Department of Diagnosis and Surgery, São Paulo State University-UNESP, School of Dentistry, Araraquara SP 14801-930, Brazil.
Department of Clinical Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro RJ 21941-617, Brazil.
Biomed Res Int. 2022 May 2;2022:5832009. doi: 10.1155/2022/5832009. eCollection 2022.
Periodontitis, a highly prevalent multicausal chronic inflammatory and destructive disease, develops as a result of complex host-parasite interactions. Dysbiotic bacterial biofilm in contact with the gingival tissues initiates a cascade of inflammatory events, mediated and modulated by the host's immune response, which is characterized by increased expression of several inflammatory mediators such as cytokines and chemokines in the connective tissue. If periodontal disease (PD) is left untreated, it results in the destruction of the supporting tissues around the teeth, including periodontal ligament, cementum, and alveolar bone, which lead to a wide range of disabilities and poor quality of life, thus imposing significant burdens. This process depends on the differentiation and activity of osteoclasts, the cells responsible for reabsorbing the bone tissue. Therefore, the inhibition of differentiation or activity of these cells is a promising strategy for controlling bone resorption. Several pharmacological drugs that target osteoclasts and inflammatory cells with immunomodulatory and anti-inflammatory effects, such as bisphosphonates, anti-RANK-L antibody, strontium ranelate, cathepsin inhibitors, curcumin, flavonoids, specialized proresolving mediators, and probiotics, were already described to manage inflammatory bone resorption during experimental PD progression in preclinical studies. Meantime, a growing number of studies have described the beneficial effects of herbal products in inhibiting bone resorption in experimental PD. Therefore, this review summarizes the role of several pharmacological drugs used for PD prevention and treatment and highlights the targeted action of all those drugs with antiresorptive properties. In addition, our review provides a timely and critical appraisal for the scientific rationale use of the antiresorptive and immunomodulatory medications in preclinical studies, which will help to understand the basis for its clinical application.
牙周炎是一种高发的多病因慢性炎症性破坏性疾病,是由于复杂的宿主-寄生虫相互作用而发展的。与牙龈组织接触的失调细菌生物膜会引发一连串的炎症事件,这些事件由宿主的免疫反应介导和调节,其特征是在结缔组织中增加了几种炎症介质(如细胞因子和趋化因子)的表达。如果牙周病(PD)得不到治疗,它会导致牙齿周围的支持组织(包括牙周韧带、牙骨质和牙槽骨)的破坏,从而导致广泛的残疾和生活质量下降,从而带来巨大的负担。这个过程取决于破骨细胞的分化和活性,破骨细胞是负责吸收骨组织的细胞。因此,抑制这些细胞的分化或活性是控制骨吸收的一种有前途的策略。几种具有免疫调节和抗炎作用的靶向破骨细胞和炎症细胞的药物,如双膦酸盐、抗 RANK-L 抗体、雷奈酸锶、组织蛋白酶抑制剂、姜黄素、类黄酮、专门的促解决介质和益生菌,已经在临床前研究中被描述为可用于控制实验性 PD 进展中的炎症性骨吸收。同时,越来越多的研究描述了草药产品在抑制实验性 PD 中骨吸收的有益作用。因此,本综述总结了几种用于 PD 预防和治疗的药物的作用,并强调了所有具有抗吸收特性的药物的靶向作用。此外,我们的综述还对这些具有抗吸收和免疫调节特性的药物在临床前研究中的科学合理应用进行了及时和批判性的评估,这将有助于理解其临床应用的基础。