Relación de la patogénesis de COVID-19 para la investigación en medicina periodontal. Parte II: Medicina Periodontal
DOI:
https://doi.org/10.33448/rsd-v10i5.13731Palabras clave:
Infecciones por Coronavirus; Pathogenesis; Periodoncia.Resumen
La respuesta inmunoinflamatoria a la infección por SARS-CoV-2 conduce a una infiltración excesiva de monocitos, macrófagos y células T, anticuerpos no neutralizantes, tormenta de citocinas sistémicas, menor recuento de plaquetas, aumento del dímero D, Proteína C reactiva y anomalías en la coagulación, aumento de la permeabilidad vascular, edema pulmonar, inflamación generalizada y daño multiorgánico. Las enfermedades periodontales tienen un perfil inflamatorio crónico, de origen infeccioso, con interacciones sistémicas vinculadas a más de 50 afecciones sistémicas. La respuesta inmunoinflamatoria de los tejidos periodontales al desafío microbiano, la respuesta protectora y la destrucción local de la influencia del periodonto están influenciadas por condiciones sistémicas. Los inhibidores del sistema renina-angiotensina/ECA también están relacionados con la patogenia de COVID-19 por SARS-CoV-2-ACE2 y con la patogénesis de la periodontitis, a través de la resorción ósea regulada por el eje ACE2/Ang- (1-7)/MasR e IL1 - β, regulación positiva de la vía cinina / receptor B2 debido a la inflamación del receptor 2 tipo Toll y respuestas Th1/Th17, la expresión del receptor de angiotensina II tipo 1 en el tejido gingival inflamado y la modulación de IL-1β inducida por IL- 6 producción en fibroblastos gingivales humanos. Es posible que la infección por SARS-CoV-2 aumente los eventos inflamatorios locales en el tejido periodontal que conducen a la destrucción de los tejidos periodontales. Apesar de la evidencia científica limitada o inexistente sobre los efectos del COVID-19 en las enfermedades periodontales y sus interacciones sistémicas hasta la fecha, es posible esperar su impacto en la investigación de la medicina periodontal.
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Derechos de autor 2021 Davi da Silva Barbirato; Mariana Fampa Fogacci; Pamella Oliveira de Azevedo; Carmelo Sansone; João Régis Ivar Carneiro; Maria Cynésia Medeiros de Barros
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