Les bactéries buccales n'infectent pas seulement la bouche mais y resident. Elles peuvent également passer dans la voie sanguine et atteindre des organes secondaires. S’il n'est pas traité, le biofilm dentaire peut provoquer une inflammation destructrice dans la cavité buccale, entrainant de graves complications médicales. Dans ce biofilm, Streptococcus gordonii, colonisateur oral primaire, constitue la plate-forme sur laquelle des colonisateurs pathogènes tardifs comme Porphyromonas gingivalis, l'agent causal des maladies parodontales, se lieront. L'objectif de la première partie de la thèse était de déterminer l'activité antibactérienne de onze composés de lichens appartenant à différentes familles chimiques, pour découvrir de nouveaux antibiotiques pouvant combattre ces bactéries buccales. Nous avons montré que trois composés avaient des activités antibactériennes prometteuses. L'acide psoromique enregistrait les CMIs le plus faibles. De nouveaux analogues de butyrolactone ont ensuite été conçus et synthétisés sur la base des composés antibactériens licheniques connus, les acides lichesteriniques, en substituant différents groupes fonctionnels sur le cycle butyrolactone pour améliorer son activité sur S. gordonii et P. gingivalis. Parmi les dérivés, B-12 et B-13 avaient la plus faible CMI où ils se sont révélés être des bactéricides plus forts, 2 à 3 fois plus, que l'antibiotique, doxycycline. B-12 et B-13 étaient également les plus efficaces vis-à-vis de P. gingivalis. La cytotoxicité de ces 2 composés a ensuite été vérifiée contre les cellulaires épithéliales gingivales humaines et les macrophages. Ils ne présentaient pas de toxicité contre les cellules testées. Une étude préliminaire de relation structure-activité a révélé le double rôle important apporté par deux substituants, chaîne alkyle en C5 et groupe carboxyle en C4 positions, dans leur mécanisme d'action. Ceci a été suivi par l'étude de l’activité antibiofilmique de B-12 et B-13 contre les deux souches orales en utilisant un test de cristal violet et microscopie confocale. Les deux dérivés ont montré, à une concentration plus faible, une inhibition maximale de la formation du biofilm, LCMI, de 9.38 μg/mL contre S. gordonii et 1.17 μg/mL contre P. gingivalis. Cependant, lorsque des concentrations sous-inhibitrices de B-12 et B-13 ont été utilisées, nous avons démontré que les deux souches étudiées pouvaient former des biofilms in vitro, accompagné d’une diminution de l'expression des gènes impliqués dans l'adhésion et la formation de biofilm. Pour mieux comprendre les mécanismes d'action des butyrolactones, nous avons étudié la localisation bactérienne du composé B-13 en synthétisant un B-13 marqué au NBD (4-nitro-benzo [1,2,5] oxadiazole) fluorescent conservant son activité antibactérienne. Par microscopie confocale et HPLC, nous avons montré que ce composé se lie à la surface cellulaire de S. gordonii. Ensuite, B-13 induit une rupture de la paroi cellulaire conduisant à la libération des constituants bactériens et par conséquent, à la mort de S. gordonii, une bactérie Gram-positive. L'expression de deux gènes, murA et alr, impliqués dans la synthèse de la paroi cellulaire, a été modifiée en présence de cette butyrolactone. Les bactéries Gram négatives telles que P. gingivalis ont également montré des cellules abimées présentant une rupture de la paroi en présence de B-13, ce qui suggère que cette butyrolactone agit sur des Gram-positives et Gram-négatives avec une plus grande efficacité contre les Gram-négatives. En outre, nous avons également démontré que l'analogue de B-13, B-12, induit une perturbation de la morphologie de P. gingivalis et S. gordonii. Toutes ces études ont démontré que les butyrolactones dérivées de lichen peuvent être proposés comme des composés antibactériens puissants contre les agents pathogènes oraux qui causent des complications médicales graves. / The oral bacteria do not only infect the mouth and reside there, but also travel via the blood and reach distant body organs. If left untreated, the dental biofilm that can cause destructive inflammation in the oral cavity may result in serious systemic medical complications. In dental biofilm, Streptococcus gordonii, a primary oral colonizer, constitutes the platform on which late pathogenic colonizers like Porphyromonas gingivalis, the causative agent of periodontal diseases, will bind. The aim of the first study was to determine the antibacterial activity of eleven natural lichen compounds belonging to different chemical families to uncover new antibiotics which can fight against the oral bacteria. Three compounds were shown to have promising antibacterial activities where psoromic acid had the lowest MICs of 11.72 and 5.86 µg/mL against S. gordonii and P. gingivalis, respectively. Novel butyrolactone analogues were then designed and synthesized based on the known lichen antibacterial compounds, lichesterinic acids (B-10 and B-11), by substituting different functional groups on the butyrolactone ring trying to enhance its activity on S. gordonii and P. gingivalis.. Among the derivatives, B-12 and B-13 had the lowest MIC of 9.38 µg/mL where they have shown to be stronger bactericidals, by 2-3 times, than the reference antibiotic, doxycycline. B-12 and B-13 were also the most efficient on P. gingivalis exhibiting MIC of 0.037 and 0.293 µg/mL and MBC of 1.17 and 0.586 µg/mL, respectively. These 2 compounds were then checked for their cytotoxicity against human gingival epithelial cells and macrophages by MTT and LDH assays which confirmed their safety against the tested cell lines. A preliminary study of the structure-activity relationships unveiled the important dual role contributed by two substituents, alkyl chain at C4 and carboxyl group at C5 positions, in their mechanism of action. This was followed by the investigation of B-12 and B-13 for their antibiofilm activity against both oral strains using crystal violet assay and confocal microscopy. Both derivatives displayed a lowest concentration with maximal biofilm inhibition, LCMI, of 9.38 µg/mL against S. gordonii and 1.17 µg/mL against P. gingivalis. However, when sub-inhibitory concentrations of B-12 and B-13 were used, we demonstrated that the two investigated strains were able to form biofilms in vitro. Indeed, this antibiofilm activity decreased as indicated by the expression of the genes implicated in adhesion and biofilm formation. To better understand the mechanism of action of butyrolactones, we have investigated B-13 bacterial localization by synthesizing a fluorescently labeled B-13 with NBD (4-nitro-benzo[1,2,5]oxadiazole) conserving its antibacterial activity. By confocal microscope, we showed that this compound binds to S. gordonii cell surface and this was also demonstrated by HPLC analysis. By adhering to cell surface, B-13 induced cell wall disruption leading to the release of bacterial constituents and consequently, the death of S. gordonii, a Gram-positive bacterium. The expression of two genes, murA and alr, implicated in cell wall synthesis, was modified in the presence of this butyrolactone. Gram-negative bacteria such as P. gingivalis showed also cracked and ruptured cells in the presence of B-13, suggesting that this butyrolactone acts on Gram-positive and Gram-negative strains, but with greater efficacy against the Gram-negatives. Besides, we also demonstrated that the analogue of B-13, B-12, has also induced disruption of P. gingivalis and S. gordonii. All these studies demonstrated that butyrolactones derived from a lichen metabolite can be proposed as potent antibacterial agents against oral pathogens causing serious medical complications.

Made available in DSpace on 2014-12-17T15:30:48Z (GMT). No. of bitstreams: 1 LizaBV.pdf: 651863 bytes, checksum: 861130b51ad28ee890a75755594ddae3 (MD5) Previous issue date: 2006-05-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The purpose of this study was evaluate the effectiveness of the chitosan at 0.4 with high molecular weight and high deacetylation degree mouthrinse over the total decrease of the streptococci, Streptococcus mutans, lactobaci/li and over the perceptible bacterial film and gingival bleeding indices. For that, a total of 68 healthy students between 11 and 13 years old, not allergic to crustacean and not users of antibiotics or antimicrobial agent for the last three months or during the treatment, was selected. From those, thirty two individuaIs used the mouthrinse test, and thirty six, the control one. The participants rinsed 10 mL of the solutions twice a day, one during the moming (which was supervised), and another one during the aftemoon (which was not supervised), for fifteen days. The saliva collect for the microbiological analysis, as well as the perceptible bacterial film and gingival bleeding indices check, were made before the use ofthe mouthrinses (base line), immediately after the last mouthrinse on the day (zero time) and fifteen days after (fifteen time). These data were collected at school and the saliva was carried inside the ice to the laboratory. The samples were diluted, and 0.1 mL ofthe 10 -1 dilution was seeded in Rogosa SL agar, for further analysis of the total of lactobaci/lus~ 0.1 mL of the 10-4 dilution in Mitis Salivarius with bacitracin, for S. mutans analysis; and 0.1 mL of the 10-6 dilution in Mitis Salivarius for the analysis ofthe total of streptococcus. The Rogosa SL agar plates were incubated in aerobic at 37?C for 72 hours and the MSB and the MS were incubated in anaerobic in Gaspak@ jars at 37?C for 48 hours for further count ofColonies Former Units (CFUs). The assay was made in duplicate for each bacterial group analyzed. The number of CFUs transformed in LOGlO was analyzed according to the following tests: ANOV A, t of Paired and Not Paired Student, Friedman, Man-Whitney and square-qui test. On the base line, alI the variables analyzed were similar on both tested groups. On both groups, for the total of streptococcus there was no significant difference along the time and for S. mutans there was a statistic significant increase of the CFUs from the base line to the zero time. For the total of lactobaccilus there was no significant difference on the test group along the time, and on the control there was a significant increase ofthe CFUs ITom the base line to the zero time. For both groups, there was significant decrease ofthe perceptible bacterial film index along the time, and that can be explained by the mechanic effect of the mouthrinse over the bacterial film and by the participation of the students on the research which could have motivated him to a better toothbrushing (Hawthome effect). The gingival bleeding index also showed a decrease along the time, even though it was not significant. Therefore, the conclusion of this study was that the chitosan at 0.4 % mouthrinse was not effective on the CFUs reduction of the three bacterial groups analyzed, as well as on the reduction of the perceptible bacterial film and gingival bleeding indices / O objetivo deste estudo foi avaliar a efic?cia do bochecho de quitosana a 0,4% com alto peso molecular e alto grau de desacetiliza??o sobre a redu??o do total de estreptococcus, Streptococcus mutans, total de lactobacilos e sobre os ?ndices de placa vis?vel e sangramento gengival. Para tanto, foram selecionados 68 estudantes saud?veis, com idade entre 11 e 13 anos, n?o al?rgicos a crust?ceos e que n?o tivessem usado antibi?tico ou antimicrobiano nos ?ltimos tr?s meses ou durante o tratamento. Trinta e dois indiv?duos utilizaram o bochecho teste e trinta e seis o controle. Os participantes bochecho 10 ML das solu??es duas vezes ao dia, um pela manh? (supervisionado) e outro ? tarde (n?o supervisionado, durante quinza dias. A coleta de saliva para an?lise microbiol?gica, bem como a aferi??o dos ?ndices de placa vis?vel e de sangramento gengival, deu-se antes do uso dos bochechos (linha base),no dia imediatamento ap?s o ?ltimo bochecho (tempo zero) e quinze dias ap?s (tempo quinze). Esses dados foram coletados na escola e a saliva transportada em gelo at? o laborat?rio. As amostras de saliva foram diluidas e 0,1ML da dilui??o 10 elevado a menos 1 foi semeada em Rogosa SL ?gar para a posterior an?lise do total de lactobacilos; 0,1mL da dilui??o 10 elevado a menos 4 em Mitis Salivarus com bacitracina, para an?lise de S mutans, e 0,1mL da dilui??o 10 elevado a menos 6 em Mitis Salivarius para an?lise do total de estreptococous. As placas de Rogosa SL ?gar foram incubadas em aerobiose a 37 grau cent?grado por 72 horas e as de MSB e MS foram incubadas em anaeribiose em jarras Gaspak a 337 grau cent?grado, por 48 horas, para posterior contagem das unidades formadoras de col?nias (UFCs). O ensaio foi feito em duplicadta para cada grupo bacteriano analisado. O n?mero de UFCs transformados em LOG10 foi analisado mediante os seguintes testes: ANOVA, t de Student emparelhado e n?o emparelhado, Friedman, Man-Whitney e teste do qui-quadrado. Na linha base, todas as vari?veis analisadas no estudo foram semelhantes nos dois grupos testados. Em ambos os grupos, para o total de estreptococcus n?o houve diferen?a significativa ao longo do tempo; para o S. mutans, houve aumento estatisticamente significativo das UFCs da linha base para o T0. Para o total de lactobacilos, n?o houve diferen?a no grupo teste ao longo do tempo e, no controle, houve aumento significativo das UFCs da linha base para o T0. Em ambos os grupos, houve diminui??o significativa do IPV ao longo do tempo. O ISG tamb?m apresentou redu??o ao longo do tempo, por?m n?o foi significativa. Portanto, este estudo concluiu que o bochecho de quitosana a 0,4% n?o foi eficaz na redu??o das UFCs dos tr?s grupos bacterianos analisados, assim como, na redu??o do IPV e ISG

One of the greatest threats to human health is increasing antimicrobial resistance among pathogens, and finding alternatives for treatment of bacterial infections is of highest importance together with a more controlled use of antibiotics. Porphyrins and heme have both been shown to be a promising class of compounds for inactivation of bacteria; porphyrins by their excellent properties to act as a photosensitizer, and heme by its importance as an iron source during a bacterial infection in vertebrates. This thesis describes the development of analytical methods for the identification and determination of porphyrins and heme using liquid chromatography coupled to tandem mass spectrometry. Subsequently, these developed methods were applied to bacterial samples to investigate different culture conditions and additives effect to the intracellular porphyrin and heme composition. Singlet oxygen production of three naturally occurring porphyrins have been determined together with the photosensitivity for blue light and the porphyrin content in E. coli. Toothbrushes equipped with a LED, emitting light with a wavelength of 450 nm, were used in an eight week randomized clinical trial to investigate any positive periodontal effect of blue light. Porphyrin and heme content in Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were highly affected by the different cultivation conditions. The culture age of A. actinomycetemcomitans affected the porphyrin profile, while only small changes were observed for P. gingivalis during growth. A large change of the porphyrin profile could be observed when the bacteria were passaged onto a new growth medium. Additional porphyrins were detected and the total porphyrin content increased up to 28 times. These findings highlight the need for more standardized cultivation procedures when performing in vitro experiments. Heme content in Escherichia coli was affected when different additives related to biosynthesis of heme were added to the growth medium. The uptake of heme could be reduced with 52% when a compound that chemically looks similar to heme was added to the growth medium. Since heme acquisition is important for many pathogens, this could be a promising target for antimicrobial drugs. E. coli showed no sensitivity for 405 nm light using light doses up to 172.8 J/cm2 and only low concentrations of porphyrins could be quantified. By adding a porphyrin precursor to E. coli the intracellular concentration of porphyrins increased remarkably and a light dose of 57.6 J/cm2 reduced the bacterial number with &gt; 5 log10 steps. This shows that E. coli can be killed due to their endogenous porphyrins. In the clinical study we could see a weak trend that the 450 nm LED toothbrush possessed a phototherapeutic effect for three clinical indices. All indices were decreased in the intervention group, but there were no statistically significant difference compared to the control group. However, four inflammation markers were significantly decreased in the intervention group while only one decreased significantly in the control group. In conclusion, this thesis has shown that porphyrins and heme are produced endogenously in microorganisms and that the porphyrin profiles vary depending on culture conditions and different additives. Furthermore, porphyrins may be used as endogenous photosensitizers to inactivate bacteria, but more research is necessary to determine if there is a specific porphyrin that contributes more to the photosensitivity. / <p>At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 4: Manuscript. Paper 5: Manuscript.</p>

Einleitung Die ständige Suche nach effektiveren und/oder weiteren botanischen Antibiotika im weiten Feld der geographischen Artenvielfalt macht den Stand der Forschung sehr unübersichtlich. Ziel dieser Arbeit ist es, durch Literaturrecherche eine Übersicht antimikrobiell wirksamer Pflanzen, Zubereitungen und Extrakte auf ausgewählte Bakterien der Mundhöhle aufzuzeigen. Material und Methoden Die Literaturrecherche erfolgte weltweit durch englische Schlüsselwörter in den elektronischen Datenbanken Cochrane Library, Pubmed / Medline, Embase und Google scholar für den Zeitraum bis einschließlich Dezember 2012. Ergebnisse Es wurden Veröffentlichungen über 735 Pflanzen gefunden, die auf ihre antimikrobielle Wirkung gegen folgende Mikroorganismen getestet wurden: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, Streptococcus mutans, Streptococcus mitis, Streptococcus oralis, Streptococcus sanguinis, Streptococcus gordonii. Gute antimikrobielle Wirkung zeigten Extrakte von 149 Pflanzen. In 87 klinischen Studien wurden Extrakte und Mixturen von ingesamt 61 Pflanzen untersucht, wovon nur 4 Studien keinen Effekt auf die klinischen Parameter hatten. Schlussfolgerung für die Klinik Pflanzenextrakte als neue potenzielle antimikrobielle Wirkstoffe in Prävention und Therapie von oralen Erkrankungen erforden noch weitere kontrollierte Studien in definierten Verfahren. / Introduction The constant search for more effective and / or other botanical antibiotics in the vast field of geographic diversity makes the state of research very confusing. The aim of this work is to show an overview of antimicrobial plants, preparations and extracts on selected bacteria of the oral cavity through literature. Material and Methods The literature search was carried worldwide by English keywords in the electronic databases Cochrane Library, PubMed / Medline, Embase and Google scholar for the period up to and including December 2012. Results Publications were found about 735 plants. They were tested for antimicrobial activity against the following microorganisms: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, Streptococcus mutans, Streptococcus mitis, Streptococcus oralis, Streptococcus sanguinis, Streptococcus gordonii. Extracts of 149 plants showed good antimicrobial effect. In 87 clinical studies, extracts and mixtures of a total of 61 plants were examined, of which only 4 studies had no effect on clinical parameters Conclusion for the clinic Require new potential plant extracts as antimicrobial agents in the prevention and treatment of oral diseases, further controlled studies in defined procedures

Made available in DSpace on 2014-12-17T15:30:59Z (GMT). No. of bitstreams: 1 EmanuelleDVD_DISSERT.pdf: 1398010 bytes, checksum: 85e1d1f82b33da3e697eacbf6655c267 (MD5) Previous issue date: 2011-08-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Photodynamic therapy (PDT) has been proposed as an alternative method for the treatment of biofilm-dependent oral diseases like dental caries. This therapy consists of simultaneous action of a visible light (L) and a photosensitizer (FS) in the presence of oxygen, which leads to production of different reactive oxygen species that can interact with the bacterial cell components, and promote cell death. This study aims to evaluate the antimicrobial action of PDT on oral bacteria in suspension, as well as the formation of mono and multi-species biofilms, in vitro, from a standard strain of Streptococcus mutans (ATCC 25175) and saliva samples, respectively. The dye methylene blue (MB) and toluidine blue (TB) were used at a concentration of 100 mg/ L and activated by halogen light (600 to 750 nm) from a modified hand held photopolymerizer (Ultralux ?, Dabi Atlante, Ribeir?o Preto , S?o Paulo, Brazil.). Planktonic cultures were prepared and submitted to different experimental conditions: 1. PDT using TB 2. PDT using MB, 3. L+ FS- , 4. TB + L - ; 5. MB+ L-; 6. L- FS- (negative control) and 7. administration of 0.12% chlorhexidine digluconate (positive control) (Periogard ?, Colgate-Palmolive Company, New York, USA). The immediate and mediated action of PDT on bacterial suspensions, as well as its effect on biofilm formation were observed from the number of colony-forming units per milliliter (CFU/mL) and measures optical density (OD). The data were statistically analyzed using the Kruskal-Wallis and Mann-Whitney test for the significance level of 5%. According to the results, the PDT showed no antibacterial action on suspensions of S. mutans, regardless of the dye used. PDT with MB activated by halogen light was able to reduce 86.6% CFU/mL multi-species planktonic cultures, however, this reduction was not significant (p > 0.05). PDT showed antibacterial effect, mediate on multi-species planktonic cultures with TB (p < 0.001) and MB (p < 0.001), activated by halogen light. PDT was able to prevent the formation of multispecies biofilm, through the activation of TB by halogen light (p = 0.01). We conclude that activation of the dye toluidine blue and methylene blue, by halogen light (PDT) showed antimicrobial activity, compared to multi-species planktonic cultures prepared from saliva samples / A terapia fotodin?mica (TFD) tem sido proposta como um m?todo alternativo para o tratamento de doen?as orais biofilme-dependentes, como a c?rie dent?ria. Tal terapia consiste na a??o simult?nea de uma fonte luminosa (FL) e de um agente fotossensibilizante (FS), na presen?a de oxig?nio tecidual, levando ? produ??o de radicais livres que ao interagirem com componentes celulares bacterianos, promovem a morte celular. Este estudo tem como objetivo avaliar a a??o antimicrobiana da TFD sobre bact?rias orais em suspens?o, bem como na forma??o de biofilmes mono e multiesp?cies, in vitro, a partir de uma cepa padr?o de Streptococcus mutans (ATCC 25175) e de amostras de saliva, respectivamente. Os corantes azul de metileno (CM) e azul de toluidina (CT) foram administrados na concentra??o de 100 mg/L e ativados por luz hal?gena (600 a 750 nm) proveniente de um aparelho fotopolimerizador modificado (Ultralux?, Dabi Atlante, Ribeir?o Preto, S?o Paulo, Brasil.). Suspens?es monoesp?cies e mistas foram preparadas e submetidas a diferentes condi??es experimentais: 1. TFD na presen?a de CT; 2. TFD na presen?a de CM; 3. irradia??o sem administra??o de qualquer corante; 4. sensibiliza??o com CT e aus?ncia de luz; 5. sensibiliza??o com CM e aus?ncia de luz; 6. aus?ncia de irradia??o e sem qualquer corante (controle negativo) e 7. administra??o de solu??o de digluconato de clorexidina a 0,12% (controle positivo) (Periogard?, Colgate-Palmolive Company, Nova York, EUA). A a??o imediata e mediata da TFD sobre as suspens?es bacterianas, bem como seu efeito sobre a forma??o de biofilme foram verificados, a partir do n?mero de unidade formadoras de col?nias por mL (UFC/mL) e de medidas de densidade ?tica (DO). Os dados obtidos foram analisados estatisticamente atrav?s dos Testes Kruskal-Wallis e Mann-Whitney, para o n?vel de signific?ncia de 5%. De acordo com os resultados, a TFD n?o apresentou a??o antibacteriana sobre as suspens?es de S. mutans, independente do corante utilizado. A TFD com CM ativado por luz hal?gena foi capaz de reduzir em 86,6% o n?mero de UFC/mL diante de suspens?es multiesp?cies, entretanto, tal redu??o n?o foi significativa (p > 0,05). A TFD apresentou efeito antibacteriano, mediato, sobre suspens?es mistas, quer na presen?a de CT (p < 0,001) ou CM (p < 0,001), ativados por luz hal?gena. A TFD preveniu a forma??o de biofilme multiesp?cie, atrav?s da ativa??o de CT por luz hal?gena (p = 0,01). Conclui-se que a ativa??o dos corantes azul de toluidina e azul de metileno, pela luz hal?gena (TFD) apresentou a??o antimicrobiana, frente a suspens?es multiesp?cies preparadas a partir de amostras de saliva, ressaltando a possibilidade da utiliza??o da terapia fotodin?mica como um m?todo coadjuvante no tratamento de les?es de c?rie dent?ria

CONTEXTE : Le cancer colorectal (CCR) reste l’un des cancers les plus diagnostiqués au Canada et dans le monde. Malgré les efforts en matière de dépistage, la moitié des cancers colorectaux sont encore diagnostiqués à des stades avancés de la maladie, réduisant ainsi les chances de survie à ce cancer. La prévention du CCR reste encore primordiale et les efforts doivent être maintenus pour l’identification de ses facteurs de risque modifiables. Durant cette dernière décennie, on a assisté à un cumul d’évidence sur l’association entre l’enrichissement colorectal en une bactérie spécifique, Fusobacterium nucleatum (F. nucleatum), et le CCR. Ce qui a ressuscité le débat sur l’association même entre la maladie parodontale (MP) et le CCR, puisque F. nucleatum est non seulement une bactérie commensale de la bouche, mais surtout l’une des principaux agents pathogènes de la MP. Des études épidémiologiques antérieures avaient en effet déjà suggéré que le la MP serait associée au risque de CCR, mais leurs résultats sont restés non concluants à cause de leurs défaillances méthodologiques. La diffusion des bactéries parodontopathogènes, comme F. nucleatum, et de leurs produits de virulence de la bouche vers le côlon et la libération des médiateurs d’inflammation chronique dans la circulation générale sont les mécanismes incriminés dans l’association entre la MP et le CCR. OBJECTIFS: 1) Vérifier l’association entre la MP et le CCR; 2) Synthétiser la littérature sur l’association entre la détection de la bactérie F. nucleatum dans le côlon et le CCR et; 3) Vérifier la faisabilité d’investiguer l’expression concomitante de F. nucleatum, dans les deux milieux buccal et colorectal, en présence de lésions néoplasiques colorectales. Ces deux derniers objectifs sont un préambule à l’investigation du rôle des bactéries causales de la MP, précisément F. nucleatum, comme mécanisme d’association entre la MP et le CCR. MÉTHODES: Nous avons entrepris trois projets de recherche distincts qui répondent aux trois objectifs respectifs de recherche cités ci-dessus: 1) Une étude cas-témoins à base populationnelle (Projet COLDENT) a inclut 348 cas incidents de CCR et 310 témoins qui lui sont appariés dans des catégories d’âge et de sexe. Des données ont été collectées sur l’exposition à la MP et aux principaux facteurs de risque du CCR; 2) Une revue systématique avec méta-analyse d’études observationnelles ayant investigué la bactérie, F. nucleatum, dans des échantillons colorectaux, chez des cas de CCR et des témoins exempts de lésions cancéreuses ou précancéreuses colorectales; 6 et 3) Une étude pilote cas-témoins à base hospitalière, auprès de 22 cas de néoplasies colorectales et 21 témoins, examinés par coloscopie. Des échantillons de salive et des biopsies de muqueuse colorectale, ainsi que des données sur l’exposition à la MP et aux principaux facteurs de risque du CCR ont été collectées. RÉSULTATS: Les résultats de notre étude cas-témoins populationnelle suggèrent que le taux d’incidence de CCR était augmenté chez les personnes avec un historique positif de MP comparé aux personnes sans historique de MP, en ajustant pour la majorité des facteurs de confusion potentiels (Rapport des taux ajusté = 1,45 ; Intervalle de confiance (IC) à 95 % : 1,04-2,01). Les résultats de notre revue systématique incluant 24 études observationnelles ont montré que dans la majorité des études où la charge de F. nucleatum dans les échantillons colorectaux était quantifiée, celle-ci était significativement plus élevée chez les cas de CCR que chez les témoins. Les résultats de la méta-analyse de 12 études observationnelles qui ont rapporté le pourcentage des échantillons colorectaux où F. nucleatum était détecté montrent une association significativement positive entre la détection de la bactérie F. nucleatum dans le côlon et le CCR (Rapport de cotes combiné = 8,3; IC à 95 % = 5,2-13; Indice d’hétérogénéité I2 = 26,3 %; p pour hétérogénéité = 0,18). Enfin, les résultats préliminaires de l’étude de faisabilité appuient la faisabilité et l’utilité de mener une étude subséquente pour investiguer F. nucleatum dans la salive et le côlon en présence de néoplasies colorectales afin de vérifier son rôle dans l’association entre la MP et le CCR, mais des ajustements doivent être apportés à la méthodologie initiale. CONCLUSION: Nos résultats suggèrent que l’exposition à la MP peut augmenter le risque de CCR, bien qu’on ne puisse encore confirmer de lien causal. On espère que ce travail sensibilise les cliniciens, décideurs en santé et public à l’importance de prévenir et de contrôler les maladies buccodentaires, notamment la MP, pour la prévention même de maladies systémiques encore plus fatales, tels que le CCR. / BACKGROUND: Colorectal cancer (CRC) remains one of the most diagnosed cancers in Canada and around the world. Despite screening efforts, half of colorectal cancers are still diagnosed at advanced stages of the disease, thus reducing the chances of survival from this cancer. Prevention of CRC still remains essential, and efforts must be maintained to identify its modifiable risk factors. Over the past decade, there has been an accumulation of evidence on the association between colorectal enrichment in a specific bacterium, Fusobacterium nucleatum (F. nucleatum), and CRC. This has sparked debate on the association between periodontal disease (PD) and CRC, since F. nucleatum is not only a commensal bacterium of the mouth, but above all one of the main pathogens of PD. Previous epidemiological studies had indeed already suggested that PD would be associated with the risk of CRC, but their results remained inconclusive because of their methodological flaws. Dissemination of periodontal pathogen bacteria such as F. nucleatum, and of their virulence products, from the mouth to the colon and the release of chronic inflammatory mediators into the bloodstream are suggested as the mechanisms involved in the association between PD and CRC. OBJECTIVES: 1) To verify the association between PD and CRC; 2) To synthesize the literature on the association between the detection of the bacterium F. nucleatum in the colon and CRC; and 3) To verify the feasibility of investigating the concomitant expression of F. nucleatum, in both oral and colorectal environments, in the presence of colorectal neoplasms. These last two objectives are a preamble to the investigation of the role of the causative bacteria of PD, specifically F. nucleatum, as a mechanism of association between PD and CRC. METHODS: We undertook three separate research projects that address the three respective research objectives listed above: 1) A population-based case-control study (COLDENT Project) included 348 incident cases of CRC and 310 age and sex frequency-matched controls. Data were collected on PD and on major risk factors for CRC; 2) A systematic review with meta-analysis of observational studies that have investigated the bacterium F. nucleatum in colorectal samples, in CRC cases and colorectal cancerous or precancerous-free controls; and 3) A pilot hospital-based case-control study, with 22 cases of colorectal neoplasms and 21 controls, examined by colonoscopy. Saliva samples and colorectal mucosal biopsies as well as data on exposure to PD and major risk factors for CRC were collected. 8 RESULTS: The results of our population-based case-control study suggest that the rate of CRC was increased in people with a positive history of PD compared to people without a history of PD, adjusting for the majority of potential confounders (adjusted rate ratio = 1.45; 95% Confidence interval (CI): 1.04-2.01). The results of our systematic review including 24 observational studies showed that in most studies where the load of F. nucleatum in colorectal samples was quantified, it was significantly higher in CRC cases than in controls. The results of the meta-analysis of 12 observational studies that reported the percentage of colorectal samples where F. nucleatum was detected show a significantly positive association between the detection of the bacterium F. nucleatum in the colon and CRC (pooled odds ratio = 8.3; 95% CI = 5.2-13; heterogeneity index I 2 = 26.3%; p for heterogeneity = 0.18). Finally, the preliminary results of the feasibility study support the feasibility and utility of conducting a subsequent study to investigate F. nucleatum in saliva and colon in the presence of colorectal neoplasms to verify its role in the association between PD and CCR, but adjustments need to be made to the original methodology. CONCLUSION: Our results suggest that exposure to PD may increase the risk of CRC, although a causal relationship cannot yet be confirmed. It is hoped that this work will sensitize clinicians, health policy makers and the public to the importance of preventing and controlling oral diseases, including PD, for the prevention of even more fatal systemic diseases, such as CRC.