This review highlights the significance of interactions between the microbiota, immune system, nervous and hormonal systems, and the brain on periodontal health and disease. Microorganisms in the microbiota, immune cells, and neurons communicate via homeostatic nervous and hormonal systems, regulating vital body functions. By modulating pro‐inflammatory and anti‐inflammatory adaptive immune responses, these systems control the composition and number of microorganisms in the microbiota. The strength of these brain‐controlled responses is genetically determined but is sensitive to early childhood stressors, which can permanently alter their responsiveness via epigenetic mechanisms, and to adult stressors, causing temporary changes. Clinical evidence and research with humans and animal models indicate that factors linked to severe periodontitis enhance the responsiveness of these homeostatic systems, leading to persistent hyperactivation. This weakens the immune defense against invasive symbiotic microorganisms (pathobionts) while strengthening the defense against non‐invasive symbionts at the gingival margin. The result is an increased gingival tissue load of pathobionts, including Gram‐negative bacteria, followed by an excessive innate immune response, which prevents infection but simultaneously destroys gingival and periodontal tissues. Thus, the balance between pro‐inflammatory and anti‐inflammatory adaptive immunity is crucial in controlling the microbiota, and the responsiveness of brain‐controlled homeostatic systems determines periodontal health.

中文翻译：

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微生物群-免疫-大脑相互作用：理解牙周健康和疾病的新视野


本综述强调了微生物群、免疫系统、神经和激素系统以及大脑之间相互作用对牙周健康和疾病的重要性。微生物群、免疫细胞和神经元中的微生物通过稳态神经和荷尔蒙系统进行交流，调节重要的身体功能。通过调节促炎和抗炎适应性免疫反应，这些系统控制微生物群中微生物的组成和数量。这些大脑控制反应的强度是由遗传决定的，但对儿童早期压力源敏感，这些压力源可以通过表观遗传机制永久改变他们的反应性，以及对成人压力源敏感，从而导致暂时的变化。临床证据和对人类和动物模型的研究表明，与严重牙周炎相关的因素会增强这些稳态系统的反应性，从而导致持续的过度激活。这削弱了对侵袭性共生微生物（致病菌）的免疫防御，同时加强了对牙龈边缘非侵袭性共生体的防御。结果是帕特菌（包括革兰氏阴性菌）的牙龈组织负荷增加，随后是过度的先天免疫反应，这可以防止感染，但同时会破坏牙龈和牙周组织。因此，促炎和抗炎适应性免疫之间的平衡对于控制微生物群至关重要，而大脑控制的稳态系统的反应性决定了牙周健康。