[论文解读] Unraveling the Link between Periodontitis and Inflammatory Bowel Disease: Challenges and Outlook

Himanshi Tanwar, Jeba Mercy Gnanasekaran+13 more|arXiv (Cornell University)|Aug 19, 2023

Oral microbiology and periodontitis research被引用 9

一句话总结

本篇叙述性综述汇总了口腔-肠道轴连接牙周炎与炎性肠病（IBD）的证据，讨论共享的微生物/免疫途径以及发病机制的多次打击模型。

ABSTRACT

Periodontitis and Inflammatory Bowel Disease (IBD) are chronic inflammatory conditions, characterized by microbial dysbiosis and hyper-immunoinflammatory responses. Growing evidence suggest an interconnection between periodontitis and IBD, implying a shift from the traditional concept of independent diseases to a complex, reciprocal cycle. This review outlines the evidence supporting an Oral-Gut axis, marked by a higher prevalence of periodontitis in IBD patients and vice versa. The specific mechanisms linking periodontitis and IBD remain to be fully elucidated, but emerging evidence points to the ectopic colonization of the gut by oral bacteria, which promote intestinal inflammation by activating host immune responses. This review presents an in-depth examination of the interconnection between periodontitis and IBD, highlighting the shared microbiological and immunological pathways, and proposing a multi-hit hypothesis in the pathogenesis of periodontitis-mediated intestinal inflammation. Furthermore, the review underscores the critical need for a collaborative approach between dentists and gastroenterologists to provide holistic oral-systemic healthcare.

研究动机与目标

• 评估通过口腔-肠道轴连接牙周炎与IBD的证据。
• 总结与两种疾病相关的共享微生物学和免疫学途径。
• 提出一个多次打击模型，描述牙周炎如何影响肠道炎症及IBD进展。
• 识别差距并倡导协同的口腔-系统性健康护理方法。

提出的方法

• 对将牙周炎与IBD联系起来的流行病学、微生物学和免疫学研究进行文献综合。
• 分析口腔和肠道微生物组数据，以识别重叠的分类群和微生态失衡模式。
• 在两种疾病背景下讨论涉及中性粒细胞、巨噬细胞、树突状细胞、T细胞和B细胞的免疫途径。
• 提出一个牙周炎介导的肠道炎症的多次打击概念框架。

实验结果

研究问题

• RQ1 牙周炎是否通过口腔-肠道轴增加IBD的风险或严重程度？
• RQ2 哪些共享的微生物标志和免疫途径将牙周炎与IBD连接起来？
• RQ3 针对牙周炎炎症的治疗能否影响IBD结局，反之亦然？
• RQ4 哪种机制模型最好地解释口腔病原体如何转移到肠道并促进炎症？

主要发现

• 有证据表明IBD患者中的牙周炎患病率更高，反之亦然。
• 口腔细菌可转移到肠道，并通过免疫激活潜在地加剧肠道炎症。
• 共享的免疫炎症通路，包括细胞因子和Th17介导的反应，连接口腔和肠道组织。
• 与IBD相关的口腔表现可能来自免疫交叉反应和黏膜免疫调控失衡。
• IBD治疗，尤其是抗TNF和糖皮质激素，可能影响牙周病的进展和治疗结局。