RESUMO
BACKGROUND: There are few studies on periodontal status related to microbiologic and immunologic profiles among individuals not or occasionally using alcohol and those with alcohol dependence. The aim of this study is to determine the effect of alcohol consumption on the levels of subgingival periodontal pathogens and proinflammatory cytokines (interleukin [IL]-1ß and tumor necrosis factor [TNF]-α) in the gingival fluid among individuals with and without periodontitis. METHODS: This observational analytic study includes 88 volunteers allocated in four groups (n = 22): individuals with alcohol dependence and periodontitis (ADP), individuals with alcohol dependence and without periodontitis (ADNP), individuals not or occasionally using alcohol with periodontitis (NAP), and individuals not or occasionally using alcohol without periodontitis (NANP). Levels of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Eikenella corrodens, and Fusobacterium nucleatum were determined by real-time polymerase chain reaction on the basis of the subgingival biofilm, and IL-1ß and TNF-α were quantified by enzyme-linked immunosorbent assay in gingival fluid samples. RESULTS: Individuals with alcohol dependence showed worse periodontal status and higher levels of P. intermedia, E. corrodens, F. nucleatum, and IL-1ß than non-users. No significant correlations between TNF-α and bacterial levels were observed. However, in the ADP group, higher levels of E. corrodens were correlated with higher levels of IL-1ß. CONCLUSION: A negative influence of alcohol consumption was observed on clinical and microbiologic periodontal parameters, as well as a slight influence on immunologic parameters, signaling the need for additional studies.
Assuntos
Consumo de Bebidas Alcoólicas , Líquido do Sulco Gengival/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Interleucina-1beta/análise , Periodontite/microbiologia , Fator de Necrose Tumoral alfa/análise , Adulto , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Consumo de Bebidas Alcoólicas/imunologia , Alcoolismo/imunologia , Alcoolismo/microbiologia , Carga Bacteriana , Biofilmes , Estudos Transversais , Eikenella corrodens/isolamento & purificação , Feminino , Fusobacterium nucleatum/isolamento & purificação , Líquido do Sulco Gengival/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/imunologia , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/isolamento & purificaçãoRESUMO
OBJECTIVES: The aim of this study was to evaluate the composition of the subgingival microbiota of alcoholic and non-alcoholic individuals. METHODS: The study was conducted with 49 alcoholic and 49 non-alcoholic males of the Philippe Pinel Institute, Rio de Janeiro, Brazil. The subjects were selected by convenience and two criteria were used to diagnose alcohol dependence: the CAGE (cut-down, annoyed, guilt, eyes-opener) questionnaire and the International Statistical Classification of Diseases, 10th edition (WHO). Subgingival biofilm samples were obtained from 4 sites, 2 with probing depth (PD) ≥ 4 mm and 2 sites with PD < 4 mm. The presence and levels of 45 bacterial taxa were analysed using the checkerboard technique. RESULTS: The prevalence of bacterial species was not significantly different between groups. However, alcoholics showed significantly higher mean counts of Aggregactibacter actinomycetemcomitans, Fusobacterium nucleatum nucleatum, and Porphyromonas gingivalis (adjusted p < 0.001). Moreover, alcoholics harboured significantly higher mean levels of Capnocytophaga sputigena, Fusobacterium nucleatum vincentii, F. nuc. nucleatum, Gemella morbillorum, Neisseria mucosa, P. gingivalis, Streptococcus gordonii, and Tannerella forsythia at sites with PD < 4 mm or ≥ 4 mm compared to non-alcoholics (p ≤ 0.001). Of interest, shallow sites of alcoholics presented significantly higher mean levels of F. nuc. vincentii, F. nuc nucleatum, P. gingivalis, and T. forsythia than sites with PD ≥ 4 mm of non-alcoholics (p ≤ 0.001). CONCLUSIONS: Alcoholics and non-alcoholics present a diverse and complex microbiota; however, alcoholics harbour significantly higher levels of periodontopathic species in the subgingival microbiota than non-alcoholics.
Assuntos
Alcoolismo/microbiologia , Placa Dentária/microbiologia , Bolsa Periodontal/microbiologia , Adulto , Brasil , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Estudos Transversais , DNA Bacteriano/análise , DNA Bacteriano/genética , Humanos , Masculino , Pessoa de Meia-Idade , Tipagem Molecular/métodos , Hibridização de Ácido Nucleico , Estatísticas não ParamétricasRESUMO
A case of the Austrian syndrome in a 23 year-old male, alcoholic and non-vaccinated against pneumococci, is reported. Autopsy study disclosed alcoholic liver disease, endocarditis, meningitis and pneumonia. Pneumococci were observed in the vegetations found in the mitral and aortic valves, in the coronarian septic embolus with acute myocardial infarction, and in the spleen abscess. The authors highlight the need for prevention measures against S. pneumoniae infection in alcoholics, suggesting that clinicians be alert to this infrequent but severe syndrome that bears Austrian's name.
Assuntos
Meningite Pneumocócica/patologia , Pneumonia Pneumocócica/patologia , Adulto , Alcoolismo/complicações , Alcoolismo/microbiologia , Alcoolismo/patologia , Autopsia , Cardiopatias/microbiologia , Cardiopatias/patologia , Valvas Cardíacas/patologia , Humanos , Masculino , Streptococcus pneumoniae , SíndromeRESUMO
CONTEXT: The oropharynx microbiota plays an important role in the origin of infections, especially among alcoholics whose airway defenses are impaired. OBJECTIVE: To compare the normal oropharingeal flora in heavy alcohol drinker and non-alcoholics. PATIENTS: 117 persons, 58 heavy alcohol drinkers and 59 non-alcoholics. SETTING: Santa Casa de São Paulo Emergency Service. DESIGN: A blind prospective study. MAIN OUTCOMES MEASURES: Prevalence of aerobic and anaerobic bacteria, and fungi. RESULTS: The study of the oropharynx microbiota among heavy alcohol drinkers demonstrated the presence of anaerobic microorganisms in 84.5% of them, including: Bacteroides sp, Prevotella melaninogenica, Fusobacterium sp, Veilonella sp, Peptostreptococcus sp, Propionibacterium sp, Bifidobacterium sp and Clostridium sp, versus 30.5% (p < 0.005) of non-alcoholics. Candida sp was present in 34.5% of heavy alcohol drinkers and 5.1% of non-alcoholics (p < 0.005). Enterobacteria predominated among heavy alcohol drinkers (25%) compared with non-alcoholics (5.5%) only in the age group 14 to 34 years (p < 0.05). CONCLUSION: Based upon these results, it was possible to conclude that the knowledge of the oropharynx microbiota among heavy drinkers and non-alcoholics has an important predictive value concerning probable etiologic agents of lower airway infections. Infections caused by anaerobic microorganisms and fungi should be taken into consideration during the choice of empirical therapy for heavy alcohol drinkers.