Graves Dana
Division of Periodontology and Oral Biology, Goldman School of Dental Medicine, Boston University, 100 E. Newton Street, Boston, MA 02118, USA.
J Periodontol. 2008 Aug;79(8 Suppl):1585-91. doi: 10.1902/jop.2008.080183.
Although periodontal diseases are initiated by bacteria that colonize the tooth surface and gingival sulcus, the host response is believed to play an essential role in the breakdown of connective tissue and bone, key features of the disease process. An intermediate mechanism that lies between bacterial stimulation and tissue destruction is the production of cytokines, which stimulates inflammatory events that activate effector mechanisms. These cytokines can be organized as chemokines, innate immune cytokines, and acquired immune cytokines. Although they were historically identified as leukocyte products, many are also produced by a number of cell types, including keratinocytes, resident mesenchymal cells (such as fibroblasts and osteoblasts) or their precursors, dendritic cells, and endothelial cells. Chemokines are chemotactic cytokines that play an important role in leukocyte recruitment and may directly or indirectly modulate osteoclast formation. This article focuses on aspects of osteoimmunology that affect periodontal diseases by examining the role of cytokines, chemokines, and immune cell mediators. It summarizes some of the key findings that attempt to delineate the mechanisms by which immune factors can lead to the loss of connective tissue attachment and alveolar bone. In addition, a discussion is presented on the importance of clarifying the process of uncoupling, a process whereby insufficient bone formation occurs following resorption, which is likely to contribute to net bone loss in periodontal disease.
尽管牙周疾病是由定植于牙齿表面和牙龈沟的细菌引发的，但宿主反应被认为在结缔组织和骨的破坏（疾病进程的关键特征）中起着至关重要的作用。介于细菌刺激和组织破坏之间的一个中间机制是细胞因子的产生，细胞因子会刺激引发激活效应机制的炎症事件。这些细胞因子可分为趋化因子、固有免疫细胞因子和获得性免疫细胞因子。尽管它们在历史上被确定为白细胞产物，但许多细胞类型也能产生，包括角质形成细胞、常驻间充质细胞（如成纤维细胞和成骨细胞）或其前体细胞、树突状细胞和内皮细胞。趋化因子是趋化性细胞因子，在白细胞募集中起重要作用，并且可能直接或间接调节破骨细胞的形成。本文通过研究细胞因子、趋化因子和免疫细胞介质的作用，重点探讨影响牙周疾病的骨免疫学方面。它总结了一些关键发现，这些发现试图阐明免疫因子导致结缔组织附着丧失和牙槽骨吸收的机制。此外，还讨论了阐明解偶联过程的重要性，解偶联是一种吸收后骨形成不足的过程，这可能导致牙周疾病中的净骨丢失。
