牙周炎与不良妊娠结局相关关系的研究进展

doi:10.13591/j.cnki.kqyx.2022.10.013

摘要/Abstract

摘要： 牙周炎是由牙周致病菌感染引起的慢性炎症性疾病,在妊娠妇女中更容易发生。不良妊娠结局是新生儿围产期死亡的重要原因,受机体全身炎症的影响。该文主要对牙周炎与不良妊娠结局的相关性进行阐述,进一步从阴道感染、菌血症、免疫炎症和肠道菌群方面对其机制进行探讨,并简述了牙周炎与不良妊娠结局共有的宿主易感性遗传背景,以期为临床上预防妊娠期牙周病和不良妊娠结局提供一定的理论指导。

关键词: 牙周炎, 不良妊娠结局, 牙龈卟啉单胞菌, 机制

Abstract: Periodontitis is a chronic inflammatory disease caused by periodontal pathogen infection, which is more likely to occur in pregnant women. Adverse pregnancy outcome is an important cause for perinatal death of newborn, which is affected by systemic inflammation. This paper expounds the correlation between periodontitis and adverse pregnancy outcomes, further explores its mechanism from aspects of vaginal infection, bacteremia, immune inflammation, and intestinal flora, and briefly describes host′s susceptibility to periodontitis and adverse pregnancy outcomes in genetic background, in order to provide theoretical guidance for the prevention of periodontal diseases in pregnancy and adverse pregnancy outcomes in clinical practice.

Key words: periodontitis, adverse pregnancy outcome, Porphyromonas gingivalis, mechanism

中图分类号:

R781.42

白雪, 高晋华, 任秀云. 牙周炎与不良妊娠结局相关关系的研究进展[J]. 口腔医学, 2022, 42(10): 932-937.

BAI Xue, GAO Jinhua, REN Xiuyun. Research progress of the relationship between periodontitis and adverse pregnancy outcomes[J]. Stomatology, 2022, 42(10): 932-937.

参考文献

[1] Madianos PN, Bobetsis YA, Offenbacher S. Adverse pregnancy outcomes (APOs) and periodontal disease:Pathogenic mechanisms[J]. J Clin Periodontol, 2013, 40(Suppl 14):S170-S180.
[2] Gomez-Lopez N,Laresgoiti-Servitje E, Olson DM, et al. The role of chemokines in term and premature rupture of the fetal membranes:A review[J]. Biol Reprod, 2010, 82(5):809-814.
[3] Leimert KB, Xu W, Princ MM, et al. Inflammatory amplification:A central tenet of uterine transition for labor[J]. Front Cell Infect Microbiol, 2021, 11:660983.
[4] Raju K, Berens L. Periodontology and pregnancy:An overview of biomedical and epidemiological evidence[J].Periodontol 2000, 2021, 87(1):132-142.
[5] 陈敦金. 降低中国单胎早产发生率任重道远[J]. 中华围产医学杂志, 2018, 21(6):362-366.
[6] Bobetsis YA, Graziani F, Gürsoy M, et al. Periodontal disease and adverse pregnancy outcomes[J]. Periodontol 2000, 2020, 83(1):154-174.
[7] Sanz M, Marco del Castillo A, Jepsen S, et al. Periodontitis and cardiovascular diseases:Consensus report[J]. J Clin Periodontol, 2020, 47(3):268-288.
[8] Jajoo NS, Shelke AU, Bajaj RS, et al. Association of periodontitis with pre term low birth weight-A review[J]. Placenta, 2020, 95:62-68.
[9] Offenbacher S, Katz V, Fertik G, et al. Periodontal infection as a possible risk factor for preterm low birth weight[J]. J Periodontol, 1996, 67(10 Suppl):1103-1113.
[10] Figueiredo MGOP, Takita SY, Dourado BMR, et al. Periodontal disease:Repercussions in pregnant woman and newborn health—A cohort study[J]. PLoS One, 2019, 14(11):e0225036.
[11] Gesase N, Miranda-Rius J, Brunet-Llobet L, et al. The association between periodontal disease and adverse pregnancy outcomes in Northern Tanzania:A cross-sectional study[J]. Afr Health Sci, 2018, 18(3):601-611.
[12] 陈晓英, 覃猇姝, 吴贾涵, 等. 孕前妇女罹患牙周病与胎儿早产及低体重儿的相关性研究[J]. 临床口腔医学杂志, 2019, 35(8):471-474.
[13] Berger R, Abele H,Bahlmann F, et al. Prevention and therapy of preterm birth. guideline of the DGGG, OEGGG and SGGG (S2k level, AWMF registry number 015/025, February 2019)-part 1 with recommendations on the epidemiology, etiology, prediction, primary and secondary prevention of preterm birth[J]. Geburtshilfe Frauenheilkd, 2019, 79(8):800-812.
[14] Sanz M,Kornman K, of the joint EFP/AAP workshop WG3. Periodontitis and adverse pregnancy outcomes:Consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases[J]. J Periodontol, 2013, 84(4 Suppl):S164-S169.
[15] Figuero E, Han YW, Furuichi Y. Periodontal diseases and adverse pregnancy outcomes:Mechanisms[J]. Periodontol 2000, 2020, 83(1):175-188.
[16] Vanterpool SF, Been JV,Houben ML, et al. Porphyromonas gingivalis within placental villous mesenchyme and umbilical cord stroma is associated with adverse pregnancy outcome[J]. PLoS One, 2016, 11(1):e0146157.
[17] Ye CC,Katagiri S, Miyasaka N, et al. The periodontopathic bacteria in placenta, saliva and subgingival plaque of threatened preterm labor and preterm low birth weight cases:A longitudinal study in Japanese pregnant women[J]. Clin Oral Investig, 2020, 24(12):4261-4270.
[18] Ebersole JL, Holt SC, Cappelli D. Periodontitis in pregnant baboons:Systemic inflammation and adaptive immune responses and pregnancy outcomes in a baboon model[J]. J Periodontal Res, 2014, 49(2):226-236.
[19] Ao M, Miyauchi M, Furusho H, et al. Dental infection of Porphyromonas gingivalis induces preterm birth in mice[J]. PLoS One, 2015, 10(8):e0137249.
[20] Phillips P, Brown MB,Progulske-Fox A, et al. Porphyromonas gingivalis strain-dependent inhibition of uterine spiral artery remodeling in the pregnant rat[J]. Biol Reprod, 2018, 99(5):1045-1056.
[21] Polyzos NP, Polyzos IP, Mauri D, et al. Effect of periodontal disease treatment during pregnancy on preterm birth incidence:A metaanalysis of randomized trials[J]. Am J Obstet Gynecol, 2009, 200(3):225-232.
[22] Bi WG,Emami E, Luo ZC, et al. Effect of periodontal treatment in pregnancy on perinatal outcomes:A systematic review and meta-analysis[J]. J Matern Fetal Neonatal Med, 2021, 34(19):3259-3268.
[23] Committee Opinion. No. 569:Oral health care during pregnancy and through the lifespan[J]. Obstet Gynecol,2013,122(2 Pt 1):417-422.
[24] Creative Commons Attribution 3.0 Unported License [EB/OL](2021-09-23).https://creativecommons.org/licenses/by/3.0./ppt.
[25] Saadaoui M, Singh P, Al Khodor S. Oral microbiome and pregnancy:A bidirectional relationship[J]. J Reprod Immunol, 2021, 145:103293.
[26] 齐帅, 林晓萍. 牙龈卟啉单胞菌与不良妊娠结局的相关研究进展[J]. 口腔医学, 2021, 41(3):265-268.
[27] Gómez LA, de Avila J, Castillo DM, et al. Porphyromonas gingivalis placental atopobiosis and inflammatory responses in women with adverse pregnancy outcomes[J]. Front Microbiol, 2020, 11:591626.
[28] 张明珠, 雷雅燕, 杨帆, 等. 牙周可疑致病菌感染与细菌性阴道炎的关系[J]. 牙体牙髓牙周病学杂志, 2013, 23(12):779-782.
[29] Terzic M, Aimagambetova G, Terzic S, et al. Periodontal pathogens and preterm birth:Current knowledge and further interventions[J]. Pathogens, 2021, 10(6):730.
[30] Agarwal K, Robinson LS, Aggarwal S, et al. Glycan cross-feeding supports mutualism between Fusobacterium and the vaginal microbiota[J]. PLoS Biol, 2020, 18(8):e3000788.
[31] Amabebe E, Anumba DOC. The vaginal microenvironment:The physiologic role of lactobacilli[J]. Front Med (Lausanne), 2018, 5:181.
[32] Brosens I, Puttemans P, Benagiano G. Placental bed research:I. The placental bed:From spiral arteries remodeling to the great obstetrical syndromes[J]. Am J Obstet Gynecol, 2019, 221(5):437-456.
[33] Liang S, Ren H, Guo H, et al. Periodontal infection with Porphyromonas gingivalis induces preterm birth and lower birth weight in rats[J]. Mol Oral Microbiol, 2018, 33(4):312-321.
[34] Ren HY, Li YH, Jiang H, et al. Porphyromonas gingivalis induces IL-8 and IFN-gamma secretion and apoptosis in human extravillous trophoblast derived HTR8/SVneo cells via activation of ERK1/2 and p38 signaling pathways[J]. Placenta, 2016, 45:8-15.
[35] 梁珊珊, 邢文燕, 季耀庭, 等. 牙龈卟啉单胞菌对大鼠胎盘及仔鼠出生体重的影响[J]. 口腔医学研究, 2018, 34(5):495-499.
[36] Chopra A, Radhakrishnan R, Sharma M. Porphyromonas gingivalis and adverse pregnancy outcomes:A review on its intricate pathogenic mechanisms[J]. Crit Rev Microbiol, 2020, 46(2):213-236.
[37] 齐帅, 林晓萍. 牙周炎和胎膜早破的关系及其炎症介质的研究进展[J]. 口腔医学, 2021, 41(5):465-469.
[38] Nemeth E, Valore EV,Territo M, et al. Hepcidin, a putative mediator of Anemia of inflammation, is a type Ⅱ acute-phase protein[J]. Blood, 2003, 101(7):2461-2463.
[39] Sangkhae V, Nemeth E. Regulation of the iron homeostatic hormone hepcidin[J]. Adv Nutr, 2017, 8(1):126-136.
[40] Sangkhae V, Fisher AL, Chua KJ, et al. Maternal hepcidin determines embryo iron homeostasis in mice[J]. Blood, 2020, 136(19):2206-2216.
[41] Olsen I,Hajishengallis G. Major neutrophil functions subverted by Porphyromonas gingivalis[J]. J Oral Microbiol, 2016, 8:30936.
[42] Schoots MH, Gordijn SJ, Scherjon SA, et al. Oxidative stress in placental pathology[J]. Placenta, 2018, 69:153-161.
[43] Menon R, Yu J,Basanta-Henry P, et al. Short fetal leukocyte telomere length and preterm prelabor rupture of the membranes[J]. PLoS One, 2012, 7(2):e31136.
[44] Hays A, Duan XY, Zhu JX, et al. Down-regulated Treg cells in exacerbated periodontal disease during pregnancy[J]. Int Immunopharmacol, 2019, 69:299-306.
[45] Fu BQ, Tian ZG, Wei HM. TH17 cells in human recurrent pregnancy loss and pre-eclampsia[J]. Cell Mol Immunol, 2014, 11(6):564-570.
[46] Pongcharoen S, Niumsup P, Sanguansermsri D, et al. The effect of interleukin-17 on the proliferation and invasion of JEG-3 human choriocarcinoma cells[J]. Am J Reprod Immunol, 2006, 55(4):291-300.
[47] Ronchetti L, Boubaker NS, Barba M, et al. Neutrophil extracellular traps in cancer:Not only catching microbes[J]. J Exp Clin Cancer Res, 2021, 40(1):231.
[48] Yang LB, Liu Q, Zhang XQ, et al. DNA of neutrophil extracellular traps promotes cancer metastasis via CCDC25[J]. Nature, 2020, 583(7814):133-138.
[49] Sun TG, Meng FH, Zhao HM, et al. Elevated first-trimester neutrophil count is closely associated with the development of maternal gestational diabetes mellitus and adverse pregnancy outcomes[J]. Diabetes, 2020, 69(7):1401-1410.
[50] vanGenderen HO, Kenis H, Hofstra L, et al. Extracellular annexin A5:Functions of phosphatidylserine-binding and two-dimensional crystallization[J]. Biochim Biophys Acta, 2008, 1783(6):953-963.
[51] Schenkein HA, Thomas RR. Anticardiolipin from periodontitis patients impact fetal loss and annexin V[J]. J Dent Res, 2020, 99(7):797-803.
[52] Arimatsu K, Yamada H, Miyazawa H, et al. Oral pathobiont induces systemic inflammation and metabolic changes associated with alteration of gut microbiota[J]. Sci Rep, 2014, 4:4828.
[53] 赵诚, 王伽略, 赵扬玉. 肠道菌群与子痫前期相关性的研究进展[J]. 中华围产医学杂志, 2018, 21(7):479-482.
[54] Couceiro J, Matos I, Mendes JJ, et al. Inflammatory factors, genetic variants, and predisposition for preterm birth[J]. Clin Genet, 2021, 100(4):357-367.