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N-乙酰半胱氨酸在口腔感染性疾病防治中的研究进展OA

Research progress on N-acetylcysteine in the prevention and treatment of oral infectious diseases

中文摘要英文摘要

N-乙酰半胱氨酸(NAC)是半胱氨酸的乙酰化衍生物,具有抗氧化、抗炎、抗菌及黏液溶解等多重生物学活性,目前已广泛应用于呼吸系统疾病的治疗.NAC不仅可通过直接清除活性氧/氮自由基及促进谷胱甘肽合成增强机体抗氧化防御能力,还可调控免疫反应、抑制核因子-κB等炎症信号通路,从而减轻炎症反应.此外,NAC通过断裂二硫键破坏生物膜结构、降低微生物毒力并提高抗菌药物的渗透性,表现出良好的抗菌及抗生物膜作用.龋病、牙周病、牙髓根尖周病及感染性口腔黏膜炎等口腔疾病的发生发展与致病菌感染、氧化应激及免疫炎症失衡密切相关.NAC可抑制变异链球菌的黏附与生物膜形成,降低其致龋毒力;通过抗菌、抗炎及抗氧化作用减轻牙周组织破坏,并可能调节骨代谢;增强对粪肠球菌生物膜的清除效果,提高抗菌药物疗效;同时抑制白色念珠菌生长及菌丝形成.随着NAC 在口腔感染性疾病防治研究中逐渐展现出重要应用潜力,本文对NAC 的主要生物活性及其在口腔感染性疾病中的作用机制与应用前景进行综述,以期为相关基础与临床研究提供理论依据.

N-acetylcysteine(NAC)is an acetylated derivative of cysteine that exerts multiple biological activities,in-cluding antioxidant,anti-inflammatory,antimicrobial,and mucolytic effects,and has been widely used clinically for the treatment of respiratory diseases.NAC not only directly scavenges reactive oxygen and nitrogen species and strengthens endogenous antioxidant defenses by promoting glutathione synthesis but also modulates immune responses and sup-presses inflammatory signaling pathways such as nuclear factor kappa B,thereby attenuating inflammation.In addition,NAC disrupts biofilm architecture by cleaving disulfide bonds,reduces microbial virulence,and enhances the penetra-tion of antimicrobial agents,conferring robust antibacterial and antibiofilm activities.The initiation and progression of oral diseases—including dental caries,periodontal disease,pulpal-periapical disease,and infectious oral mucositis—are closely associated with pathogenic infection,oxidative stress,and dysregulated immune-inflammatory responses.NAC can inhibit Streptococcus mutans adhesion and biofilm formation,thereby reducing cariogenic virulence;mitigate periodontal tissue destruction through antimicrobial,anti-inflammatory,and antioxidant actions,and may modulate bone metabolism;enhance the clearance of Enterococcus faecalis biofilms and improve the efficacy of antimicrobial therapy;and inhibit the growth and hyphal formation of Candida albicans.Collectively,NAC is emerging as a promising agent for the prevention and treatment of oral infectious diseases.This review systematically summarizes the major bioactivi-ties of NAC,its mechanistic actions in oral infectious diseases,and its therapeutic prospects,with the aim of providing a theoretical basis for future basic and clinical investigations.

杨加珍;邹静;张琼

口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心 四川大学华西口腔医院儿童口腔科,四川 成都(610041)口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心 四川大学华西口腔医院儿童口腔科,四川 成都(610041)口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心 四川大学华西口腔医院儿童口腔科,四川 成都(610041)

医药卫生

N-乙酰半胱氨酸龋病牙周炎牙髓根尖周病口腔黏膜感染变异链球菌粪肠球菌白色念珠菌生物膜氧化应激

N-acetylcysteinedental cariesperiodontitispulp and periapical diseasesoral mucosal infec-tionStreptococcus mutansEnterococcus faecalisCandida albicansbiofilmoxidative stress

《口腔疾病防治》 2026 (7)

709-719,11

国家自然科学基金面上项目(825171078)四川省自然科学基金项目(2026NSFSC0483) This study was supported by the grants from the National Natural Science Foundation of China(No.825171078),Sichuan Natu-ral Science Foundation(No.2026NSFSC0483).The funder had no role in the study design,data collection and analysis,decision to publish,or preparation of the manuscript.

10.12016/j.issn.2096-1456.202660004

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