Inborn Errors of Immunity-related Immunological Mechanisms and Pharmacological Therapy Alternatives in Periodontitis.

IF 3.4 3区 医学 Q3 IMMUNOLOGY Clinical and experimental immunology Pub Date : 2024-10-16 DOI:10.1093/cei/uxae089
Nadira Nabiyeva Çevik, Ezel Berker, Ilhan Tezcan, Deniz Cagdas
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Abstract

Periodontitis is a frequent local inflammatory disease. The microbiota and repeated exposure to bacterial endotoxins triggers excessive inflammation through oral mucosal immunity, sometimes leading to a destructive effect on the supportive mucosal tissues around the teeth. Elimination of the pathogens and increasing the tolerance of the cellular immune response is crucial in addition to standard dental therapies like mechanical debridement. Based on our experience on immune-mediated diseases, especially primary immunodeficiency diseases (PIDs), we wrote this review to discuss the treatment alternatives for severe periodontal disease. Risk factors are malnutrition, vitamin deficiencies, smoking, systemic inherited and acquired immune-mediated diseases, infections, endocrinological diseases, and pharmacological agents may accompany periodontitis. The diagnosis and treatment of dietary deficiencies, as well as the addition of nutritional supplements, may aid in epithelial regeneration and immune system function. Recently, modifications to the therapeutic option for severe periodontitis have been made depending on the fact that the immune response against bacteria may modify the severity of periodontal inflammation. The anti-inflammatory therapies support or inhibit the host's immune response. The clinical approach to severe periodontitis should extend beyond classical therapies. There is a need for a diverse therapeutic strategy that supports the epithelial barrier, which is the crucial component of innate immunity against microbiota. Leukocytes are the main cellular component in periodontal inflammation. Anti-inflammatory therapeutic options directed at leukocytes, such as IL-17 and IL-23-targeted therapies, could be the candidates for the treatment of severe periodontitis. Therapy against other inflammatory cytokines, IL-1, IL-6, IL12, IL23, TNF-alpha, PGE2, and cytokine receptors, could also be used in periodontal inflammation control.

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牙周炎中与先天性免疫错误相关的免疫机制和药物疗法替代方案。
牙周炎是一种常见的局部炎症性疾病。微生物群和反复接触细菌内毒素会通过口腔黏膜免疫引发过度炎症,有时会对牙齿周围的支持性黏膜组织造成破坏性影响。除了机械清创等标准牙科疗法外,消除病原体和提高细胞免疫反应的耐受性也至关重要。基于我们在免疫介导疾病,尤其是原发性免疫缺陷病(PID)方面的经验,我们撰写了这篇综述,讨论严重牙周病的替代治疗方法。危险因素包括营养不良、维生素缺乏、吸烟、系统性遗传和获得性免疫介导疾病、感染、内分泌疾病,以及可能伴随牙周炎的药物。诊断和治疗饮食不足以及添加营养补充剂可能有助于上皮再生和免疫系统功能。最近,根据针对细菌的免疫反应可能改变牙周炎症的严重程度这一事实,对严重牙周炎的治疗方案进行了修改。消炎疗法支持或抑制宿主的免疫反应。治疗严重牙周炎的临床方法应超越传统疗法。需要一种支持上皮屏障的多样化治疗策略,上皮屏障是对抗微生物群的先天性免疫的重要组成部分。白细胞是牙周炎症的主要细胞成分。针对白细胞的抗炎治疗方案,如 IL-17 和 IL-23 靶向疗法,可能成为治疗严重牙周炎的候选方案。针对其他炎症细胞因子(IL-1、IL-6、IL12、IL23、TNF-α、PGE2 和细胞因子受体)的疗法也可用于牙周炎症的控制。
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来源期刊
CiteScore
8.40
自引率
2.20%
发文量
101
审稿时长
3-8 weeks
期刊介绍: Clinical & Experimental Immunology (established in 1966) is an authoritative international journal publishing high-quality research studies in translational and clinical immunology that have the potential to transform our understanding of the immunopathology of human disease and/or change clinical practice. The journal is focused on translational and clinical immunology and is among the foremost journals in this field, attracting high-quality papers from across the world. Translation is viewed as a process of applying ideas, insights and discoveries generated through scientific studies to the treatment, prevention or diagnosis of human disease. Clinical immunology has evolved as a field to encompass the application of state-of-the-art technologies such as next-generation sequencing, metagenomics and high-dimensional phenotyping to understand mechanisms that govern the outcomes of clinical trials.
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