Preferential response of the periodontal apparatus and the epiphyseal plate to hydrocortisone and fluoride in the rat

Influence of immunosuppression on the progression of experimental periodontitis and on healthy periodontal tissue: A rat in vivo study

Background. The potent anti-inflammatory and immunosuppressive properties of glucocorticoids (GCs) might influence the progression of some disorders, such as periodontitis. Hence, this study aimed to investigate the influence of dexamethasone (DEX) on the alveolar bone loss (ABL) of healthy and periodontally compromised molars in rats.

Methods. Thirty male rats were randomly assigned to two groups: physiological saline solution (PSS) and DEX. The animals received subcutaneous injections of either 0.5 mL of PSS) (group PSS) or 2 mg/kg of DEX (group DEX) from one day before experimental periodontitis (EP) induction until euthanasia. EP was induced through ligature placement around the mandibular lower first molars at day 0. Contralateral molars remained unligated. Ten animals per period were euthanized on days 3, 7, and 14. Morphometric analysis was performed to access the ABL. Data were statistically analyzed with ANOVA followed by post hoc Tukey tests (P ≤ 0.05).

Results. Higher ABL was observed in both groups on days 7 and 14 than on day 3 (P ≤ 0.05). Concerning periodontitis, higher ABL was observed in group DEX on days 3, 7, and 14 days than group PSS at the same time intervals (P ≤ 0.05). Also, even in the contralateral unligated molars, group DEX exhibited higher ABL on days 3, 7, and 14 days than group PSS at the same time intervals (P ≤ 0.05).

Conclusions. Collectively, it can be concluded that DEX aggravates EP and induces spontaneous ABL in the healthy periodontium.

Association of time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected bacteria of patients after solid organ transplantation

Background

Aim of this study was to investigate the association of the time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected periodontal pathogenic bacteria of immunosuppressed patients after solid organ transplantation (SOT).

Material and Methods

169 Patients after SOT (lung, liver or kidney) were included and divided into subgroups according their time under (0-1, 1-3, 3-6, 6-10 and >10 years) and form of immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs. combination). Periodontal probing depth (PPD) and clinical attachment loss (CAL) were assessed. Periodontal disease severity was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were investigated for eleven selected potentially periodontal pathogenic bacteria using polymerasechainreaction.

Results

The mean PPD and CAL as well as prevalence of Treponema denticola and Capnocytophaga species was shown to be different but heterogeneous depending on time under immunosuppression (p<0.05). Furthermore, only the medication with Cyclosporine was found to show worse periodontal condition compared to patients without Cyclosporine (p<0.05). Prevalence of Porphyromonas gingivalis, Tannerella forsythia and Fusobacterium nucleatum was reduced and prevalence of Parvimonas micra and Capnocytophaga species was increased in patients under immunosuppression with Glucocorticoids, Mycophenolate as well as combination therapy.

Conclusions

Time under and form of immunosuppression might have an impact on the clinical periodontal and microbiological parameters of patients after SOT. Patients under Cyclosporine medication should receive increased attention. Differences in subgingival biofilm, but not in clinical parameters were found for Glucocorticoids, Mycophenolate and combination therapy, making the clinical relevance of this finding unclear.

Key words:Immunosuppression, organ transplantation, periodontitis, periodontal bacteria.

Blockade of cyclophilin D rescues dexamethasone-induced oxidative stress in gingival tissue

Glucocorticoids (GCs) are frequently used for the suppression of inflammation in chronic inflammatory diseases. Excessive GCs usage is greatly associated with several side effects, including gingival ulceration, the downward migration of the epithelium, attachment loss and disruption of transeptal fibers. The mechanisms underlying GCs-induced impairments in gingival tissue remains poorly understood. Mitochondrial dysfunction is associated with various oral diseases, such as chronic periodontitis, age-related alveolar bone loss and hydrogen peroxide-induced cell injury in gingival. Here, we reported an unexplored role of cyclophilin D (CypD), the major component of mitochondrial permeability transition pore (mPTP), in dexamethasone (Dex)-induced oxidative stress accumulation and cell dysfunctions in gingival tissue. We demonstrated that the expression level of CypD significantly increased under Dex treatment. Blockade of CypD by pharmaceutical inhibitor cyclosporine A (CsA) significantly protected against Dex-induced oxidative stress accumulation in gingival tissue. And the protective effects of blocking CypD in Dex-induced gingival fibroblasts dysfunction were evidenced by rescued mitochondrial function and suppressed production of reactive oxygen species (ROS). In addition, blockade of CypD by pharmaceutical inhibitor CsA or gene knockdown also restored Dex-induced cell toxicity in HGF-1 cells, as shown by suppressed mitochondrial ROS production, increased CcO activity and decreased apoptosis. We also suggested a role of oxidative stress-mediated p38 signal transduction in this event, and antioxidant N-acety-l-cysteine (NAC) could obviously blunted Dex-induced oxidative stress. These findings provide new insights into the role of CypD-dependent mitochondrial pathway in the Dex-induced gingival injury, indicating that CypD may be potential therapeutic strategy for preventing Dex-induced oxidative stress and cell injury in gingival tissue.

Periodontitis modified by systemic factors

Microbial dental plaque is the initiator of periodontal disease but whether it affects a particular subject, what form the disease takes, and how it progresses, are all dependent on the host defenses to this challenge. Systemic factors modify all forms periodontitis principally through their effects on the normal immune and inflammatory defenses. Some good examples of this effect exist such as when there is a reduction in number or function of polymorphonuclear leukocytes (PMNs) that may result in an increased rate and severity of periodontal destruction. Many other systemic factors are much less clear cut and are difficult to causally link to periodontitis. In many cases the literature is insufficient to make definite statements on links between systemic factors and periodontitis. It is also at times difficult to be precise regarding the causative agent in systemic exposures such as smoking and even prescribed drug therapy. The possible role of systemic diseases and systemic exposures in initiating or modifying the progress of periodontal disease is clearly a complex issue. It is however generally agreed that several conditions may give rise to an increased prevalence, incidence, or severity of gingivitis and periodontitis. The categorization of the systemic modifying factors causing periodontitis and the evidence to support the role of these factors are the focus of this review. An attempt has been made to consider the conditions under broad headings, but it will be clear that many conditions fall within more than one category and that for several conditions only case reports exist whereas in other areas an extensive literature is present.

Radioautography of dexamethasone in rabbit gingiva and buccal mucosa

The localization of 3H-dexamethasone in gingiva and in buccal mucosa was investigated radioautographically after systemic administration of the labeled glucocorticoid to rabbits. Tissue samples were processed for dry radioautography of diffusible substances. This study demonstrates localization of 3H-dexamethasone in the nuclei of target cells in the gingival epithelium, stromata, and the walls of blood vessels, and to a lesser degree in the buccal mucosa cells. The findings support the possibility of a direct effect of glucocorticoids via specific hormone cytosol-nuclear receptors in oral tissues.

Corticosteroid-induced changes in glucose metabolism of chondrocytes

Immature mice were treated for up to 12 weeks with daily doses of triamcinolone diacetate. Using quantitative histochemical methods, the proximal epiphyseal plate of the humerus was studied at regular intervals. By the tenth injection significant decrease was noted in the acid glycosaminoglycans content (25%) and in the neutral mucopolysaccharides (30%). Concomitantly, a marked increase was noted in the intracellular depots of glycogen (70%). It is suggested that the hormone's antiglycolytic effect in cartilage caused the glucose metabolic pathway to divert in the direction of glycogen synthesis, and thereby interfered with the normal synthetic pathway of the chondrocytes. The hormone's primary effect on the cells' hexose metabolism could be responsible, at least in part, for its inhibitory influence on bone growth.