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Pathogenese der Parodontitis bei rheumatischen Erkrankungen

Pathogenesis of parodontitis in rheumatic diseases

  • Leitthema
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Zusammenfassung

Die entzündliche Parodontalerkrankung (PD) ist eine weltweit verbreitete Krankheit, die in erster Linie bakterieller Genese ist und durch Dysregulation der entzündlichen Immunreaktion des Wirtes gekennzeichnet ist. Der Grad der Entzündung variiert zwischen Personen mit PD unabhängig vom Grad der bakteriellen Infektion. Das deutet darauf hin, dass funktionelle Veränderungen des Immunsystems im Wesentlichen zu den substanziellen Ursachen zählen. Rauchen, Schulbildung und „Body Mass Index“ (BMI) werden als potenzielle Risikofaktoren für eine PD diskutiert. Die meisten PD-Patienten reagieren auf bakterielle Pathogene durch die Mobilisierung ihrer Abwehrzellen und der damit verbundenen Zytokine wie Interleukin- (IL-)1β, Tumor-Nekrose-Faktor- (TNF-)α und IL-6. Ursache für die Zerstörung des Gewebes ist letztlich die Aktivierung der Bildung von kollagenolytischen Enzymen, wie Matrix-Metalloproteinasen. In letzter Zeit wurde immer deutlicher, dass eine Assoziation zwischen PD und dem erhöhten Risiko von systemischen Erkrankungen, wie Arteriosklerose, Diabetes mellitus, Schlaganfall und rheumatoider Arthritis (RA) besteht. PD und rheumatologische Erkrankungen wie die RA weisen einige gemeinsame pathogenetische und immunpathologische Aspekte auf.

Abstract

Inflammatory periodontal disease (PD) is a common disease worldwide that has a primarily bacterial aetiology and is characterized by dysregulation of the host inflammatory response. The degree of inflammation varies among individuals with PD independently of the degree of bacterial infection, suggesting that alteration of the immune function may substantially contribute to its extent. Factors such as smoking, education, and body mass index (BMI) are discussed as potential risk factors for PD. Most PD patients respond to bacterial invaders by mobilizing their defensive cells and releasing cytokines such as interleukin (IL)-1β, tumour necrosis factor (TNF)-α, and IL-6, which ultimately causes tissue destruction by stimulating the production of collagenolytic enzymes, such matrix metalloproteinases. Recently, there has been growing evidence suggesting an association between PD and the increased risk of systemic diseases, such ateriosclerosis, diabetes mellitus, stroke, and rheumatoid arthritis (RA). PD and rheumatologic diseases such as RA share many pathological aspects and immunological findings.

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  1. Klinik mit Schwerpunkt Rheumatologie und klinische Immunologie, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    J. Detert, G.-R. Burmester & F. Buttgereit

  2. Abteilung für Zahnerhaltungskunde und Parodontologie, Centrum für Zahn-, Mund- und Kieferheilkunde, Charité-Universitätsmedizin Berlin, Berlin, Deutschland

    N. Pischon

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Detert, J., Pischon, N., Burmester, GR. et al. Pathogenese der Parodontitis bei rheumatischen Erkrankungen. Z. Rheumatol. 69, 109–116 (2010). https://doi.org/10.1007/s00393-009-0560-1

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