cnm-positive Streptococcus mutans, a major pathogen in dental caries, may exacerbate IgA nephropathy via the tonsils.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2025-05-29 DOI:10.1007/s10157-025-02708-6

Seigo Ito, Taro Misaki, Shuhei Naka, Daiki Matsuoka, Kana Suehara, Yuto Suehiro, Yasuyuki Nagasawa, Ryota Nomura, Michiyo Matsumoto-Nakano, Kazuhiko Nakano

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Abstract

Background: Streptococcus mutans is a major pathogen in dental caries. This organism, which expresses Cnm protein encoded by the cnm gene, has been associated with the pathogenesis of IgA nephropathy (IgAN). Although tonsillectomy is used to treat IgAN, its efficacy is presently unclear in patients with IgAN who harbor cnm-positive S. mutans.

Methods: The presence of cnm-positive S. mutans in saliva specimens from 158 patients with IgAN was determined by polymerase chain reaction assay. The patients were divided according to the results of cnm-positive S. mutans detection and history of tonsillectomy into those who were cnm-positive S. mutans (-), tonsillectomy (-) (group A, n = 57); cnm-positive S. mutans (-), tonsillectomy ( +) (group B, n = 62); cnm-positive S. mutans ( +), tonsillectomy (-) (group C, n = 19); and cnm-positive S. mutans ( +), tonsillectomy ( +) (group D, n = 20). The patients' clinical data were compared between the four groups.

Results: The proportions of patients with proteinuria > 2 + and an estimated glomerular filtration rate < 60 mL/min/1.73 m² were significantly greater in group C than in the other groups (p < 0.0083). Moreover, the proportion of patients with a serum IgA concentration of > 347 mg/dL was significantly higher in group C than in the other groups (p < 0.05).

Conclusions: These findings suggest that exacerbation of IgAN by cnm-positive S. mutans is possibly mediated by the tonsils and that tonsillectomy may be particularly effective in patients with IgAN and cnm-positive S. mutans in the oral cavity.

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cnm阳性的变形链球菌是龋齿的主要病原体，可通过扁桃体加重IgA肾病。

背景：变形链球菌是龋齿的主要病原菌。这种表达Cnm基因编码的Cnm蛋白的生物体与IgA肾病（IgAN）的发病机制有关。虽然扁桃体切除术用于治疗IgAN，但目前尚不清楚其对携带cnm阳性变形链球菌的IgAN患者的疗效。方法：采用聚合酶链反应法检测158例IgAN患者唾液标本中cnm阳性变形链球菌的存在。根据cnm阳性变形链球菌检测结果和扁桃体切除史将患者分为cnm阳性变形链球菌（-）、扁桃体切除（-）组（A组，n = 57）；cnm阳性S. mutans(-)，扁桃体切除术（+）（B组，n = 62）；cnm阳性S. mutans(+)，扁桃体切除术（-）（C组，n = 19）；cnm阳性S. mutans(+)，扁桃体切除术（+）（D组，n = 20）。比较四组患者的临床资料。结果：C组患者蛋白尿bbb2 +和肾小球滤过率2的比例显著高于其他组（p347 mg/dL在C组显著高于其他组）。结论：这些发现表明，IgAN的恶化可能是由扁桃体介导的，扁桃体切除术可能对IgAN和cnm阳性口腔变形链球菌患者特别有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.