卟啉单胞菌与原发性感染根管相关性及毒力作用机制探讨
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摘要
目的探讨牙髓卟啉单胞菌与原发性感染根管相关性研究及毒力作用机制。方法选取2016年8月-2018年5月医院诊治的原发性感染根管患者124例,其中伴牙髓炎62例、伴根尖周炎62例。选取同期健康体检者60例,为对照组。记录所有研究对象根管冠中段、根管尖部牙髓卟啉单胞菌检出情况,分析原发性感染根管患者血清炎症因子内毒素(LPS)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平变化情况及牙髓卟啉单胞菌感染与LPS、IL-6、TNF-α指标的相关性。结果原发性感染根管患者牙髓卟啉单胞菌检出率65.32%(81/124),高于对照组的检出率3.33%(2/60),比较差异有统计学意义(χ~2=3.841,P=0.030)。其中原发性感染根管中伴牙髓炎患者牙髓卟啉单胞菌检出率高于伴根尖周炎患者(χ~2=4.150,P=0.031);牙髓炎患者根管冠中段牙髓卟啉单胞菌检出率高于根尖周炎患者,根管尖段牙髓卟啉单胞菌检出率低于根尖周炎患者;差异均有统计学意义(均P<0.05);原发性感染根管患者血清LPS、IL-6、TNF-α水平均高于对照组(P<0.05),且牙髓卟啉单胞菌感染与LPS、IL-6、TNF-α水平呈正相关。结论牙髓卟啉单胞菌是原发性感染根管的优势病原菌,其感染与原发性感染根管发生密切相关,可通过其毒力作用而损伤根管相关组织。
OBJECTIVE To explore the correlation between Porphyromonas endodontalis and root canals of primary infection and its virulence mechanisms.METHODS A total of 124 patients who were diagnosed with primary infection of root canals and treated in the hospital from Aug 2016 to May 2018 were enrolled in the study,62 of whom were complicated with pulpitis,and 62 were complicated with periapical periodontitis.Meanwhile,60 healthy people who received physical examination were chosen as the control group.The isolation rates of P.endodontalis in middle segment of root canal and tip of root canal of all the study objects were recorded.The changes of levels of serum inflammatory factors endotoxin(LPS),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)of the patients with primary infection of root canals were analyzed,and the correlation between the Pe.ndodontalis infection and the LPS,IL-6 and TNF-αwas observed.RESULTS The isolation rate of P.endodontalis of the patients with primary infection of root canals was 65.32%(81/124),higher than 3.33%(2/60)of the patients in the control group,and there was significant difference(χ~2=3.841,P=0.030).The isolation rate of Pe.ndodontalis of the primary infection of root canal patients complicated with pulpitis was significantly higher than that of the patients complicated with periapical periodontitis(χ~2= 4.150,P=0.031).The isolation rate of Pe.ndodontalis in the middle segment of root canal was higher in the patients with pulpitis than in the patients with periapical periodontitis,the isolation rate of Pe.ndodontalis in the tip of root canal was lower in the patients with pulpitis than in the patients with periapical periodontitis,and there were significant differences(all P<0.05).The levels of serum LPS,IL-6 and TNF-αof the patients with primary infection of root canals were significantly higher than those of the patients in the control group(P<0.05),and the Pe.ndodontalis infection was positively correlated with the levels of LPS,IL-6 and TNF-α.CONCLUSION Pe.ndodontalis is the predominant species of pathogen isolated from the patients with primary infection of root canals,and the Pe.ndodontalis infection is closely associated with the primary infection of root canals and leads to the damage of root canal-related tissues through its toxic effect.
OBJECTIVE To explore the correlation between Porphyromonas endodontalis and root canals of primary infection and its virulence mechanisms.METHODS A total of 124 patients who were diagnosed with primary infection of root canals and treated in the hospital from Aug 2016 to May 2018 were enrolled in the study,62 of whom were complicated with pulpitis,and 62 were complicated with periapical periodontitis.Meanwhile,60 healthy people who received physical examination were chosen as the control group.The isolation rates of P.endodontalis in middle segment of root canal and tip of root canal of all the study objects were recorded.The changes of levels of serum inflammatory factors endotoxin(LPS),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)of the patients with primary infection of root canals were analyzed,and the correlation between the Pe.ndodontalis infection and the LPS,IL-6 and TNF-αwas observed.RESULTS The isolation rate of P.endodontalis of the patients with primary infection of root canals was 65.32%(81/124),higher than 3.33%(2/60)of the patients in the control group,and there was significant difference(χ~2=3.841,P=0.030).The isolation rate of Pe.ndodontalis of the primary infection of root canal patients complicated with pulpitis was significantly higher than that of the patients complicated with periapical periodontitis(χ~2= 4.150,P=0.031).The isolation rate of Pe.ndodontalis in the middle segment of root canal was higher in the patients with pulpitis than in the patients with periapical periodontitis,the isolation rate of Pe.ndodontalis in the tip of root canal was lower in the patients with pulpitis than in the patients with periapical periodontitis,and there were significant differences(all P<0.05).The levels of serum LPS,IL-6 and TNF-αof the patients with primary infection of root canals were significantly higher than those of the patients in the control group(P<0.05),and the Pe.ndodontalis infection was positively correlated with the levels of LPS,IL-6 and TNF-α.CONCLUSION Pe.ndodontalis is the predominant species of pathogen isolated from the patients with primary infection of root canals,and the Pe.ndodontalis infection is closely associated with the primary infection of root canals and leads to the damage of root canal-related tissues through its toxic effect.
引文
[1]莫泽欢,徐琼.牙龈卟啉单胞菌脂多糖诱导人牙髓细胞炎症反应中微小RNA的表达谱变化[J].中华口腔医学研究杂志,2017,11(6):333-340.
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[13]Kim JH,Kim N.Signaling pathways in osteoclast differentiation[J].Chonnam Med J,2016,52(1):12-17.
[14]Zwicker S,Martinez GL,Bosma M,et al.Interleukin 34:a new modulator of human and experimental inflammatory bowel disease[J].Clin Sci(Lond),2015,129(3):281-290.
[15]Li Yongji,Zhang Yinghua.Observation on the effect of regenerative endodontic treatment of periapical periodontitis caused by abnormal central cusp fracture[J].Chinese J Pract Depart Stomatol,2016,9(10):613-617.
[16]Mantri CK,Chen C,Dong X,et al.Fimbriae-mediated outer membrane vesicle production and invasion of Porphyromonas gingivalis[J].Microbiologyopen,2015,4(1):53-65.
[17]王畅,唐子圣,漆正楠,等.感染根管中牙龈卟啉单胞菌fimA基因多态性研究[J].口腔医学,2016,36(1):18-34.
[18]李红,纪海,何艳艳,等.牙髓卟啉单胞菌在原发性感染和再感染根管内的定植[J].华西口腔医学杂志,2015,33(1):88-92.
[19]Fan W,Wu D,Ma T,et al.Ag-loaded mesoporous bioactive glasses against Enterococcus faecalis biofilm in root canal of human teeth[J].Dent Mater J,2015,34(1):54-60.
[20]Lee M,Arikawa K,Nagahama F.Micromolar levels of sodium fluoride promote osteoblast differentiation through runx2signaling[J].Biol Trace Elem Res,2017,178(2):283-291.
[21]Zenobia C,Hajishengallis G.Porphyromonas gingivalis virulence factors involved in subversion of leukocytes and microbial dysbiosis[J].Virulence,2015,6(3):236-243.
[22]姚雪芹,侯本祥,张琛,等.持续性根尖周炎中牙龈卟啉单胞菌的分离与鉴定[J].中华老年口腔医学杂志,2016,14(2):77-82.
[23]Kamigaki M,Hide I,Yanase Y,et al.The Toll-like receptor4-activated neuroprotective microglia subpopulation survives via granulocyte macrophage colony-stimulating factor and JAK2/STAT5 signaling[J].Neurochem Int,2016,93:82-94.
[2]Provenzano JC,Rocas IN,Tavares LF,et al.Short-chain fatty acids in infected root canals of teeth with apical periodontitis before and after treatment[J].J Endod,2015,41(6):831-835.
[3]Choi YS,Moon JH,Kim TG,et al.Potent in vitro and in vivo activity of plantibody specific for Porphyromonas gingivalis fim A[J].Clin Vaccine Immunol,2016,23(4):346-352.
[4]黄希,葛自立,刘健,等.慢性根尖周炎感染根管的病原学分析及影响因素研究[J].中华医院感染学杂志,2018,28(1):114-117.
[5]Moreno S,Jaramillo A,Parra B,et al.Porphyromonas gingivalis fim-A genotype distribution among Colombians[J].Colomb Med(Cali),2015,46(3):122-127.
[6]周琦,李军心,钟波,等.不同感染程度根管内微生物分析[J].中国口腔种植学杂志,2016,21(2):91-93.
[7]Banu S,Jabir NR,Mohan R,et al.Correlation of Toll-like receptor 4,interleukin-18,transaminases,and uric acid in patients with chronic periodontitis and healthy adults[J].J Periodontol,2015,86(3):431-439.
[8]Marinho AC,Martinho FC,Leite FR,et al.Proinflammatory activity of primarily infected endodontic content against macrophagesafter different phases of the root canal therapy[J].JEndod,2015,41(6):817-823.
[9]Visweswariah SS,Busby SJ.Evolution of bacterial transcription factors:how proteins take on new tasks,but do not always stop doing the old ones[J].Trends Microbiol,2015,23(8):463-467.
[10]赵洁,曹祥莉,钟晓波.根管预备对粪肠球菌感染根管形成细菌渗漏的影响[J].重庆医学,2015,44(21):2907-2909.
[11]Kalantar Motamedi MR,Davoodi SH,Saeidi A,et al.Technical quality of root canal therapies performed by novice dental students in preclinical practice[J].Dent Res J(Isfahan),2015,12(4):365-371.
[12]樊明文.牙体牙髓病学[M].4版.北京:人民卫生出版社,2012:227-231.
[13]Kim JH,Kim N.Signaling pathways in osteoclast differentiation[J].Chonnam Med J,2016,52(1):12-17.
[14]Zwicker S,Martinez GL,Bosma M,et al.Interleukin 34:a new modulator of human and experimental inflammatory bowel disease[J].Clin Sci(Lond),2015,129(3):281-290.
[15]Li Yongji,Zhang Yinghua.Observation on the effect of regenerative endodontic treatment of periapical periodontitis caused by abnormal central cusp fracture[J].Chinese J Pract Depart Stomatol,2016,9(10):613-617.
[16]Mantri CK,Chen C,Dong X,et al.Fimbriae-mediated outer membrane vesicle production and invasion of Porphyromonas gingivalis[J].Microbiologyopen,2015,4(1):53-65.
[17]王畅,唐子圣,漆正楠,等.感染根管中牙龈卟啉单胞菌fimA基因多态性研究[J].口腔医学,2016,36(1):18-34.
[18]李红,纪海,何艳艳,等.牙髓卟啉单胞菌在原发性感染和再感染根管内的定植[J].华西口腔医学杂志,2015,33(1):88-92.
[19]Fan W,Wu D,Ma T,et al.Ag-loaded mesoporous bioactive glasses against Enterococcus faecalis biofilm in root canal of human teeth[J].Dent Mater J,2015,34(1):54-60.
[20]Lee M,Arikawa K,Nagahama F.Micromolar levels of sodium fluoride promote osteoblast differentiation through runx2signaling[J].Biol Trace Elem Res,2017,178(2):283-291.
[21]Zenobia C,Hajishengallis G.Porphyromonas gingivalis virulence factors involved in subversion of leukocytes and microbial dysbiosis[J].Virulence,2015,6(3):236-243.
[22]姚雪芹,侯本祥,张琛,等.持续性根尖周炎中牙龈卟啉单胞菌的分离与鉴定[J].中华老年口腔医学杂志,2016,14(2):77-82.
[23]Kamigaki M,Hide I,Yanase Y,et al.The Toll-like receptor4-activated neuroprotective microglia subpopulation survives via granulocyte macrophage colony-stimulating factor and JAK2/STAT5 signaling[J].Neurochem Int,2016,93:82-94.