The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm.
The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm.
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DOI：
10.1902/annals.1998.3.1.108
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发表时间：
1998-07-01
期刊：
影响因子：
--
通讯作者：
Page, R C
中科院分区：
文献类型：
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作者：
Page, R C
牙周炎的病理生物学提出了一个新的范例，牙周炎可能涉及某些系统性疾病，如心血管疾病和早产的易感性的方式进行了描述。牙周炎是由一小群革兰氏阴性细菌引起的，它们以生物膜的形式存在于牙根表面。脂多糖（LPS）和其他物质进入牙龈组织，启动和维持免疫炎症，导致高水平的促炎细胞因子的产生。这些诱导产生破坏牙龈和牙周韧带的结缔组织的基质金属蛋白酶，以及介导牙槽骨破坏的胰高血糖素。牙周炎可以通过几种方式增加对全身性疾病的易感性。来自生物膜的LPS和活的革兰氏阴性细菌以及来自发炎牙周组织的促炎细胞因子可以致病量进入循环。此外，牙周炎和某些全身性疾病，如心血管疾病，共享的风险因素包括吸烟，男性性别，种族/民族，压力和衰老。
A new paradigm for the pathobiology of periodontitis is presented, and the manner in which periodontitis may relate to susceptibility for certain systemic diseases such as cardiovascular disease and preterm labor is described. Periodontitis is caused by a small group of Gram-negative bacteria present on the tooth root surfaces as bioffilms. Lipopolysaccharide (LPS) and other substances gain access to the gingival tissues, initiate and perpetuate immunoinflammation, resulting in production of high levels of proinflammatory cytokines. These induce production of matrix metalloproteinases which destroy the connective tissues of the gingiva and periodontal ligament, and prostaglandins which mediate alveolar bone destruction. Periodontitis may enhance susceptibility to systemic diseases in several ways. LPS and viable Gram-negative bacteria from the biofilms and proinflammatory cytokines from the inflamed periodontal tissues may enter the circulation in pathogenic quantities. In addition, periodontitis and certain systemic diseases, such as cardiovascular disease, share risk factors including tobacco smoking, male gender, race/ethnicity, stress, and aging.