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Shunmuga PD, Tadepalli A, Parthasarathy H, Ponnaiyan D, Cholan PK, Ramachandran L. Clinical evaluation of the combined efficacy of injectable platelet-rich fibrin along with scaling and root planing in the non-surgical periodontal therapy of stage III and grade C periodontitis patients having type 2 diabetes mellitus: A randomized controlled trial. Clin Adv Periodontics 2024; 14:223-231. [PMID: 37749861 DOI: 10.1002/cap.10266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/25/2023] [Accepted: 09/04/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND This randomized controlled trial was aimed to evaluate the combined efficacy of injectable platelet-rich fibrin (i-PRF) and scaling and root planing (SRP) in type 2 diabetes mellitus subjects having periodontitis. METHODS Twenty-six Stage III, grade C periodontitis subjects (HbA1c > 7) were recruited in this split-mouth study. Following SRP, the test sites received subgingival application of i-PRF, while the control sites received saline. Plaque index, bleeding on probing, modified gingival index, probing pocket depth (PPD) and clinical attachment level (CAL) were measured at baseline, 3 and 6 months. RESULTS Twenty-three participants completed the course of research. The Friedman test followed by Dunn's post hoc test, revealed significant improvement in all the clinical parameters from baseline to 3 and 6 months in both the study groups (p ≤ 0.05). The mean PPD and CAL decreased from 6.30 ± 1.25 and 7.48 ± 1.75 at baseline to 3.48 ± 1.34 and 4.39 ± 1.67 at 6 months in control sites and from 6.57 ± 1.56 and 7.61 ± 1.69 to 3.39 ± 1.23 and 4.26 ± 1.81 at 6 months in test sites (p ≤ 0.0001). Intergroup analysis found no statistical significant differences in the evaluated parameters across all time intervals (p > 0.05) CONCLUSION: The results indicated that the adjunctive application of i-PRF to SRP provided similar benefits as saline and SRP in diabetes mellitus subjects. KEY POINTS Question: To find the combined efficacy of injectable platelet-rich fibrin (i-PRF) along with scaling and root planing (SRP) in the management of periodontal pockets of Stage III and Grade C periodontitis patients having Type 2 Diabetes Mellitus (T2DM). FINDING All of the treated sites showed satisfactory healing. Both the treatment modalities (i-PRF + SRP and Saline + SRP) were effective in the treatment of periodontal pockets. At 3 and 6 months, there were no significant differences in periodontal parameters between groups. Meaning: The application of i-PRF as an adjunct to SRP provided similar benefits as saline and SRP in improving clinical parameters in subjects with stage III and grade C periodontitis patients having T2DM (HbA1C > 7).
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Affiliation(s)
- Prasanth D Shunmuga
- Department Of Periodontics, S.R.M. Dental College and Hospital, Chennai, India
| | - Anupama Tadepalli
- Department Of Periodontics, S.R.M. Dental College and Hospital, Chennai, India
| | | | - Deepa Ponnaiyan
- Department Of Periodontics, S.R.M. Dental College and Hospital, Chennai, India
| | - Priyanka K Cholan
- Department Of Periodontics, S.R.M. Dental College and Hospital, Chennai, India
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Reis-Prado AHD, Paula KDSD, Nunes GP, Abreu LG, Cintra LTA, Peixoto IFDC, Benetti F. Top 100 most-cited papers on diabetes mellitus in Dentistry: a bibliometric study. Braz Oral Res 2024; 38:e075. [PMID: 39109771 PMCID: PMC11376656 DOI: 10.1590/1807-3107bor-2024.vol38.0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/16/2024] [Indexed: 09/20/2024] Open
Abstract
This study assessed the features of the 100 most-cited papers on diabetes mellitus (DM) in dentistry using bibliometric measures. A search of the most cited papers on DM using journals included in the category "Dentistry, Oral Surgery and Medicine" in the Web of Science database up to January 2023 was performed. The complete bibliographic records of the selected papers were exported in plain text or Research Information Systems (RIS) file format. The following bibliometric indicators were collected: title, year, authors, number of citations, mean number of citations, institution, country, continent, study design, journal, impact factor, and keywords. Graphical bibliometric networks were created using the VOSviewer software. The number of citations for the 100 most-cited papers in DM research ranged from 111 to 566. Six papers each had more than 400 citations. Most were observational studies (n = 50) from the United States (USA) (n = 23) and were published in the Journal of Periodontology (30%; n=30). Robert Genco was the most cited author and contributed the most to the top 100 articles (3,653 citations; n = 13). The VOSviewer map of co-authorship showed the existence of clusters in research collaboration. The most prolific institutions were the Universities of Buffalo and Michigan (n = 6 each). "Diabetes mellitus" was the most frequent keyword, with 31 occurrences. In conclusion, the most cited studies that investigated the relationship between dentistry and DM were in periodontology. Observational studies, primarily from the USA, have been the most cited thus far.
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Affiliation(s)
| | - Kiani Dos Santos de Paula
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil
| | - Gabriel Pereira Nunes
- Universidade Estadual Paulista - Unesp, School of Dentistry of Araçatuba Department of Restorative Dentistry, São Paulo, SP, Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Child's and Adolescent's Oral Health, Belo Horizonte, MG, Brazil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista - Unesp, School of Dentistry of Araçatuba Department of Restorative Dentistry, São Paulo, SP, Brazil
| | - Isabella Faria da Cunha Peixoto
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil
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Li Y, Su Q, Tao Z, Cai X, Zhao Y, Zhou Z, Huang Y, Xiang Q. Human Periodontal Ligament Stem Cells (hPDLSCs) Spontaneously Differentiate into Myofibroblasts to Repair Diabetic Wounds. Bioengineering (Basel) 2024; 11:602. [PMID: 38927838 PMCID: PMC11200790 DOI: 10.3390/bioengineering11060602] [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: 02/15/2024] [Revised: 05/27/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Advanced glycation end product (AGE) accumulation due to diabetes causes vascular and neurological lesions, delaying healing. The use of stem cells could overcome these problems. Although many studies have shown the potential beneficial effects of stem cell therapies in the treatment of chronic and refractory skin ulcers, their delivery methods are still under investigation. Human periodontal ligament stem cells (hPDLSCs) can spontaneously differentiate into myofibroblasts in specific cultures; therefore, they have the potential to effectively treat diabetic wounds and may also have applications in the field of medical cosmetics. The myofibroblastic differentiation ability of hPDLSCs in the presence of AGEs was evaluated by the expression of α-SMA and COL1A1 using RT-qPCR and WB technology. Wound healing in diabetic mice, induced by streptozotocin (STZ) and assessed using H&E staining, Masson staining, and immunohistochemical (IHC) and immunofluorescence (IF) staining, was used to validate the effects of hPDLSCs. In the wound tissues, the expression of α-SMA, COL1A1, CD31, CD206, iNOS, and vimentin was detected. The findings indicated that in H-DMEM, the expression of COL1A1 exhibited a significant decrease, while α-SMA demonstrated an increase in P7 cells, ignoring the damage from AGEs (p < 0.05). In an STZ-induced diabetic C57BL/6J mice whole-skin defect model, the healing rate of the hPDLSCs treatment group was significantly higher than that in the models (on the 7th day, the rate was 65.247% vs. 48.938%, p < 0.05). hPDLSCs have been shown to spontaneously differentiate into myofibroblasts in H-DMEM and resist damage from AGEs in both in vivo and in vitro models, suggesting their potential in the field of cosmetic dermatology.
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Affiliation(s)
- Yuxiao Li
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China; (Y.L.); (Q.S.); (Z.T.); (X.C.); (Y.H.)
- School of Stomatology, Jinan University, Guangzhou 510632, China; (Y.Z.); (Z.Z.)
- The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Qi Su
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China; (Y.L.); (Q.S.); (Z.T.); (X.C.); (Y.H.)
- School of Stomatology, Jinan University, Guangzhou 510632, China; (Y.Z.); (Z.Z.)
- The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Zhaoyu Tao
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China; (Y.L.); (Q.S.); (Z.T.); (X.C.); (Y.H.)
- School of Stomatology, Jinan University, Guangzhou 510632, China; (Y.Z.); (Z.Z.)
- The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Xiang Cai
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China; (Y.L.); (Q.S.); (Z.T.); (X.C.); (Y.H.)
| | - Yueping Zhao
- School of Stomatology, Jinan University, Guangzhou 510632, China; (Y.Z.); (Z.Z.)
- The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Zhiying Zhou
- School of Stomatology, Jinan University, Guangzhou 510632, China; (Y.Z.); (Z.Z.)
- The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
| | - Yadong Huang
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China; (Y.L.); (Q.S.); (Z.T.); (X.C.); (Y.H.)
| | - Qi Xiang
- Institute of Biomedicine and Guangdong Provincial Key Laboratory of Bioengineering Medicine, Jinan University, Guangzhou 510632, China; (Y.L.); (Q.S.); (Z.T.); (X.C.); (Y.H.)
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Pimenta RMN, Dos Reis-Prado AH, de Castro Oliveira S, Goto J, Cosme-Silva L, Cintra LTA, Benetti F. Effects of diabetes mellitus on dental pulp: A systematic review of in vivo and in vitro studies. Oral Dis 2024; 30:100-115. [PMID: 35657117 DOI: 10.1111/odi.14267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/11/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This systematic review (PROSPERO CRD42021227711) evaluated the influence of diabetes mellitus (DM) on the response of the pulp tissue and in the pulp cells behaviour. MATERIALS AND METHODS Searches in PubMed/MEDLINE, Embase, Web of Science and OpenGrey were performed until March 2022. Studies evaluating the effects of DM in the pulp tissue inflammation and in the cell behaviour were included, followed by risk of bias assessment (Methodological Index for Non-Randomized Studies and SYRCLE's RoB tools). The meta-analysis was unfeasible, and a narrative synthesis for each outcome was provided. RESULTS Of the 615 studies, 21 were eligible, mainly with in vivo analysis (16 studies). The pulp inflammation (10 studies) was analysed mainly by haematoxylin-eosin stain; DM increased pulp inflammation/degeneration in 9 studies, especially after dental procedures. The cell viability (5 studies) was analysed mostly using MTT assay; DM and glycating agents decreased cellular viability in 3 studies. DM reduced collagen in all of three studies. There were controversial results regarding mineralization; however, increased alkaline phosphatase was reported in three of four studies. CONCLUSIONS DM seems to increase inflammation/degeneration and mineralization in the pulp tissue while reducing cell proliferation. Further analyses in human pulp are important to provide stronger evidence.
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Affiliation(s)
- Rafaella Milla Nunes Pimenta
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Sabrina de Castro Oliveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Juliana Goto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Leopoldo Cosme-Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Alagoas (UFAL), Maceió, Brazil
| | | | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Canales-Alvarez O, Canales-Martinez MM, Dominguez-Verano P, Balderas-Cordero D, Madrigal-Bujaidar E, Álvarez-González I, Rodriguez-Monroy MA. Effect of Mexican Propolis on Wound Healing in a Murine Model of Diabetes Mellitus. Int J Mol Sci 2024; 25:2201. [PMID: 38396882 PMCID: PMC10889666 DOI: 10.3390/ijms25042201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Diabetes mellitus (DM) affects the wound healing process, resulting in impaired healing or aberrant scarring. DM increases reactive oxygen species (ROS) production, fibroblast senescence and angiogenesis abnormalities, causing exacerbated inflammation accompanied by low levels of TGF-β and an increase in Matrix metalloproteinases (MMPs). Propolis has been proposed as a healing alternative for diabetic patients because it has antimicrobial, anti-inflammatory, antioxidant and proliferative effects and important properties in the healing process. An ethanolic extract of Chihuahua propolis (ChEEP) was obtained and fractionated, and the fractions were subjected to High-Performance Liquid Chromatography with diode-array (HPLC-DAD), High-Performance Liquid Chromatography-Mass Spectrometry (HPLC-MS) and Gas Chromatography-Mass Spectrometry (GC-MS) analyses and 46 compounds were detected. Deep wounds were made in a murine DM model induced by streptozotocin, and the speed of closure and the wound tensile strength were evaluated by the tensiometric method, which showed that ChEEP had similar activity to Recoveron, improving the speed of healing and increasing the wound tensile strength needed to open the wound again. A histological analysis of the wounds was performed using H&E staining, and when Matrix metalloproteinase 9 (MMP9) and α-actin were quantified by immunohistochemistry, ChEEP was shown to be associated with improved histological healing, as indicated by the reduced MMP9 and α-actin expression. In conclusion, topical ChEEP application enhances wound healing in diabetic mice.
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Affiliation(s)
- Octavio Canales-Alvarez
- Laboratorio de Genética, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Av. Wilfrido Massieu s/n, Zacatenco, Ciudad de México 07738, Mexico; (O.C.-A.); (E.M.-B.); (I.Á.-G.)
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES Iztacala, Avenida de los Barrios Número 1, Tlalnepantla 54090, Estado de México, Mexico; (P.D.-V.); (D.B.-C.)
| | - Maria Margarita Canales-Martinez
- Laboratorio de Farmacognosia, UBIPRO, UNAM, FES Iztacala, Avenida de los Barrios Número 1, Tlalnepantla 54090, Estado de México, Mexico;
| | - Pilar Dominguez-Verano
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES Iztacala, Avenida de los Barrios Número 1, Tlalnepantla 54090, Estado de México, Mexico; (P.D.-V.); (D.B.-C.)
| | - Daniela Balderas-Cordero
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES Iztacala, Avenida de los Barrios Número 1, Tlalnepantla 54090, Estado de México, Mexico; (P.D.-V.); (D.B.-C.)
| | - Eduardo Madrigal-Bujaidar
- Laboratorio de Genética, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Av. Wilfrido Massieu s/n, Zacatenco, Ciudad de México 07738, Mexico; (O.C.-A.); (E.M.-B.); (I.Á.-G.)
| | - Isela Álvarez-González
- Laboratorio de Genética, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Av. Wilfrido Massieu s/n, Zacatenco, Ciudad de México 07738, Mexico; (O.C.-A.); (E.M.-B.); (I.Á.-G.)
| | - Marco Aurelio Rodriguez-Monroy
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES Iztacala, Avenida de los Barrios Número 1, Tlalnepantla 54090, Estado de México, Mexico; (P.D.-V.); (D.B.-C.)
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Ma XX, Liu QK, Kuai L, Ma X, Luo Y, Luo Y, Song JK, Fei XY, Jiang JS, Wang MX, Shen F, Ru Y, Li B. The role of neutrophils in diabetic ulcers and targeting therapeutic strategies. Int Immunopharmacol 2023; 124:110861. [PMID: 37713783 DOI: 10.1016/j.intimp.2023.110861] [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: 05/20/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/17/2023]
Abstract
Diabetic ulcers (DUs) are a common complication of diabetes with high morbidity, poor prognosis, and a high socio-economic burden. The main pathological manifestations of DUs are chronic inflammation, impaired re-epithelialization, and impaired angiogenesis. During the inflammatory phase, neutrophils are one of the main DU cell types and act by releasing neutrophil extracellular traps (NETs), leading to poor healing in DUs. This review summarizes the role of neutrophils in the pathology and treatment of DUs, with a view to potential novel therapies and therapeutic targets.
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Affiliation(s)
- Xiao-Xuan Ma
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Qing-Kai Liu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Le Kuai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xin Ma
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Yue Luo
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Ying Luo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jian-Kun Song
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Xiao-Ya Fei
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Jing-Si Jiang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Ming-Xia Wang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Fang Shen
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China
| | - Yi Ru
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Bin Li
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China.
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Shi J, Leonardo TR, Han C, Bangash HI, Chen D, Trivedi HM, Chen L. L-Arginine Enhances Oral Keratinocyte Proliferation under High-Glucose Conditions via Upregulation of CYP1A1, SKP2, and SRSF5. Molecules 2023; 28:7020. [PMID: 37894498 PMCID: PMC10609441 DOI: 10.3390/molecules28207020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
High glucose inhibits oral keratinocyte proliferation. Diabetes can lead to delayed oral wound healing and periodontal disease. L-Arginine, one of the most versatile amino acids, plays an important role in wound healing, organ maturation, and development. In this study, L-Arginine was found to enhance oral keratinocyte proliferation under high-glucose conditions. RNA sequencing analysis discovered a significant number of genes differentially upregulated following L-Arginine treatment under high-glucose conditions. Cytochrome P450 family 1 subfamily A member 1 (CYP1A1) was the most significantly upregulated gene at 24 and 48 h after L-Arginine treatment. Gene Ontology enrichment analysis found that cell proliferation- and mitosis-related biological processes, such as mitotic nuclear division, mRNA processing, and positive regulation of cell cycle processes, were significantly upregulated. Pathway enrichment analysis found that S-phase kinase-associated protein 2 (SKP2) and serine- and arginine-rich splicing factor 5 (SRSF5) were the top upregulated genes in cell cycle and spliceosome pathways, respectively. Indirect immunofluorescent cytochemistry confirmed increased protein levels of CYP1A1, SKP2, and SRSF5 after L-Arginine treatment. Knockdown of CYP1A1, SKP2, and SRSF5 abolished the enhanced proliferative effect of L-Arginine on oral keratinocytes under high-glucose conditions. In conclusion, L-Arginine enhances oral keratinocyte proliferation under high-glucose conditions via upregulation of CYP1A1, SKP2, and SRSF5, suggesting that supplemental L-Arginine in oral care products may be beneficial for oral tissue repair and regeneration.
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Affiliation(s)
- Junhe Shi
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China;
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (T.R.L.); (C.H.); (H.I.B.)
- Center for Wound Healing and Tissue Regeneration, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Trevor R. Leonardo
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (T.R.L.); (C.H.); (H.I.B.)
- Center for Wound Healing and Tissue Regeneration, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Chen Han
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (T.R.L.); (C.H.); (H.I.B.)
- Center for Wound Healing and Tissue Regeneration, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Hiba I. Bangash
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (T.R.L.); (C.H.); (H.I.B.)
- Center for Wound Healing and Tissue Regeneration, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Dandan Chen
- Colgate-Palmolive Company, Piscataway, NJ 08854, USA; (D.C.); (H.M.T.)
| | - Harsh M. Trivedi
- Colgate-Palmolive Company, Piscataway, NJ 08854, USA; (D.C.); (H.M.T.)
| | - Lin Chen
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA; (T.R.L.); (C.H.); (H.I.B.)
- Center for Wound Healing and Tissue Regeneration, University of Illinois Chicago, Chicago, IL 60612, USA
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Zhao X, Fu L, Zou H, He Y, Pan Y, Ye L, Huang Y, Fan W, Zhang J, Ma Y, Chen J, Zhu M, Zhang C, Cai Y, Mou X. Optogenetic engineered umbilical cord MSC-derived exosomes for remodeling of the immune microenvironment in diabetic wounds and the promotion of tissue repair. J Nanobiotechnology 2023; 21:176. [PMID: 37269014 DOI: 10.1186/s12951-023-01886-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/06/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Angiogenesis and tissue repair in chronic non-healing diabetic wounds remain critical clinical problems. Engineered MSC-derived exosomes have significant potential for the promotion of wound healing. Here, we discuss the effects and mechanisms of eNOS-rich umbilical cord MSC exosomes (UCMSC-exo/eNOS) modified by genetic engineering and optogenetic techniques on diabetic chronic wound repair. METHODS Umbilical cord mesenchymal stem cells were engineered to express two recombinant proteins. Large amounts of eNOS were loaded into UCMSC-exo using the EXPLOR system under blue light irradiation. The effects of UCMSC-exo/eNOS on the biological functions of fibroblasts and vascular endothelial cells in vitro were evaluated. Full-thickness skin wounds were constructed on the backs of diabetic mice to assess the role of UCMSC-exo/eNOS in vascular neogenesis and the immune microenvironment, and to explore the related molecular mechanisms. RESULTS eNOS was substantially enriched in UCMSCs-exo by endogenous cellular activities under blue light irradiation. UCMSC-exo/eNOS significantly improved the biological functions of cells after high-glucose treatment and reduced the expression of inflammatory factors and apoptosis induced by oxidative stress. In vivo, UCMSC-exo/eNOS significantly improved the rate of wound closure and enhanced vascular neogenesis and matrix remodeling in diabetic mice. UCMSC-exo/eNOS also improved the inflammatory profile at the wound site and modulated the associated immune microenvironment, thus significantly promoting tissue repair. CONCLUSION This study provides a novel therapeutic strategy based on engineered stem cell-derived exosomes for the promotion of angiogenesis and tissue repair in chronic diabetic wounds.
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Affiliation(s)
- Xin Zhao
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
- College of Pharmacy, Hangzhou Medical College, Hangzhou, 310059, China
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, 310014, China
| | - Luoqin Fu
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Hai Zou
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yichen He
- College of Pharmacy, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Yi Pan
- College of Pharmacy, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Luyi Ye
- College of Pharmacy, Hangzhou Medical College, Hangzhou, 310059, China
| | - Yilin Huang
- College of Pharmacy, Hangzhou Medical College, Hangzhou, 310059, China
| | - Weijiao Fan
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Jungang Zhang
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Yingyu Ma
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
| | - Jinyang Chen
- Zhejiang Healthfuture Biomedicine Co., Ltd., Hangzhou, 310052, China
| | - Mingang Zhu
- Department of Dermatology, the First People's Hospital of Jiashan, Jiaxing, 314100, Zhejiang, China
| | - Chengwu Zhang
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China.
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, 310014, China.
| | - Yu Cai
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China.
- College of Pharmacy, Hangzhou Medical College, Hangzhou, 310059, China.
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China.
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, 310014, China.
| | - Xiaozhou Mou
- General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China.
- College of Pharmacy, Hangzhou Medical College, Hangzhou, 310059, China.
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China.
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, 310014, China.
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Liu Y, Liu Y, He W, Mu X, Wu X, Deng J, Nie X. Fibroblasts: Immunomodulatory factors in refractory diabetic wound healing. Front Immunol 2022; 13:918223. [PMID: 35990622 PMCID: PMC9391070 DOI: 10.3389/fimmu.2022.918223] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/15/2022] [Indexed: 12/15/2022] Open
Abstract
Diabetes is a systemic disease in which patients with diabetes may develop peripheral neuropathy of the lower extremities and peripheral vascular disease due to long-term continuous exposure to high glucose. Delayed wound healing in diabetes is one of the major complications of diabetes. Slow wound healing in diabetic patients is associated with high glucose toxicity. When the condition deteriorates, the patient needs to be amputated, which seriously affects the quality of life and even endangers the life of the patient. In general, the delayed healing of diabetes wound is due to the lack of chemokines, abnormal inflammatory response, lack of angiogenesis and epithelial formation, and fibroblast dysfunction. The incidence of several chronic debilitating conditions is increasing in patients with diabetes, such as chronic renal insufficiency, heart failure, and hepatic insufficiency. Fibrosis is an inappropriate deposition of extracellular matrix (ECM) proteins. It is common in diabetic patients causing organ dysfunction. The fibrotic mechanism of diabetic fibroblasts may involve direct activation of permanent fibroblasts. It may also involve the degeneration of fibers after hyperglycemia stimulates immune cells, vascular cells, or organ-specific parenchymal cells. Numerous studies confirm that fibroblasts play an essential role in treating diabetes and its complications. The primary function of fibroblasts in wound healing is to construct and reshape the ECM. Nowadays, with the widespread use of single-cell RNA sequencing (scRNA-seq), an increasing number of studies have found that fibroblasts have become the critical immune sentinel cells, which can detect not only the activation and regulation of immune response but also the molecular pattern related to the injury. By exploring the heterogeneity and functional changes of fibroblasts in diabetes, the manuscript discusses that fibroblasts may be used as immunomodulatory factors in refractory diabetic wound healing, providing new ideas for the treatment of refractory diabetic wound healing.
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Affiliation(s)
- Ye Liu
- College of Pharmacy, Zunyi Medical University, Zunyi, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi, China
| | - Yiqiu Liu
- College of Pharmacy, Zunyi Medical University, Zunyi, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi, China
| | - Wenjie He
- College of Pharmacy, Zunyi Medical University, Zunyi, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi, China
| | - Xingrui Mu
- College of Pharmacy, Zunyi Medical University, Zunyi, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi, China
| | - Xingqian Wu
- College of Pharmacy, Zunyi Medical University, Zunyi, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi, China
| | - Junyu Deng
- College of Pharmacy, Zunyi Medical University, Zunyi, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi, China
| | - Xuqiang Nie
- College of Pharmacy, Zunyi Medical University, Zunyi, China
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi, China
- *Correspondence: Xuqiang Nie,
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Zhang YL, Liu F, Li ZB, He XT, Li X, Wu RX, Sun HH, Ge SH, Chen FM, An Y. Metformin combats high glucose-induced damage to the osteogenic differentiation of human periodontal ligament stem cells via inhibition of the NPR3-mediated MAPK pathway. Stem Cell Res Ther 2022; 13:305. [PMID: 35841070 PMCID: PMC9284897 DOI: 10.1186/s13287-022-02992-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/23/2022] [Indexed: 02/08/2023] Open
Abstract
Background High glucose-induced damage to the osteogenic differentiation of human periodontal ligament stem cells (PDLSCs) has long been a challenge to periodontal regeneration for diabetic individuals. Metformin is an anti-hyperglycemic drug that exhibits abundant biological activities associated with cell metabolism and downstream tissue regeneration. However, how metformin combats damage to PDLSC osteogenic differentiation under high glucose and the underlying mechanisms remain unknown. Methods Osteogenic differentiation of PDLSCs was assessed by alkaline phosphatase (ALP) staining, ALP activity, Alizarin Red staining and quantitative assay, quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis. RNA-seq analysis was performed to screen target genes of metformin, and the effects of target genes were confirmed using lentivirus transfection. Western blot analysis was also used to detect the protein level of underlying signaling pathways. Results We found that osteogenic differentiation of PDLSCs under high glucose was decreased, and metformin addition enhanced this capacity of differentiation. Furthermore, the results of RNA-seq analysis showed that natriuretic peptide receptor 3 (NPR3) was upregulated in PDLSCs under high glucose and downregulated after metformin addition. When the underlying pathways involved were investigated, we found that upregulation of NPR3 can compromise the metformin-enhanced PDLSC osteogenic differentiation and activate the MAPK pathway (especially the p38 MAPK and Erk1/2 pathway), and that inhibition of the NPR3-mediated p38 MAPK or Erk1/2 pathway enhanced the osteogenic differentiation of PDLSCs under high glucose. Conclusions The present study suggests that metformin may enhance the osteogenic differentiation of PDLSCs under high glucose via downregulation of NPR3 and inhibition of its downstream MAPK pathway. This is the first report identifying the involvement of NPR3-mediated MAPK pathway in the metformin-enhanced osteogenic differentiation, indicating that NPR3 antagonists, such as metformin, may be feasible therapeutics for periodontal tissue regeneration in diabetic individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-022-02992-z.
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Affiliation(s)
- Yi-Lin Zhang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Fen Liu
- Department of Stomatology Northwest Women's and Children's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Zhi-Bang Li
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Xiao-Tao He
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Xuan Li
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Rui-Xin Wu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Hai-Hua Sun
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China
| | - Shao-Hua Ge
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Fa-Ming Chen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China.
| | - Ying An
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, People's Republic of China.
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11
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Yang CE, Wang YN, Hua MR, Miao H, Zhao YY, Cao G. Aryl hydrocarbon receptor: From pathogenesis to therapeutic targets in aging-related tissue fibrosis. Ageing Res Rev 2022; 79:101662. [PMID: 35688331 DOI: 10.1016/j.arr.2022.101662] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 04/22/2022] [Accepted: 06/02/2022] [Indexed: 11/27/2022]
Abstract
Aging promotes chronic inflammation, which contributes to fibrosis and decreases organ function. Fibrosis, the excessive synthesis and deposition of extracellular matrix components, is the main cause of most chronic diseases including aging-related organ failure. Organ fibrosis in the heart, liver, and kidneys is the final manifestation of many chronic diseases. The aryl hydrocarbon receptor (AHR) is a cytoplasmic receptor and highly conserved transcription factor that is activated by a variety of small-molecule ligands to affect a wide array of tissue homeostasis functions. In recent years, mounting evidence has revealed that AHR plays an important role in multi-organ fibrosis initiation, progression, and therapy. In this review, we summarise the relationship between AHR and the pathogenesis of aging-related tissue fibrosis, and further discuss how AHR modulates tissue fibrosis by regulating transforming growth factor-β signalling, immune response, and mitochondrial function, which may offer novel targets for the prevention and treatment of this condition.
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Affiliation(s)
- Chang-E Yang
- Faculty of Life Science & Medicine, Northwest University, No. 229 Taibai North Road, Xi'an, Shaanxi 710069, China
| | - Yan-Ni Wang
- Faculty of Life Science & Medicine, Northwest University, No. 229 Taibai North Road, Xi'an, Shaanxi 710069, China
| | - Meng-Ru Hua
- Faculty of Life Science & Medicine, Northwest University, No. 229 Taibai North Road, Xi'an, Shaanxi 710069, China
| | - Hua Miao
- Faculty of Life Science & Medicine, Northwest University, No. 229 Taibai North Road, Xi'an, Shaanxi 710069, China.
| | - Ying-Yong Zhao
- Faculty of Life Science & Medicine, Northwest University, No. 229 Taibai North Road, Xi'an, Shaanxi 710069, China.
| | - Gang Cao
- School of Pharmacy, Zhejiang Chinese Medical University, No. 548 Binwen Road, Hangzhou, Zhejiang 310053, China.
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12
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[Comparison of initial periodontal therapy and its correlation with white blood cell level in periodontitis patients with or without diabetes mellitus]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022. [PMID: 35165467 PMCID: PMC8860660 DOI: 10.19723/j.issn.1671-167x.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of initial periodontal therapy in periodontitis patients with or without type 2 diabetes mellitus and its correlation with white blood cell counts. METHODS In this study, 32 chronic periodontitis patients without systemic disease (CP group) and 27 chronic periodontitis patients with type 2 diabetes mellitus (CP+DM group) were enrolled. At admission, all the patients went through periodontal examination and fasting blood examination(baseline). Probing depth (PD), attachment loss (AL), bleeding index (BI), plaque index (PLI), white blood cells (WBC) counts and fasting blood glucose (FBG) were recorded respectively, while hemoglobin A1c (HbA1c) was recorded only in CP+DM group. After that, initial periodontal therapy was performed. All the tests were repeated 3 and 6 months after treatment. The changes of periodontal clinical indexes and WBC levels were compared between the two groups before and after treatment, and the correlation between WBC and periodontal clinical indexes and glucose metabolism indexes were analyzed by generalized linear mixed model. RESULTS At baseline, the periodontal inflammation and destruction were similar in CP and CP+DM group, but the WBC level was significantly higher in CP+DM groups [(6.01±1.26)×109/L vs. (7.14±1.99)×109/L, P=0.01]. After 3 and 6 months of initial periodontal therapy, the mean PD, AL, BI, and PLI in CP+DM and CP groups were significantly lower than the baseline, and the PD in CP+DM group was further decreased by 6 months compared with 3 months [(3.33±0.62) mm vs. (3.61±0.60) mm, P < 0.05]. However, none of these periodontal indexes showed significant difference between the two groups by 3 or 6 months. In CP+DM group, HbA1c at 3 months and 6 months were significantly lower than the baseline [(7.09±0.79)% vs. (7.64±1.16)%, P < 0.05; (7.06±0.78)% vs. (7.64±1.16)%, P < 0.05], and FBG was significantly lower than the baseline by 6 months [(7.35±1.14) mmol/L vs. (8.40±1.43) mmol/L, P < 0.05]. The WBC level in CP group was significantly lower than the baseline level by 3 months [(5.35±1.37)×109/L vs. (6.01±1.26)×109/L, P < 0.05], while that in CP+DM group was significantly lower than the baseline level by 6 months [(6.00±1.37)×109/L vs. (7.14±1.99)×109/L, P < 0.05]. The analysis of genera-lized linear mixed model showed that WBC level was significantly positively correlated with PD and FBG (P < 0.05). CONCLUSION Initial periodontal therapy can effectively improve the periodontal clinical status of patients with or without type 2 diabetes mellitus, and have benefits on glycemic control in diabetic patients. However, the response of periodontal indexes and WBC level to initial therapy were relatively delayed in diabetic patients. WBC plays an important role in the correlation between diabetes mellitus and periodontitis.
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Kim K, Mahajan A, Patel K, Syed S, Acevedo‐Jake AM, Kumar VA. Materials and Cytokines in the Healing of Diabetic Foot Ulcers. ADVANCED THERAPEUTICS 2021. [DOI: 10.1002/adtp.202100075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- KaKyung Kim
- Department of Biomedical Engineering New Jersey Institute of Technology Newark NJ 07102 USA
| | - Aryan Mahajan
- Department of Biomedical Engineering New Jersey Institute of Technology Newark NJ 07102 USA
| | - Kamiya Patel
- Department of Biomedical Engineering New Jersey Institute of Technology Newark NJ 07102 USA
| | - Shareef Syed
- Department of Biomedical Engineering New Jersey Institute of Technology Newark NJ 07102 USA
| | - Amanda M. Acevedo‐Jake
- Department of Biomedical Engineering New Jersey Institute of Technology Newark NJ 07102 USA
| | - Vivek A. Kumar
- Department of Biomedical Engineering New Jersey Institute of Technology Newark NJ 07102 USA
- Department of Chemical, Biological and Pharmaceutical Engineering New Jersey Institute of Technology Newark NJ 07102 USA
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14
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Wan R, Weissman JP, Grundman K, Lang L, Grybowski DJ, Galiano RD. Diabetic wound healing: The impact of diabetes on myofibroblast activity and its potential therapeutic treatments. Wound Repair Regen 2021; 29:573-581. [PMID: 34157786 DOI: 10.1111/wrr.12954] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/12/2022]
Abstract
Diabetes is a systemic disease in which the body cannot regulate the amount of sugar, namely glucose, in the blood. High glucose toxicity has been implicated in the dysfunction of diabetic wound healing, following insufficient production (Type 1) or inadequate usage (Type 2) of insulin. Chronic non-healing diabetic wounds are one of the major complications of both types of diabetes, which are serious concerns for public health and can impact the life quality of patients significantly. In general, diabetic wounds are characterized by deficient chemokine production, an unusual inflammatory response, lack of angiogenesis and epithelialization, and dysfunction of fibroblasts. Increasing scientific evidence from available experimental studies on animal and cell models strongly associates impaired wound healing in diabetes with dysregulated fibroblast differentiation to myofibroblasts, interrupted myofibroblast activity, and inadequate extracellular matrix production. Myofibroblasts play an important role in tissue repair by producing and organizing extracellular matrix and subsequently promoting wound contraction. Based on these studies, hyperglycaemic conditions can interfere with cytokine signalling pathways (such as growth factor-β pathway) affecting fibroblast differentiation, alter fibroblast apoptosis, dysregulate dermal lipolysis, and enhance hypoxia damage, thus leading to damaged microenvironment for myofibroblast formation, inappropriate extracellular matrix modulation, and weakened wound contraction. In this review, we will focus on the current available studies on the impact of diabetes on fibroblast differentiation and myofibroblast function, as well as potential treatments related to the affected pathways.
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Affiliation(s)
- Rou Wan
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Joshua P Weissman
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kendra Grundman
- Department of Surgery, Franciscan Health, Chicago, Illinois, USA
| | - Lin Lang
- Department of Surgery, Shanghai New Hongqiao Medical Center, Shanghai, China
| | - Damian J Grybowski
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Robert D Galiano
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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15
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Dallaserra M, Morales A, Hussein N, Rivera M, Cavalla F, Baeza M, Strauss FJ, Yoma Y, Suazo C, Jara G, Contreras J, Villanueva J, Valenzuela-Villarroel F, Gamonal J. Periodontal Treatment Protocol for Decompensated Diabetes Patients. FRONTIERS IN ORAL HEALTH 2021; 2:666713. [PMID: 35048008 PMCID: PMC8757839 DOI: 10.3389/froh.2021.666713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Decompensated diabetes is associated with a higher prevalence and severity of periodontitis and poorer response to periodontal therapy. It is conceivable that periodontal therapy may cause systemic and local complications in this type of patients. The aim of the present study was to identify and describe the best available evidence for the treatment of periodontitis in decompensated diabetics. Material and methods: An expert committee including participants from different areas gathered to discuss and develop a treatment guideline under the guidance of the Cochrane Associate Center, Faculty of Dentistry, University of Chile. In total, four research questions were prepared. The questions prepared related to decompensated diabetic patients (glycated hemoglobin >8) were, (1) Does the exposure to periodontal treatment increase the risk of infectious or systemic complications? (2) Does the antibiotic treatment or prophylaxis, compared to not giving it, reduce infectious complications? (3) Does the exposure to periodontal treatment, compared to no treatment, reduce the glycated hemoglobin levels (HbA1c)? Last question was related to diabetic patients, (4) Does the exposure to a higher level of HbA1c, compared to stable levels, increase the risk of infectious complications? Based on these questions, a search strategy was developed using MEDLINE and EPISTEMONIKOS. Only systematic reviews were considered. Results: For question 1, the search yielded 12 records in EPISTEMONIKOS and 23 in MEDLINE. None of these studies addressed the question. For question 2, the search yielded 58 records in EPISTEMONIKOS and 11 in MEDLINE. None of these studies addressed the question. For question 3, the search yielded 16 records in EPISTEMONIKOS and 11 in MEDLINE. Thirteen addressed the question. For question 4, the search yielded 7 records in EPISTEMONIKOS and 9 in MEDLINE. One addressed the question. Conclusions: In decompensated diabetic patients, there is lack of scientific information about risk of infectious or systemic complications as a result of periodontal treatment and about the impact of antibiotic treatment or prophylaxis on reduction if infectious complications. A defined HbA1c threshold for dental and periodontal treatment in diabetic patients has yet to be determined. Finally, periodontal treatment does have an impact on HbA1c levels.
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Affiliation(s)
- Matías Dallaserra
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Santiago, Chile
- Cochrane Associate Center, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Alicia Morales
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- *Correspondence: Alicia Morales
| | - Nayib Hussein
- Centro de Salud Familiar Dr. Francisco Boris Soler, Melipilla, Chile
| | - Marcela Rivera
- Departamento de Atención de las Personas, División de Atención Primaria, Subsecretaría de Redes Asistenciales del Ministerio de Salud, Santiago, Chile
| | - Franco Cavalla
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Mauricio Baeza
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Franz J. Strauss
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Yazmin Yoma
- Referencia Técnica Odontológica, Departamento de Gestión Clínica, Servicio de Salud Metropolitano Occidente, Santiago, Chile
| | - Claudio Suazo
- Programa Odontológico, Cesfam Steeger, Corporación Municipal Desarrollo Social de Cerro Navia, Santiago, Chile
| | - Gisela Jara
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Johanna Contreras
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Julio Villanueva
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Santiago, Chile
- Cochrane Associate Center, Faculty of Dentistry, University of Chile, Santiago, Chile
- Servicio de Cirugía Maxilofacial, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | | | - Jorge Gamonal
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Jorge Gamonal
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16
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Abuderman AWA, Muzaheed. Antibacterial effectiveness of scaling and root planing with and without photodynamic therapy against Campylobacter rectus counts in the oral biofilm of patients with periodontitis. Photodiagnosis Photodyn Ther 2021; 33:102170. [PMID: 33401024 DOI: 10.1016/j.pdpdt.2020.102170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/02/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is hypothesized that scaling and root planning (SRP) with adjunct photodynamic therapy (PDT) is more effective in reducing Campylobacter rectus (C. rectus) from the oral biofilm (OB) among patients with periodontitis, than SRP alone. The objective was to compare the effectiveness of SRP with and without adjunct PDT in reducing OB C. rectus counts of patients with periodontitis. METHODS Chronic gastritis patients diagnosed with periodontitis were included. Therapeutically, the patients were divided into 2-groups. Patients in the test- and control-groups underwent SRP with and without adjunct PDT, respectively. In both groups, full-mouth plaque index (PI), bleeding on probing (BOP), probing depth (PD) and marginal bone loss (MBL) were measured and subgingival OB counts of C. rectus were measured at baseline and 12-weeks after treatment. Data normality was assessed and group-comparisons were done using the paired t-test and Man-Whitney U tests. A type-1 error rate of 5 % was used. RESULTS Thirty patients with periodontitis were included. All patients had Grade-B/Stage-II periodontitis. All participants were male with no significant difference in age. At baseline PI, BOP, PD and MBL were comparable in both groups. Counts of C. rectus in the subgingival OB samples were similar in both groups at baseline. At 12-weeks of follow-up, PI (P < 0.01), GI (P < 0.01) and PD (P < 0.01) were significantly higher in the control- compared with the test-group compared with baseline. The percentages of C. rectus -positive individuals were higher in the control- than the test-group at 12-weeks' (P < 0.01). At 12-weeks' follow-up the percentages of C. rectus -positive patients were comparable with their respective baseline percentages in the control-group. CONCLUSION Compared with SRP alone, adjuvant use of PDT is more efficient in eliminating C. rectus in the OB and reducing clinical parameters in patients with grade-B/Stage-II periodontitis.
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Affiliation(s)
- Abdul Wahab Ali Abuderman
- Department of Basic Medical Science, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
| | - Muzaheed
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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