口腔微生物群落在口腔与全身疾病预警中的作用

Oral microbiota: a promising predictor of human oral and systemic diseases

口腔微生物群落是指定植于人体口腔的微生物集合,多以生物膜形式行使微生物生理学功能。当微生物群落与宿主间生态关系失衡时,可诱发多种口腔感染性疾病,包括龋病、牙髓根尖周病、牙周病、智齿冠周炎、颌骨骨髓炎等,严重危害口腔健康。更为重要的是,口腔微生物群落与口腔肿瘤、糖尿病、类风湿性关节炎、心血管疾病及早产等系统性疾病紧密相关,口腔微生物群落结构特征可作为口腔及全身健康预警的重要标记。随着"人类微生物组计划"及其他微生物宏基因组学相关项目的开展,人们对口腔微生物群落的认识不断深入,已获得了海量大数据信息。在"后微生物组计划"时代如何有效地将微生物群落大数据转化为具有实际运用价值的临床诊疗手段,进而为患者提供有效的个体化医疗服务将是推动口腔疾病乃至全身疾病"精准医疗"的重大前沿问题。本文拟从常见口腔及相关系统性疾病微生物群落研究进展入手,阐述口腔微生物群落信息在疾病发生、发展及预后预警中的作用,提出建立基于口腔微生物群落疾病预警系统的必要性,为实现口腔疾病及相关系统性疾病的个性化诊疗提供新的思路。

A human oral microbiota is the ecological community of commensal, symbiotic, and pathogenic microorganisms found in human oral cavity. Oral microbiota exists mostly in the form of a biofilm and maintains a dynamic ecological equilibrium with the host body. However, the disturbance of this ecological balance inevitably causes oral infectious diseases, such as dental caries, apical periodontitis, periodontal diseases, pericoronitis, and craniofacial bone osteomyelitis. Oral microbiota is also correlated with many systemic diseases, including cancer, diabetes mellitus, rheumatoid arthritis, cardiovascular diseases, and preterm birth. Hence, oral microbiota has been considered as a potential biomarker of human diseases. The ＂Human Microbiome Project＂ and other metagenomic projects worldwide have advanced our knowledge of the human oral microbiota. The integration of these metadata has been the frontier of oral microbiology to improve clinical translation. By reviewing recent progress on studies involving oral microbiota-related oral and systemic diseases, we aimed to propose the essential role of oral microbiota in the prediction of the onset, progression, and prognosis of oral and systemic diseases. An oral microbiotabased prediction model helps develop a new paradigm of personalized medicine and benefits the human health in the postmetagenomics era.