收稿日期: 2024-02-29
录用日期: 2024-04-01
网络出版日期: 2024-06-28
基金资助
上海交通大学医学院“双百人”项目(20221809);中央高校基本科研业务费专项资金(YG2023ZD14);国家自然科学基金(82071083);上海市自然科学基金(22ZR1436700);上海市科技创新行动计划国际科技合作项目/政府间国际科技合作项目(23410713600);上海交通大学医学院附属第九人民医院交叉研究基金(JYJC202116);上海交通大学医学院生物材料与再生医学交叉研究项目(2022LHB02);上海交通大学医学院附属第九人民医院原创项目(JYYC003)
Status and advances in the mechanism research on dento-maxillofacial skeletal abnormalities
Received date: 2024-02-29
Accepted date: 2024-04-01
Online published: 2024-06-28
Supported by
“Two-Hundred Talents” Program of Shanghai Jiao Tong University School of Medicine(20221809);Fundamental Research Funds for the Central Universities(YG2023ZD14);National Natural Science Foundation of China(82071083);Natural Science Foundation of Shanghai(22ZR1436700);Shanghai Science and Technology Innovation Action Plan-International Science and Technology Cooperation Program(23410713600);Cross-Disciplinary Research Fund of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYJC202116);Biomaterials and Regenerative Medicine Institute Cooperative Research Project, Shanghai Jiao Tong University School of Medicine(2022LHB02);Original Exploration Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYYC003)
牙颌面骨畸形发病率高、病因复杂、症状严重、诊疗困难，缺乏早期干预策略，其主要原因在于相关机制研究较少、不够深入。这类疾病主要表现为骨性畸形、牙列不齐等骨与牙的形态结构、位置关系及口颌功能异常，其中颌面骨与牙-牙周复合体是两大核心结构，分别决定了颜面美观与咬合功能。颌面骨畸形精准防治需从病因角度研究发育与致病机制，而牙列不齐等牙-牙周复合体畸形矫治则需从临床正畸应力角度研究稳态与应激改建机制，两方面机制研究均可为牙颌面骨畸形防治策略发展提供重要理论基础。既往相关研究常以突变基因与差异因子表达谱的描述为主。近年来，Cre-LoxP等条件性基因编辑技术的发展，使研究者得以在体内直观地评价单一细胞谱系中致病基因的功能，助力牙颌面骨畸形研究从表型层面向分子机制层面推进。该文梳理了国内外学者近年的研究以及笔者所在课题组的研究成果，提出牙颌面骨畸形机制研究“一体两翼”模式，即牙颌面骨畸形为“一体”，颌面骨发育与畸形致病机制为“一翼”，牙-牙周复合体稳态与应激改建机制为“另一翼”；该模式的提出旨在系统性研究疾病的发生发展，探索临床干预新思路。近年的相关研究运用前沿技术从“两翼”出发探究“一体”的机制：一方面，牙颌面骨的胚胎发育来源复杂，组成型条件性模式动物成为研究关键细胞中关键因子功能的重要新策略；另一方面，牙-牙周复合体的成体改建最为频繁，诱导型条件性模式动物为模型时程精准控制提供了技术支持。随着单细胞测序与谱系示踪技术的开发，组织特异性干细胞因其原位、特化的特征渐受青睐，越来越多的研究者开始关注其特征功能，这一发展趋势十分契合“一体两翼”的研究模式，有望加快牙颌面骨畸形的理论基础建设与应用转化。该文就牙颌面骨畸形机制“一体两翼”的研究模式进行述评。
江凌勇 . 牙颌面骨畸形机制研究的现状与发展[J]. 上海交通大学学报（医学版）, 2024 , 44(6) : 663 -675 . DOI: 10.3969/j.issn.1674-8115.2024.06.001
Dento-maxillofacial skeletal abnormalities exhibit high incidence rate, complex etiology, severe symptoms, difficult diagnosis and treatment, and lack of early intervention strategies, which is mainly due to insufficient exploration of mechanism research. These diseases are characterized by abnormal morphology, disordered mutual location and impaired function of bones and teeth, including skeletal abnormalities and malocclusion. Among them, maxillofacial bone and dento-periodontal complex are the two core structures, which respectively determine facial aesthetics and occlusal function. As for maxillofacial skeletal abnormalities, mechanism studies on skeletal development and pathogenesis are required for precise prevention and treatment. As for malocclusion, mechanism studies on homeostasis and stress remodeling are required from the perspective of orthodontics. Both mechanism studies can provide basic support for the diagnosis and treatment of dento-maxillofacial skeletal deformities. In this regard, previous studies usually focused on the expression maps of mutated genes and differential factors. In recent years, the development of conditional gene editing techniques, such as Cre-LoxP system, has enabled researchers to intuitively evaluate the function of key genes in a single cell lineage in vivo, helping to advance research on dento-maxillofacial skeletal abnormalities from phenotype level to molecular mechanism level. This review summarizes recent domestic and foreign researches on dento-maxillofacial skeletal abnormalities, as well as recent achievements of the author's team, and systematically proposes a research mode concluded as “One Centre, Two Motives”. The centre is dento-maxillofacial skeletal abnormalities. One motive is the development and pathogenic mechanisms of maxillofacial bone, and the other is the homeostasis and remodeling mechanisms of dento-periodontal complex. The research mode aims at systematical study of the pathogenesis and prognosis of diseases to explore potential therapies. Many advanced technologies have contributed to the exploration of “One Centre” through “Two Motives”: on the one hand, conditional gene editing models have provided a new strategy for studying the function of key factors in key cells in vivo; on the other hand, inducible conditional gene editing models have supported the precise control of the timeline for interventions after birth. Furthermore, with the help of single-cell sequencing and lineage tracing techniques, researchers have been focusing on tissue-specific stem cells, due to their in situ and characteristic functions. This situation is highly in line with the “One Centre, Two Motives” mode, and is benefit to shed a new insight on the theoretical researches and clinical applications of dento-maxillofacial skeletal abnormalities. The article reviews the “One Centre, Two Motives” mechanism research mode of dento-maxillofacial skeletal abnormalities.
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