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Jung WK, Park SB, Yu HY, Kim J. Improvement effect of gemigliptin on salivary gland dysfunction in exogenous methylglyoxal-injected rats. Heliyon 2024; 10:e29362. [PMID: 38628768 PMCID: PMC11019235 DOI: 10.1016/j.heliyon.2024.e29362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024] Open
Abstract
The symptom of hyposalivation associated with hypofunction of the salivary glands is a common feature of diabetes. Inadequate saliva production can cause tissue damage in the mouth, making it susceptible to infections and leading to oral health diseases. Previous studies have highlighted the harmful effects of methylglyoxal (MGO) and MGO-derived advanced glycation end products (AGEs) in diabetes. In this study, we investigated the protective effects of gemigliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, against MGO-induced salivary gland dysfunction. MGO treatment of immortalized human salivary gland acinar cells induced apoptosis via reactive oxygen species (ROS)-mediated pathways, but this effect was mitigated by gemigliptin. In vivo experiments involved the simultaneous administration of MGO (17.25 mg/kg) with aminoguanidine (100 mg/kg) and gemigliptin (10 and 100 mg/kg) daily to rats for two weeks. Gemigliptin increased the saliva volume and amylase levels in MGO-injected rats. Gemigliptin reduced the DPP-4 activity in both the salivary glands and serum of MGO-injected rats. Furthermore, gemigliptin exerted anti-glycation effects by reducing the accumulation of AGEs in the saliva, salivary glands, and serum and suppressing the expression of the receptor for AGEs. These actions protected the salivary gland cells from ROS-mediated apoptosis. Overall, gemigliptin protected the salivary gland cells from ROS-mediated cell death, reduced the accumulation of amylase and mucins in the salivary glands, and enhanced the salivary function by upregulating aquaporin 5 expression, and it exerted protective effects against MGO-induced salivary gland dysfunction by enhancing the anti-glycation, antioxidant, and salivary secretion activities. Our findings suggest gemigliptin as a potential therapeutic for patients with salivary gland dysfunction caused by the complications of diabetes.
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Affiliation(s)
- Woo Kwon Jung
- Department of Oral Pathology, School of Dentistry, Jeonbuk National University, Jeonju, 54896, South Korea
| | - Su-Bin Park
- Department of Oral Pathology, School of Dentistry, Jeonbuk National University, Jeonju, 54896, South Korea
| | - Hwa Young Yu
- Department of Oral Pathology, School of Dentistry, Jeonbuk National University, Jeonju, 54896, South Korea
| | - Junghyun Kim
- Department of Oral Pathology, School of Dentistry, Jeonbuk National University, Jeonju, 54896, South Korea
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Takeyasu M, Kozai K, Sugita M. Involvement of sodium-glucose cotransporter-1 activities in maintaining oscillatory Cl - currents from mouse submandibular acinar cells. J Comp Physiol B 2024; 194:21-32. [PMID: 38308715 PMCID: PMC10940492 DOI: 10.1007/s00360-024-01532-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/01/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024]
Abstract
In salivary acinar cells, cholinergic stimulation induces elevations of cytosolic [Ca2+]i to activate the apical exit of Cl- through TMEM16A Cl- channels, which acts as a driving force for fluid secretion. To sustain the Cl- secretion, [Cl-]i must be maintained to levels that are greater than the electrochemical equilibrium mainly by Na+-K+-2Cl- cotransporter-mediated Cl- entry in basolateral membrane. Glucose transporters carry glucose into the cytoplasm, enabling the cells to produce ATP to maintain Cl- and fluid secretion. Sodium-glucose cotransporter-1 is a glucose transporter highly expressed in acinar cells. The salivary flow is suppressed by the sodium-glucose cotransporter-1 inhibitor phlorizin. However, it remains elusive how sodium-glucose cotransporter-1 contributes to maintaining salivary fluid secretion. To examine if sodium-glucose cotransporter-1 activity is required for sustaining Cl- secretion to drive fluid secretion, we analyzed the Cl- currents activated by the cholinergic agonist, carbachol, in submandibular acinar cells while comparing the effect of phlorizin on the currents between the whole-cell patch and the gramicidin-perforated patch configurations. Phlorizin suppressed carbachol-induced oscillatory Cl- currents by reducing the Cl- efflux dependent on the Na+-K+-2Cl- cotransporter-mediated Cl- entry in addition to affecting TMEM16A activity. Our results suggest that the sodium-glucose cotransporter-1 activity is necessary for maintaining the oscillatory Cl- secretion supported by the Na+-K+-2Cl- cotransporter activity in real time to drive fluid secretion. The concerted effort of sodium-glucose cotransporter-1, Na+-K+-2Cl- cotransporter, and apically located Cl- channels might underlie the efficient driving of Cl- secretion in different secretory epithelia from a variety of animal species.
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Affiliation(s)
- Misa Takeyasu
- Department of Physiology and Oral Physiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8553, Japan
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Katsuyuki Kozai
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Sugita
- Department of Physiology and Oral Physiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8553, Japan.
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State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021; 10:5383. [PMID: 34830663 PMCID: PMC8618619 DOI: 10.3390/jcm10225383&set/a 912874875+940716348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021. [DOI: 10.3390/jcm10225383
expr 893869204 + 932072443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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González-Moles MÁ, Ramos-García P. State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021; 10:5383. [PMID: 34830663 PMCID: PMC8618619 DOI: 10.3390/jcm10225383] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18010 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18010 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Morishita S, Ohara Y, Iwasaki M, Edahiro A, Motokawa K, Shirobe M, Furuya J, Watanabe Y, Suga T, Kanehisa Y, Ohuchi A, Hirano H. Relationship between Mortality and Oral Function of Older People Requiring Long-Term Care in Rural Areas of Japan: A Four-Year Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041723. [PMID: 33579046 PMCID: PMC7916757 DOI: 10.3390/ijerph18041723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/25/2022]
Abstract
Oral ingestion influences the life sustenance, quality of life, and dignity of older adults. Thus, it is an important issue in medical care and the welfare of older adults. The purpose of this four-year prospective cohort study was to investigate the relationship between mortality and oral function among older adults who required long-term care and were living in different settings in a rural area of Japan. This study included 289 participants aged 65 and older who required long-term care and lived in the former Omorimachi area in Yokote City, Akita Prefecture, located in northern Japan. Following the baseline survey, mortality data were collected over four years; 102 participants (35.3%) died during that time. A significant difference was noted in the overall survival rates between the groups with good and deterioration of oral function such as oral dryness, rinsing ability, swallowing function, and articulation, based on Log-rank test results. After adjusting for various potential confounders using Cox proportional-hazards regression, oral dryness (HR: 1.83, 95% confidence interval: 1.12−3.00) was significantly associated with mortality within four years. This study revealed that oral dryness influences the life prognosis of older adults who receive long-term care in different settings.
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Affiliation(s)
- Shiho Morishita
- Department of Oral Health Sciences, School of Health Sciences, Meikai University, 1 Akemi, Urayasu-City, Chiba 279-8550, Japan; (S.M.); (Y.K.)
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 173-0015, Japan; (M.I.); (A.E.); (K.M.); (M.S.); (H.H.)
- Division of Welfare, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-746 Asahimachi-Dori, Chuo-Ku, Niigata 951-8518, Japan;
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 173-0015, Japan; (M.I.); (A.E.); (K.M.); (M.S.); (H.H.)
- Correspondence: ; Tel.: +81-33-964-3241 (ext. 4211); Fax: +81-33-964-2316
| | - Masanori Iwasaki
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 173-0015, Japan; (M.I.); (A.E.); (K.M.); (M.S.); (H.H.)
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 173-0015, Japan; (M.I.); (A.E.); (K.M.); (M.S.); (H.H.)
| | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 173-0015, Japan; (M.I.); (A.E.); (K.M.); (M.S.); (H.H.)
| | - Maki Shirobe
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 173-0015, Japan; (M.I.); (A.E.); (K.M.); (M.S.); (H.H.)
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-Ku, Tokyo 145-8515, Japan;
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Nishi-7, Kita-13, Kita-ku, Sapporo 060-8586, Japan;
| | - Takeo Suga
- Department of Geriatric Dentistry, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Yokohama 230-8501, Japan;
| | - Yayoi Kanehisa
- Department of Oral Health Sciences, School of Health Sciences, Meikai University, 1 Akemi, Urayasu-City, Chiba 279-8550, Japan; (S.M.); (Y.K.)
| | - Akitugu Ohuchi
- Division of Welfare, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-746 Asahimachi-Dori, Chuo-Ku, Niigata 951-8518, Japan;
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 173-0015, Japan; (M.I.); (A.E.); (K.M.); (M.S.); (H.H.)
- Tokyo Metropolitan Geriatric Hospital, Tokyo 173-0015, Japan
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Human Tongue Thermography Could Be a Prognostic Tool for Prescreening the Type II Diabetes Mellitus. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3186208. [PMID: 32419801 PMCID: PMC7201785 DOI: 10.1155/2020/3186208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/28/2019] [Accepted: 11/27/2019] [Indexed: 12/26/2022]
Abstract
Diabetes mellitus is one of the life threatening diseases over the globe, and an early prediction of diabetes is of utmost importance in this current scenario. International Diabetes Federation (IDF) reported nearly half of the world's population was undiagnosed and unaware of being developed into diabetes. In 2017, around 84 million individuals were living with diabetes, and it might increase to 156 million by the end of 2045 stated by IDF. Generally, the diagnosis of diabetes relies on the biochemical method that may cause uneasiness and probability of infections to the subjects. To overcome such difficulties, a noninvasive method is much needed around the globe for primary screening. A change in body temperature is an indication of various diseases. Infrared thermal imaging is relatively a novel technique for skin temperature measurement and turned out to be well known in the medical field due to being noninvasive, risk-free, and repeatable. According to traditional Chinese medicine, the human tongue is a sensitive mirror that reflects the body's pathophysiological condition. So, we have (i) analysed and classified diabetes based on thermal variations at human tongue, (ii) segmented the hot spot regions from tongue thermogram by RGB (red, green, blue) based color histogram image segmentation method and extracted the features using gray level co-occurrence matrix algorithm, (iii) classified normal and diabetes using various machine learning algorithms, and (iv) developed computer aided diagnostic system to classify diabetes mellitus. The baseline measurements and tongue thermograms were obtained from 140 subjects. The measured tongue surface temperature of the diabetic group was found to be greater than normal. The statistical correlation between the HbA1c and the thermal distribution in the tongue region was found to be r2 = 0.5688. The Convolutional Neural Network has outperformed the other classifiers with 94.28% accuracy rate. Thus, tongue thermograms could be used as a preliminary screening approach for diabetes prognosis.
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Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front Endocrinol (Lausanne) 2019; 10:56. [PMID: 30962800 PMCID: PMC6439528 DOI: 10.3389/fendo.2019.00056] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is associated with several microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. The pathogenesis of these complications is complex, and involves metabolic and hemodynamic disturbances, including hyperglycemia, insulin resistance, dyslipidemia, hypertension, and immune dysfunction. These disturbances initiate several damaging processes, such as increased reactive oxygen species (ROS) production, inflammation, and ischemia. These processes mainly exert their damaging effect on endothelial and nerve cells, hence the susceptibility of densely vascularized and innervated sites, such as the eyes, kidneys, and nerves. Since the oral cavity is also highly vascularized and innervated, oral complications can be expected as well. The relationship between DM and oral diseases has received considerable attention in the past few decades. However, most studies only focus on periodontitis, and still approach DM from the limited perspective of elevated blood glucose levels only. In this review, we will assess other potential oral complications as well, including: dental caries, dry mouth, oral mucosal lesions, oral cancer, taste disturbances, temporomandibular disorders, burning mouth syndrome, apical periodontitis, and peri-implant diseases. Each oral complication will be briefly introduced, followed by an assessment of the literature studying epidemiological associations with DM. We will also elaborate on pathogenic mechanisms that might explain associations between DM and oral complications. To do so, we aim to expand our perspective of DM by not only considering elevated blood glucose levels, but also including literature about the other important pathogenic mechanisms, such as insulin resistance, dyslipidemia, hypertension, and immune dysfunction.
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Affiliation(s)
- Martijn J. L. Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- *Correspondence: Martijn J. L. Verhulst
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, Netherlands
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
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Terachi M, Hirono C, Kitagawa M, Sugita M. The biphasic effect of extracellular glucose concentration on carbachol-induced fluid secretion from mouse submandibular glands. Eur J Oral Sci 2018; 126:197-205. [PMID: 29676804 DOI: 10.1111/eos.12417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cholinergic agonists evoke elevations of the cytoplasmic free-calcium concentration ([Ca2+ ]i ) to stimulate fluid secretion in salivary glands. Salivary flow rates are significantly reduced in diabetic patients. However, it remains elusive how salivary secretion is impaired in diabetes. Here, we used an ex vivo submandibular gland perfusion technique to characterize the dependency of salivary flow rates on extracellular glucose concentration and activities of glucose transporters expressed in the glands. The cholinergic agonist carbachol (CCh) induced sustained fluid secretion, the rates of which were modulated by the extracellular glucose concentration in a biphasic manner. Both lowering the extracellular glucose concentration to less than 2.5 mM and elevating it to higher than 5 mM resulted in decreased CCh-induced fluid secretion. The CCh-induced salivary flow was suppressed by phlorizin, an inhibitor of the sodium-glucose cotransporter 1 (SGLT1) located basolaterally in submandibular acinar cells, which is altered at the protein expression level in diabetic animal models. Our data suggest that SGLT1-mediated glucose uptake in acinar cells is required to maintain the fluid secretion by sustaining Cl- secretion in real-time. High extracellular glucose levels may suppress the CCh-induced secretion of salivary fluid by altering the activities of ion channels and transporters downstream of [Ca2+ ]i signals.
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Affiliation(s)
- Momomi Terachi
- Department of Physiology and Oral Physiology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chikara Hirono
- Department of Physiology and Oral Physiology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michinori Kitagawa
- Department of Physiology and Oral Physiology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Sugita
- Department of Physiology and Oral Physiology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Bhattarai KR, Junjappa R, Handigund M, Kim HR, Chae HJ. The imprint of salivary secretion in autoimmune disorders and related pathological conditions. Autoimmun Rev 2018; 17:376-390. [DOI: 10.1016/j.autrev.2017.11.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/16/2017] [Indexed: 12/11/2022]
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Hoseini A, Mirzapour A, Bijani A, Shirzad A. Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus. Electron Physician 2017; 9:5244-5249. [PMID: 29038704 PMCID: PMC5633220 DOI: 10.19082/5244] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 03/20/2017] [Indexed: 01/15/2023] Open
Abstract
Background Diabetes mellitus is one of the most prevalent metabolic diseases, with complications such as decreased salivary flow rate and xerostomia. Objective This study aimed to determine the salivary flow rate and xerostomia in type I and II diabetic patients in comparison with healthy controls. Methods This case-control study was performed on diabetic patients of a private office in Babol, Iran, between May 2015 and October 2016. This study involved two study groups (type I and II diabetes, with 40 in each group) and two control groups (control I and II, with 35 in each group) which were age- and sex-matched with the related study groups. They were all selected through simple sampling. Unstimulated whole saliva was collected through Navazesh method and the salivary flow rate was measured (ml/min). Xerostomia was evaluated via Fox’s test. Moreover, the patients’ data were recorded including age, sex, disease duration, type of diabetes, fasting blood glucose (FBG) and HbA1C. The obtained data were statistically analyzed by using SPSS version 17. Independent-samples t-test, Chi-square, Pearson correlation and multiple comparison post-hoc tests were employed as appropriated. p<0.05 was considered significant. Results The mean salivary flow rate in type I diabetics (0.35±0.11 ml/min) was lower than that in control I (0.50±0.07 ml/min) (p=0.01). The same difference was observed between type II diabetics (0.37±0.13 ml/min) and control II groups (0.47±0.11 ml/min) (p=0.01). No significant difference was observed in the salivary flow rate between type I and II diabetics (p=0.345). Furthermore, xerostomia was higher in type I (2.70±2.50, 1.17±1.60) and II (2.65±2.20–1.62±1.50) diabetics compared with the related control groups (p=0.01), (p=0.02). Conclusion Type I, II diabetic patients revealed lower salivary flow rate and higher xerostomia compared with healthy controls. The salivary flow rate and xerostomia had inverse correlation.
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Affiliation(s)
- Amineh Hoseini
- Dental Student, Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | | | - Ali Bijani
- MD, Social Determinants of Health Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Atena Shirzad
- DDS, MS, Oral Medicine, Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
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Lima DLF, Carneiro SDRM, Barbosa FTDS, Saintrain MVDL, Moizan JAH, Doucet J. Salivary flow and xerostomia in older patients with type 2 diabetes mellitus. PLoS One 2017; 12:e0180891. [PMID: 28767676 PMCID: PMC5540406 DOI: 10.1371/journal.pone.0180891] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/22/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To assess salivary flow in older patients with type 2 diabetes mellitus (DM2) and its association with xerostomia. METHODS Cross-sectional clinical study conducted with older patients diagnosed with type 2 diabetes for at least one year receiving treatment at the Integrated Center for Diabetes and Hypertension of Ceará (CIHD) in the city of Fortaleza, Ceará, Northeastern Brazil. Oral clinical examination was carried out to assess the decayed, missing and filled teeth index (DMFT). Perception of the presence of xerostomia/dry mouth was assessed using the Visual Analogue Scale. Stimulated salivary flow was measured and samples were obtained using an extra-soft silicone device. RESULTS 120 older patients with diabetes (60 insulin-dependent and 60 non-insulin-dependent) aged 65-91 years, with a mean age of 72.26 ± 6.53 years, were assessed. Of these, 111 (92.5%) presented a decrease in salivary flow while 59 (49.2%) reported moderate to severe xerostomia/dry mouth. The DMFT Index presented a mean of 27.53 ± 4.86 teeth. CONCLUSIONS Reduced salivary flow was found in the group assessed in the present research; however, this finding is not in accordance with the perception of xerostomia/dry mouth reported by the patients.
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Affiliation(s)
- Danilo Lopes Ferreira Lima
- Dental School Undergraduation and Graduation Programs, University of Fortaleza – Unifor, Fortaleza, Brazil
| | | | | | | | | | - Jean Doucet
- Department of Internal Medicine, Geriatrics and Therapeutics, Saint Julien Hospital, Rouen University Hospital, Rouen, France
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Góes VC, Neves RH, Arnóbio A, Bernardo-Filho M, Machado-Silva JR. Streptozotocin (STZ) and schistosomiasis mansoni change the biodistribution of radiopharmaceutical sodium (99m)Tc-pertechnetate in mice. Nucl Med Biol 2016; 43:581-586. [PMID: 27438409 DOI: 10.1016/j.nucmedbio.2016.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 05/31/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Technetium-99m ((99m)Tc) is a radionuclide commonly used in nuclear medicine to obtain (99m)Tc-radiopharmaceuticals, which can be used to evaluate either physiological processes or changes related to diseases. It is also used in some experimental studies. Streptozotocin (STZ) administration to rodents causes lesions in very early stages and induces severe and permanent diabetes. Most morbidity of schistosomiasis mansoni is attributed to a granulomatous inflammatory response and associated liver fibrosis. This study was designed to investigate whether STZ administration and schistosomiasis modify the biodistribution of the radiopharmaceutical sodium (99m)Tc-pertechnetate. METHODS Adult female mice were infected by exposure to 100Schistosoma mansoni cercariae (BH strain, Belo Horizonte, Brazil) and euthanized after nine weeks. STZ was administered by a single intraperitoneal injection of 100mg/kg body weight, 3 or 15days before euthanasia. Each animal received 100μl of sodium (Na) (99m)Tc-pertechnetate ((99m)TcO4(-)) (740kBq). The animals were divided into four groups: A, uninfected; B, infected; C, uninfected + STZ; and D, infected + STZ. Blood, brain, thyroid, heart, lungs, liver, spleen, pancreas and kidneys were removed. The radioactivity was counted and the percentage of the injected dose of Na(99m)TcO4 per gram of the organ (% ID/g) was determined. RESULTS Three days after the STZ injection, there was a decrease of Na(99m)TcO4 uptake by the liver, lungs, pancreas and kidneys (p<0.05) in group D when compared with group A. After 15days, the decrease of Na(99m)TcO4 uptake occurred also in the brain, thyroid, heart, spleen and blood (p<0.05) in group D. CONCLUSION We demonstrated modifications on the biodistribution of Na(99m)TcO4 due to STZ administration and schistosomiasis, possibly due to physiological alterations in some organs. ADVANCES IN KNOWLEDGE AND IMPLICATIONS FOR PATIENT CARE The biodistribution of radiopharmaceutical Na(99m)TcO4 should be carefully evaluated in subjects with diabetes and/or schistosomiasis infection.
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Affiliation(s)
- Vanessa Coelho Góes
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Av. Professor Manoel de Abreu, 444, 5° Andar, Vila Isabel, 20511-070 Rio de Janeiro, RJ, Brazil
| | - Renata Heisler Neves
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Av. Professor Manoel de Abreu, 444, 5° Andar, Vila Isabel, 20511-070 Rio de Janeiro, RJ, Brazil
| | - Adriano Arnóbio
- Laboratório de Radiofarmácia Experimental, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Av. 28 de Setembro, 87, 4° Andar fundos, Vila Isabel, 20551-030 Rio de Janeiro, RJ, Brazil
| | - Mario Bernardo-Filho
- Laboratório de Radiofarmácia Experimental, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Av. 28 de Setembro, 87, 4° Andar fundos, Vila Isabel, 20551-030 Rio de Janeiro, RJ, Brazil
| | - José Roberto Machado-Silva
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Av. Professor Manoel de Abreu, 444, 5° Andar, Vila Isabel, 20511-070 Rio de Janeiro, RJ, Brazil.
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Kara SC, Nair GK, Gogineni SB. Sialometry, sialochemistry and oral manifestations in type 2 diabetes mellitus patients—a clinical and biochemical study. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Djukić LJ, Roganović J, Brajović MD, Bokonjić D, Stojić D. The effects of anti-hypertensives and type 2 diabetes on salivary flow and total antioxidant capacity. Oral Dis 2015; 21:619-25. [PMID: 25689395 DOI: 10.1111/odi.12325] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/04/2015] [Accepted: 02/08/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The present cross-sectional study aimed to determine the effect of first-line anti-hypertensive drugs (enalapril, metoprolol, and combinations of enalapril with metoprolol and/or hydrochlorothiazide) on salivary gland function and salivary total antioxidant capacity (TAC) in hypertensive patients with/without diabetes mellitus (DM) type 2. MATERIALS AND METHODS Salivary gland function was measured as xerostomia (interview) and unstimulated whole saliva flow rate (UWSFR) in 447 subjects (387 hypertensive and 60 healthy). Salivary TAC was evaluated by spectrophotometric assay. RESULTS Enalapril is not xerogenic, while metoprolol and drug combinations are. In the presence of DM type 2, all drugs, except metoprolol, had pronounced xerogenic effect. Binary logistic regression analysis found enalapril to be significantly associated with decreased risk of xerogenic effect development, while DM type 2 with increased risk. In the presence of enalapril in hypertensive patients with/without DM type 2 salivary TAC was similar to that in healthy subjects, while for metoprolol was reduced. CONCLUSIONS Enalapril is not xerogenic but is antioxidant, which moderately reduces the risk of xerogenic effect development even in the presence of DM type 2. However, metoprolol and drug combinations exhibit xerogenic effect. In DM type 2, xerogenic effect of all drugs was pronounced except of metoprolol.
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Affiliation(s)
- L J Djukić
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - J Roganović
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - M D Brajović
- Department of Cardiology, Zvezdara University Hospital, Belgrade, Serbia
| | - D Bokonjić
- Military Medical Academy, National Poison Control Centre, Belgrade, Serbia
| | - D Stojić
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Busato IMS, Ignácio SA, Brancher JA, Moysés ST, Azevedo-Alanis LR. Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus. Community Dent Oral Epidemiol 2011; 40:62-9. [DOI: 10.1111/j.1600-0528.2011.00635.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Abiko Y, Selimovic D. The mechanism of protracted wound healing on oral mucosa in diabetes. Review. Bosn J Basic Med Sci 2011; 10:186-91. [PMID: 20846123 DOI: 10.17305/bjbms.2010.2683] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Diabetic patients increase their body's susceptibility to infection and diabetes is a risk factor for periodontal diseases and oral infection. Although many studies showed the mechanism of impaired wound healing in diabetes, there are still arguments to shed light on what kind of factors, including local and systemic factors are involved in the protracted wound healing. This review article summarizes reports on the wound healing in diabetes and discusses the mechanism of the protracted wound healing of the oral mucosa in diabetes. Delayed vascularization, reduction in blood flow, decline in innate immunity, decreases in growth factor production, and psychological stresses may be involved in the protracted wound healing of the oral mucosa in diabetics.
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Affiliation(s)
- Yoshihiro Abiko
- Department of Dental Science, Division of Oral Medicine and Pathology, Institute of Personalized Medical Science, Health Sciences University of Hokkaido, 2-5 Ainosato, Kita-ku, Sapporo, Hokkaido, 0028072, Japan
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Sabino-Silva R, Alves-Wagner ABT, Burgi K, Okamoto MM, Alves AS, Lima GA, Freitas HS, Antunes VR, Machado UF. SGLT1 protein expression in plasma membrane of acinar cells correlates with the sympathetic outflow to salivary glands in diabetic and hypertensive rats. Am J Physiol Endocrinol Metab 2010; 299:E1028-37. [PMID: 20841505 DOI: 10.1152/ajpendo.00395.2010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Salivary gland dysfunction is a feature in diabetes and hypertension. We hypothesized that sodium-glucose cotransporter 1 (SGLT1) participates in salivary dysfunctions through a sympathetic- and protein kinase A (PKA)-mediated pathway. In Wistar-Kyoto (WKY), diabetic WKY (WKY-D), spontaneously hypertensive (SHR), and diabetic SHR (SHR-D) rats, PKA/SGLT1 proteins were analyzed in parotid and submandibular glands, and the sympathetic nerve activity (SNA) to the glands was monitored. Basal SNA was threefold higher in SHR (P < 0.001 vs. WKY), and diabetes decreased this activity (∼50%, P < 0.05) in both WKY and SHR. The catalytic subunit of PKA and the plasma membrane SGLT1 content in acinar cells were regulated in parallel to the SNA. Electrical stimulation of the sympathetic branch to salivary glands increased (∼30%, P < 0.05) PKA and SGLT1 expression. Immunohistochemical analysis confirmed the observed regulations of SGLT1, revealing its location in basolateral membrane of acinar cells. Taken together, our results show highly coordinated regulation of sympathetic activity upon PKA activity and plasma membrane SGLT1 content in salivary glands. Furthermore, the present findings show that diabetic- and/or hypertensive-induced changes in the sympathetic activity correlate with changes in SGLT1 expression in basolateral membrane of acinar cells, which can participate in the salivary glands dysfunctions reported by patients with these pathologies.
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Vasconcelos ACU, Soares MSM, Almeida PC, Soares TC. Comparative study of the concentration of salivary and blood glucose in type 2 diabetic patients. J Oral Sci 2010; 52:293-8. [PMID: 20587956 DOI: 10.2334/josnusd.52.293] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The objective of the present study was to comparatively evaluate the concentrations of blood and salivary glucose as well as salivary flow and xerostomia in type 2 diabetic and non-diabetic patients. The mean salivary glucose level in diabetic patients was 14.03 +/-16.76 mg/dl and 6.35 +/- 6.02 mg/dl (P = 0.036) in the control group. The mean capillary blood glucose level in diabetic patients was 213 +/- 88 mg/dl, while that in non-diabetic patients was 99 +/- 14 mg/dl (P = 0.000). The mean value for resting salivary flow was 0.21 +/- 0.16 ml/min in diabetic patients and 0.33 +/- 0.20 ml/min in the control group (P = 0.002). The stimulated salivary flow was lower in the group of diabetic patients, with a mean of 0.63 +/- 0.43 ml/min, whereas the control group showed a mean of 1.20 +/- 0.70 ml/min (P = 0.000). Of the diabetic patients, 45% exhibited hyposalivation, in contrast to 2.5% of the non-diabetic patients (P = 0.000). Xerostomia was reported in 12.5% of diabetic patients and 5% of non-diabetic patients (P = 0.23). We can conclude that salivary glucose concentration was significantly higher in the experimental group and that there was no correlation between salivary and blood glucose concentrations in diabetic patients. The total salivary flow was significantly reduced in diabetic patients and there was no significant difference as to the presence of xerostomia in both groups.
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Affiliation(s)
- Ana Carolina U Vasconcelos
- Post-graduate Program of Dental College, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
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Busato IMS, Ignácio SA, Brancher JA, Grégio AMT, Machado MÂN, Azevedo-Alanis LR. Impact of xerostomia on the quality of life of adolescents with type 1 diabetes mellitus. ACTA ACUST UNITED AC 2009; 108:376-82. [DOI: 10.1016/j.tripleo.2009.05.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Revised: 04/22/2009] [Accepted: 05/06/2009] [Indexed: 11/29/2022]
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Sabino-Silva R, Freitas HS, Lamers ML, Okamoto MM, Santos MF, Machado UF. Na+-glucose cotransporter SGLT1 protein in salivary glands: potential involvement in the diabetes-induced decrease in salivary flow. J Membr Biol 2009; 228:63-9. [PMID: 19238474 DOI: 10.1007/s00232-009-9159-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Accepted: 01/29/2009] [Indexed: 12/20/2022]
Abstract
Oral health complications in diabetes include decreased salivary secretion. The SLC5A1 gene encodes the Na(+)-glucose cotransporter SGLT1 protein, which not only transports glucose, but also acts as a water channel. Since SLC5A1 expression is altered in kidneys of diabetic subjects, we hypothesize that it could also be altered in salivary glands, contributing to diabetic dysfunction. The present study shows a diabetes-induced decrease (p < 0.001) in salivary secretion, which was accompanied by enhanced (p < 0.05) SGLT1 mRNA expression in parotid (50%) and submandibular (30%) glands. Immunohistochemical analysis of parotid gland of diabetic rats revealed that SGLT1 protein expression increased in the luminal membrane of ductal cells, which can stimulate water reabsorption from primary saliva. Furthermore, SGLT1 protein was reduced in myoepithelial cells of the parotid from diabetic animals, and that, by reducing cellular contractile activity, might also be related to reduced salivary flux. Six-day insulin-treated diabetic rats reversed all alterations. In conclusion, diabetes increases SLC5A1 gene expression in salivary glands, increasing the SGLT1 protein content in the luminal membrane of ductal cells, which, by increasing water reabsorption, might explain the diabetes-induced decrease in salivary secretion.
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Affiliation(s)
- R Sabino-Silva
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
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Friedlander AH, Chaudhuri G, Altman L. A past medical history of gestational diabetes: its medical significance and its dental implications. ACTA ACUST UNITED AC 2007; 103:157-63. [PMID: 17234528 DOI: 10.1016/j.tripleo.2006.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Revised: 06/09/2006] [Accepted: 08/02/2006] [Indexed: 11/24/2022]
Abstract
Approximately 7% of pregnant women develop gestational diabetes mellitus (GDM), a usually transient form of diabetes mellitus, because of the production of some placental and maternal adipose tissue elaborated hormones that alter glucose metabolism. In most women the disorder resolves at delivery, but within 10 years 50% to 70% of these women go on to develop type 2 diabetes. The identification of women with past medical histories of GDM is a clinically useful marker for alerting the dentist to patients at heightened risk of occult type 2 diabetes, with a possible greater risk of developing periodontal disease and dental caries. Screening these patients for diabetes and establishing a preventative dental regimen may result in reducing the number of women with undiagnosed diabetes and diabetes-associated dental and cardiovascular diseases.
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Abstract
Salivary gland disease gives rise to salivary gland enlargement, pain, and prolonged xerostomia (dry mouth). Xerostomia is the most common long-standing problem for the majority of affected patients. There are many causes of dry mouth, with long-standing xerostomia being a particular problem in Sjögren's syndrome and after radiation to the head and neck region. Xerostomia is usually managed with saliva substitutes, but a large number of potential systemic therapies of long-standing xerostomia now exist. Some-particularly immunosuppressants-are of fundamental interest for the potential reduction of gland damage in Sjögren's syndrome but as yet are of limited clinical usefulness. Others, particularly pilocarpine and cevimeline, are, or have the potential to be, clinically useful in stimulating salivation by virtue of their action on cholinergic receptors.
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Affiliation(s)
- S R Porter
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University College London, University of London, England.
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Current literature in diabetes. Diabetes Metab Res Rev 2002; 18:419-26. [PMID: 12397584 DOI: 10.1002/dmrr.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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