口腔鞭毛蟲為一種厭氧性的口腔原蟲，常見於口腔衛生不佳者以及牙周炎患者之口腔當中，潛藏於牙齒、齒齦、舌頭之間，亦或是扁桃腺隱窩等處。過去研究發現，口腔鞭毛蟲與牙周炎病程中的發炎反應有關，並且可能從口腔中被吸入肺部，造成肺部鞭毛蟲症。根據先前實驗室的研究，其會誘導人類肺腺癌上皮細胞增加促發炎細胞激素IL-6的分泌，除此之外，目前對於其在人類肺部所造成的影響並不明瞭。首先，為了瞭解口腔鞭毛蟲在台灣肺部疾病患者中的盛行率，我們收集了肺部疾病住院患者的肺泡沖洗液檢體，利用巢式聚合酶連鎖反應偵測口腔鞭毛蟲。在來自嘉義基督教醫院中的61個樣本中口腔鞭毛蟲陽性案例有21個，檢出率為34%；在成功大學醫院的55個檢體中，則有11個口腔鞭毛蟲的陽性案例，檢出率為20%。此為台灣首次針對口腔鞭毛蟲所進行的流行病學調查。此外，了解病原體的自然感染源是相當重要的。為證實口腔鞭毛蟲在台灣自然環境水體中的存在，我們針對位於南台灣的鹽水溪以及東港河流流域進行全年度四季的水體樣本採樣，同樣以巢式聚合酶連鎖反應進行檢測，亦發現口腔鞭毛蟲的蹤跡。在完成病患與水樣的流行病學調查後，本研究進一步的嘗試釐清口腔鞭毛蟲感染對肺部的潛在影響。我們建立了口腔鞭毛蟲與人類肺腺癌上皮細胞共培養模式，以其模擬人類肺細胞受到口腔鞭毛蟲刺激的情形，再以轉錄組定序 (RNAseq)分析細胞的基因表達反應。我們發現肺腺癌上皮細胞在受到口腔鞭毛蟲刺激後，多個病毒感染應對相關基因產生了顯著表達改變，其中包括了IFI44L以及IFITM3等等基因。更進一步地，本研究證實了口腔鞭毛蟲造成這些基因表達改變的關鍵成分為蟲體的可溶性蛋白質，且展現細胞在受到刺激後目標基因的動態基因表現量。綜合本研究結果，該研究對於台灣肺部疾病患者中口腔鞭毛蟲之流行率奠定了基礎，並且也旨在建立日常口腔衛生習慣以及肺部感染之間的關聯性，從而盼能制定預防及治療之策略。

Trichomonas tenax is an oral protozoan found in patients with poor oral hygiene. It participates in the inflammatory process of periodontal disease and can potentially be aspirated into the lungs, giving rise to pulmonary trichomoniasis. However, the roles of T. tenax in the pulmonary system remain unexplored. To assess the prevalence of T. tenax infection, we collected bronchoalveolar lavage fluid samples from hospitalized patients with lung diseases. Nested PCR was employed to determine prevalence rates, yielding 21 positive cases out of 61 samples from Ditmanson Medical Foundation Chia-Yi Christian Hospital, and 11 positive cases out of 55 samples from National Cheng Kung University Hospital. Furthermore, there is a critical need for comprehensive data regarding the presence of T. tenax in environmental surface watersheds. Here, we present findings from investigations in the Yanshuei and Donggang river basins in southern Taiwan, which are crucial sources for public drinking water in the region. Following the epidemiological investigation of patients and water samples, this study further explored the potential impact of T. tenax infection on the lungs. We conducted an analysis of gene expression level changes in H292 cells after exposure to T. tenax. Our findings revealed that after H292 cells were stimulated by T. tenax, there were significant changes in the expression of genes related to multiple viral infections, including IFI44L, IFITM3, and others. Additionally, this study confirmed that the key factor driving these gene expression changes induced by T. tenax is the soluble protein, and it demonstrated the dynamic gene expression of target genes following stimulation. Crucially, this study lays the groundwork for a preliminary understanding of T. tenax prevalence in patients with pulmonary diseases. It also seeks to establish a meaningful correlation between lung infections and oral hygiene practices, with the ultimate aim of informing distinct treatment and prevention strategies.

ALwaaly1, S. A. A. M. a. A. B. M. (2019). "Prevalence trichomonas tenax in Karbala Governorate." Journal of Physics: Conference Series (JPCS) 1294(6).
Arpag, O. F. and O. M. Kaya (2020). "Presence of Trichomonas tenax and Entamoeba gingivalis in peri-implantitis lesions." Quintessence Int 51(3): 212-218.
Benabdelkader, S., J. Andreani, A. Gillet, E. Terrer, M. Pignoly, H. Chaudet, G. Aboudharam and B. La Scola (2019). "Specific clones of Trichomonas tenax are associated with periodontitis." PLoS One 14(3): e0213338.
Bonner, M., V. Amard, C. Bar-Pinatel, F. Charpentier, J. M. Chatard, Y. Desmuyck, S. Ihler, J. P. Rochet, V. Roux de La Tribouille, L. Saladin, M. Verdy, N. Girones, M. Fresno and J. Santi-Rocca (2014). "Detection of the amoeba Entamoeba gingivalis in periodontal pockets." Parasite 21: 30.
Bracamonte-Wolf, C., P. R. Orrego, C. Munoz, D. Herrera, J. Bravo, J. Gonzalez, H. Varela, A. Catalan and J. E. Araya (2019). "Observational cross-sectional study of Trichomonas tenax in patients with periodontal disease attending a Chilean university dental clinic." BMC Oral Health 19(1): 207.
Busse, D. C., D. Habgood-Coote, S. Clare, C. Brandt, I. Bassano, M. Kaforou, J. Herberg, M. Levin, J. F. Eleouet, P. Kellam and J. S. Tregoning (2020). "Interferon-Induced Protein 44 and Interferon-Induced Protein 44-Like Restrict Replication of Respiratory Syncytial Virus." J Virol 94(18).
Chen, C. H., C. W. Kuo, C. M. Tsai, Z. B. Hong, C. H. Lai, T. Y. Chan and W. C. Lin (2024). "Detection of trichomonads in patients with lung cancer and transcription analysis on the response of human pulmonary epithelial cells to Trichomonas tenax invasion." J Microbiol Immunol Infect.
Cioccarelli, C., R. Sanchez-Rodriguez, R. Angioni, F. C. Venegas, N. Bertoldi, F. Munari, A. Cattelan, B. Molon and A. Viola (2021). "IL1beta Promotes TMPRSS2 Expression and SARS-CoV-2 Cell Entry Through the p38 MAPK-GATA2 Axis." Front Immunol 12: 781352.
El Sibaei, M. M., N. S. Abdel-Fattah, S. A. Ahmed and H. M. Abou-Seri (2012). "Growth kinetics, antigen profiling, and proteinase activity of Egyptian Trichomonas tenax isolates derived from patients having oral infections." Exp Parasitol 130(4): 416-422.
Fadia Abd Al-Muhsin Al-Khayat, P. D. (2016). "The Prevalence of Oral Protozoa Trichomona Stenax in some Patients with Gingivitis " Journal of Baghdad College of Dentistry 28(1).
Hong, Z. B., Y. T. Lai, C. H. Chen, Y. J. Chen, C. C. Chen and W. C. Lin (2023). "Trichomonas tenax induces barrier defects and modulates the inflammatory cytotoxicity of gingival and pulmonary epithelial cells." Parasite 30: 7.
Ke, W., L. Zhang and Y. Dai (2020). "The role of IL-6 in immunotherapy of non-small cell lung cancer (NSCLC) with immune-related adverse events (irAEs)." Thorac Cancer 11(4): 835-839.
Leterrier, M., F. Morio, B. T. Renard, A. S. Poirier, M. Miegeville and G. Chambreuil (2012). "Trichomonads in pleural effusion: case report, literature review and utility of PCR for species identification." New Microbiol 35(1): 83-87.
Li, M., Y. P. Li, H. L. Deng, M. Q. Wang, Y. Chen, Y. F. Zhang, J. Wang and S. S. Dang (2021). "DNA methylation and SNP in IFITM3 are correlated with hand, foot and mouth disease caused by enterovirus 71." Int J Infect Dis 105: 199-208.
Lin, C., F. Ying, Y. Lai, X. Li, X. Xue, T. Zhou and D. Hu (2019). "Use of nested PCR for the detection of trichomonads in bronchoalveolar lavage fluid." BMC Infect Dis 19(1): 512.
Lo, W. L., H. B. Leu, M. C. Yang, D. H. Wang and M. L. Hsu (2019). "Dysphagia and risk of aspiration pneumonia: A nonrandomized, pair-matched cohort study." J Dent Sci 14(3): 241-247.
Mallat, H., I. Podglajen, V. Lavarde, J. L. Mainardi, J. Frappier and M. Cornet (2004). "Molecular characterization of Trichomonas tenax causing pulmonary infection." J Clin Microbiol 42(8): 3886-3887.
Marty, M., M. Lemaitre, P. Kemoun, J. J. Morrier and P. Monsarrat (2017). "Trichomonas tenax and periodontal diseases: a concise review." Parasitology 144(11): 1417-1425.
Matthew, M. A., N. Yang, J. Ketzis, S. Mukaratirwa and C. Yao (2023). "Trichomonas tenax: A Neglected Protozoan Infection in the Oral Cavities of Humans and Dogs-A Scoping Review." Trop Med Infect Dis 8(1).
Nor Azmi, N. J., S. Mohamad, W. N. S. Shahidan, H. Taib, Z. Mohamed and E. Osman (2024). "Risk factors and approaches for detection of Trichomonas tenax, the silent culprit in periodontal disease: A narrative review." Saudi Dent J 36(2): 258-261.
Pereira-Neves, A. and M. Benchimol (2008). "Trichomonas vaginalis: in vitro survival in swimming pool water samples." Exp Parasitol 118(3): 438-441.
Senthil Kumar, K. J., M. Gokila Vani, C. S. Wang, C. C. Chen, Y. C. Chen, L. P. Lu, C. H. Huang, C. S. Lai and S. Y. Wang (2020). "Geranium and Lemon Essential Oils and Their Active Compounds Downregulate Angiotensin-Converting Enzyme 2 (ACE2), a SARS-CoV-2 Spike Receptor-Binding Domain, in Epithelial Cells." Plants (Basel) 9(6).
Smith, S., T. Fernando, P. W. Wu, J. Seo, J. Ni Gabhann, O. Piskareva, E. McCarthy, D. Howard, P. O'Connell, R. Conway, P. Gallagher, E. Molloy, R. L. Stallings, G. Kearns, L. Forbess, M. Ishimori, S. Venuturupalli, D. Wallace, M. Weisman and C. A. Jefferies (2017). "MicroRNA-302d targets IRF9 to regulate the IFN-induced gene expression in SLE." J Autoimmun 79: 105-111.
Sooryanarain, H., A. J. Rogers, D. Cao, M. E. R. Haac, Y. A. Karpe and X. J. Meng (2017). "ISG15 Modulates Type I Interferon Signaling and the Antiviral Response during Hepatitis E Virus Replication." J Virol 91(19).
Tonetti, M. S., S. Jepsen, L. Jin and J. Otomo-Corgel (2017). "Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action." J Clin Periodontol 44(5): 456-462.
Tumka, A. F. (1956). "[Trichomonal invasion of the lungs]." Klin Med (Mosk) 34(12): 35-40.
Yang, N., J. Christie, H. L. Keen, M. A. Matthew and C. Yao (2022). "Draft Genome Sequence of Trichomonas tenax Strain Hs-4:NIH." Microbiol Resour Announc 11(7): e0015722.
Zhang, H., P. Xia, J. Liu, Z. Chen, W. Ma and Y. Yuan (2021). "ATIC inhibits autophagy in hepatocellular cancer through the AKT/FOXO3 pathway and serves as a prognostic signature for modeling patient survival." Int J Biol Sci 17(15): 4442-4458.