歯周炎患者におけるウシラクトフェリン経口投与の影響  [in Japanese] Effects of Oral Administration of Bovine Lactoferrin on Periodontitis Patients  [in Japanese]

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Author(s)

    • 近藤 一郎 KONDO Ichiro
    • 新潟大学大学院医歯学総合研究科摂食環境制御学講座歯周診断・再建学分野:近藤歯科医院 Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences:Kondo Dental Clinic
    • 小林 哲夫 KOBAYASHI Tetsuo
    • 新潟大学大学院医歯学総合研究科摂食環境制御学講座歯周診断・再建学分野:新潟大学医歯学総合病院歯科総合診療部 Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences:General Dentistry and Clinical Education Unit, Niigata University Medical and Dental Hospital
    • 山内 恒治 YAMAUCHI Koji
    • 森永乳業株式会社食品基盤研究所 Food Science & Technology Institute, Morinaga Milk Industry Co., Ltd.
    • 吉江 弘正 YOSHIE Hiromasa
    • 新潟大学大学院医歯学総合研究科摂食環境制御学講座歯周診断・再建学分野 Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences

Abstract

母乳に含まれるラクトフェリン(LF)は鉄結合性糖タンパク質であり,抗菌作用などの生理活性を有することが知られている.本研究では,ウシLF配合錠菓(森永乳業)を3カ月間摂取した場合の歯周炎患者に及ぼす影響を,臨床的,細菌学的,および生化学的に検討した.同意が得られた軽度慢性歯周炎患者18名を無作為に,ウシLF含有錠菓摂取群(実験群:8名)およびプラセボ錠菓摂取群(コントロール群:10名)に分けて,ともに錠菓を1日3回(1回2錠)3カ月間摂取し続けてもらった.錠菓摂取直前(ベースライン),摂取1週後,1カ月後,および3カ月後の来院時に,1)歯周組織検査,2)定量性PCRによる歯肉縁下プラークおよび唾液細菌検査(総菌数,Porphyromonas gingivalis数,Prevotella intermedia数,3)サンドイッチELISA法による歯肉溝滲出液(GCF)および唾液ヒト・ウシLF濃度検査,4)リムルステストによるGCFおよび唾液エンドトキシン濃度検査,を二重盲検法にてそれぞれ行った.各来院時での検査結果の群間差をMann-Whitney U testにて統計解析した.本実験期間中でウシLF錠菓摂取に伴う副作用は一切認められず,同錠菓の安全性が再確認された.実験群ではコントロール群と比べてベースラインに対する歯肉緑下プラーク細菌数変化量の有意な低下が,総菌数(1カ月後),P.gingivalis数(1,3カ月後),P.intermedia数(1週後)においてそれぞれ認められた.唾液細菌数および臨床所見における群間差はみられなかった.ウシLF濃度は,コントロール群と比べて実験群で有意に高いレベルが維持された.ヒトLFおよびエンドトキシンの濃度変化量には群間差はみられなかったが,実験群のGCFでは低レベルで推移する傾向が認められた.以上から,ウシLF配合錠菓の継続的な経口投与により,歯周病原細菌が減少することが臨床レベルで初めて確認された.ウシLFのレベルがGCFである程度維持され,歯肉縁下プラーク細菌を抑制した可能性が考えられる.食品成分であるウシLFを配合した錠菓の経口投与は,より安全な歯周病の予防法として有望であることが示唆された.

Lactoferrin (LF) is an iron-binding protein that is present in milk, and has a number of biological functions, including antimicrobial effects. In the present study, we evaluated the clinical, bacteriological, and biochemical changes that occur as a result of oral administration of bovine lactoferrin (bLF)-containing tablets, which were supplied by Morinaga Milk Industry, in periodontitis patients. After informed consent was obtained, 18 patients with mild chronic periodontitis were randomly selected for oral administration of tablets containing bLF (test group, 8 patients), or placebo tablets (control group, 10 patients). Oral administration of the two tablets was done three times a day for 3 months in a double-blind condition. The following measurements were recorded before and 1 week, 1 month and 3 months after the start of administration : 1) clinical periodontal conditions; 2) number of total bacteria, Porphyromonas gingivalis, and Prevotella intermedia in the subgingival plaque and saliva, as assessed by a quantitative polymerase chain reaction; 3) levels of human LF (hLF) and bLF in the gingival crevicular fluid (GCF) and saliva, as determined by a sandwich enzyme-linked immunsorbent assay; and 4) levels of endotoxin in GCF and saliva, as determined by a Limulus test. Differences in clinical, bacteriological, and biochemical changes between the two groups were assessed by the Mann-Whitney U test. No adverse effects were observed throughout the study period. In the test group, a significant reduction was seen in changes in the number of total bacteria (after 1 month), P. gingivalis (after 1 and 3 months), and P. intermedia (after 1 week) in the subgingival plaque, as compared to the control group. We also found a significant difference in GCF and saliva levels of bLF, but not in clinical measurements, saliva levels of bacteria, nor GCF and saliva levels of hLF and endotoxin between the two groups. Furthermore, a trend toward a reduction in GCF levels of hLF was observed in test group. This is the first report showing the antibacterial effects of orally administered bLF on subgingival flora in periodontitis patients, which might be partly supported by the relatively sufficient GCF levels of bLF. These results suggest that the antibacterial and food-component properties of oral bLF may contribute to the promotion of periodontal health.

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Codes

  • NII Article ID (NAID)
    110007151243
  • NII NACSIS-CAT ID (NCID)
    AN00191201
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03872343
  • Data Source
    CJP  CJPref  NII-ELS 
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