Open Your
Mouth & Say
“Ah”
Searching for Signs of
Energy Balance in the Oral
Microbiome
Center for Energy Balance Journal
Club
Kristi Hoffman, PhD, MPH
12/17/2015
Journal Club Outline
• What is the microbiome?
• Energy balance and the gut microbiota
• Why focus on the mouth?
• Data with the Mexican-American cohort
• Future Directions
Man and microbe have a symbiotic relationship
Adapted from Turnbaugh et al, 2007
The gut microbiome influences energy balance
Diet rapidly alters gut microbiota
Tremaroli & Backhed, Nature 2012
Obese gut dysbiosis influences
host physiology
Obese phenotype transmissable via gut microbiome
Tremaroli et al, Cell Metabolism 2015
Walker & Parkhill, Science 2013
What about the oral
microbiota?
Obesity increases risk for oral pathology
• Reduced salivary flow rate
• Dry mouth
• Halitosis
• Obese children at higher
risk of dental caries
• Relationship in adults
less clear
• Obese adults and children
have higher odds of
periodontal disease
• Dependent on oral hygiene
Post-prandial saliva of obese exhibits greater
proteolysis, less lipolysis
Vors et al, Int Journal of Obesity 2015
Salivary proteins vary by obese state
Falchi et al, Nature Genetics 2014
Pepino et al, Obesity 2014
Early oral microbiome studies found links with
obesity
Early oral microbiome studies found links with
obesity
Zeigler et al, Pediatric Obesity 2012
Early oral microbiome studies found links with
obesity
Tremaroli et al, Cell Metabolism 2015 (figure)
Shillitoe et al, Journal of Oral Microbiology 2012 (referenced research)
Zeigler et al, Pediatric Obesity 2012
Mano a Mano Mexican-American Cohort
• Prospective cohort
• >25,000 self-identified
Mexican-Americans
• Living in greater Houston
metropolitan area
• Demographic and health
information gathered at
baseline
• Blood, urine, buccal sample
• Followed annually for
changes in health status,
including weight gain/loss,
diabetes and cancer dx
Chow et al, Int Journal of Epidemiology 2015
Characteristics of the Mexican-American cohort
• ALL UNPUBLISHED
DATA REMOVED
FROM
PRESENTATION
Chow et al, Int Journal of Epidemiology 2015
Mano a Mano Mexican-American Cohort
• Prospective cohort
• >25,000 self-identified
Mexican-Americans
• Living in greater Houston
metropolitan area
• Demographic and health
information gathered at
baseline
• Blood, urine, buccal sample
• Followed annually for
changes in health status,
including weight gain/loss,
diabetes and cancer dx
Buccal sample
• DNA
• Swish & spit mouth wash
•
•
16S rRNA gene
>16,000 sequencing reads per
sample!
Chow et al, Int Journal of Epidemiology 2015
To summarize…
• ALL UNPUBLISHED DATA REMOVED FROM SLIDE PRESENTATION
What does it all
mean?
What does it all
mean?
Oral microbiome as a biomarker
• Biological mechanism or proxy for other factors
• Identify those most in need of intervention for weight
gain prevention
Many prospective cohorts have buccal or saliva samples
Cohort Study
Study Initiated
(Sample Collection)
Men
Buccal or Saliva
Women
Sample
Nurses' Health Study I
1976
(2001-2004)
x
121,700
33,040
Nurses' Health Study II
1989
(2006)
x
116,678
29,392
Health Professionals Follow-up Study
1986
(2006)
51,529
x
13,979
Growing Up Today
1996
(2011-2013)
12,763
15,043
3,000
NCI PLCO Trial
1994
(2000-2003)
76,683
78,214
66% of control arm
(~50,000)
59,000
>25,000
Black Women's Health Study
1995
NIH-AARP Diet & Health Study
1995
>300,000
>200,000
34,262
VITamins And Lifestyle Study (VITAL)
1999
37,314
40,424
54,417
Mano a Mano Mexican American Cohort
2001
4,886
18,720
63%
(~15,000)
Adapted and updated from Nutritional Epidemiology (2013), W. Willet
Future Plans
• Evaluate prediction model with additional taxa
• Increase sample size to 400
• ALL UNPUBLISHED DATA REMOVED FROM SLIDE PRESENTATION
Acknowledgements
UT MD Anderson Cancer Center
• Carrie Daniel-MacDougall
• Jing Zhang
Alkek Center for Metagenomics &
Microbiome Research
•
•
•
•
Joe Petrosino
Nadim Ajami
Diane Hutchinson
Dan Smith