1、现代生物医学进展Progress in Modern Biomedicine Vol.23NO.2JAN.2023doi:10.13241/ki.pmb.2023.02.028龈沟液 miR-155、miR-223 表达水平与慢性牙周炎伴 2 型糖尿病患者牙周临床指标、口腔龈下菌群以及 Th17/Treg 失衡的相关性分析*叶良静李慧孙卫国陈艳徐小倩（安徽理工大学第一附属医院口腔科 安徽 淮南 232000）摘要 目的：探讨龈沟液 miR-155、miR-223 表达水平与慢性牙周炎伴 2 型糖尿病（T2DM）患者牙周临床指标、口腔龈下菌群以及外周血辅助性 T 细胞 17（Th17）/调节性
2、T 细胞（Treg）失衡的相关性。方法：选择 2018 年 1 月至 2022 年 1 月安徽理工大学第一附属医院口腔科收治的 86 例慢性牙周炎患者，根据是否伴 T2DM 将患者分为慢性牙周炎伴 T2DM 组 15 例和单纯慢性牙周炎组71 例，另选择 65 例健康体检志愿者为对照组。检测龈沟液 miR-155、miR-223 表达水平，口腔龈下菌群以及外周血 Th17 细胞占比、Treg 细胞占比、血清白细胞介素（IL）-17、转化生长因子-（TGF-）水平。Pearson 相关分析龈沟液 miR-155、miR-223 表达水平与牙周临床指标、口腔龈下菌群、外周血 Th17/Treg 以
3、及血清 IL-17、TGF-的相关性。结果：慢性牙周炎伴 T2DM 组、单纯慢性牙周炎组龈沟液 miR-155、miR-223 表达水平高于对照组（P0.05），且慢性牙周炎伴 T2DM 组高于单纯慢性牙周炎组（P0.05）。慢性牙周炎伴 T2DM 组龈沟出血指数（SBI）、菌斑指数（PLI）、探诊深度（PD）、附着丧失（AL）、牙龈卟啉单胞菌、二氧化碳噬纤维菌、中间普氏菌、变黑普氏菌数量、外周血 Th17 细胞占比、Th17/Treg 比值、血清 IL-17 水平高于单纯慢性牙周炎组（P0.05），外周血Treg 细胞占比低于单纯慢性牙周炎组（P0.05）。龈沟液 miR-155、miR-2
4、23 表达水平与 PLI、SBI、AL、PD、牙龈卟啉单胞菌、二氧化碳噬纤维菌、中间普氏菌、变黑普氏菌数量、外周血 Th17 细胞占比、Th17/Treg 比值、血清 IL-17 水平呈正相关（P0.05），与外周血 Treg 细胞占比呈负相关（P0.05）。结论：慢性牙周炎伴 T2DM 患者龈沟液中 miR-155、miR-233 表达均上调，且与牙周组织破坏程度、龈下菌群紊乱和 Th17/Treg 失衡有关。关键词：慢性牙周炎；2 型糖尿病；口腔菌群；牙周临床指标；辅助性 T 细胞 17；调节性 T 细胞；相关性中图分类号：R587.2；R781.4文献标识码：A文章编号：1673-627
5、3（2023）02-350-06Correlation Analysis of the Expression Levels of miR-155 and miR-223in Gingival Crevicular Fluid and Periodontal Clinical Indicators,Oral Subgingival Microbiota and Th17/Treg Imbalancein Patients withChronic Periodontitis with Type 2 Diabetes Mellitus*YE Liang-jing,LI Hui,SUN Wei-guo
6、,CHEN Yan,XU Xiao-qian(Department of Stomatology,The First Affiliated Hospital of Anhui University of Technology,Huainan,Anhui,232000,China)ABSTRACT Objective:To investigate the correlation between the expression levels of miR-155 and miR-223 in gingival crevicularfluid and periodontal clinical indi
7、cators,oral subgingival microbiota and peripheral blood helper T cell 17(Th17)/regulatory T cell(Treg)imbalance in patients with chronic periodontitis with type 2 diabetes mellitus(T2DM).Methods:86 patients with chronic periodontitiswho were admitted to the Department of Stomatology,the First Affili
8、ated Hospital of Anhui University of Science and Technology fromJanuary 2018 to January 2022 were selected,and they were divided into chronic periodontitis with T2DM group with 15 cases and simplechronic periodontitis group with 71 cases according to whether they had T2DM.In addition,65 healthy volu
9、nteers were selected as thecontrol group.The expression levels of miR-155 and miR-223 in gingival crevicular fluid,oral subgingival microbiota,the proportion ofperipheral blood Th17 cells and proportion of Treg cells,serum interleukin(IL)-17 and transforming growth factor-(TGF-)weredetected.Pearson
10、correlation analysis was performed to analyze the correlation between the expression levels of miR-155 and miR-223 ingingival crevicular fluid and periodontal clinical indicators,oral subgingival microbiota,peripheral blood Th17/Treg,serum IL-17 andTGF-.Results:The expression levels of miR-155 and m
11、iR-223 in gingival crevicular fluid in chronic periodontitis with T2DM groupand simple chronic periodontitis group were higher than those in control group(P0.05),and the chronic periodontitis with T2DM groupwas higher than the simple chronic periodontitis group(P0.05).The gingival crevicular bleedin
12、g index(SBI),plaque index(PLI),prob-ing depth(PD),attachment loss(AL),Porphyromonas gingivalis,Carbon dioxide-eating fibroblasts,Prevotella intermedia,Prevotella nigrescens,the proportion of peripheral blood Th17 cells,Th17/Treg ratio,and serum IL-17 level in chronic periodontitis with T2DM*基金项目：安徽省
13、卫生计生委科研计划项目（2016qk1208）作者简介：叶良静（1987-），女，本科，主治医师，主要从事口腔牙周方向的研究，E-mail:（收稿日期：2022-05-21 接受日期：2022-06-17）350现代生物医学进展Progress in Modern Biomedicine Vol.23NO.2JAN.2023group were higher than those in simple chronic periodontitis group(P0.05),the proportion of peripheral blood Treg cells was lower thantha
14、t in simple chronic periodontitis group(P0.05).The expression levels of miR-155 and miR-223 in gingival crevicular fluid were posi-tively correlated with PLI,SBI,AL,PD,Porphyromonas gingivalis,carbon dioxide-eating fibroblasts,Prevotelia intermedia,Prevoteliamelanogra,the proportion ofperipheral blo
15、od Th17 cells,Th17/Tregratio,and serum IL-17 level(P0.05),theywere negativelycorrelatedwith the proportion of peripheral blood Treg cells(P0.05).Conclusions:The expressions of miR-155 and miR-233 in gingival crevicularfluid of patients with chronic periodontitis witn T2DM are up-regulated,which are
16、related to the degree of periodontal tissue destruction,subgingival microbiota disorder and Th17/Treg imbalance.Key words:Chronic periodontitis;Type 2 diabetes;Oral flora;Periodontal clinical indicators;T helper cell 17;Regulatory T cells;CorrelationChinese Library Classification(CLC):R587.2;R781.4Document code:AArticle ID:1673-6273(2023)02-350-06前言慢性牙周炎是牙菌斑引起的口腔慢性感染性疾病，其发生和进展与全身性疾病有关，尤其是 2 型糖尿病（T2DM）1,2，研究显示 T2DM 患者血糖控制不佳是伴发慢性牙周炎的危险因素3。现有报道显示与非 T2DM 患者比较，伴 T2DM 的慢性牙周炎患者龈下总细菌负荷量显著增加4，伴 T2DM 的慢性牙