口服微生物组调节可缓解妊娠期糖尿病的高血糖加重
Oral microbiome modulation mitigates hyperglycemia exacerbation in gestational diabetes mellitus.
摘要(中文译文)
糖代谢异常与牙周炎症在妊娠期经常同时发生，但连接这些状况的微生物机制及其干预潜力仍未被完全理解。在此，我们建立了包含2500余名志愿者的前瞻性妊娠队列，并对534名孕妇的口腔微生物组动态进行了纵向分析。我们发现，妊娠期糖尿病（GDM）与口腔微生物群从以链球菌为主导逐渐转变为以普雷沃氏菌/卟啉单胞菌富集的菌群失调相关。在小鼠和细胞模型中，这种失调的口腔微生物群诱导牙周炎症、全身性IL-17和IL-1β反应、胰高血糖素样肽-1和胰岛素的抑制以及高血糖的加重。相反，通过移植以链球菌为主导的细菌来重塑口腔微生物群，可减轻牙周炎症、恢复胰高血糖素样肽-1和胰岛素水平并改善小鼠的血糖状态。唾液代谢组学鉴定出GDM中二十二碳六烯酸（DHA）的耗竭，体外实验显示DHA可选择性地抑制菌群失调相关的口腔病原体。因此，我们在一项纳入40名GDM孕妇的双盲随机对照试验中测试了局部牙龈应用DHA（ChiCTR2400080741），以探诊深度和空腹血糖为主要终点，以牙龈指数、附着丧失和菌斑指数为次要终点。与安慰剂相比，每日牙龈应用DHA持续六周可改善探诊深度并减缓空腹血糖升高，空腹血糖相对基线的中位变化分别为0.10 mmol/L和0.27 mmol/L。综上，这些发现表明口腔菌群失调是妊娠期牙周和血糖恶化的微生物驱动因素，并支持口腔微生物组调节作为妊娠保健的潜在辅助策略，尽管临床发现仍属初步，需要在更大规模试验中以更广泛的血糖终点进行验证。
Abstract
Dysglycaemia and periodontal inflammation frequently co-occur during pregnancy, but the microbial mechanisms linking these conditions and their potential for intervention remain incompletely understood. Here, we establish prospective pregnancy cohorts including more than 2500 volunteers and longitudinally profile oral microbiome dynamics in 534 pregnant women. We show that gestational diabetes mellitus (GDM) is associated with a progressive shift from Streptococcus-dominated oral microbiota to Prevotella/Porphyromonas-enriched dysbiosis. In mouse and cellular models, this dysbiotic oral microbiota induces periodontal inflammation, systemic IL-17 and IL-1β responses, suppression of glucagon-like peptide-1 and insulin, and exacerbation of hyperglycemia. Conversely, oral microbiota remodeling through transplantation of Streptococcus-dominated bacteria attenuates periodontal inflammation, restores glucagon-like peptide-1 and insulin levels, and improves glycaemic status in mice. Salivary metabolomics identifies docosahexaenoic acid (DHA) depletion in GDM, and in vitro assays show selective suppression of dysbiosis-associated oral pathogens by DHA. We therefore test topical gingival DHA in a double-blind randomized controlled trial of 40 pregnant women with GDM (ChiCTR2400080741), with probing depth and fasting blood glucose as primary endpoints and gingival index, attachment loss and plaque index as secondary endpoints. Daily gingival DHA application for six weeks improves probing depth and attenuates fasting glucose increase compared with placebo, with median fasting glucose changes from baseline of 0.10 versus 0.27 mmol/L. Together, these findings identify oral dysbiosis as a microbial driver of periodontal and glycaemic deterioration during pregnancy and support oral microbiome modulation as a potential adjunctive strategy for pregnancy care, although the clinical findings remain preliminary and require validation in larger trials with broader glycaemic endpoints.
如何引用
AMA
Shengtao Gao, Nanlin Yin, Rujun Wei, Xiaoqing Li, Qiuhan Cheng, Alateng Zhula, et al. Oral microbiome modulation mitigates hyperglycemia exacerbation in gestational diabetes mellitus.. Nature communications. 2026; doi:10.1038/s41467-026-74917-w.
APA
Shengtao Gao, Nanlin Yin, Rujun Wei, Xiaoqing Li, Qiuhan Cheng, Alateng Zhula, et al (2026). Oral microbiome modulation mitigates hyperglycemia exacerbation in gestational diabetes mellitus.. Nature communications. https://doi.org/10.1038/s41467-026-74917-w
GB/T 7714
Shengtao Gao, Nanlin Yin, Rujun Wei, Xiaoqing Li, Qiuhan Cheng, Alateng Zhula, et al. Oral microbiome modulation mitigates hyperglycemia exacerbation in gestational diabetes mellitus.[J]. Nature communications, 2026 doi:10.1038/s41467-026-74917-w.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出