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Grant WB, van Amerongen BM, Boucher BJ. Periodontal Disease and Other Adverse Health Outcomes Share Risk Factors, including Dietary Factors and Vitamin D Status. Nutrients 2023; 15:2787. [PMID: 37375691 DOI: 10.3390/nu15122787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
For nearly a century, researchers have associated periodontal disease (PD) with risks of other adverse health outcomes such as cardiovascular disease, diabetes mellitus, and respiratory diseases, as well as adverse pregnancy outcomes. Those findings have led to the hypothesis that PD causes those adverse health outcomes either by increasing systemic inflammation or by the action of periodontopathic bacteria. However, experiments largely failed to support that hypothesis. Instead, the association is casual, not causal, and is due to shared underlying modifiable risk factors, including smoking, diet, obesity, low levels of physical activity, and low vitamin D status. Diabetes mellitus is also considered a risk factor for PD, whereas red and processed meat are the most important dietary risk factors for diabetes. Because PD generally develops before other adverse health outcomes, a diagnosis of PD can alert patients that they could reduce the risk of adverse health outcomes with lifestyle changes. In addition, type 2 diabetes mellitus can often be reversed rapidly by adopting an anti-inflammatory, nonhyperinsulinemic diet that emphasizes healthful, whole plant-based foods. This review describes the evidence that proinflammatory and prohyperinsulinemia diets and low vitamin D status are important risk factors for PD and other adverse health outcomes. We also make recommendations regarding dietary patterns, food groups, and serum 25-hydroxyvitamin D concentrations. Oral health professionals should routinely inform patients with PD that they could reduce their risk of severe PD as well as the risks of many other adverse health outcomes by making appropriate lifestyle changes.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
| | | | - Barbara J Boucher
- The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
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Tk F, Rao RJ, S S, Prabhu S, Rudresh V, Oradiyath D. Comparative analysis of sulfiredoxin and total oxidative stress levels in diabetic individuals with periodontitis: A case-control study. J Periodontol 2022. [PMID: 36542371 DOI: 10.1002/jper.22-0416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The delicate balance between oxidative stress and its antioxidant system can be disrupted in diabetes mellitus (DM), making the tissue susceptible to injury. Hence, this case-control study aims to estimate and correlate the gingival tissue sulfiredoxin and crevicular total oxidative stress (TOS) levels in generalized periodontitis Stage II individuals Grade C (PSII) with and without type II DM. MATERIAL AND METHODS A total of 72 individuals were grouped based on their glycosylated hemoglobin (HbA1c) levels and clinical parameters: group I, periodontally healthy non-diabetic (HbA1c < 5.7%) (n = 24); group II, non-diabetic with PSII (n = 24); and group III, diabetic individuals (HbA1c > 6.5%) with PSII (n = 24). Gingival tissues and crevicular fluid samples were collected. The samples with adequate protein concentrations (n = 72) were further estimated for sulfiredoxin and TOS levels by enzyme-linked immunosorbent assay (ELISA) and calorimetric method, respectively. RESULTS Tissue sulfiredoxin and crevicular TOS levels are increased significantly in the periodontitis group compared to the non-periodontitis group (p < 0.001).The tissue sulfiredoxin levels did not vary significantly between the two periodontitis groups (p < 0.179). The TOS levels are significantly higher in the diabetic compared to non-diabetic periodontitis group (p < 0.001). Correlation statistics showed a significant positive correlation (r = 0.65 and p < 0.005) between sulfiredoxin and TOS levels in diabetes with PSII group, however, no such significant correlation was observed in the non-diabetic PSII group (r = 0.255 and p < 0.422). CONCLUSION Diabetic individuals showed inadequate sulfiredoxin-mediated antioxidant response to an increase in oxidative stress levels in periodontitis Stage II Grade C individuals.
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Affiliation(s)
- Fayiza Tk
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate, Research Center, Bengaluru, Karnataka, India
| | - Ravi J Rao
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate, Research Center, Bengaluru, Karnataka, India
| | - Srirangarajan S
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate, Research Center, Bengaluru, Karnataka, India
| | - Srikumar Prabhu
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate, Research Center, Bengaluru, Karnataka, India
| | - Vinaya Rudresh
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate, Research Center, Bengaluru, Karnataka, India
| | - Deepika Oradiyath
- Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate, Research Center, Bengaluru, Karnataka, India
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Zou H, Zhou N, Huang Y, Luo A, Sun J. Phenotypes, roles, and modulation of regulatory lymphocytes in periodontitis and its associated systemic diseases. J Leukoc Biol 2021; 111:451-467. [PMID: 33884656 DOI: 10.1002/jlb.3vmr0321-027rrr] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Periodontitis is a common chronic inflammatory disease that can result in tooth loss and poses a risk to systemic health. Lymphocytes play important roles in periodontitis through multiple mechanisms. Regulatory lymphocytes including regulatory B cells (Bregs) and T cells (Tregs) are the main immunosuppressive cells that maintain immune homeostasis, and are critical to our understanding of the pathogenesis of periodontitis and the development of effective treatments. In this review, we discuss the phenotypes, roles, and modulating strategies of regulatory lymphocytes including Bregs and Tregs in periodontitis and frequently cooccurring inflammatory diseases such as rheumatoid arthritis, Alzheimer disease, diabetes mellitus, and stroke. The current evidence suggests that restoring immune balance through therapeutic targeting of regulatory lymphocytes is a promising strategy for the treatment of periodontitis and other systemic inflammatory diseases.
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Affiliation(s)
- Hang Zou
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Niu Zhou
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guangzhou Zoo, Guangzhou, China
| | - Yilian Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Aoxiang Luo
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jianbo Sun
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Lütfioğlu M, Sakallıoğlu U, Sakallıoğlu EE, Özden FO, Ürkmez SS, Bilgici B. Effects of smoking on the gingival crevicular fluid levels of interleukin-17A, interleukin-17E, and oxidative stress following periodontal treatment process. J Periodontal Res 2021; 56:388-396. [PMID: 33458831 DOI: 10.1111/jre.12831] [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: 11/18/2019] [Revised: 10/13/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE AND BACKGROUND How smoking affects periodontal inflammation and healing still needs to be revealed with all its mechanisms. In this study, the gingival crevicular fluid (GCF) levels of: (a) interleukin-17A (IL-17A) and interleukin-17E(IL-17E) with their ratios and (b) oxidative stress by means of total oxidative stress (TOS), total anti-oxidant capacity (TAOC), and their ratios as the oxidative stress index (OSI) were evaluated and compared for smoking and non-smoking periodontitis patients after a periodontitis management process including both the non-surgical and surgical treatments. MATERIALS AND METHODS Fifteen smoker and 15 non-smoker generalized periodontitis patients as 2 distinct groups participated in the study. Conventional clinical and radiographical examinations were utilized for the periodontitis diagnosis. The clinical data and GCF samples were collected at baseline, 4 week after non-surgical periodontal treatment (NSPT), and 4 weeks after surgical periodontal treatment (SPT). IL-17A, IL-17E, TOS, and TAOC were determined by ELISA and Rel Assay. RESULTS Clinical parameters in both smokers and non-smokers improved following periodontal treatment (P < .001) and their clinical data were similar for all the examination times (baseline, NSPT, and SPT) (P > .05). Following the treatment phases, the IL-17A concentration decreased and the IL-17E concentration increased in both the smokers and non-smokers (P < .01). The total amount of IL-17A decreased while the total amount of IL-17E increased in smokers throughout NSPT and SPT (P < .01). Such an alteration was seen only at SPT compared to NSPT and baseline in non-smokers (P < .01). The concentration and total amount of IL-17A were higher at baseline, and the concentration and total amount of IL-17E were lower at all examination time points in non-smokers as compared to smokers (P < .01). The 17A/E ratio decreased in both groups following the treatment phases and was higher in smokers at all the examination times (P < .01). TOS were higher and TAOC were lower in smokers versus non-smokers at all the time points, but the differences were significant only for TOS levels (P < .01). Throughout the treatment phases, the concentration and total amount of TOS decreased in smokers(P < .01) and only the total amount of TOS decreased in non-smokers (P < .01). The concentration and total amounts of TAOC increased throughout the treatments in both smokers and non-smokers without significant changes (P > .05). The baseline OSI was higher in smokers, and it decreased only in smokers following the treatment phases (P < .01). CONCLUSIONS Smoking and periodontal inflammation were found to alter IL-17A, IL-17E, and oxidant/anti-oxidant statuses in periodontitis patients. The intra-group assessments in smokers demonstrated more apparent alterations in the oxidant/anti-oxidant statuses and IL-17A and IL-17E levels after periodontitis management.
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Affiliation(s)
- Muge Lütfioğlu
- Department of Periodontology, Ondokuz Mayis University Dental Faculty, Samsun, Turkey
| | - Umur Sakallıoğlu
- Department of Periodontology, Ondokuz Mayis University Dental Faculty, Samsun, Turkey
| | - Eser Elif Sakallıoğlu
- Department of Periodontology, Ondokuz Mayis University Dental Faculty, Samsun, Turkey
| | - Feyza O Özden
- Department of Periodontology, Ondokuz Mayis University Dental Faculty, Samsun, Turkey
| | - Sebati Sinan Ürkmez
- Department of Biochemistry, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Birsen Bilgici
- Department of Biochemistry, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
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Polak D, Sanui T, Nishimura F, Shapira L. Diabetes as a risk factor for periodontal disease-plausible mechanisms. Periodontol 2000 2020; 83:46-58. [PMID: 32385872 DOI: 10.1111/prd.12298] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The present narrative review examines the scientific evidence of the biological mechanisms that may link periodontitis and diabetes, as a source of comorbidity. Publications regarding periodontitis and diabetes, in human, animals, and in vitro were screened for their relevance. Periodontal microbiome studies indicate a possible association between altered glucose metabolism in prediabetes and diabetes and changes in the periodontal microbiome. Coinciding with this, hyperglycemia enhances expression of pathogen receptors, which enhance host response to the dysbiotic microbiome. Hyperglycemia also promotes pro-inflammatory response independently or via the advanced glycation end product/receptor for advanced glycation end product pathway. These processes excite cellular tissue destruction functions, which further enhance pro-inflammatory cytokines expression and alteration in the RANKL/osteoprotegerin ratio, promoting formation and activation of osteoclasts. The evidence supports the role of several pathogenic mechanisms in the path of true causal comorbidity between poorly controlled diabetes and periodontitis. However, further research is needed to better understand these mechanisms and to explore other mechanisms.
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Affiliation(s)
- David Polak
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Terukazu Sanui
- Section of Periodontology, Division of Oral Rehabilitation, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Fusanori Nishimura
- Section of Periodontology, Division of Oral Rehabilitation, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Lior Shapira
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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Guardiola CJDA, Clemente-Napimoga JT, Martinez EF, Abdalla HB, Peruzzo DC, Joly JC, Napimoga MH. DC-STAMP and TACE Levels are Higher in Patients with Periodontitis. Braz Dent J 2020; 31:122-126. [PMID: 32556010 DOI: 10.1590/0103-6440202002939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/25/2019] [Indexed: 11/22/2022] Open
Abstract
Although periodontitis is one of the commonest infectious inflammatory diseases in humans, the mechanisms involved with its immunopathology remain ill understood. Numerous molecules may induce inflammation and lead to bone resorption, secondary to activation of monocytes into osteoclasts. TACE (TNF-α converting enzyme) and DC-STAMP (dendritic cell-specific transmembrane protein) appear to play a role on bone resorption since TACE induces the release of sRANKL (soluble receptor activator of nuclear factor kappa-β ligand) whereas DC-STAMP is a key factor in osteoclast induction. The present study evaluated the levels of TACE and DC-STAMP in patients with and without periodontitis. Twenty individuals were selected: 10 periodontally healthy participants undergoing gingivectomy for esthetic reasons and 10 diagnosed with periodontitis. Protein levels of such molecules in gingival tissue were established using Western blotting. Protein levels of both TACE and DC-STAMP were higher in the periodontitis group than in the control group (p<0.05; Student t-test). In conclusion, TACE and DC-STAMP protein levels are elevated in patients with periodontitis, favoring progression of bone resorption.
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Affiliation(s)
- Cyro José de Almeida Guardiola
- Periodontics and Implantology, Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - Juliana Trindade Clemente-Napimoga
- Laboratory of Neuroimmune Interface of Pain Research Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - Elizabeth Ferreira Martinez
- Periodontics and Implantology, Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - Henrique Balassini Abdalla
- Laboratory of Neuroimmune Interface of Pain Research Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - Daiane Cristina Peruzzo
- Periodontics and Implantology, Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - Júlio César Joly
- Periodontics and Implantology, Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - Marcelo Henrique Napimoga
- Laboratory of Neuroimmune Interface of Pain Research Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
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Drumond MHF, Puhl LE, Duarte PM, Miranda TSD, Clemente-Napimoga JT, Peruzzo DC, Martinez EF, Napimoga MH. Preliminary findings on the possible role of B-lymphocyte stimulator (BLyS) on diabetes-related periodontitis. Braz Oral Res 2020; 34:e038. [PMID: 32374812 DOI: 10.1590/1807-3107bor-2020.vol34.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/23/2020] [Indexed: 11/21/2022] Open
Abstract
The possible role of B-cell growth and differentiation-related cytokines on the pathogenesis of diabetes-related periodontitis has not been addressed so far. The aim of this study was to evaluate the effects of diabetes mellitus (DM) on the gene expression of proliferation-inducing ligand (APRIL) and B-lymphocyte stimulator (BLyS), two major cytokines associated to survival, differentiation and maturation of B cells in biopsies from gingival tissue with periodontitis. Gingival biopsies were obtained from subjects with periodontitis (n = 17), with periodontitis and DM (n = 19) as well as from periodontally and systemically healthy controls (n = 10). Gene expressions for APRIL, BLyS, RANKL, OPG, TRAP and DC-STAMP were evaluated using qPCR. The expressions APRIL, BLyS, RANKL, OPG, TRAP and DC-STAMP were all higher in both periodontitis groups when compared to the control group (p < 0.05). Furthermore, the expressions of BLyS, TRAP and RANKL were significantly higher in the subjects with periodontitis and DM when compared to those with periodontitis alone (p < 0.05). The mRNA levels of BLyS correlated positively with RANKL in the subjects with periodontitis and DM (p < 0.05). BLyS is overexpressed in periodontitis tissues of subjects with type 2 DM, suggesting a possible role of this cytokine on the pathogenesis DM-related periodontitis.
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Affiliation(s)
| | - Luciano Eduardo Puhl
- Faculdade São Leopoldo Mandic , Instituto de Pesquisas São Leopoldo Mandic , Campinas , SP , Brazil
| | - Poliana Mendes Duarte
- University of Florida , College of Dentistry , Department of Periodontology , Gainesville , FL , USA
| | | | | | - Daiane Cristina Peruzzo
- Faculdade São Leopoldo Mandic , Instituto de Pesquisas São Leopoldo Mandic , Campinas , SP , Brazil
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Abstract
Purpose of review In a prolific scientific career, Dr. Robert J. Genco dedicated himself to enriching our understanding of the pathogenesis of periodontitis. During a period of time in the 1970s and 1980s, when periodontitis was considered a classic infectious disease, Bob had the foresight to investigate and characterize the immune/inflammatory response in periodontitis, particularly Juvenile Periodontitis. His leadership in this area brought to the fore our appreciation of host-microbiome interactions that many years later (2008) culminated in the realization that periodontitis is a fundamental inflammatory disease. In this review, the question of how the host regulates the inflammatory response will be addressed in the context of how more recently-discovered pathways of resolution of inflammation play a role in disease pathogenesis. Recent findings The host inflammatory response to commensal organisms creates excess inflammation in susceptible individuals and likely drives the dysbiosis of the oral microbiome observed in people with Periodontitis. In periodontal health, the oral microbiome is in balance with the host response. It is the loss of this symbiotic relationship with excess inflammation and microbiome dysbiosis that characterizes progressive disease. In recent years, the role of mediators of resolution of inflammation in the loss of balance and their potential use as therapeutics to restore homeostasis has extended our knowledge of how the host drives immune responses to affect oral dysbiosis. Summary Dr. Genco provided the foundation for our ever-emerging understanding host-microbial interactions. The discovery of inflammation resolution pathways has furthered our knowledge in periodontal homeostasis. More studies are needed to understand how the host regulates the microbiome to fulfill the ultimate goal of more efficient therapeutics for periodontitis and related inflammatory diseases.
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Affiliation(s)
- Ning Yu
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA; The Forsyth Institute, 245 First Street, Cambridge, MA, 02142
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
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Obradović R, Kesić L, Pejčić A, Igić M, Bojović M, Stanišić D, Petrović M, Stanković I, Jovanović M. Periodontal disease in patients with type 2 Diabetes mellitus. ACTA STOMATOLOGICA NAISSI 2018. [DOI: 10.5937/asn1878858o] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Fan XM, Huang CL, Wang YM, Li N, Liang QL, Luo GA. Therapeutic Effects of Tangshen Formula on Diabetic Nephropathy in db/db Mice Using Cytokine Antibody Array. J Diabetes Res 2018; 2018:8237590. [PMID: 29682583 PMCID: PMC5842734 DOI: 10.1155/2018/8237590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/19/2017] [Accepted: 12/03/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Cytokines are essential promoters in the pathogenesis of diabetic nephropathy (DN) in type 2 diabetes. The following study investigates the adjustment mechanism of Tangshen formula (TSF) on cytokine expressions in db/db mice (DN animal model). MATERIALS AND METHODS Db/db mice were randomly divided into three groups. The treated groups were orally administered with TSF and losartan for 12 weeks. Biochemical and histological examinations were determined at 8 and 12 weeks posttreatment, while the cytokine antibody array analysis was applied to analyze the expression of 144 cytokines in kidney tissues at the end of the 12th week posttreatment. RESULTS TSF significantly reduced urinary albumin excretion and the levels of blood glucose, cholesterol, triglyceride, creatinine, and urea nitrogen. Furthermore, a significant decrease in glomerulus and mesangial area, as well as the downregulation of 24 cytokines and upregulated expressions of 5 cytokines, was found in the TSF-treated mice. CONCLUSIONS The present study reveals that TSF could ameliorate the metabolic anomalies and renal injury in db/db mice. One of the important mechanisms for treatment of DN using the treatment of TSF is the control of the JAK/STAT signaling pathway via regulation of IL-2, IL-6, IL-13, Il-15, and IFN-γ expression.
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Affiliation(s)
- Xue Mei Fan
- Beijing Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, China
| | - Chun Lian Huang
- Beijing Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, China
| | - Yi Ming Wang
- Beijing Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, China
| | - Ning Li
- School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Qiong Lin Liang
- Beijing Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, China
| | - Guo An Luo
- Beijing Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, China
- State Key Laboratory for Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China
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Radvar M, Shafaee H, Mohtasham N, Shiezadeh F, Zamanpour M. The effect of smoking on inflammatory cell infiltrate subtypes in gingival tissue of patients with chronic periodontitis. Electron Physician 2017; 9:4961-4967. [PMID: 28979729 PMCID: PMC5614279 DOI: 10.19082/4961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 06/14/2017] [Indexed: 12/21/2022] Open
Abstract
Background Examinations on blood samples and gingival crevicular fluid of subjects with chronic periodontitis showed that smoking increased production of cytokines. Objective To evaluate the expression of immune markers on mononuclear inflammatory cell infiltrate at periodontitis and healthy tissue among smoking and non-smoking subjects. Methods This case-control study was performed on 41 patients who referred to a clinic of periodontology at a Mashhad dental school in Iran in 2016. The participants were all of Iranian Khorasanian ethnicity with age range of 35–65 years. Gingival biopsies were obtained during routine periodontal flap procedure. Immunohistochemistry using markers of CD20, CD3, CD68, and CD45RO was carried out. Data was analyzed by SPSS version 15, using one-way ANOVA and Tukey HSD test. Results Nonsmoker subjects showed significantly greater numbers of CD20+, CD68+, CD3+ cells compared to smoker subjects, both at healthy and periodontitis tissue biopsies (p<0.00), whereas there was no significant difference in terms of CD45RO (p=0.120). Conclusion Cigarette smoking, results in infiltrative mononuclear chronic inflammatory cells reduction in connective periodontium.
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Affiliation(s)
- Mehrdad Radvar
- Associate Professor, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hooman Shafaee
- Assistant Professor, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Mohtasham
- Assistant Professor, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farid Shiezadeh
- Associate Professor, Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Zamanpour
- Assistant Professor, Department of Periodontics, School of Dentistry, Khorasan Shomali University of Medical Sciences, Boujnord, Iran
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Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 2016; 40 Suppl 14:S113-34. [PMID: 23627323 DOI: 10.1111/jcpe.12059] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/16/2022]
Abstract
AIMS To review the evidence for the molecular and cellular processes that may potentially link periodontal disease and diabetes. The pathogenic roles of cytokines and metabolic molecules (e.g. glucose, lipids) are explored and the role of periodontal bacteria is also addressed. Paradigms for bidirectional relationships between periodontitis and diabetes are discussed and opportunities for elaborating these models are considered. METHODS Database searches were performed using MeSH terms, keywords, and title words. Studies were evaluated and summarized in a narrative review. RESULTS Periodontal microbiota appears unaltered by diabetes and there is little evidence that it may influence glycaemic control. Small-scale clinical studies and experiments in animal models suggest that IL-1β, TNF-α, IL-6, OPG and RANKL may mediate periodontitis in diabetes. The AGE-RAGE axis is likely an important pathway of tissue destruction and impaired repair in diabetes-associated periodontitis. A role for locally activated pro-inflammatory factors in the periodontium, which subsequently impact on diabetes, remains speculative. CONCLUSION There is substantial information on potential mechanistic pathways which support a close association between diabetes and periodontitis, but there is a real need for longitudinal clinical studies using larger patient groups, integrated with studies of animal models and cells/tissues in vitro.
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Affiliation(s)
- John J Taylor
- Centre for Oral Health Research and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
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Sonnenschein SK, Meyle J. Local inflammatory reactions in patients with diabetes and periodontitis. Periodontol 2000 2015; 69:221-54. [DOI: 10.1111/prd.12089] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2014] [Indexed: 12/14/2022]
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Nociti FH, Casati MZ, Duarte PM. Current perspective of the impact of smoking on the progression and treatment of periodontitis. Periodontol 2000 2015; 67:187-210. [PMID: 25494601 DOI: 10.1111/prd.12063] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 02/05/2023]
Abstract
This literature review provides an overview of the current scenario regarding the impact of smoking on the progression and treatment of periodontitis; clinical, microbiological and immunological data from studies from our and other groups are presented. In general, preclinical and clinical data are unanimous in demonstrating that smokers present increased susceptibility, greater severity and faster progression of periodontal disease compared with nonsmokers. The evidence further demonstrates that smokers lose more teeth and have a less favorable response to therapy than do nonsmokers. Although it is well established that smoking significantly impacts on the onset, progression and outcome of periodontal disease, the mechanisms involved remain unclear. More importantly, some of the reported deleterious effects of smoking on periodontal tissues have been reported to be reversible upon participation in smoking-cessation programs. Therefore, clinicians should strongly advise smokers to enroll in cessation strategies, even temporarily, in order to improve the overall outcome.
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Okui T, Aoki-Nonaka Y, Nakajima T, Yamazaki K. The Role of Distinct T Cell Subsets in Periodontitis—Studies from Humans and Rodent Models. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s40496-014-0013-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Zhu M, Nikolajczyk BS. Immune cells link obesity-associated type 2 diabetes and periodontitis. J Dent Res 2014; 93:346-52. [PMID: 24393706 DOI: 10.1177/0022034513518943] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The clinical association between obesity-associated type 2 diabetes (T2D) and periodontitis, coupled with the increasing prevalence of these diseases, justifies studies to identify mechanisms responsible for the vicious feed-forward loop between systemic and oral disease. Changes in the immune system are critical for both obesity-associated T2D and periodontitis and therefore may link these diseases. Recent studies at the intersection of immunology and metabolism have greatly advanced our understanding of the role the immune system plays in the transition between obesity and obesity-associated T2D and have shown that immune cells exhibit similar functional changes in obesity/T2D and periodontitis. Furthermore, myeloid and lymphoid cells likely synergize to promote obesity/T2D-associated periodontitis despite complexities introduced by disease interaction. Thus the groundwork is being laid for researchers to exploit existing models to understand immune cell dysfunction and break the devastating relationship between obesity-associated T2D and oral disease.
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Affiliation(s)
- M Zhu
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
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Sánchez-Jiménez R, Alvarado-Vásquez N. IL-15 that a regulator of TNF-α in patients with diabetes mellitus type 2. Med Hypotheses 2013; 80:776-7. [PMID: 23566659 DOI: 10.1016/j.mehy.2013.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 03/09/2013] [Indexed: 12/18/2022]
Abstract
Diabetes mellitus type 2 (DM2), obesity, and the metabolic syndrome are considered that a low-grade chronic inflammatory condition. Although synthesis of different pro- and anti-inflammatory cytokines has been implicated in this process, this low-grade inflammatory condition is characterized especially by an increase in Tumor Necrosis Factor alpha (TNF-α), a cytokine that has been associated to the development of insulin resistance and muscle wasting in the diabetic patients. In consequence, mechanisms implicated in attenuating the deleterious effects of TNF-α are activated. One of these mechanisms may involve interleukin 15 (IL-15), which has proven effect on intermediate metabolisms, regulating blood glucose and lipid levels, and diminishing proteolysis in striated muscle. This suggests that the induction of endogenous IL-15 production by a simple event as physical activity may aid in decreasing or even inhibiting the negative effects of TNF-α in patient with DM2 or obesity, in which a low grade chronic inflammatory condition is present.
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Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Periodontol 2013; 84:S113-34. [DOI: 10.1902/jop.2013.134005] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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20
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Han DH, Lim S, Kim JB. The Association of Smoking and Diabetes With Periodontitis in a Korean Population. J Periodontol 2012; 83:1397-406. [DOI: 10.1902/jop.2012.110686] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kebapcilar L, Hakki SS. Letter to the editor: re: role of smoking and type 2 diabetes in the immunobalance of advanced chronic periodontitis. J Periodontol 2012; 83:1204-5. [PMID: 23016920 DOI: 10.1902/jop.2012.110678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Duarte PM, Szeremeske Miranda T, Lima JA, Dias Gonçalves TE, Santos VR, Bastos MF, Ribeiro FV. Expression of Immune-Inflammatory Markers in Sites of Chronic Periodontitis in Patients With Type 2 Diabetes. J Periodontol 2012; 83:426-34. [DOI: 10.1902/jop.2011.110324] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hosokawa Y, Hosokawa I, Ozaki K, Nakae H, Matsuo T. Interleukin (IL)-17A synergistically enhances CC chemokine ligand 20 production in IL-1β-stimulated human gingival fibroblasts. Hum Immunol 2011; 73:26-30. [PMID: 22019504 DOI: 10.1016/j.humimm.2011.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 09/02/2011] [Accepted: 10/03/2011] [Indexed: 11/17/2022]
Abstract
CC chemokine ligand 20 (CCL20) plays a pivotal role in the recruitment of T-helper (Th)-17 cells and thus in the development of periodontal disease, but the effect of simultaneous interleukin (IL)-17A and IL-1β stimulation on CCL20 production in human gingival fibroblasts (HGFs) are not known. In this study, we investigated the mechanisms of IL-1β- and IL-17A-induced CCL20 production in HGFs. IL-17A synergistically enhanced CCL20 production from IL-1β-stimulated HGFs in a concentration-dependent manner. Extracellular signal-regulated kinase (ERK) and inhibitor of nuclear factor (NF)-κB-α phosphorylation were increased in IL-1β- and IL-17A-stimulated HGFs. Inhibitors of or ERK and NF-κB decreased IL-1β- and IL-17A-induced CCL20 production. IL-1β stimulation elevated IL-17 receptor C expression on HGFs. These data suggest that IL-1β is actively related to Th17 cell migration into peripheral tissues to induce production of the Th17 chemokine, CCL20. Therefore, IL-1β might be a therapeutic target for Th17-related diseases, such as periodontal disease and arthritis.
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Affiliation(s)
- Yoshitaka Hosokawa
- Department of Conservative Dentistry, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
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Duarte PM, Napimoga MH, Fagnani EC, Santos VR, Bastos MF, Ribeiro FV, Araújo VC, Demasi APD. The expression of antioxidant enzymes in the gingivae of type 2 diabetics with chronic periodontitis. Arch Oral Biol 2011; 57:161-8. [PMID: 21975116 DOI: 10.1016/j.archoralbio.2011.08.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 08/03/2011] [Accepted: 08/04/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVES There is controversial evidence regarding the levels of antioxidant molecules in type 2 diabetes periodontitis patients. Thus, the aim of the present study was to evaluate the gene expression of antioxidant enzymes in the gingival tissue of poorly and well-controlled type 2 diabetic subjects with chronic periodontitis (CP). DESIGN Gingival biopsies were harvested from systemically and periodontally healthy subjects (n=12), systemically healthy subjects with CP (n=15), well-controlled (n=8) and poorly controlled (n=14) diabetic subjects with CP. The messenger RNA (mRNA) levels of peroxiredoxin (PRDX) 1 and 2, catalase (CAT), glutathione peroxidase (GPX1) and superoxide dismutase (SOD) 1 and 2 were measured by quantitative polymerase chain reaction (qPCR). RESULTS The results showed that PRDX1 and GPX1 were up-regulated by periodontitis (p<0.05), independently of the glycaemic status, whilst PRDX2 and SOD2 genes were slightly influenced by periodontitis, but significantly induced when periodontitis was associated with DM, especially under a poor glycaemic control (p<0.05). Moreover, CAT and SOD1 expressions were not significantly influenced by any of these inflammatory disorders (p>0.05). CONCLUSION In conclusion, both PRDX1 and GPX1 were overexpressed in CP whilst PRDX2 and SOD2 were up-regulated especially in the poorly controlled diabetic group with CP.
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Affiliation(s)
- Poliana M Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
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Interleukin-17A is involved in development of spontaneous pulmonary emphysema caused by Toll-like receptor 4 mutation. Acta Pharmacol Sin 2011; 32:1045-54. [PMID: 21706041 DOI: 10.1038/aps.2011.67] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIM To explore the pathogenic role of Th17 cells and interleukin-17A (IL-17A)-associated signaling pathways in spontaneous pulmonary emphysema induced by a Toll-like receptor 4 mutant (TLR4(mut)). METHODS Lungs were obtained from wild-type (WT) or TLR4mut mice that were treated with or without recombinant mouse IL-17A (1 μg·kg(-1)·d(-1), ip) from the age of 3 weeks to 3 months. Pulmonary emphysema was determined using histology, immunochemistry, and biochemical analysis. T cell polarization was determined with flow cytometry, the levels of cytokines were measured using ELISA, and the levels of IL-17A-associated signaling molecules were detected using Western blot. RESULTS Compared to WT mice, 3 month-old TLR4(mut) mice were characterized by significantly reduced infiltration of Th17 cells into lungs (2.49%±1.13 % νs 5.26%±1.39%), and significantly reduced expression levels of IL-17A (3.66±0.99 pg/μg νs 10.67±1.65 pg/μg), IL-23 (12.43±1.28 pg/μg νs 28.71±2.57 pg/μg) and IL-6 (51.82±5.45 pg/μg νs 92.73±10.91 pg/μg) in bronchoalveolar lavage fluid. In addition, p38 MAPK phosphorylation and AP-1 expression were decreased to 27%±9% and 51%±8%, respectively, of that in WT mice. Treatment of TLR4(mut) mice with IL-17A increased the infiltration of Th17 cells into lungs and expression levels of IL-17A, IL-6, and IL-23 in bronchoalveolar lavage fluid, attenuated MDA and apoptosis, and improved emphysema accompanied with increased phosphorylation of p38 MAPK and expression of AP-1. CONCLUSION Th17 cells, in particular the cytokine IL-17A, play a crucial role in the pathogenesis of TLR4(mut)-induced spontaneous pulmonary emphysema. Both of them are potential targets for therapeutic strategies for pulmonary emphysema.
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Javed F, Al-Askar M, Al-Hezaimi K. Cytokine profile in the gingival crevicular fluid of periodontitis patients with and without type 2 diabetes: a literature review. J Periodontol 2011; 83:156-61. [PMID: 21692634 DOI: 10.1902/jop.2011.110207] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Periodontitis may occur in patients with and without type 2 diabetes (T2D). It may be hypothesized that the gingival crevicular fluid (GCF) cytokine profile in patients with periodontitis with poorly controlled T2D may differ from the GCF cytokine profile in medically healthy individuals with periodontitis. The aim was to review the cytokine profiles in the GCF of patients with periodontitis with and without T2D. METHODS Databases were searched from 1988 to August 2011 using different combinations of various keywords. Titles and abstracts of articles that satisfied the eligibility criteria were screened by the authors and checked for agreement. Only articles published in English were included. RESULTS Ten studies were included. Two studies reported GCF concentrations of interleukin (IL)-6 to be higher in patients with periodontitis with T2D compared to medically healthy patients with periodontitis. Two studies showed GCF IL-6 levels to be higher in periodontitis with T2D compared to medically healthy subjects without periodontitis. In one study GCF levels of IL-17, IL-23, and interferon-γ were higher in patients with periodontitis with T2D compared to medically healthy patients with periodontitis. In one study, GCF concentrations of IL-8 were significantly higher in patients with periodontitis with T2D compared to medically healthy individuals with periodontitis. Three studies reported GCF levels of IL-1α to be significantly higher in patients with periodontitis with T2D compared to medically healthy individuals with periodontitis. CONCLUSION The GCF cytokine profile in patients with and without T2D seems to be governed by the intensity of periodontal inflammation and the role of T2D in this regard is rather secondary.
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Affiliation(s)
- Fawad Javed
- Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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