Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis

A growing body of evidence from multiple areas proposes that periodontal disease,accompanied by oral inflammation and pathological changes in the microbiome,induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease(NAFLD).A subgroup of NAFLD patients have a severely progressive form,namely nonalcoholic steatohepatitis(NASH),which is characterized by histological findings that include inflammatory cell infiltration and fibrosis.NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma.The oral microbiota may serve as an endogenous reservoir for gut microbiota,and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis.Gut dysbiosis increases the production of potential hepatotoxins,including lipopolysaccharide,ethanol,and other volatile organic compounds such as acetone,phenol and cyclopentane.Moreover,gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall,leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation.In particular,many animal studies support that oral administration of Porphyromonas gingivalis,a typical periodontopathic bacterium,induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis.NAFLD,also known as the hepatic phenotype of metabolic syndrome,is strongly associated with metabolic complications,such as obesity and diabetes.Periodontal disease also has a bidirectional relationship with metabolic syndrome,and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively.In this review,we will describe the link between periodontal disease and NAFLD with a focus on basic,epidemiological,and clinical studies,and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome.In conclusion,it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease,gut microbiota,and metabolic syndrome.Thus,the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics,prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.

Positive and Negative Impacts of Cross-border M&A

Mergers and acquisitions of Chinese enterprises by foreign investors have moved onto the public radar in recent years.To date,the M&A frenzy has drawn widespread attention,with a mixed reaction from proponents and opponents.Proponents consider such mergers and acquisitions conducive to realizing strategic readjustment of the national economic structure,optimizing resource allocation and improving the corporate governance structure.Opponents,however,are concerned that foreign mergers and acquisitions may jeopardize China’s industrial security and erode the executive power of the central government in undertaking industrial development planning.Are the benefits of M&A outweighed by the costs,or vice versa? The focus column of this edition features two articles which debate this issue from opposing viewpoints.In the article"Positive and Negative Impacts of Cross-border M&A",the authors consider foreign M(?)A to be a new way of boosting the level of foreign investment utilization,and advocate China taking full advantage of this approach.The authors of the article"Self-Improvement Or Self-Mutilation",meanwhile,hold foreign M&A to blame for state-owned asset erosion,and insist that China should oppose mergers and acquisitions of key state- owned enterprises by foreign investors at fire-sale prices.