Parodontitis – eine immunologische Erkrankung mit genetischer Komponente

Die Parodontitis ist eine chronisch entzündliche Erkrankung, deren Entstehung und Progression durch unterschiedliche Faktoren bedingt wird. Neben exogenen Risikofaktoren, wie Rauchen, Stress und mangelnde Mundhygiene, gilt allgemein eine Verschiebung des mikrobiellen Keimspektrums in der Mundhöhle und die damit einhergehende steigende Pathogenität des Biofilms als wichtigster initialer Faktor einer Parodontitis. Ausmaß und Verlauf der Erkrankung wird dann aber durch die körpereigene Entzündungsreaktion des Patienten bestimmt. Bereits 1997 wies Kornman [21] darauf hin, dass man dem auslösenden Reiz (Biofilm) auch immer die individuelle inflammatorische Wirtsreaktion gegenüberstellen muss. Die individuelle Entzündungskompetenz eines jeden Patienten wird durch genetische Varianten (Polymorphismen) in den für die Immunantwort relevanten Genen bestimmt und erklärt den genetischen Faktor als einen entscheidenden Risikofaktor für die Progression der Parodontitis [Abb. 1].

Abb. 1 Die individuelle Entzündungsantwort auf pathogene Bakterien wird u. a. durch genetische Varianten in den für die Immunantwort relevanten Genen bestimmt.

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