肿瘤坏死因子α在牙槽骨改建中的骨免疫学效应

Osteoimmunological effect of tumor necrosis factor alpha in alveolar bone remodeling

背景:骨免疫学强调了骨骼系统和免疫系统之间密不可分的联系,它的兴起给牙槽骨改建相关疾病的治疗提供了新的研究思路,而肿瘤坏死因子α是骨免疫学中一种重要的细胞因子,参与骨关节炎、慢性牙周炎等疾病以及正畸牙齿移动的骨代谢及骨改建。目的:阐述了肿瘤坏死因子α在牙槽骨改建过程中的骨免疫调节作用及其研究进展。方法:检索PubMed、万方及中国知网数据库收录的肿瘤坏死因子α和骨改建及骨免疫学研究相关的文献,最终纳入76篇文献进行归纳总结。结果与讨论:①牙槽骨是机体骨改建最活跃的部分,牙槽骨改建常见于正畸治疗、牙周炎以及种植体的骨结合过程。②肿瘤坏死因子α对牙槽骨改建的骨免疫学效应表现在高浓度的肿瘤坏死因子α主要通过核转录因子κB通路促进破骨基因如核转录因子κB受体活化因子配体的表达,促进破骨细胞的成熟分化引起骨吸收;③早期低浓度的肿瘤坏死因子α则通过核转录因子κB通路调节Wnt/β-连环蛋白和骨形态发生蛋白等通路间接促进成骨基因如骨钙素的表达,促进成骨细胞的成熟分化引起新骨形成。④因此肿瘤坏死因子α是调节牙槽骨改建的关键细胞因子之一,且在该过程的分子机制网络中起着核心的作用。⑤肿瘤坏死因子α的调节具有双向性,体内微环境又复杂,如何控制肿瘤坏死因子α的调节作用是一大难题。⑥文章希望为临床上正畸、牙周炎和种植治疗过程中监控肿瘤坏死因子α浓度并即时反馈,防止医源性牙槽骨过度吸收提供新的研究方向和理论基础。

BACKGROUND:Osteoimmunology emphasizes the inseparable relationship between skeletal system and immune system,and its rise provides a new research direction for the treatment of alveolar bone remodeling related diseases.Tumor necrosis factor-αis an important cytokine in osteoimmunology,which participates in bone metabolism and bone remodeling related to osteoarthritis,chronic periodontitis and orthodontic tooth movement.OBJECTIVE:To review the osteoimmunological effect of tumor necrosis factor-αduring alveolar bone remodeling and the latest progress.METHODS:The literatures related to tumor necrosis factor-α,bone remodeling,osteoimmunology were searched in PubMed,WanFang and CNKI databases,and finally 76 articles were included and summarized.RESULTS AND CONCLUSION:Alveolar bone is the most active part of bone remodeling,and alveolar bone remodeling is common in orthodontic treatment,periodontitis treatment and osseointegration of implants.The osteoimmunological effect of tumor necrosis factor-αon alveolar bone remodeling is that high concentration of tumor necrosis factor-αmainly promotes the expression of osteoclast genes such as nuclear factorκB receptor activator ligand through nuclear factor kappa-B signaling pathway,thus promoting the maturation and differentiation of osteoclasts leading to bone resorption.In the early stage,low concentration of tumor necrosis factor-αindirectly promotes the expression of osteogenic genes such as osteocalcin by activating Wnt/β-catenin and bone morphogenetic protein signaling pathways through the nuclear factor-κB pathway,which subsequently promotes osteoblast maturation and differentiation and leads to new bone formation.Therefore,tumor necrosis factor-αis one of the key cytokines regulating alveolar bone remodeling and plays a core role in the molecular mechanism network of this process.Tumor necrosis factor-αhas a bi-directional regulatory role and the microenvironment in vivo is complex,so how to control the regulation of tumor necrosis factor-αis a difficult problem.This review may be expected to provide a new research direction and theoretical basis for monitoring the concentration of tumor necrosis factor-αand immediate feedback in clinical orthodontics,periodontitis and implant treatments to prevent iatrogenic alveolar bone resorption.