Department of Oral Medicine Infection and Immunity, Harvard University School of Dental Medicine, Boston, MA.
J Periodontol. 2012 Nov;83(11):1407-19. doi: 10.1902/jop.2012.110655. Epub 2012 Feb 21.
Interleukin-1 (IL-1) gene polymorphisms have been associated with increased levels of inflammatory mediators and several inflammatory diseases. Periodontitis is a bacterially induced chronic inflammatory disease that destroys the connective tissues and bone that support the teeth, affects substantial numbers of adults, and has been implicated as a contributing factor in systemic diseases. IL-1 gene polymorphisms, most prominently IL1A (-889), IL1A (+4845), and IL1B (+3954), have been associated with chronic periodontitis (CP) in whites. Since the first report, ≥125 studies have examined IL-1 gene variation in relation to periodontal disease. These studies have produced mixed findings in diverse periodontal phenotypes and in different ethnic groups. One previous meta-analysis has been published on this topic and supported an association between IL-1 genes and periodontitis, but considerable doubt remains about the patient populations in which the association may be of clinical relevance.
A systematic review and meta-analysis was conducted in an attempt to clarify whether IL-1 gene variants were associated with well-defined clinical phenotypes of CP in white patients. Study inclusion criteria focused on the analytic framework originally proposed for the IL-1 genetic effect in which overexpression of inflammatory mediators is hypothesized to result in more severe periodontitis in response to a bacterial challenge.
Twenty-seven studies were included in the qualitative analysis. Nineteen studies yielded significant associations between carriage of the minor IL-1 alleles and periodontitis. The meta-analysis, based on 13 qualifying studies, found significant effects for the two individual gene variations (IL1A odds ratio [OR] = 1.48; IL1B OR = 1.54) and for a composite genotype that combines minor alleles at each locus (OR = 1.51). Statistically significant heterogeneity was found that could not be explained, but there was no indication of publication bias.
This review and meta-analysis show that IL1A and IL1B genetic variations are significant contributors to CP in whites.
白细胞介素-1（IL-1）基因多态性与炎症介质水平升高和多种炎症性疾病有关。牙周炎是一种由细菌引起的慢性炎症性疾病，会破坏支持牙齿的结缔组织和骨骼，影响大量成年人，并被认为是全身性疾病的一个促成因素。白细胞介素-1 基因多态性，尤其是 IL1A（-889）、IL1A（+4845）和 IL1B（+3954），与白人慢性牙周炎（CP）有关。自首次报道以来，已有≥125 项研究检查了白细胞介素-1 基因变异与牙周病的关系。这些研究在不同的牙周表型和不同的种族群体中产生了混合的结果。此前已经发表了一篇关于这个主题的荟萃分析，支持白细胞介素-1 基因与牙周炎之间存在关联，但对于可能具有临床相关性的患者群体仍存在相当大的疑问。
进行了系统的综述和荟萃分析，试图阐明白细胞介素-1 基因变异是否与白人患者 CP 的明确临床表型有关。研究纳入标准侧重于最初提出的白细胞介素-1 遗传效应分析框架，其中假设炎症介质的过度表达会导致对细菌挑战的反应更严重的牙周炎。
27 项研究纳入定性分析。19 项研究表明，携带 IL-1 等位基因的患者与牙周炎之间存在显著关联。基于 13 项合格研究的荟萃分析发现，两个个体基因变异（IL1A 比值比[OR] = 1.48；IL1B OR = 1.54）和组合每个位点的次要等位基因的复合基因型（OR = 1.51）存在显著影响。发现存在无法解释的统计学显著异质性，但没有表明存在发表偏倚。
本综述和荟萃分析表明，IL1A 和 IL1B 基因变异是白人 CP 的重要贡献者。
