{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T18:47:50Z","timestamp":1783968470683,"version":"3.55.0"},"reference-count":57,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondo para Proyectos de Impulso a la Investigaci\u00f3n","award":["PIN 2020-I"],"award-info":[{"award-number":["PIN 2020-I"]}]},{"name":"Apoyo para Pago de Publicaci\u00f3n de Art\u00edculos Cient\u00edficos 2026, Universidad de Guadalajara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The oral microbiome of patients with acute lymphoblastic leukemia (ALL) undergoes changes caused by the neoplasia as well as the antimicrobial activity of chemotherapy (CTX), which promotes the development of oral mucositis (OM). This study aimed to analyze the oral microbiome dynamics and salivary cytokine production in pediatric ALL patients before and during CTX, comparing children who did and did not develop OM. We conducted a longitudinal, observational, and analytical study including 32 newly diagnosed pediatric ALL patients (ages 2\u201316 years) undergoing CTX. Oral rinse and non-stimulated saliva samples were collected at baseline (day 0), day 14, and day 21 of induction of CTX, with an additional sample taken during OM episodes when possible. Microbiome analysis was performed using 16S rRNA sequencing on an Illumina MiSeq platform, and salivary cytokines were measured using a Luminex multiplex assay. The most pronounced microbiome changes occurred on day 14, particularly in patients who developed OM, characterized by higher \u03b1 diversity, increased abundance of opportunistic taxa, and elevated IL-6 concentrations. In contrast, patients who did not develop OM exhibited a more stable microbial composition. Overall, these findings indicate that temporal oral dysbiosis and increased IL-6 may serve as early markers and potential predictors of OM development during chemotherapy in pediatric ALL patients.<\/jats:p>","DOI":"10.3390\/microorganisms14010185","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:01:14Z","timestamp":1768388474000},"page":"185","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Oral Microbiome Dynamics in Patients with Acute Lymphoblastic Leukemia and Oral Mucositis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7479-2050","authenticated-orcid":false,"given":"Ana Elizabeth","family":"S\u00e1nchez-Becerra","sequence":"first","affiliation":[{"name":"Departamento de Microbiolog\u00eda y Patolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Pe\u00f1a-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Laboratorio de Diagn\u00f3stico de Enfermedades Emergentes y Reemergentes (LaDEER), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4749-2498","authenticated-orcid":false,"given":"Alejandra Natali","family":"Vega-Maga\u00f1a","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Ciencias Biom\u00e9dicas (IICB), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-6933","authenticated-orcid":false,"given":"Samuel","family":"Garc\u00eda-Arellano","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Ciencias Biom\u00e9dicas (IICB), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-5761","authenticated-orcid":false,"given":"Hugo Antonio","family":"Romo-Rubio","sequence":"additional","affiliation":[{"name":"Servicio de Hemato-Oncolog\u00eda Pedi\u00e1trica, Hospital Civil de Guadalajara \u201cJuan I. Menchaca\u201d, Guadalajara 44670, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sony","family":"Flores-Navarro","sequence":"additional","affiliation":[{"name":"Odontolog\u00eda en Servicio de Hemato-Oncolog\u00eda Pedi\u00e1trica, Hospital Civil de Guadalajara \u201cJuan I. Menchaca\u201d, Guadalajara 44670, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Griselda","family":"Escobedo-Melendez","sequence":"additional","affiliation":[{"name":"Servicio de Hemato-Oncolog\u00eda Pedi\u00e1trica, Hospital Civil de Guadalajara \u201cJuan I. Menchaca\u201d, Guadalajara 44670, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0379-9626","authenticated-orcid":false,"given":"Saray","family":"Aranda-Romo","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Diagn\u00f3stico, Facultad de Estomatolog\u00eda, Universidad Aut\u00f3noma de San Luis Potos\u00ed, San Luis Potos\u00ed 78000, San Luis Potos\u00ed, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-6061","authenticated-orcid":false,"given":"Jos\u00e9 Sergio","family":"Zepeda-Nu\u00f1o","sequence":"additional","affiliation":[{"name":"Departamento de Microbiolog\u00eda y Patolog\u00eda, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bustamante, J.C., Hern\u00e1ndez, A., Galv\u00e1n, C., Rivera, R., Fuentes, H.E., Meneses, A., and Olaya, A. (2024). Childhood leukemias in Mexico: Towards implementing CAR-T cell therapy programs. Front. Oncol., 18.","DOI":"10.3389\/fonc.2023.1304805"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kiyomi, A., Yoshida, K., Arai, C., Usuki, R., Yamazaki, K., Hoshino, N., Kurokawa, A., Imai, S., Suzuki, N., and Toyama, A. (2022). Salivary inflammatory mediators as biomarkers for oral mucositis and oral mucosal dryness in cancer patients: A pilot study. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0267092"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s40168-019-0679-5","article-title":"Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis","volume":"7","author":"Hong","year":"2019","journal-title":"Microbiome"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1093\/cid\/ciy153","article-title":"Gut Microbiome Composition Predicts Infection Risk During Chemotherapy in Children with Acute Lymphoblastic Leukemia","volume":"67","author":"Hakim","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e236","DOI":"10.14694\/EdBook_AM.2013.33.e236","article-title":"Oral mucositis in head and neck cancer: Risk, biology, and management","volume":"33","author":"Sonis","year":"2013","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Basile, D., Di Nardo, P., Corvaja, C., Garattini, S.K., Pelizzari, G., Lisanti, C., Bortot, L., Da Ros, L., Bartoletti, M., and Borghi, M. (2019). Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to Bedside. Cancers, 11.","DOI":"10.3390\/cancers11060857"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Sultan, A.S., Kong, E.F., Rizk, A.M., and Jabra-Rizk, M.A. (2018). The oral microbiome: A Lesson in coexistence. PLoS Pathog., 14.","DOI":"10.1371\/journal.ppat.1006719"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Cinausero, M., Aprile, G., Ermacora, P., Basile, D., Vitale, M.G., Fanotto, V., Parisi, G., Calvetti, L., and Sonis, S.T. (2017). New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury. Front. Pharmacol., 8.","DOI":"10.3389\/fphar.2017.00354"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1080\/10428194.2023.2205976","article-title":"The results of the modified St Jude Total Therapy XV Protocol in the treatment of low- and middle-income children with acute lymphoblastic leukemia","volume":"64","author":"Yilmaz","year":"2023","journal-title":"Leuk. Lymphoma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.14219\/jada.archive.1964.0034","article-title":"The Simplified Oral Hygiene Index","volume":"68","author":"Greene","year":"1964","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_11","first-page":"193","article-title":"\u201cICDAS\u201d\u2014An international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management","volume":"21","author":"Pitts","year":"2004","journal-title":"Community Dent. Health"},{"key":"ref_12","unstructured":"World Health Organization (1979). WHO Handbook for Reporting Results of Cancer Treatment, World Health Organization. Available online: https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/c1b590fa-20a6-4c97-9123-5cc4d34c7cdb\/content."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1038\/s41587-019-0209-9","article-title":"Reproducible, interactive, scalable and extensible microbiome data science using QIIME 2","volume":"37","author":"Bolyen","year":"2019","journal-title":"Nat. Biotechnol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"D590","DOI":"10.1093\/nar\/gks1219","article-title":"The SILVA ribosomal RNA gene database project: Improved data processing and web-based tools","volume":"41","author":"Quast","year":"2013","journal-title":"Nucleic Acids Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Triarico, S., Agresti, P., Rinninella, E., Mele, M.C., Romano, A., Attin\u00e0, G., Maurizi, P., Mastrangelo, S., and Ruggiero, A. (2022). Oral Microbiota during Childhood and Its Role in Chemotherapy-Induced Oral Mucositis in Children with Cancer. Pathogens, 11.","DOI":"10.3390\/pathogens11040448"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Khor, B., Snow, M., Herrman, E., Ray, N., Mansukhani, K., Patel, K.A., Said-Al-Naief, N., Maier, T., and Machida, C.A. (2021). Interconnections Between the Oral and Gut Microbiomes: Reversal of Microbial Dysbiosis and the Balance Between Systemic Health and Disease. Microorganisms, 9.","DOI":"10.3390\/microorganisms9030496"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Wang, Y., Xue, J., Zhou, X., You, M., Du, Q., Yang, X., He, J., Zou, J., Cheng, L., and Li, M. (2014). Oral microbiota distinguishes acute lymphoblastic leukemia pediatric hosts from healthy populations. PLoS ONE, 9, Correction in PLoS ONE\u00a02014, 9, e110449.","DOI":"10.1371\/journal.pone.0110449"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"6637503","DOI":"10.1155\/2021\/6637503","article-title":"Oral Health, Caries Risk Profiles, and Oral Microbiome of Pediatric Patients with Leukemia Submitted to Chemotherapy","volume":"2021","author":"Wang","year":"2021","journal-title":"BioMed Res. Int."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Chaturvedi, A.K., Vogtmann, E., Shi, J., Yano, Y., Blaser, M.J., Bokulich, N.A., Caporaso, J.G., Gillison, M.L., Graubard, B.I., and Hua, X. (medRxiv, 2024). The mouth of America: The oral microbiome profile of the US population, medRxiv, Preprint.","DOI":"10.1101\/2024.12.03.24318415"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"E559","DOI":"10.1111\/1469-0691.12287","article-title":"Oral bacterial community dynamics in paediatric patients with malignancies in relation to chemotherapy-related oral mucositis: A prospective study","volume":"19","author":"Ye","year":"2013","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_21","first-page":"81","article-title":"Salivary and serum concentrations of selected pro- and antiinflammatory cytokines in relation to oral lesions among children undergoing maintenance therapy of acute lymphoblastic leukemia","volume":"23","author":"Krzaczek","year":"2019","journal-title":"Contemp. Oncol. Pozn"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1177\/0022034516641890","article-title":"Hostmicrobiome cross-talk in oral mucositis","volume":"95","author":"Vasconcelos","year":"2016","journal-title":"J. Dent. Res."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Filetici, P., Gallottini, S.G., Corvaglia, A., Amendolea, M., Sangiovanni, R., Nicoletti, F., D\u2019Addona, A., and Dassatti, L. (2024). The role of oral microbiota in the development of oral mucositis in pediatric oncology patients treated with antineoplastic drugs: A systematic review. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-03938-y"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/prd.12365","article-title":"Resilience of the oral microbiome","volume":"86","author":"Wade","year":"2021","journal-title":"Periodontol. 2000"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"23987","DOI":"10.1038\/s41598-021-03479-2","article-title":"Stability of healthy subgingival microbiome across space and time","volume":"11","author":"Tamashiro","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13073-017-0409-1","article-title":"Characterization of oral and gut microbiome temporal variability in hospitalized cancer patients","volume":"9","author":"Smith","year":"2017","journal-title":"Genome Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/0030-4220(93)90198-D","article-title":"Changes in the oral microflora during cytotoxic chemotherapy in children being treated for acute leukemia","volume":"76","author":"Duggal","year":"1993","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/odi.12509","article-title":"A practical guide to the oral microbiome and its relation to health and disease","volume":"23","author":"Krishnan","year":"2017","journal-title":"Oral Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"42","DOI":"10.3934\/microbiol.2018.1.42","article-title":"Oral microbiome and health","volume":"4","author":"Sharma","year":"2018","journal-title":"AIMS Microbiol."},{"key":"ref_30","first-page":"e248","article-title":"Oral microbiome and systemic antineoplastics in cancer treatment: A systematic review","volume":"27","year":"2022","journal-title":"Med. Oral Patol. Oral Cirugia Bucal"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Bruno, J.S., Al-Qadami, G.H., Laheij, A.M.G.A., Bossi, P., Fregnani, E.R., and Wardill, H.R. (2023). From Pathogenesis to Intervention: The Importance of the Microbiome in Oral Mucositis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24098274"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1038\/s41598-020-59016-0","article-title":"Genetics of Taste Lab Citizen Scientists. Patterns of Oral Microbiota Diversity in Adults and Children: A Crowdsourced Population Study","volume":"10","author":"Burcham","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e165","DOI":"10.15190\/d.2023.4","article-title":"Exploring the oral microbiome: An updated multidisciplinary oral healthcare perspective","volume":"11","author":"Chowdhry","year":"2023","journal-title":"Discov. Craiova"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Crielaard, W., Zaura, E., Schuller, A.A., Huse, S.M., Montijn, R.C., and Keijser, B.J. (2011). Exploring the oral microbiota of children at various developmental stages of their dentition in the relation to their oral health. BMC Med. Genom., 4.","DOI":"10.1186\/1755-8794-4-22"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.ijfoodmicro.2008.04.002","article-title":"Real-time PCR detection of bacteria belonging to the Firmicutes Phylum","volume":"125","author":"Haakensen","year":"2008","journal-title":"Int. J. Food Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1038\/s41368-020-0082-x","article-title":"Oral microbiome: Possible harbinger for children\u2019s health","volume":"12","author":"Xiao","year":"2020","journal-title":"Int. J. Oral Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/odi.12224","article-title":"Microbiota and their role in the pathogenesis of oral mucositis","volume":"21","author":"Vanhoecke","year":"2015","journal-title":"Oral Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e0025722","DOI":"10.1128\/jb.00257-22","article-title":"Oral Commensal Streptococci: Gatekeepers of the Oral Cavity","volume":"204","author":"Baty","year":"2022","journal-title":"J. Bacteriol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Zaura, E., Keijser, B.J., Huse, S.M., and Crielaard, W. (2009). Defining the healthy \u201ccore microbiome\u201d of oral microbial communities. BMC Microbiol., 9.","DOI":"10.1186\/1471-2180-9-259"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bech, A.S., Nexoe, A.B., Dubik, M., Moeller, J.B., Soerensen, G.L., Holmskov, U., Madsen, G.I., Husby, S., and Rathe, M. (2021). Peptidoglycan Recognition Peptide 2 Aggravates Weight Loss in a Murine Model of Chemotherapy-Induced Gastrointestinal Toxicity. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.635005"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1111\/j.1600-0765.2012.01485.x","article-title":"Levels of Selenomonas species in generalized aggressive periodontitis","volume":"47","author":"Fermiano","year":"2012","journal-title":"J. Periodontal Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e0031922","DOI":"10.1128\/iai.00319-22","article-title":"Selenomonas sputigena Interactions with Gingival Epithelial Cells That Promote Inflammation","volume":"91","author":"Hawkes","year":"2023","journal-title":"Infect. Immun."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e00536","DOI":"10.1016\/j.idcr.2019.e00536","article-title":"Capnocytophaga sputigena bacteremia in a neutropenic host","volume":"17","author":"Isabel","year":"2019","journal-title":"IDCases"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1590\/s1678-9946202062048","article-title":"Capnocytophaga sputigena bloodstream infection in hematopoietic stem cell transplantations: Two cases report and review of the literature","volume":"62","author":"Mendes","year":"2020","journal-title":"Rev. Inst. Med. Trop. Sao Paulo"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"E20","DOI":"10.1086\/322649","article-title":"Bacteremia caused by Capnocytophaga species in patients with neutropenia and cancer: Results of a multicenter study","volume":"33","author":"Martino","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1111\/ipd.13303","article-title":"Prevalence and Risk Factors of Chemotherapy-Induced Oral Mucositis in 470 Children with Acute Lymphoblastic Leukemia","volume":"35","author":"He","year":"2025","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1111\/odi.13862","article-title":"The presence of Prevotella melaninogenica within tissue and preliminary study on its role in the pathogenesis of oral lichen planus","volume":"28","author":"Zheng","year":"2022","journal-title":"Oral Dis."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Yang, Z., Cui, Q., An, R., Wang, J., Song, X., Shen, Y., Wang, M., and Xu, H. (2020). Comparison of microbiomes in ulcerative and normal mucosa of recurrent aphthous stomatitis (RAS)-affected patients. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01115-5"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1365-263X.2011.01175.x","article-title":"Proinflammatory cytokines during the initial phase of oral mucositis in patients with acute lymphoblastic leukaemia","volume":"22","author":"Viera","year":"2012","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/prd.12388","article-title":"Paradigm shift in the pathogenesis and treatment of oral cancer and other cancers focused on the oralome and antimicrobial-based therapeutics","volume":"87","author":"Radaic","year":"2021","journal-title":"Periodontol. 2000"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.1038\/ijos.2017.51","article-title":"Analysis of differential expression of tight junction proteins in cultured oral epithelial cells altered by Porphyromonas gingivalis, Porphyromonas gingivalis lipopolysaccharide, and extracellular adenosine triphosphate","volume":"10","author":"Guo","year":"2018","journal-title":"Int. J. Oral Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"5846","DOI":"10.1128\/IAI.70.10.5846-5856.2002","article-title":"Discrete proteolysis of focal contact and adherens junction components in Porphyromonas gingivalis-infected oral keratinocytes: A strategy for cell adhesion and migration disabling","volume":"70","author":"Hintermann","year":"2002","journal-title":"Infect. Immun."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Aleksijevi\u0107, L.H., Aleksijevi\u0107, M., \u0160krlec, I., \u0160ram, M., \u0160ram, M., and Talapko, J. (2022). Porphyromonas gingivalis Virulence Factors and Clinical Significance in Periodontal Disease and Coronary Artery Diseases. Pathogens, 11.","DOI":"10.3390\/pathogens11101173"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Liu, D., Liu, S., Zhang, S., and Pan, Y. (2021). The Role of Porphyromonas gingivalis Outer Membrane Vesicles in Periodontal Disease and Related Systemic Diseases. Front. Cell Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.585917"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.4049\/jimmunol.2100866","article-title":"Porphyromonas gingivalis Gingipains Induce Cyclooxygenase-2 Expression and Prostaglandin E2 Production via ERK1\/2-Activated AP-1 (c-Jun\/c-Fos) and IKK\/NF-\u03baB p65 Cascades","volume":"208","author":"Nakayama","year":"2022","journal-title":"J. Immunol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"K\u00f6n\u00f6nen, E., Fteita, D., Gursoy, U.K., and Gursoy, M. (2022). Prevotella species as oral residents and infectious agents with potential impact on systemic conditions. J. Oral Microbiol., 14.","DOI":"10.1080\/20002297.2022.2079814"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12951-024-02305-x","article-title":"Amorphous silica nanoparticles and the human gut microbiota: A relationship with multiple implications","volume":"22","author":"Bianchi","year":"2024","journal-title":"J. Nanobiotechnol."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/1\/185\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:22:32Z","timestamp":1768389752000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/1\/185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["microorganisms14010185"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms14010185","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]}}}