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牙周稳态维持与失衡中的区域免疫机制

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稳态医学这一概念的提出,助力学界从全新的维度理解外界环境复杂、内部改建活跃的牙周组织.牙周区域免疫受复杂的局部刺激持续激活,与上皮屏障、软组织细胞外基质、骨耦联系统产生复杂的交互作用,共同塑造了牙周稳态.生理条件下,适度的区域免疫依靠屏障功能、固有免疫细胞控制菌群,维持稳态.病理条件下,失衡菌群通过中性粒细胞、辅助性T细胞17和B细胞等过度激活的区域免疫推动牙周稳态失衡,引起牙周炎.本文以最基本的免疫学分类为框架,系统概述了区域免疫调控牙周稳态的机制,回顾了靶向区域免疫稳态重塑策略的探索与转化研究,并提出值得挖掘的牙周稳态医学研究方向和潜在的稳态重塑新靶点、新策略.
Regional immunity involved in the maintenance and imbalance of periodontal homeostasis
The concept of homeostatic medicine has helped the researchers to understand the periodontal tissues in a completely new dimension.Periodontal tissues are subjected to complex external environmental stimuli and the internal tissues are continuously undergoing active remodeling.Periodontal regional immunity is continuously activated by local stimuli and interacts with the epithelial barrier,stromal tissue/extracellular matrix,and bone-coupled systems in a complex manner.Together,this complex network shapes the periodontal homeostasis.Under physiological conditions,moderate regional immunity relies on barrier function,intrinsic immune cells to control periodontal microbiota and maintain homeostasis.Under pathological conditions,pathogenic microbiota drive the periodontal homeostasis imbalance through over-activated regional immunity such as neutrophils,helper T(Th)17 cells and B cells,causing periodontitis.Using the most basic immunological classification as a framework,this paper provides a systematic overview of the above mechanisms by which regional immunity regulates periodontal homeostasis,reviews the translational studies that have been carried out on homeostatic remodeling strategies targeting regional immunity,and proposes a series of periodontal homeostasis medicine research directions worth exploring,as well as potential new targets and strategies for homeostatic remodeling.

PeriodontitisPeriodontal homeostasisRegional immunityBarrier functionHomeostatic remodeling therapy

王志勇、陈谦明

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浙江大学医学院附属口腔医院·浙江大学口腔医学院浙江省口腔疾病临床医学研究中心浙江省口腔生物医学重点实验室浙江大学癌症研究院,杭州 310006

牙周炎 牙周稳态 区域免疫 屏障功能 稳态重塑治疗

国家自然科学基金国家自然科学基金国家重点研发计划浙江省重点研发计划国家卫生健康委科学研究基金-浙江省卫生健康重大科技计划

81991500819915022022YFC24029002021C03074WKJ-ZJ-2212

2024

10.3760/cma.j.cn112144-20231215-00294

中华口腔医学杂志
中华医学会

中华口腔医学杂志

CSTPCD北大核心
影响因子：1.194
ISSN：1002-0098
年,卷(期)：2024.59(2)
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