Cette étude scientifique examine les corrélations entre la parodontite, la composition du microbiote et les complications métaboliques chez les patients souffrant d'obésité sévère. Les chercheurs démontrent que l'infection des gencives est liée à un déséquilibre des flores bactériennes buccales et intestinales, notamment par une hausse des Proteobacteria. Au niveau systémique, la pathologie parodontale s'accompagne d'une élévation des marqueurs inflammatoires comme l'IL-6 et d'une altération du bilan lipidique. L'analyse du tissu adipeux viscéral révèle également une activation de gènes immunitaires et une réponse antioxydante accrue en présence de parodontite. Ces résultats suggèrent que la santé bucco-dentaire influence directement l'inflammation chronique et le dysfonctionnement métabolique liés à l'obésité. En somme, l'étude souligne l'importance d'une prise en charge dentaire pour limiter les complications systémiques chez ces patients fragiles.
FASEB J
2026 May 15;40(9):e71828.
doi: 10.1096/fj.202600054R.
Periodontitis in Patients With Severe Obesity: From the Oral and Gut Microbiota Dysregulation to the Visceral Adipose Tissue Inflammatory and Metabolic Disorders
Katy Thouvenot 1, Flavie Serrat 2, Victorine Lenclume 3, Eric Doussiet 2, Eugeni Belda 4, Janice Taïlé 1, Rohia Alili 4, Philippe Rondeau 1, Karine Clément 4 5, Olivier Meilhac 1, Nathalie Le Moullec 2, Marie-Paule Gonthier 1Affiliations
PMCID: PMC13112136
DOI: 10.1096/fj.202600054RAbstractDuring periodontitis, pathogenic oral bacteria like Porphyromonas gingivalis may exert systemic effects directly by translocating into the bloodstream and indirectly by deregulating the gut microbiota, aggravating obesity-related complications. This study aimed to evaluate the links between the periodontal infection, the oral and gut microbiota composition, and the inflammatory and metabolic profile during obesity. Thirty-nine patients suffering from severe obesity, with (n = 23) or without (n = 16) periodontitis, were enrolled. We examined the subgingival microbiota composition, periodontal status and salivary inflammatory response. The fecal microbiota composition was assessed by metagenomic analysis. Inflammatory and metabolic markers were measured in the plasma and epiploon visceral adipose tissue collected during bariatric surgery. Results show that patients with periodontitis exhibited an oral microbiota dysbiosis characterized by an increased abundance of bacteria from the red and orange complexes, worsened periodontal parameters (plaque index, bleeding index, gingival recession, probing depth and clinical attachment level), and higher IL-6 salivary levels. In fecal samples of patients with periodontitis, a higher proportion of the Proteobacteria phylum and changes in functional profile of bacteria were detected. Periodontitis was also linked to higher circulating concentrations of anti-P. gingivalis IgG, total cholesterol and lipoprotein (a). Moreover, periodontitis was associated with an enhanced production of TLR2, MyD88 and TGFβ, as well as higher activities of SOD and catalase antioxidant enzymes in the adipose tissue. Overall, these findings demonstrate that during obesity, the periodontal infection correlates with deregulated oral and gut microbiota composition, higher levels of pro-inflammatory mediators, and altered markers of oxidative stress and lipid metabolism.
Keywords: adipose tissue; inflammation; lipidemia; obesity; oral and gut microbiota; oxidative stress.
- 1INSERM, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Université de La Réunion, Saint-Pierre, La Réunion, France.
- 2CHU de La Réunion, Saint-Pierre, La Réunion, France.
- 3INSERM, Centre d'Investigation Clinique (CIC) 1410, Saint-Pierre, La Réunion, France.
- 4INSERM, UMRS 1269 Nutrition and Obesities: Systemic Approaches (NutriOmique), Sorbonne Université, Paris, France.
- 5Assistance Publique-Hôpitaux de Paris, Département de Nutrition, Hôpital Pitié-Salpêtrière, Paris, France.*
PMCID: PMC13112136
DOI: 10.1096/fj.202600054RAbstractDuring periodontitis, pathogenic oral bacteria like Porphyromonas gingivalis may exert systemic effects directly by translocating into the bloodstream and indirectly by deregulating the gut microbiota, aggravating obesity-related complications. This study aimed to evaluate the links between the periodontal infection, the oral and gut microbiota composition, and the inflammatory and metabolic profile during obesity. Thirty-nine patients suffering from severe obesity, with (n = 23) or without (n = 16) periodontitis, were enrolled. We examined the subgingival microbiota composition, periodontal status and salivary inflammatory response. The fecal microbiota composition was assessed by metagenomic analysis. Inflammatory and metabolic markers were measured in the plasma and epiploon visceral adipose tissue collected during bariatric surgery. Results show that patients with periodontitis exhibited an oral microbiota dysbiosis characterized by an increased abundance of bacteria from the red and orange complexes, worsened periodontal parameters (plaque index, bleeding index, gingival recession, probing depth and clinical attachment level), and higher IL-6 salivary levels. In fecal samples of patients with periodontitis, a higher proportion of the Proteobacteria phylum and changes in functional profile of bacteria were detected. Periodontitis was also linked to higher circulating concentrations of anti-P. gingivalis IgG, total cholesterol and lipoprotein (a). Moreover, periodontitis was associated with an enhanced production of TLR2, MyD88 and TGFβ, as well as higher activities of SOD and catalase antioxidant enzymes in the adipose tissue. Overall, these findings demonstrate that during obesity, the periodontal infection correlates with deregulated oral and gut microbiota composition, higher levels of pro-inflammatory mediators, and altered markers of oxidative stress and lipid metabolism.
Keywords: adipose tissue; inflammation; lipidemia; obesity; oral and gut microbiota; oxidative stress.