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Nomogram-Based Chronic Kidney Disease Prediction Model for Type 1 Diabetes Mellitus Patients Using Routine Pathological Data. J Pers Med 2022; 12:jpm12091507. [PMID: 36143293 PMCID: PMC9501949 DOI: 10.3390/jpm12091507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) patients are a significant threat to chronic kidney disease (CKD) development during their life. However, there is always a high chance of delay in CKD detection because CKD can be asymptomatic, and T1DM patients bypass traditional CKD tests during their routine checkups. This study aims to develop and validate a prediction model and nomogram of CKD in T1DM patients using readily available routine checkup data for early CKD detection. This research utilized 1375 T1DM patients’ sixteen years of longitudinal data from multi-center Epidemiology of Diabetes Interventions and Complications (EDIC) clinical trials conducted at 28 sites in the USA and Canada and considered 17 routinely available features. Three feature ranking algorithms, extreme gradient boosting (XGB), random forest (RF), and extremely randomized trees classifier (ERT), were applied to create three feature ranking lists, and logistic regression analyses were performed to develop CKD prediction models using these ranked feature lists to identify the best performing top-ranked features combination. Finally, the most significant features were selected to develop a multivariate logistic regression-based CKD prediction model for T1DM patients. This model was evaluated using sensitivity, specificity, accuracy, precision, and F1 score on train and test data. A nomogram of the final model was further generated for easy application in clinical practices. Hypertension, duration of diabetes, drinking habit, triglycerides, ACE inhibitors, low-density lipoprotein (LDL) cholesterol, age, and smoking habit were the top-8 features ranked by the XGB model and identified as the most important features for predicting CKD in T1DM patients. These eight features were selected to develop the final prediction model using multivariate logistic regression, which showed 90.04% and 88.59% accuracy in internal and test data validation. The proposed model showed excellent performance and can be used for CKD identification in T1DM patients during routine checkups.
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Expression of TNF-α and IL-1β in Peripheral Blood of Patients with T2DM Retinopathy. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9073372. [PMID: 35979044 PMCID: PMC9377956 DOI: 10.1155/2022/9073372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/13/2022] [Indexed: 12/06/2022]
Abstract
Aims The expression and clinical significance of tumor necrosis factor-α (INF-α) and interleukin 1-β (IL-1β) in retinal cells of patients with type 2 diabetes (T2DM) retinopathy were detected by flow cytometry. Materials and Methods Fifty patients with T2DM who attended our ophthalmology clinic between May 2021 and May 2022 were selected as the observation group. Another 50 healthy individuals who were examined at our hospital during the same period were selected as the comparison group. Tear film rupture time (BUT), fluorescein staining (FL), basal tear secretion (Schirmer I) test, and conjunctival impression cytology (CIC) were detected in both groups, and the expression of TNF-α and IL-1β in retinal cells was observed by immunohistochemical staining. Results The levels of IL13 and TNF-α in the two groups were not exactly the same. The serum levels of IL13 and TNF-α in the observation group were significantly higher than those in the control group, and there was a statistically significant difference (P < 0.05). TNF-α and IL-1B expressions in the observation group were positively correlated with the fluorescence staining, and the expression of TNF-α and IL-1β in the observation group was significantly negatively correlated with the BUT test and Schirmer I test. Conclusion Serums TNF-α and IL-1β are significantly elevated in patients with T2DM retinopathy and gradually increase with disease progression. Combined detection of serums TNF-α and IL-1β can help determine the severity of the disease and assess the prognosis.
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Chowdhury NH, Reaz MBI, Haque F, Ahmad S, Ali SHM, A Bakar AA, Bhuiyan MAS. Performance Analysis of Conventional Machine Learning Algorithms for Identification of Chronic Kidney Disease in Type 1 Diabetes Mellitus Patients. Diagnostics (Basel) 2021; 11:diagnostics11122267. [PMID: 34943504 PMCID: PMC8700037 DOI: 10.3390/diagnostics11122267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/12/2021] [Accepted: 12/01/2021] [Indexed: 12/18/2022] Open
Abstract
Chronic kidney disease (CKD) is one of the severe side effects of type 1 diabetes mellitus (T1DM). However, the detection and diagnosis of CKD are often delayed because of its asymptomatic nature. In addition, patients often tend to bypass the traditional urine protein (urinary albumin)-based CKD detection test. Even though disease detection using machine learning (ML) is a well-established field of study, it is rarely used to diagnose CKD in T1DM patients. This research aimed to employ and evaluate several ML algorithms to develop models to quickly predict CKD in patients with T1DM using easily available routine checkup data. This study analyzed 16 years of data of 1375 T1DM patients, obtained from the Epidemiology of Diabetes Interventions and Complications (EDIC) clinical trials directed by the National Institute of Diabetes, Digestive, and Kidney Diseases, USA. Three data imputation techniques (RF, KNN, and MICE) and the SMOTETomek resampling technique were used to preprocess the primary dataset. Ten ML algorithms including logistic regression (LR), k-nearest neighbor (KNN), Gaussian naïve Bayes (GNB), support vector machine (SVM), stochastic gradient descent (SGD), decision tree (DT), gradient boosting (GB), random forest (RF), extreme gradient boosting (XGB), and light gradient-boosted machine (LightGBM) were applied to developed prediction models. Each model included 19 demographic, medical history, behavioral, and biochemical features, and every feature’s effect was ranked using three feature ranking techniques (XGB, RF, and Extra Tree). Lastly, each model’s ROC, sensitivity (recall), specificity, accuracy, precision, and F-1 score were estimated to find the best-performing model. The RF classifier model exhibited the best performance with 0.96 (±0.01) accuracy, 0.98 (±0.01) sensitivity, and 0.93 (±0.02) specificity. LightGBM performed second best and was quite close to RF with 0.95 (±0.06) accuracy. In addition to these two models, KNN, SVM, DT, GB, and XGB models also achieved more than 90% accuracy.
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Affiliation(s)
- Nakib Hayat Chowdhury
- Department of Electrical, Electronic and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (N.H.C.); (M.B.I.R.); (F.H.); (S.H.M.A.); (A.A.A.B.)
- Department of Computer Science and Engineering, Bangladesh Army University of Science and Technology (BAUST), Saidpur Cantonment, Saidpur 5310, Bangladesh
| | - Mamun Bin Ibne Reaz
- Department of Electrical, Electronic and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (N.H.C.); (M.B.I.R.); (F.H.); (S.H.M.A.); (A.A.A.B.)
| | - Fahmida Haque
- Department of Electrical, Electronic and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (N.H.C.); (M.B.I.R.); (F.H.); (S.H.M.A.); (A.A.A.B.)
| | - Shamim Ahmad
- Department of Computer Science and Engineering, University of Rajshahi, Rajshahi 6205, Bangladesh;
| | - Sawal Hamid Md Ali
- Department of Electrical, Electronic and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (N.H.C.); (M.B.I.R.); (F.H.); (S.H.M.A.); (A.A.A.B.)
| | - Ahmad Ashrif A Bakar
- Department of Electrical, Electronic and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia; (N.H.C.); (M.B.I.R.); (F.H.); (S.H.M.A.); (A.A.A.B.)
| | - Mohammad Arif Sobhan Bhuiyan
- Department of Electrical and Electronics Engineering, Xiamen University Malaysia, Bandar Sunsuria, Sepang 43900, Selangor, Malaysia
- Correspondence:
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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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Sereti M, Roy M, Zekeridou A, Gastaldi G, Giannopoulou C. Gingival crevicular fluid biomarkers in type 1 diabetes mellitus: A case-control study. Clin Exp Dent Res 2020; 7:170-178. [PMID: 33369174 PMCID: PMC8019764 DOI: 10.1002/cre2.351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The aim of the study is to compare the levels of Gingival Crevicular Fluid (GCF) interleukin 8 (IL-8), matrix metalloproteinase 8 (MMP-8) and advanced glycated-end products (AGEs) in a cohort of type 1 diabetic (T1D) subjects and healthy controls. MATERIAL AND METHODS GCF samples and periodontal examination were assessed in 50 subjects with T1D (30 males and 20 females; mean age: 35.2 years) recruited from the Diabetology Unit of the Geneva University Hospitals and in 50 control subjects matched for gender, age and smoking status. Samples were assessed for IL-8 and MMP-8 using a bead array multianalyte detection system and for AGEs the ELISA. The two groups were compared using the Wilcoxon signed rank test. RESULTS The mean HbA1c differed significantly between the groups (8.3% for the T1D group vs. 5.2% for the control group, p < 0.001). T1D subjects had significantly more plaque and gingival inflammation and presented more sites with bleeding on probing compared to the controls. The GCF levels of IL-8, MMP-8 and AGEs did not differ significantly between the groups. Further analysis of the GCF markers in younger (<40 years) and older (≥40 years) cohorts, revealed no significant differences between younger diabetics and controls or between older diabetics and controls. When the groups were divided according to their glycemic status (HbA1c 6.1-8, and > 8%), again no significant differences could be identified for any of the biochemical markers. CONCLUSIONS T1D subjects, particularly the younger ones, exhibited more inflammation compared to the matched healthy controls. Results on the GCF expression of IL-8, MMP-8 and AGEs did not differ between the groups. The diabetic population of our cohort was for the most part fairly-controlled, with little if any complications and with presence of only mild type of periodontal disease, as 68% had gingivitis.
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Affiliation(s)
- Maria Sereti
- Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Margaux Roy
- Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Alkisti Zekeridou
- Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Giacomo Gastaldi
- Diabetology Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Catherine Giannopoulou
- Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Resveratrol Nanoparticles: A Promising Therapeutic Advancement over Native Resveratrol. Processes (Basel) 2020. [DOI: 10.3390/pr8040458] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The importance of fruit-derived resveratrol (RES) in the treatment of various diseases has been discussed in various research publications. Those research findings have indicated the ability of the molecule as therapeutic in the context of in vitro and in vivo conditions. Mostly, the application of RES in in vivo conditions, encapsulation processes have been carried out using various nanoparticles that are made of biocompatible biomaterials, which are easily digested or metabolized, and RES is absorbed effectively. These biomaterials are non-toxic and are safe to be used as components in the biotherapeutics. They are made from naturally available by-products of food materials like zein or corn or components of the physiological system as with lipids. The versatility of the RES nanoparticles in their different materials, working range sizes, specificity in their targeting in various human diseases, and the mechanisms associated with them are discussed in this review.
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Giménez-Siurana A, Gómez García F, Pagan Bernabeu A, Lozano-Pérez AA, Aznar-Cervantes SD, Cenis JL, López-Jornet P. Chemoprevention of Experimental Periodontitis in Diabetic Rats with Silk Fibroin Nanoparticles Loaded with Resveratrol. Antioxidants (Basel) 2020; 9:antiox9010085. [PMID: 31963913 PMCID: PMC7022414 DOI: 10.3390/antiox9010085] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: the objective of the present work is to study the effectiveness of treatment with silk fibroin nanoparticles loaded with resveratrol in experimental periodontitis in a diabetic rat model. Introduction: Periodontitis is an inflammatory pathology highly related to other diseases, such as type II diabetes. Both diseases have a specific inflammatory condition, with Interleukin (IL)-6, IL-1β and Transforming Grow Factor (TGF)-1β being the most relevant proinflammatory factors. Silk fibroin (SF) nanoparticles loaded with resveratrol (Res-SFN) are a new alternative as a treatment. Methods: 40 diabetic Sprague Dawley male rats were used and periodontitis was induced by ligation. The animals were divided into 5 treatment groups, and 1 mL of treatment was administered once a day for 4 weeks. The groups were: I: Carboxymethyl cellulose (CMC) 0.8%, II: CMC 0.8% + SF 1%, III: CMC 0.8% + RES-SFN 3 mg/mL, IV: CMC 0.8% + SF 1% + RES-SFN 3 mg/mL, V: Water. A peripheral blood sample was taken every week to quantify the inflammatory profile by ELISA (IL-6, IL-1β and TGF-1β). After 4 weeks the sacrifice was carried out and biopsies of the gum were taken. Results: Treatment with SF and RES-SFN reduced the amount of chemical inflammation mediators (with the exception of IL-1β in comparisons I-IV and II-IV (p > 0.05)), as well as the anatomopathological variables linked to it, in a significant way (p < 0.05). Conclusion: treatment with RES-SFN has reduced local inflammation in this experimental periodontitis model.
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Affiliation(s)
- Ana Giménez-Siurana
- Department of Bucal Medicine, Faculty of Medicine, University of Murcia, Av. Marqués de los Vélez, 2 Floor. 3008, Murcia, Spain; (A.G.-S.); (F.G.G.)
| | - Francisco Gómez García
- Department of Bucal Medicine, Faculty of Medicine, University of Murcia, Av. Marqués de los Vélez, 2 Floor. 3008, Murcia, Spain; (A.G.-S.); (F.G.G.)
| | - Ana Pagan Bernabeu
- Department of Biotechnology, Instituto Murciano de Investigación y Desarrollo Agrario y Alimentario (IMIDA), C/Mayor 30150 La Alberca, Murcia, Spain; (A.P.B.); (A.A.L.-P.); (S.D.A.-C.); (J.L.C.)
| | - Antonio Abel Lozano-Pérez
- Department of Biotechnology, Instituto Murciano de Investigación y Desarrollo Agrario y Alimentario (IMIDA), C/Mayor 30150 La Alberca, Murcia, Spain; (A.P.B.); (A.A.L.-P.); (S.D.A.-C.); (J.L.C.)
| | - Salvador D. Aznar-Cervantes
- Department of Biotechnology, Instituto Murciano de Investigación y Desarrollo Agrario y Alimentario (IMIDA), C/Mayor 30150 La Alberca, Murcia, Spain; (A.P.B.); (A.A.L.-P.); (S.D.A.-C.); (J.L.C.)
| | - José Luis Cenis
- Department of Biotechnology, Instituto Murciano de Investigación y Desarrollo Agrario y Alimentario (IMIDA), C/Mayor 30150 La Alberca, Murcia, Spain; (A.P.B.); (A.A.L.-P.); (S.D.A.-C.); (J.L.C.)
| | - Pía López-Jornet
- Department of Bucal Medicine, Faculty of Medicine, University of Murcia, Av. Marqués de los Vélez, 2 Floor. 3008, Murcia, Spain; (A.G.-S.); (F.G.G.)
- Correspondence:
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Interleukin-1 Gene Variability and Plasma Levels in Czech Patients with Chronic Periodontitis and Diabetes Mellitus. Int J Dent 2019; 2019:6802349. [PMID: 30755772 PMCID: PMC6348895 DOI: 10.1155/2019/6802349] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/19/2018] [Indexed: 12/28/2022] Open
Abstract
Recent studies have suggested a bidirectional relationship between chronic periodontitis (CP) and diabetes mellitus (DM). Immunoregulatory factors such as cytokines play an important role in etiopathogenesis of both diseases. The aim of this study was to analyze variability in interleukin-1 (IL-1) gene cluster and IL-1β plasma levels in patients with CP, DM, and a combination of both diseases. A total of 1016 individuals participating in this case-control study—225 healthy controls, 264 patients with CP, 132 with type 1 diabetes (T1DM), and 395 patients with type 2 diabetes (T2DM)—were genotyped using methods based on polymerase chain reaction for IL-1 gene polymorphisms (IL-1A (−889C/T, rs1800587), IL-1B (+3953C/T, rs1143634), and IL-1RN (gene for IL-1 receptor antagonist, IL-1RA, 86 bp tandem repeats in intron 2)). Levels of IL-1β were measured by Luminex methods in subgroups of controls, CP, T1DM + CP, and T2DM + CP subjects. Although no significant associations were found in the genotype and allele frequencies of IL-1A (−889C/T), significant differences in the allele frequencies of IL-1B (+3953C/T) were observed between controls and CP patients (P < 0.05). In T1DM patients, IL-1RN∗S “short” allele and IL-1RN 12 genotype were significantly less frequent than those in controls (P < 0.01). In haplotype analysis, TTL haplotype decreased the risk of CP development (P < 0.01), whereas CCS and CTL haplotypes (P < 0.01 and P < 0.05) were associated with T1DM. Although IL-1β levels were measured significantly higher in mononuclear cells after stimulation by mitogens, HSP70, or selected periodontal bacteria than in unstimulated cells, IL-1 genotypes did not correlate with circulating IL-1β levels. In the Czech population, significant associations between the IL-1B polymorphism with CP and the IL-1RN variant with T1DM were found. Haplotype analysis suggests that variability in IL-1 gene cluster may be one of the factors in the CP and T1DM pathogenesis, although single variants of these polymorphisms are not substantial for protein production.
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Franco-Topete R, Zepeda-Nuño JS, Zamora-Perez AL, Fuentes-Lerma MG, Gómez-Meda BC, Guerrero-Velázquez C. IFN-γR2 is strongly expressed on endothelial cells of gingival tissues from patients with chronic periodontitis. J Appl Oral Sci 2018; 26:e20170291. [PMID: 30304122 PMCID: PMC6172018 DOI: 10.1590/1678-7757-2017-0291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/07/2018] [Accepted: 03/10/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Chronic periodontitis (CP) is characterized by gingival inflammation and bone destruction. It has been reported that interferon-gamma (IFN-γ) levels are high in CP patients; however, the IFN-γ receptor (IFN-γR) has not been studied in gingival tissue from these patients. To evaluate IFN-γ levels and IFN-γR expression in gingival tissue biopsies from chronic periodontitis patients compared with healthy subjects (HS). MATERIAL AND METHODS Gingival tissues were obtained from all study subjects, CP (n = 18) and healthy subjects (HS) (n = 12). A tissue section of each study subject was embedded in paraffin blocks to determine the expression of IFN-γ R (IFN-γR1 and IFN-γR2) through immunohistochemistry. Another section of the tissue was homogenized and IFN-γ was measured by the ELISA technique. RESULTS No significant differences were found in the IFN-γR1 expression within the cell layers of the gingival tissue of the study groups. When analyzing the IFN-γR2 expression it was found that IFN-γR2 is strongly expressed in the endothelial cells of CP patients when compared to HS (p<0.05). IFN-γ concentrations in the gingival tissue were significantly higher in CP patients than in HS. No significant correlation between IFN-γ levels and the expression of IFN-γR1 and IFN-γR2 was found. However, a positive correlation between IFN-γ levels and clinical parameters [probing depth (PD) and clinical attachment level (CAL)] was found. CONCLUSION The study of IFN-γR expression in gingival tissue samples from patients with CP showed an increase only in the IFN-γR2 chain in endothelial cells when compared to HS.
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Affiliation(s)
- Ramón Franco-Topete
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Departamento de Microbiología y Patología, Laboratorio de Patología, Guadalajara, México
| | - José Sergio Zepeda-Nuño
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Departamento de Microbiología y Patología, Laboratorio de Patología, Guadalajara, México
| | - Ana Lourdes Zamora-Perez
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Departamento de Clínicas Odontológicas Integrales, Instituto de Investigación en Odontología, Guadalajara, México
| | - Martha Graciela Fuentes-Lerma
- Universidad de Guadalajara, Centro Universitario de los Altos, Departamento de Clínicas, Tepatitlán de Morelos, México
| | - Belinda Claudia Gómez-Meda
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Instituto de Biología Molecular en Medicina y Terapia Génica, Departamento de Biología Molecular y Genómica, Guadalajara, México
| | - Celia Guerrero-Velázquez
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Departamento de Clínicas Odontológicas Integrales, Instituto de Investigación en Odontología, Guadalajara, México
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Vergnes JN, Canceill T, Vinel A, Laurencin-Dalicieux S, Maupas-Schwalm F, Blasco-Baqué V, Hanaire H, Arrivé E, Rigalleau V, Nabet C, Sixou M, Gourdy P, Monsarrat P. The effects of periodontal treatment on diabetic patients: The DIAPERIO randomized controlled trial. J Clin Periodontol 2018; 45:1150-1163. [PMID: 30136741 DOI: 10.1111/jcpe.13003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 07/13/2018] [Accepted: 08/19/2018] [Indexed: 12/14/2022]
Abstract
AIM To assess whether periodontal treatment can lead to clinical, glycaemic control and quality of life improvements in metabolically unbalanced diabetic patients (type 1 or type 2) diagnosed with periodontitis. METHODS In this open-labelled randomized controlled trial, diabetic subjects (n = 91) were given "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral health instructions). The main outcome was the effect on glycated haemoglobin (HbA1C ) and fructosamine levels. The General Oral Health Assessment Index and the SF-36 index were used to assess quality of life (QoL). RESULTS Periodontal health significantly improved after periodontal treatment (p < 0.001). Periodontal treatment seemed to be safe but had no significant effects on glycaemic control based on HbA1C (adjusted mean difference with a 95% confidence interval (aMD) of 0.04 [-0.16;0.24]) and fructosamine levels (aMD 5.0 [-10.2;20.2]). There was no obvious evidence of improvement in general QoL after periodontal treatment. However, there was significant improvement in oral health-related QoL (aMD 7.0 [2.4;11.6], p = 0.003). CONCLUSION Although periodontal treatment showed no clinical effect on glycaemic control in this trial, important data were provided to support periodontal care among diabetic patients. Periodontal treatment is safe and improves oral health-related QoL in patients living with diabetes. ISRCTN15334496.
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Affiliation(s)
- Jean-Noel Vergnes
- The Department of Epidemiology and Public Health, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France.,The Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Thibault Canceill
- The Department of Oral Rehabilitation, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France
| | - Alexia Vinel
- The Department of Oral Surgery, Periodontology and Oral Biology, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France.,The Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France
| | - Sara Laurencin-Dalicieux
- The Department of Oral Surgery, Periodontology and Oral Biology, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France.,INSERM U1043, Université Toulouse III CHU Purpan, Toulouse, France
| | - Françoise Maupas-Schwalm
- The Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France.,The Department of Biochemistry and Molecular Biology, Faculty of Medicine-Rangueil (CHU de Toulouse), Paul Sabatier Toulouse-3, IFR-150, Toulouse, France
| | - Vincent Blasco-Baqué
- The Department of Oral Surgery, Periodontology and Oral Biology, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France.,The Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France
| | - Hélène Hanaire
- The Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France.,The Department of Diabetology - Metabolic Diseases - Nutrition, CHU of Toulouse, Toulouse, France
| | - Elise Arrivé
- Department of Dentistry and Oral health, Bordeaux University Hospital, Bordeaux, France.,Department of Odontology, University of Bordeaux, Bordeaux, France
| | | | - Cathy Nabet
- The Department of Epidemiology and Public Health, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France.,INSERM U1027, Paul Sabatier University, Toulouse, France
| | - Michel Sixou
- The Department of Epidemiology and Public Health, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France
| | - Pierre Gourdy
- The Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France.,The Department of Diabetology - Metabolic Diseases - Nutrition, CHU of Toulouse, Toulouse, France
| | - Paul Monsarrat
- The Department of Oral Rehabilitation, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France.,STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, Toulouse, France
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11
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Effect of NonSurgical Periodontal Therapy on Plasma Levels of IL-17 in Chronic Periodontitis Patients with Well Controlled Type-II Diabetes Mellitus-A Clinical Study. Dent J (Basel) 2018; 6:dj6020019. [PMID: 29899268 PMCID: PMC6023374 DOI: 10.3390/dj6020019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 11/16/2022] Open
Abstract
For years the pathogenesis of periodontitis was under an immunological Th1/Th2 paradigm. Th1 cells are considered to afford protection against the intracellular pathogens. These cells produce the interferons (IFN) that are involved in macrophage activation, which, in turn, plays an important role in phagocytosis, complement fixation, and opsonization. Th2 cells are thought to have evolved as a form of protection against parasitic helminthes. Th17 subset of CD4Not Necessary+ T cells was identified in the year 2005, which added greater complexity to Th function and are pro inflammatory in nature. Interleukins (ILs) have the ability to alter immunological changes and they also possess the ability to regulate lymphocyte differentiation and haemopoietic stem cells, cell proliferation, and motility, which are classified as pro-inflammatory and anti-inflammatory. There are numerous studies that reported IL-17 levels associated with chronic periodontitis (CP) development. Type II diabetes mellitus (DM) is considered a risk factor for the development of periodontal diseases because the incidence, progression, and severity of periodontal diseases are more common with Type II DM than without DM. This study was aimed at evaluating whether non-surgical periodontal therapy had any effect on plasma concentrations of Interleukin-17 in systemically healthy chronic periodontitis patients and in chronic periodontitis patients with well controlled Type II Diabetes mellitus. Patients were divided into the two groups including the chronic periodontitis group (20 subjects) and the chronic periodontitis with well-controlled Type II Diabetes mellitus group (20 subjects). The Gingival Index and Plaque Index as well as the clinical Attachment Level (CAL) were taken from all the patients of two groups after evaluating fasting blood sugar, post prandial blood sugar, and the Glycated Hemoglobin Level (HbA1c). Then 5 mL blood samples were collected from each patient and plasma was separated and the IL-17 level is evaluated using the ELISA method. Then, as part of phase I periodontal therapy, scaling and root planning was performed. Patients were recalled after one month and clinical and biochemical parameters were reevaluated. Non-surgical periodontal therapy resulted in a reduction of plasma levels of IL-17 in chronic periodontitis patients with and without well controlled Type II Diabetes mellitus.
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12
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Sun X, Mao Y, Dai P, Li X, Gu W, Wang H, Wu G, Ma J, Huang S. Mitochondrial dysfunction is involved in the aggravation of periodontitis by diabetes. J Clin Periodontol 2017; 44:463-471. [PMID: 28207937 DOI: 10.1111/jcpe.12711] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2017] [Indexed: 12/17/2022]
Abstract
AIM To elucidate whether mitochondrial dysfunction contributes to aggravated periodontitis in diabetes. MATERIALS AND METHODS Sixty-four wistar rats were randomly assigned into four groups: control, periodontitis, diabetes, and diabetic periodontitis. Two weeks after induction of diabetes, periodontitis was induced by silk ligation for 2 weeks and thereafter evaluated by assessing alveolar bone loss and apoptosis of periodontium cells. Mitochondrial oxidative stress was detected by MitoSOX staining. Mitochondrial function was determined by measuring ATP production, and by assessing mitochondrial DNA copy number, activities of electron transport chain complexes, and biogenesis with real-time PCR. RESULTS Significantly severer bone loss, enhanced periodontium cell apoptosis, and mitochondrial oxidative stress were found in the rats with diabetic periodontitis than the others. Furthermore, diabetic rats with periodontitis presented severer mitochondrial dysfunction than lean rats with periodontitis, as reflected by compromised ATP production, decreased mitochondrial DNA copy number, reduced gene expression of electron transport chain complex I subunits, and impaired mitochondrial biogenesis (p < 0.05). Multiple regression analysis further indicated a close correlation between these mitochondrial events and bone loss in diabetic periodontitis. CONCLUSIONS Mitochondrial dysfunction was positive correlated to aggravated periodontitis in diabetes and might represent a therapeutic target for diabetic periodontitis.
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Affiliation(s)
- Xiaoyu Sun
- Department of Periodontology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Yixin Mao
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Panpan Dai
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xumin Li
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Weiyan Gu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Huining Wang
- Department of Periodontology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Gang Wu
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jianfeng Ma
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Shengbin Huang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.,Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
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13
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Salivary Alkaline Phosphatase as a Noninvasive Marker for Periodontal Disease in Children with Uncontrolled Type 1 Diabetes Mellitus. J Clin Pediatr Dent 2017; 41:70-74. [PMID: 28052205 DOI: 10.17796/1053-4628-41.1.70] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The aim of this pilot study was to determine whether salivary alkaline phosphatase levels can be a non invasive marker for early inflammatory periodontal disease in children with uncontrolled type 1 diabetes mellitus. STUDY DESIGN 10 healthy children (group 1), 10 children with recently diagnosed type 1 diabetes mellitus (group 2) and 10 children with type 1 diabetes mellitus for more than 4 years (group 3) were recruited for the study. All three groups were matched for age, gender and socioeconomic status. Periodontal health was assessed by plaque index, gingival index and probing pocket depth. Metabolic status was assessed by glycosylated hemoglobin levels, salivary alkaline phosphatase levels were determined by spectrophotometer. Data was analyzed by Kruskal Wallis ANOVA, Mann-Whitney U test and Spearman's rank correlation method. RESULTS Salivary alkaline phosphatase levels correlated significantly with the periodontal parameters in the diabetic group. An increase in salivary alkaline phosphatase levels increased with increased values of gingival index and probing pocket depth. Group 3 showed greater correlation than group 2 and group 1. At p value p<0.05. CONCLUSION The glycemic status of the children affects the periodontal disease parameters. Salivary alkaline phosphatase levels could be a useful tool in analyzing periodontal status of children with uncontrolled type I diabetes mellitus.
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14
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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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15
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Tirabassi G, Chelli FM, Ciommi M, Lenzi A, Balercia G. Influence of the hypothalamic-pituitary-adrenal axis dysregulation on the metabolic profile of patients affected by diabetes mellitus-associated late onset hypogonadism. Nutr Metab Cardiovasc Dis 2016; 26:53-59. [PMID: 26643209 DOI: 10.1016/j.numecd.2015.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 09/16/2015] [Accepted: 10/11/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Functional hypercortisolism (FH) is generated by clinical states able to chronically activate the hypothalamic-pituitary-adrenal (HPA) axis [e.g. diabetes mellitus (DM)]. No study has evaluated FH influence in worsening the metabolic profile of male patients affected by DM-associated hypogonadism. In this retrospective work, we assess the possible association between HPA axis-dysregulation and cardiovascular risk factors in men simultaneously affected by DM and late-onset hypogonadism (LOH). METHODS AND RESULTS Fourteen DM and LOH subjects affected by FH (Hypercort-DM-LOH) and fourteen DM and LOH subjects who were not suffering from FH (Normocort-DM-LOH) were retrospectively considered. Clinical, hormonal and metabolic parameters were retrieved. All metabolic parameters, except for systolic blood pressure, were significantly worse in Hypercort-DM-LOH than in Normocort-DM-LOH. After adjustment for body mass index, waist and total testosterone, Hypercort-DM-LOH subjects showed significantly worse metabolic parameters than Normocort-DM-LOH ones. In Normocort-DM-LOH, no significant correlation between general/hormonal parameters and metabolic variables was present. In Hypercort-DM-LOH, positive and significant correlations of cortisol area under the curve (AUC) after corticotropin releasing hormone with glycemia, triglycerides and blood pressure were evident; on the other hand, negative and significant correlation was present between cortisol AUC and high density lipoprotein (HDL) cholesterol. The associations of AUC cortisol with glycemia, HDL cholesterol and diastolic blood pressure (DBP) were further confirmed at quantile regression after adjustment for therapy. CONCLUSIONS FH may determine a worsening of the metabolic profile in DM-associated hypogonadism.
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Affiliation(s)
- G Tirabassi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - F M Chelli
- Department of Economics and Social Sciences, Polytechnic University of Marche, Ancona, Italy
| | - M Ciommi
- Department of Economics and Social Sciences, Polytechnic University of Marche, Ancona, Italy
| | - A Lenzi
- Andrology, Pathophysiology of Reproduction and Endocrine Diagnosis Unit, Policlinic Umberto I, University of Rome "La Sapienza", Rome, Italy
| | - G Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
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16
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FRANCO MM, MORAES MMM, DUARTE PM, NAPIMOGA MH, BENATTI BB. Glycemic control and the production of cytokines in diabetic patients with chronic periodontal disease. ACTA ACUST UNITED AC 2015. [DOI: 10.1590/1981-863720150003000093063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: To evaluate the association of glycemic control and cytokine production in type 2 diabetic subjects with chronic periodontitis. Methods: Gingival biopsies were performed in 40 patients, divided into four groups: systemically healthy subjects without periodontal disease (S); systemically healthy patients with chronic periodontitis (P); patients with well-controlled type 2 diabetes mellitus (DM) with chronic periodontitis (C); poorly controlled type 2 diabetes mellitus with chronic periodontitis (D). The production of interleukin (IL) -4, -6, -10, -17 and interferon (IFN) -g was quantified by ELISA. Results: The production of IL-4, IL-10, IL-17 and INF-g was higher on group D when compared to other groups (p <0.05), which in turn were similar (p ³0.05). In addition, there was no difference in the production of IL-6 in any of the evaluated groups (p³0.05). Conclusion: Were observed significantly elevated levels of pro-inflammatory and anti-inflammatory cytokines in patients with poorly controlled type 2 diabetes and chronic periodontitis, demonstrating that glycemic control may be associated to the immune inflammatory response of sites with chronic periodontitis.
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17
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Deppe H, Mücke T, Wagenpfeil S, Kesting M, Karl J, Noe S, Sculean A. Are selected IL-1 polymorphisms and selected subgingival microorganisms significantly associated to periodontitis in type 2 diabetes patients? a clinical study. BMC Oral Health 2015; 15:143. [PMID: 26576766 PMCID: PMC4650288 DOI: 10.1186/s12903-015-0132-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/06/2015] [Indexed: 02/06/2023] Open
Abstract
Background We evaluated the periodontal conditions in patients with type 2 diabetes mellitus compared to metabolically healthy controls, and determined whether periodontal interleukin genotypes and microorganisms differed between participants with and without type 2 diabetes mellitus. Methods From April 2011 to July 2012, we prospectively enrolled healthy controls and patients with type 2 diabetes mellitus. Evaluation included assessment of medical and periodontal findings. We also recorded the presence of several interleukin gene variants and specific microorganisms, both available through commercially available diagnostic kits. Statistical significance was tested by the chi-square test and student’s t-test. Results We enrolled 52 patients with type 2 diabetes mellitus and 52 healthy controls. Compared with controls, periodontal disease was significantly more severe in patients with type 2 diabetes mellitus for the following: plaque index, bleeding on probing, pocket probing depth, clinical attachment loss, severe periodontal destruction (i.e., clinical attachment loss ≥ 5 mm), and number of teeth. However, statistical analysis failed to detect significant differences with respect to the periodontal-related interleukin genotypes (p ≥ 0.58) or the selected oral microbiota (p ≥ 0.15). Conclusion Based on these results, it may be assumed that chronic periodontitis in patients with type 2 diabetes mellitus is most strongly associated with inadequate oral hygiene. Periodontal interleukin genotypes and differences in oral microbiota seem to play a subordinate role.
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Affiliation(s)
- Herbert Deppe
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, Homburg Saar, D-81675 Munich, Germany.
| | - Thomas Mücke
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, Homburg Saar, D-81675 Munich, Germany.
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, University of Saarland, Homburg Saar, Germany.
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, Homburg Saar, D-81675 Munich, Germany.
| | - Julia Karl
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, Homburg Saar, D-81675 Munich, Germany.
| | - Sebastian Noe
- Department of Internal Medical Department II, Technical University of Munich, Klinikum rechts der Isar, Homburg Saar, Germany.
| | - Anton Sculean
- Department of Periodontology, University of Berne, Berne, Switzerland.
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18
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Sonnenschein SK, Meyle J. Local inflammatory reactions in patients with diabetes and periodontitis. Periodontol 2000 2015; 69:221-54. [DOI: 10.1111/prd.12089] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2014] [Indexed: 12/14/2022]
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19
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Deppe H, Mücke T, Wagenpfeil S, Kesting M, Rozej A, Bajbouj M, Sculean A. Erosive esophageal reflux vs. non erosive esophageal reflux: oral findings in 71 patients. BMC Oral Health 2015. [PMID: 26208714 PMCID: PMC4513381 DOI: 10.1186/s12903-015-0069-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The purpose of this clinical study was to assess the prevalence of acidic oral mucosal lesions and periodontal conditions in patients suffering from erosive esophageal reflux disease (ERD) compared with non erosive esophageal reflux disease (NERD) patients, both treated with long term proton pump inhibitors (PPI). METHODS Seventy-one patients with diagnosed GERD were studied: i.e. 29 ERD and 42 NERD patients. Thorough visual examination of the oral mucosa and a periodontal evaluation was performed. The primary outcome was defined as a statistically significant difference, between the two groups, in the presence of acidic lesions of the oral mucosa and specific periodontal parameters. RESULTS This study failed to demonstrate statistically significant differences between ERD and NERD patients with respect to the prevalence of oral mucosal lesions. However, significantly more ERD patients suffered from severe periodontitis (CAL ≥ 5 mm) as compared to NERD patients. Accordingly, it may be assumed that PPI-use had no adverse effects on the prevalence of acidic oral mucosal lesions and on periodontal destruction. CONCLUSIONS Within the limitations of this study it may be concluded that ERD and NERD patients need separate evaluation with respect to periodontal destruction. Moreover, long term PPI medication had no adverse clinical impact on acidic oral mucosal lesions and periodontal destruction. Further studies are necessary to elucidate the role of reflux in the periodontal destruction of ERD individuals.
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Affiliation(s)
- Herbert Deppe
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany. .,Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, D-81675, München, Germany.
| | - Thomas Mücke
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany.
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, University of Saarland, Homburg/Saar, Germany.
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany.
| | - Anna Rozej
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany.
| | - Monther Bajbouj
- Department of Internal Medical Department II, Technical University of Munich, Klinikum rechts der Isar, München, Germany.
| | - Anton Sculean
- Department of Periodontology, University of Berne, Bern, Switzerland.
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20
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Kiedrowicz M, Dembowska E, Banach J, Safranow K, Pynka S. A comparison of the periodontal status in patients with type 2 diabetes based on glycated haemoglobin levels and other risk factors. Adv Med Sci 2015; 60:156-61. [PMID: 25723568 DOI: 10.1016/j.advms.2015.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 12/22/2014] [Accepted: 01/29/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of this study was to compare the periodontal status in patients with type 2 diabetes based on glycated haemoglobin levels and other risk factors. MATERIAL/METHODS 75 patients with DM2 were grouped according to glycemic control: 40 subjects with HbA1c<7.0% and 35 subjects with HbA1c≥7.0%. We performed measurements of HbA1c, C-reactive protein (CRP), Approximal Plaque Index (API), Gingival Severity Index (GSI), tooth mobility (TM) as well as periodontal parameters such as probing depth (PD) and clinical attachment level (CAL). Age, gender and duration of the disease were analyzed too. RESULTS No significant differences in PD, CAL, API, GSI and TM were found between the analyzed groups. HbA1c positively correlated with CRP (p=0.046) and the duration of DM2 (p=0.012) but not with the periodontal parameters. Patients' age was positively correlated with both the duration of DM2 (p=0.002) and CAL (p=0.034). Regardless of HbA1c, men had significantly worse periodontal parameters compared to women (respectively: PD 2.73mm vs. 2.18mm, p=0.01; CAL 3.84mm vs. 2.54mm, p=0.005; proportion of deep pockets 9.06% vs. 2.97%, p=0.01; proportion of teeth with grade 2 mobility 9.14% vs. 2.8%, p=0.02). CONCLUSIONS The selected group of patients attending the Diabetes Outpatient Clinic showed a similar periodontal status with regard to glycated haemoglobin levels and other risk factors except gender. Male gender turned out to be a significant risk factor for periodontal disease in patients with type 2 diabetes mellitus.
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Affiliation(s)
| | - Elżbieta Dembowska
- Department of Periodontology, Pomeranian Medical University, Szczecin, Poland
| | - Jadwiga Banach
- Department of Periodontology, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Sławomir Pynka
- Diabetes Outpatient Clinic, M. Curie Hospital, Szczecin, Poland
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21
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delli Muti N, Tirabassi G, Lamonica GR, Lenzi A, Balercia G. Diabetes mellitus and late-onset hypogonadism: the role of Glu298Asp endothelial nitric oxide synthase polymorphism. Andrologia 2014; 47:867-71. [DOI: 10.1111/and.12339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2014] [Indexed: 12/12/2022] Open
Affiliation(s)
- N. delli Muti
- Andrology Unit; Endocrinology; Department of Clinical and Molecular Sciences; Umberto I Hospital; School of Medicine; Polytechnic University of Marche; Ancona Italy
| | - G. Tirabassi
- Andrology Unit; Endocrinology; Department of Clinical and Molecular Sciences; Umberto I Hospital; School of Medicine; Polytechnic University of Marche; Ancona Italy
| | - G. R. Lamonica
- Department of Economy; School of Economy; Polytechnic University of Marche; Ancona Italy
| | - A. Lenzi
- Andrology; Pathophysiology of Reproduction and Endocrine Diagnosis Unit; Policlinic Umberto I; University of Rome “La Sapienza”; Rome Italy
| | - G. Balercia
- Andrology Unit; Endocrinology; Department of Clinical and Molecular Sciences; Umberto I Hospital; School of Medicine; Polytechnic University of Marche; Ancona Italy
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22
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Lorenzi T, Niţulescu EA, Zizzi A, Lorenzi M, Paolinelli F, Aspriello SD, Baniţă M, Crăiţoiu Ş, Goteri G, Barbatelli G, Lombardi T, Di Felice R, Marzioni D, Rubini C, Castellucci M. The novel role of HtrA1 in gingivitis, chronic and aggressive periodontitis. PLoS One 2014; 9:e96978. [PMID: 24979214 PMCID: PMC4076180 DOI: 10.1371/journal.pone.0096978] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 04/14/2014] [Indexed: 12/02/2022] Open
Abstract
Proteolytic tissue degradation is a typical phenomenon in inflammatory periodontal diseases. HtrA1 (High temperature requirement A 1) has a serine protease activity and is able to degrade fibronectin whose fragments induce the expression and secretion of several matrix metalloproteinases (MMPs). The aim of this study was to investigate for the first time if HtrA1 has a role in gingivitis and in generalized forms of chronic and aggressive periodontitis. Expression of HtrA1 was investigated in 16 clinically healthy gingiva, 16 gingivitis, 14 generalized chronic periodontitis and 10 generalized aggressive periodontitis by immunohistochemistry and real-time PCR. Statistical comparisons were performed by the Kruskall-Wallis test. Significantly higher levels of HtrA1 mRNA and protein expression were observed in pathological respect to healthy tissues. In particular, we detected an increase of plasma cell HtrA1 immunostaining from gingivitis to chronic and aggressive periodontitis, with the higher intensity in aggressive disease. In addition, we observed the presence of HtrA1 in normal and pathological epithelium, with an increased expression, particularly in its superficial layer, associated with increasingly severe forms of periodontal disease. We can affirm that HtrA1 expression in plasma cells could be correlated with the destruction of pathological periodontal tissue, probably due to its ability to trigger the overproduction of MMPs and to increase the inflammatory mediators TNF-α and IL-1β by inhibition of TGF-β. Moreover, epithelial HtrA1 immunostaining suggests a participation of the molecule in the host inflammatory immune responses necessary for the control of periodontal infection.
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Affiliation(s)
- Teresa Lorenzi
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | | | - Antonio Zizzi
- Pathological Anatomy, Department of Medical Sciences and Public Health, Università Politecnica delle Marche, United Hospitals, Ancona, Italy
| | - Maria Lorenzi
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Francesca Paolinelli
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Simone Domenico Aspriello
- Department of Clinical Specialistic and Dental Sciences, Periodontology, Università Politecnica delle Marche, Ancona, Italy
| | - Monica Baniţă
- Department of Histology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Ştefania Crăiţoiu
- Department of Histology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Gaia Goteri
- Pathological Anatomy, Department of Medical Sciences and Public Health, Università Politecnica delle Marche, United Hospitals, Ancona, Italy
| | - Giorgio Barbatelli
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Tommaso Lombardi
- Laboratory of Oral and Maxillofacial Pathology, Division of Stomatology and Oral Surgery, University of Geneva, Geneva, Switzerland
| | - Roberto Di Felice
- Private Dental Practice, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Daniela Marzioni
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Corrado Rubini
- Pathological Anatomy, Department of Medical Sciences and Public Health, Università Politecnica delle Marche, United Hospitals, Ancona, Italy
| | - Mario Castellucci
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
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23
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Zizzi A, Piemontese M, Gesuita R, Nori A, Berlin RS, Rocchetti R, Carle F, Rubini C, Aspriello SD. Periodontal status in the Down's syndrome subjects living in central-eastern Italy: the effects of place of living. Int J Dent Hyg 2013; 12:193-8. [DOI: 10.1111/idh.12062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 12/13/2022]
Affiliation(s)
- A Zizzi
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - M Piemontese
- Department of Clinical Special and Dental Science, Periodontology; Polytechnic University of Marche; Ancona Italy
| | - R Gesuita
- Centre of Epidemiology; Biostatistic and Medical Statistics; Polytechnic University of Marche; Ancona Italy
| | - A Nori
- SOD of Odontostomatological and Special Surgery; United Hospital of Ancona; Ancona Italy
| | - RS Berlin
- SOD of Odontostomatological and Special Surgery; United Hospital of Ancona; Ancona Italy
| | - R Rocchetti
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - F Carle
- Centre of Epidemiology; Biostatistic and Medical Statistics; Polytechnic University of Marche; Ancona Italy
| | - C Rubini
- Department of Biomedical Sciences and Public Health; Section of Pathologic Anatomy and Histopathology; Polytechnic University of Marche; Ancona Italy
| | - SD Aspriello
- Department of Clinical Special and Dental Science, Periodontology; Polytechnic University of Marche; Ancona Italy
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24
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Peräneva L, Fogarty CL, Pussinen PJ, Forsblom C, Groop PH, Lehto M. Systemic exposure to Pseudomonal bacteria: a potential link between type 1 diabetes and chronic inflammation. Acta Diabetol 2013; 50:351-61. [PMID: 22864910 DOI: 10.1007/s00592-012-0421-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 07/22/2012] [Indexed: 12/13/2022]
Abstract
Bacterial endotoxins have been associated with chronic inflammation and the development and progression of diabetic nephropathy. We hypothesized that subjects with high serum lipopolysaccharide activity also carry remains of bacterial DNA in their system. Serum-derived bacterial DNA clones were isolated and identified from 10 healthy controls and 14 patients with type 1 diabetes (T1D) using universal primers targeted to bacterial 16S rDNA. A total of 240 clones representing 35 unique bacterial species were isolated and identified. A significant proportion of the isolated bacteria could be assigned to our living environment. Proteobacteria was by far the most prevalent phylum among the samples. Notably, the patients had significantly higher frequencies of Stenotrophomonas maltophilia clones in their sera compared to the healthy controls. Real-time PCR analysis of S. maltophilia and Pseudomonas aeruginosa flagellin gene copy number in the human leukocyte DNA fraction revealed that the overall Pseudomonal bacterial load was higher in older patients with T1D. Serum IgA- and IgG-antibody levels against Pseudomonal bacteria Delftia acidovorans, P. aeruginosa, and S. maltophilia were also determined in 200 healthy controls and 200 patients with T1D. The patients had significantly higher serum levels of IgA antibodies against all three Pseudomonal bacteria. Additionally, the IgA antibodies against Pseudomonal bacteria correlated significantly with serum C-reactive protein. These findings indicate that recurrent or chronic Pseudomonal exposure may increase susceptibility to chronic inflammation in patients with T1D.
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Affiliation(s)
- Lina Peräneva
- Biomedicum Helsinki, Folkhälsan Institute of Genetics, Folkhälsan Research Center/FinnDiane, Haartmaninkatu 8, 00290, Helsinki, Finland
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25
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Mariotti G, Quaranta A, Merli M, Holtzman LP, Piemontese M. Chronic Periodontitis and Cardiovascular Disease: A Controlled Clinical Trial. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- G. Mariotti
- Division of Periodontology, School of Dentistry and Post Graduate Master in Periodontics, Università Politecnica delle Marche, Ancona, Italy
- Private Practice, Clinica Merli, Rimini, Italy
| | - A. Quaranta
- Division of Periodontology, School of Dentistry and Post Graduate Master in Periodontics, Università Politecnica delle Marche, Ancona, Italy
| | - M. Merli
- Division of Periodontology, School of Dentistry and Post Graduate Master in Periodontics, Università Politecnica delle Marche, Ancona, Italy
- Private Practice, Clinica Merli, Rimini, Italy
| | | | - M. Piemontese
- Division of Periodontology, School of Dentistry and Post Graduate Master in Periodontics, Università Politecnica delle Marche, Ancona, Italy
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26
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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 Periodontol 2013; 84:S113-34. [DOI: 10.1902/jop.2013.134005] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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27
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Zizzi A, Tirabassi G, Aspriello SD, Piemontese M, Rubini C, Lucarini G. Gingival advanced glycation end-products in diabetes mellitus-associated chronic periodontitis: an immunohistochemical study. J Periodontal Res 2012; 48:293-301. [PMID: 23017082 DOI: 10.1111/jre.12007] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE The accumulation of advanced glycation end-products (AGEs) seems to play an important role in the development of diabetes mellitus (DM)-associated periodontitis; however, some aspects of this issue are still scarcely known, such as the expression of AGEs in type 1 DM-associated periodontitis and the clinical factors able to affect their accumulation. This study aimed to clarify these points by evaluating the expression of AGEs in DM-associated periodontitis. MATERIAL AND METHODS Sixteen systemically and periodontally healthy subjects and 48 subjects suffering from generalized, severe, chronic periodontitis (16 with type 1 DM, 16 with type 2 DM and 16 systemically healthy subjects) were studied clinically, periodontally and metabolically. The immunohistochemical expression of AGEs in gingival tissues was also evaluated. RESULTS Subjects affected with type 1 DM presented a significantly higher percentage of AGE-positive cells than did subjects affected with type 2 DM, not only in the epithelium, but also in vessels and fibroblasts. A positive and significant correlation was found between gingival expression of AGEs and length of time affected with DM both in type 1 and type 2 DM; glycated hemoglobin, lipid profile, body mass index and age did not correlate significantly with gingival AGEs in any of the classes of subjects studied. CONCLUSIONS Gingival AGEs are increased in both type 1 and type 2 DM-associated periodontitis; however, the clinical parameter that determines their accumulation, and therefore their degree of influence on the development of DM-associated periodontitis, may be the duration of DM.
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Affiliation(s)
- A Zizzi
- Department of Biomedical Sciences and Public Health - Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of Marche, Ancona, Italy
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28
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Gilowski L, Kondzielnik P, Wiench R, Płocica I, Strojek K, Krzemiński TF. Efficacy of short-term adjunctive subantimicrobial dose doxycycline in diabetic patients--randomized study. Oral Dis 2012; 18:763-70. [PMID: 22621750 DOI: 10.1111/j.1601-0825.2012.01943.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To investigate the effectiveness of short-term adjunctive subantimicrobial dose doxycycline (SDD) treatment in patients with diabetes mellitus type 2 and chronic periodontitis (CP). METHODS Thirty-four patients with CP and type 2 diabetes mellitus were included in the placebo-controlled, double-blind study. After scaling and root planing (SRP), patients were randomly assigned to two groups, receiving either SDD or placebo bid for 3 months. The probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), approximal plaque index, glycated hemoglobin (HbA1c) level were recorded and gingival crevicular fluid (GCF) samples were collected at baseline and after 3-month therapy for the estimation of matrix metalloproteinase-8 levels. RESULTS Clinical attachment level, PD, and BOP improved significantly in both groups after therapy (P < 0.05). The statistically significant difference between the two groups after the therapy was observed only in PD in tooth sites with initial PD ≥ 4 mm (SRP + placebo: 3.41 ± 0.6 mm vs SRP + SDD: 2.92 ± 0.5 mm, P < 0.05). GCF matrix metalloproteinase-8 levels were significantly reduced only in SRP + SDD group (P < 0.01). There were no changes in HbA1c levels after therapy. CONCLUSION The short-term administration of SDD gives significant benefit at tooth sites with moderate disease (PD ≥ 4 mm) when compared to SRP alone in patients with diabetes and CP.
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Affiliation(s)
- L Gilowski
- Chair and Department of Pharmacology, Medical University of Silesia, Zabrze, Poland.
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