Gaffen S L, Herzberg M C, Taubman M A, Van Dyke T E
Department of Medicine, University of Pittsburgh, Division of Rheumatology & Clinical Immunology, S702 BST, 3500 Terrace Street, Pittsburgh, PA 15261, USA.
Adv Dent Res. 2014 May;26(1):30-7. doi: 10.1177/0022034514525778.
The innate and adaptive immune systems are both crucial to oral disease mechanisms and their impact on systemic health status. Greater understanding of these interrelationships will yield opportunities to identify new therapeutic targets to modulate disease processes and/or increase host resistance to infectious or inflammatory insult. The topics addressed reflect the latest advances in our knowledge of the role of innate and adaptive immune systems and inflammatory mechanisms in infectious diseases affecting the oral cavity, including periodontitis and candidiasis. In addition, several potential links with systemic inflammatory conditions, such as cardiovascular disease, are explored. The findings elucidate some of the defense mechanisms utilized by host tissues, including the role of IL-17 in providing immunity to oral candidiasis, the antimicrobial defense of mucosal epithelial cells, and the pro-resolution effects of the natural inflammatory regulators, proresolvins and lipoxins. They also describe the role of immune cells in mediating pathologic bone resorption in periodontal disease. These insights highlight the potential for therapeutic benefit of immunomodulatory interventions that bolster or modulate host defense mechanisms in both oral and systemic disease. Among the promising new therapeutic approaches discussed here are epithelial cell gene therapy, passive immunization against immune cell targets, and the use of proresolvin agents.
先天性免疫系统和适应性免疫系统对于口腔疾病机制及其对全身健康状况的影响都至关重要。对这些相互关系的更深入理解将为识别新的治疗靶点带来机会,以调节疾病进程和/或增强宿主对感染或炎症损伤的抵抗力。所讨论的主题反映了我们对先天性免疫系统和适应性免疫系统的作用以及炎症机制在影响口腔的传染病(包括牙周炎和念珠菌病)方面的最新认识进展。此外,还探讨了与全身炎症性疾病(如心血管疾病)的一些潜在联系。这些发现阐明了宿主组织所利用的一些防御机制,包括白细胞介素-17在提供针对口腔念珠菌病的免疫力中的作用、黏膜上皮细胞的抗菌防御以及天然炎症调节剂促消退素和脂氧素的促消退作用。它们还描述了免疫细胞在介导牙周病病理性骨吸收中的作用。这些见解凸显了免疫调节干预措施在增强或调节口腔和全身疾病中的宿主防御机制方面的治疗益处潜力。本文讨论的有前景的新治疗方法包括上皮细胞基因治疗、针对免疫细胞靶点的被动免疫以及促消退素制剂的使用。