Association Between ABO Blood Groups and Salivary TNF-α Levels Among Patients with Viridans Streptococci Oral Infections in Baghdad

Authors

  • Sahar Manfi Ahmed Al-Rafidain University/Dentistry college Author
  • Ali Haitham Saleem Al-Rafidain University/Dentistry College Author
  • Rand Jaleel Edan Al-Rafidain University/Dentistry College Author

Keywords:

Oral infection, Viridans Streptococci, TNF-α, ABO blood group

Abstract

Background: Oral infections are bacterial, fungal or viral diseases affecting the teeth and oral mouth tissues. include cavities, (gingivitis/periodontitis). These bacterial infections lead to increased cellular immunity and cytokines included the immunological evaluation of the TNF-α cytokine in the saliva of oral cavity patients infected with bacteria,

Aim: this study aimed to investigate the association between Viridans Streptococci oral infections, ABO blood groups and evaluation the TNF-α cytokine in saliva. 

Materials and Methods: During the period from (November 2024) until (June 2025), blood and saliva samples were collected from 150 participants who were Al-Karama Specialized Dental Center in Baghdad, their ages range from 18 to 55 years, both male and female and have no prior medical history. divided (100) clinical samples were for Viridans Streptococci infection, 50 blood and 50 saliva samples were from control individuals. 

Diagnosis of bacteria were confirmed by complete biochemical examinations using VITEK2 Compact System. Assessments included the saliva level of cytokine (TNF-α) for patients infected with Viridans Streptococci who visit Al Karama Specialized Dental Center.

Results: The study recorded a significant increase in the saliva level of TNF-α for patients infected with Viridans Streptococci (95.05 ± 25.90) pg/ml compared to control subjects (24.11 ± 1.35) pg/ml.  

Differences were observed in the percentages of phenotypic patterns of ABO blood groups among patients compared to control individuals, as individuals with blood type O showed more predisposition to infection compared to other blood groups, while blood group AB had the lowest rate of infection compared to other blood groups.

Conclusion: The Result an association was observed a correlation between different blood types and infections with Viridis streptococci in the oral tissues of infected individuals, as well as an elevated TNF-α index in the saliva of patients infected with this bacterium. 

References

1. Belibasakis GN, Mylonakis E. Oral infections: clinical and biological perspectives. Virulence. 2015 Apr 1;6(3):173–176.

2. Devine DA, Marsh PD, Meade J. Modulation of host responses by oral commensal bacteria. J Oral Microbiol. 2015;7:26941.

3. Hajishengallis G, Lamont RJ. Beyond the red complex and into more complexity: the polymicrobial synergy and dysbiosis (PSD) model of periodontal disease etiology. Molecular Oral Microbiol. 2012;27:409–19.

4. Gasner NS, Schure RS. National Laboratory of Medicine. 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554590/.

5. Abranches J, Zeng L, Kajfasz JK, Palmer SR, Chakraborty B, Wen ZT, et al. Biology of Oral Streptococci. Microbiol Spectr. 2018 Oct 18;6(5):10.1128/microbiolspec.gpp3-0042-2018.

6. Freitas M, Castelo A, Petty G, Gomes CE, Carvalho E. Viridans streptococci causing community acquired pneumonia. Arch Dis Child. 2006 May 31;91(9):779–780.

7. Al-Tai THH, Al-Qassab Y, AL-Hadithi HS, Al-Alwany AA. The role of Streptococcus sanguinis in Normal Human Health and Patients. Journal of Biotechnology Research Center. 2025;19(3):26.

8. Baucells BJ, Mercadal Hally M, Álvarez Sánchez AT, Figueras Aloy J. Asociaciones de probióticos para la prevención de la enterocolitis necrosante y la reducción de la sepsis tardía y la mortalidad neonatal en recién newborns pretérmino de menos de 1.500g: una revisión sistemática. Anales de Pediatría. 2015;85(5):247–255.

9. Doern CD, Burnham CAD. It's Not Easy Being Green: the Viridans Group Streptococci, with a Focus on Pediatric Clinical Manifestations. J Clin Microbiol. 2010 Nov;48(11):3829–3835.

10. Richter SS, Heilmann KP, Dohrn CL, Riahi F, Beekmann SE, Doern GV. Accuracy of phenotypic methods for identification of Streptococcus pneumoniae isolates included in surveillance programs. J Clin Microbiol. 2008;46:2184-2188.

11. Shelburne SA, Sahasrabhojane P, Saldana M, Yao H, Su X, Horstmann N, et al. Streptococcus mitis Strains Causing Severe Clinical Disease in Cancer Patients. Emerg Infect Dis. 2014 May;20(5):762–771.

12. Baty JJ, Stoner SN, Scoffield JA. Oral Commensal Streptococci: Gatekeepers of the Oral Cavity. J Bacteriol. 2022 Oct 26;204(11):e00257-22.

13. Aluisio GV, Spitale A, Bonifacio L, Privitera GF, Stivala A, Stefani S, et al. Streptococcus salivarius 24SMBc Genome Analysis Reveals New Biosynthetic Gene Clusters Involved in Antimicrobial Effects on Streptococcus pneumoniae and Streptococcus pyogenes. Microorganisms. 2022 Oct 16;10(10):2042.

14. Cercenado E, Díaz MD, Sánchez-Carrillo C, Vicente T, Bernaldo de Quirós JC. Enhanced activity of the combination of penicillin G and gentamicin against penicillin-resistant viridans group streptococci. Antimicrob Agents Chemother. 1995 Dec;39(12):2816–2818.

15. Abegaz SB. Human ABO Blood Groups and Their Associations with Different Diseases. Biomed Res Int. 2021 Jan 23;2021:6629060.

16. AbuKhader M, Abdulbaqi A, Petropoulou P, Qutieshat A. Relationship between ABO Blood Groups and Susceptibility to Dental Caries and Periodontitis: A Narrative Review. The Open Dentistry Journal. 2025;19.

17. Khan MA, Lal N, Chandra T, Ali W, Ismail H. Association of ABO phenotype, Rhesus factor, platelet count and hemoglobin level with oral hygiene status and severity of chronic periodontitis. J Oral Biol Craniofac Res. 2024;14(6):730-734.

18. Metgud R, Khajuria N, Mamta, Ramesh G. Evaluation of the Secretor Status of ABO Blood Group Antigens in Saliva among Southern Rajasthan Population Using Absorption Inhibition Method. J Clin Diagn Res. 2016 Feb 1;10(2):ZC01–ZC03.

19. Ptasiewicz M, Bębnowska D, Małkowska P, Sierawska O, Poniewierska-Baran A, Hrynkiewicz R, et al. Immunoglobulin Disorders and the Oral Cavity: A Narrative Review. J Clin Med. 2022 Aug 19;11(16):4873.

20. Bhattacharya A, Pandey A, Pal S, Sarkar S, Sayal K. ABO blood grouping and its relation with dental caries in school going children of Kanpur city. J Indian Dent Assoc. 2013;7(2):59–62.

21. Chauhan SP, Mani AM, Shaik MV, Husain A. Association of dental caries with ABO blood grouping among patients visiting a dental college. J Clin Diagn Res. 2017;11(1):ZC27–ZC30.

22. Almalki SA, Gowdar IM, Arishi FO, Alhumaidani RK, Alhumaidani FK, Gufran K. Association Between ABO Blood Group, Dental Caries, Gingivitis, Impacted Teeth and Malocclusion Among Saudi Adults: A Cross-Sectional Study. Clin Cosmet Investig Dent. 2024 Sep 30;16:371–379.

23. Mazumdar P, Das UK, Das D, Goswami S. Relationship between dental caries and blood group: an observational study. J Dent Med Sci. 2014;13(1):31–33.

24. Chauhan SP, Mani AM, Shaik MV, Husain A. Association of dental caries with ABO blood grouping among patients visiting a dental college. J Clin Diagn Res. 2017 Jan;11(1):ZC27-ZC30.

25. Parameswaran N, Patial S. Tumor Necrosis Factor-α Signaling in Macrophages. Crit Rev Eukaryot Gene Expr. 2010;20(2):87–103.

26. Jang DI, Lee AH, Shin HY, Song HR, Park JH, Kang TB, et al. The Role of Tumor Necrosis Factor Alpha (TNF-α) in Autoimmune Disease and Current TNF-α Inhibitors in Therapeutics. Int J Mol Sci. 2021 Mar 8;22(5):2719.

27. Webster JD, Vucic D. The Balance of TNF Mediated Pathways Regulates Inflammatory Cell Death Signaling in Healthy and Diseased Tissues. Front Cell Dev Biol. 2020;8:365.

28. Banki M, Gholizadeh N, Sheykhbahaei N. The relationship between ABO blood groups and oral diseases: a narrative review. Iran J Dent. 2024;27(2):100-106. doi:10.22034/IJD.2023.394754.1694.

29. Barman P, Chopra S, Thukral T. Direct testing by VITEK® 2: A dependable method to reduce turnaround time in Gram-negative bloodstream infections. J Lab Physicians. 2018 Jul-Sep;10(3):260-264. doi:10.4103/JLP.JLP_11_18.

30. Reily C, Stewart TJ, Renfrow MB, Novak J. Glycosylation in health and disease. Nature Reviews Nephrology. 2019;15:346–366.

31. Misevic G. ABO blood group system. Asia-Pacific Journal of Blood Types and Genes APJBG. 2018;2(2):71-84.

32. Talip VH, Khurana SR. Basic Principles in Blood Banking- Organization, Planning and Documentation. New Delhi: CBS Publishers and Distributors; 1988. p. 201-215.

33. IBM Corp. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp; Released 2019.

34. Abramson JH. WINPEPI updated: computer programs for epidemiologists, and their teaching potential. Epidemiologic Perspectives & Innovations. 2011;8:1.

35. Angeletti S, Dicuonzo G, Avola A, Crea F, Dedej E, Vailati F, et al. Viridans Group Streptococci Clinical Isolates: MALDI-TOF Mass Spectrometry versus Gene Sequence-Based Identification. PLoS One. 2015 Mar 17;10(3):e0120502.

36. Ganda RP, Aryati SS. Suitability Tests for Bacterial Identification and Antibiotic Sensitivity Tests using Microscan Walkaway on Vitek 2. Indian Journal of Forensic Medicine & Toxicology. 2021;15(2):3985.

37. Shun CT, Lu SY, Yeh CY, Chiang CP, Chia JS, Chen JY. Glucosyltransferases of Viridans Streptococci Are Modulins of Interleukin-6 Induction in Infective Endocarditis. Infect Immun. 2005 Jun;73(6):3261–3270.

38. Zhao H, Wu L, Yan G, Chen Y, Zhou M, Wu Y, et al. Inflammation and tumor progression: signaling pathways and targeted intervention. Signal Transduct Target Ther. 2021 Jul 12;6:263.

39. Fang Y, Chen X, Chu CH, Yu OY, He J, Li M. Roles of Streptococcus mutans in human health: beyond dental caries. Front Microbiol. 2024 Dec 19;15:1503657.

40. Tang YL, Sim TS, Tan KS. Oral streptococci subvert the host innate immune response through hydrogen peroxide. Sci Rep. 2022 Jan 13;12:656.

41. Lauro R, Irrera N, Eid AH, Bitto A. Could antigen presenting cells represent a protective element during SARS-CoV-2 infection in children? Pathogens. 2021;10(4):476. doi:10.3390/pathogens10040476.

42. Megha KB, Joseph X, Akhil V, Mohanan PV. Cascade of immune mechanism and consequences of inflammatory disorders. Phytomedicine. 2021 Aug 19;91:153712.

43. Al doori AAA, Al-Biaty HSJ, Abdullah WZ. Association between ABO blood group, serum IL-6 and Helicobacter pylori infection among newborn and young children. Annals of Tropical Medicine and Public Health. 2021;24(04):122-133.

44. Al-Qudsi GH, Jassem RM, Al-Amiri RM. The Correlation Between ABO Blood Group and Rhesus Factor in Patients with Periodontal Diseases: Review Subject. Tikrit Journal for Dental Sciences. 2022;10(2):191-196.

45. Chakrani Z, Robinson K, Taye B. Association Between ABO Blood Groups and Helicobacter pylori Infection: A Meta-Analysis. Sci Rep. 2018;8:17604.

46. Vuhahula EAM, Yahaya J, Morgan ED, Othieno E, Mollel E, Mremi A. Frequency and distribution of ABO and Rh blood group systems among blood donors at the Northern Zone Blood Transfusion Center in Kilimanjaro, Tanzania: a retrospective cross-sectional study. BMJ Open. 2023 Feb 14;13(2):e068984.

Downloads

Published

2026-07-27

Issue

Section

Articles