Department of Pathophysiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Periodontics and Endodontics, Okayama University Hospital, Okayama, Japan.
Front Immunol. 2019 Feb 26;10:307. doi: 10.3389/fimmu.2019.00307. eCollection 2019.
Periapical periodontitis results from pulpal infection leading to pulpal necrosis and resorption of periapical bone. The current treatment is root canal therapy, which attempts to eliminate infection and necrotic tissue. But, in some cases periapical inflammation doesn't resolve even after treatment. Resolvins belongs to a large family of specialized pro-resolving lipid mediators that actively resolves inflammation signaling via specific receptors. Resolvin D2 (RvD2), a metabolite of docosahexaenoic acid (DHA), was tested as an intracanal medicament in rats . Mechanism was evaluated in rat primary dental pulp cells (DPCs) . The results demonstrate that RvD2 reduces inflammatory cell infiltrate, periapical lesion size, and fosters pulp like tissue regeneration and healing of periapical lesion. RvD2 enhanced expression of its receptor, GPR18, dentin matrix acidic phosphoprotein 1 (DMP1) and mineralization and . Moreover, RvD2 induces phosphorylation of Stat3 transcription factor in dental pulp cells. We conclude that intracanal treatment with RvD2 resolves inflammation and promoting calcification around root apex and healing of periapical bone lesions. The data suggest that RvD2 induces active resolution of inflammation with pulp-like tissue regeneration after root canal infection and thus maybe suitable for treating periapical lesions.
根尖周炎是由牙髓感染导致牙髓坏死和根尖骨吸收引起的。目前的治疗方法是根管治疗,试图消除感染和坏死组织。但是,在某些情况下,即使经过治疗,根尖炎症仍未得到解决。消退素属于专门的促解决脂质介质大家族,通过特定的受体积极解决炎症信号。二十二碳六烯酸 (DHA) 的代谢产物 RvD2 已在大鼠中作为根管内药物进行测试。在大鼠原代牙髓细胞 (DPC) 中评估了其机制。结果表明,RvD2 可减少炎症细胞浸润、根尖病变大小,并促进牙髓样组织再生和根尖病变愈合。RvD2 增强了其受体 GPR18、牙本质基质酸性磷酸蛋白 1 (DMP1) 和矿化的表达。此外,RvD2 诱导牙髓细胞中 Stat3 转录因子的磷酸化。我们得出结论,根管内用 RvD2 治疗可解决炎症并促进根尖周围钙化和根尖骨病变的愈合。数据表明,RvD2 在根管感染后诱导具有牙髓样组织再生的炎症积极消退,因此可能适合治疗根尖病变。
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