Пародонтит і метаболічно асоційована стеатотична хвороба печінки (МАСХП): міждисциплінарний погляд на проблему

Renata Symonenko

doi:10.33295/1992-576X-2026-1-A1

Authors

Renata Symonenko Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0003-4618-6229

DOI:

https://doi.org/10.33295/1992-576X-2026-1-A1

Keywords:

periodontitis, metabolic dysfunction-associated steatotic liver disease (MASLD), oral-gut-liver axis, microbiome, oxidative stress, screening

Abstract

Modern medicine is increasingly moving away from local treatment of individual organs in favor of a systemic approach. One of the most striking examples of such a relationship is the combination of metabolic dysfunction-associated steatotic liver disease (MASLD) and periodontitis. The functioning of the oral cavity and liver as components of the digestive system has long been studied, but their role in maintaining systemic homeostasis has only recently attracted attention. Understanding environmental triggers of microbial pathogenicity and inflammatory mediators may open promising avenues for the prevention and treatment of periodontitis in patients with MASLD. A brief review of the available data on periodontal disease in patients with MASLD was conducted to provide treatment recommendations. Previous observational studies have shown a link between severe periodontal disease and worse outcomes in patients with MASLD. Further studies are needed to refine treatment recommendations for this group of patients. Importantly, the dentist may be the first specialist to detect metabolic abnormalities in a patient. Current knowledge suggests potential benefits of screening and treating periodontal disease in patients with liver disease.

Conclusions. The etiology of liver disease may correlate with the development of periodontal disease, but further research is required to clarify their relationship and to develop interdisciplinary approaches to patient rehabilitation. Introducing MASLD screening in patients with refractory and severe periodontitis will enable a shift from “dental therapy” to comprehensive patient health management.

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References

Stefan, N., Yki-Järvinen, H., & Neuschwander-Tetri, B.A. (2025). Metabolic dysfunction-associated steatotic liver disease: heterogeneous pathomechanisms and effectiveness of metabolism-based treatment. Lancet Diabetes Endocrinol., 13(2), 134–148. DOI: https://doi.org/10.1016/S2213-8587(24)00318-8. PMID: 39681121.

Younossi, Z., Anstee, Q. M., Marietti, M., et al. (2018). Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat. Rev. Gastroenterol. Hepatol., 15(1), 11–20. DOI: https://doi.org/10.1038/nrgastro.2017.109. PMID: 28930295.

Kaya, E., Zedginidze, A., Bechmann, L., & Canbay, A. (2022). Metabolic dysfunction-associated fatty liver disease (MAFLD) and non-alcoholic fatty liver disease (NAFLD): distinct fatty liver entities with different clinical outcomes? Hepatobiliary Surg. Nutr., 11(2), 299–301. DOI: https://doi.org/10.21037/hbsn-21-548. PMID: 35464288. PMCID: PMC9023843.

Ramírez-Mejía, M. M., Jiménez-Gutiérrez, C., Eslam, M., et al. (2024). Breaking new ground: MASLD vs. MAFLD-which holds the key for risk stratification? Hepatol. Int., 18, 168–178. DOI: https://doi.org/10.1007/s12072-023-10620-y. PMID: 38127259.

Rinella, M. E., Lazarus, J. V., Ratziu, V., et al. (2023). A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J. Hepatol., S0168–8278(23), 00418. DOI: https://doi.org/10.1016/j.jhep.2023.06.003.

Wong, V. W., Wong, G. L., Woo, J., et al. (2021). Impact of the new definition of metabolic associated fatty liver disease on the epidemiology of thedisease. Clin Gastroenterol Hepatol., 19(10), 2161–2171.e5. DOI: https://doi.org/10.1016/j.cgh.2020.10.046.

Mousa, N., EL-Eraky, A., Arafa, M., et al. (2023). Value of hepatic artery resistive index in evaluation of liver fibrosis related to non-alcoholic fatty liver diseases. Med. J. Viral Hepatitis, 7(2), 1–8. DOI: https://doi.org/10.21608/mjvh.2023.296888.

Liu, Y., Huang, W., Wang, J., et al. (2021). Multifaceted impacts of periodontal pathogens in disorders of the intestinal barrier. Front. Immunol., 12, 693479. DOI: https://doi.org/10.3389/fimmu.2021.693479.

Lonardo, A., Mantovani, A., Lugari, S., & Targher, G. (2020). Epidemiology and pathophysiology of the association between NAFLD and metabolically healthy or metabolically unhealthy obesity. Ann. Hepatol., 19, 359–366. DOI: https://doi.org/10.1016/j.aohep.2020.03.001.

Lou, J., Jiang, Y., Rao, B., et al. (2020). Fecalmicrobiomes distinguish patients with autoimmune hepatitis from healthy individuals. Front. Cell Infect. Microbiol., 10, 342. DOI: https://doi.org/10.3389/fcimb.2020.00342.

Mousa, E., & Rashed, H.R. (2022). Is there is a link between Oral microbiome and chronic liver diseases. Med. J. Viral Hepatitis, 6(3), 19–21. DOI: https://doi.org/10.21608/mjvh.2022.258087.

Kapila, Y. L. (2021). Oral health’s inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions. Periodontology 2000, 87(1), 11–16. DOI: https://doi.org/10.1111/prd.12398. PMID: 34463994. PMCID: PMC8457130.

Zhao, W., Ji, L., Li, J., et al. (2025). Mesaconate from Bacillus subtilis R0179 Supernatant Attenuates Periodontitis by Inhibiting Porphyromonas gingivalis in Mice. J. Periodont. Res., 60(6), 617–627. DOI: https://doi.org/10.1111/jre.13363. PMID: 39560450.

Kwon, T., Lamster, I.B., & Levin, L. (2021). Current Concepts in the Management of Periodontitis. Int. Dent. J., 71(6), 462—476. DOI: https://doi.org/10.1111/idj.12630. PMID: 34839889. PMCID: PMC9275292.

Zeng, Y., Lin, D., Chen A., et al. (2025). Periodontal Treatment to Improve General Health and Manage Systemic Diseases. Adv. Exp. Med. Biol., 1472, 245–260. DOI: https://doi.org/10.1007/978-3-031-79146-8_15. PMID: 40111696.

Ding, Y., Yanagi, K., Cheng, C., et al. (2019). Interactions between gut microbiota and non-alcoholic liver disease: The role of microbiota-derived metabolites. Pharmacol Res., 141, 521–529. DOI: https://doi.org/10.1016/j.phrs.2019.01.029. PMID: 30660825. PMCID: PMC6392453.

Kitamoto, S., Nagao-Kitamoto, H., Jiao, Y., et al. (2020). The intermucosal connection between the mouth and gut in commensal pathobiont-driven colitis. Cell, 182(2), 447–462.e414. DOI: https://doi.org/10.1016/j.cell.2020.05.048.

Cui, Z., Wang, P., & Gao, W. (2025). Microbial dysbiosis in periodontitis and peri-implantitis: pathogenesis, immune responses, and therapeutic. Front. Cell Infect. Microbiol., 15, 1517154. DOI: https://doi.org/10.3389/fcimb.2025.1517154. PMID: 40007610. PMCID: PMC11850578.

Beura, L. K., Hamilton, S. E., Bi, K., et al. (2016). Normalizing the environment recapitulates adult human immune traits in laboratory mice. Nature, 532, 512–516. DOI: https://doi.org/10.1038/nature17655.

Kuraji, R., Shiba, T., Dong, T. S., et al. (2023). Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis. World J. Gastroenterol., 29(6), 967–996. DOI: https://doi.org/10.3748/wjg.v29.i6.967. PMID: 36844143. PMCID: PMC9950865.

Arimatsu, K., Yamada, H., Miyazawa, H., et al. (2014). Oral pathobiont induces systemic inflammation and metabolic changes associated with alteration of gut microbiota. Sci. Rep., 4, 4828. DOI: https://doi.org/10.1038/srep04828.

Komazaki, R., Katagiri, S., Takahashi, H., et al. (2017). Periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans affect non-alcoholic fatty liver disease by altering gut microbiota and glucose metabolism. Sci. Rep., 7, 13950. DOI: https://doi.org/10.1038/s41598-017-14260-9.

Nakajima, M., Arimatsu, K., Kato, T., et al. (2015). Oral Administration of P. gingivalis Induces Dysbiosis of Gut Microbiota and Impaired Barrier Function Leading to Dissemination of Enterobacteria to the Liver. PLoS One, 10, e0134234. DOI: https://doi.org/10.1371/journal.pone.0134234.

Yamazaki, K., Kato, T., Tsuboi, Y., et al. (2021). Oral Pathobiont-Induced Changes in Gut Microbiota Aggravate the Pathology of Nonalcoholic Fatty Liver Disease in Mice. Front. Immunol., 12, 766170. DOI: https://doi.org/10.3389/fimmu.2021.766170.

Kashiwagi, Y., Aburaya, S., Sugiyama, N., et al. (2021). Porphyromonas gingivalis induces entero-hepatic metabolic derangements with alteration of gut microbiota in a type 2 diabetes mouse model. Sci. Rep., 11, 18398. DOI: https://doi.org/10.1038/s41598-021-97868-2.

Helenius-Hietala, J., Suominen, A.L., Ruokonen, H., et al. (2019). Periodontitis is associated with incident chronic liver disease-A population-based cohort study. Liver Int., 39, 583–591. DOI: https://doi.org/10.1111/liv.13985.

Nakahara, T., Hyogo, H., Ono, A., et al. (2018). Involvement of Porphyromonas gingivalis in the progression of non-alcoholic fatty liver disease. J. Gastroenterol., 53, 269–280. DOI: https://doi.org/10.1007/s00535-017-1368-4.

Yoneda, M., Naka, S., Nakano, K., et al. (2012). Involvement of a periodontal pathogen, Porphyromonas gingivalis on the pathogenesis of non-alcoholic fatty liver disease. BMC Gastroenterol., 12, 16. DOI: https://doi.org/10.1186/1471-230X-12-16.

Sato, S., Kamata, Y., Kessoku, T., et al. (2022). A cross-sectional study assessing the relationship between non-alcoholic fatty liver disease and periodontal disease. Sci. Rep., 12, 13621. DOI: https://doi.org/10.1038/s41598-022-17917-2.

Kamata, Y., Kessoku, T., Shimizu, T., et al. (2022). Periodontal Treatment and Usual Care for Nonalcoholic Fatty Liver Disease: A Multicenter, Randomized Controlled Trial. Clin. Transl. Gastroenterol., 13, e00520. DOI: https://doi.org/10.14309/ctg.0000000000000520.

Kuraji, R., Kapila, Y., & Numabe, Y. (2022). Periodontal Disease and Nonalcoholic Fatty Liver Disease: New Microbiome-Targeted Therapy Based on the Oral-Gut-Liver Axis Concept. Current Oral Health Reports, 9, 89–102. DOI: https://doi.org/10.1007/s40496-022-00312-1.

Acharya, C., Sahingur, S. E., & Bajaj, J. S. (2017). Microbiota, cirrhosis, and the emerging oral-gut-liver axis. JCI Insight, 2(19), e94416. DOI: https://doi.org/10.1172/jci.insight.94416.

Xie, C., & Halegoua-DeMarzio, D. (2019). Role of Probiotics in Non-alcoholic Fatty Liver Disease: Does Gut Microbiota Matter? Nutrients, 11(11), 2837. DOI: https://doi.org/10.3390/nu11112837. PMID: 31752378. PMCID: PMC6893593.

Cho, M. S., Kim, S. Y., Suk, K. T., & Kim, B. Y. (2018). Modulation of gut microbiome in nonalcoholic fatty liver disease: pro-, pre-, syn-, and antibiotics. J. Microbiol., 56(12), 855–867. DOI: https://doi.org/10.1007/s12275-018-8346-2. PMID: 30377993.

Sharma, S., Tiwari, N., & Tanwar, S. S. (2025). The current findings on the gut-liver axis and the molecular basis of NAFLD/NASH associated with gut microbiome dysbiosis. Naunyn-Schmiedeberg’s Arch. Pharmacol., 398(9), 11541–11579. DOI: https://doi.org/10.1007/s00210-025-04069-z. PMID: 40202676.

Sohn, M., Jung, H., Lee, W. S., et al. (2023). Effect of Lactobacillus plantarum LMT1-48 on Body Fat in Overweight Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial. Diabetes Metab. J., 47(1), 92–103. DOI: https://doi.org/10.4093/dmj.2021.0370. PMID: 35487505. PMCID: PMC9925147.