title: Clustering of Subgingival Microbiota Reveals Microbial Disease Ecotypes Associated with Clinical Stages of Periodontitis in a Cross-Sectional Study.
abstract: Periodontitis is characterized by chronic inflammation associated with alteration of the oral microbiota. In contrast to previous microbiome studies focusinga priorion comparison between extreme phenotypes, our study analyzed a random sample of 85 people. The aim of this study was to link microbial differences to disease's prevalence and severity. Using next generation sequencing of 16S rRNA amplicons and cluster analysis, we observed that the population can be divided into two major ecotypes: One mainly contained periodontal healthy/mild periodontitis individuals whereas the second ecotype showed a heterogeneous microbial distribution and clustered into three distinct sub-ecotypes. Those sub-ecotypes differed with respect to the frequency of diseased patients and displayed a gradual change in distinct subgingival microbiota that goes along with clinical disease symptoms. In ecotype 2, the subgroup with no clinical signs of disease was linked to an increase ofF. nucleatum vincentiibut also several other species, while only in "end-stage" dysbiosis classical red complex bacteria gained overweight. Therefore, the microbial disease ecotypes observed in our population can lead to an establishment of an early microbial risk profile for clinically healthy patients.
authors.affiliation: Department of Infectious Diseases, Medical Microbiology and Hygiene, University Hospital HeidelbergHeidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL)Heidelberg, Germany.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Boutin
authors.affiliation: Department of Periodontology and Restorative Dentistry, University Hospital MünsterMünster, Germany; Section of Periodontology, Department of Conservative Dentistry, University Hospital HeidelbergHeidelberg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hagenfeld
authors.affiliation: Institute of Public Health, Epidemiology and Biostatistics, Heidelberg University Heidelberg, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Zimmermann
authors.affiliation: Section of Periodontology, Department of Conservative Dentistry, University Hospital Heidelberg Heidelberg, Germany.
authors.forename: Nihad
authors.initials: N
authors.lastname: El Sayed
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center Heidelberg, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Höpker
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center Heidelberg, Germany.
authors.forename: Halina K
authors.initials: HK
authors.lastname: Greiser
authors.affiliation: Institute of Public Health, Epidemiology and Biostatistics, Heidelberg UniversityHeidelberg, Germany; Institute of Medical Biostatistics and Epidemiology, University Hospital Hamburg-EppendorfHamburg, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
authors.affiliation: Section of Periodontology, Department of Conservative Dentistry, University Hospital Heidelberg Heidelberg, Germany.
authors.forename: Ti-Sun
authors.initials: TS
authors.lastname: Kim
authors.affiliation: Department of Infectious Diseases, Medical Microbiology and Hygiene, University Hospital HeidelbergHeidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL)Heidelberg, Germany.
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Dalpke
keywords: microbial ecology; microbiome; periodontitis; polymicrobial infections; subgingival plaque