Schenkein Harvey A, Loos Bruno G
Department of Periodontics, Virginia Commonwealth University, Richmond, VA 23298-0566, USA.
J Clin Periodontol. 2013 Apr;40 Suppl 14(0 14):S51-69. doi: 10.1111/jcpe.12060.
In this article, inflammatory mechanisms that link periodontal diseases to cardiovascular diseases are reviewed.
This article is a literature review.
Studies in the literature implicate a number of possible mechanisms that could be responsible for increased inflammatory responses in atheromatous lesions due to periodontal infections. These include increased systemic levels of inflammatory mediators stimulated by bacteria and their products at sites distant from the oral cavity, elevated thrombotic and hemostatic markers that promote a prothrombotic state and inflammation, cross-reactive systemic antibodies that promote inflammation and interact with the atheroma, promotion of dyslipidemia with consequent increases in pro-inflammatory lipid classes and subclasses, and common genetic susceptibility factors present in both disease leading to increased inflammatory responses.
Such mechanisms may be thought to act in concert to increase systemic inflammation in periodontal disease and to promote or exacerbate atherogenesis. However, proof that the increase in systemic inflammation attributable to periodontitis impacts inflammatory responses during atheroma development, thrombotic events or myocardial infarction or stroke is lacking.
本文对将牙周疾病与心血管疾病联系起来的炎症机制进行综述。
本文为一篇文献综述。
文献研究表明,牙周感染可能通过多种机制导致动脉粥样硬化病变中的炎症反应增强。这些机制包括:口腔外部位细菌及其产物刺激导致全身炎症介质水平升高;促进血栓形成状态和炎症的血栓形成及止血标志物升高;促进炎症并与动脉粥样瘤相互作用的交叉反应性全身抗体;导致促炎脂质类别和亚类增加的血脂异常;以及两种疾病中均存在的导致炎症反应增强的共同遗传易感性因素。
这些机制可能共同作用,增加牙周疾病中的全身炎症,并促进或加剧动脉粥样硬化的发生。然而,目前缺乏证据表明牙周炎所致的全身炎症增加会影响动脉粥样硬化发展、血栓形成事件或心肌梗死或中风期间的炎症反应。