Abstract
Current microbiome research has generated tremendous amounts of data providing snapshots of molecular activity in a variety of organisms, environments, and cell types. However, turning this knowledge into whole system level of understanding on pathways and processes has proven to be a challenging task. In this review we highlight the applicability of bioinformatics and visualization techniques to large collections of data in order to better understand the information that contains related diet—oral microbiome—host mucosal transcriptome interactions. In particular, we focus on systems biology of Porphyromonas gingivalis in the context of high throughput computational methods tightly integrated with translational systems medicine. Those approaches have applications for both basic research, where we can direct specific laboratory experiments in model organisms and cell cultures, and human disease, where we can validate new mechanisms and biomarkers for prevention and treatment of chronic disorders.
Systems biology of the oral microbiome
The human oral cavity is estimated to contain more than 750 bacterial species packed in biofilms (Jenkinson and Lamont, ; Paster et al., 2006). Three key hypotheses developed recently try to explain the connection between oral microbiota and systemic diseases. The “ecological plaque” hypothesis was formulated to link the composition and phenotypic properties of the oral microbiota associated with caries initiation and progression (Marsh, ). This hypothesis envisages that caries is the result of environmental changes, particularly as a result of reduced intra-oral pH as a consequence of bacterial fermentation of dietary carbohydrates. The “keystone pathogen” hypothesis was developed to explain how despite its low-level colonization of the periodontium, Porphyromonas gingivalis (P. gingivalis) causes inflammatory periodontitis through dysbiosis, i.e., an unbalancing of the relative abundance of individual components of the microbiota compared with their abundances in health (Hajishengallis et al., ). Finally, the “dietary carbohydrate-density” hypothesis as a link between periodontal health and metabolic health tries to explain how acellular dense carbohydrates of modern foods produce an inflammatory microbiota and from the mouth onward a low-level inflammation, with multiple elements of the metabolic syndrome (MetS) strongly correlating with circulating bacterial lipopolysaccharide (LPS) concentrations (Spreadbury, 2013). To address the questions how those emerging topics may influence human health, we propose computational systems biology modeling approaches bridging microbial genome-scale metabolic modeling, system level reconstructions of epithelial transcriptome, and molecular profiling of the dietary glycobiome (Figure 1). Biological response pathways (e.g., signaling or metabolic) often integrate with a number of other pathways, operating within a complex web of pathways. Traditional reductionism approaches that seek to explain an isolated pathway by breaking it into its component parts often cannot produce a sufficiently deep mechanistic understanding to enable predictive behaviors. This state of affairs has led to the emergence of the field of “systems biology” that seeks to develop testable models to explain the behavior of complex biological systems (Palsson, 2006). Systems biology can be defined broadly as the integration of large amounts of biological data from various sources to create one or more comprehensive models of a system to enable (1) visualization of the changes in the various working parts within a particular system (e.g., “Bayesian Network” data from changes in genes, proteins, or metabolites in response to different biological conditions), (2) visualization of the known and/or predicted interaction(s) between those parts, and (3) creation of a mathematical model of interaction paths from which testable predictions about the system can be made. This framework can also highlight areas where information is scarce; promoting the focused acquisition data that will help flesh out specific parts of the model(s). Systems approaches have been extended to model and simulate gut microbiome–host intestinal transcriptome interactions (Heinken et al., ). Here we describe how they may similarly shed insight on oral microbiology.
Figure 1
Food molecular profiling
Dental caries is initiated by demineralization of the tooth surface due to the action of organic acid formed by dental plaque bacteria, arising from their fermentation of dietary carbohydrates. After fermentable carbohydrate intake, the plaque pH may decrease below the critical pH of 5.5, at which point human enamel undergoes demineralization, within minutes, and may remain acidified for several minutes up to several hours (Morse et al.,
Targeted glycoprofyling of the oral bolus (mass of food formed in the mouth after thorough chewing) via high performance liquid chromatography-chip time-of-flight mass spectrometry can be used for monosaccharide analysis, sialic acid analysis to determine relative levels of human vs. non-human sialylation, oligosaccharide profiling, and detailed glycan structure analysis (Gamsiz et al., accepted). To specific aim will be identifying oral glycoproteins that bind to bacteria and either aid or prevent the adherence of bacteria to mucosal and tooth surfaces.
In addition, food texture of the bolus can also be measured by special equipment in research laboratories and factory quality assurance (QA) labs (Peyron et al., 2011). Texture analyzers can press, pull, pierce, squash, twist, and crush samples of food in a way which tries to mimic the end use as closely as possible. In many cases, these tests have been developed to try to mimic human senses to make the test as applicable to the product as possible, for example, to represent a biting action or a chewing action. One research group in the UK, Leatherhead Food International (LFI), is even investigating textual and structural changes in low fat foods during chewing, in other words, how the food breaks down in the mouth when it is a low-fat product. Other field of food science—food microbiology knowledge could also be extrapolated toward how ingested food changes in response to different oral microbial strains.
The oral symbiont—network of interactions between microbial secretome and host mucosal transcriptome
Oral bacteria can adhere to salivary agglutinin, other plaque bacteria, extracellular matrix, and epithelial cell-surface receptors (Ellen et al.,
Virulence factors secreted by P. gingivalis include gingipains and LPS. The Arg-specific cysteine proteinases (gingipains) of P. gingivalis exhibit complement C5 convertase-like activity, which generates high levels of C5a locally to activate the C5a receptor (Hajishengallis et al.,
There are numerous examples of systems models developed for various aspects of immune function activation by virulence factors, a selection of which are described below. Transcriptomic data has been most commonly used to create systems models. Examples of this approach include Ravasi et al. (2007) and Tegnér et al. (2006), who used transcriptomic data to generate a systems model of macrophage activation. Nilsson et al. (
Several approaches have been used to study the responses of the human oral mucosa to external stimuli, including monolayers of epithelial cells isolated from unstimulated saliva, oral squamous cell carcinomas (SCC), or primary gingival keratinocytes—organotyping of oral mucosa (Dongari-Bagtzoglou and Kashleva,
Other environmental factors should be also taken into account when building the broad picture of interactions. In particular, smoking is major contributor to oral microbiome changes in later life and coordinate analysis in smokers reveals significantly lower taxonomic diversity, higher attachment loss and higher proportion of the anaerobic genera (Kumar et al.,
The oral inflammatome network
Bacterial components from caries activate cytokine/chemokine release from odontoblasts, dendritic cells, and/or macrophages via TLRs. Pro-inflammatory cytokines released from these cells act as autocrine and paracrine signals to amplify cytokine responses including antimicrobial peptide, cytokine, and chemokine production. The release of chemokines creates a migration gradient for immune cells to ODL while antimicrobial peptides reduce bacterial load. The minimal connectivity of genes increased in the odontoblast layer (ODL) and pulp of carious teeth network model (Horst et al.,
Systems medicine of the oral microbiome
“Systems medicine” is the application of systems biology approaches to medical research and medical practice (Bousquet et al.,
How oral microbiome contributes to disease?
It is intriguing to study to what extend periodontopathic bacteria may directly enhance atherogenesis. Several facts provide clues of potential connection between oral bacteria and local immuno-inflammatory response. The detection frequency of P. gingivalis, in atherosclerostic specimens was shown to be 32% (Chen et al.,
The increasing use of cone beam computed tomography (CBCT) in dentistry provides images in the third dimension (3D) which facilitates precise localization and prevalence of Carotid Artery Calcifications (CAC) on panoramic images in the general dental population over 50 years varies from 0.1 to 3.2% increasing with age and is substantially higher (22–37%) in populations exhibiting atherosclerotic (hypertension, cardiovascular disease, past stroke/CVA, transient ischemic attacks, or diabetes) or other (hypercholesterolemia, obesity and physical inactivity, cigarette smoking, sleep apnea, and male gender) risk factors (Lee and Kang,
Recent studies have pointed to the heterogeneity of macrophages infiltrated into adipose tissue; i.e., they follow at least two different polarization states: M1 or classically activated (pro-inflammatory) macrophages, which are induced by pro-inflammatory mediators such as LPS and M2 or alternatively activated (anti-inflammatory) macrophages, which are generated in vitro by exposure to Th2 cytokines such as IL-4 and IL-13 (Osborn and Olefsky, 2012; Manteiga et al.,
Figure 2

Translational systems medicine: salivomics and vaccinomics of the oral microbiome. (A) The “Fatty Neck”—new emerging marker of inflammatory complications; (B) Salivary diagnostics (salivomics)—non-invasive and applicable approach for disease detection and follow up. (C) Personalized vaccinomics—for prediction of protein–ligand binding regions, vaccine design using computational vaccinology of responders vs. non-responders with the overall role for disease prevention.
Salivomics
Saliva is the oral fluid that lubricates, buffers, and protects oral tissues against decay, damage, microbial inflammation, and facilitates the remineralization of teeth. Saliva consists primarily of water, minerals, electrolytes, buffer, and proteins that are secreted by three major glands (parotid, submandibular, sublingual) and by numerous minor glands in the lip, cheek, tongue, and palate. In addition, saliva contains microbes, epithelial cells, nasal and bronchial secretions, and serum products. These components can provide clues to local and/or systemic diseases and disorders of the human body. Diagnostically, a number of findings in the past decade have prompted interest in the use of saliva as a source of biomarkers. Levels of hormones (e.g., cortisol, oxytocin) and drugs (e.g., cisplatin, nicotine, methadone) in saliva reflect their concentration in serum (Refulio et al., 2013). A significant boost to the scientific foundation and infrastructure of salivary diagnostics research came 6 years ago when the National Institute of Dental & Craniofacial Research (NIDCR) made a significant investment toward developing the use of saliva as a diagnostic tool. Saliva has since become a biofluid that is poised for translational and clinical applications. Of note is the maturation of the salivary proteome, the first implement in the diagnostic toolbox for saliva-based diagnostics. We now know there are 1166 proteins in human saliva, the functions of which range from structural binding to participation in diverse biological processes (Rathnayake et al., 2013). A second diagnostic resource in saliva has since emerged, the salivary transcriptome. Using the salivary transcriptome as a diagnostic tool, a set of 185 mRNAs was identified as “normal salivary core transcripts” (NSCT) (Fábryová and Celec, accepted). Third, the CE-TOFMS can readily and effectively be applied to salivary metabolomics. Small molecule metabolites found in human saliva can come from several sources. Depending on the method of collection, food components may be directly observed during targeted profiling of saliva. These can be solutes already dissolved in the food, like caffeine in coffee, solid components that rapidly dissolve into the saliva, like sugars from a cookie, or metabolites resulting from the action of enzymes in the saliva, like maltose from the action of α-amylase on starches (Walsh et al., 2006). For the purpose of this review, saliva metabolomics is most applicable as a direct measure of dietary input; however, systems biology integration of metabolomics data with the rest of the oral network components has not been done thus so far.
Applied salivomics can involve both insights gained from biobanking analysis, as wells as from targeted analysis in specific phenotype subjects, e.g., obese ones or smokers (Figure 2B). Data from the UK Biobank (UKB) national epidemiological study revealed that the oral salivary microbiome shows variations between subjects and suggested that the resource of 120,000 samples held in storage will be useful for phenotyping subjects and revealing potential prognostic disease biomarkers (Pramanik et al., 2012).
Human salivary circadian 27 metabolites in saliva that demonstrate a monotonic increase or decrease across the 40-h constant routine protocol (Dallmann et al., 2012). For example, the system analysis found a more than threefold increase in two fragments of the C3 complement, which is a marker of upregulation of the immune system in general.
Comparison of the salivary metabolome profile of male smokers and non-smokers revealed that citrate, lactate, pyruvate, and sucrose to be higher and formate to be lower in concentration in smokers compared with non-smokers (Takeda et al., 2009). Gender differences were also investigated, and acetate, formate, glycine, lactate, methanol, propionate, propylene glycol, pyruvate, succinate, and taurine were significantly higher in concentration in male saliva compared to female saliva (p < 0.05). These results show that differences between male and female, stimulated and unstimulated, as well as smoking status may be observed in the salivary metabolome.
Personalized interventions
The modulation of pro-inflammatory cytokines in saliva may be proof of principle for interventional approaches, e.g., probiotics for combating inflammation in the oral cavity (Twetman et al., 2009). Several companies are already marketing probiotic chewing gums and would be interesting to test how they influence the level of oral pathogens in the mouth in controlled clinical settings (Vicario et al., 2011). Companies investing in clinical research with the goal of achieving an EFSA (European Food Safety Agency) approved health claim may want to re-examine their study design to ensure the data will serve its purpose. Recent consensus statement of ILSI Europe Nutrition and Immunity Task Force gives extensive overview of available inflammatory biomarkers and their utility to predict clinical outcome and highlights the need for the use of multiple markers and integrated analysis (Calder et al.,
Another area of intensive research is the vaccine against P. gingivalis and as soon as it enters Phase I clinical trial status would be appealing to test several of the already established hypothesis and biomarkers (Jong and van der Reijden,
Databases of vaccine clinical trials and vaccines in research also exist. The important vaccine components include vaccine antigens, vaccine adjuvants, vaccine vectors, and -vaccine preservatives. The vaccine antigens can be whole proteins or immune epitopes. Various in silico vaccine design tools are also available (He and Xiang,
The next period of medicine will focus on prevention and personalization of treatment, where identification of responders and non-responders to a given therapy will rely on early predictions based on computational modeling and stimulations. A new approach to vaccine discovery characterized as a “discover–validate–characterize–deploy” paradigm is based on the foundations of vaccinomics and personalized vaccinology and represent a range of potential components that can be assembled into a comprehensive, systems-level examination of infection/vaccination of a given pathogen (Poland et al., 2011) (Figure 2C).
In addition to combating oral inflammation with probiotics and vaccines, an intriguing study would be to estimate to what extent the anti-inflammatory effect of nicotine in the nicotine-replacement chewing gums has overall system effects, e.g., in obesity and metabolic syndrome (Lakhan and Kirchgessner,
Conclusion
The proposed computational framework is an appropriate approach for modeling biological networks that allows in silico testing of new hypotheses. Specifically, the framework allows integration of new modules of interactions between components within the network. The oral microbiome systems biology–systems medicine translational model offers achievable strategy for understanding diet–microbe–host crosstalks, and can provide insights toward reducing inflammation and chronic diseases burden. The development of user-friendly and integrated bioinformatics platform for computational analysis and visualization of selected omics data in systems biology–systems medicine of the oral microbiome context is the way forward. The platform will implement the algorithms and data structures developed into one integrated tool that make these achievements directly verifiable by the community and accessible for non-expert biomedical users. Effective, reproducible, and clinically meaningful tools for combining data-driven and knowledge-based approaches to identify predictive signatures of disease are the key to future success in the biomarker and biotechnology R&D field.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Statements
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Summary
Keywords
oral microbiome, in silico modeling, systems biology, systems medicine, Porphyromonas gingivalis, biomarkers, probiotics, vaccines
Citation
Dimitrov DV (2013) Systems approaches to computational modeling of the oral microbiome. Front. Physiol. 4:172. doi: 10.3389/fphys.2013.00172
Received
30 March 2013
Accepted
20 June 2013
Published
10 July 2013
Volume
4 - 2013
Edited by
Erwin Gianchandani, National Science Foundation, USA
Reviewed by
Sarah S. Knox, West Virginia University School of Medicine, USA; Ravi Radhakrishnan, University of Pennsylvania, USA
Copyright
© 2013 Dimitrov.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.
*Correspondence: Dimiter V. Dimitrov, Diavita Ltd., 68 Br. Miladinovi str. G, Varna 9000, Bulgaria e-mail: dimiter.v.dimitrov@gmail.com
This article was submitted to Frontiers in Computational Physiology and Medicine, a specialty of Frontiers in Physiology.
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