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疱疹病毒与成人牙周炎及牙周病原菌之间的关系。

Relationship between herpesviruses and adult periodontitis and periodontopathic bacteria.

作者信息

Contreras A, Umeda M, Chen C, Bakker I, Morrison J L, Slots J

机构信息

Department of Periodontology, School of Dentistry, University of Southern California, Los Angeles 90089-0641, USA.

出版信息

J Periodontol. 1999 May;70(5):478-84. doi: 10.1902/jop.1999.70.5.478.

Abstract

BACKGROUND

Various mammalian viruses and specific bacteria seem to play important roles in the pathogenesis of human periodontitis. This study examined the relationship between subgingival herpesviruses and periodontal disease and potential periodontopathic bacteria in 140 adults exhibiting either periodontitis or gingivitis.

METHODS

A nested-polymerase chain reaction (PCR) method determined the presence of Epstein-Barr virus type 1 and type 2 (EBV-1, EBV-2), human cytomegalovirus (HCMV), and herpes simplex virus (HSV) and a 16S rRNA PCR detection method identified Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola.

RESULTS

Using a logistic analysis, EBV-1 showed significant positive association with P. gingivalis (odds ratio [OR] 3.37), and with coinfections of P. gingivalis and P. intermedia (OR 4.03); P. gingivalis and B. forsythus (OR 3.84); P. gingivalis and T. denticola (OR 4.17); P. gingivalis, B. forsythus, and T. denticola (OR 4.06); and P. gingivalis, P. nigrescens, and T. denticola (OR 3.29). EBV-1 also showed positive association with severe periodontitis (OR 5.09), with increasing age (OR 1.03), and with periodontal probing depth at the sample sites (OR 1.77). HCMV was positively associated with coinfections of P. gingivalis and P. nigrescens (OR 3.23); P. gingivalis, B. forsythus, and P. nigrescens (OR 3.23); and P. gingivalis, P. nigrescens, and T. denticola (OR 2.59); with severe periodontitis (OR 4.65); and with age (OR 1.03). Patients with mixed viral infections revealed significant associations with P. gingivalis (OR 2.27), and with coinfections of P. gingivalis and B. forsythus (OR 2.06); P. gingivalis and P. nigrescens (OR 2.91); P. gingivalis, B. forsythus, and P. nigrescens (OR 2.91); and P. gingivalis, P. nigrescens, and T. denticola (OR 2.70) with the clinical diagnosis of slight (OR 3.73), moderate (OR 3.82), or severe periodontitis (OR 4.36), and with probing depth at the sample sites (OR 1.39). HSV and EBV-2 showed no significant associations with any of the variables tested.

CONCLUSIONS

The results indicate that subgingival EBV-1, HCMV, and viral coinfections are associated with the subgingival presence of some periodontal pathogens and periodontitis. Herpesviruses may exert periodontopathic potential by decreasing the host resistance against subgingival colonization and multiplication of periodontal pathogens.

摘要

背景

多种哺乳动物病毒和特定细菌似乎在人类牙周炎的发病机制中起重要作用。本研究调查了140例患有牙周炎或牙龈炎的成年人龈下疱疹病毒与牙周疾病及潜在牙周病原菌之间的关系。

方法

采用巢式聚合酶链反应(PCR)法检测1型和2型爱泼斯坦-巴尔病毒(EBV-1、EBV-2)、人巨细胞病毒(HCMV)和单纯疱疹病毒(HSV)的存在情况,并用16S rRNA PCR检测法鉴定伴放线放线杆菌、牙龈卟啉单胞菌、福赛坦氏菌、中间普氏菌、变黑普氏菌和具核梭杆菌。

结果

经逻辑分析,EBV-1与牙龈卟啉单胞菌呈显著正相关(比值比[OR] 3.37),与牙龈卟啉单胞菌和中间普氏菌的混合感染(OR 4.03)、牙龈卟啉单胞菌和福赛坦氏菌的混合感染(OR 3.84)、牙龈卟啉单胞菌和具核梭杆菌的混合感染(OR 4.17)、牙龈卟啉单胞菌、福赛坦氏菌和具核梭杆菌的混合感染(OR 4.06)以及牙龈卟啉单胞菌、变黑普氏菌和具核梭杆菌的混合感染(OR 3.29)均呈正相关。EBV-1还与重度牙周炎(OR 5.09)、年龄增长(OR 1.03)以及样本部位的牙周探诊深度(OR 1.77)呈正相关。HCMV与牙龈卟啉单胞菌和变黑普氏菌的混合感染(OR 3.23)、牙龈卟啉单胞菌、福赛坦氏菌和变黑普氏菌的混合感染(OR 3.23)以及牙龈卟啉单胞菌、变黑普氏菌和具核梭杆菌的混合感染(OR 2.59)、重度牙周炎(OR 4.65)和年龄(OR 1.03)呈正相关。混合病毒感染的患者与牙龈卟啉单胞菌(OR 2.27)、牙龈卟啉单胞菌和福赛坦氏菌的混合感染(OR 2.06)、牙龈卟啉单胞菌和变黑普氏菌的混合感染(OR 2.91)、牙龈卟啉单胞菌、福赛坦氏菌和变黑普氏菌的混合感染(OR 2.91)以及牙龈卟啉单胞菌、变黑普氏菌和具核梭杆菌的混合感染(OR 2.70)在轻度(OR 3.73)、中度(OR 3.82)或重度牙周炎的临床诊断方面呈正相关,且与样本部位的探诊深度(OR 1.39)呈正相关。HSV和EBV-2与所检测的任何变量均无显著相关性。

结论

结果表明龈下EBV-1、HCMV及病毒混合感染与某些牙周病原菌的龈下存在及牙周炎有关。疱疹病毒可能通过降低宿主对牙周病原菌龈下定植和增殖的抵抗力而发挥牙周致病潜能。

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