预防口腔生态失调的新策略

Mariana B Rebelo, Cláudia S Oliveira, Freni K Tavaria
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摘要

口腔疾病影响着全世界30多亿人,使其成为最常见的感染之一。最近的研究表明,降低慢性感染(如龋齿、牙龈炎、牙周炎和口臭)风险的一种方法是控制口腔微生物群的生态,而不是完全去除有害和有益的微生物。这是基于这样的认识,即口腔疾病不是由单一病原体引起的,而是由整个微生物群体内平衡的改变引起的,这一过程被称为生态失调。因此,实施能够预防和控制口腔生态失调的策略,以避免严重的并发症,包括心脏、肺和其他全身性疾病,是至关重要的。传统的治疗方法包括使用抗生素,这进一步破坏了口腔微生物群的平衡,同时在蛀牙形成后机械去除蛀牙区域。因此,必须实施替代策略,有可能克服当前治疗的缺点,即使用广谱抗生素。从这个意义上说,益生菌和后益生菌受到了特别的关注,因为它们可以调节口腔微生物群,降低口腔内的生态失调率。但是,需要处理它们的行动机制,以澄清和推动它们作为预防战略的可能应用。从这个意义上讲,本文综述了益生菌和后益生菌的潜力,重点介绍了它们的抗菌和抗生物膜活性以及它们调节炎症反应的能力。最后,本文还介绍了口服分散膜的主要优点和缺点,这是一种很有前景的针对口腔生态失调的益生菌和后益生菌的输送机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Novel Strategies for Preventing Dysbiosis in the Oral Cavity
Oral diseases affect over three billion people worldwide, making it one of the most common infections. Recent studies show that one approach to reducing the risk of chronic infections, such as caries, gingivitis, periodontitis, and halitosis, is to control the ecology of the oral microbiome instead of completely removing both the harmful and beneficial microorganisms. This is based on the knowledge that oral diseases are not caused by a single pathogen but rather by a shift in the homeostasis of the entire microbiota, a process known as dysbiosis. Consequently, it is of the utmost importance to implement strategies that are able to prevent and control oral dysbiosis to avoid serious complications, including heart, lung, and other systemic diseases. Conventional treatments include the use of antibiotics, which further disrupt the equilibrium in the oral microbiota, together with the mechanical removal of the decayed cavity area following its formation. Therefore, it is imperative to implement alternative strategies with the potential to overcome the disadvantages of the current therapy, namely, the use of broad-spectrum antibiotics. In this sense, probiotics and postbiotics have received particular attention since they can modulate the oral microbiota and decrease the dysbiotic rate in the oral cavity. However, their mechanisms of action need to be addressed to clarify and drive their possible applications as preventive strategies. In this sense, this review provides an overview of the potential of probiotics and postbiotics, focusing on their antimicrobial and antibiofilm activities as well as their ability to modulate the inflammatory response. Finally, it also showcases the main advantages and disadvantages of orodispersible films—a promising delivery mechanism for both probiotics and postbiotics to target oral dysbiosis.
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