在美国有近一半的成年人患有牙龈疾病,其中8.5%的人比较严重,可增加心脏病、糖尿病、关节炎和妊娠并发症的风险。
美国宾夕法尼亚大学的研究人员一直以来都在寻找阻止和逆转牙周炎的方法。最近在免疫学权威杂志《Journal of Immunology》发表的一项研究中,他们描述了一个很有前途的新靶点:免疫系统的一个组成部分,称为补体(complement)。研究人员用一种补体抑制剂治疗猿猴,成功地阻止了牙周炎相关的炎症和骨质流失,使其成为治疗这类疾病的一种很有前途的药物。 本文资深作者、牙科医学院微生物系教授George Hajishengallis,与共同资深作者、佩雷尔曼医学院病理系医学实验室教授John Lambris 博士共同合作完成了这项研究。 该研究小组先前的工作表明,牙周菌牙龈卟啉单胞菌(Porphyromonas gingivalis)可阻碍免疫细胞清除感染的能力,使P. gingivalis和其他细菌蓬勃发展并使牙龈组织发炎。 Hajishengallis说:“P. gingivalis有很多机制来逃避免疫系统的杀伤,但是完全摆脱炎症对于它们并不好,因为它们以此作为食物来源。所以P. gingivalis通过为其他细菌创建一种宜人的环境,从而帮助抑制免疫系统。” 研究人员想找出补体系统的哪些成分可能参与导致并保持疾病中的炎症。他们的实验集中在第三补体成分C3,它在触发炎症和先天免疫系统激活的信号级联反应中占据关键的位置。 研究小组发现,缺乏C3的培育小鼠,在感染P. gingivalis几周后,与正常小鼠相比牙龈具有更少的骨质流失和炎症。C3不足小鼠也免受其他两种疾病模型的牙周炎:结扎线法引起的牙周炎和衰老有关的牙周炎。 Hajishengallis指出:“如果没有一个不同补体成分(C5a受体)的参与,P. gingivalis就不能在牙龈定植。但是,如果没有C3,疾病就不能长期持续下去。” 根据这一发现,研究人员检测了一种可阻断C3的人类药物,看看它们是否能减少猿猴牙周疾病的迹象,猿猴不同于小鼠,它会对人类药物作出反应。他们发现,C3抑制剂(一种称为Cp40的药物,用来治疗罕见血液病PNH和ABO血型不相容肾移植),可减少炎症并显著保护猿猴免于骨质流失。 Lambris称:“我们认为,这种药物为治疗成人牙周炎,提供了一种新的可能性。局部性地阻断口腔中的C3,可帮助改变细菌的平衡,产生一种全面有益的作用。” 原文摘要: Genetic and Intervention Studies Implicating Complement C3 as a Major Target for the Treatment of Periodontitis Abstract: Chronic periodontitis is induced by a dysbiotic microbiota and leads to inflammatory destruction of tooth-supporting connective tissue and bone. The third component of complement, C3, is a point of convergence of distinct complement activation mechanisms, but its involvement in periodontitis was not previously addressed. We investigated this question using two animal species models, namely, C3-deficient or wild-type mice and nonhuman primates (NHPs) locally treated with a potent C3 inhibitor (the compstatin analog Cp40) or an inactive peptide control. In mice, C3 was required for maximal periodontal inflammation and bone loss, and for the sustenance of the dysbiotic microbiota. The effect of C3 on the microbiota was therefore different from that reported for the C5a receptor, which is required for the initial induction of dysbiosis. C3-dependent bone loss was demonstrated in distinct models, including Porphyromonas gingivalis–induced periodontitis, ligature-induced periodontitis, and aging-associated periodontitis. Importantly, local treatment of NHPs with Cp40 inhibited ligature-induced periodontal inflammation and bone loss, which correlated with lower gingival crevicular fluid levels of proinflammatory mediators (e.g., IL-17 and RANKL) and decreased osteoclastogenesis in bone biopsy specimens, as compared with control treatment. To our knowledge, this is the first time, for any disease, that complement inhibition in NHPs was shown to inhibit inflammatory processes that lead to osteoclastogenesis and bone loss. These data strongly support the feasibility of C3-targeted intervention for the treatment of human periodontitis. 2万家牙科招聘,6万名牙医求职,上康强医疗人才网 www.kq36.com
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