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Actinomyces and Alimentary Tract Diseases: a Review of Its Biological Functions and Pathology

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Actinomyces and Alimentary Tract Diseases: a Review of Its Biological Functions and Pathology Hindawi BioMed Research International Volume 2018, Article ID 3820215, 8 pages https://doi.org/10.1155/2018/3820215 Review Article Actinomyces and Alimentary Tract Diseases: A Review of Its Biological Functions and Pathology Jun Li,1 Ying Li,2 Yu Zhou,3 Changzheng Wang,1 Benyan Wu ,1 and Jun Wan 1 1 Department of Gastroenterology, General Hospital of PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China 2Department of Oncology, General Hospital of PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China 3Department of Nanlou Clinical Laboratory, General Hospital of PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China Correspondence should be addressed to Benyan Wu; [email protected] and Jun Wan; [email protected] Received 9 May 2018; Accepted 2 July 2018; Published 26 August 2018 Academic Editor: Takashi Saku Copyright © 2018 Jun Li et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Actinomyces are nonmotile, flamentous, Gram-positive bacteria that cause actinomycosis in immunodefciency patients. Although the prognosis of actinomycosis is good, the diagnosis of actinomycosis is quite difcult. Recent studies on actinomycosis have shown that Actinomyces play an important role in various biological and clinical processes, such as the formation of dental plaque and the degradation of organics in the gastrointestinal tract. Here, the distribution of Actinomyces in the digestive tract, and diferent biological efects of actinomycosis, and its clinical association with infammatory diseases are discussed. Furthermore, an overview of the most commonly used treatment methods and drugs used to treat Actinomyces infected alimentary canal diseases is presented. 1. Introduction (1) the distribution of Actinomyces species in the alimentary canal, (2) the biological function of Actinomyces species, (3) Actinomyces species (A.) are nonmotile, flamentous, Gram- actinomycosis diseases in the digestive tract with diagnosis positive, and obligate anaerobic bacteria, which are faculta- and treatment, and (4) possible correlations between the Acti- tively pathogenic commensal inhabitants of the oral cavity, nomyces species and other infammatory diseases of the ali- pharynx, gut, genitourinary tract, and skin [1]. Actinomyces mentary tract. also readily cause actinomycosis in immunodefciency pa- tients, which is an indolent progressing granulomatous dis- 2. Overview of Actinomyces ease [2]. Actinomycosis can afect all tissues and organs, cate- Species and Actinomycosis gorized as cervicofacial, thoracic, abdominopelvic and other types of actinomycosis [3] (Figure 1). Although the prognosis Actinomyces species, belonging to the phylum Actinobacteria, oftheseinfectionsnormallyisgoodwithmedical andsurgical order Actinomycetales, and family Actinomycetaceae, are treatments, actinomycosis still can lead to the death of pa- ubiquitous, occurring in soil and in the animal and human tients due to the difculties of early diagnosis and the severe microbiota. Although currently a total of 47 Actinomyces infection difusion of Actinomyces [4]. species have been identifed, among which 25 are found in the Te mechanisms of pathogenicity of Actinomyces are not human microbiota [10], advanced molecular techniques have completely understood, but the invasion of breached or been applied for taxonomic reassessment [11, 12] and revealed necrotic tissue has been proposed to be the initiating event novel Actinomyces genera [13, 14]. Te Actinomyces phylum for Actinomyces to penetrate and proliferate in deeper body includes the pathogens Corynebacterium, Propionibacterium, structures [5]. Some studies have paid attention to Actino- Mycobacterium,andNocardia. In addition, Propionibac- myces related systemic infections including central nervous terium propionicum and Bifdobacterium dentium have been system (CNS) and cardiovascular and digestive tract diseases documented as important pathogens involved in infections [6–9]. In the present review, we provide a brief review of with similar symptoms to actinomycosis [15, 16]. However, 2 BioMed Research International Natural habitats Body sites of infections Mouth[31-33,37,47,48,53,54]: Mouth[37]: A. odontolyticus A. odontolyticus A. oris A. oris A. israelii A. meyeri A. naeslundii Cervicofacial[5]: A. oricola A. gerencseriae A. radicidentis A. israelii A. gerencseriae Tonsils[39]: Tonsils[39]: A. odontolyticus A. odontolyticus A. georgiae A. georgiae A. israelii A. israelii A. gerencseriae A. gerencseriae A. meyeri A. meyeri A. naeslundii A. naeslundii A. radicidentis A. radicidentis Distal esophagus[34]: Liver[40-42]: A. odontolyticus A. israelii A. meyeri A. meyeri A. graevenitzii A. funkei A. odontolyticus A. turicensis Abdomen[35]: A. israelii Abdomen[35]: A. meyeri A. israelii A. turicensis A. meyeri Blood[17]: A. israelii A. meyeri A. odontolyticus Figure 1: Natural habitats and infection sites of Actinomyces species. A. gerencseriae and A. israelii are the most commonly re- original infected lesions [22, 23]. It is widely assumed that ported species found in human forms of the disease, which the decline in the incidence of all forms of actinomycosis in are responsible for about 70% of orocervicofacial infections recent years is due to improved oral hygiene and the orga- [5], whereas A. israelii, A. meyeri,andA. odontolyticus are nism’s susceptibility to many antimicrobial drugs used for mainly associated with the rare hematogenous dissemination bacteria diseases. However, actinomycosis is still widely dis- of actinomycosis [17]. It is noteworthy that most Actino- tributed worldwide and afects mostly middle-aged individu- myces species are found colonizing polymicrobial fora. Hu- als, especially males [19, 24]. man actinomycosis lesions usually consist of other aerobic and/or anaerobic species including A. actinomycetemcomi- tans, Eikenella corrodens, Capnocytophaga, Fusobacteria, Bac- 3. Actinomyces Species as teroides, Staphylococci, Streptococci,andEnterobacteriaceae an Important Member of the Microbiome in [15, 18]. Terefore, the isolation and subsequent identifcation the Human Alimentary Tract of the infecting bacteria by culture and pathology are crucial for the diagnosis of actinomycosis and the choice of adjunc- It should be noted that the bacterial microbiome in the hu- tive antibiotics due to its polymicrobial nature. man alimentary tract is associated with both health and dis- Actinomyces species are the causative agents for actino- ease. Bacteria contribute to the development of mucosal bar- mycosis, which is a rare invasive bacterial disease and usually rier functions and suppress the establishment of pathogens characterized by the formation of granulomatous tissue, [25], but can also be a chronic infammatory stimulus to necrosis and major reactive fbrosis, draining sinuses, ab- adjacent tissues [26, 27]. As a type of human commensal fora scesses, and the development of fstulas as the infection that normally colonizes the oral mucosa and nasopharyn- progresses [19]. Multiple diferent clinical features of acti- geal, gastrointestinal tract and urogenital tracts, Actinomyces nomycosis at various anatomical sites have been described, species play an important role in human health [28]. Before which cervicofacial actinomycosis being the most commonly the further analysis of diseases caused by Actinomyces,itis reported form, accounting for about 50% of all cases [20], perhaps useful to discuss the microbiome of Actinomyces in followed by abdominal actinomycosis (20%) and thoracic diferent locations of the alimentary tract. actinomycosis (15-20%) [21]. Involvement of the CNS, bone, Te Human Microbiome Project Consortium investi- and skin are rare conditions, most likely occurring as a gated the dominant bacteria present in the oral cavity includ- result of hematogenous spread or direct dissemination of the ing Streptococcus, Haemophilus, Actinomyces,andPrevotella BioMed Research International 3 [29].VariousActinomyces species have been shown to emerge arrive at the infected sites. Nevertheless, plasma cells may in the oral cavity in one-third of infants at the age of 2 arise as a result of stimulation of B lymphocytes by specifc months and the diversity of Actinomyces increases with age A. viscosus antigens [45]. However, usually the Actinomyces [30]. A recent human oral microbiome study showed that species would not produce infections alone and actinomyco- the main members of the human oral microbiota included A. sis ofen involves companion bacteria such as Gram-negative odontolyticus, A. gerencseriae, A. israelii, A. meyeri, A. naes- bacilli and anaerobic Streptococci. Jordan et al. established lundii, A. oricola, A. radicidentis, and others not yet identifed experimental actinomycotic infections in mice and the histo- [31]. A. odontolyticus has been shown to be one of the most logical evidence showed that polymorphonuclear leukocytes prevalent Actinomyces species and participates in the forma- were not able to penetrate and invade the developing central tion of the bioflm on teeth at all ages [32]. Te involvement bacterial granule of A. israelii lesions, which resulted in the of Actinomyces species in the early stage of bioflm formation “unreachable attack” of the leukocytes towards the bacteria on teeth include A. naeslundii, A. oris,andA. gerencseriae inside the granule, while the existence of the inside
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