抗菌肽在龋病防治中的研究进展

Research progress on antimicrobial peptides in terms of the prevention and treatment of dental caries

抗菌肽是一种具有抗菌作用的肽类物质,可分为天然抗菌肽和人工合成抗菌肽两种。人工合成抗菌肽主要是根据天然抗菌肽结构,通过重组不同功能结构域、调整原有氨基酸序列,或者完全重新设计,而获得新的抗菌肽。抗菌肽可抑制多种致龋微生物的生长,抑制微生物生物膜的形成,降低微生物产酸耐酸的特性。天然抗菌肽基因可作为龋病遗传易感性标志物,在口腔龋病防治方面具有良好的应用前景,但天然抗菌肽的不稳定性、无法实现靶向缓释,限制了其在口腔龋病防治中的应用。人工合成抗菌肽可提高抗菌肽稳定性和对微生物的杀灭作用;可与口腔常用粘接剂聚合,减少龋病充填治疗后的微渗漏,防止继发龋的发生;可根据龋病动态进展中的pH值敏感性靶向缓释,促进早期龋的再矿化。但人工合成抗菌肽的安全性和生物相容性较天然抗菌肽差;抗菌肽与其他龋病防治药物,如氟化物等联用效果尚不确切。本文针对目前抗菌肽的种类、防龋作用机制和改良设计方法进行综述,为龋病防治提供新方法与新思路。

Antimicrobial peptides have antibacterial effects on various pathogenic microorganisms,including natural antimicrobial peptides and synthetic antimicrobial peptides.According to the structure of natural antimicrobial peptides,synthetic antimicrobial peptides can be obtained by recombining different functional domains,adjusting the original amino acid sequence,or completely redesigning the peptides from scratch.Antimicrobial peptides can inhibit the growth of various cariogenic microorganisms and the formation of microbial biofilms.They also reduce acid production and acid resistance of microorganisms.Natural antimicrobial peptide genes can be used as genetic susceptibility markers for predicting the development of caries,thus,showing potential applications in the prevention and treatment of dental caries.The instability of natural antimicrobial peptides and the inability to achieve targeted sustained release limit their application in the prevention and treatment of oral caries.Synthetic antimicrobial peptides can enhance their stability and the antibacterial effect.Synthetic antimicrobial peptides can also be polymerized with common oral adhesives to reduce the incidence of microleakage after filling treatment for caries and to prevent the occurrence of secondary caries.The pH-sensitive antimicrobial peptides are slowly released to promote remineralization in the process of caries.However,the safety and biocompatibility of synthetic antimicrobial peptides are worse than those of natural antimicrobial peptides.Moreover,the combined effect of antibacterial peptides and anticaries drugs,such as fluoride,is still uncertain.Therefore,in this paper,we will review the design methods,application and underlying mechanisms of antimicrobial peptides to introduce novel methods and ideas for the prevention and treatment of dental caries.