黄嘌呤氧化还原酶抑制剂对牙周炎的治疗潜力研究进展  

Research advances in the therapeutic potential of xanthine oxidoreductase inhibitors for periodontitis

作　　者：李咏珊 吴志聪 王梓星 余熹煌 刘茜 余挺[1] LI Yongshan;WU Zhicong;WANG Zixing;YU Xihuang;LIU Xi;YU Ting(Department of Periodontics,School and Hospital of Stomatology,Guangzhou Medical University,Guangdong Engineering Research Center of Oral Restoration and Reconstruction,Guangzhou Key laboratory of Basic and Applied Research of Oral Regenerative Medicine,Guangzhou 510182,China)

机构地区：[1]广州医科大学口腔医学院牙周病学教研室、广州医科大学附属口腔医院牙周病科、广东省口腔组织修复与重建工程技术研究中心、广州市口腔再生医学基础与应用研究重点实验室,广东广州510182

出　　处：《口腔疾病防治》2023年第12期901-906,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省基础与应用基础研究基金(2023A1515030037,2022A1515010497);广东省国际及港澳台人才交流专项(粤科智字〔2022〕232⁃1⁃68);广东省大学生创新创业训练计划项目(S202110570054)。

摘　　要：牙周炎与嘌呤代谢异常有关,表现为宿主血尿酸增多和牙周组织中的嘌呤降解酶——黄嘌呤氧化还原酶(xanthine oxidoreductase,XOR)表达增加。在病理条件下XOR和尿酸都是促氧化、促炎症介质。动物实验发现,注射尿酸促进牙周炎进展,非布司他(一种XOR抑制剂)可改善牙周炎的组织破坏,阻断尿酸来源可能是一种控制牙周炎进展的治疗策略。本文旨在对XOR抑制剂作为牙周炎潜在治疗药物的合理性进行综述。文献复习结果提示,XOR抑制剂显示出抗氧化、抗炎和抗破骨作用;而且,XOR抑制剂在治疗感染性、炎症性和溶骨性疾病方面显示出临床效果;目前虽无直接证据支持XOR抑制剂对牙周微生态失调有改善作用,但其可调节肠道菌群失调,且有间接证据支持XOR抑制剂对牙周微生态失调的有利作用。综上,XOR抑制剂有可能作为一种免疫调节剂,通过抑制炎症、氧化应激反应和抗破骨作用,对牙周炎起到辅助治疗作用。Periodontitis is associated with abnormal purine metabolism,which is manifested by increased uric acid in host blood and increased expression of the purinedegrading enzyme,xanthine oxidoreductase(XOR),in periodontal tissues.Both XOR and uric acid are prooxidative and proinflammatory mediators under pathological conditions.Animal studies have found that injection of uric acid promotes the progression of periodontitis and that febuxostat(an XOR inhibitor)improves tissue destruction in periodontitis.Therefore,blocking the source of uric acid may be a therapeutic strategy to control the progression of periodontitis.In this article,the rationality of XOR inhibitors as potential therapeutic drugs for periodontitis is reviewed.The literature review results suggest that XOR inhibitors show antioxidative,antiinflammatory,and antiosteoclastic effects,and XOR inhibitors show clinical efficacy in the treatment of infectious,inflammatory and osteolytic diseases.Although there is no direct evidence to support the finding that XOR inhibitors can ameliorate periodontal microecological dysbiosis,these drugs can modulate intestinal microflora dysbiosis,and there is indirect evidence to support a beneficial effect of XOR inhibitors on periodontal microecological dysbiosis.In conclusion,XOR inhibitors may be used as immunomodulators for the adjuvant treatment of periodontitis by inhibiting inflammation,oxidative stress and antiosteoclast effects.

关 键 词：牙周炎 宿主免疫调节 嘌呤分解代谢 降尿酸药物 黄嘌呤氧化还原酶抑制剂 非布司他 别嘌呤醇 炎症 氧化应激 

分 类 号：R78[医药卫生—口腔医学]