PDF(Pubmed)
Abstract：
The frequent severe COVID-19 course in patients with periodontitis suggests a link of the aetiopathogenesis of both diseases. The formation of intravascular neutrophil extracellular traps (NETs) is crucial to the pathogenesis of severe COVID-19. Periodontitis is characterised by an increased level of circulating NETs, a propensity for increased NET formation, delayed NET clearance and low-grade endotoxemia (LGE). The latter has an enormous impact on innate immunity and susceptibility to infection with SARS-CoV-2. LPS binds the SARS-CoV-2 spike protein and this complex, which is more active than unbound LPS, precipitates massive NET formation. Thus, circulating NET formation is the common denominator in both COVID-19 and periodontitis and other diseases with low-grade endotoxemia like diabetes, obesity and cardiovascular diseases (CVD) also increase the risk to develop severe COVID-19. Here we discuss the role of propensity for increased NET formation, DNase I deficiency and low-grade endotoxaemia in periodontitis as aggravating factors for the severe course of COVID-19 and possible strategies for the diminution of increased levels of circulating periodontitis-derived NETs in COVID-19 with periodontitis comorbidity.
摘要：
牙周炎患者常见的严重COVID-19病程表明这两种疾病的病因之间存在联系。血管内中性粒细胞胞外诱捕网（NETs）的形成对重症COVID-19的发病机制至关重要。牙周炎的特征是循环NETs水平升高，净形成增加的倾向，延迟净清除和低度内毒素血症（LGE）。后者对先天免疫和对SARS-CoV-2感染的易感性具有巨大影响。LPS结合SARS-CoV-2刺突蛋白和这个复合物，比未结合的LPS更活跃，沉淀大量的净形成。因此，循环网络的形成是COVID-19和牙周炎以及其他低级别内毒素血症如糖尿病的疾病的共同点，肥胖和心血管疾病（CVD）也会增加患严重COVID-19的风险。在这里，我们讨论了增加净形成倾向的作用，牙周炎中的DNaseI缺乏和低度内毒素血症是COVID-19严重病程的加重因素，以及降低COVID-19伴牙周炎共病的循环牙周炎源性NETs水平升高的可能策略。
