牙周炎与慢性乙型肝炎的关联及机制
The Association and Mechanisms between Periodontitis and Chronic Hepatitis B
摘要: 牙周炎作为常见的口腔慢性感染性疾病,与慢性乙型肝炎之间存在着复杂的相互关系。本文详细阐述了牙周炎的基本特征、影响因素及其全身性影响,深入探讨了牙周炎与慢性乙型肝炎在病毒传播、炎症反应、免疫系统功能等方面的相互作用,分析了慢性乙型肝炎向肝硬化及肝细胞癌进展过程中牙周炎及微生物群落失衡所起的作用,同时阐述了口腔微生物群落失衡与口–肠–肝轴的关系,强调了重视口腔健康对慢性乙型肝炎防治的重要意义,并对未来研究方向提出展望。
Abstract: As a common chronic infectious disease of the oral cavity, periodontitis has a complex interrelationship with chronic hepatitis B. This paper elaborates in detail on the basic characteristics, influencing factors and systemic impacts of periodontitis, and conducts an in-depth exploration of the interactions between periodontitis and chronic hepatitis B in terms of virus transmission, inflammatory response, immune system function, etc. It also analyzes the roles that periodontitis and the imbalance of the microbial community play in the progression of chronic hepatitis B to liver cirrhosis and hepatocellular carcinoma. Meanwhile, it expounds on the relationship between the imbalance of the oral microbial community and the oral-gut-liver axis, emphasizes the great significance of attaching importance to oral health in the prevention and treatment of chronic hepatitis B, and presents prospects for future research directions.
文章引用:陈佳泰, 高志. 牙周炎与慢性乙型肝炎的关联及机制[J]. 临床医学进展, 2025, 15(1): 1769-1777. https://doi.org/10.12677/acm.2025.151236

参考文献

[1] Sehgal, R., Bedi, O. and Trehanpati, N. (2020) Role of Microbiota in Pathogenesis and Management of Viral Hepatitis. Frontiers in Cellular and Infection Microbiology, 10, Article 341. [Google Scholar] [CrossRef] [PubMed]
[2] Frencken, J.E., Sharma, P., Stenhouse, L., Green, D., Laverty, D. and Dietrich, T. (2017) Global Epidemiology of Dental Caries and Severe Periodontitis—A Comprehensive Review. Journal of Clinical Periodontology, 44, S94-S105. [Google Scholar] [CrossRef] [PubMed]
[3] GBD 2016 Disease and Injury Incidence and Prevalence Collaborators (2017) Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 328 Diseases and Injuries for 195 Countries, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016. The Lancet, 390, 1211-1259. [Google Scholar] [CrossRef
[4] Loos, B.G. and Van Dyke, T.E. (2020) The Role of Inflammation and Genetics in Periodontal Disease. Periodontology 2000, 83, 26-39. [Google Scholar] [CrossRef] [PubMed]
[5] Lalla, E. and Papapanou, P.N. (2011) Diabetes Mellitus and Periodontitis: A Tale of Two Common Interrelated Diseases. Nature Reviews Endocrinology, 7, 738-748. [Google Scholar] [CrossRef] [PubMed]
[6] Farrugia, C., Stafford, G.P., Potempa, J., Wilkinson, R.N., Chen, Y., Murdoch, C., et al. (2020) Mechanisms of Vascular Damage by Systemic Dissemination of the Oral Pathogen Porphyromonas gingivalis. The FEBS Journal, 288, 1479-1495. [Google Scholar] [CrossRef] [PubMed]
[7] Diaz, P.I. (2020) Subgingival Fungi, Archaea, and Viruses under the Omics Loupe. Periodontology 2000, 85, 82-89. [Google Scholar] [CrossRef] [PubMed]
[8] O’Toole, P.W. and Cooney, J.C. (2008) Probiotic Bacteria Influence the Composition and Function of the Intestinal Microbiota. Interdisciplinary Perspectives on Infectious Diseases, 2008, Article ID: 175285. [Google Scholar] [CrossRef] [PubMed]
[9] Hajishengallis, G. and Chavakis, T. (2021) Local and Systemic Mechanisms Linking Periodontal Disease and Inflammatory Comorbidities. Nature Reviews Immunology, 21, 426-440. [Google Scholar] [CrossRef] [PubMed]
[10] Pussinen, P.J., Tuomisto, K., Jousilahti, P., Havulinna, A.S., Sundvall, J. and Salomaa, V. (2007) Endotoxemia, Immune Response to Periodontal Pathogens, and Systemic Inflammation Associate with Incident Cardiovascular Disease Events. Arteriosclerosis, Thrombosis, and Vascular Biology, 27, 1433-1439. [Google Scholar] [CrossRef] [PubMed]
[11] Qin, N., Yang, F., Li, A., Prifti, E., Chen, Y., Shao, L., et al. (2014) Alterations of the Human Gut Microbiome in Liver Cirrhosis. Nature, 513, 59-64. [Google Scholar] [CrossRef] [PubMed]
[12] Kamimura, H., Watanabe, J., Sugano, T., Kohisa, J., Abe, H., Kamimura, K., et al. (2021) Relationship between Detection of Hepatitis B Virus in Saliva and Periodontal Disease in Hepatitis B Virus Carriers in Japan. Journal of Infection and Chemotherapy, 27, 492-496. [Google Scholar] [CrossRef] [PubMed]
[13] Pollock, J.J., Andors, L., Gulumoglu, A. and Ells, P.F. (1984) Direct Measurement of Hepatitis B Viral Antibody and Antigen Markers in Gingival Crevicular Fluid. Oral Surgery, Oral Medicine, Oral Pathology, 57, 499-503. [Google Scholar] [CrossRef] [PubMed]
[14] Ding, L., Liang, L., Zhao, Y., Yang, Y., Liu, F., Ding, Q., et al. (2019) Porphyromonas gingivalis‐Derived Lipopolysaccharide Causes Excessive Hepatic Lipid Accumulation via Activating NF‐κB and JNK Signaling Pathways. Oral Diseases, 25, 1789-1797. [Google Scholar] [CrossRef] [PubMed]
[15] Schroeder, B.O. and Bäckhed, F. (2016) Signals from the Gut Microbiota to Distant Organs in Physiology and Disease. Nature Medicine, 22, 1079-1089. [Google Scholar] [CrossRef] [PubMed]
[16] Moon, A.M., Singal, A.G. and Tapper, E.B. (2020) Contemporary Epidemiology of Chronic Liver Disease and Cirrhosis. Clinical Gastroenterology and Hepatology, 18, 2650-2666. [Google Scholar] [CrossRef] [PubMed]
[17] Tsuchida, T. and Friedman, S.L. (2017) Mechanisms of Hepatic Stellate Cell Activation. Nature Reviews Gastroenterology & Hepatology, 14, 397-411. [Google Scholar] [CrossRef] [PubMed]
[18] Bedossa, P. and Paradis, V. (2003) Liver Extracellular Matrix in Health and Disease. The Journal of Pathology, 200, 504-515. [Google Scholar] [CrossRef] [PubMed]
[19] Hajishengallis, G. (2014) Periodontitis: From Microbial Immune Subversion to Systemic Inflammation. Nature Reviews Immunology, 15, 30-44. [Google Scholar] [CrossRef] [PubMed]
[20] Chen, R., Xu, L., Du, S., Huang, S., Wu, H., Dong, J., et al. (2016) Lactobacillus rhamnosus GG Supernatant Promotes Intestinal Barrier Function, Balances T Reg and TH 17 Cells and Ameliorates Hepatic Injury in a Mouse Model of Chronic-Binge Alcohol Feeding. Toxicology Letters, 241, 103-110. [Google Scholar] [CrossRef] [PubMed]
[21] Wight, T.N. and Potter-Perigo, S. (2011) The Extracellular Matrix: An Active or Passive Player in Fibrosis? American Journal of Physiology-Gastrointestinal and Liver Physiology, 301, G950-G955. [Google Scholar] [CrossRef] [PubMed]
[22] Schuppan, D. and Afdhal, N.H. (2008) Liver Cirrhosis. The Lancet, 371, 838-851. [Google Scholar] [CrossRef] [PubMed]
[23] Tamaki, N., Takaki, A., Tomofuji, T., Endo, Y., Kasuyama, K., Ekuni, D., et al. (2011) Stage of Hepatocellular Carcinoma Is Associated with Periodontitis. Journal of Clinical Periodontology, 38, 1015-1020. [Google Scholar] [CrossRef] [PubMed]
[24] Wei, C., Ni, C., Song, T., Liu, Y., Yang, X., Zheng, Z., et al. (2010) The Hepatitis B Virus X Protein Disrupts Innate Immunity by Downregulating Mitochondrial Antiviral Signaling Protein. The Journal of Immunology, 185, 1158-1168. [Google Scholar] [CrossRef] [PubMed]
[25] Isayama, F., Hines, I.N., Kremer, M., Milton, R.J., Byrd, C.L., Perry, A.W., et al. (2006) LPS Signaling Enhances Hepatic Fibrogenesis Caused by Experimental Cholestasis in Mice. American Journal of Physiology-Gastrointestinal and Liver Physiology, 290, G1318-G1328. [Google Scholar] [CrossRef] [PubMed]
[26] Arimatsu, K., Yamada, H., Miyazawa, H., Minagawa, T., Nakajima, M., Ryder, M.I., et al. (2014) Oral Pathobiont Induces Systemic Inflammation and Metabolic Changes Associated with Alteration of Gut Microbiota. Scientific Reports, 4, Article No. 4828. [Google Scholar] [CrossRef] [PubMed]
[27] Cifcibasi, E., Ciblak, M., Kiran, B., Badur, S., Firatli, E., Issever, H., et al. (2015) The Role of Activated Cytotoxic T Cells in Etiopathogenesis of Periodontal Disease: Does It Harm or Does It Heal? Scientific Reports, 5, Article No. 9262. [Google Scholar] [CrossRef] [PubMed]
[28] Albuquerque‐Souza, E. and Sahingur, S.E. (2022) Periodontitis, Chronic Liver Diseases, and the Emerging Oral‐Gut‐Liver Axis. Periodontology 2000, 89, 125-141. [Google Scholar] [CrossRef] [PubMed]
[29] Dubinkina, V.B., Tyakht, A.V., Odintsova, V.Y., Yarygin, K.S., Kovarsky, B.A., Pavlenko, A.V., et al. (2017) Links of Gut Microbiota Composition with Alcohol Dependence Syndrome and Alcoholic Liver Disease. Microbiome, 5, Article No. 141. [Google Scholar] [CrossRef] [PubMed]
[30] Ziegler, K., Kerimi, A., Poquet, L. and Williamson, G. (2016) Butyric Acid Increases Transepithelial Transport of Ferulic Acid through Upregulation of the Monocarboxylate Transporters SLC16A1 (MCT1) and SLC16A3 (MCT4). Archives of Biochemistry and Biophysics, 599, 3-12. [Google Scholar] [CrossRef] [PubMed]
[31] Xu, W., Zhou, W., Wang, H. and Liang, S. (2020) Roles of Porphyromonas gingivalis and Its Virulence Factors in Periodontitis. Advances in Protein Chemistry and Structural Biology, 120, 45-84. [Google Scholar] [CrossRef] [PubMed]
[32] Saygun, I., Nizam, N., Keskiner, I., Bal, V., Kubar, A., Açıkel, C., et al. (2011) Salivary Infectious Agents and Periodontal Disease Status. Journal of Periodontal Research, 46, 235-239. [Google Scholar] [CrossRef] [PubMed]
[33] Tripathi, A., Debelius, J., Brenner, D.A., Karin, M., Loomba, R., Schnabl, B., et al. (2018) The Gut-Liver Axis and the Intersection with the Microbiome. Nature Reviews Gastroenterology & Hepatology, 15, 397-411. [Google Scholar] [CrossRef] [PubMed]