背景:目前的文献表明,泡沫细胞通过在动脉粥样硬化斑块中形成坏死核心,在动脉粥样硬化的启动中具有重要作用。此外,一种重要的牙周病原体,称为牙龈卟啉单胞菌(P.牙龈)在这方面起着重要作用。因此,本系统综述的目的是全面研究牙龈卟啉单胞菌作为牙周病中一种突出的细菌种类的途径,可以诱导泡沫细胞,从而启动动脉粥样硬化形成的过程。
方法:在三个数据库中进行了电子搜索(Pubmed,Scopus,和WebofScience),以确定从2000年1月到2023年3月发表的研究。还使用QUIN偏倚风险评估工具评估了每项研究中的偏倚风险。
结果:筛选过程完成后,11项体外研究符合纳入标准,并纳入进一步评估。其中9项研究代表了中等偏倚风险,而另外两个有很高的偏倚风险。所有的研究都报道了牙龈卟啉单胞菌通过感染巨噬细胞和诱导氧化低密度脂蛋白(oxLDL)摄取而显著诱导泡沫细胞形成。该过程通过各种介质和途径被激活。在这方面最重要的因素是牙龈卟啉单胞菌的脂多糖及其外膜囊泡,以及跨膜脂质转运通道表达率的变化,包括香草素亚家族4(TRPV4)的瞬时受体电位通道,溶酶体整合蛋白2(LIMP2),CD36等在此过程中涉及的鉴定的分子途径包括但不限于NF-κB,ERK1/2,p65。
结论:根据本研究的结果,可以得出结论,牙龈卟啉单胞菌可以通过各种致病因素有效促进泡沫细胞的形成,这种细菌可以影响细胞和溶酶体膜中各种基因的表达率以及特定受体的功能。然而,由于研究中存在中度到高度的偏倚风险,在这方面需要进一步的研究。
The current literature suggests the significant role of foam cells in the initiation of atherosclerosis through the formation of a necrotic core in atherosclerotic plaques. Moreover, an important periodontal pathogen called Porphyromonas gingivalis (P. gingivalis) is indicated to play a significant role in this regard. Thus, the aim of this systematic
review was to comprehensively study the pathways by which P. gingivalis as a prominent bacterial species in periodontal disease, can induce foam cells that would initiate the process of atherosclerosis formation.
An electronic search was undertaken in three databases (Pubmed, Scopus, and Web of Science) to identify the studies published from January 2000 until March 2023. The risk of bias in each study was also assessed using the QUIN risk of bias assessment tool.
After the completion of the screening process, 11 in-vitro studies met the inclusion criteria and were included for further assessments. Nine of these studies represented a medium risk of bias, while the other two had a high risk of bias. All of the studies have reported that P. gingivalis can significantly induce foam cell formation by infecting the macrophages and induction of oxidized low-density lipoprotein (oxLDL) uptake. This process is activated through various mediators and pathways. The most important factors in this regard are the lipopolysaccharide of P. gingivalis and its outer membrane vesicles, as well as the changes in the expression rate of transmembrane lipid transportation channels, including transient receptor potential channel of the vanilloid subfamily 4 (TRPV4), lysosomal integral protein 2 (LIMP2), CD36, etc. The identified molecular pathways involved in this process include but are not limited to NF-κB, ERK1/2, p65.
Based on the results of this study, it can be concluded that P. gingivalis can effectively promote foam cell formation through various pathogenic elements and this bacterial species can affect the expression rate of various genes and the function of specific receptors in the cellular and lysosomal membranes. However, due to the moderate to high level of risk of bias among the studies, further studies are required in this regard.