牙周病与冠心病相关性研究进展综述
Research Progress on the Correlation between Periodontal Disease and Coronary Heart Disease
DOI: 10.12677/acm.2026.1693092, PDF,    科研立项经费支持
作者: 谭亚平, 易娇娇*, 冯玉龙, 史亚丽, 陈智键, 地力木热提·阿巴拜克日：新疆生产建设兵团第一师医院口腔科，新疆 阿克苏；古拉丽亚·艾里别克：塔里木大学动物科学与技术学院，新疆 阿拉尔
关键词: 牙周病；冠状动脉粥样硬化；免疫逃避；血液及淋巴循环 ；Periodontal Disease； Coronary Atherosclerosis； Immune Evasion； Blood and Lymphatic Circulation
摘要: 冠心病主要由冠状动脉粥样硬化斑块引发，是全球致死、致残的首要原因之一，每年有数百万人死亡。牙周病是牙齿支持组织的进行性疾病，以牙槽骨吸收为主要特征，严重可致牙齿松动脱落，全球受其影响人群超10亿，属全球第六大常见疾病。近十年，二者的潜在关联成为研究热点，一方面，牙龈卟啉单胞菌在逃避宿主免疫清除后，会持续刺激机体产生免疫应答，促使全身炎症介质和自身抗体的生成，进而促进动脉粥样硬化；而另一方面，牙龈卟啉单胞菌逃避宿主的固有免疫和适应性免疫，扩散并定植在动脉血管壁上引发血管局部炎症及损伤。本综述主要梳理了牙龈卟啉单胞菌致动脉粥样硬化的具体机制以及相关细胞的相互作用原因，为日后预防该疾病提供新思路。
Abstract: Coronary heart disease is mainly caused by coronary atherosclerotic plaques, which is one of the leading causes of death and disability in the world. Millions of people die every year. Periodontal disease is a progressive disease of tooth support tissue, characterized by alveolar bone resorption, which can seriously cause tooth loosening and shedding. The global affected population is more than 1 billion, which is the sixth common disease in the world. In the past decade, the potential association between the two has become a research hotspot. On the one hand, Porphyromonas gingivalis will continue to stimulate the body to produce an immune response after evading host immune clearance, promoting the production of systemic inflammatory mediators and autoantibodies, thereby promoting atherosclerosis. On the other hand, Porphyromonas gingivalis evades the host’s innate immunity and adaptive immunity, spreads and colonizes on the arterial wall, causing local inflammation and injury of blood vessels. This review mainly reviews the specific mechanism of atherosclerosis caused by Porphyromonas gingivalis and the reasons for the interaction of related cells, so as to provide new ideas for the prevention of this disease in the future.
文章引用：谭亚平, 易娇娇, 冯玉龙, 史亚丽, 陈智键, 地力木热提·阿巴拜克日, 古拉丽亚·艾里别克. 牙周病与冠心病相关性研究进展综述[J]. 临床医学进展, 2026, 16(9): 659-667. https://doi.org/10.12677/acm.2026.1693092

参考文献

[1] 王兴. 第四次全国口腔健康流行病学调查报告[M]. 北京: 人民卫生出版社, 2018.
[2] Trindade, D., Carvalho, R., Machado, V., Chambrone, L., Mendes, J.J. and Botelho, J. (2023) Prevalence of Periodontitis in Dentate People between 2011 and 2020: A Systematic Review and Meta‐Analysis of Epidemiological Studies. Journal of Clinical Periodontology, 50, 604-626.
https://doi.org/10.1111/jcpe.13769
[3] 国家心血管病中心. 中国心血管健康与疾病报告2024 [J]. 中国心血管病研究, 2025, 23(9): 771-793.
[4] Ruan, Q.J., Guan, P., Qi, W.J., Li, J.T., et al. (2023) Porphyromonas Gingivalis Regulates Atherosclerosis through an Immune Pathway. Frontiers in Immunology, 14, Article 1103592.
https://doi.org/10.3389/fimmu.2023.1103592
[5] Chhibber-Goel, J., Singhal, V., Bhowmik, D., Vivek, R., Parakh, N., Bhargava, B., et al. (2016) Linkages between Oral Commensal Bacteria and Atherosclerotic Plaques in Coronary Artery Disease Patients. npj Biofilms and Microbiomes, 2, Article No. 7.
https://doi.org/10.1038/s41522-016-0009-7
[6] Pavlic, V., Peric, D., Kalezic, I.S., Madi, M., Bhat, S.G., Brkic, Z., et al. (2021) Identification of Periopathogens in Atheromatous Plaques Obtained from Carotid and Coronary Arteries. BioMed Research International, 2021, Article 9986375.
https://doi.org/10.1155/2021/9986375
[7] Mougeot, J.C., Stevens, C.B., Paster, B.J., Brennan, M.T., Lockhart, P.B. and Mougeot, F.K.B. (2017) Porphyromonas gingivalis Is the Most Abundant Species Detected in Coronary and Femoral Arteries. Journal of Oral Microbiology, 9, Article 1281562.
https://doi.org/10.1080/20002297.2017.1281562
[8] Guo, X., Li, X., Liao, C., Feng, X. and He, T. (2023) Periodontal Disease and Subsequent Risk of Cardiovascular Outcome and All-Cause Mortality: A Meta-Analysis of Prospective Studies. PLOS ONE, 18, e0290545.
https://doi.org/10.1371/journal.pone.0290545
[9] 孟焕新. 牙周病学[M]. 第5版. 北京: 人民卫生出版社, 2020.
[10] Lux, J. and Lavigne, S. (2004) Your Mouth-Portal to Your Body. CDHA Position Paper on the Links between Oral and General Health. Part I. Probe, 38, 114-134.
[11] Tran, A.H., Zaidi, A.H., Bolger, A.F., Del Brutto, O.H., Hegde, R., Patton, L.L., et al. (2025) Periodontal Disease and Atherosclerotic Cardiovascular Disease: A Scientific Statement from the American Heart Association. Circulation, 153, e287-e304.
https://doi.org/10.1161/cir.0000000000001390
[12] Lasserre, J.F., Brecx, M.C. and Toma, S. (2018) Oral Microbes, Biofilms and Their Role in Periodontal and Peri-Implant Diseases. Materials, 11, Article 1802.
https://doi.org/10.3390/ma11101802
[13] Hajishengallis, G. and Lamont, R.J. (2012) Beyond the Red Complex and into More Complexity: The Polymicrobial Synergy and Dysbiosis (PSD) Model of Periodontal Disease Etiology. Molecular Oral Microbiology, 27, 409‑419.
https://doi.org/10.1111/j.2041-1014.2012.00663.x
[14] Olsen, I., Lambris, J.D. and Hajishengallis, G. (2017) Porphyromonas gingivalis Disturbs Host—Commensal Homeostasis by Changing Complement Function. Journal of Oral Microbiology, 9, Article 1340085.
https://doi.org/10.1080/20002297.2017.1340085
[15] Huang, X., Xie, M., Lu, X., Mei, F., Song, W., Liu, Y., et al. (2023) The Roles of Periodontal Bacteria in Atherosclerosis. International Journal of Molecular Sciences, 24, Article 12861.
https://doi.org/10.3390/ijms241612861
[16] Wu, D., Li, X., Zhao, G., Hao, L. and Liu, X. (2025) Discovery of Gingipains and Porphyromonas gingivalis Inhibitors from Food-Derived Natural Products: A Narrative Review. Foods, 14, Article 2869.
https://doi.org/10.3390/foods14162869
[17] Meghil, M.M., Ghaly, M. and Cutler, C.W. (2022) A Tale of Two Fimbriae: How Invasion of Dendritic Cells by Porphyromonas gingivalis Disrupts DC Maturation and Depolarizes the T-Cell-Mediated Immune Response. Pathogens, 11, Article 328.
https://doi.org/10.3390/pathogens11030328
[18] Batty, M., Bennett, M.R. and Yu, E. (2022) The Role of Oxidative Stress in Atherosclerosis. Cells, 11, Article 3843.
https://doi.org/10.3390/cells11233843
[19] Zeng, R.X., Li, S. and Li, J.J. (2026) Cholesterol-Inflammation Fusion Hypothesis in Atherosclerosis: An Evolving Paradigm in Pathogenesis and Therapy. JACC: Asia, 6, 284-296.
https://doi.org/10.1016/j.jacasi.2026.01.002
[20] Naito, M., Suzuki, H., Mori, T., et al. (1992) Coexpression of Type I and Type II Human Macrophage Scavenger Receptors in Macrophages of Various Organs and Foam Cells in Atherosclerotic Lesions. The American Journal of Pathology, 141, 591-599.
[21] Jebari-Benslaiman, S., Galicia-García, U., Larrea-Sebal, A., Olaetxea, J.R., Alloza, I., Vandenbroeck, K., et al. (2022) Pathophysiology of Atherosclerosis. International Journal of Molecular Sciences, 23, Article 3346.
https://doi.org/10.3390/ijms23063346
[22] 段兴鹏, 刘景丽, 王澈, 尚德静. 巨噬细胞清道夫受体与toll样受体对ox-LDL摄取和炎症的影响[J]. 生物技术进展, 2024, 14(4): 668-675.
[23] Zindel, J. and Kubes, P. (2020) DAMPs, PAMPs, and LAMPs in Immunity and Sterile Inflammation. Annual Review of Pathology: Mechanisms of Disease, 15, 493-518.
https://doi.org/10.1146/annurev-pathmechdis-012419-032847
[24] Ohshima, J., Wang, Q., Fitzsimonds, Z.R., Miller, D.P., Sztukowska, M.N., Jung, Y., et al. (2019) Streptococcus gordonii Programs Epithelial Cells to Resist ZEB2 Induction by Porphyromonas gingivalis. Proceedings of the National Academy of Sciences, 116, 8544-8553.
https://doi.org/10.1073/pnas.1900101116
[25] Kanellakis, P., Agrotis, A., Kyaw, T.S., Koulis, C., Ahrens, I., Mori, S., et al. (2011) High-Mobility Group Box Protein 1 Neutralization Reduces Development of Diet-Induced Atherosclerosis in Apolipoprotein E-Deficient Mice. Arteriosclerosis, Thrombosis, and Vascular Biology, 31, 313-319.
https://doi.org/10.1161/atvbaha.110.218669
[26] Charoensaensuk, V., Chen, Y., Lin, Y., Ou, K., Yang, L. and Lu, D. (2021) Porphyromonas gingivalis Induces Proinflammatory Cytokine Expression Leading to Apoptotic Death through the Oxidative Stress/NF-κB Pathway in Brain Endothelial Cells. Cells, 10, Article 3033.
https://doi.org/10.3390/cells10113033
[27] Zhang, J., Xie, M., Huang, X., Chen, G., Yin, Y., Lu, X., et al. (2021) The Effects of Porphyromonas gingivalis on Atherosclerosis-Related Cells. Frontiers in Immunology, 12, Article 766560.
https://doi.org/10.3389/fimmu.2021.766560
[28] Zhu, X.Z., Huang, H.Y. and Zhao, L. (2022) PAMPs and DAMPs as the Bridge between Periodontitis and Atherosclerosis: The Potential Therapeutic Targets. Frontiers in Cell and Developmental Biology, 10, Article 856118.
https://doi.org/10.3389/fcell.2022.856118
[29] 葛颂, 喻丽, 冯馨仪. 牙龈卟啉单胞菌的研究进展[J]. 口腔疾病防治, 2016, 24(5): 314-317.
[30] Hajishengallis, G., Darveau, R.P. and Curtis, M.A. (2012) The Keystone-Pathogen Hypothesis. Nature Reviews Microbiology, 10, 717-725.
https://doi.org/10.1038/nrmicro2873
[31] Gorasia, D.G., Veith, P.D., Chen, D., Seers, C.A., Mitchell, H.A., Chen, Y., et al. (2015) Porphyromonas gingivalis Type IX Secretion Substrates Are Cleaved and Modified by a Sortase-Like Mechanism. PLOS Pathogens, 11, e1005152.
https://doi.org/10.1371/journal.ppat.1005152
[32] 吴沁蕊, 彭显. 牙龈卟啉单胞菌促进心血管疾病的研究进展[J]. 口腔医学研究, 2022, 38(2): 108-112.
[33] 雷双, 庾靖君, 唐晓琳. 牙龈卟啉单胞菌对不同组织来源血管内皮细胞的作用及机制的研究进展[J]. 国际口腔医学杂志, 2021, 48(1): 23-28.
[34] Chistiakov, D.A., Orekhov, A.N. and Bobryshev, Y.V. (2016) Links between Atherosclerotic and Periodontal Disease. Experimental and Molecular Pathology, 100, 220-235.
https://doi.org/10.1016/j.yexmp.2016.01.006
[35] Schenkein, H.A., Papapanou, P.N., Genco, R. and Sanz, M. (2020) Mechanisms Underlying the Association between Periodontitis and Atherosclerotic Disease. Periodontology 2000, 83, 90-106.
https://doi.org/10.1111/prd.12304
[36] 王泽坤, 徐欣, 周学东. 牙周致病菌在心血管疾病中的作用机制研究进展[J]. 四川大学学报(医学版), 2022, 53(4): 732-736.
[37] Wu, Y., Xu, W., Hou, J., Liu, Y., Li, R., Liu, J., et al. (2019) Porphyromonas gingivalis-Induced MIF Regulates Intercellular Adhesion Molecule-1 Expression in EA.hy926 Cells and Monocyte-Endothelial Cell Adhesion through the Receptors CD74 and CXCR4. Inflammation, 42, 874-883.
https://doi.org/10.1007/s10753-018-0942-0
[38] Berggreen, E. and Wiig, H. (2013) Lymphangiogenesis and Lymphatic Function in Periodontal Disease. Journal of Dental Research, 92, 1074-1080.
https://doi.org/10.1177/0022034513504589
[39] Olsen, I. and Progulske-Fox, A. (2015) Invasion of Porphyromonas gingivalis Strains into Vascular Cells and Tissue. Journal of Oral Microbiology, 7, Article 28788.
https://doi.org/10.3402/jom.v7.28788
[40] Reiner, Ž. (2017) Hypertriglyceridaemia and Risk of Coronary Artery Disease. Nature Reviews Cardiology, 14, 401-411.
https://doi.org/10.1038/nrcardio.2017.31
[41] Costa, F.O., Cota, L.O., Lages, E.J., et al. (2013) Associations of Duration of Smoking Cessation and Cumulative Smoking Exposure with Periodontitis. Journal of Oral Science, 55, 245-253.
https://doi.org/10.2334/josnusd.55.245
[42] 吴亚菲, 刘程程. 慢性牙周炎与心血管疾病关系的研究进展[J]. 口腔疾病防治, 2017, 25(11): 681-686.
[43] Ebersole, J.L., Graves, C.L., Gonzalez, O.A., Dawson, D., Morford, L.A., Huja, P.E., et al. (2016) Aging, Inflammation, Immunity and Periodontal Disease. Periodontology 2000, 72, 54-75.
https://doi.org/10.1111/prd.12135
[44] Hansen‑Poulsen, T., Gæde, P., Holm‑Pedersen, J., et al. (2023) Treated Periodontitis and Recurrent Events after First‑Time Myocardial Infarction: A Danish Nationwide Cohort Study. Journal of Clinical Periodontology, 50, 1042‑1051.
https://doi.org/10.1111/jcpe.13853
[45] Norhammar, A., Näsman, P., Buhlin, K., de Faire, U., Ferrannini, G., Gustafsson, A., et al. (2025) Does Periodontitis Increase the Risk for Future Cardiovascular Events? Long‐Term Follow‐Up of the PAROKRANK Study. Journal of Clinical Periodontology, 52, 16-23.
https://doi.org/10.1111/jcpe.14064

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