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The oral microbiome has been shown to be associated with respiratory health, primarily in adult case studies or among children. This relationship has been scarcely investigated in adult population-based cohorts. To investigate the association between oral microbiome and respiratory health, more specifically asthma, chronic rhinosinusitis (CRS), lung function and fractional exhaled nitric oxide (FeNO) in a population-based cross-continental multicentre study among adults. Subgingival samples from 355 adult European Community Respiratory Health Survey participants from Norway, Australia and Estonia underwent metagenomic sequencing. Respiratory disease was defined from questionnaires and sensitisation from specific immunoglobulin E (IgE)/skin prick tests. Spirometry and FeNO were measured. The associations between alpha diversity and disease status were evaluated in cross-sectional analyses using logistic regression adjusting for sex, smoking and study centre. Differential abundance analyses were performed using analysis of compositions of microbiomes with bias correction. Alpha diversity differed by study centre and sensitisation status and was associated with non-allergic CRS (richness: 1.12, 95% CI 1.03 to 1.22). A similar though not statistically significant pattern was seen for forced vital capacity (FVC) below the lower limit of normal (LLN). Lachnospiraceae and Xanthomonas were more abundant in the oral microbiome of non-asthmatics and individuals without CRS, respectively, as compared with asthmatics and CRS patients. Several functional genes (1477-3391) and genera (54-98) were only present in the non-case groups, whereas individuals with affected respiratory health had 0-74 unique functional genes, but no unique genera present only in their respective groups. Increased alpha diversity was associated with non-allergic CRS and a similar trend was seen for FVC below LLN. Bacterial composition and functional profiles of the oral microbiome differed by respiratory health status. This study is novel in exploring functional gene profiling in relation to asthma and FeNO.

Canine oral lymphoma is an uncommon neoplasm that mimics inflammatory or immune-mediated oral diseases as well as other round-cell tumors, complicating diagnosis and potentially delaying treatment. The objective of this study was to describe the clinical presentation, behavior, and outcomes of canines diagnosed with oral lymphoma, including epitheliotropic and nonepitheliotropic forms of the disease. A retrospective review of 75 cases diagnosed between 2019 and 2022 was performed, evaluating histologic categorization, lesion characteristics (solitary vs multifocal, anatomic location, and descriptors), and survival data when obtainable. There were 73 cases (97.3%) of epitheliotropic T-cell lymphoma (ETCL), 1 case (1.3%) of lingual T-zone lymphoma, and 1 case (1.3%) of peripheral T cell lymphoma-not otherwise specified. The most common anatomic locations for ETCL were the mucocutaneous junction (65.3%) and buccal or labial mucosa (62.7%). Lesions affecting the mucocutaneous junction were commonly located on the mandibular labial frenulum (61.2%), and 46.7% of mandibular frenulum lesions were the only lesions present in the oral cavity. Lesions associated with ETCL were likely to be multifocal (57.3%) and ulcerated (62.8%). Patient survival was not significantly associated with lesion number (solitary vs multifocal) among epitheliotropic cases. These findings indicate that canine oral lymphoma is predominantly epitheliotropic and frequently multifocal, underscoring the importance of biopsy and histopathologic evaluation of oral tissues exhibiting subtle mucosal changes such as erythema or depigmentation. Adjunctive diagnostics, including immunohistochemistry, flow cytometry, and polymerase chain reaction for antigen receptor rearrangements, may facilitate earlier detection. Prospective studies are warranted to clarify disease progression, treatment response, and prognosis.

The Oral Behaviours Checklist (OBC) is widely used, but its latent structure remains unclear. This study was designed to clarify its latent structure and to identify common factors and isolated items relevant to TMD assessment. A cross-sectional study of 1014 patients with TMD (79.1% female; median age, 25.0 years) was conducted. The waking-state OBC's structure was examined using Bayesian exploratory factor analysis (EFA) and validated by confirmatory factor analysis (CFA). Network analysis was used to identify central and isolated items and to examine bridging connections with depression, anxiety, jaw function, and oral health-related quality of life. Bayesian EFA revealed a robust five-factor structure for the waking-state OBC: (1) Awake Bruxism, (2) Jaw Posturing, (3) Oral Manipulation, (4) Jaw Bracing, and (5) Functional Behaviours. This structure was supported by sensitivity analyses and demonstrated good fit in CFA (CFI = 0.943, TLI = 0.919, RMSEA = 0.050, SRMR = 0.044). Network analysis identified three isolated items. Only the Awake Bruxism factor was significantly associated with pain-related TMD and pain intensity. Cross-scale network analysis showed the Oral Manipulation factor was a central bridge to depression, while Awake Bruxism items bridged to anxiety, jaw dysfunction, and reduced oral health-related quality of life. The waking-state OBC exhibits a five-factor structure, with three isolated items that should be evaluated separately. For clinical efficiency, focusing on the core 'Awake Bruxism' items is justified, whereas factor-specific scoring is recommended in research to capture the heterogeneity of oral behaviours.

Schwann cell derived extracellular vesicles (SC-EVs) have emerged as a specialized extracellular vesicle subtype with intrinsic neuroregenerative, neuroimmune, and neurovascular regulatory capacities, making them particularly relevant for diabetic oral mucosal wound healing. Unlike more widely studied extracellular vesicles derived from mesenchymal stem cells, SC-EVs originate from the principal glial cells of the peripheral nervous system and therefore retain biological programs directly related to axonal repair, neurotrophic support, and nerve-associated tissue regeneration. Diabetic oral mucosal wounds are characterized by persistent inflammation, impaired angiogenesis, oxidative stress, extracellular matrix dysregulation, and neuropathy-associated defects in epithelial repair. SC-EVs contain a distinctive cargo of proteins, RNAs, and lipids, including neurotrophic factors such as nerve growth factor and brain-derived neurotrophic factor, regulatory microRNAs such as miR-21 and miR-146a, and antioxidant molecules that collectively modulate these pathological processes. This review first summarizes the pathophysiological features of diabetic oral mucosal wounds, with emphasis on neurovascular and neuroimmune disruption. It then discusses the biogenesis, molecular composition, and functional mechanisms of SC-EVs, highlighting their roles in inflammatory recalibration, angiogenesis, neuroregeneration, and redox homeostasis. A dedicated discussion of SC-EV-specific cargo composition is included to clarify why SC-EVs represent a particularly suitable extracellular vesicle source for neuropathy-associated oral wound repair. Finally, we evaluate current progress in scalable production, targeted engineering, and biomaterial-assisted delivery, while outlining remaining limitations related to standardization, potency assessment, long-term safety, and clinical translation. By integrating glial biology with extracellular vesicle nanomedicine, this review provides a focused framework for developing SC-EV-based therapeutics for diabetic oral mucosal lesions.

Thyroid hormones have a crucial impact on all physiological systems. Diagnosis of thyroid diseases using salivary biomarkers is an emerging discipline and requires consolidation of existing information. This systematic review is aimed at identifying and analyzing salivary biomarkers that are associated with thyroid diseases and evaluate their potential as diagnostic applicability as non-invasive indicators of thyroid dysfunction. Literature search was conducted in PubMed, Cochrane, EBSCO, ProQuest, and Google Scholar from date of inception to May 2025. Human observational studies, clinical trials, and diagnostic accuracy studies published in the English language, that related biomarkers in saliva to thyroid diseases were collected and analyzed for relevant information. The search resulted in 35 records, followed by PRISMA 2020 compliant screening which resulted in 9 records included for data synthesis. Data extraction, tabulation and Risk of Bias assessment was carried out by 2 independent reviewers. Included studies suggest that FT3, amino acids, salivary metabolic profiling, glycan profiles, microbiome, and thyroid antibodies present in saliva could be putative and noninvasive biomarkers of diagnostic and prognostic importance. Heterogeneity in study design and analytical techniques has limited definitive conclusions about said markers, necessitating future well-designed clinical studies for validation of these biomarkers for noninvasive thyroid screeing and diagnosis. Hormones produced by thyroid glands have a role to play in all systems of the body. Hence abnormal thyroid function needs to be detected and treated earlier. Currently tests require blood samples that are invasive to collect requiring exploration of non invasive samples from the body. saliva is one such source and is being currently explored. This review searched studies that analyzed various substances in saliva that could indicate disorders in thyroid function. The analysis pointed at some compounds in saliva, viz. free T3 hormone, thyroid-related antibodies, certain amino acids, oral microbiomes to reflect thyroid problems. Among these, free T3 and thyroid antibodies are apparently the most promising variables in saliva that help diagnose and monitor thyroid diseases.

Dental caries and periodontitis are the most common chronic oral diseases, their occurrence and progression are closely linked to the complex oral microenvironment. These processes involve pathogenic microbial colonization, biofilm formation, inflammatory responses, and oxidative stress imbalance. Reactive oxygen species (ROS) exhibit dual biological roles in oral diseases: they participate in antimicrobial defense while potentially exacerbating tissue damage and inflammation when excessively accumulated, rendering precise redox homeostasis regulation a critical challenge in localized therapy. In recent years, nanozymes have demonstrated unique advantages in oral disease prevention and treatment due to their enzyme-mimicking catalytic functions, high stability, and structural tunability. This review first outlines the catalytic mechanisms of nanozymes and their roles in oral disease-related pathological processes, focusing on ROS regulation, antimicrobial activity, biofilm disruption, and oral microenvironment modulation. The structural classification and mechanisms of different nanozymes are subsequently summarized, including metals and metal compounds, carbon-based materials, and organic framework materials. Importantly, this review compares the applications of ROS-generating and ROS-scavenging nanozymes in dental caries and periodontitis, highlighting their therapeutic mechanisms and disease-specific design strategies. Furthermore, within specific disease contexts, this review examines representative nanozyme applications in caries prevention and periodontitis treatment, encompassing monotherapy and multimodal synergistic strategies. Particular attention is given to three emerging trends in oral nanozyme research, including microenvironment-responsive systems, multimodal therapeutic approaches, and clinical translation potential. Finally, this paper explores key challenges and future directions for the clinical translation of nanozymes in oral diseases, aiming to provide insights into material design and therapeutic optimization strategies.

To evaluate intraoral-ultrasound (ioUS) features of benign and malignant oral lesions. In this prospective cross-sectional study, patients with oral soft tissue lesions underwent ioUS followed by biopsy within 2&#x2009;weeks. Sonographic features: size, echogenicity, cystic areas, calcifications, margins, and vascularity were compared with histopathology. Associations between sonographic features and malignancy were explored using univariate and multivariable analyses. ROC analysis was used descriptively to explore discriminatory ability. Fifty-one patients with 52 lesions (24 females, 27 males; mean age 60.1&#x2009;&#xb1;&#x2009;16.7&#x2009;years, range 18-90) were recruited. Following exclusions, the study comprised 23 histologically confirmed malignant cases (squamous cell carcinoma, SCC) and 23 benign cases. Multivariate analysis identified maximal diameter (>&#x2009;12&#x2009;mm; sensitivity 0.76 [95% CI: 0.53-0.90], specificity 0.77 [95% CI: 0.57-0.90]), ill-defined margins (p&#x2009;<&#x2009;0.001), and increased vascularity (p&#x2009;=&#x2009;0.002) as being associated with SCC in this cohort. Combinations of these features showed high apparent discrimination (AUC 0.92 [95% CI: 0.84-1.00]), but likely reflect optimistic bias given the small sample size and lack of validation. This pilot study describes ioUS features in benign and malignant oral lesions and identifies sonographic features potentially associated with malignancy. These findings are exploratory and hypothesis-generating and require validation in larger, more diverse cohorts before any clinical application.

Oral submucous fibrosis (OSF) is a chronic progressive oral fibrotic disorder characterized by dysregulated immune inflammation, fibroblast activation, and vascular homeostasis disruption, yet synchronously regulating these axes remains challenging. We developed a multifunctional nucleic acid nanomedicine, Apt02-tFNAs-siTGF-&#x3b2; (A-T-S), in which tetrahedral framework nucleic acids co-deliver siRNA against TGF-&#x3b2; (siTGF-&#x3b2;) and the proangiogenic aptamer Apt02, enabling programmable integration and stable delivery. A-T-S was efficiently internalized by macrophages, human oral mucosal fibroblasts, and endothelial cells and concurrently modulated inflammatory phenotypes, fibrotic programs, and angiogenesis-related features in vitro. Transcriptomic profiling revealed coordinated reprogramming of pathways involved in inflammation, fibrosis, and extracellular matrix remodeling. In a rat OSF model, A-T-S reduced collagen deposition and profibrotic signaling while mitigating inflammatory infiltration and vascular abnormalities, without evident toxicity in major organs. These findings indicate that A-T-S can synergistically remodel the OSF lesion microenvironment and represents a promising strategy for OSF and other fibroinflammatory diseases.

Ursolic acid (UA), the antimalarial triterpenic mixture 8TTE (containing C-27 feruloyl and coumaroyl esters of ursane and oleane skeletons), and the semi-synthetic antitrypanosomal derivative ursolic acid O-phenyl propionate (UAOPP) exhibit high lipophilicity, which may limit their oral bioavailability. This study aimed to develop lipid nanocapsules (LNCs) to improve the solubility, intestinal permeability, and antiparasitic activity of these triterpenic compounds for potential oral delivery. LNCs formulations containing UA, 8TTE, and UAOPP were prepared and evaluated. A sensitive UPLC\x{2013}MS method was developed and validated for selected triterpenes quantification during transport studies across Caco-2 cell monolayers [limit of detection (LOD): 2 nM; limit of quantification (LOQ): 25 nM]. Cytotoxicity and permeability studies were conducted on Caco-2 cells to assess formulation safety and intestinal transport. In vitro antiparasitic activity of free and formulated compounds was evaluated against Plasmodium falciparum and Trypanosoma brucei brucei (Tbb). The formulations were non-toxic to Caco-2 cells at concentrations up to 2 mg/mL. Permeability studies demonstrated enhanced transport for the formulated triterpenic esters, with permeability increases of up to 2.68-fold, shifting their classification from poorly absorbed to moderately absorbed compounds in humans [apparent permeability coefficient (Papp) > 1 &#xd7; 10-6 cm/s]. Free UA showed the highest Papp value (4.95 &#xd7; 10-6 cm/s &#xb1; 1.29 &#xd7; 10-7), but caused epithelial integrity disruption after 2 h of incubation and during the following 48 h, whereas formulated UA induced minimal integrity loss at the same concentration. In antiparasitic assays, blank LNCs exhibited maximum non-toxic concentrations of 165 &#x3bc;g/mL against P. falciparum and 65 &#x3bc;g/mL against Tbb. At these maximum concentrations, formulated UA and 8TTE showed enhanced antiplasmodial activity; however, blank LNCs produced comparable effects. In contrast, UAOPP-loaded LNCs showed significantly improved antitrypanosomal activity by approximately 20% at 2.15 &#x3bc;M (cell viability: 38.20% &#xb1; 5.41) compared with free UAOPP (20.38% &#xb1; 8.80). These findings suggest that LNCs represent promising oral delivery systems for lipophilic triterpenes. Further in vivo pharmacokinetic and efficacy studies are needed to confirm their therapeutic potential.

Background Periodontal disease can impact several functional elements, such as chewing, swallowing, speech, and appearance, which in turn can affect self-confidence. People suffering from periodontitis typically report a diminished quality of life in comparison to those with healthy gums. Objective To evaluate the impact of chronic periodontal disease on the oral health-related quality of life of a patient visiting the tertiary hospital. Method The descriptive cross-sectional study was conducted among patients visiting the Department of Periodontology and Oral Implantology, Kathmandu University Hospital, using a predesigned/prevalidated self-administered questionnaire for a duration of 3 months from June 2024 to August 2024 after obtaining ethical approval. Data was collected and entered into Microsoft Excel, and further analysis was done using SPSS v21. Result A total of 380 participants were included in the study, comprising 197 (51.80%) males and 183 (48.20%) females. The mean age of the participants was 35.62 &#xb1; 13.56 years. The highest mean score was for physical disability (2.81 &#xb1; 1.99), indicating that this was the most frequently experienced impact. This was followed by physical pain (2.65 &#xb1; 1.96) and psychological disability (2.14 &#xb1; 2.22). The least affected domains were social disability (0.62 &#xb1; 1.33) and handicap (0.76 &#xb1; 1.50), suggesting that participants' social lives and overall life roles were less impacted by their periodontal condition. Conclusion There was negative impact of periodontal diseases on various aspects of patients' oral health-related quality of life, including functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap.

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To determine the prevalence of dental caries and analyze associated factors among children aged 6 to 12 years in Conakry, Guinea. This cross-sectional study was conducted on 869 children in Conakry, Guinea, from July to December 2023. Sociodemographic characteristics of children and their caregivers were evaluated. The DMFT index was used to measure caries prevalence. Explanatory variables included age, sex, education, district of residence, oral hygiene (OHI-S), gingival inflammation, orthodontic anomalies, and brushing habits. Descriptive, bivariate, and multivariable logistic regression analyses were performed to identify factors independently associated with caries prevalence. Among 869 children, 72.8% had dental caries (DMFT > 0) and 27.2% were caries-free. The mean DMFT score was 2.24&#x2009;&#xb1;&#x2009;1.96. In multivariable analysis, four factors were independently associated with dental caries: age group 10-12 years (aOR=3.44; 95% CI: 2.41-4.90; p&#x2009;<&#x2009;0.001), poor oral hygiene as assessed by OHI-S (aOR=1.54; 95% CI: 1.10-2.16; p&#x2009;=&#x2009;0.013), gingival inflammation (aOR=1.85; 95% CI: 1.16-2.96; p&#x2009;=&#x2009;0.010), and use of non-standard brushing materials (aOR=1.49; 95% CI: 1.00-2.23; p&#x2009;=&#x2009;0.050). This study found a high prevalence of dental caries among children in urban Conakry, Guinea, driven by behavioral and clinical factors. Age group, poor oral hygiene, and gingival inflammation were identified as the main independent risk factors, with children aged 10-12 years being particularly vulnerable. These findings highlight the urgent need for targeted public health interventions, including school-based oral health education and improved access to affordable dental care to address this significant health burden.

To examine global, regional, and national trends in the incidence of permanent tooth caries among adults aged &#x2265; 55 years from 1990 to 2021 and to evaluate disparities across sociodemographic contexts. Incidence data were obtained from the Global Burden of Diseases 2021 study covering 204 countries and territories. Incidence rates and incident case numbers were analysed at global, regional, and national levels. Temporal trends were assessed using Joinpoint regression to calculate annual percentage change (APC) and average annual percentage change (AAPC). Globally, the number of caries cases in the elderly increased from 121.54 million in 1990 to 260.18 million in 2021, with a relative change of 114%, while the incidence rate slightly decreased from 18.1% in 1990 to 17.5% in 2021. However, there were differences in trends among different age groups, genders, and regions. The 55-59-year-old group had the highest incident rate. Low-to-middle Socio-demographic Index (SDI) areas had a consistently high incidence. The number of cases increased in all Global Burden of Diseases, Injuries, and Risk Factors Study regions. Joinpoint analysis identified significant temporal change points in multiple regions, indicating divergent epidemiological trajectories. Permanent tooth caries among adults aged &#x2265; 55 years continues to represent a significant public health challenge. Although some high-income settings show stabilising trends, increasing incidence in socioeconomically transitioning regions highlights inequalities in preventive coverage and access to care. Targeted, age-specific preventive strategies are essential to address the growing needs of ageing populations.

Subcutaneous antibiotic administration is increasingly considered an alternative to intravenous therapy in selected patients. It can facilitate early discharge and outpatient management when oral treatment is not possible. We retrospectively evaluated the effectiveness and tolerability of subcutaneous ceftriaxone, teicoplanin, and ertapenem in adults treated in a tertiary care infectious diseases center between January 2017 and February 2023. A total of 136 patients were included. The median age was 64&#x202f;years (interquartile range 53-78), and 38% were older than 75&#x202f;years. Bone and joint infections (45.6%), urinary tract infections (25.7%), and pulmonary infections (22.1%) were the most frequent indications. Overall clinical cure was achieved in 126/136 patients (92.6%). Cure rates reached 100% for urinary tract and cardiovascular infections and 96.7% for pulmonary infections. Twenty-one adverse events were reported, including injection site pain in 11 patients (8.1%). No severe local complication occurred. Teicoplanin trough concentrations, available in three patients with adverse events, remained within the therapeutic range. These findings support subcutaneous ceftriaxone, teicoplanin, and ertapenem administration as a safe and effective alternative when oral or intravenous therapy is not feasible.

Perimenopausal Syndrome (PS) results from estrogen fluctuations due to ovarian dysfunction, leading to autonomic and neuropsychological symptoms. Existing therapeutic methods have certain limitations, and integrated Chinese-Western medicine (ICWM) treatment can achieve complementary advantages. We defined 16 clinical questions and outcomes for PS and searched CNKI, PubMed, the Cochrane Library, and other databases and relevant websites from inception to August 29, 2025. Relevant clinical practice guidelines/consensus statements (CPGs/CSs), systematic reviews (SRs), and randomized controlled trials (RCTs) were included, and their methodological quality was apprised using AGREE II, AMSTAR 2, and ROBUST-RCT, respectively. Data synthesis and visualization were performed using Microsoft Excel 2021 and R. 280 studies (5 CPGs/CSs, 38 SRs, 237 RCTs) were included, of which 84.6% were Chinese publications. Acupuncture and oral Chinese herbal medicine (CHM) had abundant evidence, some Chinese Medicine interventions had little or no evidence, and study quality varied across types. Evidence summaries showed acupuncture versus conventional Western therapy and integrated oral CHM and western medication (WM) versus WM alone were superior or equivalent in efficacy and safety for PS. This study mainly assesses the available evidence on acupuncture and integrated oral CHM and WM interventions for PS. Both treatment strategies demonstrate potential benefits for PS. Nevertheless, inconsistencies in the evidence base across different interventions, methodological shortcomings, and limited international applicability weaken the overall quality of current findings. Future research should target these gaps to advance evidence-based, personalized ICWM strategies, improving outcomes for women with PS worldwide.

Peripheral nerve injury (PNI) poses a substantial global health burden, affecting over 20 million individuals annually with frequent suboptimal recovery and persistent disability. The inherent limitations of nerve autografts, such as donor site morbidity and limited supply, underscore the clinical importance of nerve guidance conduits (NGCs) as a promising alternative. Nonetheless, the efficacy of current NGCs remains limited by their inability to recapitulate the spatiotemporally precise molecular cues of the native regenerative microenvironment. Our network meta-analysis highlights a significant efficacy gap in current NGCs and underscores the urgent clinical need for novel bioactive strategies. Metal ions have emerged as pivotal therapeutic candidates, capable of orchestrating regeneration by reactivating developmental programs through their tunable release kinetics and pleiotropic effects. By integrating spatiotemporal metal ion dynamics with single-cell transcriptomic data, this review deciphers a conserved, cell-type-specific signaling axis that operates across both development and regeneration. The review further evaluates advanced tissue engineering platforms, ranging from biodegradable metals to functional polymers, coupled with innovative fabrication technologies that enable spatiotemporally controlled ion delivery. This synthesis culminates in a development-inspired engineering blueprint that proposes a paradigm shift from passive structural support to active, development-mimetic instruction, ultimately aiming to accelerate the clinical translation of metal ion-based therapies for PNI (Scheme 1).

In Germany, approximately 23.000 individuals require home-based intensive care (HIC) provided by specialized nurses due to life-threatening conditions such as invasive ventilation, life-supporting noninvasive ventilation, or the presence of tracheal tubes requiring tracheobronchial suctioning. The current study's objective was to characterize individuals receiving home-based intensive care from a private German provider to inform healthcare structures and clinical practice guidelines. On June 12, 2024, the quality management department of a private German home-based intensive care service collected cross-sectional data on all individuals receiving home-based intensive care. Data from 851 individuals were collected, of which 511 (60%) were sixty years or older. Three hundred and thirty two individuals (39%) were female and 519 (61%) were male. Seven hundred and thirty four individuals (86%) were living in shared apartments and 117 (14%) lived at home with 24&#x202f;h individual nursing care. Six hundred and eighty two individuals (80%) suffered from various neurological diseases, 116 (14%) from COPD, and 30 (4%) from oral, pharyngeal or laryngeal cancer. Twenty seven individuals (3%) had been admitted to HIC after a COVID-19 infection. Seven hundred and forty one individuals (89%) were tracheostomized, 220 (26%) needed invasive ventilation, 44 (5%) noninvasive ventilation and 14 (2%) hemodialysis. In Germany, neurological diagnoses and COPD are predominant in HIC. Most individuals are tracheostomized, and one in four requires invasive ventilation via tracheostomy. They also require multidisciplinary care by neurologists, pulmonologists, specialist nurses, respiratory therapists, speech-and-language therapists, physiotherapists, occupational therapists and other professionals. Neurological rehabilitation of individuals needing HIC should be established.

Epstein-Barr virus (EBV) is associated with several malignancies and immune-mediated conditions, but its relationship with human microbial communities remains incompletely understood. We systematically searched PubMed, Embase, and Scopus for human studies evaluating EBV-associated alterations in the microbiome. Because of substantial clinical and methodological heterogeneity, findings were synthesized narratively, and study quality was assessed using the ROBINS-I tool. Nine observational studies published between 2017 and 2025 were included, covering the oral cavity, nasopharynx, gut, gastric tissue, and subgingival plaque. EBV positivity or EBV-related clinical status was associated with niche-specific microbial shifts, including altered gut bacterial profiles, distinct microbial patterns in EBV-associated gastric cancer tissue, and enrichment of oral-associated pathobionts in nasopharyngeal carcinoma compartments. Alpha- and beta-diversity findings were inconsistent across studies. Overall, the evidence suggests context-dependent alterations in the microbiome in EBV-positive or EBV-related disease settings. However, these findings should be interpreted as EBV-associated rather than EBV-specific, particularly when EBV status overlaps with malignancy. The small observational evidence base, heterogeneous EBV-status definitions, methodological variability, and residual confounding limit causal inference. Larger longitudinal and standardized multi-omic studies are needed to clarify directionality, mechanisms, and clinical relevance.