Rajendran Maheaswari, Priyadharshini V, Arora Gaurav
Department of Periodontics, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India.
J Indian Soc Periodontol. 2013 Mar;17(2):169-74. doi: 10.4103/0972-124X.113064.
Current concept in periodontal diseases (PDs) states that it is the host's response toward the periodontal pathogens which leads to tissue destruction and attachment loss. Hence the role of immune response in the progression and resolution of PD must be considered vital. Any alteration in the immune system disturbs the homeostasis of the periodontium. Decline in immune system is the hallmark of aging, leading to increased susceptibility of elderly individuals to bacterial infections. The periodontal apparatus which is being constantly exposed to plaque biofilm is more vulnerable to destruction in aged individuals. Ageing related alterations in immune system has been discussed elsewhere as a contributor to various chronic inflammatory diseases like atherosclerosis, preterm, and low birth weight, etc. This paper reviews on the possible role of aging in periodontal destruction through altered immunity. Aging has long been associated with altered systemic inflammation. It has been discussed whether (1) this systemic inflammation is a consequence of increased occurrence of chronic inflammatory diseases upon aging or (2) aging associated systemic inflammation leads to such diseases. The immune responses which are protective at the first stages of life might result detrimental in the elderly. Hence it might be very difficult to individuate genetic profiles that might allow to identify individuals with a major risk for one or more age related diseases. Taking this into consideration, the cause of PDs in elderly is addressed with a systemic approach in order to understand the complex interplay between the aging immunity and PDs.
当前牙周疾病(PDs)的概念表明,是宿主对牙周病原体的反应导致了组织破坏和附着丧失。因此,免疫反应在PD进展和消退中的作用必须被视为至关重要。免疫系统的任何改变都会扰乱牙周组织的稳态。免疫系统衰退是衰老的标志,导致老年人更容易受到细菌感染。不断暴露于菌斑生物膜的牙周组织在老年人中更容易受到破坏。免疫系统与衰老相关的改变在其他地方已被讨论为导致各种慢性炎症性疾病(如动脉粥样硬化、早产和低出生体重等)的一个因素。本文综述了衰老通过改变免疫在牙周破坏中可能发挥的作用。长期以来,衰老一直与全身性炎症的改变有关。人们一直在讨论:(1)这种全身性炎症是衰老后慢性炎症性疾病发生率增加的结果,还是(2)与衰老相关的全身性炎症导致了这些疾病。在生命早期具有保护作用的免疫反应在老年人中可能会产生有害影响。因此,可能很难确定能够识别出患一种或多种与年龄相关疾病风险较高个体的基因特征。考虑到这一点,本文采用系统方法探讨老年人PDs的病因,以了解衰老免疫与PDs之间复杂的相互作用。