{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:30:54Z","timestamp":1787923854893,"version":"build-2784847793"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral health significantly impacts overall health. Periodontal disease and chronic obstructive pulmonary disease (COPD) are prevalent chronic inflammatory conditions among older adults, but their causal link is not well-established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Multivariable logistic regression, including subgroup, sex-stratified, and interaction analyses, was used to investigate the link between self-reported periodontal disease and COPD. Two-sample Mendelian randomization (MR) was utilized to explore causality, primarily through inverse-variance weighting (IVW), and supported by four additional MR approaches. Sensitivity analyses were performed to evaluate pleiotropy and heterogeneity. Normal human bronchial epithelial cells were stimulated\n                      <jats:italic>in vitro<\/jats:italic>\n                      with the periodontal pathogens\n                      <jats:italic>F. nucleatum<\/jats:italic>\n                      and\n                      <jats:italic>P. gingivalis<\/jats:italic>\n                      . The expression levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) were then quantified using qPCR and chemiluminescence immunoassay.\n                      <jats:italic>In vivo<\/jats:italic>\n                      , a combined rat model of periodontitis and COPD was established to compare pulmonary inflammatory severity with a COPD-only model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multivariable logistic regression revealed significant associations between self-reported periodontal disease, oral hygiene practices, and COPD. The self-reported periodontal disease-COPD association was moderated by hypertension and flossing behavior. Mendelian randomization studies provided suggestive, exploratory evidence that periodontal disease may be associated with a higher risk of COPD in European populations, although the association did not survive multiple-testing correction and was not observed in East Asian populations.\n                      <jats:italic>In vitro<\/jats:italic>\n                      , both pathogens significantly upregulated IL-6 and IL-8 at both mRNA and protein levels.\n                      <jats:italic>In vivo<\/jats:italic>\n                      , rats with comorbid periodontitis and COPD exhibited significantly exacerbated pulmonary inflammation compared with those having COPD alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Periodontal disease may promote COPD pathogenesis, with\n                      <jats:italic>in vitro<\/jats:italic>\n                      data supporting a direct pro-inflammatory role of\n                      <jats:italic>P. gingivalis<\/jats:italic>\n                      and\n                      <jats:italic>F. nucleatum<\/jats:italic>\n                      in airway epithelium.\n                      <jats:italic>In vivo<\/jats:italic>\n                      , periodontitis as a complex disease state exacerbates pulmonary inflammation in COPD. Maintaining good oral hygiene may represent a potential supportive strategy that warrants further investigation in interventional studies, with potential public health implications, especially among high-risk populations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1896617","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:50:42Z","timestamp":1787921442000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From oral infection to pulmonary inflammation: periodontal pathogens and their potential role in COPD susceptibility"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaohao","family":"Liu","sequence":"first","affiliation":[{"name":"Shenzhen Clinical College of Stomatology, School of Stomatology, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen Stomatology Hospital(Pingshan) of Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Stomatological Hospital of Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengxiang","family":"Shi","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingchun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Stomatological Hospital of Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Stomatological Hospital of Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaming","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Stomatological Hospital of Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuaimei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Stomatological Hospital of Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buling","family":"Wu","sequence":"additional","affiliation":[{"name":"Shenzhen Clinical College of Stomatology, School of Stomatology, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen Stomatology Hospital(Pingshan) of Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s12890-021-01429-2","article-title":"Effect of periodontal therapy on COPD outcomes: a systematic review","volume":"21","author":"Apessos","year":"2021","journal-title":"BMC Pulm. 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