Department of Pharmaceutical Biology and Botany, Wroclaw Medical University, 50556 Wroclaw, Poland.
Department of Dental Surgery, Wroclaw Medical University, 50425 Wroclaw, Poland.
Nutrients. 2021 Jan 15;13(1):239. doi: 10.3390/nu13010239.
This paper continues the systematic review on proanthocyanidins and flavan-3-ols in the prevention and treatment of periodontal disease and covers the immunomodulatory effects, and animal- and clinical studies, while the other part discussed the direct antibacterial properties. Inflammation as a major response of the periodontal tissues attacked by pathogenic microbes can significantly exacerbate the condition. However, the bidirectional activity of phytochemicals that simultaneously inhibit bacterial proliferation and proinflammatory signaling can provide a substantial alleviation of both cause and symptoms. The modulatory effects on various aspects of inflammatory and overall immune response are covered, including confirmed and postulated mechanisms of action, structure activity relationships and molecular targets. Further, the clinical relevance of flavan-3-ols and available outcomes from clinical studies is analyzed and discussed. Among the numerous natural sources of flavan-3-ols and proanthocyanidins the most promising are, similarly to antibacterial properties, constituents of various foods, such as fruits of species, tea leaves, grape seeds, and tannin-rich medicinal herbs. Despite a vast amount of in vitro and cell-based evidence of immunomodulatory there are still only a few animal and clinical studies. Most of the reports, regardless of the used model, indicated the efficiency of these phytochemicals from cranberries and other species and tea extracts (green or black). Other sources such as grape seeds and traditional medicinal plants, were seldom. In conclusion, the potential of flavan-3-ols and their derivatives in prevention and alleviation of periodontal disease is remarkable but clinical evidence is urgently needed for issuing credible dietary recommendation and complementary treatments.
本文延续了关于原花青素和黄烷-3-醇在预防和治疗牙周病方面的系统综述，涵盖了其免疫调节作用，以及动物和临床研究，而另一部分则讨论了其直接的抗菌特性。炎症是牙周组织受到致病微生物攻击的主要反应，会显著加重病情。然而，植物化学物质的双向活性可以同时抑制细菌增殖和促炎信号，从而为病因和症状提供实质性的缓解。本文涵盖了对炎症和整体免疫反应各个方面的调节作用，包括已证实和推测的作用机制、构效关系和分子靶点。此外，还分析和讨论了黄烷-3-醇的临床相关性和临床研究的结果。在黄烷-3-醇和原花青素的众多天然来源中，最有前途的是各种食物的成分，如 种果实、茶叶、葡萄籽和富含单宁的草药，它们同样具有抗菌特性。尽管有大量体外和基于细胞的免疫调节证据，但仍只有少数动物和临床研究。大多数报告，无论使用何种模型，都表明了这些来自蔓越莓和其他 种植物以及茶提取物（绿茶或红茶）的植物化学物质的功效。其他来源，如葡萄籽和传统药用植物，则很少有报道。总之，黄烷-3-醇及其衍生物在预防和缓解牙周病方面具有显著的潜力，但为了发布可信的饮食建议和补充治疗，迫切需要临床证据。
