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J Clin Med. 2019 Jul 26;8(8). pii: E1110. doi: 10.3390/jcm8081110.

Next Generation Sequencing Discoveries of the Nitrate-Responsive Oral Microbiome and Its Effect on Vascular Responses.

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School of Dentistry, Institute of Clinical Sciences, University of Birmingham and Birmingham Community Healthcare Foundation Trust, Birmingham B5 7EG, UK.
Swedish Dental Service of Skåne, 222 37 Lund, Sweden.
Department of Periodontology, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden.


Cardiovascular disease is a worldwide human condition which has multiple underlying contributing factors: one of these is long-term increased blood pressure-hypertension. Nitric oxide (NO) is a small nitrogenous radical species that has a number of physiological functions including vasodilation. It can be produced enzymatically through host nitric oxide synthases and by an alternative nitrate-nitrite-NO pathway from ingested inorganic nitrate. It was discovered that this route relies on the ability of the oral microbiota to reduce nitrate to nitrite and NO. Next generation sequencing has been used over the past two decades to gain deeper insight into the microbes involved, their location and the effect of their removal from the oral cavity. This review article presents this research and comments briefly on future directions.


nitrate; nitric oxide; nitrite; oral microbiome; saliva

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