Biologically informed stratification of periodontal disease holds the key to achieving precision oral health.
GWAS
genomics
periodontal disease
precision medicine
risk assessment
Journal
Journal of periodontology
ISSN: 1943-3670
Titre abrégé: J Periodontol
Pays: United States
ID NLM: 8000345
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
13
02
2020
revised:
27
03
2020
accepted:
30
03
2020
pubmed:
21
5
2020
medline:
18
11
2020
entrez:
21
5
2020
Statut:
ppublish
Résumé
Medicine and dentistry need to treat the individual not the "average patient." This personalized or precision approach to health care involves correctly diagnosing and properly classifying people to effectively customize prevention, diagnosis, and treatment. This is not a trivial undertaking. Achieving precision health requires making sense of big data, both at the population level and at the molecular level. The latter can include genetic, epigenetic, transcriptomic, proteomic, metabolomic data, and microbiome data. This biological information can augment established clinical measurements and supplement data on socioeconomic status, lifestyle, behaviors, and environmental conditions. Here, the central thesis is that, with sufficient data and appropriate methods, it is possible to segregate symptom-based and phenotypically based categories of patients into clinically and biologically similar groups. These groups are likely to have different clinical trajectories and benefit from different treatments. Additionally, such groups are optimal for investigations seeking to unveil the genomic basis of periodontal disease susceptibility. Analysis of these complex data to produce actionable and replicable health and disease categories requires appropriately sophisticated bioinformatics approaches and thorough validation in diverse patient samples and populations. Successful research programs will need to consider both population-level and well-controlled deep phenotyping approaches. Biologically informed stratification of periodontal disease is both feasible and desirable. Ultimately, this approach can accelerate the development of precision health through improvements in research and clinical applications.
Identifiants
pubmed: 32432812
doi: 10.1002/JPER.20-0096
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S50-S55Informations de copyright
© 2020 American Academy of Periodontology.
Références
Berkson J. Limitations of the application of fourfold table analysis to hospital data. Biometrics. 1946;2(3):47-53.
Insel TR, Cuthbert BN. Medicine. Brain disorders? Precisely. Science. 2015;348(6234):499-500.
Watson JD, Crick FH. Molecular structure of nucleic acids; a structure for deoxyribose nucleic acid. Nature. 1953;171(4356):737-738.
Divaris K. The era of the genome and dental medicine. J Dent Res. 2019;98(9):949-955.
Divaris K. Fundamentals of precision medicine. Compend Contin Educ Dent. 2017;38(8 Suppl):30-32.
Schaefer AS, Richter GM, Nothnagel M, et al. A genome-wide association study identifies GLT6D1 as a susceptibility locus for periodontitis. Hum Mol Genet. 2010;19(3):553-562.
Divaris K, Monda KL, North KE, et al. Genome-wide association study of periodontal pathogen colonization. J Dent Res. 2012;91(7 Suppl):21S-28S.
Divaris K, Monda KL, North KE, et al. Exploring the genetic basis of chronic periodontitis: a genome-wide association study. Hum Mol Genet. 2013;22(11):2312-2324.
Munz M, Willenborg C, Richter GM, et al. A genome-wide association study identifies nucleotide variants at SIGLEC5 and DEFA1A3 as risk loci for periodontitis [published correction appears in Hum Mol Genet. 2018 Mar 1;27(5):941-942]. Hum Mol Genet;26(13):2577-2588.
Tong H, Wei Z, Yin J, et al. Genetic susceptibility of common polymorphisms in NIN and SIGLEC5 to chronic periodontitis. Sci Rep. 2019;9(1):2088.
Shungin D, Haworth S, Divaris K, et al. Genome-wide analysis of dental caries and periodontitis combining clinical and self-reported data. Nat Commun. 2019;10(1):2773.
Agler CS, Moss K, Philips KH, et al. Biologically defined or biologically informed traits are more heritable than clinically defined ones: the case of oral and dental phenotypes. Adv Exp Med Biol. 2019;1197:179-189.
Offenbacher S, Divaris K, Barros SP, et al. Genome-wide association study of biologically informed periodontal complex traits offers novel insights into the genetic basis of periodontal disease. Hum Mol Genet. 2016;25(10):2113-2129.
Offenbacher S, Jiao Y, Kim SJ, et al. GWAS for Interleukin-1β levels in gingival crevicular fluid identifies IL37 variants in periodontal inflammation. Nat Commun. 2018;9(1):3686.
Morelli T, Agler CS, Divaris K. Genomics of periodontal disease and tooth morbidity. Periodontol 2000. 2020;82(1):143-156.
Nibali L, Di Iorio A, Tu YK, Vieira AR. Host genetics role in the pathogenesis of periodontal disease and caries. J Clin Periodontol. 2017;44(Suppl 18):S52-S78.
Schaefer AS. Genetics of periodontitis: discovery, biology, and clinical impact. Periodontol 2000. 2018;78(1):162-173.
Vieira AR, Albandar JM. Role of genetic factors in the pathogenesis of aggressive periodontitis. Periodontol 2000. 2014;65(1):92-106.
Divaris K. Searching deep and wide: advances in the molecular understanding of dental caries and periodontal disease. Adv Dent Res. 2019;30(2):40-44.
Kornman KS, Polverini PJ. Clinical application of genetics to guide prevention and treatment of oral diseases. Clin Genet. 2014;86(1):44-49.
Morelli T, Moss KL, Beck J, et al. Derivation and validation of the periodontal and tooth profile classification system for patient stratification. J Periodontol. 2017;88(2):153-165.
Morelli T, Moss KL, Preisser JS, et al. Periodontal profile classes predict periodontal disease progression and tooth loss. J Periodontol. 2018;89(2):148-156.
Beck JD, Moss KL, Morelli T, Offenbacher S. In search of appropriate measures of periodontal status: the Periodontal Profile Phenotype (P3) system. J Periodontol. 2018;89(2):166-175.
Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions-introduction and key changes from the 1999 classification. J Periodontol. 2018;89(Suppl 1):S1-S8.
Agler CS, Divaris K. Sources of bias in genomics research of oral and dental traits. Community Dent Health. 2020;37(1):102-106.
Beck JD, Moss KL, Morelli T, Offenbacher S. Periodontal profile class is associated with prevalent diabetes, coronary heart disease, stroke, and systemic markers of C-reactive protein and interleukin-6. J Periodontol. 2018;89(2):157-165.
Traylor M, Markus H, Lewis CM. Homogeneous case subgroups increase power in genetic association studies. Eur J Hum Genet. 2015;23(6):863-869.