龋病患儿唾液中免疫球蛋白、口腔微生物群落的变化及与龋病严重程度的多因素关联性分析

Changes in salivary immunoglobulins and oral microbiota in children with dental caries and their multivariate association with caries severity

摘要:

目的 分析儿童龋病患儿唾液中免疫球蛋白水平及口腔微生物群落的变化，探讨其与龋病严重程度的多因素关联性。方法 选取2023年5月—2024年5月山西省儿童医院收治的109例龋病患儿。根据龋病严重程度将患儿分为轻度组（47例）、重度组（62例），选取同期该院50例健康儿童作为对照组。通过免疫透射比浊法检测患儿唾液中免疫球蛋白水平，荧光定量聚合酶链反应分析唾液样本中的口腔微生物群落结构。比较各组免疫球蛋白水平、口腔微生物群落变化，并结合龋失补指数（DMFT）评估其与龋病严重程度的相关性。采用多元线性回归模型评估免疫球蛋白、口腔微生物群落与龋病严重程度的关系。结果 重度组与轻度组患儿的分泌型免疫球蛋白A（sIgA）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）水平均高于对照组（P <0.05），重度组患儿的sIgA、IgA、IgG和IgM水平均高于轻度组（P <0.05）。重度组与轻度组患儿的变形链球菌、远缘链球菌、乳酸杆菌、双歧杆菌丰度均高于对照组（P <0.05），重度组患儿的变形链球菌、远缘链球菌、乳酸杆菌、双歧杆菌丰度均高于轻度组（P <0.05）。Pearson相关性分析结果表明，唾液免疫球蛋白（sIgA、IgA、IgG、IgM）与唾液口腔微生物（变形链球菌、远缘链球菌、乳酸杆菌、双歧杆菌）均呈正相关（P <0.05）。多元线性回归分析结果显示，sIgA、IgA、IgG、IgM及变形链球菌、远缘链球菌、乳酸杆菌、双歧杆菌水平升高与DMFT增加有关（P <0.05）。结论 儿童龋病的严重程度与唾液中的免疫球蛋白水平及口腔微生物群落的变化密切相关。免疫球蛋白浓度和特定微生物群落的丰度可作为评估龋病严重程度的潜在生物标志物，为龋病的早期诊断和干预提供新思路。

Abstract:

Objective To investigate the changes in salivary immunoglobulin levels and oral microbiota composition in children with dental caries and their multivariate correlation with caries severity.Methods This study included 109 children with dental caries treated at our hospital from May 2023 to May 2024. Based on caries severity, the children were divided into a mild group (n = 47) and a severe group (n = 62), with 50 healthy children in our hospital during the same period serving as the control group. Salivary immunoglobulin concentrations were measured using immunoturbidimetry, and the structure of oral microbiota in saliva samples was analyzed using quantitative real-time PCR. The immunoglobulin levels and microbiota composition were compared among the groups, and their correlation with caries severity was assessed using the Decayed-Missing-Filled Teeth (DMFT) index. Multivariate linear regression analysis was applied to evaluate the associations between immunoglobulins and microbiota and the caries severity.Results Levels of sIgA, IgA, IgG, and IgM were significantly higher in the severe and mild groups compared to the control group (P < 0.05), with the severe group showing higher levels than the mild group (P < 0.05). Similarly, the abundance of Streptococcus mutans, Streptococcus sobrinus, Lactobacillus, and Bifidobacterium was significantly elevated in both caries groups versus the control group (P < 0.05), with the severe group exhibiting higher microbial loads than the mild group (P < 0.05). Pearson correlation analysis revealed positive correlations between salivary immunoglobulin levels and oral microbiota abundance (P < 0.05). Multivariate regression demonstrated that increased levels of sIgA, IgA, IgG, and IgM, as well as the elevated abundance of Streptococcus mutans, Streptococcus sobrinus, Lactobacillus, and Bifidobacterium, were significantly associated with a higher DMFT index (all P < 0.05).Conclusion The severity of dental caries in children is closely associated with salivary immunoglobulin levels and changes in oral microbiota composition. Immunoglobulin concentrations and the abundance of specific microbiota can serve as potential biomarkers for assessing caries severity, offering new perspectives for early diagnosis and intervention in dental caries.