We found that poor oral health status is associated with increased risk of pancreatic cancer. Because poor oral health status is due to oral bacterial dysbiosis, we hypothesize that oral microbiota potentiate pancreas carcinogenesis. Supporting this, recent cohort studies reported that individuals with greater circulating antibodies to multipe oral bacteria have a greater risk of pancreatic cancer. Directly assessing oral microbiome from high-throughput genomic sequencing of oral samples in our recent case-control study, we found that specific gram-negative oral bacteria are associated with 3-fold increased risk of pancreatic cancer. We also showed that these bacteria are present in the human pancreatic duct and showed in animal experiments that oral microbiota access the pancreas and have oncogenic effects via inflammation at the organ site. Because case-control studies are limited for causal inference, a current critical research gap is the lack of prospective confirmation of the link between pre-diagnostic oral microbiome and pancreatic cancer risk. A second research gap is the limited understanding of the comprehensive functional roles of the microbiota and the human host response. The overarching goals of this study are to identify oral microbiota associated with subsequent risk of pancreas cancer and to improve our understanding of the role of the microbiome in host responses potentially related to pancreatic tumorigenesis.
Our specific aims are: 1) to test whether oral microbiome is associated with subsequent risk of pancreatic cancer in a nested case-control study and 2) to identify metabolically active bacterial function in the human pancreas and correlate these bacterial activities with expression of human inflammatory signaling pathways. Strengths of this study include a large prospective study design, with oral samples collected prior to cancer development, and state-of-art genomic microbiome and transcriptome assays for assessing oral and pancreas microbiota and related functions. This study is the first study of oral and pancreas microbiome and pancreatic cancer risk. Pancreatic cancer is highly lethal and little is known about ways to detect and prevent this disease. We expect to identify specific oral bacteria associated with risk of pancreas cancer and to identify metabolically active bacterial functions in the pancreas and related host pancreatic inflammatory responses. These outcomes will expand our current limited knowledge on the causes of pancreatic cancer, will help to identify people at high risk for this disease, and may lead to microbial-based prophylactic preventions for pancreatic cancer. Thus, findings may help to rapidly advance our ability to reduce the burden of this highly fatal disease.

Public Health Relevance

Pancreatic cancer is a highly fatal malignancy. Our research is designed to identify oral bacteria associated with risk for this disease, and to identify relate microbial-host functional interrelationships in pancreatic tissue. The study will expand our current limited knowledge on the causes of pancreatic cancer, will help to identify people at high risk for this disease, and may lead to microbial-based prophylactic preventions for pancreatic cancer.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA164964-04
Application #
9331444
Study Section
Epidemiology of Cancer Study Section (EPIC)
Program Officer
Starks, Vaurice
Project Start
2014-09-19
Project End
2019-08-31
Budget Start
2017-09-01
Budget End
2019-08-31
Support Year
4
Fiscal Year
2017
Total Cost
Indirect Cost
Name
New York University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10010
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Hayes, Richard B; Ahn, Jiyoung; Fan, Xiaozhou et al. (2018) Association of Oral Microbiome With Risk for Incident Head and Neck Squamous Cell Cancer. JAMA Oncol 4:358-365
Xu, Wanli; Luo, Zhenwu; Alekseyenko, Alexander V et al. (2018) Distinct systemic microbiome and microbial translocation are associated with plasma level of anti-CD4 autoantibody in HIV infection. Sci Rep 8:12863
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Fan, Xiaozhou; Peters, Brandilyn A; Min, Deborah et al. (2018) Comparison of the oral microbiome in mouthwash and whole saliva samples. PLoS One 13:e0194729
Fan, Xiaozhou; Alekseyenko, Alexander V; Wu, Jing et al. (2018) Human oral microbiome and prospective risk for pancreatic cancer: a population-based nested case-control study. Gut 67:120-127
Peters, Brandilyn A; Wu, Jing; Hayes, Richard B et al. (2017) The oral fungal mycobiome: characteristics and relation to periodontitis in a pilot study. BMC Microbiol 17:157
Peters, Brandilyn A; Wu, Jing; Pei, Zhiheng et al. (2017) Oral Microbiome Composition Reflects Prospective Risk for Esophageal Cancers. Cancer Res 77:6777-6787
Peters, Brandilyn A; Dominianni, Christine; Shapiro, Jean A et al. (2016) The gut microbiota in conventional and serrated precursors of colorectal cancer. Microbiome 4:69
Sinha, Rashmi; Ahn, Jiyoung; Sampson, Joshua N et al. (2016) Fecal Microbiota, Fecal Metabolome, and Colorectal Cancer Interrelations. PLoS One 11:e0152126

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