四環黴素的非抗菌特性與牙周病的關聯

Relations between the non-antimicrobial Properties of Tetracycline and Periodontal Diseases

徐世勳(Shih-Shiun Shyu) ； 呂炫堃(Hsein-Kun Lu)

《中華民國牙周病醫學會雜誌》 12卷4期 (2007/12) Pp. 323-336

摘要

牙周病爲一細菌感染的傳染性疾病，牙周致病菌藉由本身產生間質金屬結合蛋白酶(Matrix Metalloproteinase, MMP)破壞組織，或藉由內毒素刺激宿主產生免疫反應，引發宿主自己產生MMP或藉由分泌細胞激素(cytokine)來促進MMP的產生和破骨細胞生成，進而造成牙周組織的破壞。四環黴素的非抗菌特性可以改善牙周狀況而達到治療牙周病的效果，其中其非抗菌特性包括抑制MMP、促進成骨細胞(osteoblast)的骨生成作用、抑制破骨細胞生成的作用、降低一氧化氮的生成、抑制蛋白激本酶C(Protein kinase C)、抑制發炎前驅物質(pro-inflammation mediators)生成、保護α1抗胰蛋白酶(α1-antitrypsin)使組織免於被破壞等，這些在對於組織破壞方面都有改善的效果。另外四環黴素療法也逐漸更新，許多的化學修飾的四環黴素(chemically modified tetracycline, CMT)逐漸的被合成出來，目前主要以長期的使用低於抗菌劑量的脫氧羥基四環素(sub-antimicrobial-dose doxycycline)發揮其抑制組織破壞的非抗菌特性來達到改善牙周狀況的目的。

關鍵字

化學修飾的四環黴素 ； 間質金屬結合蛋白酶 ； 白血球間質－1 ； 白血球間質－6 ； 前列腺素E2 ； 低於抗菌劑量的脫氧羥基四環素

並列摘要

Periodontal disease is an infectious disease which is caused by bacteria. Some bacteria that cause periodontal disease can produce matrix metalloproteinase (MMP) to destroy the normal tissue. Others can produce endotoxin, which can stimulate immune system to cause body cells to release MMP or cytokines that can stimulate the production of MMP and osteoclasts to cause periodontal tissue damage. The non-antimicrobial properties of tetracycline which include reducing MMP, stimulating the osteogenesis by osteoblasts, inhibiting the production of osteoclasts, reducing the formation of nitric oxide, inhibiting protein kinase C, inhibiting the formation of pro-inflammation mediators, protecting α 1-antitrypsin etc., can improve the periodontal status. Furthermore, more and more chemically modified tetracycline (CMT) has been synthesized. Up to date, long term administration of sub-antimicrobial-dose doxycycline (SDD) has become a prevailing treatment for the treatment of periodontal disease by utilizing its non-antimicrobial properties.

並列關鍵字

chemically modified tetracycline CMT ； matrix metalloproteinase MMP ； interleukin-1 IL-1 ； interleukin-6 IL-6 ； prostaglandin E2 PGE2 ； subantimicrobial-dose doxycycline SDD