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Sangalli L, Souza LC, Letra A, Shaddox L, Ioannidou E. Sex as a Biological Variable in Oral Diseases: Evidence and Future Prospects. J Dent Res 2023; 102:1395-1416. [PMID: 37967405 DOI: 10.1177/00220345231197143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
The interest of the scientific community on sex and gender differences in health and disease has increased substantially over the past 25 to 30 y as a result of a long process of events and policies in the biomedical field. This is crucial as compelling evidence from human and animal model studies has demonstrated that sex and gender influence health, molecular and cellular processes, and response and predisposition to disease. The present scoping review aims to provide a synthesis of sex differences in oral diseases, ranging from periodontal disease to orofacial pain conditions, from risk of caries development to apical periodontitis. Overall, findings from this review further support a role for sexual dimorphism influencing disease predisposition and/or progression in oral diseases. Of note, this review also highlights the lack of consideration of additional factors such as gender and other psychosocial and external factors potentially influencing oral health and disease. New conceptual frameworks capable of capturing multiple fundamental domains and measurements should be developed in clinical and preclinical studies to inform sex-based individualized preventive and treatment strategies.
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Affiliation(s)
- L Sangalli
- College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, USA
| | - L C Souza
- Center for Craniofacial Research, Department of Endodontics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A Letra
- Departments of Oral and Craniofacial Sciences, Endodontics, and Center for Craniofacial and Dental Genetics, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
| | - L Shaddox
- Center for Oral Health Research, Division of Periodontology, University of Kentucky, College of Dentistry, Lexington, KY, USA
| | - E Ioannidou
- UCSF, Department of Orofacial Sciences, San Francisco, CA, USA
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Hariyani N, Halimah AN, Al-Junaid M, Fadhila O, Budhy TI. Mouse periodontitis models using whole Porphyromonas gingivalis bacteria induction. Saudi Dent J 2021; 33:819-825. [PMID: 34938021 PMCID: PMC8665201 DOI: 10.1016/j.sdentj.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 07/09/2021] [Accepted: 08/01/2021] [Indexed: 12/01/2022] Open
Affiliation(s)
- Ninuk Hariyani
- Dental Health Science Postgraduate Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Corresponding author at: Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Indonesia.
| | - Anisa Nur Halimah
- Dental Health Science Postgraduate Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Mohammed Al-Junaid
- Department of Dentistry, Faculty of Medicine, University of Alsaeed, Taiz, Yemen
- Doctoral program of Dental Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Oki Fadhila
- Dental Health Science Postgraduate Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Theresia Indah Budhy
- Dental Health Science Postgraduate Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Oral Pathology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
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Influence of Gestational Hormones on the Bacteria-Induced Cytokine Response in Periodontitis. Mediators Inflamm 2021; 2021:5834608. [PMID: 34707462 PMCID: PMC8545568 DOI: 10.1155/2021/5834608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 02/07/2023] Open
Abstract
Periodontitis is an inflammatory disease that affects the supporting structures of teeth. The presence of a bacterial biofilm initiates a destructive inflammatory process orchestrated by various inflammatory mediators, most notably proinflammatory cytokines, which are upregulated in the gingival crevicular fluid, leading to the formation of periodontal pockets. This represents a well-characterized microbial change during the transition from periodontal health to periodontitis; interestingly, the gestational condition increases the risk and severity of periodontal disease. Although the influence of periodontitis on pregnancy has been extensively reviewed, the relationship between pregnancy and the development/evolution of periodontitis has been little studied compared to the effect of periodontitis on adverse pregnancy outcomes. This review is aimed at summarizing the findings on the pregnancy-proinflammatory cytokine relationship and discussing its possible involvement in the development of periodontitis. We address (1) an overview of periodontal disease, (2) the immune response and possible involvement of proinflammatory cytokines in the development of periodontitis, (3) how bone tissue remodelling takes place with an emphasis on the involvement of the inflammatory response and metalloproteinases during periodontitis, and (4) the influence of hormonal profile during pregnancy on the development of periodontitis. Finally, we believe this review may be helpful for designing immunotherapies based on the stage of pregnancy to control the severity and pathology of periodontal disease.
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Lin P, Niimi H, Ohsugi Y, Tsuchiya Y, Shimohira T, Komatsu K, Liu A, Shiba T, Aoki A, Iwata T, Katagiri S. Application of Ligature-Induced Periodontitis in Mice to Explore the Molecular Mechanism of Periodontal Disease. Int J Mol Sci 2021; 22:ijms22168900. [PMID: 34445604 PMCID: PMC8396362 DOI: 10.3390/ijms22168900] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is an inflammatory disease characterized by the destruction of the periodontium. In the last decade, a new murine model of periodontitis has been widely used to simulate alveolar bone resorption and periodontal soft tissue destruction by ligation. Typically, 3-0 to 9-0 silks are selected for ligation around the molars in mice, and significant bone loss and inflammatory infiltration are observed within a week. The ligature-maintained period can vary according to specific aims. We reviewed the findings on the interaction of systemic diseases with periodontitis, periodontal tissue destruction, the immunological and bacteriological responses, and new treatments. In these studies, the activation of osteoclasts, upregulation of pro-inflammatory factors, and excessive immune response have been considered as major factors in periodontal disruption. Multiple genes identified in periodontal tissues partly reflect the complexity of the pathogenesis of periodontitis. The effects of novel treatment methods on periodontitis have also been evaluated in a ligature-induced periodontitis model in mice. This model cannot completely represent all aspects of periodontitis in humans but is considered an effective method for the exploration of its mechanisms. Through this review, we aimed to provide evidence and enlightenment for future studies planning to use this model.
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Affiliation(s)
- Peiya Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Hiromi Niimi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
- Correspondence: (H.N.); (Y.O.); Tel.: +81-3-5803-5488 (H.N. & Y.O.)
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
- Correspondence: (H.N.); (Y.O.); Tel.: +81-3-5803-5488 (H.N. & Y.O.)
| | - Yosuke Tsuchiya
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Tsuyoshi Shimohira
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Keiji Komatsu
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
| | - Anhao Liu
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Takahiko Shiba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
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Mata K, Nobre AVV, Felix Silva PH, Oliezer RS, Fernandes C, Amaral J, Ramos J, Constante Gabriel Del-Arco M, Messora MR, Tanus-Santos JE, Gerlach RF, Salvador SL. A new mixed model of periodontitis-induced preeclampsia: A pilot study. J Periodontal Res 2021; 56:726-734. [PMID: 33686671 DOI: 10.1111/jre.12869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/26/2021] [Accepted: 02/14/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES/BACKGROUND Recent studies have shown that periodontal disease is strongly related to gestational complications such as preeclampsia (PE). PE is responsible for 42% of maternal deaths worldwide and kills approximately 76 000 women a year. In addition, children born under PE conditions are at increased risk of hospitalization due to metabolic disorders, epilepsy, and other complications. Numerous reviews and clinical studies on PE have been published, but the mechanisms underlying the relationship between periodontal disease and PE and the way periodontopathogens alter vascular response in pregnant women remain unclear. METHODS This study aims to verify whether periodontal disease induces PE by using the association of two periodontitis (PD) models: ligature and oral Porphyromonas gingivalis (P. gingivalis) W83 inoculation in Wistar rats. At gestational day 5, the ligature was placed on each mandibular first molar, which was followed by daily oral P. gingivalis inoculation for 15 days. At gestational day 19, urine was collected, and invasive arterial pressure was measured. The animals were euthanized, and plasma and tissues were collected. RESULTS After 15 days of the association of ligature and P. gingivalis inoculation, the animals presented the characteristic symptoms of PE: altered blood pressure, proteinuria, and change in litter size (number of pups) and pup weight when compared to the control group (p < .005). The PE animals also presented greater bone porosity, trabecular separation, and reduced bone volume in the hemimandibles, as well as altered inflammatory response. The level of cytokine IL-6 was higher in the PE group than in the control group (p < .005). CONCLUSION The association of two PD models effectively induced PE. To our knowledge, this is the first study on the oral use of P. gingivalis for PE induction. Our results support the importance of PD as a possible cause for PE development, opening an important new avenue to study cause and consequence relationships in inflammation and PE due to exposure to periodontal infection.
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Affiliation(s)
- Karina Mata
- Department of Basic and Oral Biology, Dental School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.,University of Rio Verde, UniRV, Formosa, GO, Brazil
| | - Atila Vinícius Vitor Nobre
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirao Preto Dental School, University of Sao Paulo-USP, Ribeirao Preto, SP, Brazil
| | - Pedro Henrique Felix Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirao Preto Dental School, University of Sao Paulo-USP, Ribeirao Preto, SP, Brazil
| | - Rene Seabra Oliezer
- Department of Basic and Oral Biology, Dental School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Cleverson Fernandes
- University of Rio Verde, UniRV, Formosa, GO, Brazil.,Department of Pathology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Jefferson Amaral
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Junia Ramos
- Department of Basic and Oral Biology, Dental School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Marina Constante Gabriel Del-Arco
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo-USP, Ribeirao Preto, SP, Brazil
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirao Preto Dental School, University of Sao Paulo-USP, Ribeirao Preto, SP, Brazil
| | - José Eduardo Tanus-Santos
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Raquel Fernanda Gerlach
- Department of Basic and Oral Biology, Dental School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Sergio Luiz Salvador
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo-USP, Ribeirao Preto, SP, Brazil
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Hays A, Duan X, Zhu J, Zhou W, Upadhyayula S, Shivde J, Song L, Wang H, Su L, Zhou X, Liang S. Down-regulated Treg cells in exacerbated periodontal disease during pregnancy. Int Immunopharmacol 2019; 69:299-306. [PMID: 30753969 PMCID: PMC6411422 DOI: 10.1016/j.intimp.2019.01.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 12/17/2022]
Abstract
Pregnancy is a special period marked with complicated changes in various immune responses. Although pregnant women are prone to developing gingival inflammation, its immunological mechanism remains to be clarified. In a modified ligature-induced periodontal disease murine model, pregnant mice developed more severe alveolar bone loss. Using this model, we investigated the Treg responses during exacerbated periodontal disease in pregnant mice. We tested Treg-associated molecules in gingival tissues by quantitative real-time PCR and found decreased gingival expression of Foxp3, TGFβ, CTLA-4, and CD28 in pregnant mice after periodontal disease induction. We further confirmed that lower number of Treg cells were present in the cervical lymph nodes of pregnant periodontitis mice. Treg cells from the cervical lymph nodes of ligated pregnant mice and non-pregnant mice were tested for their suppressive function in vitro. We manifested that Treg suppressive function was also down-regulated in the pregnant mice. Additionally, we demonstrated that more inflammatory Th17 cells were present in the cervical lymph nodes of ligated pregnant mice. Therefore, impaired Treg development and function, together with upregulated Th17 response, may contribute to the exacerbated periodontal disease during pregnancy.
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Affiliation(s)
- Aislinn Hays
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA
| | - Xingyu Duan
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA
| | - Jianxin Zhu
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA
| | - Wei Zhou
- Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Satya Upadhyayula
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA
| | - Juili Shivde
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA
| | - Li Song
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Huizhi Wang
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA
| | - Li Su
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xuyu Zhou
- Institute of Microbiology, Chinese Academy of Sciences, Beijing, China; Savaid Medical School, University of Chinese Academy of Sciences, Beijing 101408, China
| | - Shuang Liang
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY 40202, USA.
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