口腔衰老的研究：增龄性改变及其与全身衰老的关联^*

Oral Aging: Age-Related Changes and Their Association With Systemic Aging

摘要

衰老并非由单一事件驱动，而是遗传稳定性下降、表观遗传调控异常、代谢失衡以及细胞应激反应紊乱等多种机制共同作用的结果。口腔衰老是全身衰老在口腔的体现，更是加快机体衰老的主要因素，不仅影响口腔局部稳态，还可通过炎症因子释放等途径与全身系统性衰老相互作用。口腔衰老性疾病，如根面龋、牙龈退缩、牙槽骨吸收、口干症、味觉减退、牙列缺失缺损等，严重危害老年人口颌系统功能，也可加重或引发全身性疾病。目前口腔衰老的研究面临基础与临床转化不足、口腔衰老与全身衰老关联机制不清以及早期诊断和有效干预手段缺乏等关键挑战。未来应通过多组学技术构建口腔衰老分子图谱，系统解析其发生发展机制及与全身衰老的互作网络，并加速衰老细胞清除药物等新型干预策略的临床转化。系统解析口腔衰老的生物学机制与发生规律，不仅为保留天然牙提供支持，更是理解口腔-全身共病互作、促进全身健康的核心，也为口腔衰老性疾病防治提供重要理论基础。

Abstract

Aging is not driven by a single event but results from the synergistic effects of multiple mechanisms, including genetic instability, epigenetic dysregulation, metabolic imbalance, and disrupted cellular stress responses. Oral aging represents a localized manifestation of systemic aging in the oral cavity and acts as a key contributor to the accelerated aging of the whole body. It not only affects local oral homeostasis but also interacts bidirectionally with systemic aging through pathways such as the release of inflammatory mediators. Age-related oral diseases, such as root caries, gingival recession, alveolar bone resorption, xerostomia, taste impairment, and tooth loss and dentition defects, severely compromise the function of the oral and maxillofacial system in older adults and may exacerbate or trigger systemic diseases. Current research on oral aging faces several critical challenges, including limited translation from basic to clinical studies, an incomplete understanding of the mechanisms linking oral aging to systemic aging, and lack of strategies for early diagnosis and effective intervention. Future efforts should be focused on leveraging multi-omics approaches to construct comprehensive molecular maps of oral aging, systematically elucidating its developmental mechanisms and networks for interactions with systemic aging, and accelerating the clinical translation of novel intervention strategies, such as senolytic drugs. A systematic understanding of the biological mechanisms and developmental patterns of oral aging will not only support the preservation of natural dentition but also provide critical insights into oral and systemic health interactions and promote overall health. Furthermore, it may pave the way for novel preventive and therapeutic strategies for age-related oral diseases.

关键词

衰老 / 口腔疾病 / 细胞衰老 / 综述

Key words

Aging / Oral diseases / Cellular senescence / Review

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基金资助

*国家自然科学基金(82571077)

国家自然科学基金(82370945)

四川省自然科学基金项目(2024NSFSC0545)