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Porphyromonas gingivalis e Fusobacterium nucleatum na oncogénese oral e progressão tumoral: revisão sistemática
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| 18756 | 3.75 MB | Adobe PDF |
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A patologia oncológica da cavidade oral continua a ser objeto de estudo para a comunidade científica, quer pelo impacto significativo que tem na qualidade de vida dos pacientes e seus cuidadores, quer pelo impacto que causa na saúde pública. Segundo o Instituto Nacional de Estatística, a doença oncológica é a 2ª causa de morte em Portugal, sendo que o cancro da cavidade oral e faringe tem uma taxa de incidência de 16,7% e uma taxa de mortalidade se reflete em aproximadamente 50% dos casos. A doença periodontal é uma das condições infeciosas mais prevalentes do mundo, afetando entre 25% e 40% da população adulta. Esta patologia está associada frequentemente à presença das bactérias Porphyromonas gingivalis e Fusobacterium nucleatum. Esta patologia é uma consequência das interações complexas entre estes microorganismos e seus produtos, desencadeando uma resposta inflamatória do hospedeiro, conduzindo à destruição de tecidos e associada cada vez mais nos estudos, à oncogénese oral e progressão tumoral. Pretende-se estudar o envolvimento das bactérias Porphyromonas gingivalis e Fusobacterium nucleatum na oncogénese oral e progressão tumoral de forma a melhor compreender como influenciam a fisiopatologia do cancro da cavidade oral. Realizou-se uma revisão sistemática da literatura em que foram utilizadas as diretrizes Cochrane, bem como uma a estratégia de pesquisa sistematizada através do diagrama de análise Preferred Reporting Items for Systematic Reviews and Meta-analysis e baseada nos critérios Population, Intervention, Comparison, Outcome. A pesquisa bibliográfica desta revisão sistemática abrangeu 4 bases de dados eletrónicas - B On, Science Direct, Pub Med, Cochrane library - e incluiu também consulta de literatura cinzenta (teses de mestrado, atas de eventos científicos, organizações mundiais). Foram selecionados artigos disponíveis entre 2013 e 2023 para leitura completa. São vários os mecanismos que explicam a associação entre as bactérias Porphyromonas gingivalis e Fusobacterium nucleatum e a oncogénese oral e progressão tumoral. Estas bactérias podem promover a proliferação celular, ao modularem diversas vias de sinalização. Estas bactérias facilitam também a invasão celular, permitindo a disseminação das células cancerígenas. Outro mecanismo importante é a indução de inflamação crónica, onde a resposta inflamatória prolongada cria um ambiente favorável à progressão tumoral. Citocinas pró-inflamatórias como a interleucina-6 e a interleucina-8 têm papéis fundamentais no processo inflamatório, promovendo a proliferação celular, invasão e metástase. A evasão imunológica é um mecanismo adicional pelo qual as células cancerígenas evitam a deteção e destruição pelo sistema imunitário. A Porphyromonas gingivalis e Fusobacterium nucleatum contribuem para este processo ao modularem a resposta imunitária do hospedeiro, criando um ambiente que favorece a sobrevivência e a disseminação das células cancerígenas. Esta revisão sistemática destaca a complexa interação entre a inflamação crónica induzida por bactérias periodontais e a oncogénese oral. Os resultados sublinham a necessidade de futuras investigações para aprofundar a compreensão dos mecanismos moleculares envolvidos e desenvolver abordagens terapêuticas eficazes. A identificação precoce e o tratamento direcionado da inflamação crónica, assim como a modulação do microbioma oral, podem ser estratégias promissoras para melhorar os resultados clínicos dos pacientes com cancro oral, evidenciando a importância das medidas preventivas em oncologia oral.
Oncological pathology of the oral cavity continues to be a subject of study for the scientific community, both due to the significant impact it has on the quality of life of patients and their caregivers and due to the impact it causes on public health. According to the National Institute of Statistics, oncological disease is the second leading cause of death in Portugal, with oral and pharyngeal cancer having an incidence rate of 16.7% and a mortality rate that reflects approximately 50% of cases. Periodontal disease is one of the most prevalent infectious conditions in the world, affecting between 25% and 40% of the adult population. This pathology is often associated with the presence of the bacteria Porphyromonas gingivalis and Fusobacterium nucleatum. This pathology is a consequence of the complex interactions between these microorganisms and their products, triggering a host inflammatory response that leads to tissue destruction and is increasingly associated in studies with oral oncogenesis and tumor progression. The aim is to study the involvement of the bacteria Porphyromonas gingivalis and Fusobacterium nucleatum in oral oncogenesis and tumor progression to better understand how they influence the pathophysiology of oral cavity cancer. A systematic literature review was conducted using Cochrane guidelines and a systematic search strategy through the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) diagram and based on the Population, Intervention, Comparison, Outcome (PICO) criteria. The bibliographic search for this systematic review covered four electronic databases - B On, Science Direct, PubMed, Cochrane Library - and also included consultation of grey literature (master's theses, conference proceedings, world organizations). Articles available between 2013 and 2023 were selected for full reading. There are several mechanisms that explain the association between the bacteria Porphyromonas gingivalis and Fusobacterium nucleatum and oral oncogenesis and tumor progression. These bacteria can promote cell proliferation by modulating various signaling pathways. They also facilitate cellular invasion, allowing the dissemination of cancer cells. Another important mechanism is the induction of chronic inflammation, where the prolonged inflammatory response creates a favorable environment for tumor progression. Pro-inflammatory cytokines such as interleukin-6 and interleukin-8 play key roles in the inflammatory process, promoting cell proliferation, invasion, and metastasis. Immune evasion is an additional mechanism by which cancer cells avoid detection and destruction by the immune system. Porphyromonas gingivalis and Fusobacterium nucleatum contribute to this process by modulating the host's immune response, creating an environment that favors the survival and dissemination of cancer cells. This systematic review highlights the complex interaction between chronic inflammation induced by periodontal bacteria and oral oncogenesis. The results underline the need for future investigations to deepen the understanding of the molecular mechanisms involved and to develop effective therapeutic approaches. Early identification and targeted treatment of chronic inflammation, as well as modulation of the oral microbiome, may be promising strategies to improve clinical outcomes for patients with oral cancer, highlighting the importance of preventive measures in oral oncology.
Oncological pathology of the oral cavity continues to be a subject of study for the scientific community, both due to the significant impact it has on the quality of life of patients and their caregivers and due to the impact it causes on public health. According to the National Institute of Statistics, oncological disease is the second leading cause of death in Portugal, with oral and pharyngeal cancer having an incidence rate of 16.7% and a mortality rate that reflects approximately 50% of cases. Periodontal disease is one of the most prevalent infectious conditions in the world, affecting between 25% and 40% of the adult population. This pathology is often associated with the presence of the bacteria Porphyromonas gingivalis and Fusobacterium nucleatum. This pathology is a consequence of the complex interactions between these microorganisms and their products, triggering a host inflammatory response that leads to tissue destruction and is increasingly associated in studies with oral oncogenesis and tumor progression. The aim is to study the involvement of the bacteria Porphyromonas gingivalis and Fusobacterium nucleatum in oral oncogenesis and tumor progression to better understand how they influence the pathophysiology of oral cavity cancer. A systematic literature review was conducted using Cochrane guidelines and a systematic search strategy through the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) diagram and based on the Population, Intervention, Comparison, Outcome (PICO) criteria. The bibliographic search for this systematic review covered four electronic databases - B On, Science Direct, PubMed, Cochrane Library - and also included consultation of grey literature (master's theses, conference proceedings, world organizations). Articles available between 2013 and 2023 were selected for full reading. There are several mechanisms that explain the association between the bacteria Porphyromonas gingivalis and Fusobacterium nucleatum and oral oncogenesis and tumor progression. These bacteria can promote cell proliferation by modulating various signaling pathways. They also facilitate cellular invasion, allowing the dissemination of cancer cells. Another important mechanism is the induction of chronic inflammation, where the prolonged inflammatory response creates a favorable environment for tumor progression. Pro-inflammatory cytokines such as interleukin-6 and interleukin-8 play key roles in the inflammatory process, promoting cell proliferation, invasion, and metastasis. Immune evasion is an additional mechanism by which cancer cells avoid detection and destruction by the immune system. Porphyromonas gingivalis and Fusobacterium nucleatum contribute to this process by modulating the host's immune response, creating an environment that favors the survival and dissemination of cancer cells. This systematic review highlights the complex interaction between chronic inflammation induced by periodontal bacteria and oral oncogenesis. The results underline the need for future investigations to deepen the understanding of the molecular mechanisms involved and to develop effective therapeutic approaches. Early identification and targeted treatment of chronic inflammation, as well as modulation of the oral microbiome, may be promising strategies to improve clinical outcomes for patients with oral cancer, highlighting the importance of preventive measures in oral oncology.
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Keywords
Porphyromonas gingivalis Fusobacterium nucleatum Doença periodontal Microbioma oral Oncogénese oral Fatores de risco Periodontal disease Oral microbiome Oral oncogenesis Risk factors