn as individual dots. *p = 0.02, **p = 0.01.