Пародонтит и окислительный стресс: современные тенденции в изучении патогенетической взаимосвязи и способы коррекции
Ключевые слова:
пародонтит, патогенез, окислительный стресс, воспаление, антиоксидантная терапия
Аннотация
В обзоре отражены современные представления о патогенетической роли реакций окислительного стресса и недостаточности факторов антиоксидантной защиты в развитии воспалительных заболеваний пародонта, основанные на анализе результатов экспериментальных и клинических исследований. Патогенез данного рода заболеваний является многофакторным, и, как правило, включает взаимодействие процесса биопленкообразования, предрасполагающих факторов и иммуногенности организма. Доказана тесная связь пародонтита, как воспалительного процесса, с сердечно-сосудистыми, нейродегенеративными, аутоиммунными, а также онкологическими заболеваниями. В последние годы большое внимание уделяется активным формам кислорода (АФК) в связи с их центральной ролью в прогрессировании многих воспалительных заболеваний, в том числе связанных с тканями пародонта. При пародонтите выделено шесть ключевых генов окислительного стресса (ОС) (CXCR4, SELL, FCGR3B, FCGR2B, PECAM1 и ITGAL), в основном связанных с межклеточной адгезией лейкоцитов, фагоцитозом и клеточной экстравазацией. У пациентов с пародонтитом отмечается повышенное количество определенных фенотипов нейтрофилов с избыточной реактивностью в виде усиленной продукции АФК и провоспалительных медиаторов, что способствует нарушению их хемотаксической способности. Регистрируются как местные, так и системные нарушения редокс-баланса. При пародонтите наблюдается повышенный уровень маркеров ОС в десневой жидкости, тканях десен, слюне, плазме, сыворотке и клетках крови. Также отмечается изменение общего антиоксидантного статуса, активности супероксиддисмутазы, каталазы, глутатионредуктазы, глутатионпероксидазы, миелопероксидазы, уровня витаминов С и Д, каротиноидов, мочевой кислоты, восстановленного глутатиона, мелатонина. Многочисленные свидетельства эффективности антиоксидантной терапии (полифенольных соединений, каротиноидов, флавоноидов, антоцианов, водо- и жирорастворимых витаминов и т. д.) в отношении пародонтита однозначно установили, что их использование должно быть частью терапевтического подхода в лечении.
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Литература
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Опубликован
2025-03-14
Как цитировать
Даренская М. А., Гончаров . И. С., Колесников С. И., Семенова Н. В., Колесникова Л. И. Пародонтит и окислительный стресс: современные тенденции в изучении патогенетической взаимосвязи и способы коррекции // Патологическая физиология и экспериментальная терапия. 2025. Т. 69. № 1. С. 81–91.
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