Oral and Gut Microbial Diversity and Immune Regulation in Patients with HIV on Antiretroviral TherapyOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
This study examined the relationship between oral and gut microbial diversity and chronic systemic inflammation in people living with HIV (PLWH) who were on antiretroviral therapy (ART) and had prevalent severe periodontitis. Researchers profiled bacterial communities using 16S rRNA sequencing and fungal communities using internal transcribed spacer (ITS) sequencing at oral (plaque, saliva) and gastrointestinal sites. They then used linear mixed-effect regression and differential abundance analyses to link clinical characteristics and immune markers to microbial diversity and community composition.
Who was studied?
The cohort consisted of 52 ART-treated people living with HIV, described as primarily postmenopausal women, who had prevalent severe periodontitis. Samples were collected from oral sites (plaque and saliva) and the gastrointestinal tract within this cohort. The abstract does not provide further demographic detail beyond ART status, HIV status, sex composition, and periodontitis status.
What were the most important findings?
Bacterial alpha-diversity in plaque, saliva, and gut samples was each associated with different immunological markers of inflammation and immune dysfunction. Lipopolysaccharide-positive (LPS+) bacteria, previously linked to inflammatory outcomes, were enriched at oral sites in patients with severe periodontitis. In contrast, mycobial (fungal) diversity was not associated with soluble or cellular biomarkers of immune stimulation or T cell dysfunction. Fungal alpha-diversity was reduced in plaque taken from teeth with higher levels of periodontal disease severity.
What are the greatest implications of this study?
The findings suggest that oral bacterial communities, particularly LPS-producing taxa associated with periodontitis, may contribute to the chronic immune activation seen in ART-treated PLWH, independent of viral suppression. Because bacterial but not fungal diversity tracked with immune markers, oral bacterial dysbiosis and periodontal disease may be a more direct driver of systemic inflammation than the oral mycobiome in this population. This points to periodontal health as a potential target for reducing residual inflammation in people with HIV on ART.