Palmer R M, Scott D A, Meekin T N, Poston R N, Odell E W, Wilson R F
Department of Periodontology, Guy's, Kings School of Medicine & Dentistry, King's College London, UK.
J Periodontal Res. 1999 Oct;34(7):363-9. doi: 10.1111/j.1600-0765.1999.tb02267.x.
Tobacco smoking is probably the most important, controllable environmental risk factor in periodontitis. It results in changes in the vascular, inflammatory, immune and healing responses. The degree of exposure to tobacco smoking can be measured in pack years or by measuring serum cotinine and nicotine levels. In a previous paper we reported elevated levels of serum soluble intercellular adhesion molecule-1 (sICAM-1) in smokers, regardless of periodontal status. Elevated sICAM-1 has been found to be a risk marker for cardiovascular disease. In the present paper we report the short-term effects of an episode of smoking on blood flow and levels of sICAM-1. Human volunteers included non-smokers, light smokers and heavy smokers. Relative blood flow was monitored in the gingivae and forehead skin using a laser Doppler flowmeter and serum levels of sICAM-1, cotinine and nicotine measured before during and up to 60 min following an episode of smoking. We could not provide evidence to support the theory that there is localized vasoconstriction within the gingival tissues. In contrast, there was a significant increase in blood flow in the forehead skin of light smokers which was not observed in non-smoking controls or in heavy smokers, suggesting a long-term tolerance in this latter group. The level of sICAM-1 remained unchanged during this episode, further suggesting a long-term effect. In a parallel group of subjects, we were able to demonstrate a direct significant correlation between sICAM and serum cotinine levels. These observations may be relevant to aetiological mechanisms in periodontitis and other smoking-associated diseases.
吸烟可能是牙周炎最重要的、可控制的环境风险因素。它会导致血管、炎症、免疫和愈合反应发生变化。吸烟暴露程度可以用吸烟包年数来衡量，也可以通过测量血清可替宁和尼古丁水平来衡量。在之前的一篇论文中，我们报道了吸烟者血清可溶性细胞间黏附分子-1（sICAM-1）水平升高，无论其牙周状况如何。已发现sICAM-1水平升高是心血管疾病的一个风险标志物。在本文中，我们报告了一次吸烟事件对血流和sICAM-1水平的短期影响。人类志愿者包括非吸烟者、轻度吸烟者和重度吸烟者。使用激光多普勒血流仪监测牙龈和前额皮肤的相对血流，并在一次吸烟事件之前、期间以及之后长达60分钟测量血清sICAM-1、可替宁和尼古丁水平。我们无法提供证据支持牙龈组织内存在局部血管收缩的理论。相反，轻度吸烟者前额皮肤的血流显著增加，而在非吸烟对照组或重度吸烟者中未观察到这种情况，这表明后者存在长期耐受性。在此期间，sICAM-1水平保持不变，进一步表明存在长期影响。在一组平行的受试者中，我们能够证明sICAM与血清可替宁水平之间存在直接显著相关性。这些观察结果可能与牙周炎和其他吸烟相关疾病的病因机制有关。
