PERİODONTAL HASTALIKLARDA GENETİK POLİMORFİZMLERİN ROLÜ

Abstract

Periodontoloji disiplini, periodontal hastalık patogenezine olan bakış açısını salt mikrobiyal dental plak esaslı ekseninden çıkarmış, enfeksiyon ile konak yanıtı arasındaki çok değişkenli ve karmaşık etkileşim biçiminde geliştirmiştir. Periodontal hastalık patogenezine ait bilinmeyenleri cevaplayabilmek için konak immün yanıtı ile periodontopatik bakteriler arasındaki etkileşimin dinamiklerini bilmek ve bu karmaşık süreçte rol aldığı düşünülen diğer etkenleri analiz etmek gereklidir. Her ne kadar bakteriyel plak varlığı periodontitisin başlaması için gerekli ise de, plak miktarının hastalık şiddeti ile mutlaka korelasyon göstermediği ve bireysel faktörlerin klinik tabloda belirleyici olduğu bilinmektedir. Periodontal hastalığın çağdaş tanımında bakteriyel etiyolojiden çok, konak yanıtı vurgulanmaktadır. Literatürdeki pek çok çalışma ile konak immün yanıtındaki bireyler arası değişkenlik ve pek çok patolojideki genetik bileşen varlığı ortaya konmuştur. İmmün hücre gelişiminde, antijen hücre sunumunda veya non-spesifik immün yanıtta rol alan inflamatuvar medyatörlerdeki genetik varyasyonlar, periodontitis de dahil olmak üzere belli durumlar için risk faktörü olabilir. Bu açıdan bakıldığında periodontitis, fenotipi etkilenen bireydeki genetik yapı ve çevresel etkenler ile şekillenen karmaşık bir genetik hastalık olarak dikkate alınabilir. Dolayısı ile periodontitis ile ilişkili genetik duyarlılık profilinin haritasının çıkarılmasının, tanı yöntemleri ve bireysel tedavi stratejileri geliştirmek açısından getiri sağlayacağı öngörülebilir. Bu sistematik olmayan derlemenin amacı, periodontal hastalıklarda genetik polimorfizmlerin olası rolünün altını çizmek ve ilişkilendirme çalışmalarındaki yöntemler ile ilgili tartışmaları gözden geçirmekti.

Keywords

• Periodontal hastalık,gen polimorfizmi

THE ROLE OF GENETIC POLYMORPHISMS IN PERIODONTAL DISEASES

Abstract

Discipline of periodontology shifted the understanding of periodontal disease pathogenesis from solely microbial dental plaque based axis to complex, multi-variate interplay between infection and host response. It is essential to initialize the dynamics of the interaction between the host immune response and periodontopathic bacteria, and to analyse other factors possibly playing role in this complex process. Where the existence of bacterial plaque is a pre-requirement for the initiation of periodontitis, it is well known that amount of plaque does not necessarily correlate with disease severity and individual factors are determinative on clinical presentation. Rather than bacterial aetiology, host response in more emphasized in modern definition of periodontal disease. A sum of researches in the literature has revealed the inter-individual variability regarding host immune response and influence of genetic components in numerous pathologic conditions. Genetic variations in immune cell development, antigen cell presentation or inflammatory mediators of non-spesific immune response could be the risk factors for certain conditions, including periodontitis. From this point of view, periodontitis could be considered as a complex genetic disease with a phenotype configured through the genetic make-up and environmental factors in the affected individual. Therefore, it could be foreseen that mapping of the genetic suspectibility profile related with periodontitis might be very valuable for developing diagnostic techniques and individual treatment strategies. The aim of this non-systematic review was to underline the possible role of genetic polymorphisms in periodontal diseases and to revise the discussions on the methods for association studies.

Keywords

• Periodontal disease,genetic polymorphism

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