Uloga oksidacionog stresa i sistema antioksidantne zaštite u periodontitisu

  • Vesna S Obradović Zavod za stomatologiju Kragujevac

Sažetak


SAŽETAK

Prevalenca parodontalnih oboljenja  je veoma visoka u adultnoj populaciji. Prema rezultatima istraživanja čak 46% ukupne populacije je bilo zahvaćeno parodontalnom bolešću u periodu od 2010 do 2012 godine, što bi značilo da 64,7 miliona ljudi ima periodontitis od kojih 8% ima tešku formu ove bolesti. Imajući u vidu klinički i socioekonomski značaj parodontitisa, ovaj pregledni rad ima za cilj da na sveobuhvatan način predstavi patogenetske aspekte  sa posebnim osvrtom na oksidativni stres i antioksidativne mehanizme zaštite kao moguće molekularne mehanizme nastanka i razvoja periodontitisa kod odraslih. Oksidacioni stres je uključen u progresiju ovog oboljenja kao hronične inflamatorne bolesti parodoncijuma koji nastaje kao posledica neravnoteže između odgovora domaćina i bakterijske infekcije. U isto vreme nastaje i smanjena antioksidativna aktivnost i kapacitet pljuvačnih zlezda što doprinosi daljem razvoju ove bolesti. MDA je najčešći derivat lipidne peroksidacije koji nastaje u periodontitisu. Svi navedeni literaturni podaci, navode na zaključke da povišene vrednosti MDA mogu biti posledica i lokalnog i sistemskog oksidacionog stresa kao odogovora na inflamatornu parodontalnu bolest samostalno ili u kombinaciji sa drugim sistemskim poremećajima i pušenjem. Štetni efekti ROS-a tokom oksidativnog stresa odigravaju se kroz procese lipidne peroksidacije i ireverzibilnu modifikaciju proteina do ćelijske apoptoze i programirane ćelijske smrti. Pored dva najznačajnija signalna puta, kaspaza put i NADPH oksidaza-4 put, još nekoliko signalnih puteva posreduje u oksidativnim oštećenjima ćelije: PERK/NRF2 signalni put, JNK/mitogen-aktivirajući put (MAP). Kada dođe do klinički vidljivog inflamatornog procesa u parodoncijumu to obično predstavlja stanje koje je u većoj ili manjoj meri ireverzibilano. U parodontologiji je zato i dalje otvorena ideja o uvođenju biohemijskih analiza koje bi dijagnostikovale postojanje inflamatornog procesa u parodoncijumu pre nego što je moguće da se on uoči na kliničkom nivou. Upravo iz tog razloga, nesumnjiv je značaj pozvananja uloge oksidacionog stresa, antioksidatvne zaštite organizma kao i molekularnih mehanizama kojima oštećenje nastaje.

Procena i merenje biomarkera oksidacionog stresa i enzima antioksidativne zaštite može imati centralnu ulogu u praćenju biohemijskih pokazatelja stanja parodoncijuma i čak pomoći različitim metodama lečenja parodontopatije.

Ključne reči: oksidativni stres, antioksidativna zaštita, parodontitis, lipidna peroksidacija, kaspazni put, NOX-4

 

Biografija autora

Vesna S Obradović, Zavod za stomatologiju Kragujevac
Specijalista ortopedije vilica

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2021/01/12
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