title: Relationship between Cnm-positive Streptococcus mutans and cerebral microbleeds in humans.
abstract: OBJECTIVE
  Cerebral hemorrhage has been shown to occur in animals experimentally infected with Streptococcus mutans carrying the collagen-binding Cnm gene. However, the relationship between cerebral microbleeds and oral hygiene, with a focus on Cnm gene-positive S. mutans infection, remains unclear.
  
  
  METHODS
  One hundred and thirty-nine subjects participated. The presence or absence of Cnm-positive S. mutans and its collagen-binding activity were investigated using saliva samples, and relationship with cerebral microbleeds detected on MRI investigated, including clinical information and oral parameters.
  
  
  RESULTS
  Fifty-one subjects were identified as Cnm-positive S. mutans carriers (36.7%), with cerebral microbleeds being detected in 43 (30.9%). A significantly larger number of subjects carried Cnm-positive S. mutans in the cerebral microbleeds (+) group. S. mutans with Cnm collagen-binding ability was detected in 39 (28.1%) of all subjects, and the adjusted odds ratio for cerebral microbleeds in the Cnm-positive group was 14.4. Regarding the presence of cerebral microbleeds, no significant differences were noted in the number of remaining teeth, dental caries, or in classic arteriosclerosis risk factors.
  
  
  CONCLUSIONS
  The occurrence of cerebral microbleeds was higher in subjects carrying Cnm-positive S. mutans, indicating that the presence of Cnm-positive S. mutans increases cerebral microbleeds, and is an independent risk for the development of cerebrovascular disorders.
authors.affiliation: Departments of Dental Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.|Department of Epidemiology for Community health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Miyatani
authors.affiliation: Department of Epidemiology for Community health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.|Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kuriyama
authors.affiliation: Departments of Dental Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.|Department of Epidemiology for Community health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Watanabe
authors.affiliation: Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Nomura
authors.affiliation: Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nakano
authors.affiliation: Departments of Dental Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.|Department of Epidemiology for Community health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Matsui
authors.affiliation: Department of Epidemiology for Community health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Ozaki
authors.affiliation: Department of Epidemiology for Community health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Departments of Dental Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nishigaki
authors.affiliation: Departments of Dental Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Tamura
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Akazawa
authors.affiliation: Kyoto Industrial Health Association, Kyoto, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Takada
authors.affiliation: Kyoto Industrial Health Association, Kyoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ihara
authors.affiliation: Departments of Dental Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kanamura
authors.affiliation: Department of Neurology, University of Louisville, KY, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Friedland
authors.affiliation: Department of Epidemiology for Community health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
mesh_terms: D018829:Adhesins, Bacterial / Q000235:genetics*; D000368:Aged; D002352:Carrier Proteins / Q000235:genetics*; D002353:Carrier State / Q000175:diagnosis / Q000382:microbiology*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003094:Collagen / Q000378:metabolism; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D012463:Saliva / Q000378:metabolism / Q000382:microbiology*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D013295:Streptococcus mutans / Q000235:genetics* / Q000378:metabolism
chemical_list: D018829:Adhesins, Bacterial; D002352:Carrier Proteins; C488758:Cnm protein, Streptococcus mutans; D003094:Collagen
keywords: Cnm-positive Streptococcus Mutans; Magnetic Resonance Imaging; collagen-binding protein; intracranial hemorrhage; microbleeds; stroke