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Wang H, Divaris K, Pan B, Li X, Lim JH, Saha G, Barovic M, Giannakou D, Korostoff JM, Bing Y, Sen S, Moss K, Wu D, Beck JD, Ballantyne CM, Natarajan P, North KE, Netea MG, Chavakis T, Hajishengallis G. Clonal hematopoiesis driven by mutated DNMT3A promotes inflammatory bone loss. Cell 2024; 187:3690-3711.e19. [PMID: 38838669 PMCID: PMC11246233 DOI: 10.1016/j.cell.2024.05.003] [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: 08/23/2023] [Revised: 02/19/2024] [Accepted: 05/01/2024] [Indexed: 06/07/2024]
Abstract
Clonal hematopoiesis of indeterminate potential (CHIP) arises from aging-associated acquired mutations in hematopoietic progenitors, which display clonal expansion and produce phenotypically altered leukocytes. We associated CHIP-DNMT3A mutations with a higher prevalence of periodontitis and gingival inflammation among 4,946 community-dwelling adults. To model DNMT3A-driven CHIP, we used mice with the heterozygous loss-of-function mutation R878H, equivalent to the human hotspot mutation R882H. Partial transplantation with Dnmt3aR878H/+ bone marrow (BM) cells resulted in clonal expansion of mutant cells into both myeloid and lymphoid lineages and an elevated abundance of osteoclast precursors in the BM and osteoclastogenic macrophages in the periphery. DNMT3A-driven clonal hematopoiesis in recipient mice promoted naturally occurring periodontitis and aggravated experimentally induced periodontitis and arthritis, associated with enhanced osteoclastogenesis, IL-17-dependent inflammation and neutrophil responses, and impaired regulatory T cell immunosuppressive activity. DNMT3A-driven clonal hematopoiesis and, subsequently, periodontitis were suppressed by rapamycin treatment. DNMT3A-driven CHIP represents a treatable state of maladaptive hematopoiesis promoting inflammatory bone loss.
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Affiliation(s)
- Hui Wang
- Department of Basic and Translational Sciences, Laboratory of Innate Immunity and Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599, USA
| | - Bohu Pan
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR 72079, USA
| | - Xiaofei Li
- Department of Basic and Translational Sciences, Laboratory of Innate Immunity and Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Shanghai Jiao Tong University, School of Life Sciences and Biotechnology, Sheng Yushou Center of Cell Biology and Immunology, Shanghai 200240, China
| | - Jong-Hyung Lim
- Department of Basic and Translational Sciences, Laboratory of Innate Immunity and Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Gundappa Saha
- Department of Basic and Translational Sciences, Laboratory of Innate Immunity and Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Marko Barovic
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Danai Giannakou
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - Jonathan M Korostoff
- Department of Periodontics, Laboratory of Innate Immunity and Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yu Bing
- Human Genetics Center, Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Souvik Sen
- Department of Neurology, University of South Carolina, Columbia, SC 29209, USA; Center for the Study of Aphasia Recovery, University of South Carolina, Columbia, SC 29209, USA
| | - Kevin Moss
- Department of Biostatistics and Health Data Sciences, School of Medicine, Indiana University, Indianapolis, IN 46202, USA; Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599, USA
| | - Di Wu
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599, USA
| | - James D Beck
- Division of Comprehensive Oral Health-Periodontology, Adams School of Dentistry, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599, USA
| | | | - Pradeep Natarajan
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02141, USA; Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599, USA
| | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6525 XZ Nijmegen, the Netherlands; Department of Immunology and Metabolism, LIMES, University of Bonn, 53115 Bonn, Germany
| | - Triantafyllos Chavakis
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital, Technische Universität Dresden, 01307 Dresden, Germany
| | - George Hajishengallis
- Department of Basic and Translational Sciences, Laboratory of Innate Immunity and Inflammation, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Lyra P, Botelho J, Rota S, Poplawska-Domaszewicz K, Machado V, Guerreiro D, Proença L, Barroso H, Mendes JJ, Chaudhuri KR. Non-Surgical Periodontal Therapy's Influence on Alpha-Synuclein and Inflammatory Marker Levels: A Pilot Study. J Clin Med 2024; 13:3586. [PMID: 38930115 PMCID: PMC11204787 DOI: 10.3390/jcm13123586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Microbial dysbiosis may contribute to alpha-synuclein (α-Syn) homeostasis disruption, yet the burden of inflammatory periodontal infection and its treatment have never been studied in this regard. We aimed to compare the cytokine and α-Syn levels in the saliva and blood of patients with periodontitis who underwent non-surgical periodontal therapy (NSPT) and those of their healthy counterparts. Methods: Periodontal examination and saliva and blood sample collection were carried out in incoming patients at a university clinic. The periodontitis group (PG) received NSPT. The sample collection and periodontal observation were repeated 30 days after. IL-6, IL1-β and total α-Syn were quantified using immunoassay methods. The periodontal inflamed surface area (PISA) was calculated as a proxy for periodontal inflammation. Results: Eleven participants formed the PG, and there were fifteen healthy controls (HC). At baseline, no correlation between salivary and plasma α-Syn was found. The salivary α-Syn levels revealed a tendency to decrease 30 days after, particularly in the PD cases. The variation in PISA and α-Syn showed significant correlation. Salivary α-Syn correlated negatively with salivary IL-6 levels at both timepoints in the total sample (rho = -0.394 and rho = -0.451) and in the HC (rho = -0.632 and rho = -0.561). Variations in plasma IL-6 and α-Syn were negatively correlated (rho = -0.518) in the healthy participants. Baseline plasma IL1-β negatively correlated with plasmatic α-Syn at 30 days in the HC (rho = -0.581). Conclusions: Salivary and plasma α-Syn bioavailability operate independently, and periodontal diagnosis was not a confounding factor. Salivary α-Syn levels were significantly affected by NSPT, contrary to plasma levels. These results should be confirmed in future larger and prospective studies.
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Affiliation(s)
- Patrícia Lyra
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - João Botelho
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Silvia Rota
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (S.R.); (K.R.C.)
- Parkinson’s Foundation Center of Excellence, King’s College Hospital, London SE5 9RS, UK;
| | - Karolina Poplawska-Domaszewicz
- Parkinson’s Foundation Center of Excellence, King’s College Hospital, London SE5 9RS, UK;
- Department of Neurology, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Vanessa Machado
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Daniela Guerreiro
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Luís Proença
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Helena Barroso
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - José João Mendes
- Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal; (P.L.); (J.B.); (V.M.); (D.G.); (L.P.); (H.B.)
| | - Kallol Ray Chaudhuri
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (S.R.); (K.R.C.)
- Parkinson’s Foundation Center of Excellence, King’s College Hospital, London SE5 9RS, UK;
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Alblowi JA, Farid ZS, Attia MS. Comparative Study of Azithromycin Versus Doxycycline Effect on the Resistin Level in Periodontitis Patients With Type 2 Diabetes: A Randomized Controlled Clinical Trial. Cureus 2024; 16:e54849. [PMID: 38533160 PMCID: PMC10964125 DOI: 10.7759/cureus.54849] [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] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
AIM The present study aimed to determine if azithromycin (AZM) and doxycycline therapy, as an adjunct to scaling and root planning (SRP), modulate host response and improve clinical outcomes in periodontitis patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS Forty-five periodontal sites in 15 periodontitis patients with T2DM received nonsurgical periodontal therapy (NSPT). In Group I, patients were placebo (not receiving any medication), Group II patients received systemic AZM therapy (AZM 250 mg/day for five days), and Group III patients received doxycycline (20 mg twice per day for three months. The resistin level was collected and measured by enzyme-linked immunosorbent assay (ELISA). Gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, one-month, and three-month intervals. RESULTS All groups showed improvement in clinical parameters and resistin levels throughout the study. The mean resistin level at three months was the highest in Group I and the lowest in Group III. Patients in Group II showed a larger decrease in mean PD than those in Group I and III. Group III had the highest gain in mean CAL, with an increase of 1.78 mm in attachment. CONCLUSION Resistin might be a useful indicator of current disease status. In addition, benefits from adjunctive systemic use of AZM and doxycycline have been administered with non-surgical periodontal therapy.
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Affiliation(s)
- Jazia A Alblowi
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Zienab S Farid
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine, Al-Azhar University (Girls Branch), Cairo, EGY
| | - Mai S Attia
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine, Al-Azhar University (Girls Branch), Cairo, EGY
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine, Misr International University, Cairo, EGY
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Li S, Li H, Kong H, Wu SY, Cheng CK, Xu J. Endogenous and microbial biomarkers for periodontitis and type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1292596. [PMID: 38149100 PMCID: PMC10750125 DOI: 10.3389/fendo.2023.1292596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/20/2023] [Indexed: 12/28/2023] Open
Abstract
It has been well documented that there is a two-way relationship between diabetes mellitus and periodontitis. Diabetes mellitus represents an established risk factor for chronic periodontitis. Conversely, chronic periodontitis adversely modulates serum glucose levels in diabetic patients. Activated immune and inflammatory responses are noted during diabetes and periodontitis, under the modulation of similar biological mediators. These activated responses result in increased activity of certain immune-inflammatory mediators including adipokines and microRNAs in diabetic patients with periodontal disease. Notably, certain microbes in the oral cavity were identified to be involved in the occurrence of diabetes and periodontitis. In other words, these immune-inflammatory mediators and microbes may potentially serve as biomarkers for risk assessment and therapy selection in diabetes and periodontitis. In this review, we briefly provide an updated overview on different potential biomarkers, providing novel diagnostic and therapeutic insights on periodontal complications and diabetes mellitus.
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Affiliation(s)
- Songjun Li
- Longgang Ear-Nose-Throat (ENT) Hospital, Institute of Ear-Nose-Throat (ENT) and Shenzhen Key Laboratory of Ear-Nose-Throat (ENT), Shenzhen, China
| | - Hongwen Li
- Longgang Ear-Nose-Throat (ENT) Hospital, Institute of Ear-Nose-Throat (ENT) and Shenzhen Key Laboratory of Ear-Nose-Throat (ENT), Shenzhen, China
- Shenzhen Longgang Institute of Stomatology, Longgang Ear-Nose-Throat (ENT) Hospital, Shenzhen, China
| | - Haiying Kong
- Longgang Ear-Nose-Throat (ENT) Hospital, Institute of Ear-Nose-Throat (ENT) and Shenzhen Key Laboratory of Ear-Nose-Throat (ENT), Shenzhen, China
| | - Shang Ying Wu
- Department of Laboratory Medicine, Shenzhen Hospital, Peking University, Shenzhen, China
| | - Chak Kwong Cheng
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Jian Xu
- Longgang Ear-Nose-Throat (ENT) Hospital, Institute of Ear-Nose-Throat (ENT) and Shenzhen Key Laboratory of Ear-Nose-Throat (ENT), Shenzhen, China
- Shenzhen Longgang Institute of Stomatology, Longgang Ear-Nose-Throat (ENT) Hospital, Shenzhen, China
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Zhao D, Sun Y, Li X, Wang X, Lu L, Li C, Pan Y, Wang S. Association between Periodontitis and HbA1c Levels in Non-Diabetic Patients: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2649. [PMID: 37830686 PMCID: PMC10572398 DOI: 10.3390/healthcare11192649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND A high detection rate of diabetes among dental visitors has been reported recently. This systematic review aimed to evaluate the association between periodontitis and glycated hemoglobin (HbA1c) levels among non-diabetic individuals. METHODS The EMBASE, MEDLINE, Web of Science, Cochrane Library, PubMed, and Open GREY databases were searched, and observational studies published until 1st June 2023 were identified. A methodological quality assessment was conducted based on the original and modified versions of the Newcastle-Ottawa scale. Cohort, case-control, and cross-sectional studies that performed clinical periodontal examinations and measured HbA1c levels in non-diabetic adults were included. A meta-analysis was conducted to estimate the weighted mean difference (WMD) between individuals with and without periodontitis. RESULTS In total, 29 case-control and 5 cross-sectional studies were selected from 2583 potentially eligible articles. Among them, sixteen case-control and three cross-sectional studies with moderate to high quality were selected for the meta-analyses. The HbA1c levels in periodontitis patients were significantly higher than those in individuals with healthy periodontal conditions (WMD = 0.16; p < 0.001) among the non-diabetic populations. CONCLUSIONS This study reveals a significant association between periodontitis and HbA1c levels in non-diabetic populations. Thus, HbA1c screening may be recommended to detect potential hyperglycemia in non-diabetic periodontitis patients.
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Affiliation(s)
- Dan Zhao
- Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China;
| | - Yangyang Sun
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Xin Li
- School of Public Health, National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China;
| | - Xiaoxiao Wang
- Department of Oral Implantology and Prosthodontics, Shenzhen Stomatology Hospital Affiliated to Shenzhen University, Shenzhen 518001, China;
| | - Lijie Lu
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Chen Li
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Yaping Pan
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang 110002, China; (Y.S.); (L.L.); (C.L.); (Y.P.)
| | - Songlin Wang
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Laboratory of Oral Health and Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
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Zhao M, Xie Y, Gao W, Li C, Ye Q, Li Y. Diabetes mellitus promotes susceptibility to periodontitis-novel insight into the molecular mechanisms. Front Endocrinol (Lausanne) 2023; 14:1192625. [PMID: 37664859 PMCID: PMC10469003 DOI: 10.3389/fendo.2023.1192625] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
Diabetes mellitus is a main risk factor for periodontitis, but until now, the underlying molecular mechanisms remain unclear. Diabetes can increase the pathogenicity of the periodontal microbiota and the inflammatory/host immune response of the periodontium. Hyperglycemia induces reactive oxygen species (ROS) production and enhances oxidative stress (OS), exacerbating periodontal tissue destruction. Furthermore, the alveolar bone resorption damage and the epigenetic changes in periodontal tissue induced by diabetes may also contribute to periodontitis. We will review the latest clinical data on the evidence of diabetes promoting the susceptibility of periodontitis from epidemiological, molecular mechanistic, and potential therapeutic targets and discuss the possible molecular mechanistic targets, focusing in particular on novel data on inflammatory/host immune response and OS. Understanding the intertwined pathogenesis of diabetes mellitus and periodontitis can explain the cross-interference between endocrine metabolic and inflammatory diseases better, provide a theoretical basis for new systemic holistic treatment, and promote interprofessional collaboration between endocrine physicians and dentists.
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Affiliation(s)
- Mingcan Zhao
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Yuandong Xie
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Wenjia Gao
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Chunwang Li
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Qiang Ye
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Yi Li
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
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7
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Himawan A, Vora LK, Permana AD, Sudir S, Nurdin AR, Nislawati R, Hasyim R, Scott CJ, Donnelly RF. Where Microneedle Meets Biomarkers: Futuristic Application for Diagnosing and Monitoring Localized External Organ Diseases. Adv Healthc Mater 2023; 12:e2202066. [PMID: 36414019 DOI: 10.1002/adhm.202202066] [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: 08/16/2022] [Revised: 11/03/2022] [Indexed: 11/24/2022]
Abstract
Extracellular tissue fluids are interesting biomatrices that have recently attracted scientists' interest. Many significant biomarkers for localized external organ diseases have been isolated from this biofluid. In the diagnostic and disease monitoring context, measuring biochemical entities from the fluids surrounding the diseased tissues may give more important clinical value than measuring them at a systemic level. Despite all these facts, pushing tissue fluid-based diagnosis and monitoring forward to clinical settings faces one major problem: its accessibility. Most extracellular tissue fluid, such as interstitial fluid (ISF), is abundant but hard to collect, and the currently available technologies are invasive and expensive. This is where novel microneedle technology can help tackle this significant obstacle. The ability of microneedle technology to minimally invasively access tissue fluid-containing biomarkers will enable ISF and other tissue fluid utilization in the clinical diagnosis and monitoring of localized diseases. This review attempts to present the current pursuit of the application of microneedle systems as a diagnostic and monitoring platform, along with the recent progress of biomarker detection in diagnosing and monitoring localized external organ diseases. Then, the potential use of various microneedles in future clinical diagnostics and monitoring of localized diseases is discussed by presenting the currently studied cases.
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Affiliation(s)
- Achmad Himawan
- School of Pharmacy, Queen's University Belfast, Belfast, BT97BL, UK.,Department of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | | | - Andi Dian Permana
- Department of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | - Sumarheni Sudir
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | - Airin R Nurdin
- Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia.,Hasanuddin University Hospital, Hasanuddin University, Makassar, 90245, Indonesia
| | - Ririn Nislawati
- Hasanuddin University Hospital, Hasanuddin University, Makassar, 90245, Indonesia.,Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia
| | - Rafikah Hasyim
- Department of Oral Biology, Faculty of Dentistry, Hasanuddin University, Makassar, 90245, Indonesia
| | - Christopher J Scott
- Patrick G Johnson Centre for Cancer Research, Queen's University Belfast, Belfast, BT97BL, UK
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Belfast, BT97BL, UK
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8
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Dikilitaş A, Karaaslan F, Evirgen Ş, Ertuğrul AS. Gingival crevicular fluid CSF-1 and IL-34 levels in patients with stage III grade C periodontitis and uncontrolled type 2 diabetes mellitus. J Periodontal Implant Sci 2022; 52:455-465. [PMID: 36468466 PMCID: PMC9807851 DOI: 10.5051/jpis.2106260313] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Periodontal diseases are inflammatory conditions that alter the host's response to microbial pathogens. Type 2 diabetes mellitus (T2DM) is a complex disease that affects the incidence and severity of periodontal diseases. This study investigated the gingival crevicular fluid (GCF) levels of colony-stimulating factor-1 (CSF-1) and interleukin-34 (IL-34) in patients with stage III grade C periodontitis (SIII-GC-P) and stage III grade C periodontitis with uncontrolled type 2 diabetes (SIII-GC-PD). METHODS In total, 72 individuals, including 24 periodontally healthy (PH), 24 SIII-GC-P, and 24 SIII-GC-PD patients, were recruited for this study. Periodontitis patients (stage III) had interdental attachment loss (AL) of 5 mm or more, probing depth (PD) of 6 mm or more, radiographic bone loss advancing to the middle or apical part of the root, and tooth loss (<5) due to periodontal disease. Radiographic bone loss in the teeth was also evaluated; grade C periodontitis was defined as a ratio of the percentage of root bone loss to age greater than 1.0. The plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), PD, and clinical AL were used for clinical periodontal assessments. GCF samples were obtained and analyzed using an enzyme-linked immunosorbent assay. RESULTS All clinical parameters-PD, AL, GI, BOP, and PI-were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups for both the full mouth and each sampling site (P<0.05). The total IL-34 and CSF-1 levels were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups (P<0.05), and there were significant differences between the periodontitis groups (P<0.05). CONCLUSIONS These findings suggest that IL-34 and CSF-1 expression increases in patients with SIII-GC-PD. CSF-1 was associated with the inflammatory status of periodontal tissues and T2DM, while IL-34 was associated only with T2DM. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04891627.
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Affiliation(s)
- Ahu Dikilitaş
- Department of Periodontology, Faculty of Dentistry, Usak University, Usak, Turkey
| | - Fatih Karaaslan
- Department of Periodontology, Faculty of Dentistry, Usak University, Usak, Turkey
| | - Şehrazat Evirgen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Usak University, Usak, Turkey
| | - Abdullah Seçkin Ertuğrul
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, İzmir, Turkey
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Luong A, Tawfik AN, Islamoglu H, Gobriel HS, Ali N, Ansari P, Shah R, Hung T, Patel T, Henson B, Thankam F, Lewis J, Mintline M, Boehm T, Tumur Z, Seleem D. Periodontitis and diabetes mellitus co-morbidity: A molecular dialogue. J Oral Biosci 2021; 63:360-369. [PMID: 34728373 DOI: 10.1016/j.job.2021.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and periodontitis are two biologically linked diseases that often coexist in complex interaction. While periodontitis may lead to insulin receptor desensitization, diabetes may increase the expression of inflammatory cytokines, such as Tumor Necrosis Factor-α (TNF-α) and Interleukin 6 (IL-6), in the gingival crevicular fluid and activate osteoclasts via Receptor activator of nuclear factor kappa-Β ligand (RANK-L) production, leading to bone resorption. However, the association between the two diseases processes, where one may exacerbate the progression of the other, is unclear. In addition, both diseases have similar mechanistic themes, such as chronic inflammation and oxidative stress. This review aimed to investigate the pathophysiological and molecular mechanisms underlying T2DM and periodontitis. HIGHLIGHT Uncontrolled diabetes is often associated with severe periodontitis, measured by clinical attachment loss. Alteration in the oral microbiome composition, which may activate the host inflammatory response and lead to irreversible oxidative stress, is a common finding in both diseases. An understanding of the molecular crosstalk between the two disease processes is crucial for developing therapeutic targets that inhibit bone resorption and halt the progression of periodontitis in patients with diabetes. CONCLUSION The Oral microbiome composition in T2DM and periodontitis shifts toward dysbiosis, favoring bacterial pathogens, such as Fusobacteria and Porphyromonas species. Both conditions are marked by pro-inflammatory immune activity via the activation of Interleukin 17 (IL-17), Interleukin 1 (IL-1), TNF-α, and Nuclear Factor Kappa Beta (NF-κB). Common molecular crosstalk signaling appears to involve advanced glycation end products (AGEs) and oxidative stress. Thus, future drug targets are multifactorial, ranging from modulatory of host inflammatory response to preventing the accumulation of AGEs and oxidative free radicals.
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Affiliation(s)
- Anthony Luong
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Andy Nassif Tawfik
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Hicret Islamoglu
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Hanaa Selim Gobriel
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Nada Ali
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Pouya Ansari
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Ruchita Shah
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Tiffany Hung
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Tanusha Patel
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Bradley Henson
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Finosh Thankam
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Jill Lewis
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Mark Mintline
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Tobias Boehm
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Zohra Tumur
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Dalia Seleem
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA.
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Pirih FQ, Monajemzadeh S, Singh N, Sinacola RS, Shin JM, Chen T, Fenno JC, Kamarajan P, Rickard AH, Travan S, Paster BJ, Kapila Y. Association between metabolic syndrome and periodontitis: The role of lipids, inflammatory cytokines, altered host response, and the microbiome. Periodontol 2000 2021; 87:50-75. [PMID: 34463996 PMCID: PMC8457155 DOI: 10.1111/prd.12379] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis has been associated with many systemic diseases and conditions, including metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur concomitantly and together they increase the risk of cardiovascular disease and double the risk of type 2 diabetes. In this review, we focus on the association between metabolic syndrome and periodontitis; however, we also include information on diabetes mellitus and cardiovascular disease, since these two conditions are significantly intertwined with metabolic syndrome. With regard to periodontitis and metabolic syndrome, to date, the vast majority of studies point to an association between these two conditions and also demonstrate that periodontitis can contribute to the development of, or can worsen, metabolic syndrome. Evaluating the effect of metabolic syndrome on the salivary microbiome, data presented herein support the hypothesis that the salivary bacterial profile is altered in metabolic syndrome patients compared with healthy patients. Considering periodontitis and these three conditions, the vast majority of human and animal studies point to an association between periodontitis and metabolic syndrome, diabetes, and cardiovascular disease. Moreover, there is evidence to suggest that metabolic syndrome and diabetes can alter the oral microbiome. However, more studies are needed to fully understand the influence these conditions have on each other.
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Affiliation(s)
- Flavia Q Pirih
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, California
| | | | - Neelima Singh
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | | | - Jae Min Shin
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Tsute Chen
- The Forsyth Institute, Cambridge, Massachusetts
- Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | - Alexander H Rickard
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Suncica Travan
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, Massachusetts
- Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
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11
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Alqerban A. Levels of proinflammatory chemokines and advanced glycation end products in patients with type-2 diabetes mellitus undergoing fixed orthodontic treatment. Angle Orthod 2021; 91:105-110. [PMID: 33289806 PMCID: PMC8032277 DOI: 10.2319/051120-420.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/01/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To explore the effect of diabetic status on the proinflammatory chemokine profile and levels of advanced glycation end products (AGEs) in gingival crevicular fluid (GCF) derived from patients with type 2 diabetes mellitus (T2DM) undergoing fixed orthodontic treatment. MATERIALS AND METHODS Two groups, nondiabetic and T2DM, were included. Their demographics, biochemical parameters including hemoglobin A1c, fasting blood glucose, body mass index, and oral hygiene status were recorded. GCF sampling was performed after 2 months of placement of stainless steel archwires and chemokines (primary outcome) were quantified using Human Magnetic Luminex multiplex assay. Secondary outcomes were assessment of clinical periodontal status, unstimulated whole saliva flow rate, and GCF flow rate. RESULTS Twenty participants each in the nondiabetic (mean age: 26.4 years) and T2DM (mean age: 27.2 years) groups gave consent to participate. Biochemical analysis showed significantly increased values for hemoglobin A1c (P < .001), fasting blood glucose (P < .0001), body mass index(P = .047), and unstimulated whole saliva flow rate (P = .041) for the T2DM group. Bleeding on probing was significantly higher in participants with T2DM than nondiabetic participants (P = .039). Resistin (P = .034) and AGEs (P = .017) showed significantly higher values in participants with T2DM than nondiabetic participants. Pearson correlation analysis indicated a significant positive correlation between resistin (r = 0.1372; P = .022) and AGEs (r = 0.0194; P = .0186) against bleeding on probing in participants with T2DM. CONCLUSIONS The biochemical profile of GCF samples from participants with T2DM after alignment demonstrated higher levels of resistin and AGEs. The data suggest the presence of a proinflammatory response in patients with T2DM undergoing fixed orthodontic treatment.
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12
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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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13
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Inönü E, Kayis SA, Eskan MA, Hakki SS. Salivary Del‐1, IL‐17, and LFA‐1 levels in periodontal health and disease. J Periodontal Res 2020; 55:511-518. [DOI: 10.1111/jre.12738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/13/2020] [Accepted: 02/04/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Elif Inönü
- Department of Periodontology Faculty of Dentistry Baskent University Ankara Turkey
| | - Seyit Ali Kayis
- Department of Biostatistics Faculty of Medicine Karabuk University Karabuk Turkey
| | - Mehmet Akif Eskan
- Department of Periodontics NOVA Southeastern University College of Dental Medicine Fort Lauderdale FL USA
| | - Sema S. Hakki
- Department of Periodontology Faculty of Dentistry Selcuk University Konya Turkey
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Resistin Is Increased in Periodontal Cells and Tissues: In Vitro and In Vivo Studies. Mediators Inflamm 2020; 2020:9817095. [PMID: 32410876 PMCID: PMC7201489 DOI: 10.1155/2020/9817095] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/30/2019] [Indexed: 12/12/2022] Open
Abstract
Resistin, a proinflammatory adipokine, is elevated in many inflammatory diseases. However, little is known about its performance in periodontitis. The present study is aimed at evaluating resistin expression and synthesis in periodontal cells and tissues under inflammatory/microbial stress in addition to its effects on the periodontium. In vivo, 24 male rats were randomly divided into two groups: control and ligature-induced periodontal disease. After 6 and 12 days, animals were sacrificed to analyze gene expression of adipokines, bone loss, inflammation, and resistin synthesis. In vitro, human periodontal ligament (PDL) fibroblasts were used to evaluate the expression of resistin after inflammatory stimuli. In addition, PDL fibroblasts were exposed to resistin to evaluate its role on soft and hard tissue metabolism markers. The periodontitis group demonstrated significant bone loss, an increase in the number of inflammatory cells and vascular structures, an increase in resistin expression and synthesis, and a decrease in the expression of adiponectin, leptin, and its functional receptor. PDL fibroblasts showed a significant increase in resistin expression and synthesis in response to the inflammatory stimulus by IL-1β. Resistin induced an increase in cytokine expression and a decrease in the regulation of some hard tissue and matrix formation genes in PDL fibroblasts. These data indicate that resistin is produced by periodontal cells and tissues, and this effect is enhanced by inflammatory stimuli. Moreover, resistin seems to interfere with soft and hard tissue metabolism during periodontitis by reducing markers related to matrix formation and bone tissue.
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15
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Doğusal G, Afacan B, Bozkurt E, Sönmez I. Gingival crevicular fluid and salivary resistin and tumor necrosis factor-alpha levels in obese children with gingivitis. J Periodontol 2019; 89:973-982. [PMID: 29635809 DOI: 10.1002/jper.17-0613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/08/2018] [Accepted: 02/13/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to evaluate the levels of resistin and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF) and saliva of obese children with gingivitis. METHODS One-hundred and thirty children (65 obese and 65 normal weight; age range 8 to 12 years) were recruited for the study. The children were classified into four subgroups based on their body mass and periodontal status; 1) obese children with gingivitis (OG, n = 33); 2) obese children with healthy periodontium (OH, n = 32); 3) normal weight children with gingivitis (NWG, n = 32); 4) normal weight children with healthy periodontium (NWH, n = 33). Body mass index (BMI) percentile, probing pocket depth (PPD), gingival index (GI), and plaque index (PI) were recorded. Resistin and TNF-α were analyzed in GCF and saliva samples by ELISA. RESULTS Obese children had higher BMI percentiles than normal weight children (p < 0.0001). PPD, GI, PI, GCF volume, GCF, and salivary resistin and TNF-α levels were similar between obese and normal weight children (P > 0.05). OG and NWG subgroups had significantly higher GI, PI, GCF volume, GCF resistin total amounts, and salivary resistin concentrations but lower GCF resistin and TNF-α concentrations than OH and NWH (P < 0.0001 for all). GCF resistin total amounts were positively correlated with GI, PI, and GCF TNF-α total amounts (P < 0.05). CONCLUSIONS To our knowledge, this is the first study evaluated the levels of resistin in GCF and saliva of children. Obesity is not associated with GCF and salivary resistin and TNF-α levels in children in the presence of gingival inflammation.
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Affiliation(s)
- Gülçin Doğusal
- Department of Pediatric Dentistry, Faculty of Dentistry, Adnan Menderes University, Aydın, Turkey
| | - Beral Afacan
- Department of Periodontology, Faculty of Dentistry, Adnan Menderes University, Aydın, Turkey
| | - Emir Bozkurt
- Section of Molecular Biology, Department of Biology, Faculty of Science and Letters, Celal Bayar University, Manisa, Turkey
| | - Işıl Sönmez
- Department of Pediatric Dentistry, Faculty of Dentistry, Adnan Menderes University, Aydın, Turkey
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Rathwa N, Patel R, Palit SP, Ramachandran A, Begum R. Genetic variants of resistin and its plasma levels: Association with obesity and dyslipidemia related to type 2 diabetes susceptibility. Genomics 2019; 111:980-985. [DOI: 10.1016/j.ygeno.2018.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 01/04/2023]
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17
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Rode PA, Kolte RA, Kolte AP, Purohit HJ, Ahuja CR. Relevance of single-nucleotide polymorphism to the expression of resistin gene affecting serum and gingival crevicular fluid resistin levels in chronic periodontitis and type 2 diabetes mellitus: A randomized control clinical trial. J Indian Soc Periodontol 2019; 23:131-136. [PMID: 30983784 PMCID: PMC6434728 DOI: 10.4103/jisp.jisp_361_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: The present study is aimed to investigate whether single-nucleotide polymorphism (SNP) of resistin gene (RETN) at −420 and +299 sites, is associated with resistin levels in serum and gingival crevicular fluid (GCF) in periodontally healthy, chronic periodontitis (CP) with and without type 2 diabetes mellitus (T2DM) patients. Materials and Methods: Serum and GCF samples were procured from all the 60 patients (twenty in each group) of the three study groups i.e., periodontally healthy (Group I), CP (Group II) and CP with T2DM patients (Group III) to analyze resistin levels using enzyme-linked immunosorbent assay test and clinical parameters were assessed at baseline and at 3 months after scaling and root planing (SRP). RETN polymorphism at −420 and +299 was genotyped by polymerase chain reaction-restriction fragment length polymorphism technique. Results: Patients with SNP −420 and +299 were positively correlated with increased serum and GCF resistin levels in Group II and Group III patients. SRP led to substantial reduction in the serum and GCF resistin levels. Conclusion: These findings are suggestive of a biologic link between resistin, periodontal diseases, and periodontal diseases with T2DM and RETN SNP at −420 and +299 in imparting increased resistin levels in inflammatory and diabetic conditions.
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Affiliation(s)
- Pranita Avinash Rode
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Rajashri Abhay Kolte
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Abhay Pandurang Kolte
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Hemant Jyotiswarup Purohit
- Environmental Genomics Division, National Environmental Engineering Research Institute, Nagpur, Maharashtra, India
| | - Charu Ram Ahuja
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
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Ghallab NA. Diagnostic potential and future directions of biomarkers in gingival crevicular fluid and saliva of periodontal diseases: Review of the current evidence. Arch Oral Biol 2018; 87:115-124. [DOI: 10.1016/j.archoralbio.2017.12.022] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/04/2017] [Accepted: 12/21/2017] [Indexed: 11/25/2022]
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Graziani F, Gennai S, Solini A, Petrini M. A systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes An update of the EFP-AAP review. J Clin Periodontol 2017; 45:167-187. [PMID: 29277926 DOI: 10.1111/jcpe.12837] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2017] [Indexed: 12/23/2022]
Abstract
AIM To update the available evidence on the impact of periodontitis on diabetes control, incidence and complications. METHODS Observational studies on the effect of periodontitis on diabetes, published after 2012, were identified through electronic databases and hand-searched journals. Findings were summarized by evidence tables, using PRISMA statement. Quality of the included studies was evaluated through the Newcastle Ottawa scale. RESULTS Healthy individuals with periodontitis exhibit a poor glycaemic control and a higher risk of developing diabetes. Individuals affected by diabetes show a deterioration of glycaemic control if also affected by periodontitis and significantly higher prevalence of diabetes-related complications. Limited evidence is available on gestational diabetes and type 1 diabetes. CONCLUSIONS Periodontitis has a significant impact on diabetes control, incidence and complications. Nevertheless, the heterogeneity and quality of the included publications suggest that caution should be exercised when interpreting the data and that there remains an important need for additional evidence.
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Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Anna Solini
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy.,Unit of Internal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Morena Petrini
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
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Polak D, Shapira L. An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 2017; 45:150-166. [PMID: 29280184 DOI: 10.1111/jcpe.12803] [Citation(s) in RCA: 197] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 02/06/2023]
Abstract
AIM To provide an update of the review by Taylor (Journal of Clinical Periodontology, 2013, 40, S113) regarding the scientific evidence of the biological association between periodontitis and diabetes. METHODS Literature searches were performed using MeSH terms, keywords and title words and were published between 2012 and November 2016. All publications were screened for their relevance. The data from the articles were extracted and summarized in tables and a narrative review. RESULTS Small-scale molecular periodontal microbiome studies indicate a possible association between altered glucose metabolism in pre-diabetes and diabetes and changes in the periodontal microbiome, with no evidence for casual relationships. Clinical and animal studies found elevated gingival levels of IL1-β, TNF-α, IL-6, RANKL/OPG and oxygen metabolites in poorly controlled diabetes. In addition, individuals with diabetes and periodontitis exhibit high levels of circulating TNF-α, CRP and mediators of oxidative stress, and successful periodontal treatment reduces their levels. CONCLUSIONS The elevated pro-inflammatory factors in the gingiva of patients with poorly controlled diabetes suggest a biological pathway that may aggravate periodontitis. Some evidence suggests that the systemic inflammatory burden in periodontitis has the potential to affect diabetes control, but no studies addressed the impact of successful periodontal therapy on the pathophysiological mechanisms involved in systemic complications of diabetes.
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Affiliation(s)
- David Polak
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
| | - Lior Shapira
- Department of Periodontology, Hebrew University-Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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21
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Khanuja PK, Narula SC, Rajput R, Sharma RK, Tewari S. Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population. Front Med 2017; 11:110-119. [DOI: 10.1007/s11684-016-0484-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 08/17/2016] [Indexed: 12/17/2022]
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22
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Akram Z, Baharuddin NA, Vaithilingam RD, Rahim ZHA, Chinna K, Krishna VG, Saub R, Safii SH. Effect of nonsurgical periodontal treatment on clinical periodontal variables and salivary resistin levels in obese Asians. J Oral Sci 2017; 59:93-102. [DOI: 10.2334/josnusd.16-0127] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Zohaib Akram
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya
- Department of Periodontology, Faculty of Dentistry, Ziauddin University
| | - Nor A. Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya
| | | | - Zubaidah H. A. Rahim
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, University of Malaya
| | - Karuthan Chinna
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya
| | - Vignes G. Krishna
- Department of Development Studies, Faculty of Economics and Administration, University of Malaya
| | - Roslan Saub
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya
| | - Syarida H. Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya
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Nazar Majeed Z, Philip K, Alabsi AM, Pushparajan S, Swaminathan D. Identification of Gingival Crevicular Fluid Sampling, Analytical Methods, and Oral Biomarkers for the Diagnosis and Monitoring of Periodontal Diseases: A Systematic Review. DISEASE MARKERS 2016; 2016:1804727. [PMID: 28074077 PMCID: PMC5198140 DOI: 10.1155/2016/1804727] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 10/07/2016] [Accepted: 10/23/2016] [Indexed: 12/25/2022]
Abstract
Background. Several studies in the last decades have focused on finding a precise method for the diagnosis of periodontal disease in its early stages. Aim. To evaluate from current scientific literature the most common and precise method for gingival crevicular fluid (GCF) sample collection, biomarker analytical methods, and the variability of biomarker quantification, even when using the same analytical technique. Methodology. An electronic search was conducted on in vivo studies that presented clinical data on techniques used for GCF collection and biomarker analysis. Results. The results showed that 71.1%, 24.7%, and 4.1% of the studies used absorption, microcapillary, and washing techniques, respectively, in their gingival crevicular fluid collection. 73.1% of the researchers analyzed their samples by using enzyme-linked immunosorbent assay (ELISA). 22.6%, 19.5%, and 18.5% of the researchers included interleukin-1 beta (IL-1β), matrix metalloproteinase-8 (MMP-8), and tumor necrosis factor-alpha (TNF-α), respectively, in their studies as biomarkers for periodontal disease. Conclusion. IL-1β can be considered among the most common biomarkers that give precise results and can be used as an indicator of periodontal disease progression. Furthermore, paper strips are the most convenient and accurate method for gingival crevicular fluid collection, while enzyme-linked immunosorbent assay can be considered the most conventional method for the diagnosis of biofluids.
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Affiliation(s)
- Zeyad Nazar Majeed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
- Department of Periodontology, Faculty of Dentistry, University of Babylon, Babylon, Iraq
| | - Koshy Philip
- Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - A. M. Alabsi
- Department of Oral and Craniofacial Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Saravanan Pushparajan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Dasan Swaminathan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Akram Z, Rahim ZHA, Taiyeb-Ali TB, Shahdan MSA, Baharuddin NA, Vaithilingam RD, Safii SH. Resistin as potential biomarker for chronic periodontitis: A systematic review and meta-analysis. Arch Oral Biol 2016; 73:311-320. [PMID: 27567495 DOI: 10.1016/j.archoralbio.2016.08.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/15/2016] [Accepted: 08/16/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To determine the serum and gingival crevicular fluid (GCF) levels of resistin between individuals with chronic periodontitis (CP) and those without CP, and to evaluate the role of resistin in CP. MATERIALS AND METHODS The addressed focused question was "Is there a difference in the resistin levels between individuals with CP and those without CP?" four electronic databases: Medline, PubMed (National Institutes of Health, Bethesda), EMBASE, and Science direct databases from 1977 up to March 2016 for appropriate articles addressing the focused question. EMBASE and Medline were accessed using OVID interface which facilitated simultaneous search of text words, MeSH or Emtree. Unpublished studies (gray literature) were identified by searching the Open-GRAY database and references of the included studies (cross referencing) were performed to obtain new studies. In-vitro studies, animal studies, studies that reported levels of other cytokines but not resistin, letters to the editor and review papers were excluded. RESULTS Ten studies were included. Nine studies compared resistin levels between CP and periodontally healthy (H) individuals and reported higher mean serum and GCF levels of resistin in CP patients than the H controls. Two studies showed comparable resistin levels from GCF and serum between diabetes mellitus with CP (DMCP) and CP groups. Three studies included obese subjects and showed comparable serum and GCF resistin levels between obese subjects with CP (OBCP) and CP subjects. CONCLUSIONS CP patients were presented with elevated levels of GCF or serum resistin as compared with H individuals. Resistin modulates inflammation in chronic periodontal disease and may be used as surrogate measure to identify subjects at risk for periodontitis. Resistin levels in patients with CP and systemic inflammatory disorders such as diabetes, obesity, or rheumatoid arthritis was not significantly higher than the levels in patients with only CP.
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Affiliation(s)
- Zohaib Akram
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Periodontology, Faculty of Dentistry, Ziauddin University, 75600-Karachi, Pakistan
| | - Zubaidah Haji Abdul Rahim
- Department of Oral Biology & Biomedical Sciences, Faculty of Dentistry, Balai Ungku Aziz, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Tara Bai Taiyeb-Ali
- Department of Oral Biology & Biomedical Sciences, Faculty of Dentistry, Balai Ungku Aziz, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohd Shahril Amin Shahdan
- Department of Oral Biology & Biomedical Sciences, Faculty of Dentistry, Balai Ungku Aziz, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Rathna Devi Vaithilingam
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Impact of a chronic smoking habit on the osteo-immunoinflammatory mediators in the peri-implant fluid of clinically healthy dental implants. Arch Oral Biol 2016; 70:55-61. [PMID: 27328151 DOI: 10.1016/j.archoralbio.2016.05.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 12/08/2015] [Accepted: 05/20/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of chronic cigarette smoking on the profile of osteo-immunoinflammatory markers in the peri-implant crevicular fluid (PICF) from clinically healthy implants DESIGNS: Twenty-five smokers and 23 non-smoker subjects with a unitary screwed implant-supported crown in the molar or pre-molar region were enrolled in this study. The implants should have been in functioning for at least 12 months, and the peri-implant tissue should be clinically healthy [probing depth (PD)<4mm with no bleeding on probing (BoP) and no evidence of radiographic bone loss beyond bone remodeling]. The levels of interferon (INF)-γ, interleukin (IL)-4, IL-17, IL-1β, IL-10, IL-6, IL-8, tumor necrosis factor (TNF)-α, matrix metalloproteinase (MMP)-2, MMP-9, osteoprotegerin (OPG), soluble receptor activator of nuclear factor-κβ ligand (RANKL), osteocalcin (OC), osteopontin (OPN), transforming growth factor (TGF)-β, and cross-linked telopeptide of type I collagen (ICTP) in the PICF were quantified by a multiplexed bead immunoassay. RESULTS The smokers presented reduced levels of IL-4, IL-8, and TNF-α compared with the non-smoker individuals (p<0.05). In addition, although lower OPG levels were detected in the PICF of the smokers, the RANKL/OPG ratio did not show a significant difference (p>0.05). Moreover, higher ICTP concentrations and a higher TH1/TH2 ratio were observed in the PICF of the smoker patients (p<0.05). No differences between the groups were observed for the other markers evaluated (p>0.05). CONCLUSIONS Smoking habit modulate peri-implant cytokine profile, leading to reductions in IL-4, -8 TNF-α, and OPG levels and an increased ICTP and TH1/TH2 ratio in peri-implant crevicular fluid.
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Bozkurt Doğan Ş, Öngöz Dede F, Ballı U, Sertoğlu E. Levels of vaspin and omentin-1 in gingival crevicular fluid as potential markers of inflammation in patients with chronic periodontitis and type 2 diabetes mellitus. J Oral Sci 2016; 58:379-89. [DOI: 10.2334/josnusd.15-0731] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Şeyma Bozkurt Doğan
- Department of Periodontology, Faculty of Dentistry, Ankara Yıldırım Beyazıt University
| | - Figen Öngöz Dede
- Department of Periodontology, Faculty of Dentistry, Ordu University
| | - Umut Ballı
- Department of Periodontology, Faculty of Dentistry, Bülent Ecevit University
| | - Erdim Sertoğlu
- Department of Medical Biochemistry, GATA Haydarpasa Training Hospital
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Srinivasan M, Blackburn C, Mohamed M, Sivagami AV, Blum J. Literature-based discovery of salivary biomarkers for type 2 diabetes mellitus. Biomark Insights 2015; 10:39-45. [PMID: 26005324 PMCID: PMC4433061 DOI: 10.4137/bmi.s22177] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/01/2015] [Accepted: 02/02/2015] [Indexed: 11/24/2022] Open
Abstract
The alarming increase in type 2 diabetes mellitus (T2DM) underscores the need for efficient screening and preventive strategies. Select protein biomarker profiles emerge over time during T2DM development. Periodic evaluation of these markers will increase the predictive ability of diabetes risk scores. Noninvasive methods for frequent measurements of biomarkers are increasingly being investigated. Application of salivary diagnostics has gained importance with the establishment of significant similarities between the salivary and serum proteomes. The objective of this study is to identify T2DM-specific salivary biomarkers by literature-based discovery. A serial interrogation of the PubMed database was performed using MeSH terms of specific T2DM pathological processes in primary and secondary iterations to compile cohorts of T2DM-specific serum markers. Subsequent search consisted of mining for the identified serum markers in human saliva. More than 60% of T2DM-associated serum proteins have been measured in saliva. Nearly half of these proteins have been reported in diabetic saliva. Measurements of salivary lipids and oxidative stress markers that can exhibit correlated saliva plasma ratio could constitute reliable factors for T2DM risk assessment. We conclude that a high percentage of T2DM-associated serum proteins can be measured in saliva, which offers an attractive and economical strategy for T2DM screening.
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Affiliation(s)
- Mythily Srinivasan
- Departments of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Corinne Blackburn
- Departments of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Mohamed Mohamed
- Departments of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - A V Sivagami
- Department of Oral Medicine and Radiology, Sree Balaji Dental College and Hospital, Chennai, TN, India
| | - Janice Blum
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA
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Gonçalves TED, Zimmermann GS, Figueiredo LC, Souza MDC, da Cruz DF, Bastos MF, da Silva HDP, Duarte PM. Local and serum levels of adipokines in patients with obesity after periodontal therapy: one-year follow-up. J Clin Periodontol 2015; 42:431-9. [PMID: 25858047 DOI: 10.1111/jcpe.12396] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2015] [Indexed: 12/30/2022]
Abstract
AIM This study evaluated the effects of scaling and root planing (SRP) on gingival crevicular fluid (GCF) and serum levels of adipokines in patients with chronic periodontitis (CP) with or without obesity. METHODS Twenty patients with obesity and 20 patients without obesity, all with CP, received SRP. Serum and GCF levels of resistin, adiponectin, leptin, tumour necrosis factor [TNF]-α and interleukin [IL]-6 were evaluated by enzyme-linked immunosorbent assay at baseline, 3, 6 and 12 months post-therapy. RESULTS SRP reduced the amounts of TNF-α in deep sites and increased the concentration of adiponectin in shallow sites of non-obese patients (p < 0.05). SRP increased the concentrations of TNF-α and leptin in patients with obesity (p < 0.05). GCF levels of TNF-α were higher in patients with obesity than in patients without obesity at all time-points (p < 0.05). There were no changes in serum levels of any adipokines for any group after therapy (p > 0.05). Patients with obesity exhibited higher serum levels of leptin at all time-points and IL-6 at 3 months post-therapy (p < 0.05). CONCLUSIONS Obesity may modulate systemic and periodontal levels of adipokines in favour of pro-inflammation, independently of periodontal therapy. SRP did not affect the circulating levels of adipokines in patients with or without obesity.
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Affiliation(s)
| | - Glaucia Santos Zimmermann
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.,Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Monique de Carvalho Souza
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Daniele Ferreira da Cruz
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Marta Ferreira Bastos
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | - Poliana Mendes Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
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Mittal M, Hassan B, Desai K, Duseja S, Kumar S, Reddy SG. GCF Resistin As A Novel Marker in Patients with Chronic Periodontitis and Rheumatoid Arthritis. J Clin Diagn Res 2015; 9:ZC62-4. [PMID: 26023646 DOI: 10.7860/jcdr/2015/12327.5849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 03/14/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND The associational studies between periodontitis and rheumatoid arthritis are less documented, although they are found to have similar inflammatory pathogenesis. Resistin, a novel adipokine is suggested to be a common link between periodontitis and rheumatoid arthritis. The aim of the present study was to reinforce the inter-relationship between periodontitis and rheumatoid arthritis by using resistin as a potent inflammatory marker. MATERIALS AND METHODS Hundred patients (aged >30 y) of either sex were selected for this study and were divided equally into four groups of 25 patients each. Group A consisted of healthy individuals, Group B consisted of patients with chronic periodontitis, Group C of patients with rheumatoid arthritis and Group D had patients suffering from both arthritis and periodontitis. Periodontal parameters assessed were plaque index (PI), modified gingival index (GI) and probing depth (PD). Panoramic radiographs were taken to confirm the diagnosis of periodontitis. Rheumatoid arthritis was confirmed by the rheumatologists and seropositivity for rheumatoid factor (RF) was checked. Resistin levels were analysed in GCF collected from all the four groups and statistical analysis was done by using Pearson correlation coefficient. RESULTS The GCF of all the patients showed presence of resistin. The level of resistin was highest in Group D patients and least in Group A patients. On analysing the samples together positive co-relation was found between GCF resistin and PD, PI, GI and RF. CONCLUSION Resistin levels are increased in both chronic periodontitis and rheumatoid arthritis. Therefore, the increased level of GCF resistin can be regarded as potential inflammatory marker for periodontitis and rheumatoid arthritis.
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Affiliation(s)
- Manoj Mittal
- Professor and HOD, Department of Periodontology, RKDF Dental College , Bhopal, Madhya Pradesh, India
| | - Basit Hassan
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, RKDF Dental College , Bhopal, Madhya Pradesh, India
| | - Khushboo Desai
- Senior Lecturer, Department of Periodontics, Karnavati School of Dentistry , Gandhinagar, India
| | - Shilpa Duseja
- Reader, Department of Periodontics, Karnavati School of Dentistry , Gandhinagar, Gujarat, India
| | - Santosh Kumar
- Reader, Department of Periodontics, Karnavati School of Dentistry , Gandhinagar, Gujarat, India
| | - Sharaschandra G Reddy
- Reader, Department of Conservative Dentistry and Endodontics, Vydehi Institute of Dental Sciences , Bengaluru, Karnataka, India
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Ghiraldini B, Conte A, Casarin RC, Casati MZ, Pimentel SP, Cirano FR, Ribeiro FV. Influence of Glycemic Control on Peri-Implant Bone Healing: 12-Month Outcomes of Local Release of Bone-Related Factors and Implant Stabilization in Type 2 Diabetics. Clin Implant Dent Relat Res 2015; 18:801-9. [PMID: 25825337 DOI: 10.1111/cid.12339] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The poor glycemic status seems to be an important factor affecting implant complication rates, including peri-implant bone loss. PURPOSE This trial evaluated the influence of glycemic control of type 2 diabetes mellitus (T2DM) patients on implant stabilization and on the levels of bone markers in peri-implant fluid during the healing. MATERIALS AND METHODS Systemically healthy patients (SH,n = 19), better-controlled T2DM (BCDM,n = 16), and poorly controlled T2DM (PCDM,n = 16) indicated for implant therapy were recruited. The implant stability quotient (ISQ) was determined at implant placement, 3, 6, and 12 months. Levels of transforming growth factor- β (TGF-β), fibroblast growth factor (FGF), osteopontin (OPN), osteocalcin (OC), and osteoprotegerin (OPG) in the peri-implant fluid were quantified at 15 days, and 3, 6, and 12 months, using the Luminex assay. RESULTS OPG and OPN levels were higher in SH at 12 months than at15 days (p < .05), whereas OC and TGF-β were lower in PCDM at 12 months compared with the 15-day and 3-month follow-ups, respectively (p < .05). Inter-group analyses showed lower OPN levels in PCDM compared with SH at 12 months (p < .05). The ISQ was higher at 12 months when compared with baseline and 3 months in SH (p < .05), whereas no differences were observed during follow-up in diabetics, regardless of glycemic control (p > .05). No difference in ISQ was observed among groups over time (p > .05). CONCLUSION Poor glycemic control negatively modulated the bone factors during healing, although T2DM, regardless of glycemic status, had no effect on implant stabilization.
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