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Walther C, Lieske B, Borof K, Kühn S, Härter M, Löwe B, Beikler T, Heydecke G, Kuta P, Seedorf U, Spinler K, Gallinat J, Aarabi G. Association between periodontitis and depression severity - A cross-sectional study of the older population in Hamburg. Brain Behav Immun Health 2023; 34:100689. [PMID: 37822872 PMCID: PMC10562758 DOI: 10.1016/j.bbih.2023.100689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/13/2023] Open
Abstract
The aim of the current study is to investigate the association between periodontitis (exposure variable) and depression severity (outcome variable) in an older German population. We evaluated data from 6,209 participants (median age 62 years) of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Depression severity were assessed with the 9-item Patient Health Questionnaire (PHQ-9). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Multiple linear regression models were adjusted for age, sex, diabetes, education, smoking, and antidepressant medication. Linear regression analyses revealed a significant association between log-transformed depression severity and periodontitis when including the interaction term for periodontitis * age, even after adjusting for age, sex, diabetes, education, smoking and antidepressant medication. We identified a significant association between severe periodontitis and elevated depression severity, which interacts with age. Additionally, we performed a linear regression model for biomarker analyses, which revealed significant associations between depression severity and severe periodontitis with log-transformed inflammatory biomarkers interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP). In order to identify new therapeutic strategies for patients with depression and periodontal disease, future prospective studies are needed to assess the physiological and psychosocial mechanisms behind this relationship and the causal directionality.
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Affiliation(s)
- Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Berit Lieske
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Piotr Kuta
- Institute of Clinical Chemistry and Laboratory Medicine, Center for Diagnostics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Udo Seedorf
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kristin Spinler
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Andriankaja OM, Adatorwovor R, Kantarci A, Hasturk H, Shaddox L, Levine MA. Periodontal Disease, Local and Systemic Inflammation in Puerto Ricans with Type 2 Diabetes Mellitus. Biomedicines 2023; 11:2770. [PMID: 37893143 PMCID: PMC10604368 DOI: 10.3390/biomedicines11102770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Periodontal disease (PD) is prevalent in type 2 diabetic condition (T2DM). OBJECTIVES We assessed the associations between serum or gingival crevicular fluid (GCF) endothelial and inflammatory mediators and chronic PD among T2DM Hispanic adults. METHODS We enrolled 248 Puerto Rican residents with T2DM aged 40-65 years. The exposures included serum inflammatory mediators (IL-1b, IL-6, IL-10, and TNF-α), endothelial adhesion molecules, RANKL levels, and the GCF content of these analytes from a subset of 158 samples. The outcomes included the percent of sites with a probing pocket depth (PPD) ≥ 4 mm and clinical attachment loss ≥ 4 mm. Adjusted logistic regression models were fit to the categorized outcomes. RESULTS Increased serum IL-10 (Adj. OR: 1.10, p = 0.04), sICAM-1 (Adj. OR: 1.01; p = 0.06), and elevated serum IL-1β (Adj. OR: 1.93; p = 0.06) were statistically significant or close to being significantly associated with a percent of sites with PPD ≥ 4 mm. An increase in GCF IL-1α (Adj. OR: 1.16; p < 0.01) and IL-1β (Adj: 2.40; p = 0.02) was associated with periodontal parameters. CONCLUSIONS Our findings suggested that oral and systemic endothelial and inflammatory mediators are associated with periodontal clinical parameters among Hispanic adults with T2DM.
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Affiliation(s)
- Oelisoa M. Andriankaja
- Center for Oral Health Research (COHR), University of Kentucky College of Dentistry, Lexington, KY 40536, USA;
| | - Reuben Adatorwovor
- College of Public Health, University of Kentucky, Lexington, KY 40536, USA;
| | | | - Hatice Hasturk
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA 02142, USA;
| | - Luciana Shaddox
- Center for Oral Health Research (COHR), University of Kentucky College of Dentistry, Lexington, KY 40536, USA;
| | - Michael A. Levine
- Center for Bone Health, Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
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Gündüz G, Beler M, Ünal İ, Cansız D, Emekli-Alturfan E, Kose KN. Endotoxin of Porphyromonas gingivalis amplifies the inflammatory response in hyperglycemia-induced zebrafish through a mechanism involving chitinase-like protein YKL-40 analogs. Toxicol Res 2023; 39:625-636. [PMID: 37779592 PMCID: PMC10541394 DOI: 10.1007/s43188-023-00190-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 10/03/2023] Open
Abstract
Porphyromonas gingivalis (P. gingivalis), a key pathogen in periodontal diseases, is also associated with hyperglycemia-associated systemic diseases, including diabetes mellitus (DM). Gingipains are the most important endotoxins of P. gingivalis, and in vivo studies using gingipains are scarce. Zebrafish (Danio rerio) is a vertebrate with high physiological and genetic homology with humans that has multiple co-orthologs for human genes, including inflammation-related proteins. The aim of our study was to determine the effects of gingipain in a hyperglycemia-induced zebrafish model by evaluating inflammation, oxidant-antioxidant status, and the cholinergic system. Adult zebrafish were grouped into the control group (C), hyperglycemia-induced group subjected to 15 days of overfeeding (OF), gingipain-injected group (GP), and gingipain-injected hyperglycemic group (OF + GP). At the end of 15 days, an oral glucose tolerance test (OGTT) was performed, and fasting blood glucose (FBG) levels were measured. Lipid peroxidation (LPO), nitric oxide (NO), glutathione (GSH), glutathione S-transferase, catalase, acetylcholinesterase (AChE), alkaline phosphatase (ALP), and sialic acid (SA) levels were determined spectrophotometrically in the hepatopancreas. The expression levels of tnf-⍺, il-1β, ins, crp, and the acute phase protein YKL-40 analogs chia.5 and chia.6 were evaluated by RT‒PCR. After two weeks of overfeeding, significantly increased weight gain, FBG, and OGTT confirmed that the zebrafish were hyperglycemic. Increased oxidative stress, inflammation, and AChE and ALP activities were observed in both the overfeeding and GP groups. Amplification of inflammation and oxidative stress was evident in the OF + GP group through increased expression of crp, il-1β, chia.5, and chia.6 and increased LPO and NO levels. Our results support the role of gingipains in the increased inflammatory response in hyperglycemia-associated diseases.
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Affiliation(s)
- Gizem Gündüz
- Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Merih Beler
- Department of Biochemistry, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - İsmail Ünal
- Department of Biochemistry, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Derya Cansız
- Department of Biochemistry, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ebru Emekli-Alturfan
- Department of Biochemistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Kemal Naci Kose
- Department of Periodontology, Faculty of Dentistry, Marmara University, Marmara University Basibuyuk Medical Campus, Basibuyuk, Maltepe, 34854 Istanbul, Turkey
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Andriankaja OM, Pérez CM, Modi A, Suaréz EL, Gower BA, Rodríguez E, Joshipura K. Systemic Inflammation, Endothelial Function, and Risk of Periodontitis in Overweight/Obese Adults. Biomedicines 2023; 11:1507. [PMID: 37371602 PMCID: PMC10294979 DOI: 10.3390/biomedicines11061507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
The network interaction between systemic inflammatory mediators, endothelial cell adhesion function, and adiponectin as mediators of the association between metabolic diseases and periodontitis has not been evaluated. The objective of this study is to assess whether the interaction of baseline serum levels of TNF-α, hs-CRP, ICAM-1, VCAM-1, and adiponectin leads to periodontitis. Five hundred and ninety-seven overweight/obese (overweight: BMI 25 to <30 kg/m2; obese: >30 kg/m2) adults, aged 40-65 years, with complete 3-year follow-up data were included. Generalized structural equation models with negative binomial regression were used to estimate the regression coefficient (β) for the outcome number of teeth with probing pocket depth (PPD) ≥ 4 mm and bleeding on probing (BOP) at 3-year follow-up for a 1 standard deviation unit increase (Δ = +1SD) in each biomarker. After adjusting for multiple covariates, baseline ICAM-1 and VCAM-1 had significant direct effects on increased log-transformed number of teeth with PPD ≥ 4 mm and BOP (β: 0.16; 95% CI: 0.02-0.30; β: 0.15; 95% CI: 0.02-0.30, respectively). Baseline hs-CRP showed a significant indirect effect via ICAM-1 on the log-transformed number of teeth with PPD ≥ 4 mm and BOP (β: 4.84; 95% CI: 0.27-9.42). Thus, elevated serum ICAM-1 and VCAM-1 have a significant direct effect and increased hs-CRP has a significant indirect effect on the predicted level of periodontitis at the 3-year follow-up among overweight/obese Hispanic adults.
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Affiliation(s)
- Oelisoa M. Andriankaja
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA
| | - Cynthia M. Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (C.M.P.); (E.L.S.)
| | - Ashwin Modi
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (A.M.); (E.R.); (K.J.)
| | - Erick L. Suaréz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (C.M.P.); (E.L.S.)
| | - Barbara A. Gower
- Department of Nutrition Sciences, Division of Physiology & Metabolism, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Elaine Rodríguez
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (A.M.); (E.R.); (K.J.)
| | - Kaumudi Joshipura
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00936-5067, Puerto Rico; (A.M.); (E.R.); (K.J.)
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
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Alahmari MM, AlShaiban HM, Mahmood SE. Prevalence and Associated Factors for Periodontal Disease among Type I and II Diabetes Mellitus Patients: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11060796. [PMID: 36981453 PMCID: PMC10048528 DOI: 10.3390/healthcare11060796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/26/2023] [Accepted: 03/05/2023] [Indexed: 03/30/2023] Open
Abstract
In Saudi Arabia, the prevalence of diabetes mellitus (DM) is high. DM is a risk factor for periodontal disease. The current study aimed to estimate the prevalence and potential associated factors for periodontitis among type I and II DM patients in Abha, Saudi Arabia. A cross-sectional study was conducted among patients with DM who attended the Periodontal Consultant Center at King Khalid University and Aseer Central Hospital, in Abha city, from January 2020 to January 2022. A questionnaire was used to collect relevant data. Patients were assessed for the severity of periodontitis. A total of 499 DM patients were enrolled in this study. The prevalence of periodontitis was 7.4% among type I DM and 46.4% among type II DM patients. The prevalence of periodontitis was significantly associated with age among type I DM patients (p-value = 0.001) and type II DM patients (p-value = 0.001), respectively, and smoking among type I DM patients (p-value = 0.002) and among type II DM patients (p-value = 0.000), respectively. Age and smoking were the potential associated factors for the prevalence of periodontitis among type I and II DM. The study provides evidence about the prevalence of periodontitis among DM patients, creates awareness regarding the factors that potentially contribute to worsening periodontal tissues, and the importance of early diagnosis and prevention to avoid the irreversible destruction of the periodontal tissues.
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Affiliation(s)
- Manea Musa Alahmari
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia
| | - Hassan M AlShaiban
- Saudi Board of Preventive Medicine Program, Aseer Directorate of Health Affairs, Ministry of Health, Abha 62523, Saudi Arabia
| | - Syed E Mahmood
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia
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6
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Parveen S, Alhazmi YA. Impact of Intermittent Fasting on Metabolic Syndrome and Periodontal Disease-A Suggested Preventive Strategy to Reduce the Public Health Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14536. [PMID: 36361416 PMCID: PMC9657467 DOI: 10.3390/ijerph192114536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 05/27/2023]
Abstract
Metabolic syndrome (MetS) prevalence continues to climb significantly worldwide in today's ad libitum society. MetS has tremendous societal and economic ramifications, making it imperative to develop effective strategies for preventing and controlling it to alleviate this growing burden. Periodontal disease and MetS are associated with several risk factors. Studies in the past have demonstrated that obesity, cardiovascular illness, and type 2 diabetes mellitus have a negative effect on the severity of the periodontal disease. Patients with metabolic syndrome have elevated serum levels of proinflammatory mediators such as tumor necrosis factor-alpha interleukin-6 and C-reactive protein. Similar inflammatory mediators, such as interleukin-6, tumor necrosis factor-alpha, and C-reactive protein, are increased in patients with severe periodontal disease. Remarkably, intermittent fasting is underpinned by scientific evidence, claiming to be the most effective non-pharmacological, potential therapeutic alternative for combating a wide range of metabolic, inflammatory, and lifestyle-related diseases. Nonetheless, an insufficient investigation has been performed to determine whether intermittent fasting has therapeutic benefits on periodontal inflammation and diseases. Here, we show the interrelationship between metabolic syndrome and periodontal disease and contextualize the beneficial impact of intermittent fasting in modulating the chronic metabolic and periodontal inflammatory response. We also anticipate that this review paves the way for further exploration of intermittent fasting as a unique research paradigm representing a cost-effective alternative strategy to conventional disease management in patients with periodontal diseases and metabolic syndrome which may serve as the foundation for an integrative vision relevant to primary, diagnostic, and therapeutic purposes.
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Affiliation(s)
- Sameena Parveen
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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7
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Krutyhołowa A, Strzelec K, Dziedzic A, Bereta GP, Łazarz-Bartyzel K, Potempa J, Gawron K. Host and bacterial factors linking periodontitis and rheumatoid arthritis. Front Immunol 2022; 13:980805. [PMID: 36091038 PMCID: PMC9453162 DOI: 10.3389/fimmu.2022.980805] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023] Open
Abstract
Observations from numerous clinical, epidemiological and serological studies link periodontitis with severity and progression of rheumatoid arthritis. The strong association is observed despite totally different aetiology of these two diseases, periodontitis being driven by dysbiotic microbial flora on the tooth surface below the gum line, while rheumatoid arthritis being the autoimmune disease powered by anti-citrullinated protein antibodies (ACPAs). Here we discuss genetic and environmental risk factors underlying development of both diseases with special emphasis on bacteria implicated in pathogenicity of periodontitis. Individual periodontal pathogens and their virulence factors are argued as potentially contributing to putative causative link between periodontal infection and initiation of a chain of events leading to breakdown of immunotolerance and development of ACPAs. In this respect peptidylarginine deiminase, an enzyme unique among prokaryotes for Porphyromonas gingivalis, is elaborated as a potential mechanistic link between this major periodontal pathogen and initiation of rheumatoid arthritis development.
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Affiliation(s)
- Anna Krutyhołowa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Karolina Strzelec
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agata Dziedzic
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Grzegorz P. Bereta
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Katarzyna Łazarz-Bartyzel
- Department of Periodontology and Oral Medicine, Faculty of Medicine, Medical College, Jagiellonian University, Krakow, Poland
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland,Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, KY, United States,*Correspondence: Katarzyna Gawron, ; Jan Potempa,
| | - Katarzyna Gawron
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland,*Correspondence: Katarzyna Gawron, ; Jan Potempa,
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Kim OS, Park KJ, Jin HM, Cho YN, Kim YS, Kwon SH, Koh JT, Ju JK, Kee SJ, Park YW. Activation and increased production of interleukin-17 and tumour necrosis factor-α of mucosal-associated invariant T cells in patients with periodontitis. J Clin Periodontol 2022; 49:706-716. [PMID: 35569027 DOI: 10.1111/jcpe.13648] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 04/08/2022] [Accepted: 05/10/2022] [Indexed: 12/28/2022]
Abstract
AIM Mucosal-associated invariant T (MAIT) cells are known to be resident in oral mucosal tissue, but their roles in periodontitis are unknown. This study aimed to examine the level and function of MAIT cells in periodontitis patients. MATERIALS AND METHODS Frequency, activation, and function of MAIT cells from 28 periodontitis patients and 28 healthy controls (HCs) were measured by flow cytometry. RESULTS Circulating MAIT cells were numerically reduced in periodontitis patients. Moreover, they exhibited higher expression of CD69 and annexin V, together with more increased production of interleukin (IL)-17 and tumour necrosis factor (TNF)-α, in periodontitis patients than in HCs. Interestingly, periodontitis patients had higher frequencies of MAIT cells in gingival tissue than in peripheral blood. In addition, circulating MAIT cells had elevated expression of tissue-homing chemokine receptors such as CCR6 and CXCR6, and the corresponding chemokines (i.e., CCL20 and CXCL16) were more strongly expressed in inflamed gingiva than in healthy gingiva. CONCLUSIONS This study demonstrates that circulating MAIT cells are numerically deficient with an activated profile toward the production of IL-17 and TNF-α in periodontitis patients. Furthermore, circulating MAIT cells have the potential to migrate to inflamed gingival tissues.
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Affiliation(s)
- Ok-Su Kim
- Department of Periodontology, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-Tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Ki-Jeong Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hye-Mi Jin
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Young-Nan Cho
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Ye Seul Kim
- Department of Periodontology, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Seung-Hee Kwon
- Hard-Tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Jeong-Tae Koh
- Hard-Tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Jae Kyun Ju
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Yong-Wook Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
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9
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Su SYS, Chien WC, Chung CH, Su WF, Fu E. Association of periodontitis with tinnitus: A population-based cohort study in Taiwan. J Clin Periodontol 2022; 49:970-979. [PMID: 35634696 DOI: 10.1111/jcpe.13670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/21/2022] [Accepted: 05/18/2022] [Indexed: 12/16/2022]
Abstract
AIM Tinnitus, ringing in the ears, is speculated to be driven by inflammation. This study examined whether periodontitis is a risk factor for tinnitus using Taiwan's National Health Insurance Research Database. MATERIALS AND METHODS Among the 79,456 patients who visited for dental concerns, 11,055 patients who were diagnosed with periodontitis and underwent periodontal treatment between 2000 and 2015 were enrolled in Group 1. After matching for sex, age, and index year, 11,055 patients with periodontitis who received no treatment were enrolled in Group 2. Similarly, 11,055 participants without periodontitis were included as controls. RESULTS At the end of the follow-up, 412 and 404 participants in the two periodontitis groups and 321 participants in the control group had tinnitus. Cumulative risk for tinnitus in Group 1 or 2 was significantly greater than in the control group. More periodontitis patients than controls developed tinnitus (adjusted hazard ratios were 1.71 (95% confidence interval [CI]: 1.49-1.97, p < .001) and 1.64 (95% CI: 1.37-1.86, p < .001) in Groups 1 and 2, respectively). The risks were not significantly different between Groups 1 and 2. Similar findings were obtained after excluding data for the first 1 or 5 years. CONCLUSIONS The study findings indicate that periodontitis is associated with tinnitus.
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Affiliation(s)
- Suzanne Ying-Shan Su
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wan-Fu Su
- Department of Otolaryngology-Head and Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Earl Fu
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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PİRİM GÖRGÜN E. KNOWLEDGE LEVELS AND ATTITUDES OF INTERNISTS ABOUT THE RELATIONSHIP BETWEEN PERIODONTAL DISEASE AND DIABETES. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1061217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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11
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Cicalău GIP, Babes PA, Calniceanu H, Popa A, Ciavoi G, Iova GM, Ganea M, Scrobotă I. Anti-Inflammatory and Antioxidant Properties of Carvacrol and Magnolol, in Periodontal Disease and Diabetes Mellitus. Molecules 2021; 26:6899. [PMID: 34833990 PMCID: PMC8623889 DOI: 10.3390/molecules26226899] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/03/2021] [Accepted: 11/13/2021] [Indexed: 12/15/2022] Open
Abstract
Periodontal disease and diabetes mellitus are two pathologies that are extremely widespread worldwide and share the feature of chronic inflammation. Carvacrol is a phenolic monoterpenoid, produced by a variety of herbs, the most well-known of which is Origanum vulgare. Magnolol is a traditional polyphenolic compound isolated from the stem bark of Magnolia officinalis, mainly used in Chinese medicine. The purpose of this paper is to review the therapeutic properties of these bioactive compounds, in the treatment of periodontitis and diabetes. Based on our search strategy we conducted a literature search in the PubMed and Google Scholar databases to identify studies. A total of one hundred eighty-four papers were included in the current review. The results show that carvacrol and magnolol have anti-inflammatory, antioxidant, antimicrobial, anti-osteoclastic, and anti-diabetic properties that benefit both pathologies. Knowledge of the multiple activities of carvacrol and magnolol can assist with the development of new treatment strategies, and the design of clinical animal and human trials will maximize the potential benefits of these extracts in subjects suffering from periodontitis or diabetes.
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Affiliation(s)
- Georgiana Ioana Potra Cicalău
- Doctoral School of Biomedical Science, University of Oradea, 1st University Street, 410087 Oradea, Romania;
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
| | - Petru Aurel Babes
- Doctoral School of Biomedical Science, University of Oradea, 1st University Street, 410087 Oradea, Romania;
| | - Horia Calniceanu
- Department of Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Periodontal and Periimplant Diseases Research Center “Prof. Dr. Anton Sculean”, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adelina Popa
- Department of Orthodontics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Orthodontic Research Center (ORTHO-CENTER), Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Gabriela Ciavoi
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
| | - Gilda Mihaela Iova
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
| | - Mariana Ganea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania;
| | - Ioana Scrobotă
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
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12
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Raju K, Taylor GW, Tahir P, Hyde S. Association of tooth loss with morbidity and mortality by diabetes status in older adults: a systematic review. BMC Endocr Disord 2021; 21:205. [PMID: 34663281 PMCID: PMC8524900 DOI: 10.1186/s12902-021-00830-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This systematic review assesses the association of tooth loss (TL), as the exposure, with morbidity and mortality by diabetes mellitus (DM) status, as the outcome, in older adults. BACKGROUND Individuals with DM have higher prevalence of severe TL and increased risk of developing morbidities and mortality. No systematic review has evaluated the association between TL with morbidity and mortality by DM status. MATERIAL AND METHODS Comprehensive searches used multiple publication databases containing reports published between 01/01/2000 and 04/21/2021. Two authors independently evaluated included studies for quality and risk of bias using the Critical Appraisal Skills Programme (CASP) checklist for cohort and Center for Evidence-Based Medicine (CEBM) critical appraisal sheet for cross-sectional studies, while a third author arbitrated decisions to resolve disagreements. RESULTS Thirteen studies met the inclusion criteria: eight cross-sectional and five cohort. Qualitative review of the included studies indicated TL is associated with increased incidence and prevalence of DM. TL is also associated with DM-related morbidities including greater prevalence of heart disease, diabetic retinopathy, metabolic syndrome; poorer health-related quality of life; poorer survival of participants with chronic kidney disease; and increased medical expenditure. Overall, the quality of the evidence reviewed was medium, as per the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. CONCLUSIONS/PRACTICAL IMPLICATIONS This review found significant associations of TL with prevalence and incidence of DM and adverse DM-related outcomes. An interprofessional team-care approach that includes an oral health component could benefit the prevention and management of DM.
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Affiliation(s)
- Karen Raju
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - George W. Taylor
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
| | - Peggy Tahir
- University of California, UCSF Library, 530 Parnassus Ave, San Francisco, CA 94143-0840 USA
| | - Susan Hyde
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758 USA
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Kuraji R, Sekino S, Kapila Y, Numabe Y. Periodontal disease-related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral-liver axis. Periodontol 2000 2021; 87:204-240. [PMID: 34463983 PMCID: PMC8456799 DOI: 10.1111/prd.12387] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Periodontal disease, a chronic inflammatory disease of the periodontal tissues, is not only a major cause of tooth loss, but it is also known to exacerbate/be associated with various metabolic disorders, such as obesity, diabetes, dyslipidemia, and cardiovascular disease. Recently, growing evidence has suggested that periodontal disease has adverse effects on the pathophysiology of liver disease. In particular, nonalcoholic fatty liver disease, a hepatic manifestation of metabolic syndrome, has been associated with periodontal disease. Nonalcoholic fatty liver disease is characterized by hepatic fat deposition in the absence of a habitual drinking history, viral infections, or autoimmune diseases. A subset of nonalcoholic fatty liver diseases can develop into more severe and progressive forms, namely nonalcoholic steatohepatitis. The latter can lead to cirrhosis and hepatocellular carcinoma, which are end‐stage liver diseases. Extensive research has provided plausible mechanisms to explain how periodontal disease can negatively affect nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, namely via hematogenous or enteral routes. During periodontitis, the liver is under constant exposure to various pathogenic factors that diffuse systemically from the oral cavity, such as bacteria and their by‐products, inflammatory cytokines, and reactive oxygen species, and these can be involved in disease promotion of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Also, gut microbiome dysbiosis induced by enteral translocation of periodontopathic bacteria may impair gut wall barrier function and promote the transfer of hepatotoxins and enterobacteria to the liver through the enterohepatic circulation. Moreover, in a population with metabolic syndrome, the interaction between periodontitis and systemic conditions related to insulin resistance further strengthens the association with nonalcoholic fatty liver disease. However, most of the pathologic links between periodontitis and nonalcoholic fatty liver disease in humans are provided by epidemiologic observational studies, with the causal relationship not yet being established. Several systematic and meta‐analysis studies also show conflicting results. In addition, the effect of periodontal treatment on nonalcoholic fatty liver disease has hardly been studied. Despite these limitations, the global burden of periodontal disease combined with the recent nonalcoholic fatty liver disease epidemic has important clinical and public health implications. Emerging evidence suggests an association between periodontal disease and liver diseases, and thus we propose the term periodontal disease–related nonalcoholic fatty liver disease or periodontal disease–related nonalcoholic steatohepatitis. Continued efforts in this area will pave the way for new diagnostic and therapeutic approaches based on a periodontologic viewpoint to address this life‐threatening liver disease.
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Affiliation(s)
- Ryutaro Kuraji
- Department of Life Science Dentistry, The Nippon Dental University, Tokyo, Japan.,Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan.,Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Satoshi Sekino
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Yvonne Kapila
- Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
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Codella R, Della Guardia L, Terruzzi I, Solini A, Folli F, Varoni EM, Carrassi A, Luzi L. Physical activity as a proxy to ameliorate inflammation in patients with type 2 diabetes and periodontal disease at high cardiovascular risk. Nutr Metab Cardiovasc Dis 2021; 31:2199-2209. [PMID: 34099361 DOI: 10.1016/j.numecd.2021.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/19/2021] [Accepted: 04/24/2021] [Indexed: 12/17/2022]
Abstract
While the beneficial impact of physical activity has been ascertained in a variety of pathological scenarios, including diabetes and low-grade systemic inflammation, its potential remains still putative for periodontal health. Periodontal disease has been associated with inflammatory systemic alterations, which share a common denominator with type 2 diabetes mellitus and cardiovascular disease. Physical exercise, along with nutritional counseling, is a cornerstone in the treatment and prevention of type 2 diabetes, also able to reduce the prevalence of periodontal disease and cardiovascular risk. In addition, considering the higher incidence of periodontitis in patients with type 2 diabetes compared to healthy controls, the fascinating research question would be whether physical activity could relieve the inflammatory pressure exerted by the combination of these two diseases. This multi-disciplinary viewpoint discusses available literature in order to argument the hypothesis of a "three-way relationship" linking diabetes, periodontitis, and physical activity.
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Affiliation(s)
- Roberto Codella
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Lucio Della Guardia
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy
| | - Ileana Terruzzi
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, Università di Pisa, Pisa, Italy
| | - Franco Folli
- Endocrinology and Metabolism, Department of Health Science, Università Degli Studi di Milano, Milano, Italy
| | - Elena Maria Varoni
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy
| | - Antonio Carrassi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy
| | - Livio Luzi
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy.
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Romano F, Perotto S, Mohamed SEO, Bernardi S, Giraudi M, Caropreso P, Mengozzi G, Baima G, Citterio F, Berta GN, Durazzo M, Gruden G, Aimetti M. Bidirectional Association between Metabolic Control in Type-2 Diabetes Mellitus and Periodontitis Inflammatory Burden: A Cross-Sectional Study in an Italian Population. J Clin Med 2021; 10:jcm10081787. [PMID: 33924022 PMCID: PMC8073754 DOI: 10.3390/jcm10081787] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
This study assessed the periodontal conditions of type 2 diabetes (T2DM) patients attending an Outpatient Center in North Italy and explored the associations between metabolic control and periodontitis. Periodontal health of 104 T2DM patients (61 men and 43 women, mean age of 65.3 ± 10.1 years) was assessed according to CDC/AAP periodontitis case definitions and Periodontal Inflamed Surface Area (PISA) Index. Data on sociodemographic factors, lifestyle behaviors, laboratory tests, and glycated hemoglobin (HbA1c) levels were collected by interview and medical records. Poor glycemic control (HbA1c ≥ 7%), family history of T2DM, and C-reactive protein levels were predictors of severe periodontitis. An increase in HbA1c of 1% was associated with a rise in PISA of 89.6 mm2. On the other hand, predictors of poor glycemic control were severe periodontitis, waist circumference, unbalanced diet, and sedentary lifestyle. A rise in PISA of 10 mm2 increased the odds of having HbA1c ≥ 7% by 2%. There is a strong bidirectional connection between periodontitis and poor glycemic control. The inflammatory burden posed by periodontitis represents the strongest predictor of poor glycemic control.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Stefano Perotto
- Postgraduate Program in Periodontology, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
| | - Sara Elamin Osman Mohamed
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Sara Bernardi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Marta Giraudi
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Paola Caropreso
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, 10126 Turin, Italy; (P.C.); (G.M.)
| | - Giulio Mengozzi
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, 10126 Turin, Italy; (P.C.); (G.M.)
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Giovanni Nicolao Berta
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy
- Correspondence: (G.N.B.); (M.A.)
| | - Marilena Durazzo
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Gabriella Gruden
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
- Correspondence: (G.N.B.); (M.A.)
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Toraman A, Arabaci T, Aytekin Z, Albayrak M, Bayir Y. Effects of vitamin C local application on ligature-induced periodontitis in diabetic rats. J Appl Oral Sci 2020; 28:e20200444. [PMID: 33263670 PMCID: PMC7695129 DOI: 10.1590/1678-7757-2020-0444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/31/2020] [Indexed: 04/09/2023] Open
Abstract
Objective: This study evaluated the effects of local vitamin C treatment on tissue advanced glycation end products (AGE), interleukin (IL)-6, 8-hydroxy-2-deoxyguanosine (8-OHdG), and matrix metalloproteinases (MMP)-8 in tissues; serum C-terminal telopeptide fragments (CTX); and alveolar bone loss (ABL) in rats. Methodology: 35 male Sprague Dawley rats were divided equally into five groups: 1) control (C), 2) experimental periodontitis (P), 3) experimental diabetes (D), 4) experimental diabetes and experimental periodontitis (D + P), and 5) experimental diabetes–experimental periodontitis–locally applied vitamin C (D + P + LvitC). Diabetes was induced in rats with alloxan monohydrate, after which periodontitis was induced by ligature placement in the right mandibular first molar teeth for 11 days. In the treatment group, vitamin C was administered locally three times with two-days interval after ligature removal. The animals were sacrificed, and the samples were analyzed histometrically and immunohistochemically. Results: CTX, 8-OHdG, and AGE values significantly decreased in the treatment group compared to the D + P group. IL-6 and MMP-8 values decreased in the treatment group compared to the D + P group, but this is not significant. ABL was significantly reduced by the local delivery of vitamin C. Conclusion: This study reveals that vitamin C treatment may be beneficial to reduce serum CTX and gingival MMP-8 levels, oxidative stress, inflammation, and AGE accumulation in periodontal tissue. Vitamin C may be an immunomodulator and antioxidant locally applied in the treatment of periodontitis to reduce the adverse effects of diabetes in periodontal tissues.
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Affiliation(s)
- Ayşe Toraman
- Sağlık Bilimleri University, Faculty of Dentistry, Department of Periodontology, İstanbul, Turkey
| | - Taner Arabaci
- Atatürk University, Faculty of Dentistry, Department of Periodontology, Erzurum, Turkey
| | - Zeliha Aytekin
- Akdeniz University, Faculty of Dentistry, Department of Periodontology, Antalya, Turkey
| | - Mevlüt Albayrak
- Ataturk University, Health Services Vocational Training School, Department of Medical Laboratory Techniques, Erzurum, Turkey
| | - Yasin Bayir
- Atatürk University, Faculty of Pharmacy Department of Basic Pharmacy Sciences, Department of Biochemistry, Erzurum, Turkey
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Jain P, Ved A, Dubey R, Singh N, Parihar AS, Maytreyee R. Comparative Evaluation of Serum Tumor Necrosis Factor α in Health and Chronic Periodontitis: A Case-Control Study. Contemp Clin Dent 2020; 11:342-349. [PMID: 33850400 PMCID: PMC8035841 DOI: 10.4103/ccd.ccd_97_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/08/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Tumor necrosis factor-alpha (TNF-α), a " major inflammatory cytokine," not only plays an important role in periodontal destruction but also is extremely toxic to the host. Till date, there are not many studies comparing the levels of TNF-α in serum and its relationship to periodontal disease. AIM Our study aimed to compare the serum TNF-α among the two study groups, namely, healthy controls and chronic periodontitis patients and establish a correlation between serum TNF-α and various clinical parameters. Hence, an attempt is made to estimate the level of TNF-α in serum, its relationship to periodontal disease and to explore the possibility of using the level of TNF-α in serum as a biochemical " marker" of periodontal disease. MATERIALS AND METHODS Forty individuals participated in the study and were grouped into two subgroups. Group A - 20 systemically and periodontally healthy controls. Group B - twenty patients with generalized chronic periodontitis. The serum samples were assayed for TNF-α levels by enzyme-linked immunosorbent assay method. RESULTS The mean serum TNF-α cytokines for Group B Generalized chronic periodontitis (GCP) was 2.977 ± 1.011, and Group A (healthy) was 0.867 ± 0.865. The range of serum TNF-α was from (0.867 to 2.977). Serum TNF-α cytokines had highly significant correlation with all clinical parameters (plaque index, probing pocket depth, clinical attachment loss, and gingival index) among all study participants (P = 0.001). CONCLUSION These observations suggest a positive association between periodontal disease and increased levels of TNF-α in serum. It can be concluded that there is a prospect of using the estimation of TNF-α in serum as a "marker" of periodontal disease in future. However, it remains a possibility that the absence or low levels of TNF-α in serum might indicate a stable lesion and elevated levels might indicate an active site but only longitudinal studies taking into account, the disease "activity" and "inactivity" could suggest the possibility of using TNF-α in serum as an "Indicator" of periodontal disease.
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Affiliation(s)
- Prince Jain
- Consultant Periodontist and Implantologist, Vidisha, India
| | - Aditi Ved
- Dental Surgeon, Dental Planet Clinic, Vidisha, India
| | - Rajat Dubey
- Department of Dentistry, Government Hospital, Ratlam, India
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18
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Changes of saliva microbiota in the onset and after the treatment of diabetes in patients with periodontitis. Aging (Albany NY) 2020; 12:13090-13114. [PMID: 32634783 PMCID: PMC7377876 DOI: 10.18632/aging.103399] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/25/2020] [Indexed: 01/06/2023]
Abstract
The relationship between type 2 diabetes mellitus (T2DM) and oral microbiota is still insufficiently recognized. In the present study, we compared the salivary microbiome of nondiabetic individuals, treatment-naïve diabetic patients, and diabetic patients treated with metformin or a combination of insulin and other drugs. The α- and β-diversity demonstrated significant differences in the salivary microbiome between the nondiabetic people and patients with a history of diabetes, while little divergence was found among individuals with a history of diabetes. After characterizing the effects of periodontitis on the microbial composition of each group, the salivary microbiome of the treatment-naïve diabetic patient group was compared with that of nondiabetic people and the metformin/combined treatment groups. The results revealed changes in the contents of certain bacteria after both the onset and the treatment of diabetes; among these differential bacteria, Blautia_wexlerae, Lactobacillus_fermentum, Nocardia_coeliaca and Selenomonas_artemidis varied in all processes. A subsequent correlational analysis of the differential bacteria and clinical characteristics demonstrated that salivary microbes were related to drug treatment and certain pathological changes. Finally, the four common differential bacteria were employed for distinguishing the treatment-naïve diabetic patients from the nondiabetic people and the treated patients, with prediction accuracies of 83.3%, 75% and 75%, respectively.
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Kumar G, Ponnaiyan D, Parthasarathy H, Tadepalli A, Veeramani S. Evaluation of Endocan and Tumor Necrosis Factor-α as Inflammatory Biomarkers in Type 2 Diabetes and Periodontal Disease. Genet Test Mol Biomarkers 2020; 24:431-435. [DOI: 10.1089/gtmb.2020.0037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Gayathri Kumar
- Department of Periodontology, SRM Dental College, Chennai, India
| | - Deepa Ponnaiyan
- Department of Periodontology, SRM Dental College, Chennai, India
| | | | | | - Suresh Veeramani
- Department of Craniofacial, Esthetic and Plastic Surgery, SIMS Hospital, Chennai, India
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20
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Luo W, Li Y, Luo Z, Xu B. Chronic atrophic gastritis aggravate chronic periodontitis with Helicobacter pylori infection and CD4+Th cytokines infiltration. Histol Histopathol 2019; 35:665-672. [PMID: 31749138 DOI: 10.14670/hh-18-187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the potential effect of chronic atrophic gastritis on chronic periodontitis and further explore the possible mechanism. METHODS Local periodontal lesions were collected from periodontitis tissues of 30 CAG patients and 35 control adults without CAG (non-CAG). Clinical periodontal parameters were recorded, and the expression levels of distinct CD4+ Th specific cytokines at local periodontitis lesions were evaluated by real time PCR (RT-PCR). Helicobacter pylori (H. pylori) detection was carried out in both gastric and periodontitis lesions of CAG and non CAG patients. RESULTS Clinical parameters analysis showed that the level of clinical attachment loss in periodontitis lesions of CAG group was significantly higher than non-CAG group. It was observed that the infection rate of H. pylori in the CAG group was higher than non-CAG group. Further cytokine analysis showed that Th17 associated cytokines IL-17, IL-21 and IL-23 were increased in periodontal lesions of CAG patients when compared with non-CAG patients. However, Th1, Th2, Th9 and Treg cells specific cytokines were not significantly increased in CAG group when compared with non-CAG group. CONCLUSIONS Patients with CAG demonstrated that significant elevated attachment loss in periodontitis lesions, while elevated Th17 cytokines IL-17, IL-21 and IL-23 participate in immunopathogenesis of both diseases.
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Affiliation(s)
- Wei Luo
- Department of Gastroenterology, Beijing Luhe Hospital of Capital Medical University, Beijing, PR China
| | - Yaqiang Li
- Department of Gastroenterology, Beijing Luhe Hospital of Capital Medical University, Beijing, PR China
| | - Zhenhua Luo
- Department of Periodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, PR China
| | - Baohong Xu
- Department of Gastroenterology, Beijing Luhe Hospital of Capital Medical University, Beijing, PR China.
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21
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Srivastava MC, Srivastava R, Verma PK, Gautam A. Metabolic syndrome and periodontal disease: An overview for physicians. J Family Med Prim Care 2019; 8:3492-3495. [PMID: 31803642 PMCID: PMC6881921 DOI: 10.4103/jfmpc.jfmpc_866_19] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/08/2019] [Accepted: 10/21/2019] [Indexed: 01/26/2023] Open
Abstract
The metabolic syndrome (MetS) (also known as insulin resistance syndrome, syndrome X) is a cluster of factors associated with increased risk of developing coronary heart disease or type 2 diabetes mellitus. Several studies in the past have reviewed an association between MetS and periodontitis. Periodontal disease is considered an infectious and chronic inflammatory disease, and it has been considered to be a potential risk in cardiovascular and respiratory diseases and diabetes, and has implications in adverse pregnancy outcomes, osteoporosis, and so on. These systemic disorders have been documented as capable of affecting the periodontium or treatment of periodontal disease. Oral inflammatory lesions have different basic mechanisms concerning the possible association with systemic diseases. They concern local spread, metastatic spread, or immunologic cross-reactivity. In many studies, sometimes contrasting, periodontal pathogens have been evaluated in atheromatous plaques isolated from patients with chronic periodontitis. Oral inflammatory lesions have been shown unequivocally to contribute to elevated systemic inflammatory responses. In some studies, intensive periodontal therapy showed a significant reduction in c-reactive protein levels, interleukin-6, and low-density lipoprotein cholesterol after 2 months. The aim of this article is to reflect the association between MetS and periodontitis and to suggest an understanding to promote interprofessional practice; with proper oral care and plaque control, we can reduce the severity of MetS.
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Affiliation(s)
- Mahesh C Srivastava
- Department of Medicine, Prasad Institute of Medical Sciences, Banthara, Lucknow, Uttar Pradesh, India
| | - Ruchi Srivastava
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Pushpendra Kumar Verma
- Department of Conservative Dentistry and Endodontics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Anju Gautam
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, Rengo G. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci 2019; 20:ijms20061414. [PMID: 30897827 PMCID: PMC6470716 DOI: 10.3390/ijms20061414] [Citation(s) in RCA: 218] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease, initiated by the presence of a bacterial biofilm, called dental plaque, which affects both the periodontal ligaments and bone surrounding teeth. In the last decades, several lines of evidence have supported the existence of a relationship between periodontitis and systemic health. For instance, as periodontitis acts within the same chronic inflammatory model seen in cardiovascular disease (CVD), or other disorders, such as diabetes, several studies have suggested the existence of a bi-directional link between periodontal health and these pathologies. For instance, people with diabetes are more susceptible to infections and are more likely to suffer from periodontitis than people without this syndrome. Analogously, it is now evident that cardiac disorders are worsened by periodontitis, both experimentally and in humans. For all these reasons, it is very plausible that preventing periodontitis has an impact on the onset or progression of CVD and diabetes. On these grounds, in this review, we have provided an updated account on the current knowledge concerning periodontal disease and the adverse effects exerted on the cardiovascular system health and diabetes, informing readers on the most recent preclinical studies and epidemiological evidence.
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Affiliation(s)
- Daniela Liccardo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Center for Translational Medicine, Temple University, Philadelphia, PA 19140, USA.
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia.
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100 Siena, Italy.
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
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Rampally P, Koduganti RR, Ganapathi SN, Panthula VR, Surya PJ. Comparison of effectiveness of low-dose aspirin versus omega-3 fatty acids as adjuvants to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis. J Indian Soc Periodontol 2019; 23:249-256. [PMID: 31143006 PMCID: PMC6519093 DOI: 10.4103/jisp.jisp_528_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Context: Periodontitis and diabetes are universally prevalent diseases which are interlinked with each other. Inflammatory products released both by the microorganisms, and the host plays a pivotal role in causing both the diseases. Pentraxins are acute-phase proteins which are often found to be elevated in inflammatory states. Anti-inflammatory agents have a very important role to play in curbing infection of which, aspirin and omega-3 fatty acids (O3FAs) are being administered often nowadays. Nonsurgical periodontal therapy (NSPT) remains the gold standard of treatment, and other agents have been used as adjuvants only, to increase the efficacy of treatment. Aims: This study compares the effects of low-dose aspirin versus O3FAs when used as adjuvants to NSPT in patients with diabetes and chronic periodontitis. Settings and Design: A total of 42 patients (mean age of 30–65 years) from a diabetic center who were diagnosed with Type II diabetes and chronic periodontitis were included in the study. Materials and Methods: This study was done in the department of periodontics of a tertiary referral care hospital in Hyderabad, in collaboration with a reputed diabetic center. Statistical Analysis Used: Intragroup comparison was done using the paired t-test for continuous data and Wilcoxon signed-rank test for score data. Intergroup comparison was compiled using independent t-test. All P < 0.05 were considered statistically significant. Results: Intragroup comparison at baseline and 3 months after NSPT showed statistically significant results (P < 0.001) in all the three groups pertaining to the clinical (gingival index, probing pocket depth, and clinical attachment level) and biochemical (glycosylated hemoglobin and pentraxin) parameters. However, the intergroup comparison showed a significant improvement in Group II related to pentraxin levels only (P < 0.001). Conclusions: O3FAs proved to be better than low-dose aspirin and placebo after NSPT.
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Affiliation(s)
- Prathyusha Rampally
- Department of Periodontics, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Rekha Rani Koduganti
- Department of Periodontics, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | | | - Veerendranath Reddy Panthula
- Department of Periodontics, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Prasanna Jammula Surya
- Department of Periodontics, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
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24
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Li G, Robles S, Lu Z, Li Y, Krayer JW, Leite RS, Huang Y. Upregulation of free fatty acid receptors in periodontal tissues of patients with metabolic syndrome and periodontitis. J Periodontal Res 2018; 54:356-363. [PMID: 30597558 DOI: 10.1111/jre.12636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 11/02/2018] [Accepted: 12/02/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Metabolic syndrome (MetS) exacerbates periodontitis. Since saturated fatty acid (SFA) is increased in MetS and enhances lipopolysaccharide (LPS)-induced proinflammatory cytokine expression in macrophages, it has been considered to play a role in MetS-exacerbated periodontitis. However, it remains unknown how fatty acid receptors, which mediate the interaction of cells with SFA and uptake of SFA, are expressed and regulated in the periodontal tissue. In this study, we tested our hypothesis that the periodontal expression of fatty acid receptors GPR40 and CD36 is increased in patients with both MetS and periodontitis. We also determined the effect of SFA and LPS on GPR40 and CD36 expression in vitro. MATERIAL AND METHODS Periodontal tissue specimens were collected from 11 participants without MetS and periodontitis, 12 participants with MetS, 11 participants with periodontitis, and 14 participants with both MetS and periodontitis after surgeries. The tissues were processed, and GPR40 and CD36 were detected by immunohistochemistry. Furthermore, cultured macrophages and gingival fibroblasts were treated with LPS, palmitate, a major SFA, or LPS plus palmitate and the expression of GPR40 and CD36 was then quantified. RESULTS Analysis of clinical data showed that age, smoker, gender, and race/ethnicity were not significantly different among 4 groups. Immunohistochemistry showed that GPR40 and CD36 were expressed by epithelial cells, fibroblasts, and immune cells. Quantitative data showed that GPR40 expression is increased in patients with periodontitis, MetS, or both periodontitis and MetS while CD36 expression is increased only in patients with both periodontitis and MetS. The in vitro studies showed that the expression of GPR40 and CD36 in macrophages and fibroblasts was upregulated by the combination of LPS and palmitate. CONCLUSION Periodontal expression of GPR40 and CD36 was upregulated in patients with both MetS and periodontitis, and GPR40 and CD36 in macrophages and fibroblasts were upregulated in vitro by the combination of LPS and palmitate, suggesting that GPR40 and CD36 may be involved in MetS-exacerbated periodontitis.
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Affiliation(s)
- Guang Li
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Samantha Robles
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Zhongyang Lu
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Yanchun Li
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Joe W Krayer
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Renata S Leite
- Division of Periodontics, Department of Stomatology, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina.,Center for Oral Health Research, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Yan Huang
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
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D'Aiuto F, Gkranias N, Bhowruth D, Khan T, Orlandi M, Suvan J, Masi S, Tsakos G, Hurel S, Hingorani AD, Donos N, Deanfield JE. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol 2018; 6:954-965. [PMID: 30472992 DOI: 10.1016/s2213-8587(18)30038-x] [Citation(s) in RCA: 241] [Impact Index Per Article: 40.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/26/2017] [Accepted: 10/02/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic inflammation is believed to be a major mechanism underlying the pathophysiology of type 2 diabetes. Periodontitis is a cause of systemic inflammation. We aimed to assess the effects of periodontal treatment on glycaemic control in people with type 2 diabetes. METHODS In this 12 month, single-centre, parallel-group, investigator-masked, randomised trial, we recruited patients with type 2 diabetes, moderate-to-severe periodontitis, and at least 15 teeth from four local hospitals and 15 medical or dental practices in the UK. We randomly assigned patients (1:1) using a computer-generated table to receive intensive periodontal treatment (IPT; whole mouth subgingival scaling, surgical periodontal therapy [if the participants showed good oral hygiene practice; otherwise dental cleaning again], and supportive periodontal therapy every 3 months until completion of the study) or control periodontal treatment (CPT; supra-gingival scaling and polishing at the same timepoints as in the IPT group). Treatment allocation included a process of minimisation in terms of diabetes onset, smoking status, sex, and periodontitis severity. Allocation to treatment was concealed in an opaque envelope and revealed to the clinician on the day of first treatment. With the exception of dental staff who performed the treatment and clinical examinations, all study investigators were masked to group allocation. The primary outcome was between-group difference in HbA1c at 12 months in the intention-to-treat population. This study is registered with the ISRCTN registry, number ISRCTN83229304. FINDINGS Between Oct 1, 2008, and Oct 31, 2012, we randomly assigned 264 patients to IPT (n=133) or CPT (n=131), all of whom were included in the intention-to-treat population. At baseline, mean HbA1c was 8·1% (SD 1·7) in both groups. After 12 months, unadjusted mean HbA1c was 8·3% (SE 0·2) in the CPT group and 7·8% (0·2) in the IPT group; with adjustment for baseline HbA1c, age, sex, ethnicity, smoking status, duration of diabetes, and BMI, HbA1c was 0·6% (95% CI 0·3-0·9; p<0·0001) lower in the IPT group than in the CPT group. At least one adverse event was reported in 30 (23%) of 133 patients in the IPT group and 23 (18%) of 131 patients in the CPT group. Serious adverse events were reported in 11 (8%) patients in the IPT group, including one (1%) death, and 11 (8%) patients in the CPT group, including three (2%) deaths. INTERPRETATION Compared with CPT, IPT reduced HbA1c in patients with type 2 diabetes and moderate-to-severe periodontitis after 12 months. These results suggest that routine oral health assessment and treatment of periodontitis could be important for effective management of type 2 diabetes. FUNDING Diabetes UK and UK National Institute for Health Research.
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Affiliation(s)
- Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK.
| | - Nikolaos Gkranias
- Centre for Clinical Oral Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Devina Bhowruth
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Tauseef Khan
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Jean Suvan
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK
| | - Stefano Masi
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Steve Hurel
- Department of Endocrinology, University College London Hospitals, University College London, London, UK
| | - Aroon D Hingorani
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Nikos Donos
- Centre for Clinical Oral Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - John E Deanfield
- Institute of Cardiovascular Sciences, University College London, London, UK
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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Sudhakara P, Gupta A, Bhardwaj A, Wilson A. Oral Dysbiotic Communities and Their Implications in Systemic Diseases. Dent J (Basel) 2018; 6:E10. [PMID: 29659479 PMCID: PMC6023521 DOI: 10.3390/dj6020010] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 03/29/2018] [Accepted: 04/06/2018] [Indexed: 12/20/2022] Open
Abstract
The human body supports the growth of a wide array of microbial communities in various niches such as the oral cavity, gastro-intestinal and urogenital tracts, and on the surface of the skin. These host associated microbial communities include yet-un-cultivable bacteria and are influenced by various factors. Together, these communities of bacteria are referred to as the human microbiome. Human oral microbiome consists of both symbionts and pathobionts. Deviation from symbiosis among the bacterial community leads to “dysbiosis”, a state of community disturbance. Dysbiosis occurs due to many confounding factors that predispose a shift in the composition and relative abundance of microbial communities. Dysbiotic communities have been a major cause for many microbiome related systemic infections. Such dysbiosis is directed by certain important pathogens called the “keystone pathogens”, which can modulate community microbiome variations. One such persistent infection is oral infection, mainly periodontitis, where a wide array of causal organisms have been implied to systemic infections such as cardio vascular disease, diabetes mellitus, rheumatoid arthritis, and Alzheimer’s disease. The keystone pathogens co-occur with many yet-cultivable bacteria and their interactions lead to dysbiosis. This has been the focus of recent research. While immune evasion is one of the major modes that leads to dysbiosis, new processes and new virulence factors of bacteria have been shown to be involved in this important process that determines a disease or health state. This review focuses on such dysbiotic communities, their interactions, and their virulence factors that predispose the host to other systemic implications.
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Affiliation(s)
- Preethi Sudhakara
- Department of Genetic Engineering, SRM University, Chennai 603203, India.
| | - Abishek Gupta
- Department of Genetic Engineering, SRM University, Chennai 603203, India.
| | | | - Aruni Wilson
- Division of Microbiology and Molecular Genetics, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA.
- Musculoskeletal Diseases Center, VA Loma Linda, Department of Veterans Affairs, Loma Linda, CA 92350, USA.
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Piras V, Usai P, Mezzena S, Susnik M, Ideo F, Schirru E, Cotti E. Prevalence of Apical Periodontitis in Patients with Inflammatory Bowel Diseases: A Retrospective Clinical Study. J Endod 2018; 43:389-394. [PMID: 28231978 DOI: 10.1016/j.joen.2016.11.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 10/24/2016] [Accepted: 11/02/2016] [Indexed: 12/13/2022]
Abstract
AIM We evaluated the prevalence of apical periodontitis (AP) and the oral health status in patients with inflammatory bowel diseases (IBDs) treated with immunomodulators, with particular attention to biologic medications (BMs). METHODS One hundred ten patients, 49 men and 61 women (average age, 46 ± 13.8 years), from the Gastroenterology Unit of the University Hospital with IBDs who were treated with BMs or corticosteroids were included in the study. One hundred ten patients who registered for a dental check-up at the Dental Clinic were matched for age, sex, and physical characteristics with the study group without systemic diseases and not taking medications who were the control. Patients underwent a complete oral, dental, and radiographic examination. Decayed, missing, and filled teeth and periapical index score indexes were recorded. Student t test, χ2, and Mann-Whitney U test were used as appropriate. RESULTS The prevalence of AP was 64% in IBD patients and 59% in the control; according to the gender-stratified analysis, the difference was not significant among the male groups, whereas the number of teeth with AP was significantly higher in female patients with IBDs than in the controls (P ≤ .05). The prevalence of AP in patients treated with BMs was 65%; women showed 69% higher risk for AP and presented a significantly higher number of teeth with AP (P ≤ .05). Decayed, missing, and filled teeth index was similar in both groups, whereas patients with IBDs had a higher periapical index score than the controls. CONCLUSIONS Women with IBDs and taking immunomodulators had a higher prevalence of AP. All patients with IBDs had larger lesions than healthy subjects. These data emphasize the influence of the status of the immune system in the onset of AP and the need for further studies to confirm these findings.
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Affiliation(s)
- Vanessa Piras
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - Paolo Usai
- Department of Gastroenterology, School of Medicine, University of Cagliari, Cagliari, Italy
| | - Silvia Mezzena
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - Marta Susnik
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - Francesca Ideo
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - Elia Schirru
- Department of Endodontology, Kings College Dental Institute, London, United Kingdom
| | - Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy.
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Widita E, Yoshihara A, Hanindriyo L, Miyazaki H. Relationship between clinical periodontal parameters and changes in liver enzymes levels over an 8-year period in an elderly Japanese population. J Clin Periodontol 2018; 45:311-321. [DOI: 10.1111/jcpe.12861] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Elastria Widita
- Division of Preventive Dentistry; Department of Oral Health Science; Graduate School of Medical and Dental Science; Niigata University; Niigata Japan
- Dental Hygiene Program; Faculty of Dentistry; Universitas Gadjah Mada; Yogyakarta Indonesia
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion; Department of Oral Health and Welfare; Graduate School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - Lisdrianto Hanindriyo
- Division of Preventive Dentistry; Department of Oral Health Science; Graduate School of Medical and Dental Science; Niigata University; Niigata Japan
- Department of Preventive and Community Dentistry; Faculty of Dentistry; Universitas Gadjah Mada; Yogyakarta Indonesia
| | - Hideo Miyazaki
- Division of Preventive Dentistry; Department of Oral Health Science; Graduate School of Medical and Dental Science; Niigata University; Niigata Japan
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30
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Polak D, Shapira L. An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 2017; 45:150-166. [PMID: 29280184 DOI: 10.1111/jcpe.12803] [Citation(s) in RCA: 197] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 02/06/2023]
Abstract
AIM To provide an update of the review by Taylor (Journal of Clinical Periodontology, 2013, 40, S113) regarding the scientific evidence of the biological association between periodontitis and diabetes. METHODS Literature searches were performed using MeSH terms, keywords and title words and were published between 2012 and November 2016. All publications were screened for their relevance. The data from the articles were extracted and summarized in tables and a narrative review. RESULTS Small-scale molecular periodontal microbiome studies indicate a possible association between altered glucose metabolism in pre-diabetes and diabetes and changes in the periodontal microbiome, with no evidence for casual relationships. Clinical and animal studies found elevated gingival levels of IL1-β, TNF-α, IL-6, RANKL/OPG and oxygen metabolites in poorly controlled diabetes. In addition, individuals with diabetes and periodontitis exhibit high levels of circulating TNF-α, CRP and mediators of oxidative stress, and successful periodontal treatment reduces their levels. CONCLUSIONS The elevated pro-inflammatory factors in the gingiva of patients with poorly controlled diabetes suggest a biological pathway that may aggravate periodontitis. Some evidence suggests that the systemic inflammatory burden in periodontitis has the potential to affect diabetes control, but no studies addressed the impact of successful periodontal therapy on the pathophysiological mechanisms involved in systemic complications of diabetes.
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Affiliation(s)
- David Polak
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Lior Shapira
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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31
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Cotti E, Abramovitch K, Jensen J, Schirru E, Rice DD, Oyoyo U, Torabinejad M. The Influence of Adalimumab on the Healing of Apical Periodontitis in Ferrets. J Endod 2017; 43:1841-1846. [PMID: 28967493 DOI: 10.1016/j.joen.2017.06.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 05/31/2017] [Accepted: 06/03/2017] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Given the increasing use of anti-tumor necrosis factor α (anti-TNFα) biologic medications, and their interferences with the immune-inflammatory response, this study evaluated the effect of adalimumab (anti-TNFα), on healing and healing time of apical periodontitis (AP) in ferrets. METHODS Twelve male ferrets received cone beam computed tomography of the jaws at baseline health (T0); AP confirmation (T1); and 30 (T2), 60 (T3), and 90 (T4) days after root canal treatment (RCT) to monitor healing. All animals had AP induced in the canines; 3 ferrets (12 teeth) provided the positive controls for the histologic evaluation; 9 ferrets were randomly divided into 3 treatment groups with 12 teeth each in the following manner: Systemic: conventional RCT and systemic anti-TNFα; Local: RCT and periapical administration of anti-TNFα before canal obturation; conventional RCT only (control). Two calibrated radiologists assessed the cone beam computed tomography images independently and blindly for AP identification and quantification. Rank-based analysis of covariance was used for statistical analysis of lesion size. RESULTS AP was induced in all teeth. Following RCT, all AP lesions in the 3 groups showed a significant reduction in size. Specific pairwise comparisons of the related samples (Friedman's 2-way analysis of variance by ranks within each group) demonstrated a decreasing trend in lesion size with healing time in all 3 groups, most pronounced for local group (local adalimumab). No statistical difference was noticed between groups. CONCLUSIONS Both systemic and local anti-TNFα did not hinder AP healing in this animal model and a faster healing response may also be anticipated. These findings encourage follow-up studies with larger sample sizes.
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Affiliation(s)
- Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, Università degli Studi di Cagliari, Cagliari, Italy.
| | - Kenneth Abramovitch
- Department of Radiology and Imaging Sciences, School of Dentistry, Loma Linda University, Loma Linda, California
| | - James Jensen
- Private Practice in Endodontics, Lethbridge, Alberta, Canada
| | - Elia Schirru
- Department of Conservative Dentistry and Endodontics, Università degli Studi di Cagliari, Cagliari, Italy
| | - Dwight D Rice
- Department of Radiology and Imaging Sciences, School of Dentistry, Loma Linda University, Loma Linda, California
| | - Udochukwu Oyoyo
- Department of Dental Education Services, School of Dentistry, Loma Linda University, Loma Linda, California
| | - Mahmoud Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California
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Hayashi J, Hasegawa A, Hayashi K, Suzuki T, Ishii M, Otsuka H, Yatabe K, Goto S, Tatsumi J, Shin K. Effects of periodontal treatment on the medical status of patients with type 2 diabetes mellitus: a pilot study. BMC Oral Health 2017; 17:77. [PMID: 28431542 PMCID: PMC5399866 DOI: 10.1186/s12903-017-0369-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 04/12/2017] [Indexed: 01/22/2023] Open
Abstract
Background Studies have demonstrated that periodontal disease is associated with the development of systemic complications in patients with type 2 diabetes mellitus (T2DM). The purpose of this pilot study was to investigate which markers among various systemic disease parameters are affected by periodontal treatment in patients with T2DM. Methods Twelve patients with T2DM were given oral hygiene instructions and subsequent subgingival scaling and root planing. The periodontal status was recorded, and blood and urine samples were taken to measure various parameters of glucose control and systemic status at baseline and 1 month following the periodontal treatment. Serum concentrations of tumor necrosis factor-α and high-sensitivity C-reactive protein were measured by enzyme-linked immunosorbent assay. Results After the periodontal treatment, the glycated hemoglobin value was significantly improved. The levels of urinary N-acetyl-β-D-glucosaminidase and albumin, which are markers of renal dysfunction, also decreased significantly after treatment. Among the parameters measured in serum, the γ-glutamyl transpeptidase level, which is usually interpreted as a marker of liver dysfunction, was significantly reduced. The serum concentrations of tumor necrosis factor-α and high-sensitivity C-reactive protein were also significantly reduced by periodontal treatment. Conclusion Within the limitations of this pilot study, periodontal treatment may be effective not only in improving metabolic control, but also in reducing the risk of diabetic kidney and liver disease in patients with T2DM.
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Affiliation(s)
- Joichiro Hayashi
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan.
| | | | - Kohei Hayashi
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Takafumi Suzuki
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Makiko Ishii
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Hideharu Otsuka
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Kazuhiro Yatabe
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Seiichi Goto
- Meikai University School of Dentistry, Saitama-ken, Japan
| | - Junichi Tatsumi
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Kitetsu Shin
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
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Seraphim APCG, Chiba FY, Pereira RF, Mattera MSDLC, Moimaz SAS, Sumida DH. Relationship among Periodontal Disease, Insulin Resistance, Salivary Cortisol, and Stress Levels during Pregnancy. Braz Dent J 2017; 27:123-7. [PMID: 27058372 DOI: 10.1590/0103-6440201600596] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/11/2016] [Indexed: 11/22/2022] Open
Abstract
Pregnancy is a period involving important metabolic changes that enable the maintenance of the mother's health and development of the fetus. This study aimed to assess the relationship among periodontal disease, insulin resistance, salivary cortisol concentration and level of perceived stress in pregnant women. This was a cross-sectional study. The sample comprised 96 pregnant women between the fifth and seventh month of pregnancy registered at the Basic Health Units of the Unified Health System (SUS). The periodontal condition was assessed after obtainment free and informed consent from the participants. Participants were divided into three groups: control subjects with a healthy periodontal condition (CN; n=46), patients with gingivitis (GI; n=26), and patients with periodontitis (PI; n=24). Saliva and blood samples were collected for evaluation of salivary cortisol concentration, glycemia, insulinemia and Homeostasis Model Assessment-Insulin Resistance index. A validated survey for the assessment of perceived stress levels was also performed. PI group showed significantly higher (p<0.05) blood glucose levels (CN: 4.43±0.05; GI: 4.46±0.04; PI: 4.68±0.08), insulinemia (CN: 6.93±0.45; GI: 8.87±0.79; PI: 12.77±1.30), insulin resistance (CN: 1.40±0.10; GI: 1.81±0.18; PI: 2.66±0.29) compared with the CN and GI groups. The levels of perceived stress were higher (p<0.05) in PI and GI groups when compared to CN group (CN: 20.5±1.26; GI: 25.8±1.95; PI: 26.6±1.36). There was no significant difference in the concentration of salivary cortisol between the groups (CN: 11.13±0.58; GI: 11.96±0.74; PI: 11.47±0.74). It was concluded that there is a relationship between higher levels of perceived stress, insulin resistance and the occurrence of periodontal disease during pregnancy. This study emphasizes the importance of preventing periodontitis in order to avoid insulin resistance and stress during pregnancy since these can cause systemic complications for the mother and the fetus.
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Affiliation(s)
| | - Fernando Yamamoto Chiba
- Department of Child and Social Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Renato Felipe Pereira
- Department of Basic Sciences, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | - Suzely Adas Saliba Moimaz
- Department of Child and Social Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Doris Hissako Sumida
- Department of Basic Sciences, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
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Khanuja PK, Narula SC, Rajput R, Sharma RK, Tewari S. Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population. Front Med 2017; 11:110-119. [DOI: 10.1007/s11684-016-0484-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 08/17/2016] [Indexed: 12/17/2022]
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Abstract
Periodontitis and diabetes are common, complex, chronic diseases with an established bidirectional relationship. That is, diabetes (particularly if glycaemic control is poor) is associated with an increased prevalence and severity of periodontitis, and, severe periodontitis is associated with compromised glycaemic control. Periodontal treatment (conventional non-surgical periodontal therapy) has been associated with improvements in glycaemic control in diabetic patients, with reductions in HbA1c of approximately 0.4% following periodontal therapy. For these reasons, management of periodontitis in people with diabetes is particularly important. The dental team therefore has an important role to play in the management of people with diabetes. An emerging role for dental professionals is envisaged, in which diabetes screening tools could be used to identify patients at high risk of diabetes, to enable them to seek further investigation and assessment from medical healthcare providers.
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Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 2016; 40 Suppl 14:S113-34. [PMID: 23627323 DOI: 10.1111/jcpe.12059] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/16/2022]
Abstract
AIMS To review the evidence for the molecular and cellular processes that may potentially link periodontal disease and diabetes. The pathogenic roles of cytokines and metabolic molecules (e.g. glucose, lipids) are explored and the role of periodontal bacteria is also addressed. Paradigms for bidirectional relationships between periodontitis and diabetes are discussed and opportunities for elaborating these models are considered. METHODS Database searches were performed using MeSH terms, keywords, and title words. Studies were evaluated and summarized in a narrative review. RESULTS Periodontal microbiota appears unaltered by diabetes and there is little evidence that it may influence glycaemic control. Small-scale clinical studies and experiments in animal models suggest that IL-1β, TNF-α, IL-6, OPG and RANKL may mediate periodontitis in diabetes. The AGE-RAGE axis is likely an important pathway of tissue destruction and impaired repair in diabetes-associated periodontitis. A role for locally activated pro-inflammatory factors in the periodontium, which subsequently impact on diabetes, remains speculative. CONCLUSION There is substantial information on potential mechanistic pathways which support a close association between diabetes and periodontitis, but there is a real need for longitudinal clinical studies using larger patient groups, integrated with studies of animal models and cells/tissues in vitro.
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Affiliation(s)
- John J Taylor
- Centre for Oral Health Research and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
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Zhang L, Ding Y, Rao GZ, Miao D. Effects of IL-10 and glucose on expression of OPG and RANKL in human periodontal ligament fibroblasts. Braz J Med Biol Res 2016; 49:e4324. [PMID: 27074164 PMCID: PMC4828925 DOI: 10.1590/1414-431x20154324] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/08/2015] [Indexed: 11/22/2022] Open
Abstract
The effects of interleukin-10 (IL-10) and glucose on mRNA and protein expression of
osteoprotegerin (OPG), and its ligand, receptor activator of nuclear factor-κB ligand
(RANKL), were investigated in human periodontal ligament fibroblasts (HPDLFs).
Primary HPDLFs were treated with different concentrations of IL-10 (0, 1, 10, 25, 50,
and 100 ng/mL) or glucose (0, 5.5, 10, 20, 30, and 40 mmol/L). Changes in mRNA and
protein expression were examined using the reverse-transcription polymerase chain
reaction (RT-PCR) and Western blot analysis, respectively. After IL-10 treatment,
mRNA and protein levels of OPG were increased, while mRNA and protein levels of RANKL
were decreased (P<0.05), both in a concentration-dependent manner. Glucose
stimulation had the opposite concentration-dependent effect to that of IL-10 on OPG
and RANKL expression. IL-10 upregulated OPG expression and downregulated RANKL
expression, whereas high glucose upregulated RANKL and downregulated OPG in HDPLFs.
Abnormal levels of IL-10 and glucose may contribute to the pathogenesis of
periodontal disease.
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Affiliation(s)
- L Zhang
- Stomatology Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - Y Ding
- Wuxi Mental Health Center of, Nanjing Medical University, China
| | - G Z Rao
- Stomatology Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
| | - D Miao
- Stomatology Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China
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Grauballe MB, Østergaard JA, Schou S, Flyvbjerg A, Holmstrup P. Blockade of RAGE in Zucker obese rats with experimental periodontitis. J Periodontal Res 2016; 52:97-106. [PMID: 26971526 DOI: 10.1111/jre.12373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis and type 2 diabetes mellitus (T2D) are two interrelated chronic diseases. Periodontitis is more prevalent in patients with T2D than in healthy subjects, and studies indicate that periodontitis impacts the metabolic control of patients with T2D. Hyperglycemia in T2D leads to the formation of advanced glycation end-products (AGEs). Binding of AGEs to the receptor of AGE (RAGE) elicits an increased inflammatory response that may be a key modulator linking the two diseases. The present study aimed to elucidate the effect of blocking the RAGE on the interrelationship between periodontitis and T2D in a rat model of both diseases. MATERIAL AND METHODS Zucker obese rats (HsdHlr:ZUCKER-Lepr fa/fa ) and their lean littermates were divided into five treatment groups, with and without periodontitis. Monoclonal anti-RAGE IgG3 were injected into the rats three times a week. The diabetic state was evaluated by oral glucose tolerance tests (OGTTs), the homeostasis model assessment (HOMA), concentration of free fatty acids and repeated measurements of blood glucose. Markers of systemic inflammation, including interleukin (IL)-1β, IL-6 and tumor necrosis factor α, were evaluated in plasma. Kidney complications were evaluated by quantitative real-time PCR, the creatinine clearance rate, the albumin excretion rate and kidney hypertrophy. Periodontitis was evaluated by morphometric registration of alveolar bone loss and radiographic recording of bone support. RESULTS The diabetic state was improved by antibody treatment for 4 wk, resulting in a lower area under the glucose concentration curve during OGTTs, lower insulin levels and a lower HOMA. Furthermore, the antibody treatment resulted in milder kidney complications, as evaluated by measuring the albumin excretion rate and the kidney weight. There was no impact of periodontal inflammation on the level of complications. Periodontal bone support was influenced by diabetes, but the altered diabetic status as a result of treatment with anti-RAGE Ig had no effect on periodontitis. CONCLUSION In this study, treatment with anti-RAGE IgG3 resulted in improved glucose tolerance and attenuated renal complications. However, no effect was observed on the diabetes-associated periodontitis in Zucker obese rats. Furthermore, periodontitis had no effect on diabetic markers or renal complications. Therefore, activation of RAGE is important in the development of T2D.
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Affiliation(s)
- M B Grauballe
- Section for Periodontology, Department of Odontology, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - J A Østergaard
- Medical Research Laboratories, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.,Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Danish Diabetes Academy, University of Copenhagen, Copenhagen, Denmark
| | - S Schou
- Section for Oral and Maxillofacial Surgery, University of Copenhagen, Copenhagen, Denmark
| | - A Flyvbjerg
- Medical Research Laboratories, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.,Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - P Holmstrup
- Section for Periodontology, Department of Odontology, Faculty of Health, Aarhus University, Aarhus, Denmark.,Section for Periodontology, Microbiology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Ramos UD, Ayub LG, Reino DM, Grisi MF, Taba M, Souza SL, Palioto DB, Novaes AB. Antimicrobial photodynamic therapy as an alternative to systemic antibiotics: results from a double-blind, randomized, placebo-controlled, clinical study on type 2 diabetics. J Clin Periodontol 2016; 43:147-55. [DOI: 10.1111/jcpe.12498] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Umberto D. Ramos
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Lauro G. Ayub
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Danilo M. Reino
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Márcio F.M. Grisi
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Mário Taba
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Sérgio L.S. Souza
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Daniela B. Palioto
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
| | - Arthur B. Novaes
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology; School of Dentistry of Ribeirao Preto; University of Sao Paulo; Ribeirão Preto SP Brazil
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Imbalanced insulin action in chronic over nutrition: Clinical harm, molecular mechanisms, and a way forward. Atherosclerosis 2016; 247:225-82. [PMID: 26967715 DOI: 10.1016/j.atherosclerosis.2016.02.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 12/31/2015] [Accepted: 02/02/2016] [Indexed: 02/08/2023]
Abstract
The growing worldwide prevalence of overnutrition and underexertion threatens the gains that we have made against atherosclerotic cardiovascular disease and other maladies. Chronic overnutrition causes the atherometabolic syndrome, which is a cluster of seemingly unrelated health problems characterized by increased abdominal girth and body-mass index, high fasting and postprandial concentrations of cholesterol- and triglyceride-rich apoB-lipoproteins (C-TRLs), low plasma HDL levels, impaired regulation of plasma glucose concentrations, hypertension, and a significant risk of developing overt type 2 diabetes mellitus (T2DM). In addition, individuals with this syndrome exhibit fatty liver, hypercoagulability, sympathetic overactivity, a gradually rising set-point for body adiposity, a substantially increased risk of atherosclerotic cardiovascular morbidity and mortality, and--crucially--hyperinsulinemia. Many lines of evidence indicate that each component of the atherometabolic syndrome arises, or is worsened by, pathway-selective insulin resistance and responsiveness (SEIRR). Individuals with SEIRR require compensatory hyperinsulinemia to control plasma glucose levels. The result is overdrive of those pathways that remain insulin-responsive, particularly ERK activation and hepatic de-novo lipogenesis (DNL), while carbohydrate regulation deteriorates. The effects are easily summarized: if hyperinsulinemia does something bad in a tissue or organ, that effect remains responsive in the atherometabolic syndrome and T2DM; and if hyperinsulinemia might do something good, that effect becomes resistant. It is a deadly imbalance in insulin action. From the standpoint of human health, it is the worst possible combination of effects. In this review, we discuss the origins of the atherometabolic syndrome in our historically unprecedented environment that only recently has become full of poorly satiating calories and incessant enticements to sit. Data are examined that indicate the magnitude of daily caloric imbalance that causes obesity. We also cover key aspects of healthy, balanced insulin action in liver, endothelium, brain, and elsewhere. Recent insights into the molecular basis and pathophysiologic harm from SEIRR in these organs are discussed. Importantly, a newly discovered oxide transport chain functions as the master regulator of the balance amongst different limbs of the insulin signaling cascade. This oxide transport chain--abbreviated 'NSAPP' after its five major proteins--fails to function properly during chronic overnutrition, resulting in this harmful pattern of SEIRR. We also review the origins of widespread, chronic overnutrition. Despite its apparent complexity, one factor stands out. A sophisticated junk food industry, aided by subsidies from willing governments, has devoted years of careful effort to promote overeating through the creation of a new class of food and drink that is low- or no-cost to the consumer, convenient, savory, calorically dense, yet weakly satiating. It is past time for the rest of us to overcome these foes of good health and solve this man-made epidemic.
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Ryan ME, Raja V. Diet, Obesity, Diabetes, and Periodontitis: a Syndemic Approach to Management. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s40496-016-0075-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Acharya AB, Thakur S, Muddapur MV, Kulkarni RD. Tumor necrosis factor-α, interleukin-4 and -6 in the serum of health, chronic periodontitis, and type 2 diabetes mellitus. J Indian Soc Periodontol 2016; 20:509-513. [PMID: 29242686 PMCID: PMC5676332 DOI: 10.4103/0972-124x.201694] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Cytokines are significant in the development and progression of chronic periodontitis (ChP) and type 2 diabetes mellitus (DT2). Insufficient information is available regarding the pro- versus anti-inflammatory cytokines in ChP's influence on systemic levels of cytokines on DT2. This study investigated the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-4 and IL-6 in the serum of patients with ChP, DT2, and with both ChP and DT2, as compared to health. Materials and Methods A total of eighty participants were grouped equally groups as healthy (NH), ChP with, and without DT2 (ChP and ChP + DT2) and only type 2 diabetes (DT2). Plaque and gingival indices, bleeding on probing, pocket probing depths, clinical attachment loss, were evaluated. Serum samples were collected to measure glycated hemoglobin, random blood sugar. TNF-α, IL-4 and -6 was assessed by ELISA. Results The selected cytokines were detected in all the participants. TNF-α and IL-6 were highest in ChP + DT2 group, whereas IL-4 was highest in health. Significant differences and correlation were observed between the cytokines, periodontal, and glycemic parameters and among the four groups. Conclusion TNF-α and IL-6 appear to heighten the inflammatory state in patients with both type 2 diabetes and periodontitis, but IL-4, though considered an anti-inflammatory mediator was not convincing in such a role in this study. The cytokine behavior needs to be studied further in larger studies.
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Affiliation(s)
| | - Srinath Thakur
- Department of Periodontics, S.D.M. College of Medical Sciences and Hospital, Dharwad, Karnataka, India
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Mesia R, Gholami F, Huang H, Clare-Salzler M, Aukhil I, Wallet SM, Shaddox LM. Systemic inflammatory responses in patients with type 2 diabetes with chronic periodontitis. BMJ Open Diabetes Res Care 2016; 4:e000260. [PMID: 27651910 PMCID: PMC5020743 DOI: 10.1136/bmjdrc-2016-000260] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/10/2016] [Accepted: 07/05/2016] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The objective of this case-control study was to quantify the immune responsiveness in individuals with type 2 diabetes (T2D) as compared with patients without diabetes (NT2D) diagnosed with periodontitis. RESEARCH DESIGN AND METHODS Peripheral blood was collected from 20 patients with moderate-to-severe chronic periodontitis (10 T2D, 10 NT2D). Blood samples were stimulated with ultrapure Porphyromonas gingivalis and Escherichia coli lipopolysaccharide (LPS) for 24 hours. 14 cytokines/chemokines were quantified in culture supernatants using multiplex technology. RESULTS T2D individuals demonstrated higher unstimulated levels of interleukin 6 (IL-6), IL-1β, tumor necrosis factor α, interferon γ, IL-10, IL-8, macrophage inflammatory protein 1α (MIP1α), and 1β (MIP1β), and higher stimulated levels of IL-6, IL-8, IL-10, MIP1α and MIP1β, along with lower unstimulated and stimulated levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) when compared with NT2D (p<0.05). Importantly, the LPS-induced levels of IL-6, IL-8, IL-10 and MIP1α strongly correlated with severity of disease, measured by pocket depths (PD), within the T2D group (r(2)≥0.7, p<0.05), but not within NT2D. CONCLUSIONS Among patients with chronic periodontitis, patients with T2D seem to have an enhanced LPS-induced immune responsiveness than individuals without diabetes, which correlates with periodontal disease severity, concomitant with a less robust GM-CSF response. This data may in part explain the higher predisposition to periodontitis in this population.
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Affiliation(s)
- Ruben Mesia
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Fatemeh Gholami
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Hong Huang
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Michael Clare-Salzler
- Department of Endocrinology, Diabetes and Metabolism, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Ikramuddin Aukhil
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Shannon M Wallet
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Luciana M Shaddox
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, Florida, USA
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Joseph R, Nagrale AV, Joseraj MG, Pradeep Kumar KM, Kaziyarakath JA, Chandini R. Low levels of serum Vitamin D in chronic periodontitis patients with type 2 diabetes mellitus: A hospital-based cross-sectional clinical study. J Indian Soc Periodontol 2015; 19:501-6. [PMID: 26644714 PMCID: PMC4645534 DOI: 10.4103/0972-124x.167162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: Vitamin D is associated with inflammatory diseases such as periodontal disease and diabetes mellitus (DM). The aim of our study was to find out the level of serum Vitamin D in chronic periodontitis patients (CHP) with and without type 2 DM. Materials and Methods: This study consists of 141 subjects, including 48 controls. Case groups consisted of 43 chronic periodontitis patients with type 2 DM (CHPDM) and 50 CHP. pocket depth (PD), clinical attachment loss (CAL), modified gingival index (MGI), plaque index (PI), and calculus index (CI) were taken. Serum 25-hydroxyvitamin D (25[OH] D) level in ηg/ml was estimated by electrochemiluminescence immunoassay with Elecsys and cobase e immunoassay analysers(cobase e 411). Other laboratory investigations including fasting blood sugar (FBS) and serum calcium were measured in all subjects. Results: The mean serum 25(OH) D level was 22.32 ± 5.76 ηg/ml, 14.06 ± 4.57 ηg/ml and 16.94 ± 5.58 ηg/ml for control, CHPDM and CHP groups respectively. The difference was statistically significant (P < 0.05). The mean value of FBS was significantly high in CHPDM group as compared to CHP group. Periodontal parameters like MGI, PI, PD, and CI showed significant difference between groups (P < 0.05) and higher score was found in CHP group, while CAL and PI showed no statistically significant difference between CHP and CHPDM group (P > 0.05). Conclusions: This study observed a low level of serum Vitamin D level in patients with CHP and CHPDM. Low Vitamin D level was observed in case groups may be due to the diseases process rather than low Vitamin D acting as a cause for the disease.
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Affiliation(s)
- Rosamma Joseph
- Department of Periodontics, Government Dental College, Calicut, Kerala, India
| | - Amol Vijay Nagrale
- Department of Periodontics, Government Dental College, Calicut, Kerala, India
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Hasturk H, Kantarci A. Activation and resolution of periodontal inflammation and its systemic impact. Periodontol 2000 2015; 69:255-73. [PMID: 26252412 PMCID: PMC4530469 DOI: 10.1111/prd.12105] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2015] [Indexed: 02/06/2023]
Abstract
Inflammation is a highly organized event impacting upon organs, tissues and biological systems. Periodontal diseases are characterized by dysregulation or dysfunction of resolution pathways of inflammation that results in failure to heal and in a dominant chronic, progressive, destructive and predominantly unresolved inflammation. The biological consequences of inflammatory processes may be independent of the etiological agents, such as trauma, microbial organisms and stress. The impact of the inflammatory pathological process depends upon the tissues or organ system affected. Whilst mediators are similar, there is tissue specificity for the inflammatory events. It is plausible that inflammatory processes in one organ could directly lead to pathologies in another organ or tissue. Communication between distant parts of the body and their inflammatory status is also mediated by common signaling mechanisms mediated via cells and soluble mediators. This review focuses on periodontal inflammation, its systemic associations and advances in therapeutic approaches based on mediators acting through orchestration of natural pathways to resolution of inflammation. We also discuss a new treatment concept in which natural pathways of resolution of periodontal inflammation can be used to limit systemic inflammation and promote healing and regeneration.
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Affiliation(s)
- Hatice Hasturk
- The Forsyth Institute, Department of Applied Oral Sciences, Center for Periodontology, Cambridge, MA 02142, USA. Phone: 617-892-8499; Fax: 617-892-8505
| | - Alpdogan Kantarci
- The Forsyth Institute, Department of Applied Oral Sciences, Center for Periodontology, Cambridge, MA 02142, USA. Phone: 617-892-8530
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Grauballe MB, Østergaard JA, Schou S, Flyvbjerg A, Holmstrup P. Effects of TNF-α blocking on experimental periodontitis and type 2 diabetes in obese diabetic Zucker rats. J Clin Periodontol 2015; 42:807-816. [PMID: 26257165 DOI: 10.1111/jcpe.12442] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Tumour necrosis factor α (TNF-α) is considered a key signalling modulator in the pathogenesis of both periodontitis (PD) and type 2 diabetes mellitus (DM2). This study aims at elucidating the effect of TNF-α blocking on the interplay between PD and DM2. METHODS Obese diabetic Zucker rats and their lean littermates were divided into five treatment groups with or without periodontitis. Anti-TNF-α treatment was provided with Etanercept injections. Diabetic state was evaluated by oral glucose tolerance test, the homeostatic model assessment, free fatty acids and blood glucose. Systemic inflammation was assessed by measurement of interleukin (IL)-1β, IL-6 and TNF-α in plasma. Kidney complications were evaluated by real-time rtPCR, creatinine clearance rate, urinary albumin excretion and increase in weight. PD was evaluated by registration of alveolar bone level. RESULTS After 4 weeks the diabetic state was modified by Etanercept treatment with lower insulin levels and lower homeostatic model assessment. Furthermore, while kidney complications were reduced by Etanercept treatment, PD had no effect. PD was influenced by diabetic state, but the impact was attenuated by Etanercept treatment. CONCLUSION In this study anti-TNF-α treatment improved glucose tolerance and compensated for the increased periodontal disease in obese diabetic Zucker. PD did not influence diabetic parameters assessed including complications of the rats kidneys.
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Affiliation(s)
- Morten Bay Grauballe
- Section for Periodontology, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jakob Appel Østergaard
- The Medical Research Laboratories, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.,Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Danish Diabetes Academy, Odense, Denmark
| | - Søren Schou
- Section for Oral and Maxillofacial Surgery and Oral Pathology, Department of Odontology, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Allan Flyvbjerg
- The Medical Research Laboratories, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.,Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Palle Holmstrup
- Section for Periodontology, Faculty of Health, Aarhus University, Aarhus, Denmark.,Section for Periodontology, Microbiology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Xing J, Lian M, Shen Q, Feng G, Huang D, Lu X, Gu Z, Li L, Zhang J, Huang S, You Q, Wu X, Zhang D, Feng X. AGS3 is involved in TNF-α medicated osteogenic differentiation of human dental pulp stem cells. Differentiation 2015; 89:128-36. [DOI: 10.1016/j.diff.2015.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 05/27/2015] [Accepted: 06/17/2015] [Indexed: 01/01/2023]
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Effect of periodontal therapy on glycemic control and circulating TNF-α in type 2 diabetic patients. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-014-0236-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Clinical significance of IL-23 regulating IL-17A and/or IL-17F positive Th17 cells in chronic periodontitis. Mediators Inflamm 2014; 2014:627959. [PMID: 25525302 PMCID: PMC4265697 DOI: 10.1155/2014/627959] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/05/2014] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To investigate the expression level and clinical significance of (IL-17A(+) and/or IL-17F(+)) Th17 cells under IL-23 regulation in patients of chronic periodontitis (CP) and healthy controls (HC). MATERIALS AND METHODS The whole peripheral blood samples were collected from 30 CP patients and 25 healthy controls. Flow cytometry was used to test the (IL-17A(+) and/or IL-17F(+)) Th17 expression level. Recombinant human IL-23 (rhIL-23) was used to detect Th17 differentiation and expansion. Correlation coefficient analysis between Th17 expression level and clinical parameters was analyzed by SPSS software. RESULTS Flow cytometry results showed that IL-17A(+)IL-17F(-) and IL-17A(-)IL-17F(+) Th17 were both increased in CP group than in HC group (P < 0.01), while, under recombinant human IL-23 (rhIL-23) stimulation, the number of IL-17A(+)IL-17F(-) Th17 cells was significantly increased in both CP and HC groups (P < 0.01). Interestingly, IL-17A(-)IL-17F(+) Th17 cells were only increased in CP group after rhIL-23 stimulation. Additionally, correlation coefficient analysis showed significant correlation between IL-17A(+)IL-17F(-) Th17 cell and attachment loss or probing depth (P < 0.05). CONCLUSIONS This study indicates that both the IL-17A(+)IL-17F(-) and IL-17A(-)IL-17F(+) Th17 cells may be involved in pathogenesis of periodontitis. The role of these Th17 cells in the disease pathogenesis needs to be further investigated.
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