牙齦卟啉單胞菌影響血管平滑肌細胞調(diào)節(jié)性細胞死亡及表型轉(zhuǎn)換的研究進展

[中圖分類號]R780.2[文獻標志碼]A[doi] 10.7518/gjkq.2025055

Research progressinto the effects of Porphyromonas gingivalis on regulatory celldeath and phenotypic switching of vascular smooth muscle cells

BieMengyao，ZhouJieyu，WuYafei，Zhaoei

StateKeyLaboratoryofOralDiseasesamp;NationalCenterforStomatologyamp;NationalClinicalResearchCenterforOral Diseasesamp;ptridontologyWestaHosptalototologyianUersitygduin Supportedby：NationalNaturalScienceFoundationofChina （81970944）；NationalNaturalScienceFoundationofChina YouthFund （823o089）；Researchndveloprogram，WesthinaHospitaloftomatologyichanUnivesityD02-202407）

Correspondence：ZhaoLei，Email：jollyzldoc@163.com

[Abstract]Periodontitis isachronic inflammatorydiseasecausedbybacterial infection.Epidemiologicalstudiesandin vivo/invitroresearchhaveconsistentlydemonstratedastrongasociationbetweenperiodontitisandanincreasedriskof cardiovascular diseases.Vascular smooth muscle cells （VSMCs）participate in the pathogenesisof atherosclerosis，aortic aneurysms，and vascularcalcification viaregulatedcelldeath mechanisms （inluding autophagyapoptosis，and pyopto sis）andphenotypic switching.Porphyromonas gingivalis，acritical periodontal pathogen，alters VSMCbiological behavior，notonly invading VSMCs to influence their regulated celldeath processbutalso promoting phenotypic switching characterized by proliferation，migration，and calcification.These mechanisms playpivotalroles incardiovasculardisease

development. This review aims to synthesize recent research advances and elucidate the connections between periodontitisand VSMC-regulated cell death/phenotypic switching.Novel insightsinto improved preventionand treatment strategies for periodontitisand cardiovascular diseases are provided.

[Key words] Porphyromonas gingivalis； vasculai smooth muscle cell； cardiovascular diseases； phenotypic switching； periodontitis

牙周炎是由菌斑微生物引起的慢性感染性疾病，表現(xiàn)為牙周支持組織破壞，例如牙周袋形成、附著水平喪失、牙槽骨吸收、牙齒脫落等，能夠造成口腔局部及全身的慢性炎癥。牙周病原菌及其代謝產(chǎn)物的增加不僅會刺激口腔局部炎癥介質(zhì)和細胞因子的產(chǎn)生，造成局部炎癥狀態(tài)，還可以通過破損的牙周袋上皮進入血液，導(dǎo)致細菌傳播和全身慢性感染。在心血管系統(tǒng)的不同組織和器官（包括人心臟組織、心包液、心臟瓣膜）和動脈粥樣硬化病變中均可以檢測到牙周病原體或其產(chǎn)物[1-4]。2020年關(guān)于牙周炎和心血管疾病（car-diovasculardiseases，CVD）的共識報告[5也指出：牙周炎患者罹患冠心病、血管疾病、心力衰竭和房顫等CVD事件的風(fēng)險顯著增加。

牙齦卟啉單胞菌（Porphyromonasgingivalis，P.gingivalis）是一種革蘭陰性厭氧球桿菌，不僅屬于促進牙周炎發(fā)生發(fā)展的關(guān)鍵“基石菌群”，還與動脈粥樣硬化、類風(fēng)濕性關(guān)節(jié)炎、阿爾茨海默病等全身性疾病密切相關(guān)。P.gingivalis產(chǎn)生多種毒力因子，如脂多糖（lipopolysaccharide，LPS）、牙齦素（Gingipain）、外膜囊泡和菌毛等，黏附并侵入宿主細胞，逃避宿主免疫監(jiān)視，引起局部組織損傷，破壞宿主的免疫機制，誘導(dǎo)產(chǎn)生更多的炎癥因子。不僅如此，P.gingivalis還可以通過咀嚼、刷牙、牙周治療或袋壁潰瘍等進入血液循環(huán)，導(dǎo)致血管損傷和功能障礙，從而促進CVD的發(fā)生發(fā)展。有研究顯示：在侵襲性牙周炎和慢性牙周炎患者唾液和牙周袋中都能夠檢出 P . gingivalis，唾液中檢出率為 4 6 . 3 % ，牙周袋中高達 73 . 3 % 。不僅如此， P . gingivalis在頸動脈病變和動脈粥樣硬化組織的檢出率也較高，分別為 78 . 6 % 和 。……