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Harboring Cnm-expressing Streptococcus mutans in the oral cavity relates to both deep and lobar cerebral microbleeds

Shuhei Ikeda1,2,3, Satoshi Saito1,4,5, Satoshi Hosoki1

  • 1Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan.

European Journal of Neurology
|January 28, 2023
PubMed
Abstract

Insights

Presence of Cnm-positive Streptococcus mutans in the mouth is linked to more cerebral microbleeds (CMBs) in stroke patients. Targeting this oral bacterium may offer a new stroke treatment strategy.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiovascular Research

Background:

  • Cerebral microbleeds (CMBs) significantly impact stroke patient prognoses.
  • Streptococcus mutans, via its collagen-binding protein Cnm, can cause cerebrovascular inflammation and impair blood-brain barrier integrity, leading to cerebral bleeding.
  • This study investigates the direct association between Cnm-positive S. mutans and the occurrence of CMBs.

Purpose of the Study:

  • To determine the association between oral carriage of Cnm-positive Streptococcus mutans and the presence and number of cerebral microbleeds in acute stroke patients.
  • To explore potential therapeutic targets for reducing CMBs in stroke survivors.

Main Methods:

  • A cohort of acute stroke patients was analyzed from a single-center registry.
  • Oral bacterial samples were tested for Cnm-positive and Cnm-negative S. mutans using polymerase chain reaction (PCR).
  • Quasi-Poisson and logistic regression models were employed to assess the association between Cnm-positive S. mutans and CMB counts, including the presence of >10 CMBs, while controlling for confounding factors.

Main Results:

  • The study included 428 patients for oral bacterial examination, with 326 found to harbor S. mutans.
  • Patients with Cnm-positive S. mutans (n=72) showed a significant independent association with a higher number of CMBs, particularly in deep and lobar locations.
  • Specifically, Cnm-positive S. mutans was linked to the presence of >10 CMBs (adjusted odds ratio 2.20) and increased counts of deep (adjusted risk ratio 1.61) and lobar CMBs (adjusted risk ratio 5.14).

Conclusions:

  • Harboring Cnm-positive Streptococcus mutans is independently associated with an increased number of cerebral microbleeds in deep and lobar brain regions.
  • Reducing the burden of Cnm-positive S. mutans in the oral cavity presents a potential novel therapeutic strategy for managing and preventing CMBs in stroke patients.
Keywords:
Streptococcus mutansdental cariesmicrobleedsrisk factorstroke

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