慢性牙周炎牙龈卟啉单胞菌感染毒力因子与TLR9、PD-L1的关系

Relationship between Porphyromonas gingivalis virulence factors and expressions of TLR9 and PD-L1 in patients with chronic periodontitis

目的探究慢性牙周炎患者牙龈卟啉单胞菌(Pg)感染毒力因子与Toll样受体9(TLR9)、程序性死亡分子配体1(PD-L1)表达的关系。方法选择2018年2月-2021年2月宜春市人民医院收治的128例慢性牙周炎患者为研究对象,测定患者Pg感染情况,Pg毒力因子牙龈蛋白酶K(Kgp)、外周血TLR9、PD-L1表达情况以及牙周健康指标。结果128例患者中Pg阳性114例,阳性率为89.06%;Pg阳性患者Kpg阳性例数,外周血TLR9、PD-L1表达水平,附着丧失(AL)、探诊深度(PD)、龈沟出血指数(SBI)等牙周健康指标均高于Pg阴性患者(P<0.05);PD-L1、AL与Pg感染呈正相关关系(P<0.05);Kpg阳性患者TLR9、PD-L1、AL、PD以及SBI均高于Kpg阴性患者(P<0.05);TLR9、PD、SBI与Kpg呈正相关关系(P<0.05);Pg感染患者治疗后有效患者Kpg阳性占比、TLR9、PD-L1、AL、PD、SBI表达水平低于无效患者(P<0.05);受试者工作特征(ROC)曲线显示Kpg、TLR9、PD-L1、AL、PD、SBI用于预测慢性牙周炎Pg感染治疗疗效曲线下面积(AUC)值分别为0.576、0.887、0.894、0.858、0.757、0.896。结论慢性牙周炎Pg感染表面毒力因子Kpg与外周血TLR9、PD-L1表达及牙周健康关系密切,其与外周血TLR9、PD-L1表达及牙周健康指标均可以用于预测患者Pg感染治疗疗效。

OBJECTIVE To explore the relationship between Porphyromonas gingivalis virulence factors and expression levels of Toll-like receptor 9(TLR9)and programmed death ligand 1(PD-L1)in patients with chronic periodontitis.METHODS A total of 128 patients with chronic periodontitis who were treated in Yichun People′s Hospital from Feb 2018 to Feb 2021 were recruited as the study subjects,the prevalence of P.gingivalis infection was determined,the P.gingivalis virulence factor gingival proteinase K(Kgp),peripheral blood TLR9,PD-L1 and periodontal heath indexes were detected.RESULTS Among the 128 patients,114 were tested positive for P.gingivalis,with the positive rate 89.06%.The percentage of the Kpg-positive patients,expression levels of peripheral blood TLR9 and PD-L1 and the periodontal health indexes attachment loss(AL),probing depth(PD)and sulcus bleeding index(SBI)of the P.gingivalis-positive patients were higher than those of the P.gingivalis-negative patients(P<0.05).The PD-LI and AL were positively correlated with the P.gingivalis infection(P<0.05).The TLR-9,PD-L1,AL,PD and SBI of the Kpg-positive patients were higher than those of the Kpg-negative patients(P<0.05);the TLR9,PD and SBI were positively correlated with the Kpg(P<0.05).Among the patients with P.gingivalis infection,the percentage of Kpg-positive patients,TLR9,PD-L1,AL,PD and SBI of the patients who were effective for treatment were lower than those of the patients who were not effective for treatment(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under curves(AUCs)of Kpg,TLR9,PD-L1,AL,PD and SBI were respectively 0.576,0.887,0.894,0.858,0.757 and 0.896 in prediction of curative effect on the chronic periodontitis with P.gingivalis infection.CONCLUSION The P.gingivalis surface virulence factor Kpg of the patients with chronic periodontitis is closely associated with the expressions of peripheral blood TLR9 and PD-L1 as well as the periodontal health.The virulence factor Kpg,peripheral blood TLR9 and PD-L1 and periodontal health indexes can be used for prediction of curative effect on the patients with P.gingivalis infection.