Analysis of oral microbiome in palmoplantar pustulosis patients

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K08759
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53050:Dermatology-related
• Research Institution: Tokyo Dental College
• Principal Investigator: Kouno Michiyoshi 東京歯科大学, 歯学部, 准教授 (30403182)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 掌蹠膿疱症 / 歯性病巣感染 / マイクロバイオーム

Outline of Final Research Achievements

More than half of palmoplantar pustulosis (PPP) patients improved after dental treatment, while the rest did not. Thus, we here investigated the microbial factors affecting the clinical course of PPP after dental treatment. The differences of oral microbiota among healthy controls (HC; n=10), improved (Group I; n=7) and not-improved (Group N; n=6) patients were analyzed. When the alpha microbial diversity was assessed by Shannon index, Pielou’s index and the average operational taxonomic units (OTUs), not-improved patients had a lower-diversity microbiota compared to improved patients. The degree of changes of oral microbiota after dental focal infection treatment was higher in improved patients than in not-improved patients. Our findings suggested that oral microbial compositions and diversity could account for the distinct clinical course of PPP patients after dental infection control.

Free Research Field

皮膚科学

Academic Significance and Societal Importance of the Research Achievements

2022年に日本皮膚科学会より上梓された「掌蹠膿疱症診療の手引き」では歯性病巣感染治療の重要性が示されており、PPPと歯性病巣感染の関連性を示すエビデンスとなりうる本研究成果の学術的意義は高い。また、現在PPPの治療薬として承認された抗IL-23抗体に加え、複数のバイオ製剤の開発が進められているが、歯科治療により改善する症例や、関節症状のない症例では導入する意義は低い。真に必要な症例に対するバイオ製剤導入のエビデンスを提供し得る予後予測因子の同定は、独創的かつ患者本位の診療、我が国の医療経済に資するものであり社会的意義を持つと考えられる。