肿瘤坏死因子-α在慢性牙周炎中的研究进展

Research progress of tumor necrosis factor-α in chronic periodontitis

慢性牙周炎是由病原微生物与宿主免疫之间相互作用而发生的一种慢性炎症性疾病,它作为一种常见的口腔类疾病具有病程长、进展缓慢、发病率高等特点,是导致成人尤其是老年人牙齿拔除或脱落的主要原因之一。炎症介质在慢性牙周炎的发生发展过程中起着重要作用,其中,肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)作为一种有效的炎性细胞因子,参与炎症过程。炎症初期,TNF-α可在炎症部位聚集并激活白细胞,进而杀灭细菌微生物,起到抗感染的作用;随着炎性刺激的增加,TNF-α大量分泌,它通过刺激促炎因子的产生及抑制抗炎因子的分泌,并引起细胞粘附分子和趋化因子的表达等,进一步加重炎症反应;与此同时,它还能够上调胶原酶以及前列腺素(prostaglandin,PG)E2的分泌,促进骨吸收相关因子的产生,造成牙周组织的破坏,严重时可导致牙齿脱落,影响患者的生活质量。本文主要从TNF-α的化学定义及生物学效应、不同部位的水平变化情况、对牙周组织的影响、临床意义及相关基因研究等几个方面进行综述,以便更好的了解慢性牙周炎的发病机制,为其临床诊断及治疗提供理论基础。

Chronic periodontitis is a chronic inflammatory disease caused by the interaction between pathogenic microorganisms and host immunity.As a common oral disease with long course,slow progress and high incidence of disease,it is one of the main causes of tooth extraction or loss in adults,especially in the elderly.Inflammatory mediators play an important role in the development of chronic periodontitis,Among them,tumor necrosis factor-alpha(TNF-α)is a potent inflammatory cytokine that involved in the inflammatory process.In the early stage of inflammation,TNF-αcan accumulate and activate white blood cells at in the site of inflammation,acting as an anti-infective agent by killing bacterial microorganisms;With the increase of inflammatory stimulation,a large amount of TNF-alpha is secreted,which further aggravates the inflammatory response by stimulating the production of pro-inflammatory factors,inhibiting the secretion of anti-inflammatory factors,and causing the expression of cell adhesion molecules and chemokines.At the same time,it can also upregulate the secretion of collagenase and prostaglandin(PG)E2,promote the production of bone resorption-related factors,which can eventually cause the destruction of periodontal tissues,even lead to tooth loss and affect quality of life of patients.This paper reviews from several aspects like the chemical definition and biological effects of TNF-α,the level changes in various parts,the influence on periodontal tissues,clinical significance and related gene research,etc,in order to better understand the pathological mechanism of chronic periodontitis and provide a theoretical basis for its clinical diagnosis and treatment.