Rylev Mette, Kilian Mogens
Institute of Medical Microbiology and Immunology, University of Aarhus, Aarhus, Denmark.
J Clin Periodontol. 2008 Sep;35(8 Suppl):346-61. doi: 10.1111/j.1600-051X.2008.01280.x.
Detailed genetic analysis of bacteria has demonstrated an unanticipated genetic diversity within species, which often reveals evolutionary lineages that are disproportionately associated with infection. There is evidence that some evolutionary lineages of bacteria have adapted to particular ethnic groups.
This review analyzes to what extent observed differences in periodontal disease prevalence among ethnically or geographically distinct populations may be explained by restricted host adaptation of clones of principal periodontal pathogens.
Carriage rates of several putative periodontal pathogens and particular subsets of these species vary between ethnic groups. Few of these differences can, with the limited information available, be directly related to differences in periodontal disease prevalence. Asian populations are regularly colonized with Actinobacillus actinomycetemcomitans serotype c with questionable pathogenic potential. Conversely, the JP2 clone of A. actinomycetemcomitans has enhanced virulence and causes significantly higher prevalence of aggressive periodontitis in adolescents whose descent can be traced back to the Mediterranean and Western parts of Africa. Some genetically distinct types of Porphyromonas gingivalis are more associated with disease than others, but additional work is required to relate this to clinical differences.
Studies that take into account differences linked to the genetics of both patients and potential pathogens are likely to give better insight into the aetiology of periodontal diseases.
对细菌的详细基因分析表明，物种内部存在意想不到的基因多样性，这常常揭示出与感染不成比例相关的进化谱系。有证据表明，细菌的一些进化谱系已适应特定种族群体。
本综述分析了在种族或地理上不同的人群中观察到的牙周病患病率差异，在多大程度上可能是由主要牙周病原体克隆的宿主适应性受限所解释的。
几种假定的牙周病原体及其特定亚群的携带率在不同种族群体之间有所不同。根据现有有限信息，这些差异中很少能直接与牙周病患病率差异相关。亚洲人群经常被致病性存疑的伴放线放线杆菌血清型c定植。相反，伴放线放线杆菌的JP2克隆具有更强的毒力，在其祖先可追溯到地中海地区和非洲西部的青少年中，侵袭性牙周炎的患病率显著更高。牙龈卟啉单胞菌的一些基因不同类型比其他类型与疾病的关联更强，但需要更多研究将其与临床差异联系起来。
考虑到与患者和潜在病原体基因相关差异的研究，可能会更好地洞察牙周病的病因。
