Searching Deep and Wide: Advances in the Molecular Understanding of Dental Caries and Periodontal Disease.
Searching Deep and Wide: Advances in the Molecular Understanding of Dental Caries and Periodontal Disease.
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DOI：
10.1177/0022034519877387
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发表时间：
2019-11-01
影响因子：
--
通讯作者：
Divaris, K
中科院分区：
文献类型：
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作者：
Divaris, K
在过去的几十年中，在理解两种最常见的口腔疾病，龋齿和牙周病的分子基础方面取得了显着的进展。我们对这些疾病的基础生物学知识的提高已经阐明了以前未被认识的发病机制。重要的是，口腔（龈上和龈下）微生物组的关键作用现在已经得到了很好的认识，这两种疾病现在最好被理解为生态失调。从宿主易感性的角度来看，在剖析"高度炎症"特征和牙周炎易感性的其他途径方面已经取得了一些进展，并且已经报道了龋齿的新易感性位点。然而，要将这些发现转化为现实，实现精准口腔健康，还有很长的路要走。有希望和希望的是，快速增加的生成多组学数据层的能力以及研究样本和由数千名参与者组成的队列的聚合将加速发现和翻译过程。在这个过程中的第一个关键因素是识别和询问的生物学信息的疾病性状，这些“深”或“精确”的性状有可能揭示生物同质的疾病签名和遗传易感性基因座，可能会出现重叠或异质的临床体征。第二个关键因素是形成国际联盟，其目标是结合和协调来自不同环境的数千人的口腔健康数据这些"广泛"的合作方法利用大样本量的力量，旨在发现或验证遗传影响，否则不可能检测到。重要的是，通过这些方向的进步需要系统生物学和团队科学模型的前所未有的参与。文章强调了新的见解龋齿和慢性牙周炎的分子基础，已获得从最近和正在进行的研究，涉及“深”和“宽”的分析方法。
During the past decades, remarkable progress has been made in the understanding of the molecular basis of the 2 most common oral diseases, dental caries and periodontal disease. Improvements in our knowledge of the diseases' underlying biology have illuminated previously unrecognized aspects of their pathogenesis. Importantly, the key role of the oral (supragingival and subgingival) microbiome is now well recognized, and both diseases are now best understood as dysbiotic. From a host susceptibility standpoint, some progress has been made in dissecting the "hyperinflammatory" trait and other pathways of susceptibility underlying periodontitis, and novel susceptibility loci have been reported for dental caries. Nevertheless, there is a long road to the translation of these findings and the realization of precision oral health. There is promise and hope that the rapidly increasing capacity of generating multiomics data layers and the aggregation of study samples and cohorts comprising thousands of participants will accelerate the discovery and translation processes. A first key element in this process has been the identification and interrogation of biologically informed disease traits-these "deep" or "precise" traits have the potential of revealing biologically homogeneous disease signatures and genetic susceptibility loci that might present with overlapping or heterogeneous clinical signs. A second key element has been the formation of international consortia with the goals of combining and harmonizing oral health data of thousands of individuals from diverse settings-these "wide" collaborative approaches leverage the power of large sample sizes and are aimed toward the discovery or validation of genetic influences that would otherwise be impossible to detect. Importantly, advancements via these directions require an unprecedented engagement of systems biology and team science models. The article highlights novel insights into the molecular basis of dental caries and chronic periodontitis that have been gained from recent and ongoing studies involving "deep" and "wide" analytical approaches.