Tengku Ab Malek, Tengku Maryam Fatimah; (2023) How do the changes in the environment alter the oral mycobiome of adolescents. Doctoral thesis (D.Dent), UCL (University College London).

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Abstract

INTRODUCTION: Oral microbiota residing in oral cavity play important roles in health and disease and its components are affected by various factors, including host and external environments. Research on oral microbiota often focused on bacteria, with fungi trailing behind, leading it to be understudied and poorly characterized in comparison. Minimal studies on oral mycobiome led to an interest in how and when oral mycobiome is established and stabilised in early life and how the environment would affect the composition and diversity of oral mycobiome. AIMS & OBJECTIVES: The aim of this study is to analyse the oral fungal microbiota (mycobiome) of adolescents, its diversity and stability over time, and how the environment might influence its composition. A systematic review was also conducted to explore how environmental and host factors are related to diversity of human mycobiome in children, specifically in oral cavity and gut. DESIGN: Collection of saliva samples from 17 subjects were done at nine different time points over the span of ten months. Subjects were students at an independent boarding school, with age ranging from 11 to 16 years. They were grouped as boarders and non-boarders. 135 saliva samples were collected and processed for analysis of ITS sequences. RESULTS: The boarders group showed a higher alpha diversity of oral mycobiome in comparison to those in the non-boarders group but could be attributed to more subjects in the boarders group. In terms of beta diversity, there was no statistically significant dissimilarity between both groups. The low number of participants in total (n=17) indicated data was more indicative rather than definitive. Ascomycota was the most abundant phylum in both groups. No Candida species was found in the taxonomic analysis of both groups, which suggested potential issues during sample collection, processing, and analysis. Systematic review carried out identified caries, age, obesity, diet, Crohn’s disease, antibiotics and probiotics as potential host and environmental factors related to oral/gut mycobiome diversity in children. All included studies were also deemed to be of fair quality with high risk of bias. CONCLUSION: This study served as a pilot investigation into the role of environmental factors on the oral mycobiome of adolescents and highlighted the need for further research with considerations of collection of saliva samples over a longer period, with a larger and more evenly distributed subjects. The systematic review revealed other potential host and environmental factors worth exploring to determine their association and potential effects on oral/gut mycobiome.

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