Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients

Abstract Objective This study investigated the impact of anticancer treatment on the oral microbiome in pediatric patients and its association with oral mucositis (OM). Materials and methods A double-blind, randomized trial involving 34 pediatric cancer patients (ages 2–17.99) with solid or hematolo...

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Main Authors: Egle Immonen, Lauri Paulamäki, Hannaleena Piippo, Atte Nikkilä, Liisa Aine, Timo Peltomäki, Olli Lohi, Mataleena Parikka
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06405-4
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author Egle Immonen
Lauri Paulamäki
Hannaleena Piippo
Atte Nikkilä
Liisa Aine
Timo Peltomäki
Olli Lohi
Mataleena Parikka
author_facet Egle Immonen
Lauri Paulamäki
Hannaleena Piippo
Atte Nikkilä
Liisa Aine
Timo Peltomäki
Olli Lohi
Mataleena Parikka
author_sort Egle Immonen
collection DOAJ
description Abstract Objective This study investigated the impact of anticancer treatment on the oral microbiome in pediatric patients and its association with oral mucositis (OM). Materials and methods A double-blind, randomized trial involving 34 pediatric cancer patients (ages 2–17.99) with solid or hematological malignancies. Mucosal swab samples were collected before and after chemotherapy. Patients underwent two 7-day rinse cycles—one with Caphosol and one with saline—in a randomized order. Bacterial DNA from 110 mucosal swabs was analyzed using 16S rRNA sequencing. Results Chemotherapy altered bacterial composition. No life-threatening OM cases (WHO grade 4) were observed, but mild to severe OM (grades 1–3) occurred in three patients. In patients without oral lesions, Bergeyella genus was more abundant prior to treatment while Alloprevotella was more abundant in the post-treatment samples, compared to patients with lesions. OM was linked to distinct microbiome profiles, including Stenotrophomonas, Leptotrichia sp., Serratia sp.,Capnocytophaga sputigena, Sphingomonas sp., Parapusillimonas sp., Staphylococcus sp., and Turicibacter genera. Additionally, Burkholderia-Caballeronia-Paraburkholderia (p = 0.013) were more prevalent in the Caphosol group compared to the saline group. Conclusions These findings indicate that chemotherapy-induced microbiome shifts associate with OM risk, highlighting the potential for microbial markers to predict high-risk patients and support protective strategies. Trial registration The trial titled "Supersaturated Calcium Phosphate Oral Rinse (Caphosol®) for the Prevention of Oral Mucositis in Children Undergoing Chemotherapeutic Treatments" was registered on ClinicalTrials.gov (ID NCT02807337), with the first submission date 2016–06-07.
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spelling doaj-art-b508fcd88a8c441fbc64ec4332fd10392025-08-20T03:45:39ZengBMCBMC Oral Health1472-68312025-07-0125111310.1186/s12903-025-06405-4Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patientsEgle Immonen0Lauri Paulamäki1Hannaleena Piippo2Atte Nikkilä3Liisa Aine4Timo Peltomäki5Olli Lohi6Mataleena Parikka7Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere UniversityFaculty of Medicine and Health Technology, Tampere UniversityFaculty of Medicine and Health Technology, Tampere UniversityTampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere UniversityFaculty of Medicine and Health Technology, Tampere UniversityFaculty of Medicine and Health Technology, Tampere UniversityTampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere UniversityFaculty of Medicine and Health Technology, Tampere UniversityAbstract Objective This study investigated the impact of anticancer treatment on the oral microbiome in pediatric patients and its association with oral mucositis (OM). Materials and methods A double-blind, randomized trial involving 34 pediatric cancer patients (ages 2–17.99) with solid or hematological malignancies. Mucosal swab samples were collected before and after chemotherapy. Patients underwent two 7-day rinse cycles—one with Caphosol and one with saline—in a randomized order. Bacterial DNA from 110 mucosal swabs was analyzed using 16S rRNA sequencing. Results Chemotherapy altered bacterial composition. No life-threatening OM cases (WHO grade 4) were observed, but mild to severe OM (grades 1–3) occurred in three patients. In patients without oral lesions, Bergeyella genus was more abundant prior to treatment while Alloprevotella was more abundant in the post-treatment samples, compared to patients with lesions. OM was linked to distinct microbiome profiles, including Stenotrophomonas, Leptotrichia sp., Serratia sp.,Capnocytophaga sputigena, Sphingomonas sp., Parapusillimonas sp., Staphylococcus sp., and Turicibacter genera. Additionally, Burkholderia-Caballeronia-Paraburkholderia (p = 0.013) were more prevalent in the Caphosol group compared to the saline group. Conclusions These findings indicate that chemotherapy-induced microbiome shifts associate with OM risk, highlighting the potential for microbial markers to predict high-risk patients and support protective strategies. Trial registration The trial titled "Supersaturated Calcium Phosphate Oral Rinse (Caphosol®) for the Prevention of Oral Mucositis in Children Undergoing Chemotherapeutic Treatments" was registered on ClinicalTrials.gov (ID NCT02807337), with the first submission date 2016–06-07.https://doi.org/10.1186/s12903-025-06405-4Oral microbiomeDiversityChemotherapyRandomizedPediatricMucositis
spellingShingle Egle Immonen
Lauri Paulamäki
Hannaleena Piippo
Atte Nikkilä
Liisa Aine
Timo Peltomäki
Olli Lohi
Mataleena Parikka
Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients
BMC Oral Health
Oral microbiome
Diversity
Chemotherapy
Randomized
Pediatric
Mucositis
title Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients
title_full Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients
title_fullStr Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients
title_full_unstemmed Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients
title_short Oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients
title_sort oral microbiome diversity and composition before and after chemotherapy treatment in pediatric oncology patients
topic Oral microbiome
Diversity
Chemotherapy
Randomized
Pediatric
Mucositis
url https://doi.org/10.1186/s12903-025-06405-4
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AT hannaleenapiippo oralmicrobiomediversityandcompositionbeforeandafterchemotherapytreatmentinpediatriconcologypatients
AT attenikkila oralmicrobiomediversityandcompositionbeforeandafterchemotherapytreatmentinpediatriconcologypatients
AT liisaaine oralmicrobiomediversityandcompositionbeforeandafterchemotherapytreatmentinpediatriconcologypatients
AT timopeltomaki oralmicrobiomediversityandcompositionbeforeandafterchemotherapytreatmentinpediatriconcologypatients
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