南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (05): 759-764.doi: 10.12122/j.issn.1673-4254.2020.05.24

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牙周致病菌与系统性疾病的相关性研究进展

杜 芹,马歆茹   

  • 出版日期:2020-05-20 发布日期:2020-05-20
  • 基金资助:

Research progress of correlation between periodontal pathogens and systemic diseases

  

  • Online:2020-05-20 Published:2020-05-20

摘要: 牙周致病菌是牙周炎主要的致病因素,其具有多种毒力因子,可以感染牙周组织并刺激机体炎症细胞因子产生,介导全身性慢性炎症;牙周致病菌还能侵入循环系统,免疫系统等多个人体系统并定植于组织器官,引起多种系统性疾病。近年来大量研究提示,牙周致病菌与全身多种系统性疾病如心血管疾病、糖尿病、类风湿性关节炎、癌症等的发生发展息息相关。牙周致病菌如牙龈卟啉单胞菌等能够定植于动脉粥样硬化斑块中,破坏血管内皮功能,促进其发生发展。牙龈卟啉单胞菌等也能升高炎症因子如TNF-α的水平,促进胰岛素抵抗及糖尿病的发展。类风湿性关节炎患者的关节滑膜液中能检测到牙龈卟啉单胞菌,福赛坦氏菌和中间普氏菌等多种牙周致病菌,也提示牙周致病菌参与了类风湿性关节炎的发病;具核梭杆菌能够改变小鼠肠道微生物构成,形成肠道炎性微环境,促进肠道肿瘤的进程等等。本文从牙周致病菌促进系统性疾病的机制及牙周致病菌与系统性 疾病的相关性方面作一综述。

Abstract: Periodontal pathogens are the main pathogenic factor of periodontitis. Periodontal pathogens have a large variety of virulence factors such as lipopolysaccharide, fimbriae and proteases, which enables the pathogens to infect periodontal tissues and stimulate the secretion of inflammatory cytokines, causing chronic systemic inflammation. Periodontal pathogens may invade multiple systems such as the circulatory system, immune system, respiratory system and digestive system to cause systematic diseases. Recent studies have shown that periodontal pathogens may have close relations with systemic diseases such as cardiovascular disease, diabetes, rheumatoid arthritis, and cancer. Among the periodontal pathogens, Porphyromonas gingivalis can be found in atherosclerotic plaques to impairing the function of the vascular endothelium; Porphyromonas gingivalis may also increase the level of inflammatory factors such as TNF-α to promote insulin resistance and diabetes. Many of the periodontal pathogens such as Porphyromonas gingivalis, Tannerella forsythia and Prevotella intermedia can be detected in the synovial fluid of rheumatoid arthritis patients, suggesting their involvement in the pathogenesis of rheumatoid arthritis. Fusobacterium nucleatum may cause alterations in the intestinal microbiome in mice and promote the occurrence of intestinal tumors. Herein we review the recent progresses in the relationship between periodontal pathogens and systemic diseases.