牙周病與風濕性關節炎之相關性－白細胞介素－17重要性之探討

Relationship between Periodontal Disease and Rheumatoid arthritis-significance of interleukin-17

王進瑋(Chin-Wei Wang) ； 呂炫堃(Hsein-Kun Lu)

《中華牙醫學雜誌（中文版）》 26卷1期 (2007/03) Pp. 9-16

https://doi.org/10.7106/CJD.200703.0009

摘要

牙周病(Periodontal disease)與風濕性關節炎（Rheumatoid arthritis，簡稱RA）的相關性可以從很多方面來探討，從兩者的生理結構、流行病學、致病機轉、臨床特徵、遺傳基因等都有其共同的相關性。然而兩者致病的機轉其實尚未明朗化，畢竟都是多重因子所造成的疾病。而本文提出透過白細胞介素－17（Interleukin-17，簡稱IL-17），可以進一步切入探討兩者的相關性。根據最新的研究發現IL-17主要由幫手型T細胞－17(Th17)所分泌。Th17細胞位於先天免疫與後天免疫反應之間的中樞協調位置，而其所分泌的IL-17則是位於自體免疫反應與感染發炎反應一個最重要的居中角色。IL-17可以直接或間接促進基質分解酶以及蝕骨細胞的生成，進而導致基質的溶解和蝕骨作用。由此可知IL-17在牙周病與風濕性關節炎的致病機轉有不可取代的角色。另外在兩種病變的組織當中IL-17都有顯著的表現，表示兩者與IL-17的相關性，而且IL-17的表現也會進一步影響下游細胞激素的作用。尤其在牙周病的組織當中發現IL-17在病情惡化的初期有更為顯著的表現，表示IL-17在整個致病的起始過程當中影響更為重要。本文提出藉由了解IL-17在兩者之間所扮演的角色，可以進一步建立牙周病與風濕性關節炎兩者之間的相關性，帶來後續更多的討論與研究，以期牙周病能夠與風濕性關節炎和其他慢性發炎疾病同步發展，帶來臨床治療上的新突破。

關鍵字

幫手型T細胞－17 ； 白細胞介素－17 ； 牙周病 ； 風濕性關節炎

並列摘要

The significant association between periodontal disease and rheumatoid arthritis has already been established. Similarities between these 2 diseases can be discussed in terms of the physiological structure, epidemiology, pathogenicity, clinical features, and genetic properties. Multiple factors are involved in both diseases; however, little is known about the relationship between periodontal disease and rheumatoid arthritis. The purpose of this review was to investigate the role of interleukin (IL)-17 in order to better understand the relationship between periodontal disease and rheumatoid arthritis. According to recent findings, IL-17 is exclusively secreted by T helper cells (Th)-17. Th17 cells are a newly found T-cell subset that coordinate innate immunity and adapted immunity. In addition, IL-17 secreted by Th17 cells interferes with interactions among autoimmune and infectious inflammatory responses. Moreover, IL-17 can directly or indirectly increase the expression of matrix metalloproteinase (MMP) and promote osteoclastogenesis. Therefore, IL-17 plays a crucial role in both diseases. In addition, while T cells are abundant in both lesions, classic T cell-derived cytokines are scarce except for IL-17. This suggests that both diseases are strongly associated with IL-17. IL-17 was found to have higher expression in the early stage of periodontal disease, and IL-17 may greatly contribute to the initiation of destructive progression. In this review, we reestablished and strengthened the relationship between periodontal disease and rheumatoid arthritis through understanding the role and expression of IL-17. We highlight the field for discussion to inspire novel clinical treatments for periodontal disease, rheumatoid arthritis, and other chronic inflammatory diseases.

並列關鍵字

Th17 cell ； interleukin-17 IL-17 ； periodontal disease ； rheumatoid arthritis