雌激素对牙周膜细胞修复重建牙周组织调节机制的研究进展
Research progress on the regulatory mechanism of estrogen in periodontal ligament cells repair and the reconstruction of periodontal tissue
通讯作者: 韩倩倩,副主任医师,博士,Email:hanqianqian04@163.com,Tel:86-18520392936
责任编辑: 罗燕鸿
收稿日期: 2021-03-17 修回日期: 2021-04-3 网络出版日期: 2021-11-20
基金资助: |
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Corresponding authors: HAN Qianqian, Email:hanqianqian04@163.com, Tel: 86-18520392936
Received: 2021-03-17 Revised: 2021-04-3 Online: 2021-11-20
Fund supported: |
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作者简介 About authors
黎祺,副教授,硕士,Email:Licy13@163.com
牙周组织再生修复是牙周病治疗的热点和难点,而牙周膜细胞的增殖、分化、迁移、黏附及与其胞外基质蛋白之间互相调节的动态关系,是牙周组织形态改建、功能维持和组织修复的基础。本文对雌激素调控下牙周膜细胞修复重建牙周组织的机制作一综述,为外源性雌激素替代治疗牙周炎和促进牙周组织修复重建的后续研究提供依据。在一定浓度的雌激素调控下,牙周膜干细胞(periodontal ligament stem cells,PDLSCs)、骨髓间充质干细胞(bone mesenchymal stem cells,BMSCs)向牙周膜细胞的增殖、分化能力增强,同时PDLSCs、BMSCs、牙周膜成纤维细胞(human periodontal ligament fibroblasts,HPLFs)、成骨细胞、成牙骨质细胞合成并往胞外基质中分泌胶原蛋白I型(collagen I,COLI)、骨桥蛋白(osteopontin,OPN)、骨涎蛋白(bone sialoprotein,BSP)、骨钙蛋白(osteocalcin,OCN)增多,与胞外基质中的纤维粘连蛋白(fibronectin,FN)、牙骨质附着蛋白(cementum attachment protein,CAP)等互相链接、结合形成多种链合物并相互调节,促进牙周膜细胞生长、迁移、黏附和纤维化,使牙周膜胶原纤维骨架修复并与新生牙骨质和固有牙槽骨重新黏附。
关键词:
Periodontium regeneration and repair is a controversial and difficult point in the treatment of periodontosis. The proliferation, differentiation, migration and adhesion of periodontal ligament cells and the dynamic relationship between periodontal ligament cells and their extracellular matrix proteins are the basis of periodontium morphological reconstruction, functional maintenance and tissue repair. This article reviews the mechanism of estrogen-regulated periodontal membrane fine repair and periodontal tissue reconstruction to provide the basis for follow-up research on the treatment of periodontitis and the promotion of periodontal tissue repair and reconstruction by exogenous estrogen-mediated periodontal membranes. Under the regulation of certain concentrations of estrogen, the proliferation and differentiation ability of periodontal ligament stem cells (PDLSCs) and bone mesenchymal stem cells (BMSCs) to other periodontal ligament cells were enhanced. At the same time, PDLSCs, BMSCs, human periodontal ligament fibroblasts (HPLFSs), osteoblasts and cementoblasts synthesized and secreted collagen I (COLI), osteopontin (OPN), bone sialoprotein (BSP) and osteocalcin (OCN) into the extracellular matrix. They interact with fibronectin (FN) and cementum attachment protein (CAP) in the extracellular matrix to form a variety of chain complexes and regulate each other, thus promoting the growth, migration, adhesion and fibrosis of periodontal ligament cells, repairing the collagen fiber skeleton of the periodontal ligament and adhering the two ends to the new cementum and the inherent alveolar bone.
Keywords:
本文引用格式
黎祺, 王贺, 黄紫君, 韩倩倩.
LI Qi, WANG He, HUANG Zijun, HAN Qianqian.
开放科学(资源服务)标识码(OSID)
牙周病是口腔最常见的疾病之一,特点是牙周组织破坏、吸收、牙齿松动、脱落,牙周组织再生修复是牙周病治疗的热点和难点[1]。牙周组织由牙周膜、牙槽骨、牙骨质及牙龈组成,牙周膜纤维束的两端分别埋入牙根表面的牙骨质和牙槽窝表面的固有牙槽骨,使牙体稳固在牙槽窝中。牙周组织在形态改建和组织修复的过程中,牙槽骨会不断吸收和重建,新的牙周膜纤维也会重新附着在牙根表面,形成继发性牙骨质[2],这个过程主要依赖牙周膜细胞及其胞外基质蛋白的生物学行为,并可受到雌激素的调控和影响。本文就雌激素对牙周膜细胞增殖、分化、合成分泌胞外基质蛋白的调控机制,以及雌激素调控下牙周膜细胞及其胞外基质主要蛋白修复重建牙周组织的机制进行综述。
1 牙周膜细胞及其胞外基质
牙周膜细胞包括牙周膜干细胞(periodontal ligament stem cells,PDLSCs)、牙周膜成纤维细胞(human periodontal ligament fibroblasts,HPLFs)、成牙骨质细胞、成骨细胞、破骨细胞、骨髓间充质干细胞(bone mesenchymal stem cells,BMSCs)。其中HPLFs是牙周膜最主要的细胞,具有独特且高效的合成和分解胞外基质中胶原蛋白的能力,对于维持牙周组织正常改建和损伤后修复有重要意义[3]。而PDLSCs的重要潜能是向HPLFs、成牙骨质细胞、成骨细胞和破骨细胞分化[4],BMSCs也是具有多向分化潜能的干细胞,PDLSCs和BMSCs是雌激素调控牙周组织再生修复的重要上游细胞。
牙周膜细胞的胞外基质是牙周膜细胞合成和分泌的,由结构蛋白、蛋白聚糖、粘连糖蛋白和水组成的复杂的网架混合结构[5]。细胞可通过改变胞外基质各种蛋白和反应因子的合成、降解和组织结构来重建胞外基质环境,胞外基质环境变化又对细胞行为产生重要影响。因此,牙周膜细胞的增殖、分化等生物学行为与其胞外基质蛋白、反应因子之间互相调节,是牙周组织形态改建、组织修复和功能维持的基础,而这些生物学行为可受雌激素调控。
2 雌激素调控牙周膜细胞增殖和分化
在细胞增殖和分化方面,雌激素与PDLSCs、BMSCs的细胞膜ERα和ERβ结合后,刺激雌激素靶基因启动子的DNA序列——雌激素应答元件调控细胞内的信号表达,促进细胞增殖并向HPLFs、成骨细胞和成牙骨质细胞分化[4,8-10]。PDLSCs、BMSCs的增殖分化机制含有诸多通路,其中以Wnt/β-catenin通路的研究最多,国内外学者研究发现雌激素调控下,PDLSCs、BMSCs细胞的Wnt/β-catenin通路被激活,糖原合成酶激酶-3β被磷酸化而丧失活性,β-catenin蛋白在细胞内聚集,并转移至胞核内与转录因子/淋巴增强因子结合,调节下游靶基因细胞周期素D1的表达,从而调控干细胞的增殖、分化、凋亡等代谢活动[8,10-11]。雌激素还可通过调节Notch信号通路促进成牙骨质细胞增殖、分化、矿化和牙骨质形成[10]。
3 雌激素调控牙周膜细胞合成分泌蛋白
大量研究发现,雌激素在促进PDLSCs、BMSCs向其他牙周膜细胞分化和增殖的同时,还能促进PDLSCs、BMSCs、HPLFs、成骨细胞、成牙骨质细胞合成,并往胞外基质中分泌胶原蛋白I型(collagen I,COLI)、骨桥蛋白(osteopontin,OPN)、骨涎蛋白(bone sialoprotein,BSP)、骨钙蛋白(osteocalcin,OCN)等[4,8-11],它们是支持、修复、重建牙周组织结构和调节牙周膜细胞增殖、分化、迁移、黏附、功能表达等生物学过程的重要因子[15,16,17,18,19,20]。动物实验研究发现,浓度为10-7 mol/L的E2能使PDLSCs、BMSCs等牙周膜细胞的COLI、OPN、BSP、OCN合成增多,提高细胞成骨分化和胞外基质的沉积、矿化能力[9,11]。
4 雌激素调控下牙周膜细胞及其胞外基质主要蛋白修复重建牙周组织的机制
笔者在整合、分析、归纳国内外文献基础上,建立了雌激素调控下牙周膜细胞及其胞外基质主要蛋白修复重建牙周组织的机制模型(图1)。在一定浓度的雌激素调控下,PDLSCs、BMSCs增殖、分化能力增强,牙周膜细胞数量增多,合成分泌COLI、OPN、BSP、OCN增多,与胞外基质中的纤维粘连蛋白(fibronectin,FN)、牙骨质附着蛋白(cementum attachment protein,CAP)等互相链接、结合形成多种链合物并相互调节,进而促进牙周膜细胞生长、迁移、黏附和纤维化,使牙周膜胶原纤维骨架修复并与新生牙骨质和固有牙槽骨重新黏附。
图1
图1
雌激素调控下牙周膜细胞及其胞外基质主要蛋白修复重建牙周组织的机制模型
Figure 1
Mechanistic model of the periodontal ligament cells and extracellular matrix proteins in periodontal tissue repair and reconstruction under estrogen regulation
BMSCs: bone mesenchymal stem cells; PDLSCs: periodontal ligament stem cells; HPLFs: human periodontal ligament fibroblasts; OCN: osteocalcin; BSP: bone sialoprotein; OPN: osteopontin; COLI: collagen I; FN: fibronectin; CAP: cementum attachment protein
4.1 牙周膜胶原纤维骨架的修复
HPLFs在一定浓度的雌激素调控下分泌胶原增多,其中以COLI最明显,是成骨分化的早、中期标志物[9]。COLI和胞外基质中的FN相互诱导、结合、沉积形成COLI-FN链合物,构成结构稳定的胶原网络。FN是存在于各种动物的血液、体液和组织中,分子量约为450 KD的黏附性非胶原糖蛋白,是牙周细胞外基质中细胞间、细胞与基质之间的重要黏附因子[20]。FN是由两个亚基组成的二聚体,每个亚基上有与胶原、细胞表面受体高亲和结合的位点[20],FN通过自身结构的精氨酸-甘氨酸-天冬氨酸三肽序列(arginine-glycine-aspatic acid, RGD)与HPLFs的细胞膜表面一类整合素结合[26],使更多的HPLFs识别、迁移和附着于COLI-FN网状链合物上,HPLFs持续不断地分泌胶原对牙周膜胶原纤维进行改建,从而修复胶原纤维骨架,并作为胞外基质蛋白沉积、链接和矿化的底物基础[21,27]。雌激素缺乏可使胶原纤维成分减少并导致排列结构紊乱[4]。
4.2 牙周膜胶原纤维与新生牙骨质重新黏附
CAP是一种相对分子质量为55 000的蛋白,是牙骨质再生的重要趋化因子,参与牙周新附着的形成[20]。COLI不与CAP直接结合,但FN对CAP有极强的亲和力,可与FN结合形成FN-CAP链合物,COLI与FN结合形成COLI-FN链合物后,FN作为中介物调控CAP与COLI-FN链合物,再结合形成COLI-FN-CAP链合物,使CAP牢固结合到牙周膜纤维组织上[28]。CAP可选择性结合HPLFs、PDLSCs等牙周膜细胞,使这些细胞在牙根表面迁移和黏附,并分化为成牙骨质细胞,同时CAP对羟基磷灰石有高亲和力,促进成牙骨细胞外基质羟基磷灰石晶体形成、矿化[29]。因此,COLI-FN-CAP链合物将牙周韧带纤维的一端在新生牙骨质中重新黏附。此外,牙周膜细胞外基质中的牙骨质蛋白1(cementum protein 1,CEMP1)和釉基质蛋白(enamel matrix proteins,EMPs)也可诱导PDLSCs增殖,并向成牙骨质细胞分化,促进牙骨质羟基磷灰石晶体在有序成核方面发挥调节作用[20]。
4.3 牙周膜胶原纤维埋入重建的固有牙槽骨
牙周膜细胞外基质中的BSP和OPN主要由BMSCs、成骨细胞合成分泌,BSP和OPN在胶原上有特异的定向结合位点,多位于胶原纤维网靠近固有牙槽骨的“孔区”[30]。雌激素调控下OPN在成骨分化的早期表达增多,OPN与COLI、FN均可结合,三者形成OPN-COLI-FN链合物,并通过OPN端的RGD序列吸引更多的成骨细胞黏附[31]。而BSP 是成熟骨标志性蛋白,BSP与COLI、FN结合形成BSP-COLI-FN链合物[22,23],通过BSP端的RGD序列与更多的HPLFs、成骨细胞黏附,大量成骨细胞被吸引,定向移行至“孔区”后,分泌骨基质并矿化,最终将牙周膜胶原纤维靠近牙槽骨的一端埋入重建的固有牙槽骨中。
5 小结
综上所述,一定浓度的雌激素可促进牙周膜细胞增殖、分化、基质蛋白合成分泌增加和活性增强,使牙周膜纤维修复并重新黏附在新生的牙骨质和重建的牙槽骨中。但目前雌激素对牙周膜细胞外基质中FN、CAP等调控机制尚不明确,牙周膜细胞增殖和成骨分化的路径和调节因子还待不断被发现和验证。
【Author contributions】 Li Q and Huang ZJ wrote the article, Wang H and Han QQ revised the article. All authors read and approved the final manuscript as submitted.
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[J].Specifics of the biochemical pathways that modulate collagen cross-links in the periodontal ligament (PDL) are not fully defined. Better knowledge of the collagen post-translational modifications that give PDL its distinct tissue properties is needed to understand the pathogenic mechanisms of human PDL destruction in periodontal disease. In this study, the post-translational phenotypes of human and mouse PDL type I collagen were surveyed using mass spectrometry. PDL is a highly specialized connective tissue that joins tooth cementum to alveolar bone. The main function of the PDL is to support the tooth within the alveolar bone while under occlusal load after tooth eruption. Almost half of the adult population in the USA has periodontal disease resulting from inflammatory destruction of the PDL, leading to tooth loss. Interestingly, PDL is unique from other ligamentous connective tissues as it has a high rate of turnover. Rapid turnover is believed to be an important characteristic for this specialized ligament to function within the oral-microbial environment. Like other ligaments, PDL is composed predominantly of type I collagen. Collagen synthesis is a complex process with multiple steps and numerous post-translational modifications including hydroxylation, glycosylation and cross-linking. The chemistry, placement and quantity of intermolecular cross-links are believed to be important regulators of tissue-specific structural and mechanical properties of collagens. Type I collagen was isolated from several mouse and human tissues, including PDL, and analyzed by mass spectrometry for post-translational variances. The collagen telopeptide cross-linking lysines of PDL were found to be partially hydroxylated in human and mouse, as well as in other types of ligament. However, the degree of hydroxylation and glycosylation at the helical Lys87 cross-linking residue varied across species and between ligaments. These data suggest that different types of ligament collagen, notably PDL, appear to have evolved distinctive lysine/hydroxylysine cross-linking variations. Another distinguishing feature of PDL collagen is that, unlike other ligaments, it lacks any of the known prolyl 3-hydroxylase 2-catalyzed 3-hydroxyproline site modifications that characterize tendon and ligament collagens. This gives PDL a novel modification profile, with hybrid features of both ligament and skin collagens. This distinctive post-translational phenotype may be relevant for understanding why some individuals are at risk of rapid PDL destruction in periodontal disease and warrants further investigation. In addition, developing a murine model for studying PDL collagen may be useful for exploring potential clinical strategies for promoting PDL regeneration. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
17β-Estradiol positively modulates growth hormone signaling through the reduction of SOCS2 negative feedback in human osteoblasts
[J].Recent evidence demonstrated an interplay between estrogens and growth hormone (GH) at cellular level. To investigate the possible mechanism/s involved, we studied the effect of 17β-estradiol (E2) on GH signaling pathways in primary culture of human osteoblasts (hOBs). Exposure of hOBs to E2 (10(-8) M) 60 min before GH (5 ng/ml) significantly increased phosphorylated STAT5 (P-STAT5) levels compared with GH alone. E2 per se had no effect on P-STAT5. E2-enhanced GH signaling was effective in increasing osteopontin, bone-sialoprotein, and IGF II mRNA expression to a greater extent than GH alone. We then studied the effect of E2 on the protein levels of the negative regulator of GH signaling, suppressor of cytokine signaling-2 (SOCS2). E2 (10(-11) M-10(-7) M) reduced dose-dependently SOCS2 protein levels without modifying its mRNA expression. The silencing of SOCS2 gene prevented E2 positive effect on GH induced P-STAT5 and on GH induced bone-sialoprotein and osteopontin mRNA expression. Treatment with the inhibitor of DNA-dependent RNA synthesis, actinomycin-D, did not prevent E2 induced decrease of SOCS2, thus suggesting a non-genomic effect. E2 promoted an increase in SOCS2 ubiquitination. To determine if increased ubiquitination of SOCS2 by E2 led to degradation by proteasome, hOBs were pretreated with the proteasome inhibitor MG132 (5 μM) which blocked E2 reduction of SOCS2. These findings demonstrate for the first time that E2 can amplify GH intracellular signaling in hOBs with an essential role played by the reduction of the SOCS2 mediated feedback loop. Copyright © 2013 Elsevier Inc. All rights reserved.
Deletion of OPN in BSP knockout mice does not correct bone hypomineralization but results in high bone turnover
[J].
Unliganded estrogen receptor α stimulates bone sialoprotein gene expression
[J].
Estrogen-related receptor alpha interacts cooperatively with peroxisome proliferator-activated receptor-gamma coactivator-1alpha to regulate osteocalcin gene expression
[J].
Ligand density-dependent influence of arginine-glycine-aspartate functionalized Gold nanoparticles on osteogenic and adipogenic differentiation of mesenchymal stem cells
[J].
Cryptic binding sites become accessible through surface reconstruction of the type I collagen fibril
[J].
Specific cementum attachment protein enhances selectively the attachment and migration of periodontal cells to root surfaces
[J].A specific cementum attachment protein (CAP) was identified in human cementum and found to bind with high affinity to non-demineralized root surfaces, hydroxyapatite and fibronectin. Attempting to elucidate the biological function of this protein and its possible role in cementogenesis the capacity of CAP to promote selective cell migration towards and attachment of various periodontal derived cell populations to root surfaces in vitro was assessed. Human gingival fibroblasts (HGF), periodontal ligament cells (HPC), and alveolar bone cells (HABC) were labeled with [3H]Thymidine during their exponential growth phase. Root slices, 300 microns thick, were incubated with increasing concentrations of CAP. Untreated and fibronectin (FN) treated root slices served as negative and positive controls, respectively. Migration was assessed by placing root slices on confluent layers of labeled cells maintained in serum free medium and determining the number of cells migrated onto the root surface 3 days thereafter. Attachment was assessed by incubating root slices with labeled cell suspensions for 2 h and determining the number of attached cells. CAP promoted both cell migration and attachment dose dependently. HABC responded better than HPC and HGF to CAP treated root slices, and HPC response was higher than that of HGF. Cell attachment was dose dependently inhibited by synthetic RGD peptides. FN did not affect the migration of HGF, barely enhanced that of HABC, and was less potent than CAP at enhancing the migration of HPC. FN was more effective than CAP in promoting the attachment of HGF to root slices, but it was as potent as CAP in supporting the attachment of HPC and HABC.(ABSTRACT TRUNCATED AT 250 WORDS)
Human recombinant cementum attachment protein (hrPTPLa/CAP) promotes hydroxyapatite crystal formation in vitro and bone healing in vivo
[J].
Identification of the type I collagen-binding domain of bone sialoprotein and characterization of the mechanism of interaction
[J].
Controlling the orientation of bone osteopontin via its specific binding with collagen I to modulate osteoblast adhesion
[J].
Osteopontin regulates dentin and alveolar bone development and mineralization
[J].
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