Drinking alcohol is associated with variation in the human oral microbiome in a large study of American adults.

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PubMed ID: 29685174

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Fan X, Peters BA, Jacobs EJ, Gapstur SM, Purdue MP, Freedman ND, Alekseyenko AV, Wu J, Yang L, Pei Z, Hayes RB, Ahn J

Microbiome. Apr 2018. doi: 10.1186/s40168-018-0448-x

COMMENT: Several previous studies, in both animals and humans, have observed effects of alcohol consumption on oral bacteria. Dysbiosis of the oral microbiome can lead to local oral disease and potentially to cancers of the head, neck, and digestive tract. In small-scale human studies, drinking at least one glass of red wine per day was associated with reduced species richness and reduction of certain anaerobic bacteria in sub- and supragingival plaque. Aside from direct effects, alcohol may indirectly impact the oral microbiota through disturbing the host defense system, subsequently resulting in host-mediated periodontitis. Large population-based studies have consistently demonstrated that alcohol consumption is associated with increased risk of periodontal disease in a dose-dependent fashion.

Despite this evidence suggesting an impact of alcohol on the oral microbiome, no study has comprehensively investigated the relationship of the oral microbiome to alcohol drinking habits in terms of drinking amount and types of alcoholic beverages consumed. In this study the authors tested the relationship of level and types of alcoholic beverages, with the oral microbiome in 1044 individuals from two large US national cohorts.

Bacterial 16S rRNA genes from oral wash samples were amplified, sequenced, and assigned to bacterial taxa. The association of alcohol drinking level (non-drinker, moderate drinker, or heavy drinker) and type (liquor, beer, or wine) with overall microbial composition and individual taxon abundance was tested.

The main results of the study were: 

  • The diversity of oral microbiota and overall bacterial profiles differed between heavy drinkers and non-drinkers (α-diversity richness p = 0.0059 and β-diversity unweighted UniFrac p = 0.0036)
  • The abundance of commensal order Lactobacillales tends to be decreased with higher alcohol consumption (fold changes = 0.89 and 0.94 for heavy and moderate drinkers, p trend = 0.005 [q = 0.064]).
  • Certain genera were enriched in subjects with higher alcohol consumption, including Actinomyces, Leptotrichia, Cardiobacterium, and Neisseria; some of these genera contain oral pathogens, while Neisseria can synthesize the human carcinogen acetaldehyde from ethanol.
  • Wine drinkers may differ from non-drinkers in microbial diversity and profiles (α-diversity richness p = 0.048 and β-diversity unweighted UniFrac p = 0.059) after controlling for drinking amount, while liquor and beer drinkers did not.

In conclusion the authors found that alcohol consumption is related to overall oral microbiome community composition and to the abundance of specific oral taxa. Heavy drinking may influence bacterial composition, including potential depletion of beneficial commensal bacteria and increased colonization of potentially pathogenic bacteria. Such changes potentially contribute to alcohol-related diseases, including periodontal disease, head and neck cancer, and digestive tract cancers, but further research is needed to relate alcohol-related composition changes to disease phenotypes. The taxa they have identified can be further investigated to tease out their potential relationship with underlying oral health status and to elucidate their potential role in alcohol-related health consequences.

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Javier Velasco