Relationship between Streptococcus mutans expressing Cnm in the oral cavity and non-alcoholic steatohepatitis: A pilot study

Shuichi Tonomura, Shuhei Naka, Keiko Tabata, Tasuku Hara, Kojiro Mori, Saiyu Tanaka, Yoshio Sumida, Kazuyuki Kanemasa, Ryota Nomura, Michiyo Matsumoto-Nakano, Masafumi Ihara, Nobuyuki Takahashi, Kazuhiko Nakano

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Background: Non-alcoholic steatohepatitis (NASH) is a severe state of non-alcoholic fatty liver disease (NAFLD), which is pathologically characterised by steatosis, hepatocyte ballooning, and lobular inflammation. Host-microbial interaction has gained attention as one of the risk factors for NASH. Recently, cnm-gene positive Streptococcus mutans expressing cell surface collagen-binding protein, Cnm (cnm-positive S. mutans), was shown to aggravate NASH in model mice. Here, we assessed the detection rate of cnm-positive S. mutans in oral samples from patients with NASH among NAFLD. Methods: This single hospital cohort study included 41 patients with NAFLD. NASH was diagnosed histologically or by clinical score. The prevalence of cnm-positive S. mutans, oral hygiene and blood tests, including liver enzymes, adipocytokines and inflammatory and fibrosis markers, were assessed in biopsy-proven or clinically suspected NASH among NAFLD. Results: Prevalence of cnm-positive S. mutans was significantly higher in patients with NASH than patients without NASH (OR 3.8; 95% CI 1.02 to 15.5). The cnm-positive S. mutans was related to decreased numbers of naturally remaining teeth and increased type IV collagen 7S level (median (IQR) 10.0 (5.0-17.5) vs 20.0 (5.0-25.0), p=0.06; 5.1 (4.0-7.9) vs 4.4 (3.7-5.3), p=0.13, respectively). Conclusions: Prevalence of cnm-positive S. mutans in the oral cavity could be related to fibrosis of NASH among NAFLD.

Original languageEnglish
Article numbere000329
JournalBMJ Open Gastroenterology
Issue number1
Publication statusPublished - Oct 1 2019


  • bacterial infection
  • infectious disease
  • nonalcoholic steatohepatitis

ASJC Scopus subject areas

  • Gastroenterology


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