Hassell T M, Harris E L
Department of Periodontology, College of Dentistry, University of Florida, Gainesville 32610, USA.
Crit Rev Oral Biol Med. 1995;6(4):319-42. doi: 10.1177/10454411950060040401.
Deciphering the relative roles of heredity and environmental factors ("nature vs. nurture") in the pathogenesis of dental caries and diseases of the periodontium has occupied clinical and basic researchers for decades. Success in the endeavor has come more easily in the case of caries; the complex interactions that occur between host-response mechanisms and putative microbiologic pathogens in periodontal disease have made elucidation of genetic factors in disease susceptibility more difficult. In addition, during the 30-year period between 1958 and 1987, only meager resources were targeted toward the "nature" side of the nature/nurture dipole in periodontology. In this article, we present a brief history of the development of genetic epistemology, then describe the three main research mechanisms by which questions about the hereditary component of diseases in humans can be addressed. A critical discussion of the evidence for a hereditary component in caries susceptibility is next presented, also from a historical perspective. The evolution of knowledge concerning possible genetic ("endogenous", "idiotypic") factors in the pathogenesis of inflammatory periodontal disease is initiated with an analysis of some foreign-language (primarily German) literature that is likely to be unfamiliar to the reader. We identify a turning point at about 1960, when the periodontal research community turned away from genetics in favor of microbiology research. During the past five years, investigators have re-initiated the search for the hereditary component in susceptibility to common adult periodontal disease; this small but growing body of literature is reviewed. Recent applications of in vitro methods for genetic analyses in periodontal research are presented, with an eye toward a future in which persons who are at risk--genetically predisposed--to periodontal disease may be identified and targeted for interventive strategies. Critical is the realization that genes and environment do not act independently of each other; the appearance or magnitude of heritability may differ with various environments.
几十年来，临床和基础研究人员一直在探讨遗传因素和环境因素（“先天与后天”）在龋齿和牙周疾病发病机制中的相对作用。在龋齿方面，这一努力取得成功相对较为容易；而在牙周疾病中，宿主反应机制与假定的微生物病原体之间发生的复杂相互作用，使得阐明疾病易感性中的遗传因素变得更加困难。此外，在1958年至1987年的30年间，牙周病学领域针对“先天/后天”二元关系中“先天”方面的研究资源非常匮乏。在本文中，我们简要介绍了遗传认识论的发展历程，然后描述了三种主要的研究机制，通过这些机制可以探讨人类疾病遗传成分的相关问题。接下来，我们也从历史角度对龋齿易感性中遗传成分的证据进行批判性讨论。通过分析一些读者可能不熟悉的外语（主要是德语）文献，开始阐述有关炎症性牙周疾病发病机制中可能的遗传（“内源性”“个体基因型”）因素的知识演变。我们确定了大约1960年的一个转折点，当时牙周研究界从遗传学转向了微生物学研究。在过去五年中，研究人员重新开始寻找常见成人牙周疾病易感性中的遗传成分；本文对这一虽小但不断增长的文献进行了综述。本文介绍了牙周研究中体外基因分析方法的最新应用，着眼于未来能够识别出有患牙周疾病遗传倾向的高危人群，并针对他们采取干预策略。关键在于认识到基因和环境并非相互独立起作用；遗传度的表现或程度可能因不同环境而有所不同。
