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Barnawi BM, Alanazi MM, Al-Mutiri FA, Alqahtani RS, Al-Harbi MS, Al-Raqqas SK, Mahjoub WK, Alsetri MM, Al-Sultan ZM, Alghamdi GM, Almutawah RI. Interlinked Pathways: Exploring the Bidirectional Impacts of Periodontitis and Metabolic Syndrome. Cureus 2024; 16:e67544. [PMID: 39310407 PMCID: PMC11416629 DOI: 10.7759/cureus.67544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2024] [Indexed: 09/25/2024] Open
Abstract
Metabolic syndrome (MBS) and periodontitis are distinct conditions with overlapping and unique risk factors. Periodontitis is a chronic destructive disease of the periodontium, driven by alterations in the host immune-inflammatory response to virulent periodontal pathogens. MBS is characterized by various abnormalities, including visceral abdominal obesity, dyslipidemia (low high-density lipoprotein (HDL) and high triglyceride (TG) levels), hypertension, and hyperglycemia. These factors collectively increase the risk of atherosclerotic cardiovascular disease (CVD) and diabetes. Several pro-inflammatory mediators are involved in the pathogenesis of periodontitis and MBS, and the deleterious bidirectional effects of these mediators exacerbate the severity and progression of both conditions. This comprehensive review focuses on the intricate relationship between MBS and periodontitis. Specifically, it explores the pathophysiological mechanisms of each disease component of MBS and its impact on periodontitis, and vice versa.
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Affiliation(s)
| | - Maram M Alanazi
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Fai A Al-Mutiri
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Rahaf S Alqahtani
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Madhawi S Al-Harbi
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Fentoğlu Ö, Tülüceoğlu EE, Orhan H. Plasminogen gene polymorphisms [c.924C>T and IVS 8+14 G>A] in periodontitis and familial Mediterranean fever: A case-control study. J Periodontal Res 2021; 57:371-380. [PMID: 34939186 DOI: 10.1111/jre.12966] [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: 09/22/2021] [Revised: 11/23/2021] [Accepted: 12/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE The plasminogen (PLG) activation system plays an essential role in severe inflammation based diseases such as periodontitis, destructive membranous periodontal disease (ligneous periodontitis), familial Mediterranean fever (FMF), and amyloidosis. We have aimed to evaluate variations in PLG and the associations between PLG and MEFV genotypes in patients with FMF/ FMF-related secondary amyloidosis and periodontitis. MATERIAL AND METHODS A total of 247 individuals who were either diagnosed with FMF or systemically healthy were recruited to this human observational study with a cross-sectional design. All individuals were also diagnosed with periodontitis or periodontally healthy. Blood samples were obtained from patients with FMF and systemically healthy controls. Clinical periodontal indicators were recorded. All polymorphisms located in exons 6 and 8 of PLG and mutations located on exons 2 and 10 of the MEFV gene were analyzed by DNA Sanger Sequencing. Genotypes and allele frequencies of PLG and MEFV were detected and tested by the Hardy-Weinberg equilibrium. Serum levels of amyloid A (SAA), high-sensitive C-reactive protein (hs-CRP), PLG, and salivary PLG levels were determined by using enzyme-linked immunosorbent assay (ELISA). RESULTS Two polymorphisms were identified in PLG: G to A polymorphism on the 14th nucleotide of intron 8 and C to T polymorphism on the 924th nucleotide of the coding region (IVS 8+14 G>A and c.924C>T, respectively). In IVS 8+14 G>A polymorphisms, wild-type genotype: GG, heterozygote genotype: GA and homozygote genotype: AA. In c.924C>T polymorphism, wild-type genotype: CC, heterozygote genotype: CT and homozygote genotype: TT. The frequency of the heterozygous polymorphisms of PLG was significantly increased (17.6%) in FMF patients with periodontitis (p = .027). A large proportion of the test group that was heterozygous for MEFV-R202Q also had heterozygous PLG polymorphisms. Remarkable exacerbation in periodontal parameters was observed in patients with FMF and amyloidosis. SAA and hs-CRP levels were significantly correlated with salivary PLG levels in patients with periodontitis and heterozygous PLG. CONCLUSIONS The current study describes IVS 8+14 G>A (rs2295368) and c.924C>T (rs1380916375) polymorphisms for the first time in the periodontal literature, which might play an important role in the pathogenesis of periodontitis, FMF, or amyloidosis. The elucidation of PLG polymorphisms is beneficial from a public health perspective by increasing the quality of life in these patients and reducing the mortality and morbidity associated with inflammatory diseases such as periodontal disease, FMF, and FMF-related amyloidosis.
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Affiliation(s)
- Özlem Fentoğlu
- Periodontology Department, Faculty of Dentistry, University of Suleyman Demirel, Isparta, Turkey
| | - Eda Evgen Tülüceoğlu
- Medical Biology Department, Faculty of Medicine, Univesity of Suleyman Demirel, Isparta, Turkey
| | - Hikmet Orhan
- Biostatistics and Medical Informatics Department, Faculty of Medicine, University of Suleyman Demirel, Isparta, Turkey
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Shaddox LM, Morford LA, Nibali L. Periodontal health and disease: The contribution of genetics. Periodontol 2000 2020; 85:161-181. [PMID: 33226705 DOI: 10.1111/prd.12357] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Periodontitis is an infectious, inflammatory disease that is associated with a complex interplay between specific bacteria, host response, and environmental factors. Because of its high degree of familial aggregation, specifically for the more aggressive forms of the disease, genetics factors have been implicated in disease pathogenesis for several decades. This review provides an overview of what we currently know regarding the genetic and epigenetic contributions to periodontal disease and discusses future opportunities in the field.
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Affiliation(s)
- Luciana Macchion Shaddox
- Division of Periodontology, Department of Oral Health Practice, University of Kentucky College of Dentistry, Lexington, Kentucky, USA
| | - Lorri Ann Morford
- Division of Orthodontics, Department of Oral Health Sciences, University of Kentucky College of Dentistry, Lexington, Kentucky, USA
| | - Luigi Nibali
- Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, Guy's Hospital, London, UK
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Debnath P, Dewangan J, Tandon D, Govila V, Sharma M, Kumar V, Govila S, Rath SK. Plasminogen activator inhibitor-1 polymorphisms as a risk factor for chronic periodontitis in North Indian population. J Oral Biol Craniofac Res 2019; 9:226-229. [PMID: 31211041 DOI: 10.1016/j.jobcr.2018.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/12/2018] [Indexed: 10/17/2022] Open
Abstract
Objectives Impaired plasminogen activator inhibitor-1 (PAI-1), controlling coagulation and the fibrinolytic system is supposed to be involved in the pathogenesis of periodontitis. This study was performed to examine the association of PAI-1 gene polymorphisms with Chronic Periodontitis (CP) and alveolar bone loss severity involved with the disease and for understanding the role of genetic contributions in disease progression. Methods 87 volunteers were included in the study. Genomic DNA was isolated from peripheral blood, subsequently, DNA samples were subjected to polymerase chain reaction and endonuclease digestion. Direct gene sequencing were performed for all the samples to identify genotype polymorphisms (rs 11560324) in the 3' untranslated region of PAI-1 gene. For bone loss assessment full mouth IOPA was taken. Results Statistical analysis showed that for SNP PAI-I in 3' UTR, genotype CC (homozygous mutant) and allele C (mutant) has a risk associated with CP, although statistically significant association was not found. An increased risk of association of disease severity with CG (heterozygous mutant) and CC (homozygous mutant) genotypes, i.e., an increased carriage rate of genotype CG and CC (homozygous mutant) was evident with the increase in the severity of CP, highlighting an increased susceptibility to CP due to this gene polymorphisms. Conclusion PAI-1 genotype has a risk association with CP and alveolar bone loss severity in North-Indian population.
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Affiliation(s)
- Puja Debnath
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Jayant Dewangan
- Genotoxicity Lab, Division of Toxicology & Experimental Medicine, CSIR- Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Divya Tandon
- Genotoxicity Lab, Division of Toxicology & Experimental Medicine, CSIR- Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Vivek Govila
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Mona Sharma
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Virendra Kumar
- Department of Dentistry, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India
| | - Smita Govila
- Department of Conservative Dentistry, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Srikanta Kumar Rath
- Genotoxicity Lab, Division of Toxicology & Experimental Medicine, CSIR- Central Drug Research Institute, Lucknow, Uttar Pradesh, India
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Effect of plasminogen activator inhibitor-1 and tissue plasminogen activator polymorphisms on susceptibility to type 2 diabetes in Malaysian subjects. J Biomed Biotechnol 2012; 2012:234937. [PMID: 22577291 PMCID: PMC3336151 DOI: 10.1155/2012/234937] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Revised: 02/05/2012] [Accepted: 02/15/2012] [Indexed: 11/18/2022] Open
Abstract
Elevated activity of plasminogen activator inhibitor-1 (PAI-1) and decreased tissue plasminogen activator (tPA) activity are considered to be important risk factors for type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). The aim of this study was to investigate the association of the PAI-1 4G/5G and tPA Alu-repeat I/D polymorphisms with T2DM in Malaysian subjects. Serum insulin, coronary risk panel, plasma glucose, and PAI-1 4G/5G and tPA Alu-repeat I/D polymorphisms were studied in 303 T2DM subjects (227 with MetS and 76 without MetS) and 131 normal subjects without diabetes and MetS. Statistical analysis showed that the dominant and additive models of PAI-1 4G/5G polymorphism showed a weak association with T2DM without MetS (OR = 2.35, P = 0.045; OR = 1.67, P = 0.058). On the other hand, the recessive model of the tPA Alu-repeat I/D polymorphism showed an association with T2DM with MetS (OR = 3.32, P = 0.013) whereas the dominant and additive models of the tPA Alu-repeat I/D polymorphism were not associated with T2DM either with or without MetS.
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Sivolella S, De Biagi M, Sartori MT, Berengo M, Bressan E. Destructive membranous periodontal disease (ligneous gingivitis): a literature review. J Periodontol 2011; 83:465-76. [PMID: 21859319 DOI: 10.1902/jop.2011.110261] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Destructive membranous periodontal disease, or ligneous gingivitis, is a rare condition involving nodular gingival enlargement with ulceration and periodontal tissue destruction. This review gives a brief account of the cases reported in the literature. An effort is also made to define the periodontal disease caused by plasminogen deficiency with a view to its potential inclusion in the classification of periodontal diseases. METHODS A MEDLINE/PubMed and manual search was conducted to find papers describing ≥1 case of ligneous disease involving the oral mucosa. RESULTS We identified 23 articles reporting 35 cases. For each patient, we analyzed various characteristics, including age, sex, age of onset, oral symptoms, histologic features, plasminogen levels (functional activity, plasma antigen), genetic features, treatment, and results of treatment during the reported follow-up. CONCLUSIONS Ligneous gingivitis is a rare periodontal disorder closely associated with ligneous conjunctivitis and plasminogen deficiency. Its diagnosis may be supported by the finding of genetic mutations responsible for the condition. Research is focusing on the future development of an effective therapy capable of arresting the destructive evolution of the disease. Additional studies, investigating features such as probing depth and attachment loss, are needed for the appropriate classification of this periodontal disease.
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Affiliation(s)
- Stefano Sivolella
- Department of Oral Surgery, University of Padova, Institute of Clinical Dentistry, Padova, Italy.
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Gene polymorphisms in chronic periodontitis. Int J Dent 2010; 2010:324719. [PMID: 20339487 PMCID: PMC2844543 DOI: 10.1155/2010/324719] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 11/09/2009] [Accepted: 01/06/2010] [Indexed: 02/06/2023] Open
Abstract
We aimed to conduct a review of the literature for gene polymorphisms associated with chronic periodontitis (CP) susceptibility. A comprehensive search of the literature in English was performed using the keywords: periodontitis, periodontal disease, combined with the words genes, mutation, or polymorphism. Candidate gene polymorphism studies with a case-control design and reported genotype frequencies in CP patients were searched and reviewed. There is growing evidence that polymorphisms in the IL1, IL6, IL10, vitamin D receptor, and CD14 genes may be associated with CP in certain populations. However, carriage rates of the rare (R)-allele of any polymorphism varied considerably among studies and most of the studies appeared under-powered and did not correct for other risk factors. Larger cohorts, well-defined phenotypes, control for other risk factors, and analysis of multiple genes and polymorphisms within the same pathway are needed to get a more comprehensive insight into the contribution of gene polymorphisms in CP.
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Gene polymorphisms of matrix metalloproteinase-2, -9 and -12 in periodontal health and severe chronic periodontitis. Arch Oral Biol 2007; 53:337-45. [PMID: 18155181 DOI: 10.1016/j.archoralbio.2007.11.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2007] [Revised: 10/31/2007] [Accepted: 11/09/2007] [Indexed: 01/10/2023]
Abstract
AIM Matrix metalloproteinases (MMPs) are involved in periodontal tissue remodeling and degradation. MMP polymorphisms could alter transcription and function of these enzymes. The aim of this study was to investigate MMP-2, MMP-9 and MMP-12 gene polymorphisms in relation to susceptibility to severe chronic periodontitis (CP). METHODS Genomic DNA was obtained from peripheral blood of 87 severe CP patients and 107 periodontally healthy subjects. MMP-2 -735C/T, MMP-9 -1562C/T and MMP -12357Asn/Ser gene polymorphisms were genotyped by polymerase chain reaction and restriction fragment length polymorphism. Probing depth, clinical attachment loss, supragingival plaque accumulation and bleeding on probing were recorded. The data were analyzed by chi-square, logistic regression and Mann-Whitney-U-tests. RESULTS The genotype distributions and allele frequencies of MMP-2, MMP-9 and MMP-12 genes were similar in CP and healthy subjects (p>0.05). Differences between rare allele carriage rates of CP and healthy groups regarding MMP-2, MMP-9 and MMP-12 gene polymorphisms were not significant (p>0.05). However, T allele carriers of MMP-9 -1562 gene had less risk for CP (OR=0.36; 95% CI=0.16-0.81). CONCLUSION These data suggest that MMP-2 -735C/T, MMP-9 -1562C/T and MMP-12 357Asn/Ser polymorphisms are not associated with susceptibility to severe CP in Turkish population. However, T allele of MMP-9 -1562 gene might be associated with decreased susceptibility to severe CP.
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