The oral microbiome and the immunobiology of periodontal disease and caries.
The oral microbiome and the immunobiology of periodontal disease and caries.
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DOI：
10.1016/j.imlet.2014.08.017
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发表时间：
2014-12
影响因子：
4.4
通讯作者：
Herzberg, Mark C.
中科院分区：
文献类型：
--
作者：
Costalonga, Massimo;Herzberg, Mark C.
口腔微生物组的组成从一个口内部位到另一个口内部位是不同的，部分反映了每个部位的宿主反应和免疫能力。通过关注两种主要的口腔感染，牙周病和龋齿，疾病的新原则出现。牙周病会影响支持牙齿的软组织和骨骼。龋病是牙体硬组织的一种特殊感染。这两种疾病的开始都以微生物组复杂性的增加为标志。在牙周炎中，致病菌和关键病原体如牙龈卟啉单胞菌的比例比健康人更大。牙龈卟啉单胞菌是引起牙周炎的关键病原菌，它损害宿主的免疫反应，是引起牙周炎的必要条件，但并不足以引起牙周炎。历史上，龋齿与变形链球菌有因果关系。当代微生物组研究表明，单一病原体在龋齿或牙周炎中并不明显。这两种疾病似乎都是由于当地微生物群落中相对较小的成分之间的扰动导致生态失调。各个微生物组的次要成员的紧急联合体协同作用，以强调宿主的反应和保护能力。在牙周病中，宿主保护首先发生在固有牙龈上皮免疫水平。分泌型伊加抗体和其他唾液抗微生物系统也对牙周病和致龋联合体起作用。当牙龈免疫反应受损时，当中性粒细胞释放基质金属蛋白酶和T细胞介导牙槽骨丢失时，牙周组织病理学结果。在龋齿中，几种物质是产酸和耐酸的，并且似乎协同作用以促进釉质和牙本质的脱矿。虽然在技术上是可能的，特别是对于龋齿，但由于龋齿和牙周炎的发病率低，疫苗在不久的将来不太可能商业化。
The composition of the oral microbiome differs from one intraoral site to another, reflecting in part the host response and immune capacity at each site. By focusing on two major oral infections, periodontal disease and caries, new principles of disease emerge. Periodontal disease affects the soft tissues and bone that support the teeth. Caries is a unique infection of the dental hard tissues. The initiation of both diseases is marked by an increase in the complexity of the microbiome. In periodontitis, pathobionts and keystone pathogens such as Porphyromonas gingivalis appear in greater proportion than in health. As a keystone pathogen, P. gingivalis impairs host immune responses and appears necessary but not sufficient to cause periodontitis. Historically, dental caries had been causally linked to Streptococcus mutans. Contemporary microbiome studies now indicate that singular pathogens are not obvious in either caries or periodontitis. Both diseases appear to result from a perturbation among relatively minor constituents in local microbial communities resulting in dysbiosis. Emergent consortia of the minor members of the respective microbiomes act synergistically to stress the ability of the host to respond and protect. In periodontal disease, host protection first occurs at the level of innate gingival epithelial immunity. Secretory IgA antibody and other salivary antimicrobial systems also act against periodontopathic and cariogenic consortia. When the gingival immune response is impaired, periodontal tissue pathology results when matrix metalloproteinases are released from neutrophils and T cells mediate alveolar bone loss. In caries, several species are acidogenic and aciduric and appear to work synergistically to promote demineralization of the enamel and dentin. Whereas technically possible, particularly for caries, vaccines are unlikely to be commercialized in the near future because of the low morbidity of caries and periodontitis.
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