3ª questão da Gincana - 7º FICHAMENTO
Autor: Lucas Queiróz | Publicado: 2011-06-04T15:01:00-03:00

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Polimorfismo genético associado à doença periodontal na população brasileira: revisão de literatura
HOÇOYA, L. S; JARDINI, M. A. N. Polimorfismo genético associado à doença periodontal na população brasileira: revisão de literatura. Rev Odontol UNESP, v.39, n.5, p.305-310, Araraquara, set/out., 2010.
“A doença periodontal destrutiva atinge uma percentagem&nbsp; considerável&nbsp; de&nbsp; indivíduos&nbsp; em&nbsp; várias&nbsp; populações, sendo&nbsp; a&nbsp; forma&nbsp; crônica&nbsp; da&nbsp; doença&nbsp; a mais&nbsp; prevalente. Como&nbsp; se sabe,&nbsp; por&nbsp; ser multifatorial,&nbsp; só&nbsp; a&nbsp; presença&nbsp; dos microrganismos não é sufciente para desenvolver o problema. Fatores de risco e ambientais somados à resposta do hospedeiro estão diretamente ligados&nbsp; à&nbsp; susceptibilidade&nbsp; individual&nbsp; e&nbsp; ao&nbsp; desenvolvimento&nbsp; da doença2.&nbsp; ” (p.306)
“Alguns estudos&nbsp; têm mostrado que a distribuição da doença não&nbsp; é&nbsp; semelhante&nbsp; se&nbsp; forem&nbsp; comparados&nbsp; países desenvolvidos&nbsp; e em&nbsp; desenvolvimento,&nbsp; assim&nbsp; como&nbsp; as&nbsp; populações&nbsp; urbanas&nbsp; e&nbsp; as isoladas. Dentre&nbsp; as&nbsp; variáveis&nbsp; associadas&nbsp; a&nbsp; um maior&nbsp; ou menor risco&nbsp; para&nbsp; a&nbsp; periodontite,&nbsp; destacam-se:&nbsp; fumo,&nbsp; idade,&nbsp; nível socioeconômico,&nbsp; raça, gênero, nível de&nbsp; instrução,&nbsp; frequência de atendimento odontológico, dentre outras” (p.306)
“O polimorfsmo genético é a variação genética na sequência de&nbsp; alelos,&nbsp; na&nbsp; sequência&nbsp; de&nbsp; bases&nbsp; nucleotídicas&nbsp; ou&nbsp; na&nbsp; estrutura cromossômica, que ocorre com uma frequência maior que 1% na população7.” (p.306)
“A&nbsp; presença&nbsp; de&nbsp; um&nbsp; polimorfsmo&nbsp; pode&nbsp; implicar&nbsp; em mudança no código genético, que é a&nbsp; relação entre a&nbsp; sequência de&nbsp; ácido desoxirribonucleico&nbsp; (DNA)&nbsp; e&nbsp; a&nbsp; sequência da proteína correspondente, levando a alterações no genótipo (sequência de bases),&nbsp; afetando&nbsp; ou&nbsp; não&nbsp; o&nbsp; fenótipo,&nbsp; que&nbsp; determinará&nbsp; a&nbsp; função proteica9.” (p.306)
“Polimorfsmos nos genes da&nbsp; IL-1 estão entre os mais estudados na população brasileira. Esta é uma citocina pró-infamatória que está envolvida no início e na progressão da destruição do tecido conjuntivo&nbsp; e&nbsp; ósseo12.&nbsp; Potente&nbsp; estimulador&nbsp; de&nbsp; reabsorção&nbsp; óssea, da&nbsp; produção&nbsp; de&nbsp; proteases&nbsp; e&nbsp; da&nbsp; síntese&nbsp; de&nbsp; ácido&nbsp; araquidônico, substâncias estas diretamente relacionadas à periodontite13,14.” (p.306).
“Os&nbsp; polimorfsmos&nbsp; têm&nbsp; suas&nbsp; frequências&nbsp; e&nbsp; distribuições variando consideravelmente conforme diferenças raciais39 e têm sido usados como marcadores genéticos para&nbsp; localizar os genes causadores das doenças por meio dos estudos das heranças8.” (p.308)
“Ressalte-se&nbsp; ainda&nbsp; que&nbsp; a&nbsp; microfora&nbsp; patogênica&nbsp; deverá ser&nbsp; incluída&nbsp; nos&nbsp; estudos&nbsp; de&nbsp; polimorfsmo&nbsp; genético-doença periodontal,&nbsp; já&nbsp; que&nbsp; a&nbsp; presença&nbsp; dos microrganismos&nbsp; é&nbsp; essencial para o início e a progressão da doença8,30.” (p.308)
“Segundo Nevins, Nevins43,&nbsp; a presença de um polimorfsmo genético não deve ser considerada como diagnóstico para a doença periodontal.&nbsp; Ele&nbsp; deve&nbsp; atuar&nbsp; como&nbsp; indicador&nbsp; de&nbsp; prognóstico, auxiliando&nbsp; o&nbsp; profssional&nbsp; a&nbsp; optar&nbsp; pela&nbsp; melhor&nbsp; conduta&nbsp; de tratamento, uma vez que a escolha da terapia é baseada não só na destruição periodontal que o paciente apresenta, mas também no seu risco de desenvolver problemas periodontais mais severos.” (p.308)