Dubuc Antoine, Planat-Bénard Valérie, Marty Mathieu, Monsarrat Paul, Kémoun Philippe
Dental Faculty, Paul Sabatier University, Toulouse Hospital (Hôpitaux de Toulouse) University, and Toulouse Institute of Oral Medicine, Toulouse, France.
RESTORE Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France.
Adv Exp Med Biol. 2022;1373:377-397. doi: 10.1007/978-3-030-96881-6_20.
Periodontitis is a chronic inflammatory disease characterized by the loss of tooth-supporting tissues (or periodontium) leading to the formation of periodontal pocket then to tooth loss. Conventional therapies that involve tooth root debridement are still disappointing because they are more centered on periodontal repair than disease pathophysiology causes. The meta-analysis we present here focused on the results of experimental studies that investigated periodontal mesenchymal stromal cells (MSCs) therapy, a promising strategy to regenerate tissue, given to their immunomodulatory and trophic properties.
Using PubMed database and ICTRP search portal, 84 animal and 3 randomized human studies were analyzed.
Overall, our results highlighted that MSCs grafting, regardless of their tissue origin, enhances periodontal regeneration. A defect morphology suitable for an initial clot stabilization increases the procedure efficacy, especially if cells are carried using a vehicle from natural origin. Nevertheless, methodological biases have been highlighted and still limit the translation to human with high prognosis and regulatory considerations. Besides, because only 2 randomized human trials demonstrated the efficacy of the procedure, further studies are needed to investigate periodontal regeneration procedures on experimental models closer to human pathophysiology.
Although MSCs grafting in periodontal disease demonstrated therapeutic benefits in animal, it is critical to define more accurately protocols translatable to human and focus on the treatment of the pathology as a whole rather than on the restitution of the sole destroyed tissues.
牙周炎是一种慢性炎症性疾病，其特征是牙齿支持组织（或牙周组织）丧失，导致牙周袋形成，进而导致牙齿脱落。涉及牙根清创术的传统疗法仍然令人失望，因为它们更多地侧重于牙周修复，而非疾病的病理生理原因。我们在此呈现的荟萃分析聚焦于实验研究的结果，这些研究调查了牙周间充质干细胞（MSC）疗法，鉴于其免疫调节和营养特性，这是一种有前景的组织再生策略。
使用PubMed数据库和ICTRP搜索门户，分析了84项动物研究和3项随机对照人体研究。
总体而言，我们的结果突出表明，无论MSC的组织来源如何，其移植均可增强牙周组织再生。适合初始血凝块稳定的缺损形态可提高该治疗方法的疗效，特别是当细胞通过天然来源的载体携带时。然而，已发现方法学上的偏差，这些偏差在高预后和监管考量方面仍然限制了向人体的转化。此外，由于仅有2项随机对照人体试验证明了该治疗方法的有效性，因此需要进一步研究，以在更接近人类病理生理学的实验模型上研究牙周组织再生方法。
尽管在牙周疾病中移植MSC在动物实验中显示出治疗益处，但至关重要的是更准确地定义可转化为人体应用的方案，并将重点放在对整个疾病的治疗上，而非仅对受损组织的修复。
