Plasma Antibodies to Oral Bacteria and Risk of Pancreatic Cancer in a Large European Prospective Cohort Study

Authors

• Dominique S. Michaud, Brown UniversityFollow
• Jacques Izard, Forsyth Institute and Harvard UniversityFollow
• Charlotte S. Wilhelm-Benartzi, Imperial College London
• Doo-Ho You, Forsyth Institute
• Verena A. Grote, German Cancer Research Center
• Anne Tjønneland, Danish Cancer Society
• Christina C. Dahm, Aarhus University
• Kim Overvad, Aarhus University
• Mazda Jenab, International Agency for Research on Cancer (IARC-WHO)
• Veronika Fedirko, International Agency for Research on Cancer (IARC-WHO)
• Marie Christine Boutron-Ruault, Paris South University
• Françoise Clavel- Chapelon, Paris South University
• Antoine Racine, Paris South University
• Rudolf Kaaks, German Cancer Research Center (DKFZ)
• Heiner Boeing, German Institute of Human Nutrition Potsdam-Rehbruecke
• Jana Foerster, German Institute of Human Nutrition Potsdam-Rehbruecke
• Antonia Trichopoulou, University of Athens
• Pagona Lagiou, University of Athens
• Dimitrios Trichopoulos, Harvard University
• Carlotta Sacerdote, Center for Cancer Prevention (CPO-Piemonte)
• Sabina Sieri, Fondazione IRCCS Istituto Nazionale dei Tumori
• Domenico Palli, ISPO- Cancer Research and Prevention Institute
• Rosario Tumino, "Civile - M.P.Arezzo" Hospital
• Salvatore Panico, University Medical Centre Utrecht
• Peter Siersema, University Medical Centre Utrecht
• Petra HM Peeters, University Medical Center Utrecht
• Eiliv Lund, University of Tromsø
• Aurelio Barricarte, Public Health Institute of Navarra
• José-María Huerta, CIBER Epidemiología y Salud Pública (CIBERESP)
• Esther Molina-Montes, Andalusian School of Public Health
• Miren Dorronsoro, Basque Regional Health Department
• J. Ramón Quirós, Health and Health Care Services Council
• Eric J. Duell, Catalan Institute of Oncology (ICO-IDIBELL)
• Weimin Ye, Umeå University
• Malin Sund, Umeå University
• Björn Lindkvist, University of Gothenburg
• Dorthe Johansen, Skåne University Hospital
• Kay-Tee Khaw, University of Cambridge
• Nick Wareham, MRC Epidemiology Unit
• Ruth C. Travis, University of Oxford
• Paolo Vineis, Imperial College London
• H. Bas Bueno-de-Mesquita, University Medical Centre Utrecht
• Elio Riboli, Imperial College London

ORCID IDs

Izard https://orcid.org/0000-0002-5904-5436

Document Type

Article

Date of this Version

12-2013

Citation

Gut (December 2013) 62(12)

doi: 10.1136/gutjnl-2012-303006

Abstract

Objective: Examine the relationship between antibodies to 25 oral bacteria and pancreatic cancer risk in a prospective cohort study.

Design: We measured antibodies to oral bacteria in prediagnosis blood samples from 405 pancreatic cancer cases and 416 matched controls, nested within the European Prospective Investigation into Cancer and Nutrition study (EPIC). Analyses were conducted using conditional logistic regression and additionally adjusted for smoking status and body mass index.

Results: Individuals with high levels of antibodies against Porphyromonas gingivalis ATTC 53978, a pathogenic periodontal bacteria, had a 2-fold higher risk of pancreatic cancer than individuals lower levels of these antibodies (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.05–4.36; >200 ng/ml versus ≤ 200 ng/ml). To explore the association with commensal (nonpathogenic) oral bacteria, we performed a cluster analysis and identified two groups of individuals, based on their antibody profiles. A cluster with overall higher levels of antibodies had a 45% lower risk of pancreatic cancer than a cluster with overall lower levels of antibodies (OR, 0.55; 95% CI, 0.36–0.83).

Conclusion: Periodontal disease might increase the risk for pancreatic cancer. Moreover, increased levels of antibodies against specific commensal oral bacteria, which can inhibit growth of pathogenic bacteria, might reduce the risk of pancreatic cancer. Studies are needed to determine whether oral bacteria have direct effects on pancreatic cancer pathogenesis or serve as markers of the immune response.