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 Table of Contents  
LETTER TO EDITOR
Year : 2020  |  Volume : 7  |  Issue : 4  |  Page : 238-239

Could there be an overlooked association of oral bacterium Aggregatibacter sp. in aggravating COVID-19 disease?


1 Department of Public Health, Parul Institute of Public Health, Parul University, Vadodara, Gujarat, India
2 Department of Epidemiology, Indian Institute of Public Health, Gandhinagar, Gujarat, India

Date of Submission27-Jul-2020
Date of Acceptance12-Aug-2020
Date of Web Publication30-Nov-2020

Correspondence Address:
Vaibhav Patwardhan
Parul Institute of Public Health, Parul University, P.O. Limda, Waghodia, Vadodara - 391 760, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrr.jdrr_92_20

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How to cite this article:
Patwardhan V, Kotwani P, Saxena D. Could there be an overlooked association of oral bacterium Aggregatibacter sp. in aggravating COVID-19 disease?. J Dent Res Rev 2020;7:238-9

How to cite this URL:
Patwardhan V, Kotwani P, Saxena D. Could there be an overlooked association of oral bacterium Aggregatibacter sp. in aggravating COVID-19 disease?. J Dent Res Rev [serial online] 2020 [cited 2021 Sep 27];7:238-9. Available from: https://www.jdrr.org/text.asp?2020/7/4/238/302061



Dear Editor,

Aggregatibacter actinomycetemcomitans is an anaerobic, Gram-negative coccobacillus,[1] and is a habitant of oral flora of humans, especially in gingival and periodontal pockets, and also of various animals.[2]A. actinomycetemcomitans is responsible to cause multiple periodontal diseases, along with other infections such as endocarditis and respiratory infections.[3]

The current COVID-19 pandemic, caused by severe acute respiratory syndrome corona virus-2, has so far affected more than 10 million individuals across the globe.[4] Despite repeated and desperate measures by the governments and health-care professionals worldwide, the death toll has crossed 0.5 million mark and is constantly rising with each passing day.[4] The most common manifestations of moderate to severely ill COVID-19 patient is reported to be persistent high fever, dyspnea, and respiratory distress, etc., that may further progress into interstitial pneumonia and acute respiratory distress syndrome (ARDS), as the individual's clinical state worsens.[5]

ARDS in severe cases of COVID-19 patients occurs in response to the abundant release of inflammatory substances resulting in “cytokine storm.” Several studies suggest that oral bacteria are known to cause the production of cytokine from oral epithelial cells.[6],[7] Out of all the bacteria, the oral bacterium A. actinomycetemcomitans is the prolific and strongest stimulator for cytokine production in both oral epithelium and respiratory epithelium. It has the potential to elicit the cytokine production in respiratory epithelium similar to respiratory pathogens.[8]

Considering the cohesion between the inflammatory response caused by A. actinomycetemcomitans and COVID-19-related adverse events, the authors hypothesize that there could a possible common pathway between the two events. Therefore, it is suggestive that the individuals harboring A. actinomycetemcomitans due to periodontal infections are potentially at higher risk to develop severe respiratory distress if they contract COVID-19 infection. Future studies should elucidate the association between the two variables, and if the linkage is established, periodontal therapy should be incorporated in the treatment guidelines for the management of COVID-19 patients. Accordingly, healthy individuals should also be encouraged to maintain oral hygiene (in addition to hand hygiene), to prevent adverse events related to COVID-19.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Aggregatibacter actinomycetemcomitans – Infectious Disease and Antimicrobial Agents. Available from: http://www.antimicrobe.org/b72.asp. [Last accessed on 2020 Jul 01].  Back to cited text no. 1
    
2.
Kaplan AH, Weber DJ, Oddone EZ, Perfect JR. Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review. Rev Infect Dis 1989;11:46-63. Available from: https://academic.oup.com/cid/article/11/1/46/300840. [Last accessed on 2020 Jul 01].  Back to cited text no. 2
    
3.
Bansal M, Khatri M, Taneja V. Potential role of periodontal infection in respiratory diseases – A review. J Med Life 2013;6:244-8. Available from: https://pmc/articles/PMC3786481/?report=abstract. [Last accessed on 2020 Jul 01].  Back to cited text no. 3
    
4.
Worldometers.info. Coronavirus Cases [Internet]. Worldometer. Dover, Delaware, U.S.A.; 2020. Available from: https://www.worldometers.info/coronavirus/?. [Cited 2020 Jul 01].  Back to cited text no. 4
    
5.
Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). 2020 Aug 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32150360. [Last accessed on 2020 Jul 01].   Back to cited text no. 5
    
6.
Yumoto H, Nakae H, Fujinaka K, Ebisu S, Matsuo T. Interleukin-6 (IL-6) and IL-8 are induced in human oral epithelial cells in response to exposure to periodontopathic Eikenella corrodens. Infect Immun 1999;67:384-94. Available from: https://iai.asm.org/content/67/1/384. [Last accessed on 2020 Jul 01].  Back to cited text no. 6
    
7.
Huang GT, Haake SK, Kim JW, Park NH. Differential expression of interleukin-8 and intercellular adhesion molecule-1 by human gingival epithelial cells in response to Actinobacillus actinomycetemcomitans or Porphyromonas gingivalis infection. Oral Microbiol Immunol 1998;13:301-9. Available from: http://doi.wiley.com/10.1111/j.1399-302X.1998.tb00711.x. [Last accessed on 2020 Jul 01].  Back to cited text no. 7
    
8.
Scannapieco FA, Wang B, Shiau HJ. Oral bacteria and respiratory infection: Effects on respiratory pathogen adhesion and epithelial cell proinflammatory cytokine production. Ann Periodontol 2001;6:78-86. Available from: http://doi.wiley.com/10.1902/annals.2001.6.1.78. [Last accessd on 2020 Jul 01].  Back to cited text no. 8
    




 

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