Role of Maternal Periodontitis in Preterm Birth.
Role of Maternal Periodontitis in Preterm Birth.
复制标题
母亲牙周炎在早产中的作用
DOI：
10.3389/fimmu.2017.00139
复制
发表时间：
2017
影响因子：
7.3
通讯作者：
Du M
中科院分区：
文献类型：
--
作者：
Ren H;Du M
在过去的二十年中，许多研究都集中在牙周炎是否是早产（PTB）的危险因素上。然而，流行病学调查和干预试验均从不同的研究中得出相互矛盾的结果。如何解释这些不同的发现，未来的研究应该如何进行以更好地评估这一风险因素？这篇文章回顾了最近的流行病学、动物和体外研究以及评估牙周炎和肺结核之间联系的干预试验。牙周炎可能作为微生物和炎症介质的远距离储存库，并有助于诱发PTB。动物研究表明，母体感染牙周病原体可增加循环IL-1β、IL-6、IL-8、IL-17和TNF-α水平，诱发PTB。体外模型显示牙周病原体/副产物诱导胎盘组织/细胞分泌COX-2、IL-8、IFN-γ和TNF-α和/或凋亡。牙周治疗预防PTB的有效性受牙周炎诊断标准、微生物群落组成、牙周炎严重程度、治疗策略、治疗效果和妊娠期治疗时间的影响。尽管干预试验报告了相互矛盾的结果，但口腔健康维护是预防保健的重要组成部分，在整个怀孕期间既有效又安全，应该在怀孕前和怀孕期间得到支持。随着相互矛盾的流行病学和干预研究的不断发表，这里提出了两种新的观点：(1)严重和/或全身性牙周炎促进PTB的发生；(2)牙周炎仅在年轻或感染hiv或有子痫前期、孕前肥胖或易感基因型的孕妇中促进PTB的发生。
In the last two decades, many studies have focused on whether periodontitis is a risk factor for preterm birth (PTB). However, both epidemiological investigation and intervention trials have reached contradictory results from different studies. What explains the different findings, and how should future studies be conducted to better assess this risk factor? This article reviews recent epidemiological, animal, and in vitro studies as well as intervention trials that evaluate the link between periodontitis and PTB. Periodontitis may act as a distant reservoir of microbes and inflammatory mediators and contribute to the induction of PTB. Animal studies revealed that maternal infections with periodontal pathogens increase levels of circulating IL-1β, IL-6, IL-8, IL-17, and TNF-α and induce PTB. In vitro models showed that periodontal pathogens/byproducts induce COX-2, IL-8, IFN-γ, and TNF-α secretion and/or apoptosis in placental tissues/cells. The effectiveness of periodontal treatment to prevent PTB is influenced by the diagnostic criteria of periodontitis, microbial community composition, severity of periodontitis, treatment strategy, treatment efficiency, and the period of treatment during pregnancy. Although intervention trials reported contradictory results, oral health maintenance is an important part of preventive care that is both effective and safe throughout pregnancy and should be supported before and during pregnancy. As contradictory epidemiological and intervention studies continue to be published, two new ideas are proposed here: (1) severe and/or generalized periodontitis promotes PTB and (2) periodontitis only promotes PTB for pregnant women who are young or HIV-infected or have preeclampsia, pre-pregnancy obesity, or susceptible genotypes.
影响因子：
4.3
作者：
Schenkein HA;Koertge TE;Sabatini R;Brooks CN;Gunsolley JC
通讯作者：
Gunsolley JC