Potential pathogenic mechanisms of periodontitis associated pregnancy complications.
Potential pathogenic mechanisms of periodontitis associated pregnancy complications.
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DOI：
10.1902/annals.1998.3.1.233
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发表时间：
1998-07-01
期刊：
影响因子：
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通讯作者：
Beck, J D
中科院分区：
文献类型：
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作者：
Offenbacher, S;Jared, H L;Beck, J D
在正常妊娠期间，母体激素和局部作用的细胞因子在调节分娩、宫颈成熟、子宫收缩和分娩中起关键作用。怀孕期间的母体感染已被证明会扰乱这种正常的细胞因子和激素调节的妊娠，有时会导致早产、胎膜早破和早产低出生体重（PLBW），即< 2,500 g和< 37妊娠周。我们的研究重点是确定牙周感染是否可以为母亲提供足够的挑战来触发PLBW。来自48例病例对照受试者的新实验测量了龈沟液（GCF）中PGE(2)和il -1- β的水平，以确定介质水平是否与当前妊娠结局有关。此外，采用微生物特异性DNA探针检测4种牙周病原体的水平。结果显示，与正常出生体重（NBW）对照组相比，低体重母亲的GCF-PGE(2)水平显著较高（分别为131.4 +/- 21.8对62.6 +/- 10.3[平均+/- SE ng/mL]， P = 0.02）。此外，在初产PLBW母亲中，出生体重（以及胎龄）与GCF-PGE(2)水平之间存在显著的负相关（P = 0.023）。这些数据表明，GCF-PGE升高作为当前牙周病活跃性和出生体重降低的标志存在剂量-反应关系(2)。微生物数据表明，与NBW对照组相比，PLBW母亲中检测到4种与成熟斑块和进展性牙周炎相关的微生物——连翘拟杆菌、牙龈卟啉单胞菌、放线菌杆菌和密螺旋体。这些数据表明，母亲牙周状况和口腔微生物负担的生化指标与目前的PLBW有关。
During normal pregnancy, maternal hormones and locally acting cytokines play a key role in regulating the onset of labor, cervical ripening, uterine contraction, and delivery. Maternal infections during pregnancy have been demonstrated to perturb this normal cytokine and hormone-regulated gestation, sometimes resulting in preterm labor, preterm premature rupture of membranes, and preterm low birth weight (PLBW), i.e., < 2,500 g and < 37 weeks of gestation. Our research focus has been to determine whether periodontal infections can provide sufficient challenge to the mother to trigger PLBW. New experiments from 48 case-control subjects have measured gingival crevicular fluid (GCF) levels of PGE(2) and IL-1-beta to determine whether mediator levels were related to current pregnancy outcome. In addition, the levels of 4 periodontal pathogens were measured by using microbe-specific DNA probes. Results indicate that GCF-PGE(2) levels are significantly higher in PLBW mothers, as compared with normal birth weight (NBW) controls (131.4 +/- 21.8 vs. 62.6 +/- 10.3 [mean +/- SE ng/mL], respectively, at P = 0.02). Furthermore, within primiparous PLBW mothers, there was a significant inverse association between birth weight (as well as gestational age) and GCF-PGE(2) levels at P = 0.023. These data suggest a dose-response relationship for increasing GCF-PGE(2) as a marker of current periodontal disease activity and decreasing birth weight. Microbial data indicate that 4 organisms associated with mature plaque and progressing periodontitis--bacteroides forsythus, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Treponema denticola--were detected at higher levels in PLBW mothers, as compared to NBW controls. These data suggest that biochemical measures of maternal periodontal status and oral microbial burden are associated with current PLBW.