Adverse pregnancy outcomes (APOs) and periodontal disease: pathogenic mechanisms

被引:0
作者
Madianos, Phoebus N. [1 ]
Bobetsis, Yiorgos A. [1 ]
Offenbacher, Steven [2 ]
机构
[1] Univ Athens, Sch Dent, Dept Periodontol, Athens 11527, Greece
[2] Univ North Carolina Sch Dent, Dept Periodontol, Chapel Hill, NC USA
关键词
adverse pregnancy outcomes; experimental studies; in vitro studies; pathogenic mechanisms; periodontal disease; C-REACTIVE-PROTEIN; PORPHYROMONAS-GINGIVALIS INFECTION; MATERNAL SERUM INTERLEUKIN-6; NECROSIS-FACTOR-ALPHA; AMNIOTIC-FLUID; FUSOBACTERIUM-NUCLEATUM; PRETERM DELIVERY; ORAL PATHOGENS; INTRAUTERINE INFECTION; GROWTH RESTRICTION;
D O I
10.1111/jcpe.12082
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Aim To evaluate the evidence on potential biological pathways underlying the possible association between periodontal disease (PD) and adverse pregnancy outcomes (APOs). Material & Methods Human, experimental and in vitro studies were evaluated. Results Periodontal pathogens/byproducts may reach the placenta and spread to the foetal circulation and amniotic fluid. Their presence in the foeto-placental compartment can stimulate a foetal immune/inflammatory response characterized by the production of IgM antibodies against the pathogens and the secretion of elevated levels of inflammatory mediators, which in turn may cause miscarriage or premature birth. Moreover, infection/inflammation may cause placental structural changes leading to pre-eclampsia and impaired nutrient transport causing low birthweight. Foetal exposure may also result in tissue damage, increasing the risk for perinatal mortality/morbidity. Finally, the elicited systemic inflammatory response may exacerbate local inflammatory responses at the foeto-placental unit and further increase the risk for APOs. Conclusions Further investigation is still necessary to fully translate the findings of basic research into clinical studies and practice. Understanding the systemic virulence potential of the individual's oral microbiome and immune response may be a distinctly different issue from categorizing the nature of the challenge using clinical signs of PD. Therefore, a more personalized targeted therapy could be a more predictive answer to the current one-size-fits-all interventions.
引用
收藏
页码:S170 / S180
页数:11
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