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Ismail H, Pathak AK, Lal N, Rastogi P, Ahmad K, Khan MA. Effect of non-surgical periodontal therapy on salivary and gingival crevicular fluid concentration of visfatin in periodontal health and disease. J Oral Biol Craniofac Res 2024; 14:430-434. [PMID: 38832289 PMCID: PMC11144723 DOI: 10.1016/j.jobcr.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 06/05/2024] Open
Abstract
Background and objective Visfatin, a pleotropic mediator mostly produced by visceral fat, is crucial in controlling the immunological and defensive systems. It serves the roles of a cytokine, an enzyme involved in energy metabolism, and a growth factor. The objective of the present study was to assess the impact of non-surgical periodontal therapy (scaling and root planing) on visfatin concentrations in saliva and gingival crevicular fluid in individuals with Periodontitis (stage-II grade-A). Materials and methods 54 individuals were divided into Group A (Periodontally Healthy) and Group B1(Periodontitis baseline) based on periodontal parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and radiographic parameters. After NSPT (SRP), Group B1 patients were recalled after 4 weeks, constituting Group B2 (post NSPT group B1). At baseline and 4 weeks after non-surgical periodontal therapy (SRP), all clinical parameters, salivary and GCF samples were recorded. An ELISA kit was used to measure the levels of visfatin. Using the paired t-test, unpaired t-test, and Pearson's correlation coefficient, data were analysed using SPSS 15. Results After non-surgical periodontal treatment (SRP), the mean salivary and gingival crevicular fluid concentration of visfatin considerably decreased to a level comparable to periodontal health. In all groups, GCF visfatin concentration was higher than salivary concentration of visfatin. In periodontitis patients, visfatin concentration in GCF was 1.5 times higher than in saliva. Conclusion The results of this investigation suggest a direct correlation between salivary and gingival crevicular fluid visfatin concentration and periodontal tissue inflammation and disease activity.
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Affiliation(s)
- Hira Ismail
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - Anjani Kumar Pathak
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - Nand Lal
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - Pavitra Rastogi
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - Kaleem Ahmad
- Department of Biochemistry, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - Mohd. Aamir Khan
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Uttar Pradesh, Lucknow, India
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Checa-Ros A, Hsueh WC, Merck B, González-Torres H, Bermúdez V, D’Marco L. Obesity and Oral Health: The Link Between Adipokines and Periodontitis. TOUCHREVIEWS IN ENDOCRINOLOGY 2024; 20:25-31. [PMID: 38812668 PMCID: PMC11132655 DOI: 10.17925/ee.2024.20.1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/15/2023] [Indexed: 05/31/2024]
Abstract
Periodontitis is a chronic inflammatory disease of the periodontium, or the supportive tissues around the tooth. This disease has been related to different risk factors, such as the presence of plaque and calculus, tobacco smoking, low socioeconomic status, and the immune state of the host. Importantly, the chronic inflammatory environment generated by periodontitis may lead to tooth loss and diverse systemic complications, such as cardiovascular disease, osteoarthritis and metabolic disease. Recent investigations have supported the role of obesity as a risk factor for periodontitis. Furthermore, studies have found obesity to compromise healing after periodontal therapy; however, the mechanisms underlying this association are not well understood. Proteins called 'adipokines' could be the factor linking obesity to periodontitis. Adipokines are bioactive molecules with hormonal properties and a structure similar to cytokines produced by the adipose tissue. Although adipokines have both pro-and anti-inflammatory effects, the shift towards pro-inflammatory actions occurs when the adipose tissue becomes pathological, as observe in the progression of conditions such as obesity or adiposopathy. This article reviews the role of adipokines in the pathophysiology and progression of periodontitis by focusing on their impact on inflammation and the molecular mechanisms through which adipokines contribute to the onset and development of periodontitis.
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Affiliation(s)
- Ana Checa-Ros
- Grupo de Investigación en Enfermedades Cardiorrenales y Metabólicas, Departamento de Medicina y Cirugía, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Wei-Chung Hsueh
- Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Belén Merck
- Grupo de Investigación en Enfermedades Cardiorrenales y Metabólicas, Departamento de Medicina y Cirugía, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Henry González-Torres
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia
- Centro de Investigaciones en Ciencias de la Vida, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Valmore Bermúdez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Luis D’Marco
- Grupo de Investigación en Enfermedades Cardiorrenales y Metabólicas, Departamento de Medicina y Cirugía, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Saito M, Shimazaki Y, Yoshii S, Takeyama H. Periodontitis and the incidence of metabolic syndrome: An 8-year longitudinal study of an adult Japanese cohort. J Clin Periodontol 2024; 51:54-62. [PMID: 37743671 DOI: 10.1111/jcpe.13881] [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: 04/11/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
AIM To examine the effect of periodontitis on the development of metabolic syndrome (MetS) and MetS components. MATERIALS AND METHODS This study included 4761 participants aged 30-74 years who underwent health examinations at both baseline and 8-year follow-up. The Japanese MetS criteria were used for diagnosis. The Community Periodontal Index was used to assess periodontal status. The association between periodontal status and MetS incidence was examined by Poisson regression analysis. RESULTS Multivariate analysis revealed that individuals with a ≥6 mm periodontal pocket had a significantly higher relative risk (RR) for MetS onset, as compared to individuals without deep periodontal pockets (adjusted RR 1.30, 95% confidence interval [CI]: 1.01-1.67). Compared to individuals without a deep periodontal pocket, individuals with a ≥6 mm periodontal pocket had significantly higher RRs for developing two components of MetS; the RRs were 1.25 (95% CI: 1.01-1.56) for abdominal obesity and 1.39 (95% CI: 1.03-1.86) for hyperglycaemia. CONCLUSIONS Individuals with periodontitis had a significantly higher risk of MetS onset, possibly due to the influence of periodontitis on abdominal obesity and hyperglycaemia.
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Affiliation(s)
- Mizuki Saito
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Saori Yoshii
- Aichi Health Promotion Foundation, Nagoya, Japan
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Yoldaş O, Nogueira AVB, Kantar PM, Ziskoven PC, Deschner J, Buduneli N. Gingival crevicular fluid levels of apelin correlates with clinical periodontal diagnosis. Clin Oral Investig 2023; 28:50. [PMID: 38153555 DOI: 10.1007/s00784-023-05461-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES Limitations of clinical periodontal measurements have led to the search for reliable biomarkers that can be used in diagnosis and monitoring of periodontal diseases. Considering the relationship of adipokines with periodontal disease, diabetes, and obesity, apelin may be a biomarker for periodontal diseases due to its modulating effects on inflammation. The present study was conducted to determine gingival crevicular fluid (GCF) apelin levels in systemically healthy individuals and to evaluate the potential of apelin as a biomarker for periodontal diagnosis. MATERIALS AND METHODS Ten individuals with clinically healthy periodontal tissues, 10 patients diagnosed with gingivitis, and 10 patients with periodontitis were included in the present study. Whole mouth clinical periodontal measurements were recorded and GCF samples were obtained from the buccal approximal regions of single-rooted teeth with features that would represent clinical periodontal diagnosis. Apelin level in the samples was determined by ELISA. Clinical and biochemical findings were statistically analyzed. Possible relationship between the variables was evaluated with Pearson correlation analysis. RESULTS Apelin level in the gingivitis group was higher than that in the clinically healthy group (p = 0.000) and lower than that in the periodontitis group (p = 0.000). A positive correlation was found between GCF apelin concentration and plaque score, bleeding on probing, and probing depth (p = 0.000). CONCLUSIONS Within the limits of this study, it can be suggested that GCF apelin concentration may be a biomarker that can distinguish between healthy periodontal tissues, gingivitis, and periodontitis patients. CLINICAL RELEVANCE Apelin concentration in the gingival crevicular fluid may aid in the diagnosis of periodontal disease.
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Affiliation(s)
- Onur Yoldaş
- Department of Periodontology, School of Dentistry, Ege University, 35100, Bornova, İzmir, Turkey
| | - Andressa V B Nogueira
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - Pınar Meriç Kantar
- Department of Periodontology, School of Dentistry, Ege University, 35100, Bornova, İzmir, Turkey
| | - Pablo Cores Ziskoven
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, 35100, Bornova, İzmir, Turkey.
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Zhang Y, Zhang Y, Tan Y, Luo X, Jia R. Increased RBP4 and Asprosin Are Novel Contributors in Inflammation Process of Periodontitis in Obese Rats. Int J Mol Sci 2023; 24:16739. [PMID: 38069063 PMCID: PMC10706687 DOI: 10.3390/ijms242316739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
There is a significant comorbidity between obesity and periodontitis, while adipokines are pivotal in the immunoinflammatory process, which may play a role in this special relationship. We aimed to assess the effect of adipokines as mediators in the progression of periodontitis in obese Sprague Dawley rats. Rats were divided into four groups: normal body weight with and without periodontitis and obesity with and without periodontitis. Experimental obesity and periodontitis were induced by a high-fat diet or ligaturing, and the effect was measured using metabolic and micro-computed tomography analysis and histological staining. Compared with the other three groups, the group of periodontitis with obesity (OP) had the heaviest alveolar bone absorption, the largest increase in osteoclasts, the utmost inflammatory cell infiltration and the highest expressions of pro-inflammatory cytokines and nuclear factor-kappa B ligand (RANKL); meanwhile, its expression of the osteogenesis-related gene was the lowest among the four groups. The expressions of leptin, visfatin, resistin, retinol-binding protein 4 (RBP4) and asprosin were upregulated, while adiponectin was decreased significantly in OP. The strong positive associations between the periodontal or circulating levels of RBP4 (or asprosin) and the degree of alveolar resorption in experimental periodontitis and obese rats were revealed. The upregulated expression of inflammation biomarkers, the corresponding degradation in connective tissue and the generation of osteoclasts in periodontitis were activated and exacerbated in obesity. The elevated level of RBP4/asprosin may contribute to a more severe periodontal inflammatory state in obese rats.
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Affiliation(s)
- Yuwei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.Z.); (Y.Z.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Yifei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.Z.); (Y.Z.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Yutian Tan
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China;
| | - Xiao Luo
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China;
| | - Ru Jia
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China; (Y.Z.); (Y.Z.)
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Xi’an 710004, China
- Department of Digital Oral Implantology and Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
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Damanaki A, Beisel-Memmert S, Nokhbehsaim M, Abedi A, Rath-Deschner B, Nogueira AVB, Deschner J. Influence of Occlusal Hypofunction on Alveolar Bone Healing in Rats. Int J Mol Sci 2023; 24:9744. [PMID: 37298695 PMCID: PMC10253992 DOI: 10.3390/ijms24119744] [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: 01/31/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
The aim of this in vivo study was to investigate the effect of occlusal hypofunction on alveolar bone healing in the absence or presence of an enamel matrix derivative (EMD). A standardized fenestration defect over the root of the mandibular first molar in 15 Wistar rats was created. Occlusal hypofunction was induced by extraction of the antagonist. Regenerative therapy was performed by applying EMD to the fenestration defect. The following three groups were established: (a) normal occlusion without EMD treatment, (b) occlusal hypofunction without EMD treatment, and (c) occlusal hypofunction with EMD treatment. After four weeks, all animals were sacrificed, and histological (hematoxylin and eosin, tartrate-resistant acid phosphatase) as well as immunohistochemical analyses (periostin, osteopontin, osteocalcin) were performed. The occlusal hypofunction group showed delayed bone regeneration compared to the group with normal occlusion. The application of EMD could partially, but not completely, compensate for the inhibitory effects of occlusal hypofunction on bone healing, as evidenced by hematoxylin and eosin and immunohistochemistry for the aforementioned molecules. Our results suggest that normal occlusal loading, but not occlusal hypofunction, is beneficial to alveolar bone healing. Adequate occlusal loading appears to be as advantageous for alveolar bone healing as the regenerative potential of EMD.
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Affiliation(s)
- Anna Damanaki
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, 55131 Mainz, Germany
| | - Svenja Beisel-Memmert
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111 Bonn, Germany
| | - Marjan Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111 Bonn, Germany
| | - Ali Abedi
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, 55131 Mainz, Germany
| | - Birgit Rath-Deschner
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111 Bonn, Germany
| | - Andressa V. B. Nogueira
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, 55131 Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, 55131 Mainz, Germany
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Li Z, Zheng Z, Pathak JL, Li H, Wu G, Xu S, Wang T, Cheng H, Piao Z, Jaspers RT, Wu L. Leptin-deficient ob/ob mice exhibit periodontitis phenotype and altered oral microbiome. J Periodontal Res 2023; 58:392-402. [PMID: 36710264 DOI: 10.1111/jre.13099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/18/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVE Leptin-deficient obesity is associated with various systemic diseases including diabetes and low bone mass phenotype. However, the periodontal status of leptin-deficient obese individuals is still unclear. In this study, we aimed to analyze the periodontal status, alveolar bone phenotype, and oral microbiome status in leptin-deficient obese mice (ob/ob mice). METHODS This study used 12-week-old wild-type and ob/ob male mice. The alveolar bone phenotype and periodontal status in the maxilla were analyzed by micro-CT and histological analysis. Osteoclasts in alveolar bone were visualized by TRAP staining. Expressions of inflammatory markers (MMP-9, IL-1β, and TGF-β1) and osteoclastogenic markers (RANKL and OPG) in periodontium were analyzed by immunohistochemistry and RT-qPCR. The oral microbiome was analyzed by 16 S rDNA sequencing. RESULTS CEJ-ABC distance in maxillary molars (M1-M3) of ob/ob mice was significantly higher compared with that of wild-type. The alveolar bone BV/TV ratio was reduced in ob/ob mice compared with wild-type. Higher numbers of osteoclasts were observed in ob/ob mice alveolar bone adjacent to the molar root. Epithelial hyperplasia in gingiva and disordered periodontal ligaments was observed in ob/ob mice. RANKL/OPG expression ratio was increased in ob/ob mice compared with wild-type. Expressions of inflammatory markers MMP-9, IL-1β, and TGF-β1 were increased in ob/ob mice compared with wild-type. Oral microbiome analysis showed that beneficial bacteria Akkermansia and Ruminococcaceae_UCG_014 were more abundant in the wild-type mice while the inflammation-related Flavobacterium was more abundant in ob/ob mice. CONCLUSION In conclusion, ob/ob mice showed higher expressions of inflammatory factors, increased alveolar bone loss, lower abundance of the beneficial bacteria, and higher abundance of inflammatory bacteria in the oral cavity, suggesting leptin-deficient obesity as a risk factor for periodontitis development in ob/ob mice.
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Affiliation(s)
- Zhicong Li
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Zhichao Zheng
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, HZ, The Netherlands
| | - Janak L Pathak
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Hongtao Li
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Gang Wu
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Shaofen Xu
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Tianqi Wang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Haoyu Cheng
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Zhengguo Piao
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Richard T Jaspers
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, HZ, The Netherlands
| | - Lihong Wu
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
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High Levels of Leptin and Adipsin Are Associated with Clinical Activity in Early Rheumatoid Arthritis Patients with Overweight and Periodontal Infection. Diagnostics (Basel) 2023; 13:diagnostics13061126. [PMID: 36980434 PMCID: PMC10047025 DOI: 10.3390/diagnostics13061126] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 03/18/2023] Open
Abstract
Adipokines are associated with the pathogenesis of rheumatoid arthritis (RA) and are potential biomarkers of disease activity, periodontitis, and obesity. The aim of this was to establish the association between adipokine profile, RA disease activity, body mass index, and periodontal infection. This study evaluated 51 patients with early-RA and 51 controls including serum rheumatological markers, adipokine levels, detection of Porphyromonas gingivalis and serum anti-Porphyromonas gingivalis antibodies, clinical and periodontal measurements. Statistical analyses were run with SPSS® V26, with a logistic regression model to confirm associations. The results show high levels of leptin were more frequent in patients (p = 0.001) who simultaneously showed a higher frequency of Porphyromonas gingivalis (p = 0.004). Patients with concomitant presence of Porphyromonas gingivalis, high clinical activity score, and overweight were correlated with high levels of leptin (OR, 7.20; 95% CI, 2.68–19.33; p = 0.0001) and adipsin (OR, 2.69; 95% CI, 1.00–7.28; p = 0.005). The conclusion is that high levels of leptin and adipsin are associated with greater clinical activity in early-RA patients with overweight and periodontal infection, whereby overweight and Porphyromonas gingivalis may enhance RA activity. This may represent a pathological mechanism between these conditions, where adipokines seem to have a key role.
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Cores Ziskoven P, Nogueira AVB, Gutierrez LS, Weusmann J, Eick S, Buduneli N, Deschner J. Apelin Enhances the Effects of Fusobacterium nucleatum on Periodontal Ligament Cells In Vitro. Int J Mol Sci 2023; 24:ijms24054733. [PMID: 36902162 PMCID: PMC10002786 DOI: 10.3390/ijms24054733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
This study aimed to explore effects of Fusobacterium nucleatum with or without apelin on periodontal ligament (PDL) cells to better understand pathomechanistic links between periodontitis and obesity. First, the actions of F. nucleatum on COX2, CCL2, and MMP1 expressions were assessed. Subsequently, PDL cells were incubated with F. nucleatum in the presence and absence of apelin to study the modulatory effects of this adipokine on molecules related to inflammation and hard and soft tissue turnover. Regulation of apelin and its receptor (APJ) by F. nucleatum was also studied. F. nucleatum resulted in elevated COX2, CCL2, and MMP1 expressions in a dose- and time-dependent manner. Combination of F. nucleatum and apelin led to the highest (p < 0.05) expression levels of COX2, CCL2, CXCL8, TNF-α, and MMP1 at 48 h. The effects of F. nucleatum and/or apelin on CCL2 and MMP1 were MEK1/2- and partially NF-κB-dependent. The combined effects of F. nucleatum and apelin on CCL2 and MMP1 were also observed at protein level. Moreover, F. nucleatum downregulated (p < 0.05) the apelin and APJ expressions. In conclusion, obesity could contribute to periodontitis through apelin. The local production of apelin/APJ in PDL cells also suggests a role of these molecules in the pathogenesis of periodontitis.
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Affiliation(s)
- Pablo Cores Ziskoven
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
| | - Andressa V. B. Nogueira
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
- Correspondence: ; Tel.: +49-0-6131-17-7091
| | - Lorena S. Gutierrez
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University-UNESP, Araraquara 14801-385, SP, Brazil
| | - Jens Weusmann
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
| | - Sigrun Eick
- Laboratory of Oral Microbiology, Department of Periodontology, University of Bern, 3010 Bern, Switzerland
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, 35040 Izmir, Turkey
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
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Toy VE, Ataoglu T, Eltas A, Otlu HG, Karabulut AB. Obesity as a modifying factor of periodontal therapy outcomes: local and systemic adipocytokines and oxidative stress markers. Clin Oral Investig 2023:10.1007/s00784-022-04854-7. [PMID: 36604342 DOI: 10.1007/s00784-022-04854-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Adipocytokines and oxidative stress (OS) are involved in the pathogenesis of both obesity and periodontitis. The aim of this study was to evaluate periodontal therapy outcomes in terms of serum and gingival crevicular fluid (GCF) levels of adipocytokines and OS markers in obese patients with periodontitis, in order to have an insight into the association between obesity and periodontitis. MATERIALS AND METHODS A total of 39 patients (20 obese, 19 non-obese) with periodontitis were included in this study. Clinical periodontal parameters were assessed; serum and GCF levels of adipocytokines and OS markers were evaluated by ELISA at baseline and 3 months after non-surgical periodontal therapy. RESULTS Significant improvements in clinical periodontal parameters were observed in both groups at 3 months (p < 0.01). While serum levels of TNF-α, leptin, and total oxidant status (TOS) in the obese group were higher at baseline (p < 0.01), leptin levels remained higher at 3 months despite a significant decrease (p < 0.01). Although NSPT improved GCF levels of total antioxidant status (TAS) and TOS in both groups, they were significantly different between the groups after therapy (p < 0.05). CONCLUSIONS It seems that leptin, TNF-α, and TOS contribute to systemic inflammatory and oxidative state in patients with obesity. Despite improvements in clinical periodontal parameters, obesity might be a modulating factor in the development and progression of periodontal disease in terms of some adipocytokines and OS markers. CLINICAL RELEVANCE Since the global burden of both obesity and periodontitis is continuously increasing, the management of these inflammatory diseases has become more important. The current study contributes to our understanding of the role of OS and adipocytokines on the relationship between obesity and periodontitis by response to periodontal treatment.
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Affiliation(s)
- Vesile Elif Toy
- Department of Periodontology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
| | - Tamer Ataoglu
- Department of Periodontology, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | - Abubekir Eltas
- Department of Periodontology, Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - Husniye Gul Otlu
- Medical Laboratory Techniques Program, Vocational School of Health Services, Turgut Ozal University, Malatya, Turkey
| | - Aysun Bay Karabulut
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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11
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Periodontal Disease in Obese Patients; Interleukin-6 and C-Reactive Protein Study: A Systematic Review. Dent J (Basel) 2022; 10:dj10120225. [PMID: 36547041 PMCID: PMC9777236 DOI: 10.3390/dj10120225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
Periodontal disease (PD) and obesity are characterized by a dysregulated inflammatory state. Both conditions trigger inflammatory and immune responses with an increase in proinflammatory cytokines such as Interleukin 6 (IL-6) and the release of inflammatory mediators such as C-reactive protein (CRP). Individuals with a high body mass index (BMI) present a chronic inflammatory state. The aim of the present study was to perform a systematic review of inflammatory markers (IL-6 and CRP) in obese patients with PD and their possible relationship by analyzing the levels of these markers. A digital literature search was performed in three databases-PubMed, SciElo and Medigraphic-through an advanced search for original articles, employing IL-6 and CRP in obese patients with PD, within a publication period from 2010 to 2021. PRISMA guidelines, the JADAD scale and a qualitative analysis of scientific evidence were performed using the Cochrane collaboration method and the RoB 2 assessment tool. Ten articles were included in this analysis with the variables recorded and associated with subjects with obesity and PD. Of the ten articles included, three analyzed IL-6 and CRP, four analyzed IL-6 and three analyzed CRP. In conclusion, and based on the available evidence, the aforementioned markers of inflammation demonstrate that there is a relationship between PD and obesity.
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12
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Marcantonio CC, Lopes MES, Mofatto LS, Salmon CR, Deschner J, Nociti-Junior FH, Cirelli JA, Nogueira AVB. Obesity affects the proteome profile of periodontal ligament submitted to mechanical forces induced by orthodontic tooth movement in rats. J Proteomics 2022; 263:104616. [PMID: 35595054 DOI: 10.1016/j.jprot.2022.104616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 12/20/2022]
Abstract
The prevalence of obesity has increased significantly worldwide. Therefore, this study aimed to evaluate the influence of obesity on the proteomic profile of periodontal ligament (PDL) tissues of rat first maxillary molars (1 M) submitted to orthodontic tooth movement (OTM). Ten Holtzman rats were distributed into two groups (n = 5): the M group (OTM), and the OM group (obesity induction plus OTM). Obesity was induced by a high-fat diet for the entire experimental periods After that period, the animals were euthanized and the hemimaxillae removed and processed for laser capture microdissection of the PDL tissues of the 1 M. Peptide extracts were obtained and analyzed by LC-MS/MS. Data are available via ProteomeXchange with identifier PXD033647. Out of the 109 proteins with differential abundance, 49 were identified in the OM group, including Vinculin, Cathepsin D, and Osteopontin, which were selected for in situ localization by immunohistochemistry analysis (IHC). Overall, Gene Ontology (GO) analysis indicated that enriched proteins were related to the GO component cellular category. IHC validated the trends for selected proteins. Our study highlights the differences in the PDL proteome profiling of healthy and obese subjects undergoing OTM. These findings may provide valuable information needed to better understand the mechanisms involved in tissue remodeling in obese patients submitted to orthodontic treatment. SIGNIFICANCE: The prevalence of obesity is increasing worldwide. Emerging findings in the field of dentistry suggest that obesity influences the tissues around the teeth, especially those in the periodontal ligament. Therefore, evaluation of the effect of obesity on periodontal tissues remodeling during orthodontic tooth movement is a relevant research topic. To our knowledge, this is the first study to evaluate proteomic changes in periodontal ligament tissue in response to the association between orthodontic tooth movement and obesity. Our study identified a novel protein profile associated with obesity by using laser microdissection and proteomic analysis, providing new information to increase understanding of the mechanisms involved in obese patients undergoing orthodontic treatment which can lead to a more personalized orthodontic treatment approach.
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Affiliation(s)
- Camila Chierici Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - Maria Eduarda Scordamaia Lopes
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - Luciana Souto Mofatto
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Cristiane Ribeiro Salmon
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
| | - Francisco Humberto Nociti-Junior
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil; São Leopoldo Mandic Research Center, Campinas, São Paulo, Brazil.
| | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - Andressa Vilas Boas Nogueira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University - UNESP, Araraquara, São Paulo, Brazil; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
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13
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Lopes MES, Marcantonio CC, de Molon RS, Cerri PS, Salmon CR, Mofatto LS, Nociti Junior FH, Deschner J, Cirelli JA, Nogueira AVB. Obesity influences the proteome of periodontal ligament tissues following periodontitis induction in rats. J Periodontal Res 2022; 57:545-557. [PMID: 35246839 DOI: 10.1111/jre.12983] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Many studies have been conducted to better understand the molecular mechanism involved with periodontitis progression. There has been growing interest in the potential impact of obesity on periodontitis onset and progression, but the mechanisms involved remain to be elucidated. The present study was designed to determine the impact of obesity on experimentally induced periodontitis in rats and identify novel pathways involved. METHODS Sixteen Holtzman rats were distributed into two groups (n = 8): ligature-induced periodontitis (P) and obesity plus ligature-induced periodontitis (OP). Obesity was induced by a high-fat diet for 70 days, whereas periodontitis was induced for 20 days, with a cotton thread placed around the upper first molars bilaterally. Alveolar bone loss was measured by microtomographic analysis and histologically by histometry on the hemimaxillae. The protein composition of the periodontal ligament was evaluated by proteomic analysis. RESULTS Data analysis (body weight, adipose tissue weight, and blood test) confirmed obesity induction, whereas bone loss was confirmed by micro-CT and histologic analyses. Proteome analysis from the periodontal ligament tissues (PDL) identified 819 proteins, 53 exclusive to the P group, 28 exclusive to the OP group, and 738 commonly expressed. Validation was performed by immunohistochemistry for selected proteins (spondin1, vinculin, and TRAP). CONCLUSION Histologically, it was found that obesity did not significantly affect bone loss resulting from periodontitis. However, the present study's findings indicated that obesity affects the proteome of PDL submitted to experimental periodontitis, allowing for identifying potential targets for personalized approaches.
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Affiliation(s)
- Maria Eduarda Scordamaia Lopes
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, Brazil
| | - Camila Chierici Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, Brazil
| | - Paulo Sérgio Cerri
- Department of Morphology, School of Dentistry at Araraquara, São Paulo State University, Araraquara, Brazil
| | - Cristiane Ribeiro Salmon
- Division of Periodontics, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, Brazil
| | - Luciana Souto Mofatto
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas - UNICAMP, Campinas, Brazil
| | - Francisco Humberto Nociti Junior
- Division of Periodontics, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, Brazil.,São Leopoldo Mandic Research Center, Campinas, Brazil
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, Brazil
| | - Andressa Vilas Boas Nogueira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, Brazil.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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14
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Vaziri F, Bahrololoomi Z, Savabieh Z, Sezavar K. The relationship between children's body mass index and periodontal status. J Indian Soc Periodontol 2022; 26:64-68. [PMID: 35136319 PMCID: PMC8796783 DOI: 10.4103/jisp.jisp_899_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/26/2021] [Accepted: 07/11/2021] [Indexed: 11/04/2022] Open
Abstract
Background Childhood obesity is a serious medical condition that affects children and adolescents. Being overweight and obese are important risk factors for various adult diseases including diabetes, cardiovascular, and cerebrovascular disease, hypertension, and periodontal diseases. This study aimed to compare the periodontal findings in obese children with those exhibiting normal body mass. Materials and Methods In the present retrospective cohort study, 108 children, 12 years of age, were randomly assigned to the two groups with equal gender distribution, selected from the schools in Yazd, Iran: obese (body mass index [BMI] ≥25) and nonobese (BMI <25). After obtaining informed consent forms from their parents, each participant's demographic data and BMI were recorded, and periodontal indices were determined including plaque index (PI), bleeding on probing (BOP), pocket depth (PD), and clinical attachment loss (CAL). Then, a questionnaire on dietary and oral hygiene habits was completed by the participants. The data were collected and analyzed with a Chi-square test and t-test. Results The results showed statistically significantly higher mean PI, BOP, and PD in obese participants than nonobese participants (P < 0.05), with no statistically significant difference in CAL between the two groups (P > 0.05). Conclusions The periodontal indices of PI, BOP, and PD in obese children were significantly higher than in children with a normal weight. However, there was no statistically significant difference in CAL between the two groups.
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Affiliation(s)
- Farzane Vaziri
- Department of Periodontology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Bahrololoomi
- Social Determinants of Oral Health Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Savabieh
- Pediatric Dentistry, Social Determinants of Oral Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kimiya Sezavar
- Department of Periodontology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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15
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Effects of Obesity on Bone Healing in Rats. Int J Mol Sci 2021; 22:ijms222413339. [PMID: 34948136 PMCID: PMC8704371 DOI: 10.3390/ijms222413339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
Although the association between periodontitis and obesity is well explored, it is unclear whether obesity is associated with a worse therapeutic outcome after periodontal treatment. The aim of this study was to investigate the effects of obesity on bone healing with and without the application of regeneration-promoting molecules. A standardized bone fenestration-type defect was created over the root of the mandibular first molar in 15 Wistar rats. Ten animals received a high-fat, high-sucrose diet (HFSD), while the remaining five animals were fed a standard diet. During surgery, the fenestration defects from half of the HFSD-fed, i.e., obese animals, were treated with regeneration-promoting molecules (enamel matrix derivative; EMD). After four weeks, bone healing was evaluated by histomorphometry, TRAP staining and immunohistochemistry for RUNX2 and osteopontin. The analyses revealed that the spontaneous healing of the periodontal defects was compromised by obesity. Application of EMD partially compensated for the negative effect of obesity. Nevertheless, EMD-stimulated bone healing in obese animals was not better than the spontaneous healing in the obesity-free control group, indicating that obesity may also inhibit the stimulatory effects of regeneration-promoting molecules. Our results show that obesity can negatively influence bone healing and suggest that bone healing may be compromised in humans.
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16
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Kuraji R, Sekino S, Kapila Y, Numabe Y. Periodontal disease-related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral-liver axis. Periodontol 2000 2021; 87:204-240. [PMID: 34463983 PMCID: PMC8456799 DOI: 10.1111/prd.12387] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Periodontal disease, a chronic inflammatory disease of the periodontal tissues, is not only a major cause of tooth loss, but it is also known to exacerbate/be associated with various metabolic disorders, such as obesity, diabetes, dyslipidemia, and cardiovascular disease. Recently, growing evidence has suggested that periodontal disease has adverse effects on the pathophysiology of liver disease. In particular, nonalcoholic fatty liver disease, a hepatic manifestation of metabolic syndrome, has been associated with periodontal disease. Nonalcoholic fatty liver disease is characterized by hepatic fat deposition in the absence of a habitual drinking history, viral infections, or autoimmune diseases. A subset of nonalcoholic fatty liver diseases can develop into more severe and progressive forms, namely nonalcoholic steatohepatitis. The latter can lead to cirrhosis and hepatocellular carcinoma, which are end‐stage liver diseases. Extensive research has provided plausible mechanisms to explain how periodontal disease can negatively affect nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, namely via hematogenous or enteral routes. During periodontitis, the liver is under constant exposure to various pathogenic factors that diffuse systemically from the oral cavity, such as bacteria and their by‐products, inflammatory cytokines, and reactive oxygen species, and these can be involved in disease promotion of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Also, gut microbiome dysbiosis induced by enteral translocation of periodontopathic bacteria may impair gut wall barrier function and promote the transfer of hepatotoxins and enterobacteria to the liver through the enterohepatic circulation. Moreover, in a population with metabolic syndrome, the interaction between periodontitis and systemic conditions related to insulin resistance further strengthens the association with nonalcoholic fatty liver disease. However, most of the pathologic links between periodontitis and nonalcoholic fatty liver disease in humans are provided by epidemiologic observational studies, with the causal relationship not yet being established. Several systematic and meta‐analysis studies also show conflicting results. In addition, the effect of periodontal treatment on nonalcoholic fatty liver disease has hardly been studied. Despite these limitations, the global burden of periodontal disease combined with the recent nonalcoholic fatty liver disease epidemic has important clinical and public health implications. Emerging evidence suggests an association between periodontal disease and liver diseases, and thus we propose the term periodontal disease–related nonalcoholic fatty liver disease or periodontal disease–related nonalcoholic steatohepatitis. Continued efforts in this area will pave the way for new diagnostic and therapeutic approaches based on a periodontologic viewpoint to address this life‐threatening liver disease.
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Affiliation(s)
- Ryutaro Kuraji
- Department of Life Science Dentistry, The Nippon Dental University, Tokyo, Japan.,Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan.,Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Satoshi Sekino
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Yvonne Kapila
- Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
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17
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Yao S, Jiang C, Zhang H, Gao X, Guo Y, Cao Z. Visfatin regulates Pg LPS-induced proinflammatory/prodegradative effects in healthy and inflammatory periodontal cells partially via NF-κB pathway. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2021; 1868:119042. [PMID: 33901513 DOI: 10.1016/j.bbamcr.2021.119042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 12/17/2022]
Abstract
Periodontitis is a widespread chronic infectious-inflammatory disease associated with multiple systemic diseases. Visfatin is an adipokine-enzyme that can be locally produced by human periodontal ligament cells (hPDLCs) and human gingival fibroblasts (hGFs). It can upregulate proinflammatory cytokines and matrix metalloproteinases (MMPs) in various types of cells. However, the effects of visfatin on healthy and inflammatory human periodontal cells as well as the underlying molecular mechanisms remain unclear. This study firstly demonstrated visfatin expression was highly elevated in inflamed human gingiva and Pg LPS-treated hPDLCs. Moreover, recombinant visfatin significantly upregulated the expression of proinflammatory cytokines (TNF-α, IL-1β and IL-6) and prodegradative factors (EMPPRIN, MMP1, MMP3 and MMP13) in hPDLCs. Next, we found the levels of proinflammatory and prodegradative cytokines were significantly increased in visfatin-overexpressing hPDLCs, and decreased in visfatin-silencing inflammatory hGFs (iGFs) when treated with Pg LPS. In the absence of Pg LPS, visfatin silencing failed to affect the expression of these factors in iGFs, and overexpression of visfatin upregulated MMPs but no other factors in hPDLCs. Furthermore, marked NF-κB pathway activation with increased phosphorylation of p65 was observed in visfatin-overexpressing hPDLCs. BAY11-7082, a specific inhibitor of NF-κB, partially reversed the upregulation proinflammatory and prodegradative factors induced by visfatin overexpression. Taken together, this study showed that visfatin critically regulates Pg LPS-induced proinflammatory/prodegradative effects in healthy and inflammatory periodontal cells partially via NF-κB pathway. The findings suggest that visfatin is closely involved in the development of periodontitis, and may serve as a promising novel biomarker and therapeutic target for periodontitis management.
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Affiliation(s)
- Siqi Yao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chenxi Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Huihui Zhang
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xudong Gao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yi Guo
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhengguo Cao
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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18
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Adiponectin inhibits lipoplysaccharide-induced inflammation and promotes osteogenesis in hPDLCs. Biosci Rep 2021; 41:227897. [PMID: 33616153 PMCID: PMC7926180 DOI: 10.1042/bsr20192668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/21/2020] [Accepted: 02/16/2021] [Indexed: 11/17/2022] Open
Abstract
Periodontal diseases are infections of the structures that surround and support the teeth; they are characterized by local inflammation and alveolar bone loss. Most treatments focus on only one aspect, inhibiting inflammation, or promoting osteoblasts. We set out to develop a new method that would intervene in the two aspects simultaneously. Adiponectin (APN), secreted by adipocytes, inhibits the inflammatory response and promotes osteogenesis. However, its role in human periodontal ligament cells (hPDLCs) is unclear. Therefore, we aim to investigate whether APN could suppress lipopolysaccharide (LPS)-induced inflammation and promote osteogenesis in hPDLCs. In the present study, we stimulated hPDLCs with LPS in the presence or absence of APN. Real-time PCR and Western blotting results demonstrated that APN partially inhibited the activation of the classical nuclear factor κ-B (NF-κB) pathway. These results were confirmed by a change of expressions of NF-κB downstream inflammatory genes, such as decreased cyclooxygenase (COX)-2 and tumor necrosis factor α (TNF-α), along with increased interleukin (IL)-10. As for the role of APN in osteogenesis, Alizarin Red S staining showed that APN treatment induced more calcium deposition nodules than controls. We also found that APN enhanced the expression of osteoblast-related genes (osteopontin (OPN), collagen 1, osteocalcin, alkaline phosphatase, runt-related transcription factor 2 (RUNX2), and bone morphogenetic protein 2) in hPDLCs via the APPL1 (the adaptor protein containing PH domain, PTB domain, and leucine zipper motif 1)/p38 signal transduction pathway. Therefore, APN inhibits LPS-induced inflammation and promotes osteogenesis in hPDLCs and may have potential therapeutic value in treating periodontitis by inhibiting the inflammatory lesions and contributing to bone tissue regeneration.
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19
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Wang Z, Chen Z, Fang F, Qiu W. The role of adiponectin in periodontitis: Current state and future prospects. Biomed Pharmacother 2021; 137:111358. [PMID: 33561644 DOI: 10.1016/j.biopha.2021.111358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/10/2021] [Accepted: 01/31/2021] [Indexed: 12/14/2022] Open
Abstract
Adiponectin (APN), which is an adipokine primarily secreted by adipose tissue into the peripheral blood, exerts anti-inflammatory and metabolic regulatory functions in many systemic inflammatory diseases. Periodontitis is a localized inflammatory disease and is also the sixth-leading complication of diabetes. Uncontrolled periodontal inflammation gradually destructs the periodontal supporting apparatus and leads to the consequent loss of teeth. Recently, emerging evidence has revealed an association between APN and periodontitis. Herein, we summarize the basic information of APN and its receptor agonists. We also overview current studies considering the role of APN in periodontitis and discuss the potential mechanisms in terms of inflammation and bone metabolism. At last, we outline the correlation between APN and systemic diseases related periodontitis. Above all, APN and its agonists are promising candidates for the treatment of periodontitis, while the underlying mechanisms and clinical translational application require further exploration.
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Affiliation(s)
- Zhaodan Wang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou 510515, PR China
| | - Zehao Chen
- Department of Stomatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou 510515, PR China
| | - Fuchun Fang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou 510515, PR China.
| | - Wei Qiu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou 510515, PR China.
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20
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Marcantonio CC, Nogueira AVB, Leguizamón NDP, de Molon RS, Lopes MES, Silva RCL, Cerri PS, Deschner J, Cirelli JA. Effects of obesity on periodontal tissue remodeling during orthodontic movement. Am J Orthod Dentofacial Orthop 2021; 159:480-490. [PMID: 33563505 DOI: 10.1016/j.ajodo.2019.12.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 11/01/2019] [Accepted: 12/01/2019] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Orthodontic movement triggers a sequence of cellular and molecular events that may be affected by different systemic conditions. This study evaluated the effect of obesity on rat periodontal tissue remodeling induced by mechanical orthodontic force. METHODS Thirty-two Holtzman rats were distributed into 4 groups: control, obesity induction (O), orthodontic movement (M), and obesity induction and orthodontic movement (OM). Obesity was induced by a high-fat diet for 90 days. After 15 days of orthodontic movement, the animals were killed. Obesity induction was confirmed by animal body weight, adipose tissue weight, and serologic analysis. Periodontal tissue remodeling was evaluated using microcomputed tomography and histologic analysis. The gene expression of adipokines and cytokines in gingival tissues was evaluated. RESULTS An increase in body and adipose tissue weight was observed in the obesity induction groups. The O group presented an increase in lipids and blood glucose. The OM group showed a decrease in bone volume fraction and bone mineral density compared with all other groups and a tendency for more rapid tooth movement than the M group. The OM group showed a higher quantity of inflammatory cells and higher Mmp1 expression than the O group. The O and OM groups showed higher Nampt expression than the control group and lower Nampt expression than the M group. CONCLUSIONS Obesity modulates periodontal tissue remodeling during orthodontic movement and results in more inflammation and bone loss than in nonobese animals.
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Affiliation(s)
- Camila Chierici Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Andressa Vilas Boas Nogueira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Rhineland-Palatinate, Germany
| | - Natalia Da Ponte Leguizamón
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Maria Eduarda Scordamaia Lopes
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Renata Cristina Lima Silva
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Paulo Sergio Cerri
- Department of Morphology, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Rhineland-Palatinate, Germany
| | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil.
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21
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Filifactor alocis and Tumor Necrosis Factor-Alpha Stimulate Synthesis of Visfatin by Human Macrophages. Int J Mol Sci 2021; 22:ijms22031235. [PMID: 33513808 PMCID: PMC7865436 DOI: 10.3390/ijms22031235] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 12/18/2022] Open
Abstract
There is little known about the effect of the periodontopathogen Filifactor alocis on macrophages as key cells of the innate immune defense in the periodontium. Therefore, the aim of the present study was to investigate the effect of F. alocis and additionally of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNFα) on visfatin and other pro-inflammatory and proteolytic molecules associated with periodontitis in human macrophages. The presence of macrophage markers CD14, CD86, CD68, and CD163 was examined in gingival biopsies from healthy individuals and periodontitis patients. Human macrophages were incubated with F. alocis and TNFα for up to 2 d. The effects of both stimulants on macrophages were determined by real-time PCR, ELISA, immunocytochemistry, and immunofluorescence. F. alocis was able to significantly stimulate the synthesis of visfatin by human macrophages using TLR2 and MAPK pathways. In addition to visfatin, F. alocis was also able to increase the synthesis of cyclooxygenase 2, TNFα, and matrix metalloproteinase 1. Like F. alocis, TNFα was also able to stimulate the production of these proinflammatory and proteolytic molecules. Our results highlight the pathogenetic role of F. alocis in periodontal diseases and also underline the involvement of visfatin in the aetiopathogenesis of periodontitis.
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Paul R, Suresh S, Sudhakar U, Jean C, Fernandez KJ. Evaluation of association between Porphyromonas gingivalis and visfatin levels in chronic periodontitis patients. J Indian Soc Periodontol 2021; 24:530-534. [PMID: 33424169 PMCID: PMC7781248 DOI: 10.4103/jisp.jisp_641_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Periodontal disease is one of the most common prevailing diseases, where the destruction occurs due to the direct effect of microorganisms and indirectly by the stimulation of host cells. The diverse inflammatory action of visfatin made this adipokine a potential periodontal biomarker of choice along with the periopathogen Porphyromonas gingivalis. Aim: Our study was carried out to evaluate the visfatin levels in gingival crevicular fluid (GCF) and P. gingivalis levels in subgingival plaque in periodontal health and disease. Materials and Methods: A total of 60 participants were divided into two groups of thirty participants each as Group I – patients who have healthy periodontium and Group II – patients with generalized chronic periodontitis. The clinical parameters assessed for the participants were plaque index, probing pocket depth, papillary bleeding index, and clinical attachment loss. The subgingival plaque samples were obtained to estimate P. gingivalis levels and GCF was collected to check visfatin levels. Results: The clinical parameters, P. gingivalis, and GCF visfatin levels between the two groups showed a notable significant difference. A significant positive correlation was noted on the correlation of GCF visfatin levels with clinical parameters. Conclusion: Our study outcomes propose that P. gingivalis can be the bonafide periopathogen which modulate the visfatin levels in individuals with periodontal disease and GCF visfatin can also be evaluated as a biomarker in periodontal disease.
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Affiliation(s)
- Roshini Paul
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
| | - Snophia Suresh
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
| | - Uma Sudhakar
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
| | - Catherine Jean
- Department of Periodontics, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
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23
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Isler SC, Soysal F, Ozcan E, Saygun NI, Unsal FB, Baris E, Ilikci R. Evaluation of adipokines and inflammatory mediator expression levels in patients with periodontitis and peri-implantitis: a cross-sectional study. Clin Oral Investig 2020; 25:3555-3565. [PMID: 33184718 DOI: 10.1007/s00784-020-03678-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the mRNA and protein expression of adiponectin, leptin, visfatin, tumor necrosis factor (TNF)-α, and interleukin (IL)-6 levels in periodontitis and peri-implantitis sites in systemically healthy individuals and to investigate the influence of the presence of current periodontitis on their expression levels in peri-implantitis sites. MATERIALS AND METHODS Soft tissue biopsy samples were collected from 60 systemically healthy patients [15 periodontally healthy patients (group I), 16 patients with periodontitis (group II), 15 patients with peri-implantitis (group III), and 14 patients with peri-implantitis and periodontitis (group IV)]; mRNA expression levels of adiponectin, leptin, visfatin, TNF-α, and IL-6 were measured by quantitative real-time PCR; and their protein levels were assessed by immunohistochemistry. RESULTS The mRNA expression levels of all biomarkers were significantly higher for group II compared to group I, while significantly higher levels of leptin, TNF-α, and IL-6 were observed in group III in comparison with group I. Group II exhibited significantly higher mRNA expression of adiponectin and TNF-α than group III. Group IV showed significantly higher expression levels of adiponectin, leptin, TNF-α, and IL-6 compared to group III. Regarding the expression of protein levels, which was estimated through quantification of the histoscore, both groups II and III presented higher H-scores than group I for all biomarkers except leptin. CONCLUSIONS The presence of current periodontitis may enhance expression levels of adiponectin, leptin, TNF-α, and IL-6 in peri-implant soft tissue. CLINICAL RELEVANCE The presence of periodontitis is an important risk factor for the severity of peri-implant inflammation as well as the onset of peri-implantitis.
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Affiliation(s)
- Sila Cagri Isler
- Department of Periodontology, Faculty of Dentistry, Gazi University, Biskek caddesi 1.sokak 06500 Emek, Ankara, Turkey.
| | - Fatma Soysal
- Department of Periodontology, Faculty of Dentistry, Gazi University, Biskek caddesi 1.sokak 06500 Emek, Ankara, Turkey
| | - Erkan Ozcan
- Department of Periodontology, Gulhane Faculty of Dental Medicine, Health Sciences University, Ankara, Turkey
| | - N Isıl Saygun
- Department of Periodontology, Gulhane Faculty of Dental Medicine, Health Sciences University, Ankara, Turkey
| | - F Berrin Unsal
- Department of Periodontology, Faculty of Dentistry, Gazi University, Biskek caddesi 1.sokak 06500 Emek, Ankara, Turkey
| | - Emre Baris
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Rahsan Ilikci
- Department of Medical Biology, School of Medicine, Usak University, Usak, Turkey
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24
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Jepsen S, Suvan J, Deschner J. The association of periodontal diseases with metabolic syndrome and obesity. Periodontol 2000 2020; 83:125-153. [PMID: 32385882 DOI: 10.1111/prd.12326] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Periodontitis is a multifactorial chronic inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth-supporting apparatus. Globally, it is estimated that 740 million people are affected by its severe form. Periodontitis has been suggested to be linked to obesity and metabolic syndrome. Obesity, defined as excessive fat accumulation, is a complex multifactorial chronic inflammatory disease, with a high and increasing prevalence. Metabolic syndrome is defined as a cluster of obesity, dyslipidemia, hypertension, and dysglycemia. Obesity, metabolic syndrome and periodontitis are among the most common non-communicable diseases and a large body of evidence from epidemiologic studies supports the association between these conditions. Extensive research has established plausible mechanisms to explain how these conditions can negatively impact each other, pointing to a bidirectional adverse relationship. At present there is only limited evidence available from a few intervention studies. Nevertheless, the global burden of periodontitis combined with the obesity epidemic has important clinical and public health implications for the dental team. In accordance with the common risk factor approach for tackling non-communicable diseases, it has been proposed that oral healthcare professionals have an important role in the promotion of periodontal health and general well-being through facilitation of healthy lifestyle behaviours.
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Affiliation(s)
- Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Jean Suvan
- Department of Periodontology, UCL Eastman Dental Institute, London, UK
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University of Mainz, Mainz, Germany
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Borilova Linhartova P, Janos J, Poskerova H, Kavrikova D, Fassmann A, Dusek L, Izakovicova Holla L. Adipokine gene variability and plasma levels in patients with chronic periodontitis -a case-control study. Braz Oral Res 2019; 33:e034. [PMID: 31038568 DOI: 10.1590/1807-3107bor-2019.vol33.0034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 03/19/2019] [Indexed: 11/22/2022] Open
Abstract
Specific variants in genes that encode adipokines and their mRNA and protein expression were previously studied in type 2 diabetes mellitus (T2DM) and obesity, and similar studies have been performed for chronic periodontitis (CP). The aim of this case-control study was to investigate the possible impacts of adiponectin (ADIPOQ), leptin (LEP) and its receptor (LEPR), and resistin (RETN) on the etiopathogenesis of CP. Examinations were performed on 118 non-periodontitis healthy subjects (healthy controls, HC), 205 healthy individuals with CP (H + CP) and 86 type 2 diabetes patients with CP (T2DM + CP). Variants within the ADIPOQ (rs2241766, rs1501299), LEP (rs13228377, rs2167270), LEP receptor (rs1805096), and RETN (rs1862513) genes were determined by qPCR. In addition, the plasma levels of ADIPOQ, LEP, and RETN were analysed by ELISA for 80 individuals. The genotype frequencies of the SNP ADIPOQ +45G/T (rs2241766) differed between the HC and H + CP groups (p=0.03, pcorr>0.05), and carriers of the TT genotype had a lower risk of developing CP compared to carriers of the GG or TG genotypes (p<0.01, pcorr>0.05). However, there were no significant differences in the plasma levels of ADIPOQ, LEP or RETN between the study groups (p > 0.05). Plasma levels of the adipokines were also independent of the gene profiles (p > 0.05). Adipokine plasma levels did not change in patients with H + CP/T2DM + CP compared to HC, but we did identify a specific polymorphism in the ADIPOQ gene that was associated with CP. Although the ADIPOQ +45G/T (rs2241766) gene variant may be a candidate biomarker for CP, further research is required in larger populations with different ethnic backgrounds before any final conclusions can be drawn about the role of this gene in CP.
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Affiliation(s)
| | - Julius Janos
- Masaryk University, Faculty of Medicine, Clinic of Stomatology, Brno, Czech Republic
| | - Hana Poskerova
- Masaryk University, Faculty of Medicine, Clinic of Stomatology, Brno, Czech Republic
| | - Denisa Kavrikova
- Masaryk University, Faculty of Medicine, Clinic of Stomatology, Brno, Czech Republic
| | - Antonin Fassmann
- Masaryk University, Faculty of Medicine, Clinic of Stomatology, Brno, Czech Republic
| | - Ladislav Dusek
- Masaryk University, Institute of Biostatistics and Analyses, Brno, Czech Republic
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26
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Memmert S, Damanaki A, Nokhbehsaim M, Nogueira AVB, Eick S, Cirelli JA, Jäger A, Deschner J. Regulation of somatostatin receptor 2 by proinflammatory, microbial and obesity-related signals in periodontal cells and tissues. Head Face Med 2019; 15:2. [PMID: 30609928 PMCID: PMC6319011 DOI: 10.1186/s13005-018-0185-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 12/04/2018] [Indexed: 12/18/2022] Open
Abstract
Background Periodontitis is a chronic disease characterized by a progressive and irreversible destruction of the tooth-supporting tissues, including gingiva and periodontal ligament (PDL). Microorganisms, such as Fusobacterium nucleatum, evoke an inflammatory host response, which leads to increased levels of inflammatory mediators, such as interleukin (IL)-1β. Periodontitis has been linked to obesity, and adipokines have been suggested to represent a pathomechanistic link. The hormone somatostatin (SST) exerts antiproliferative, antiangiogenetic, proapoptotic, anti-nociceptive and other effects through binding to its receptors, such as SSTR2. Therefore, the objective of the present study was to examine the regulation of SSTR2 in periodontal cells and tissues under inflammatory, microbial and obesity-related conditions. Methods In-vitro, human PDL fibroblasts were exposed to IL-1β, F. nucleatum, leptin or visfatin. The SSTR2 regulation was assessed by real-time PCR and immunocytochemistry. In-vivo, the SSTR2 expression was analyzed in gingival biopsies of periodontally diseased and healthy subjects by real-time PCR and immunohistochemistry. Additionally, the SSTR2 expression was determined in gingival biopsies of rats with ligature-induced periodontitis, rats with diet-induced obesity, and periodontally and systemically healthy control animals. For statistical analyses, the Mann-Whitney-U test and ANOVA with post-hoc tests were applied (p < 0.05). Results Exposure of PDL cells to IL-1β and F. nucleatum caused a significant SSTR2 upregulation by 2.6-fold and 6.4-fold, respectively. Additionally, leptin and visfatin increased significantly the SSTR2 gene expression by 3.0-fold and 2.8-fold, respectively. These stimulatory effects were also observed at protein level. SSTR2 expressions in human gingival biopsies from sites of periodontitis were significantly higher than those in healthy biopsies. Similarly, SSTR2 expression levels were significantly enhanced at periodontally-diseased sites in rat experimental periodontitis. Finally, the SSTR2 expression was significantly upregulated in gingival biopsies of obese rats as compared to normal weight control animals. Conclusions Our study provides original insights into the SSTR2 regulation in cells and tissues of the periodontium. We demonstrate for the first time that proinflammatory, microbial and obesity-associated molecules result in an SSTR2 upregulation. Since SST has been shown to be antiproliferative, antiangiogenetic, and proapoptotic, our study suggests that SSTR2 might play a critical role in the aetiopathogenesis of periodontitis.
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Affiliation(s)
- Svenja Memmert
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstr, 17 53111, Bonn, Germany. .,Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany.
| | - Anna Damanaki
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Marjan Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Andressa V B Nogueira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University, UNESP, Araraquara, Brazil
| | - Sigrun Eick
- Department of Periodontology, Laboratory for Oral Microbiology, zmk bern, Zahnmedizinische Kliniken, Bern, Switzerland
| | - Joni A Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University, UNESP, Araraquara, Brazil
| | - Andreas Jäger
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstr, 17 53111, Bonn, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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27
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Dziedzic DSM, Mogharbel BF, Ferreira PE, Irioda AC, de Carvalho KAT. Transplantation of Adipose-derived Cells for Periodontal Regeneration: A Systematic Review. Curr Stem Cell Res Ther 2019; 14:504-518. [PMID: 30394216 DOI: 10.2174/1574888x13666181105144430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/22/2018] [Accepted: 10/29/2018] [Indexed: 12/22/2022]
Abstract
This systematic review evaluated the transplantation of cells derived from adipose tissue for applications in dentistry. SCOPUS, PUBMED and LILACS databases were searched for in vitro studies and pre-clinical animal model studies using the keywords "ADIPOSE", "CELLS", and "PERIODONTAL", with the Boolean operator "AND". A total of 160 titles and abstracts were identified, and 29 publications met the inclusion criteria, 14 in vitro and 15 in vivo studies. In vitro studies demonstrated that adipose- derived cells stimulate neovascularization, have osteogenic and odontogenic potential; besides adhesion, proliferation and differentiation on probable cell carriers. Preclinical studies described improvement of bone and periodontal healing with the association of adipose-derived cells and the carrier materials tested: Platelet Rich Plasma, Fibrin, Collagen and Synthetic polymer. There is evidence from the current in vitro and in vivo data indicating that adipose-derived cells may contribute to bone and periodontal regeneration. The small quantity of studies and the large variation on study designs, from animal models, cell sources and defect morphology, did not favor a meta-analysis. Additional studies need to be conducted to investigate the regeneration variability and the mechanisms of cell participation in the processes. An overview of animal models, cell sources, and scaffolds, as well as new perspectives are provided for future bone and periodontal regeneration study designs.
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Affiliation(s)
- Dilcele Silva Moreira Dziedzic
- Pele Pequeno Principe Institute for Child and Adolescent Health Research, Pequeno Principe Faculty, Curitiba, Brazil
- Dentistry Faculty, Universidade Positivo, Curitiba, Brazil
| | - Bassam Felipe Mogharbel
- Pele Pequeno Principe Institute for Child and Adolescent Health Research, Pequeno Principe Faculty, Curitiba, Brazil
| | - Priscila Elias Ferreira
- Pele Pequeno Principe Institute for Child and Adolescent Health Research, Pequeno Principe Faculty, Curitiba, Brazil
| | - Ana Carolina Irioda
- Pele Pequeno Principe Institute for Child and Adolescent Health Research, Pequeno Principe Faculty, Curitiba, Brazil
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28
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Regulation of tyrosine hydroxylase in periodontal fibroblasts and tissues by obesity-associated stimuli. Cell Tissue Res 2018; 375:619-628. [PMID: 30361782 DOI: 10.1007/s00441-018-2941-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/04/2018] [Indexed: 12/20/2022]
Abstract
Tyrosine hydroxylase (TH) catalyzes the rate-limiting step in the synthesis of catecholamines and has been connected to aggravated progression of periodontal disease under chronic stress. Obesity is known to increase the risk of periodontitis and adipokines have been suggested to be a pathomechanistic link. This study examines if obesity-associated stimuli have regulatory effects on TH levels in periodontal cells and tissues. Human periodontal ligament fibroblasts were cultured in the presence of leptin or visfatin for up to 2 days. Untreated cells served as control. TH regulation was analyzed by real-time PCR, immunocytochemistry and ELISA. TH gene expression in periodontal tissues of normal-weight and obese rodents was determined. Examination of gingival biopsies from rats and patients with and without periodontal disease was performed by real-time PCR or immunohistochemistry. For statistics, ANOVA and post hoc tests were applied (p < 0.05). In vitro, TH gene expression and protein levels were increased by leptin and visfatin. In vivo, TH gene expression was upregulated in periodontal tissues of obese rodents as compared to normal-weight animals. Additionally, increased TH gene expression was found in rat gingival biopsies with experimental periodontitis. Human gingival biopsies from sites of periodontitis confirmed the animal data by demonstrating elevated TH levels at periodontally diseased sites. This study provides original evidence that obesity-associated stimuli induce a TH upregulation in periodontal cells and tissues. Since TH levels were also increased at periodontitis sites, our in vitro and animal findings suggest that this enzyme could represent a pathomechanism whereby obesity contributes to periodontitis.
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29
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Araújo IMP, Albuquerque-Souza E, Aguiar-Oliveira MH, Holzhausen M, Oliveira-Neto LA, Salvatori R, Saraiva L, Mayer MPA, Pannuti CM, Ribeiro AO, Romito GA, Pustiglioni FE. Immunological and microbiological periodontal profiles in isolated growth hormone deficiency. J Periodontol 2018; 89:1351-1361. [PMID: 29797719 DOI: 10.1002/jper.17-0687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/09/2018] [Accepted: 04/29/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Growth hormone (GH) has been identified as an important regulator of the immune response. We have previously shown that adults with isolated GH deficiency (IGHD) due to a mutation in the GH releasing hormone receptor (GHRHR) gene, have a greater chance of having periodontitis. However, the interaction of GH with periodontal tissues is still unknown, and this population has emerged as a unique model to investigate this issue. Therefore, we evaluated the microbiological and immunological periodontal profiles of such individuals. METHODS Nineteen IGHD and 19 controls matched by age, sex, diabetes, and smoking status, were enrolled in this case-control study. Periodontal clinical parameters (probing depth [PD] and clinical attachment loss [AL]) were measured at six sites per tooth. Immune mediators (C-reactive protein, matrix metalloproteinase [MMP]-8, MMP-9, interleukin [IL]-1α, IL-6, IL-8, tumor necrosis factor [TNF]-α, adiponectin, and leptin) were analyzed by enzyme-linked immunosorbent assay (ELISA) in the gingival crevicular fluid (GCF) in four non-adjacent sites for each participant (two with PD ≤3 mm [shallow sites] and two with PD ≥7 mm or the worst PD found in the mouth [deep sites]). Bacterial quantification (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) of subgingival biofilm samples collected from these same sites was performed by quantitative real-time polymerase chain reaction (qPCR). RESULTS IGHD individuals presented higher values of PD and AL, and increased levels of CRP, IL-8, MMP-8, and adiponectin in the GCF. Bacterial quantification did not identify differences between the two groups. CONCLUSION IGHD alters the local immune response in periodontal pockets leading to greater attachment loss, and GH stands out as an important hormone to be evaluated in the pathogenesis of periodontitis.
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Affiliation(s)
- I M P Araújo
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - E Albuquerque-Souza
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - M H Aguiar-Oliveira
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, SE, Brazil
| | - M Holzhausen
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - L A Oliveira-Neto
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, SE, Brazil
| | - R Salvatori
- Division of Endocrinology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - L Saraiva
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - M P A Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
| | - C M Pannuti
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - A O Ribeiro
- Federal University of Sergipe, Division of Immunology and Molecular Biology Laboratory, SE, Brazil
| | - G A Romito
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - F E Pustiglioni
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
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30
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Damanaki A, Nokhbehsaim M, Hiththetiya K, Memmert S, Gao J, Nguyen KA, Götz W, Jäger A, Wahl G, Deschner J. Characterization of a diet-induced obesity rat model for periodontal research. Clin Oral Investig 2018; 23:937-946. [PMID: 29907930 DOI: 10.1007/s00784-018-2514-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 06/04/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Obesity is associated with periodontitis, but the mechanisms underlying this association have yet to be unraveled. The present investigation was to evaluate a common rat model, in which obesity is induced by high-fat, high-sucrose diet (HFSD), for its applicability in periodontal research. MATERIALS AND METHODS Ten male Wistar rats were fed a 3-month HFSD along with a matching control group. Afterwards, the body weight, adipocyte morphology, leptin and adiponectin levels in adipose tissue, gingiva, and serum as well as the serum levels of triglyceride, cholesterol, and glucose were analyzed. For statistical analyses, parametric and non-parametric tests were applied (p < 0.05). RESULTS Body weight was significantly higher in the HFSD group after dieting as compared to control. HFSD caused a significant increase in serum triglyceride, low-density lipoprotein cholesterol, and leptin levels and a significant decrease in high-density lipoprotein cholesterol. Furthermore, adipose tissue from HFSD rats exhibited significantly larger adipocytes, displayed a significant upregulation of leptin and, surprisingly, elevated adiponectin levels, which is in contrast to chronic obesity in humans. Although leptin and adiponectin were also observed in gingival biopsies, no obvious differences between the groups were found. CONCLUSIONS Although this rat diet-induced obesity model is characterized by changes typical of obesity, it also has limitations, which have to be considered when data, especially with regard to adipokines, are extrapolated to humans. CLINICAL RELEVANCE The rodent diet-induced obesity model may be useful for unraveling pathomechanisms underlying the association between obesity and periodontal destruction but conclusions have to be drawn with caution.
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Affiliation(s)
- Anna Damanaki
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | - Marjan Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
| | | | - Svenja Memmert
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Jinlong Gao
- Westmead Institute for Medical Research and Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Ky-Anh Nguyen
- Westmead Institute for Medical Research and Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Werner Götz
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Andreas Jäger
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - Gerhard Wahl
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - James Deschner
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany.
- Noel Martin Visiting Chair, Faculty of Dentistry, University of Sydney, Sydney, Australia.
- Department of Periodontology and Operative Dentistry, University Medical Center, Johannes Gutenberg University, Augustusplatz 2, 55131, Mainz, Australia.
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Damanaki A, Memmert S, Nokhbehsaim M, Sanyal A, Gnad T, Pfeifer A, Deschner J. Impact of obesity and aging on crestal alveolar bone height in mice. Ann Anat 2018; 218:227-235. [PMID: 29730468 DOI: 10.1016/j.aanat.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/27/2018] [Accepted: 04/12/2018] [Indexed: 12/20/2022]
Abstract
Obesity and aging are associated with periodontitis, which represents a chronic inflammatory disease of the tooth-supporting tissues, i.e. the periodontium. However, if both risk factors also have a negative impact on crestal alveolar bone in a clinically healthy periodontium, has yet to be elucidated and was analyzed in this in-vivo study. Eight C57BL/6 mice were fed a normal diet during the entire study. Half of these mice were sacrificed at week 19 (group 1: younger lean mice), whereas the other half of the animals were sacrificed at week 25 (group 2: older lean mice). In addition, four mice were fed a high-fat diet until their sacrifice at week 19 (group 3: younger obese mice). Mandibles and maxillae were scanned by micro-computed tomography and, subsequently, the distance between the cementoenamel junction and alveolar bone crest (CEJ-ABC) at all molars was determined. Levels of interleukin-6, cyclooxygenase-2, visfatin and adiponectin in gingival samples were quantified by real-time PCR. For statistical analyses, the Mann-Whitney-U test was applied (p<0.05). As compared to lean mice, obese animals presented a significantly increased CEJ-ABC distance, i.e. reduced alveolar bone crest height, at week 19. The alveolar bone loss was mainly found at the first molars of the mandibles. In animals fed a normal diet, the alveolar bone crest height in the mandibles and maxillae was significantly lower in the older mice as compared to the younger animals. Furthermore, gingival cyclooxygenase-2 and visfatin expressions were higher in the obese versus lean mice and in the older versus younger mice. This in-vivo investigation shows that obesity and older age can result in reduced alveolar bone crest height and suggests that they represent risk factors even in a clinically healthy periodontium.
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Affiliation(s)
- Anna Damanaki
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Svenja Memmert
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany; Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Marjan Nokhbehsaim
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Abhishek Sanyal
- Institute of Pharmacology and Toxicology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Thorsten Gnad
- Institute of Pharmacology and Toxicology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Alexander Pfeifer
- Institute of Pharmacology and Toxicology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Augustusplatz 2, 55131 Mainz, Germany.
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Boyapati R, Chintalapani S, Ramisetti A, Salavadhi SS, Ramachandran R. Evaluation of Serum Leptin and Adiponectin in Obese Individuals with Chronic Periodontitis. Contemp Clin Dent 2018; 9:S210-S214. [PMID: 30294146 PMCID: PMC6169280 DOI: 10.4103/ccd.ccd_1_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objectives Studies have reported changes in leptin and adiponectin levels in the gingival crevicular fluid, saliva, and blood serum of obese patients with periodontal disease. The aim of the study is to evaluate serum leptin and adiponectin levels in obese and nonobese individuals with chronic periodontitis and to deduce a relationship between the clinical parameters and the inflammatory biochemical parameters. Materials and Methods In this case-control study, a total of fifty individuals were selected based on the body mass index (BMI): Group I of obese individuals with chronic periodontitis and Group II of nonobese individuals with chronic periodontitis. Periodontal parameters used in this study were plaque index, gingival index, probing pocket depth, and clinical attachment level. The effects of obesity and periodontal status on serum leptin and adiponectin levels of both groups were statistically analyzed using an independent t- test. Results Statistical analysis showed that the effect of BMI on serum leptin and adiponectin levels was statistically significant (P < 0.01), and the effect of chronic periodontitis on the serum leptin and adiponectin levels was also statistically significant compared to nonobese individuals (P < 0.0001). However, there is no statistically significant correlation between serum leptin and adiponectin, which indicates that both are independent to each other. Conclusions In obese individuals with chronic periodontitis, serum leptin levels were significantly high compared to nonobese individuals and serum adiponectin levels were significantly lower in obese individuals compared to nonobese individuals with periodontitis, though both the parameters were independent of each other.
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Affiliation(s)
| | | | - Arpita Ramisetti
- Department of Periodontics, Mamata Dental College, Khammam, Telangana, India
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Haugen S, Aasarød KM, Stunes AK, Mosti MP, Franzen T, Vandevska-Radunovic V, Syversen U, Reseland JE. Adiponectin prevents orthodontic tooth movement in rats. Arch Oral Biol 2017; 83:304-311. [DOI: 10.1016/j.archoralbio.2017.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/18/2017] [Accepted: 08/19/2017] [Indexed: 12/15/2022]
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Zuza EP, Garcia VG, Theodoro LH, Ervolino E, Favero LFV, Longo M, Ribeiro FS, Martins AT, Spolidorio LC, Zuanon JAS, de Toledo BEC, Pires JR. Influence of obesity on experimental periodontitis in rats: histopathological, histometric and immunohistochemical study. Clin Oral Investig 2017; 22:1197-1208. [DOI: 10.1007/s00784-017-2207-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/11/2017] [Indexed: 01/03/2023]
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NAMPT enzyme activity regulates catabolic gene expression in gingival fibroblasts during periodontitis. Exp Mol Med 2017; 49:e368. [PMID: 28819322 PMCID: PMC5579510 DOI: 10.1038/emm.2017.116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 12/13/2022] Open
Abstract
Periodontal disease is one of the most prevalent chronic disorders worldwide. It is accompanied by inflammation of the gingiva and destruction of periodontal tissues, leading to alveolar bone loss. Here, we focused on the role of adipokines, which are locally expressed by periodontal tissues, in the regulation of catabolic gene expression leading to periodontal inflammation. The expression of the nicotinamide phosphoribosyltransferase (NAMPT) adipokine was dramatically increased in inflamed human and mouse gingival tissues. NAMPT expression was also increased in lipopolysaccharide- and proinflammatory cytokine-stimulated primary cultured human gingival fibroblasts (GF). Adenovirus-mediated NAMPT (Ad-Nampt) overexpression upregulated the expression and activity of COX-2, MMP1 and MMP3 in human GF. The upregulation of IL-1β- or Ad-Nampt-induced catabolic factors was significantly abrogated by the intracellular NAMPT (iNAMPT) inhibitor, FK866 or by the sirtuin (SIRT) inhibitor, nicotinamide (NIC). Recombinant NAMPT protein or extracellular NAMPT (eNAMPT) inhibition using a blocking antibody did not alter NAMPT target gene expression levels. Moreover, intragingival Ad-Nampt injection mediated periodontitis-like phenotypes including alveolar bone loss in mice. SIRT2, a part of the SIRT family, was positively associated with NAMPT actions in human GF. Furthermore, in vivo inhibition of the NAMPT-NAD+-SIRT axis by NIC injection in mice ameliorated the periodontal inflammation and alveolar bone erosion caused by intragingival injection of Ad-Nampt. Our findings indicate that NAMPT is highly upregulated in human GF, while its enzymatic activity acts as a crucial mediator of periodontal inflammation and alveolar bone destruction via regulation of COX-2, MMP1, and MMP3 levels.
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Zhu J, Guo B, Gan X, Zhang L, He Y, Liu B, Chen X, Zhang S, Yu H. Association of circulating leptin and adiponectin with periodontitis: a systematic review and meta-analysis. BMC Oral Health 2017; 17:104. [PMID: 28662701 PMCID: PMC5492908 DOI: 10.1186/s12903-017-0395-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 06/19/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study aimed to assess the difference in serum levels of leptin and adiponectin in patients with periodontitis and in periodontally healthy individuals and evaluate the changes in circulating leptin and adiponectin after periodontal therapy. Leptin and adiponectin are the most generally studied adipokines that function as inflammatory cytokines. Although the association between periodontitis and serum levels of leptin and adiponectin has been studied extensively, the results were not consistent. METHODS A systematic search of the Pubmed, Embase, Web of Science, and Cochrane Library up to September 2016 was conducted. The studies were screened and selected by two writers according to the specific eligibility criteria. The quality of included cross-sectional studies was assessed using the quality assessment form recommended by the Agency for Healthcare Research and Quality and Methodological Index for Nonrandomized Studies. The meta-analyses were conducted using the STATA 12.0 software. RESULTS A total of 399 manuscripts were yielded and 25 studies were included in the present meta-analysis. Significantly elevated serum levels of leptin and decreased serum levels of adiponectin in patients with periodontitis were observed in the subgroup analysis of body mass index (BMI) <30. The overall and subgroup analyses showed no significant change in the serum levels of leptin in patients with periodontitis after periodontal treatment. The subgroup analysis of systemically healthy patients showed no significant change in serum levels of adiponectin in patients with periodontitis after periodontal treatment. CONCLUSIONS The present meta-analysis supported elevated serum levels of leptin and decreased serum levels of adiponectin in patients with periodontitis compared with controls in the BMI <30 population. In systemically healthy patients with periodontitis, serum levels of leptin and adiponectin do not significantly change after periodontal treatment.
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Affiliation(s)
- Junfei Zhu
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Bin Guo
- Institute of Stomatology of Chinese PLA General Hospital, 28 Fuxing Road,Haidian District, Beijing, 100853 People’s Republic of China
| | - Xueqi Gan
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Ling Zhang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Yuting He
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Beilei Liu
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Xin Chen
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Suhan Zhang
- West China Medical School, Sichuan University, Chengdu, 610041 China
| | - Haiyang Yu
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
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Kim D, Lee G, Huh Y, Lee S, Park K, Kim S, Kim J, Koh J, Ryu J. NAMPT Is an Essential Regulator of RA-Mediated Periodontal Inflammation. J Dent Res 2017; 96:703-711. [DOI: 10.1177/0022034517690389] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Recent studies have indicated a potential correlation between rheumatoid arthritis (RA) and periodontal inflammation. We undertook this study to verify whether RA mediates periodontitis-like phenotypes in experimental mouse models of RA and to explore the role of nicotinamide phosphoribosyltransferase (NAMPT) in periodontal inflammation during RA pathogenesis. Periodontal inflammation and alveolar bone loss have been reported in mice with collagen-induced arthritis (CIA) and in genetically modified tumor necrosis factor–α (TNF-α) transgenic (TG) mouse models. Among the adipokines examined in our study, NAMPT expression was markedly upregulated in the periodontal ligament (PDL) tissues in RA mouse models and in human PDL cells stimulated by the proinflammatory cytokines, interleukin (IL) 1β and TNF-α. When NAMPT was overexpressed with the Nampt-synthesizing adenovirus vector (Ad- Nampt), the PDL cells exhibited an increased expression of cytokines (IL6), chemokines (IL8 and chemokine [C-C motif] ligand 5 [CCL5]), inflammatory mediators (cyclooxygenase 2 [COX-2]), and matrix-degrading enzymes (matrix metalloproteinase [MMP] 1 and MMP3). Inhibition of NAMPT by the intracellular NAMPT (iNAMPT) inhibitor, FK866, or by the sirtuin inhibitor, nicotinamide, in PDL cells led to inhibition of the IL1β or Ad- Nampt–induced upregulation of catabolic factors, whereas treatment with recombinant NAMPT protein or blockade of extracellular NAMPT (eNAMPT) with blocking antibody did not. Moreover, NAMPT inhibition by the intraperitoneal or intragingival injection of FK866 in CIA mice inhibited periodontal tissue damage, under conditions of RA. Thus, our results verified the co-occurrence of RA and periodontal inflammation using experimental mouse models of RA, suggesting that iNAMPT in PDL cells plays a pivotal role in the pathogenesis of RA-mediated periodontal inflammation by regulating the expression levels of catabolic genes, such as IL6, IL8, CCL5, COX-2, MMP1, and MMP3.
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Affiliation(s)
- D. Kim
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
- Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - G. Lee
- Bioimaging and Cell Logistics Research Center, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Y.H. Huh
- Bioimaging and Cell Logistics Research Center, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - S.Y. Lee
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
- Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - K.H. Park
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
- Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - S. Kim
- Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - J. Kim
- Department of Pediatric Dentistry, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - J. Koh
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
- Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - J. Ryu
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
- Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
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Ebersole JL, Kryscio RJ, Campbell C, Kinane DF, McDevitt J, Christodoulides N, Floriano PN, Miller CS. Salivary and serum adiponectin and C-reactive protein levels in acute myocardial infarction related to body mass index and oral health. J Periodontal Res 2016; 52:419-427. [PMID: 27549083 DOI: 10.1111/jre.12406] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Adiponectin is produced by adipose cells and is considered an anti-inflammatory molecule. In contrast, C-reactive protein (CRP) has been identified as a hallmark of systemic inflammation and used as a risk marker of cardiovascular disease (CVD). Of interest was the relationship of these two biomarkers to oral health and CVD risk. MATERIAL AND METHODS This investigation examined these two molecules in serum and unstimulated whole saliva of patients within 48 h of an acute myocardial infarction (AMI) compared to control subjects. We hypothesized a differential response in these biomolecules resulting from the heart attack that would be affected by both the body mass index and oral health characteristics of the individuals. RESULTS Significantly lower adiponectin levels were observed in the serum of patients with AMI. Serum adiponectin in both groups and salivary adiponectin in patients with AMI decreased with increasing body mass index. Oral health was significantly worse in patients with AMI, and both serum and salivary adiponectin were elevated with better oral health in control subjects. Serum CRP levels were increased in patients with AMI regardless of their oral health, and both serum and salivary CRP were significantly elevated in S-T wave elevated patients with MI. CONCLUSIONS These initial data provide evidence relating obesity and oral health to salivary and serum analyte levels that occur in association with cardiac events. Relationships have been described between CVD risk and periodontal disease. Additionally, various systemic inflammatory biomarkers appear to reflect both the CVD risk and the extent/severity of periodontitis. Our findings indicated that oral health and obesity contribute to altering levels of these salivary and serum analytes in association with cardiac events. The potential that serum and/or salivary biomarkers could aid in evaluating CVD risk requires knowledge regarding how the oral health of the individual would impact the effectiveness of these biological measures.
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Affiliation(s)
- J L Ebersole
- Department of Oral Health Practice & Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - R J Kryscio
- Department of Statistics, College of Arts and Sciences and Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - C Campbell
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - D F Kinane
- College of Dentistry, University of Pennsylvania, Philadelphia, PA, USA
| | - J McDevitt
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA
| | - N Christodoulides
- Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA
| | - P N Floriano
- Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA
| | - C S Miller
- Department of Oral Health Practice & Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Doğan ŞB, Ballı U, Dede FÖ, Sertoğlu E, Tazegül K. Chemerin as a Novel Crevicular Fluid Marker of Patients With Periodontitis and Type 2 Diabetes Mellitus. J Periodontol 2016; 87:923-33. [DOI: 10.1902/jop.2016.150657] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Özcan E, Işıl Saygun N, Serdar MA, Umut Bengi V, Kantarcı A. Non-Surgical Periodontal Therapy Reduces Saliva Adipokine and Matrix Metalloproteinase Levels in Periodontitis. J Periodontol 2016; 87:934-43. [DOI: 10.1902/jop.2016.160046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Increased visfatin expression is associated with nuclear factor-kappa B and phosphatidylinositol 3-kinase in periodontal inflammation. Clin Oral Investig 2016; 21:1113-1121. [PMID: 27283324 DOI: 10.1007/s00784-016-1871-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
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Kell DB, Kenny LC. A Dormant Microbial Component in the Development of Preeclampsia. Front Med (Lausanne) 2016; 3:60. [PMID: 27965958 PMCID: PMC5126693 DOI: 10.3389/fmed.2016.00060] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/04/2016] [Indexed: 12/12/2022] Open
Abstract
Preeclampsia (PE) is a complex, multisystem disorder that remains a leading cause of morbidity and mortality in pregnancy. Four main classes of dysregulation accompany PE and are widely considered to contribute to its severity. These are abnormal trophoblast invasion of the placenta, anti-angiogenic responses, oxidative stress, and inflammation. What is lacking, however, is an explanation of how these themselves are caused. We here develop the unifying idea, and the considerable evidence for it, that the originating cause of PE (and of the four classes of dysregulation) is, in fact, microbial infection, that most such microbes are dormant and hence resist detection by conventional (replication-dependent) microbiology, and that by occasional resuscitation and growth it is they that are responsible for all the observable sequelae, including the continuing, chronic inflammation. In particular, bacterial products such as lipopolysaccharide (LPS), also known as endotoxin, are well known as highly inflammagenic and stimulate an innate (and possibly trained) immune response that exacerbates the inflammation further. The known need of microbes for free iron can explain the iron dysregulation that accompanies PE. We describe the main routes of infection (gut, oral, and urinary tract infection) and the regularly observed presence of microbes in placental and other tissues in PE. Every known proteomic biomarker of "preeclampsia" that we assessed has, in fact, also been shown to be raised in response to infection. An infectious component to PE fulfills the Bradford Hill criteria for ascribing a disease to an environmental cause and suggests a number of treatments, some of which have, in fact, been shown to be successful. PE was classically referred to as endotoxemia or toxemia of pregnancy, and it is ironic that it seems that LPS and other microbial endotoxins really are involved. Overall, the recognition of an infectious component in the etiology of PE mirrors that for ulcers and other diseases that were previously considered to lack one.
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Affiliation(s)
- Douglas B. Kell
- School of Chemistry, The University of Manchester, Manchester, UK
- The Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
- Centre for Synthetic Biology of Fine and Speciality Chemicals, The University of Manchester, Manchester, UK
- *Correspondence: Douglas B. Kell,
| | - Louise C. Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
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Jaedicke KM, Preshaw PM, Taylor JJ. Salivary cytokines as biomarkers of periodontal diseases. Periodontol 2000 2015; 70:164-83. [DOI: 10.1111/prd.12117] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2015] [Indexed: 12/15/2022]
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Özcan E, Saygun NI, Serdar MA, Kubar A, Bengi VU. Porphyromonas gingivalis and Epstein-Barr Virus Are Associated With Increased Levels of Visfatin in Gingival Crevicular Fluid. J Periodontol 2015; 87:443-51. [PMID: 26561994 DOI: 10.1902/jop.2015.150424] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is little clinical information on the relationship between periodontopathogens and visfatin. The purpose of this study is to determine visfatin levels in the gingival crevicular fluid (GCF) of healthy individuals and patients with periodontitis and to investigate the possible relationship between this adipokine and the presence and levels of Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescense, and Epstein-Barr virus (EBV). METHODS Eighteen healthy individuals and 27 patients with periodontitis were included in this study. GCF and plaque samples were obtained from all individuals. Visfatin levels were analyzed by enzyme-linked immunosorbent assay, and the bacterial numbers were evaluated by the reverse transcription-polymerase chain reaction method. RESULTS In patients with periodontitis, the visfatin levels in the GCF (mean: 84.29 ng/mL; range: 63.8 to 108.9 ng/mL) were significantly higher compared with those of the healthy individuals (mean: 38.06 ng/mL; range: 13.8 to 89.02 ng/mL) (P <0.01). There was a positive correlation between the visfatin levels and P. gingivalis (r = 0.266, P <0.05), whereas no correlation was found between visfatin levels and other microorganisms. In addition, the visfatin levels were found to be higher in individuals in whom P. gingivalis was detected than for those without P. gingivalis (P <0.01). The visfatin levels were also found to be higher in individuals in whom EBV was detected (P <0.05). CONCLUSIONS To the best of the authors' knowledge, the present study is the first one to show the correlation of periodontopathogens and GCF visfatin levels. P. gingivalis colonization of the periodontal pockets may increase visfatin secretion. Furthermore, the presence of EBV in the plaque may be another factor that causes an increase in visfatin levels.
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Affiliation(s)
- Erkan Özcan
- Department of Periodontology, Center of Oral Health, Gülhane Military Hospital, Ankara, Turkey
| | - N Işıl Saygun
- Department of Periodontology, Center of Oral Health, Gülhane Military Hospital, Ankara, Turkey
| | | | - Ayhan Kubar
- Department of Microbiology, Center of Oral Health, Gülhane Military Hospital
| | - V Umut Bengi
- Department of Periodontology, Center of Oral Health, Gülhane Military Hospital, Ankara, Turkey
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Potempa J, Lamont RJ. Introduction to 'gums and joints' special issue. Introduction. Mol Oral Microbiol 2015; 29:245-7. [PMID: 25394214 DOI: 10.1111/omi.12084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J Potempa
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, KY, USA
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Ghallab NA, Amr EM, Shaker OG. Expression of Leptin and Visfatin in Gingival Tissues of Chronic Periodontitis With and Without Type 2 Diabetes Mellitus: A Study Using Enzyme-Linked Immunosorbent Assay and Real-Time Polymerase Chain Reaction. J Periodontol 2015; 86:882-9. [PMID: 25811944 DOI: 10.1902/jop.2015.140434] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The aim of this study is to investigate the protein and gene expression of leptin and visfatin in gingival tissue from patients with chronic periodontitis (CP), patients with CP and type 2 diabetes mellitus (T2DM), and healthy individuals. METHODS The study includes 50 individuals: 10 healthy individuals, 20 patients with CP, and 20 patients with CP and T2DM. Plaque index, gingival index, probing depth, and clinical attachment loss were measured, and gingival biopsies were obtained. Leptin and visfatin protein expression in gingival tissues was determined using enzyme-linked immunosorbent assay, and messenger RNA (mRNA) expression was measured via real-time polymerase chain reaction. RESULTS The highest leptin mRNA and protein expression was observed in the control group and was significantly (P ≤0.05) different from the CP and CP+T2DM groups. Gingival tissues from patients with CP and T2DM had a significant increase in visfatin and a decrease in leptin gene and protein expression (P <0.05) compared with both controls and patients with CP. CONCLUSION Expression of leptin and visfatin in the gingival tissues suggests a possible role for these adipokines in the pathogenesis of CP and T2DM.
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Affiliation(s)
- Noha A Ghallab
- Department of Oral Medicine, Periodontology, and Diagnosis, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Eman M Amr
- Department of Oral Medicine, Periodontology, and Diagnosis, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Olfat G Shaker
- Department of Medical Biochemistry, Faculty of Medicine, Cairo University
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Papageorgiou SN, Reichert C, Jäger A, Deschner J. Effect of overweight/obesity on response to periodontal treatment: systematic review and a meta-analysis. J Clin Periodontol 2015; 42:247-61. [DOI: 10.1111/jcpe.12365] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2014] [Indexed: 01/17/2023]
Affiliation(s)
- Spyridon N. Papageorgiou
- Department of Orthodontics; School of Dentistry; University of Bonn; Bonn Germany
- Department of Oral Technology; School of Dentistry; University of Bonn; Bonn Germany
- Clinical Research Unit 208; University of Bonn; Bonn Germany
| | - Christoph Reichert
- Department of Orthodontics; School of Dentistry; University of Bonn; Bonn Germany
| | - Andreas Jäger
- Department of Orthodontics; School of Dentistry; University of Bonn; Bonn Germany
- Clinical Research Unit 208; University of Bonn; Bonn Germany
| | - James Deschner
- Clinical Research Unit 208; University of Bonn; Bonn Germany
- Section of Experimental Dento-Maxillo-Facial Medicine; Center of Dento-Maxillo-Facial Medicine; University of Bonn; Bonn Germany
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48
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The role of adipokines in periodontal infection and healing. Br Dent J 2015. [DOI: 10.1038/sj.bdj.2015.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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