{"title":"罗伊氏乳杆菌对牙周炎患者牙龈炎症及牙槽骨丢失的临床影响。","authors":"Jian Lu, Xiaoxiang He, Ting Du, Dongjie Fu","doi":"10.3290/j.ohpd.c_2289","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This randomized, double-blind, placebo-controlled trial evaluated the clinical efficacy of Lactobacillus reuteri in reducing gingival inflammation and alveolar bone loss in periodontitis by modulating endoplasmic reticulum (ER) stress.</p><p><strong>Materials and methods: </strong>A total of 120 patients (aged 22-47 years) with periodontitis (n = 84) or gingivitis (n = 36) were allocated to receive either L. reuteri (1×10⁹ CFU/day, n = 60) or placebo (n = 60) for 8 weeks. Primary outcomes included ER stress markers (GRP78/CHOP), while secondary outcomes comprised probing depth (PD), clinical attachment level (CAL), inflammatory biomarkers (TNF-α, IL-6, CRP), and radiographic alveolar bone loss (Moffat grading). Statistical analyses utilized ANOVA, Welch's t-test, and ANCOVA, with significance at p 0.05.</p><p><strong>Results: </strong>The L. reuteri group exhibited statistically significant reductions in TNF-α (30.01 ± 5.15 vs 16.57 ± 3.88 pg/ml, -45.3%, p 0.05), IL-6 (25.84 ± 3.11 vs 14.35 ± 2.16 pg/ml, -45.2%, p 0.05), and CRP (6.41 ± 1.18 vs 2.68 ± 1.04 mg/L, -57.8%, p 0.05) compared to placebo. Gingival pain (VAS) decreased by 48.5% (5.22 ± 0.51 to 2.69 ± 0.20, p 0.001). ER stress markers GRP78 and CHOP declined by 37.6% (p 0.01) and 35.2% (p 0.01), respectively. PD improved by 35.8% (4.92 ± 1.13 vs 3.12 ± 0.37 mm, p 0.05), with 68.3% of patients achieving ≥2 mm PD reduction (vs 13.3% in controls, p 0.001). Radiographic bone loss improved to mild Moffat grades in 66.7% of test patients (vs 33.3% in controls, p 0.001).</p><p><strong>Conclusions: </strong>L. reuteri statistically significantly alleviates periodontitis by inhibiting ER stress and inflammatory pathways, demonstrating clinically meaningful reductions in PD, CAL, and alveolar bone loss. These findings underscore its therapeutic potential as an adjunctive intervention.</p>","PeriodicalId":19696,"journal":{"name":"Oral health & preventive dentistry","volume":"23 ","pages":"585-591"},"PeriodicalIF":1.4000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Effects of Lactobacillus reuteri on Gingival Inflammation and Alveolar Bone Loss in Periodontitis.\",\"authors\":\"Jian Lu, Xiaoxiang He, Ting Du, Dongjie Fu\",\"doi\":\"10.3290/j.ohpd.c_2289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This randomized, double-blind, placebo-controlled trial evaluated the clinical efficacy of Lactobacillus reuteri in reducing gingival inflammation and alveolar bone loss in periodontitis by modulating endoplasmic reticulum (ER) stress.</p><p><strong>Materials and methods: </strong>A total of 120 patients (aged 22-47 years) with periodontitis (n = 84) or gingivitis (n = 36) were allocated to receive either L. reuteri (1×10⁹ CFU/day, n = 60) or placebo (n = 60) for 8 weeks. Primary outcomes included ER stress markers (GRP78/CHOP), while secondary outcomes comprised probing depth (PD), clinical attachment level (CAL), inflammatory biomarkers (TNF-α, IL-6, CRP), and radiographic alveolar bone loss (Moffat grading). Statistical analyses utilized ANOVA, Welch's t-test, and ANCOVA, with significance at p 0.05.</p><p><strong>Results: </strong>The L. reuteri group exhibited statistically significant reductions in TNF-α (30.01 ± 5.15 vs 16.57 ± 3.88 pg/ml, -45.3%, p 0.05), IL-6 (25.84 ± 3.11 vs 14.35 ± 2.16 pg/ml, -45.2%, p 0.05), and CRP (6.41 ± 1.18 vs 2.68 ± 1.04 mg/L, -57.8%, p 0.05) compared to placebo. Gingival pain (VAS) decreased by 48.5% (5.22 ± 0.51 to 2.69 ± 0.20, p 0.001). ER stress markers GRP78 and CHOP declined by 37.6% (p 0.01) and 35.2% (p 0.01), respectively. PD improved by 35.8% (4.92 ± 1.13 vs 3.12 ± 0.37 mm, p 0.05), with 68.3% of patients achieving ≥2 mm PD reduction (vs 13.3% in controls, p 0.001). Radiographic bone loss improved to mild Moffat grades in 66.7% of test patients (vs 33.3% in controls, p 0.001).</p><p><strong>Conclusions: </strong>L. reuteri statistically significantly alleviates periodontitis by inhibiting ER stress and inflammatory pathways, demonstrating clinically meaningful reductions in PD, CAL, and alveolar bone loss. These findings underscore its therapeutic potential as an adjunctive intervention.</p>\",\"PeriodicalId\":19696,\"journal\":{\"name\":\"Oral health & preventive dentistry\",\"volume\":\"23 \",\"pages\":\"585-591\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oral health & preventive dentistry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3290/j.ohpd.c_2289\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oral health & preventive dentistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3290/j.ohpd.c_2289","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的：本随机、双盲、安慰剂对照试验评估罗伊氏乳杆菌通过调节内质网应激减轻牙周炎患者牙龈炎症和牙槽骨丢失的临床疗效。材料与方法：共有120例牙周炎（n = 84）或牙龈炎（n = 36）患者（年龄22-47岁）被分配给罗伊氏乳杆菌（1×10⁹CFU/天，n = 60）或安慰剂（n = 60），为期8周。主要结果包括内质网应激标志物（GRP78/CHOP），次要结果包括探探深度（PD）、临床附着水平（CAL）、炎症生物标志物（TNF-α、IL-6、CRP）和放射学牙槽骨丢失（Moffat分级）。统计分析采用方差分析、Welch’st检验和方差分析，p < 0.05为显著性。结果：与安慰剂相比，罗伊氏乳杆菌组TNF-α（30.01±5.15 vs 16.57±3.88 pg/ml, -45.3%, p 0.05）、IL-6（25.84±3.11 vs 14.35±2.16 pg/ml, -45.2%, p 0.05）和CRP（6.41±1.18 vs 2.68±1.04 mg/L, -57.8%, p 0.05）均有统计学意义降低。牙龈疼痛（VAS）评分降低48.5%（5.22±0.51 ~ 2.69±0.20,p < 0.001）。内质网应激标志物GRP78和CHOP分别下降37.6% （p 0.01）和35.2% （p 0.01）。PD改善35.8%(4.92±1.13 vs 3.12±0.37 mm, p 0.05)，其中68.3%的患者PD减少≥2 mm（对照组为13.3%,p 0.001）。66.7%的测试患者的x线骨丢失改善到轻度Moffat级（对照组为33.3%,p < 0.001）。结论：罗伊氏乳杆菌通过抑制内质网应激和炎症通路，显著缓解牙周炎，显示PD、CAL和牙槽骨丢失有临床意义的降低。这些发现强调了其作为辅助干预的治疗潜力。
Clinical Effects of Lactobacillus reuteri on Gingival Inflammation and Alveolar Bone Loss in Periodontitis.
Purpose: This randomized, double-blind, placebo-controlled trial evaluated the clinical efficacy of Lactobacillus reuteri in reducing gingival inflammation and alveolar bone loss in periodontitis by modulating endoplasmic reticulum (ER) stress.
Materials and methods: A total of 120 patients (aged 22-47 years) with periodontitis (n = 84) or gingivitis (n = 36) were allocated to receive either L. reuteri (1×10⁹ CFU/day, n = 60) or placebo (n = 60) for 8 weeks. Primary outcomes included ER stress markers (GRP78/CHOP), while secondary outcomes comprised probing depth (PD), clinical attachment level (CAL), inflammatory biomarkers (TNF-α, IL-6, CRP), and radiographic alveolar bone loss (Moffat grading). Statistical analyses utilized ANOVA, Welch's t-test, and ANCOVA, with significance at p 0.05.
Results: The L. reuteri group exhibited statistically significant reductions in TNF-α (30.01 ± 5.15 vs 16.57 ± 3.88 pg/ml, -45.3%, p 0.05), IL-6 (25.84 ± 3.11 vs 14.35 ± 2.16 pg/ml, -45.2%, p 0.05), and CRP (6.41 ± 1.18 vs 2.68 ± 1.04 mg/L, -57.8%, p 0.05) compared to placebo. Gingival pain (VAS) decreased by 48.5% (5.22 ± 0.51 to 2.69 ± 0.20, p 0.001). ER stress markers GRP78 and CHOP declined by 37.6% (p 0.01) and 35.2% (p 0.01), respectively. PD improved by 35.8% (4.92 ± 1.13 vs 3.12 ± 0.37 mm, p 0.05), with 68.3% of patients achieving ≥2 mm PD reduction (vs 13.3% in controls, p 0.001). Radiographic bone loss improved to mild Moffat grades in 66.7% of test patients (vs 33.3% in controls, p 0.001).
Conclusions: L. reuteri statistically significantly alleviates periodontitis by inhibiting ER stress and inflammatory pathways, demonstrating clinically meaningful reductions in PD, CAL, and alveolar bone loss. These findings underscore its therapeutic potential as an adjunctive intervention.
期刊介绍：
Clinicians, general practitioners, teachers, researchers, and public health administrators will find this journal an indispensable source of essential, timely information about scientific progress in the fields of oral health and the prevention of caries, periodontal diseases, oral mucosal diseases, and dental trauma. Central topics, including oral hygiene, oral epidemiology, oral health promotion, and public health issues, are covered in peer-reviewed articles such as clinical and basic science research reports; reviews; invited focus articles, commentaries, and guest editorials; and symposium, workshop, and conference proceedings.
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