The Bacterial Connection between the Oral Cavity and the Gut Diseases

Abstract

More than 100 trillion symbiotic microorganisms constitutively colonize throughout the human body, including the oral cavity, the skin, and the gastrointestinal tract. The oral cavity harbors one of the most diverse and abundant microbial communities within the human body, second to the community that resides in the gastrointestinal tract, and is composed of >770 bacterial species. Advances in sequencing technologies help define the precise microbial landscape in our bodies. Environmental and functional differences render the composition of resident microbiota largely distinct between the mouth and the gut and lead to the development of unique microbial ecosystems in the 2 mucosal sites. However, it is apparent that there may be a microbial connection between these 2 mucosal sites in the context of disease pathogenesis. Accumulating evidence indicates that resident oral bacteria can translocate to the gastrointestinal tract through hematogenous and enteral routes. The dissemination of oral microbes to the gut may exacerbate various gastrointestinal diseases, including irritable bowel syndrome, inflammatory bowel disease, and colorectal cancer. However, the precise role that oral microbes play in the extraoral organs, including the gut, remains elusive. Here, we review the recent findings on the dissemination of oral bacteria to the gastrointestinal tract and their possible contribution to the pathogenesis of gastrointestinal diseases. Although little is known about the mechanisms of ectopic colonization of the gut by oral bacteria, we also discuss the potential factors that allow the oral bacteria to colonize the gut.

Keywords: bacteria; host-pathogen interactions; microbiology; mucosal immunity; periodontal disease/periodontitis; systemic health/disease.

Figure.

Possible routes of oral bacteria transmigration from the mouth to the gut. The diagram depicts possible routes of oral bacteria transmigration from the oral cavity to the gut and potential factors contributing to the ectopic colonization of oral bacteria in the gut. Laboratory and clinical studies discussed in this review reveal 2 possible routes: hematogenous (red) and enteral (blue). *Enterobacter aerogenes was renamed Klebsiella aerogenes in 2017.