Vaithilingam R D, Safii S H, Baharuddin N A, Ng C C, Cheong S C, Bartold P M, Schaefer A S, Loos B G
Faculty of Dentistry, Department of Restorative Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
J Periodontal Res. 2014 Dec;49(6):683-95. doi: 10.1111/jre.12167. Epub 2014 Feb 17.
Studies to elucidate the role of genetics as a risk factor for periodontal disease have gone through various phases. In the majority of cases, the initial 'hypothesis-dependent' candidate-gene polymorphism studies did not report valid genetic risk loci. Following a large-scale replication study, these initially positive results are believed to be caused by type 1 errors. However, susceptibility genes, such as CDKN2BAS (Cyclin Dependend KiNase 2B AntiSense RNA; alias ANRIL [ANtisense Rna In the Ink locus]), glycosyltransferase 6 domain containing 1 (GLT6D1) and cyclooxygenase 2 (COX2), have been reported as conclusive risk loci of periodontitis. The search for genetic risk factors accelerated with the advent of 'hypothesis-free' genome-wide association studies (GWAS). However, despite many different GWAS being performed for almost all human diseases, only three GWAS on periodontitis have been published - one reported genome-wide association of GLT6D1 with aggressive periodontitis (a severe phenotype of periodontitis), whereas the remaining two, which were performed on patients with chronic periodontitis, were not able to find significant associations. This review discusses the problems faced and the lessons learned from the search for genetic risk variants of periodontitis. Current and future strategies for identifying genetic variance in periodontitis, and the importance of planning a well-designed genetic study with large and sufficiently powered case-control samples of severe phenotypes, are also discussed.
旨在阐明遗传学作为牙周病风险因素所起作用的研究历经了多个阶段。在大多数情况下,最初的“基于假设”的候选基因多态性研究并未报告有效的遗传风险位点。经过大规模的重复研究,这些最初的阳性结果被认为是由I类错误导致的。然而,诸如细胞周期蛋白依赖性激酶2B反义RNA(CDKN2BAS;别名ANRIL [INK位点反义RNA])、含糖基转移酶6结构域1(GLT6D1)和环氧化酶2(COX2)等易感基因已被报告为牙周炎的确凿风险位点。随着“无假设”的全基因组关联研究(GWAS)的出现,对遗传风险因素的探索加速了。然而,尽管针对几乎所有人类疾病都开展了许多不同的GWAS,但关于牙周炎的GWAS仅发表了三项——一项报告了GLT6D1与侵袭性牙周炎(牙周炎的一种严重表型)的全基因组关联,而其余两项针对慢性牙周炎患者进行的研究未能发现显著关联。本综述讨论了在寻找牙周炎遗传风险变异过程中所面临的问题及吸取的教训。还讨论了当前和未来识别牙周炎遗传变异的策略,以及设计一项精心规划的、针对严重表型的大型且样本量充足的病例对照样本的遗传研究的重要性。