| 摘要: | 台灣面臨高齡化社會的挑戰，將需要照顧越來越多的高齡失能患者。由於長期臥床，這些患者的口腔衛生和義齒清潔經常被忽視，導致齲齒、牙周病和口腔念珠菌感染等問題。而乾口症缺乏唾液潤滑和抑菌作用，容易導致潰瘍、灼燒感、吞嚥困難和細菌滋生。尤其是高齡者和療養機構居民，誤嚥和吞嚥困難的情況十分常見，這可能引起呼吸道感染和吸入性肺炎等嚴重併發症，並導致高死亡率。因此，本研究旨在利用無患子純露 (Sapindus mukorossi hydrosol, SMH)來對抗口腔致病菌和抗發炎，以改善口腔健康，預防相關疾病，並降低肺炎的發生率和死亡率，特別是吸入性肺炎。
為研究無患子種仁應用在口腔中的可行性，利用無患子種仁萃取成純露後，以人體肺臟腫瘤細胞 (Human lung cancer cell, Calu-3)作為實驗模型，細胞經SMH處理，經MTT Assay檢測細胞活性最高增加28.6%。經暴露LPS (0.1ug/ml)致細胞發炎後，ELISA檢測IL-6分泌量減少45.8%，IL-8分泌量減少8.4%。
致口腔與呼吸道相關疾病之致病菌的抗菌率：肺炎鏈球菌99.76%、伴放線聚集桿菌99.98%、牙齦??單胞菌99.99%與變異鏈球菌99.89%。
小鼠飲用SMH後，在小鼠腹腔注射LPS後致使肺臟發炎，並製作肺臟組織切片，在SMH的介入下，肺泡壁的腫脹程度有顯著改善，肺泡空間佔比提高15.16％。
經上述實驗結果證實SMH確實具有抗菌及抗炎之效果，且並無生物毒性，可預防齲齒、牙周炎與口臭等疾病，確立SMH在口腔中應用的基礎，而動物實驗證實肺臟發炎反應被成功抑制，未來或許可作為日常肺部或口腔保健保養及抑制發炎反應之藥物，水性質地可作為藥物溶劑，改善人工唾液之抗菌性能有潛力在未來作為口腔保健/殺菌劑與肺部炎症治療吸入劑。
Taiwan is facing the challenges of an aging society and will require the care of an increasing number of elderly and disabled patients. Due to prolonged bed rest, oral hygiene and denture cleaning are often neglected in these patients, leading to dental caries, periodontal disease, and oral candidiasis, among other issues.
Dry mouth, or xerostomia, which is characterized by a lack of saliva lubrication and antimicrobial action, can result in ulcers, burning sensations, swallowing difficulties, and bacterial growth. Especially among the elderly and residents of nursing homes, occurrences of dysphagia and swallowing difficulties are highly common. These conditions can lead to serious complications such as respiratory infections and aspiration pneumonia, resulting in high mortality rates.
Therefore, this study aims to utilize Sapindus mukorossi hydrosol (SMH) to combat pathogenic oral bacteria and inflammation, improving oral health, preventing related diseases, and reducing the incidence and mortality rates of pneumonia, particularly aspiration pneumonia.
To investigate the feasibility of applying SMH in the oral cavity, an extract of Sapindus mukorossi seed was prepared and tested using human lung cancer cells (Calu-3) as an experimental model. The cells were treated with SMH, and cell viability was assessed using the MTT assay, which showed a maximum increase of 28.6% in cell activity. After exposure to lipopolysaccharide (LPS) at a concentration of 0.1 μg/ml to induce inflammation, the secretion of IL-6 decreased by 45.8%, and the secretion of IL-8 decreased by 8.4% as determined by ELISA.
The antibacterial efficacy of SMH against pathogens associated with oral and respiratory diseases is as follows: Streptococcus pneumoniae (99.76%), Aggregatibacter actinomycetemcomitans (99.98%), Porphyromonas gingivalis (99.99%), and Streptococcus mutans (99.89%).
After the oral administration of SMH to mice, followed by intraperitoneal injection of LPS, the mice developed lung inflammation. However, histological examination of lung tissue sections under the intervention of SMH showed a significant improvement in the degree of alveolar wall edema, with a 15.16% increase in alveolar space occupancy.
The above experimental results have confirmed the antibacterial and anti-inflammatory effects of SMH. It has been shown to be non-toxic and can prevent diseases such as dental caries, periodontitis, and halitosis, establishing the foundation for its application in the oral cavity. Animal experiments have also demonstrated the successful suppression of lung inflammation. In the future, it may serve as a daily lung and oral healthcare product, as well as an anti-inflammatory agent. Its water-based nature makes it a potential solvent for medications, and it also shows promise in improving the antimicrobial properties of artificial saliva. Therefore, it has potential as a dental hygiene/disinfectant agent and as an inhalable treatment for pulmonary inflammation. |
