15d-PGJ2促进颌骨缺损患者牙周组织再生的可能机制  

Possible mechanism of 15D-PGJ2 in promoting periodontal tissue regeneration in patients with mandibular defects

作　　者：刘紫娟 陈冰译 张锐 周舟[1] 叶思颖 吴嘉聪 夏慧玲 马婧媛[3] 唐美秀[1] LIU Zi-juan;CHEN Bing-yi;ZHANG Rui;ZHOU Zhou;YE Si-ying;WU Jia-cong;XIA Hui-ling;MA Jing-yuan;TANG Mei-xiu(Changsha Medical University,Changsha 410219,China;Hangzhou Stomatology Hospital,Hangzhou 310000,China;The Second Affiliated Hospital of Zhejiang University Medical College,Hangzhou 310000,China)

机构地区：[1]长沙医学院,湖南长沙410219 [2]杭州口腔医院,浙江杭州310000 [3]浙江大学医学院附属第二医院,浙江杭州310000

出　　处：《海南医学院学报》2021年第3期180-185,191,共7页Journal of Hainan Medical University

基　　金：湖南省大学生创新创业训练计划项目[(2019)191-2440];浙江省自然基金(GF18H140006)。

摘　　要：目的:探讨脂质信号分子环戊烯同类前列腺素(cyclopentene isoprostaglandins,15d-PGJ2)促进牙周病导致颌骨缺损患者牙周组织再生的主要生理机制。方法:2016年2月~2019年7月,对长沙医学院73例健康体检居民(健康组)和73例牙周病合并颌骨缺损患者(病例组)进行了对照研究,比较两组对象龈沟液生长因子、外周血细胞、牙骨质特异性蛋白、外周血清酶、骨代谢产物含量,比较病例组治疗前后(15d-PGJ2按200μg/kg剂量治疗14 d)各指标含量,探索各指标的内在关联性。结果:病例组白细胞介素(IL-1β)、白细胞介素-17(IL-17)、碱性成纤维细胞生长因子(bFGF)、几丁质酶3样蛋白(YKL-40)、人骨成型蛋白2(BMP-2)、Ⅰ型胶原交联羧基末端肽(ICTP)、Ⅰ型原胶原羧基末端前肽(PICP)、Ⅰ型胶原交联C端肽(CTX)高于健康组;病例组核因子κB受体活化因子配体(RANKL)、相关黏附分子1(ICAM-1)、转化生长因子-β(TGF-β1)、辅助性T细胞17(Th17)、调节性T细胞(Treg)、牙周韧带干细胞(PDLSCs)、硬化蛋白(SOST)、骨质附着蛋白(CAP)、高迁移率蛋白1(HMGB1)、组织蛋白酶(CTSK)、5-脂氧合酶(5-LOX)、环氧化酶-2(COX-2)、Ⅰ型胶原交联N端肽(NTX)低于健康组;组间差异均有统计学意义(P<0.05)。治疗后相比治疗前,IL-1β、IL-17、bFGF、YKL-40、BMP-2、ICTP、PICP、CTX明显降低;而RANKL、ICAM-1、TGF-β1、Th17、Treg、PDLSCs、SOST、CAP、HMGB1、CTSK、5-LOX、COX-2、NTX明显升高;差异均有统计学意义(P<0.05)。因子分析发现,21项指标可提取4个公因子,累积贡献率96.993%。结论:15d-PGJ2治疗牙周病伴颌骨缺损患者可明显影响多项特征指标的表达,可能牵涉到四种机制:细胞分化或迁移失调、局部炎症或免疫失衡、牙槽骨微结构被破坏、负荷或刺激影响重塑,具体与何种通路相关仍需进一步探究。Objective To explore the main physiological mechanism of 15d-PGJ2 promoting periodontal tissue regeneration in patients with jaw defects caused by periodontal disease.MethodsFrom February 2016 to July 2019,a controlled study was conducted on 73 healthy residents(healthy group)and 73 patients(case group)with periodontal disease combined with jaw defects in Changsha medical university.T test was used to compare the growth factors of gingival crevicular fluid between the two groups,which include peripheral blood cells,cement-specific protein,peripheral blood enzyme and tatistical differences in bone metabolites.The t test method compared the content of each index before and after treatment(15d-PGJ2 was treated at a dose of 200 mu/kg for 14 d).The method of factor analysis explores the internal correlation of each index.ResultFactors including RANKL,ICAM-1,TGF-β1,Th17,Treg,PDLSCs,SOST,CAP,HMGB1,CTSK,5-LOX,COX-2,NTX were higher in the case group than in the healthy group.In the case group,RANKL,ICAM-1,TGF-β1,Th17,Treg,PDLSCs,SOST,CAP,HMGB1,CTSK,5-LOX,COX-2,NTX were lower than those in the healthy group.The differences between the groups were statistically significant(P<0.05).Compared with before treatment,IL-1β,IL-17,bFGF,YKL-40,BMP-2,ICTP,PICP and CTX were significantly decreased after treatment.Factors such as RANKL,ICAM-1,TGF-β1,Th17,Treg,PDLSCs,SOST,CAP,HMGB1,CTSK,5-LOX,COX-2 and NTX were significantly increased.The differences were statistically significant(P<0.05).Factor analysis shows that four common factors can be extracted from 21 indicators,and the cumulative contribution rate is 96.993%.ConclusionsThe treatment of 15d-PGJ2 in patients with periodontal disease with maxillary defects can significantly affect the expression of multiple characteristic indicators,which may involve four mechanisms dysregulation of cell differentiation or migration,local inflammation or immune imbalance,destruction of alveolar bone microstructure,load or stimulation,and remodeling.The specific pathway related to this is still

关 键 词：牙周病 颌骨缺损 信号分子 环戊烯同类前列腺素 因子分析 组织再生 机制研究 

分 类 号：R782.4[医药卫生—口腔医学]