Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지
DOI QR코드

DOI QR Code

Helicobacter pylori in the Oral Cavity

구강 내 Helicobacter pylori

  • Ahn, Jong-Mo (Department of Oral Medicine, School of Dentistry, Chosun University)
  • 안종모 (조선대학교 치의학전문대학원 구강내과학교실)
  • Received : 2012.03.12
  • Accepted : 2012.03.26
  • Published : 2012.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Helicobacter pylori(H. pylori) associated with gastritis and gastric cancer is mainly detected dental plaque and saliva in the oral cavity. Most infection is probably acquired in childhood, but the route of transmission is not clear. The oral cavity has been indicated as secondary reservoir of H. pylori, and may therefore be argued in the route of transmission and reinfection of the stomach which follows treatment of H. pylori infection. So this review aimed to discuss about H. pylori in the oral cavity. H. pylori in stomach can appear in the oral cavity by gastroesophageal reflex or vomiting, but infection of stomach and oral cavity is different. Diagnostic methods are serological method, urea breath test, PCR method, urease test, histologic method and so on. Nested PCR recommend for detection of H. pylori in saliva and dental plaque. H. pylori infection in the oral cavity appear variously and is no relation with dental diseases. The antimicrobial mouthrinse recommend in patients with periodontal diseases because of high detection rate fo H. pylori. Thus H. pylori may be considered as the normal oral microflora.

위염 및 위암 등의 발생과 관련되어 있는 Helicobacter pylori(H. pylori)는 구강의 치태와 타액에서 주로 발견이 된다. 유년시절 동안 주로 감염되는 것으로 알려져 있지만 감염경로는 불분명하다. 구강이 H. pylori의 두 번째 서식지로서 전염경로 및 위장내 H. pylori의 제균 후 재감염에 중요한 영향을 끼칠 수 있는지는 논쟁이 되고 있다. 따라서 본 저자는 문헌고찰을 통하여 구강 내에 존재하는 H. pylori에 관하여 알아보고자 하였다. 위장에 존재하는 H. pylori는 위인두반사나 구토에 의해 구강 내 발현될 수도 있으나, 구강과 위의 감염은 서로 관련성이 없는 것으로 보고되고 있다. 진단방법으로는 혈청학적검사, 요소호기검사, 중합효소연쇄반응(polymerase chain reaction: PCR)방법, Urease검사, 조직검사 등이 있으나, 타액과 치태에서는 nested PCR 방법이 주로 추천되어 진다. 구강 내 감염율은 다양하게 나타나며, 치과질환과의 연관성은 없는 것으로 사료된다. 그러나 치주질환 환자의 구강 내에서 발현율은 높게 나타나므로, 주의가 요구되며 향균 구강세척제의 사용이 권유된다. 결과적으로 구강 내 H. pylori는 정상세균총으로 사료되며, 향후 구강내 H. pylori에 관한 추가적인 많은 연구가 필요하리라 사료된다.

Keywords

References

  1. 안종모, 나명수, 김병옥. 성인형 치주염 환자의 타액 및 치은연하치태에서 Helicobacter pylori의 발현양상. 대한치주과학회지 2004;34(4):723-731.
  2. Tytgat GN, Noach LA, Rauws EA. Helicobacter pylori infection and duodenal ulcer disease. Gastroenterol clin North Am 1993;22:127-139.
  3. Kitcheus DH, Binkely CJ, Wallace DL, Darling D. Helicobacter pylori infection in people who are intellectually and developmentally disabled : a review. Spec Care Dentist 2007;27(4):127-133. https://doi.org/10.1111/j.1754-4505.2007.tb00334.x
  4. 강승우, 유지원, 윤창륙, 안종모. 구강과 위 내 Helicobacter pylori의 상호관련성. 대한구강내과학회지 2010;35(2):101-110.
  5. 유지원, 이장근, 이명수, 윤창륙, 안종모. 한국인 소아의 타액에서 Helicobacter pylori의 검출. 대한구강내과학회지 2008;33(1):9-13.
  6. Megraud F. When and how does Helicobacter pylori infection occur? Gastroenterol Clin Biol 2003;27:374-379.
  7. Tursi A, Cammarota G, Papa A et al. The modes of transmission of Helicobacter pylori infection. Recenti prog Med 1997;88:232-236.
  8. Dowsett SA, Kowolik MJ. Oral Helicobacter pylori : Can we stomach it ? Crit Rew Oral Biol Med 2003;14:226-233. https://doi.org/10.1177/154411130301400307
  9. 안종모, 윤창륙, 이장근, 이영수, 이상호. 한국인의 타액에서 연령증가에 따른 Helicobacter pylori의 발현양상. 구강생물학회지 2005;29(3):5-12.
  10. Bussac G. Helicobacter pylori and the oral environment. Pract periodontics and aesthetic dent 1999;11(8):918-922.
  11. Danielsson D, Farmery SH, Blomberg B, Perry S, Rautelin H, Crabtree JE. Co-expression in Helicobacter pylori of cag A and non-opsonic neutrophil activation enhances the association with peptic ulcer disease. J Clin Pathol 2000;53(4):318-321. https://doi.org/10.1136/jcp.53.4.318
  12. 백승철, 김종배, 조명제 등. 한국인 정상성인의 Helicobacter pylori 보균율. 대한미생물학회지 1990;25(6):455-462.
  13. Gwak J, Shin A, Kim CS et al. Cag A-producing Helicobacter pylori and increased risk of gastric cancer : a nested case-control study in Korea. Br J Cancer 2006;95(5):639-641. https://doi.org/10.1038/sj.bjc.6603309
  14. Andersen RN, Ganeshkumar N, Kolenbrander PE. Helicobacter pylori adheres selectively to Fusobacterium spp. Oral microbiol Immunol 1998;13(1):51-54. https://doi.org/10.1111/j.1399-302X.1998.tb00751.x
  15. Veerman EC, Bank CN, Namavar F et al. Sulfated glycans on oral mucin as receptors for Helicobacter pylori. Glycobiology 1997;7(6):737-743. https://doi.org/10.1093/glycob/7.6.737
  16. Leung WK, Kris LL, Carrie KL, Chan SY, Rita S, Joseph JY. Isolation of Helicobacter pylori from vomitus in children and its implication in gastro-oral transmission. Am J Gastroenterology 1999;94(10):2881-2884. https://doi.org/10.1111/j.1572-0241.1999.01431.x
  17. Li C, Musich PR, Ha T et al. High prevalence of Helicobacter pylori in saliva demonstrated by a novel PCR assay. J Clin Pathol 1995;48(1):662-666. https://doi.org/10.1136/jcp.48.7.662
  18. Silva Rossi-Aguiar Up, Navarro-Rodriguez T, Matter R et al. Oral cavity is not a reservoir for Helicobacter pylori in infected patients with functional dyspepsia. Oral microbiol Immmunol 2009;24(3):255-257. https://doi.org/10.1111/j.1399-302X.2008.00491.x
  19. Czesnikiezicz-Guzik M, Loster B, Bielanski W et al. Implication of oral for the outcome of its gastric eradiation therapy. J Clin Gastroenterol 2007;41(2):145-151. https://doi.org/10.1097/01.mcg.0000225654.85060.3d
  20. Karczewska E, Konturek JE, Konturek PC et al. Oral cavity as a potential source of gastric reinfection by Helicobacter pylori. Dig Dis Sci 2002;47(5):978-986. https://doi.org/10.1023/A:1015017502772
  21. Kim N, Lim SH, Lee KH et al. Helicobacter pylori in dental plaque and saliva. Korea J Intern Med 2000;15:187-194. https://doi.org/10.3904/kjim.2000.15.3.187
  22. Schimada T, Ogura J, Ota S. Identification of Helicobacter pylori in gastric specimens, gastric juice, saliva and feces of Japanese patients. Lancet 1994;343:1636-1637.
  23. Umeda M, Kobayashi H. Takeuchi Y. High prevalence of Helicobacter pylori detected by PCR in the oral cavities of periodontitis patients. J periodontol 2003;74:129-134. https://doi.org/10.1902/jop.2003.74.1.129
  24. Song Q, Lange T, Spahr A, Adler G, Bode G. Characteristic distribution pattern of Helicobacter pylori in dental plaque and saliva detected with Nested PCR. J Med Microbiol 2000;49(4):349-353. https://doi.org/10.1099/0022-1317-49-4-349
  25. Song Q, Spahr A, Schmid RM, Adler G, Bode G. Helicobacter pylori in the oral cavity : high prevalence and great DNA diversity. Dig Dis Sci 2000;45(11):2162-2167. https://doi.org/10.1023/A:1026636519241
  26. 김나영, 김재준, 최연호 등. 헬리코박터 파일로리 감염의 진단 및 치료 가이드라인. 대한소화기학회 2009;54:269-278.
  27. Song Q, Haller B, Schmid RM et al. Helicobacter pylori in dental plaque : A comparison of different PCR primer sets. Dig Dis Sci 1999;44:479-484. https://doi.org/10.1023/A:1026680618122
  28. 한태희, 백인기. 타액에서 Nested polymerase Chain Reaction을 이용한 Helicobacter pylori 검출. 대한임상미생물학회지 2001;4(2):102-107.
  29. Birek C, Grandhi R, Mcneill K, Singer D, Ficarra G, Bowden G. Detection of Helicobacter pylori in oral aphthous ulcers. J Oral Pathol Med 1999;28(5):197-203.
  30. Riggio MP, Lennon A, Wray D. Detection of Helicobacter pylori DNA in recurrent aphthous stomatitis tissue by PCR. K Oral Pathol Med 2000;29(10):507-513. https://doi.org/10.1034/j.1600-0714.2000.291005.x
  31. Sanli H, Cetinkaya H, Tursen U, Kaya M, Kuzu I, Gurler A. Upper gastrointestinal findings in oral lichen planus. Turk J Gastroenterol 2002;13(1):31-34.
  32. Hur W, Yoon CL, Ahn JM. Detection of Herpes simplex virus, Varicella Zoster Virus, Helicobacter pylori and Candida in saliva of patients with Recurrent aphthous ulceration. Korean J Oral Med 2005;30(3):319-328.
  33. Ryu JW, Kang SW, Yoon CL, Ahn JM. Detection of Helicobacter pylori in saliva of patient with oral lichen planus. 2008;33(3):241-246.
  34. Vanio E, Huovinen S, Liutu M, Uksila J, Leino R. Peptic ulcer and Helicobacter pylori in patients with lichen planus. Acta Derm Venereol. 2000;80(6): 427-429. https://doi.org/10.1080/000155500300012855
  35. Shimoyama T, Horie N, Kato T, Kaneko T, Kemiyama K. Helicobacter pylori in oral ulcerations. J Oral Sci 2000;42(4):225-229. https://doi.org/10.2334/josnusd.42.225
  36. Suzuki N, Yoneda, Naito T et al. Detection of Helicobacter pylori DNA in the saliva of patients complaining of halitosis. J Med Microbiol 2008;57:1553-1559. https://doi.org/10.1099/jmm.0.2008/003715-0
  37. Adler I, Denninghoff VC, Ālvarez MI, Avagnina A, Yoshida R, Elsner B. Helicobacter pylori associated with glossitis and halitosis. Helicobacter 2005;10(4):312-317. https://doi.org/10.1111/j.1523-5378.2005.00322.x
  38. 김준호, 유지원, 윤창륙, 안종모. 구강작열감증후군과구강 내 Helicobacter pylori의 상호관련성. 대한구강내과학회지. 2011;36(2):91-97.
  39. Souto R, Colombo AP. Detection of Helicobacter pylori by polymerase chain reaction in the subgingival biofilm and saliva of non-dyspeptic periodontal patients. J Periodontol 2008;79(1):97-103. https://doi.org/10.1902/jop.2008.070241
  40. Gebara EC, Pannuti C, Faria CM, Chehter L, Mayer MP, Lima LA. Prevalence of Helicobacter pylori detected by polymerase chain reaction in the oral cavity of periodontitis patients. Oral Microbiol Immunol 2004:19(4):277-280. https://doi.org/10.1111/j.1399-302X.2004.00153.x
  41. 구강내과학회. 위장관질환. 전신질환자 및 노인, 장애환자의 치과치료. 구강내과학 제 2편, 서울, 1997, 신흥인터내셔날, pp.71,72.
  42. Graham DY, Lew GM, Evans DG, Evans DJ Jr. Klein PD. Effect of triple therapy (antibiotic plus bismuth) on duodenal ulcer healing : a randomized controlled trial. Ahn Intern Med 1991;115:266-269.
  43. Okuda K, Adach M, Lijima K. The efficacy of antimicrobial mouth rinses in oral health care. Bull Tokyo Dent Coll 1998;39(1):7-14.