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Hopkins S, Gajagowni S, Qadeer Y, Wang Z, Virani SS, Meurman JH, Leischik R, Lavie CJ, Strauss M, Krittanawong C. More than just teeth: How oral health can affect the heart. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 43:100407. [PMID: 38873102 PMCID: PMC11169959 DOI: 10.1016/j.ahjo.2024.100407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024]
Abstract
Epidemiological evidence has revealed a potential relationship between periodontal disease and cardiovascular disease (CVD). Consensus regarding a link between these pathologies remains elusive, however, largely secondary to the considerable overlap between risk factors and comorbidities common to both disease processes. This review article aims to update the evidence for an association by summarizing the evidence for causality between periodontitis and comorbidities linked to CVD, including endocarditis, hypertension (HTN), atrial fibrillation (AF), coronary artery disease (CAD), diabetes mellitus (DM) and hyperlipidemia (HLD). This article additionally discusses the role for periodontal therapy to improved management of the comorbidities, with the larger goal of examining the value of periodontal therapy on reduction of CVD risk. In doing so, we endeavor to further the understanding of the commonality between periodontitis, and CVD.
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Affiliation(s)
- Steven Hopkins
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Yusuf Qadeer
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Salim S. Virani
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Office of the Vice Provost (Research), The Aga Khan University, Karachi 74800, Pakistan
| | - Jukka H. Meurman
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Roman Leischik
- Department of Cardiology, Sector Preventive Medicine, Health Promotion, Faculty of Health, School of Medicine, University Witten/Herdecke, 58095 Hagen, Germany
| | - Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA
| | - Markus Strauss
- Department of Cardiology, Sector Preventive Medicine, Health Promotion, Faculty of Health, School of Medicine, University Witten/Herdecke, 58095 Hagen, Germany
- Department of Cardiology I- Coronary and Periphal Vascular Disease, Heart Failure Medicine, University Hospital Muenster, Cardiol, 48149 Muenster, Germany
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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: 12] [Impact Index Per Article: 12.0] [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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He W, Fu Y, Yao S, Huang L. Programmed cell death of periodontal ligament cells. J Cell Physiol 2023; 238:1768-1787. [PMID: 37566596 DOI: 10.1002/jcp.31091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 08/13/2023]
Abstract
The periodontal ligament is a crucial tissue that provides support to the periodontium. Situated between the alveolar bone and the tooth root, it consists primarily of fibroblasts, cementoblasts, osteoblasts, osteoclasts, periodontal ligament stem cells (PDLSCs), and epithelial cell rests of Malassez. Fibroblasts, cementoblasts, osteoblasts, and osteoclasts are functionally differentiated cells, whereas PDLSCs are undifferentiated mesenchymal stem cells. The dynamic development of these cells is intricately linked to periodontal changes and homeostasis. Notably, the regulation of programmed cell death facilitates the clearance of necrotic tissue and plays a pivotal role in immune response. However, it also potentially contributes to the loss of periodontal supporting tissues and root resorption. These findings have significant implications for understanding the occurrence and progression of periodontitis, as well as the mechanisms underlying orthodontic root resorption. Further, the regulation of periodontal ligament cell (PDLC) death is influenced by both systemic and local factors. This comprehensive review focuses on recent studies reporting the mechanisms of PDLC death and related factors.
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Affiliation(s)
- Wei He
- Department of Orthodontics, College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yu Fu
- Department of Orthodontics, College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Song Yao
- Department of Orthodontics, College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lan Huang
- Department of Orthodontics, College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Şimşek OK, Baser U, Özgünler Ö, Demirci O, Aydin AF, Kucukgergin C, Yalcin F. Comparison of oxidative stress markers in the saliva, gingival crevicular fluid, and serum samples of pregnant women with gestational diabetes and healthy pregnant women. J Periodontal Res 2023. [PMID: 37154237 DOI: 10.1111/jre.13132] [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: 04/21/2022] [Revised: 03/29/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND AND OBJECTIVE To compare oxidative stress (OS) markers in the saliva, gingival crevicular fluid (GCF), and serum samples of pregnant women with gestational diabetes (GDM) and healthy pregnant women and to investigate the association between periodontal health/diseases and OS and GDM. METHOD Eighty women with GDM and 80 healthy pregnant women were included in the study. Medical and clinical anamnesis was obtained from all the pregnant women included in the study, and their plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing pocket depth (PPD), and clinical attachment level (CAL) measurements were performed. GCF, saliva, and serum samples were collected for the measurements of the local and systemic total antioxidant status (TAS) and total oxidant status (TOS). RESULTS Clinical periodontal parameters were found to be significantly higher in the GDM group compared to the control group. The serum and saliva TAS, TOS, and TAS/TOS values were significantly lower in the GDM group than in the control group. In the analysis of the GCF samples, the mean TAS and TAS/TOS values were significantly lower and the TOS value was significantly higher in the GDM group than in the control group. The multivariate reduced model indicated that gravidity, salivary TAS/TOS, and GCF TAS were significant independent variables in the development of GDM (p < .05). CONCLUSION Our results indicated that the OS of serum, saliva, and GCF samples increased in patients with GDM compared to healthy pregnant women. The role of local OS parameters in GDM may be associated with elevated clinical periodontal parameters.
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Affiliation(s)
- Oya Kaya Şimşek
- Faculty of Dentistry, Periodontology Department, Istanbul University, Istanbul, Turkey
| | - Ulku Baser
- Faculty of Dentistry, Periodontology Department, Istanbul University, Istanbul, Turkey
| | - Özgür Özgünler
- Faculty of Dentistry, Periodontology Department, Istanbul University, Istanbul, Turkey
| | - Oya Demirci
- Perinatology Clinic, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Abdurrahman Fatİh Aydin
- Faculty of Medicine, Department of Medical Biochemistry, Istanbul University, Istanbul, Turkey
| | - Canan Kucukgergin
- Faculty of Medicine, Department of Medical Biochemistry, Istanbul University, Istanbul, Turkey
| | - Funda Yalcin
- Faculty of Dentistry, Periodontology Department, Istanbul University, Istanbul, Turkey
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Ding C, Du F, Li L, Chen Y. Synergistic effect of blood lipids and uric acid on periodontitis in patients with type 2 diabetes. Am J Transl Res 2023; 15:1430-1437. [PMID: 36915719 PMCID: PMC10006784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/18/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE This study investigated the interaction of dyslipidemia and hyperuricemia on periodontitis in patients with type 2 diabetes mellitus (T2DM). METHODS The clinical data of 220 patients with T2DM (diabetes group) treated in Tianjin Baodi Hospital from January 2019 to December 2021 were retrospectively analyzed. Another 200 healthy subjects in the same period were selected as the control group. The correlation of hyperuricemia and hyperlipidemia with diabetes was tested by the spearman correlation coefficient. Multivariate logistic regression was used to analyze the multiplicative interaction and additive interaction of dyslipidemia and hyperuricemia on periodontitis. RESULTS Diabetes was positively correlated with hyperuricemia and hyperlipidemia (P<0.05). Patients with dyslipidemia (OR = 8.107, 95% CI: 2.687-24.457) and hyperuricemia (OR = 2.940, 95% CI: 0.970-8.909) had a higher risk of periodontitis, but there was no multiplicative interaction effect of dyslipidemia and hyperuricemia on periodontitis (OR = 1.864, 95% CI: 0.256-13.545, P>0.05). The risk of developing diabetes was higher in individuals with dyslipidemia and hypertension than in those without (OR = 2.887, 95% CI: 1.478-4.855). The evaluation indexes of the combined interaction effect relative excess risk due to interaction, interaction attribution percentage and synergy index were 0.902 (95% CI: 0.379-1.496), 0.273 (95% CI: 0.106-0.458) and 1.485 (95% CI: 0.978-2.165), respectively. CONCLUSION Dyslipidemia and hyperuricemia may have a synergistic effect on periodontitis in people with T2DM. Improving blood lipids and controlling blood uric acid may synergistically prevent periodontitis.
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Affiliation(s)
- Chunyan Ding
- Department of Stomatology, Tianjin Baodi Hospital Tianjin 301800, China
| | - Fangchong Du
- Department of Xiangshan Road Outpatient General Clinic, The 8TH Medical Center, Chinese PLA General Hospital Beijing 100089, China
| | - Ling Li
- Department of Stomatology, The Navy Special Service Infirmary in Qingdao Qingdao 266000, Shandong, China
| | - Yuhui Chen
- Department of Dental, PLA Strategic Support Force Characteristic Medical Center Beijing 100101, China
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Zhang Y, Zhang Y, Mei Y, Zou R, Niu L, Dong S. Reactive Oxygen Species Enlightened Therapeutic Strategy for Oral and Maxillofacial Diseases-Art of Destruction and Reconstruction. Biomedicines 2022; 10:biomedicines10112905. [PMID: 36428473 PMCID: PMC9687321 DOI: 10.3390/biomedicines10112905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
Reactive oxygen species (ROS) are byproducts of cell metabolism produced by living cells and signal mediators in biological processes. As unstable and highly reactive oxygen-derived molecules, excessive ROS production and defective oxidant clearance, or both, are associated with the pathogenesis of several conditions. Among them, ROS are widely involved in oral and maxillofacial diseases, such as periodontitis, as well as other infectious diseases or chronic inflammation, temporomandibular joint disorders, oral mucosal lesions, trigeminal neuralgia, muscle fatigue, and oral cancer. The purpose of this paper is to outline how ROS contribute to the pathophysiology of oral and maxillofacial regions, with an emphasis on oral infectious diseases represented by periodontitis and mucosal diseases represented by oral ulcers and how to effectively utilize and eliminate ROS in these pathological processes, as well as to review recent research on the potential targets and interventions of cutting-edge antioxidant materials. The PubMed, Web of Science, and Embase databases were searched using the MesH terms "oral and maxillofacial diseases", "reactive oxygen species", and "antioxidant materials". Irrelevant, obsolete, imprecise, and repetitive articles were excluded through screening of titles, abstracts, and eventually full content. The full-text data of the selected articles are, therefore, summarized using selection criteria. While there are various emerging biomaterials used as drugs themselves or delivery systems, more attention was paid to antioxidant drugs with broad application prospects and rigorous prophase animal experimental results.
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Affiliation(s)
- Yuwei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Yifei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Yukun Mei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Rui Zou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
| | - Lin Niu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Correspondence: (L.N.); (S.D.)
| | - Shaojie Dong
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Department of Prosthodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an 710004, China
- Correspondence: (L.N.); (S.D.)
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Ng MY, Lin T, Chao SC, Chu PM, Yu CC. Potential Therapeutic Applications of Natural Compounds in Diabetes-Associated Periodontitis. J Clin Med 2022; 11:jcm11133614. [PMID: 35806899 PMCID: PMC9267692 DOI: 10.3390/jcm11133614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
Diabetes mellitus (DM) is a major worldwide health burden. DM is a metabolic disease characterized by chronic hyperglycemia, and if left untreated, can lead to various complications. Individuals with uncontrolled DM are more susceptible to periodontitis due to both a hyper-inflammatory host response and an impaired immune response. Periodontitis, on the other hand, may exacerbate DM by increasing both local and systemic inflammatory components of DM-related complications. The current standard for periodontal treatment in diabetes-associated periodontitis (DP) focuses mostly on reducing bacterial load and less on controlling the excessive host response, and hence, may not be able to resolve DP completely. Over the past decade, natural compounds have emerged as an adjunct approach for modulating the host immune response with the hope of curing DP. The anti-oxidant, anti-inflammatory, and anti-diabetic characteristics of natural substances are well-known, and they can be found in regularly consumed foods and drinks, as well as plants. The pathophysiology of DP and the treatment benefits of various bioactive extracts for DP will be covered in this review.
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Affiliation(s)
- Min Yee Ng
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan; (M.Y.N.); (T.L.)
| | - Taichen Lin
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan; (M.Y.N.); (T.L.)
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Shih-Chi Chao
- Institute of Oral Sciences, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Medical Research and Education, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yi-lan, Luodong 265501, Taiwan
| | - Pei-Ming Chu
- Department of Anatomy, School of Medicine, China Medical University, Taichung 404333, Taiwan;
| | - Cheng-Chia Yu
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan; (M.Y.N.); (T.L.)
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Institute of Oral Sciences, Chung Shan Medical University, Taichung 40201, Taiwan;
- Correspondence: ; Tel.: +886-4-2471-8668
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Antioxidant Effects of Curcumin Gel in Experimental Induced Diabetes and Periodontitis in Rats. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7278064. [PMID: 35592526 PMCID: PMC9113860 DOI: 10.1155/2022/7278064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/26/2022] [Indexed: 12/17/2022]
Abstract
This study aimed to evaluate the effect of curcumin gel on antioxidant marker level in experimental induced diabetes and periodontitis (EDP) in rats. Adult Wistar rats were randomized into five groups (20 each): (1) EDP treated with scaling and root planing (SRP) + curcumin gel (CU), (2) EDP treated with CU, (3) EDP treated with SRP, (4) EDP without treatment, and (5) systemically healthy and without ligature (control). Each group was subdivided equally into 4 subgroups of 5 rats. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ), and periodontitis was induced by a ligature. Blood samples were collected by cardiac puncture at 0, 7, 14, and 21 days to assess oxidative stress of malondialdehyde (MDA) and antioxidant enzymes of glutathione peroxidase (GPx), catalase (CAT), and suproxidase dismutase (SOD) levels. The results showed a significant increase in serum MDA and antioxidant enzyme levels in the untreated EDP group compared to the control group (
). The adjuvant use of CU to SRP resulted in a significant reduction of MDA and CAT levels as compared to the SRP group (
); however, significant reduction of GPX and SOD levels can be found only at day 7. It can be concluded that the decreased level of antioxidant enzymes can be construed as a result of decreased oxidative stress by curcumin therapy.
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Chopra A, Jayasinghe TN, Eberhard J. Are Inflamed Periodontal Tissues Endogenous Source of Advanced Glycation End-Products (AGEs) in Individuals with and without Diabetes Mellitus? A Systematic Review. Biomolecules 2022; 12:biom12050642. [PMID: 35625570 PMCID: PMC9138899 DOI: 10.3390/biom12050642] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022] Open
Abstract
Advanced glycation end-products (AGEs) are heterogeneous compounds formed when excess sugars condense with the amino groups of nucleic acids and proteins. Increased AGEs are associated with insulin resistance and poor glycemic control. Recently, inflamed periodontal tissues and certain oral bacteria were observed to increase the local and systemic AGE levels in both normoglycemic and hyperglycemic individuals. Although hyperglycemia induced AGE and its effect on the periodontal tissues is known, periodontitis as an endogenous source of AGE formation is not well explored. Hence, this systematic review is aimed to explore, for the first time, whether inflamed periodontal tissues and periodontal pathogens have the capacity to modulate AGE levels in individuals with or without T2DM and how this affects the glycemic load. Six electronic databases were searched using the following keywords: (Periodontitis OR Periodontal disease OR Periodontal Inflammation) AND (Diabetes mellitus OR Hyperglycemia OR Insulin resistance) AND Advanced glycation end products. The results yielded 1140 articles, of which 13 articles were included for the review. The results showed that the mean AGE levels in gingival crevicular fluid was higher in individuals with diabetes mellitus and periodontitis (521.9 pg/mL) compared to healthy individuals with periodontitis (234.84 pg/mL). The serum AGE levels in normoglycemic subjects having periodontitis was higher compared to those without periodontitis (15.91 ng/mL vs. 6.60 ng/mL). Tannerella forsythia, a common gram-negative anaerobe periodontal pathogen in the oral biofilm, was observed to produce methylglyoxal (precursor of AGE) in the gingival tissues. Increased AGE deposition and activate of AGE receptors was noted in the presence of periodontitis in both normoglycemic and hyperglycemic individuals. Hence, it can be concluded that periodontitis can modulate the local and systemic levels of AGE levels even in absence of hyperglycemia. This explains the bidirectional relationship between periodontitis and development of prediabetes, incident diabetes, poor glycemic control, and insulin resistance.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, India
- Correspondence:
| | - Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Araújo EG, de Oliveira DMSL, Martins CC, Stefani CM. Efficacy of Antioxidant Supplementation to Non-Surgical Periodontal Therapy on Metabolic Control in Type 2 Diabetes Patients: A Network Meta-Analysis. Antioxidants (Basel) 2022; 11:621. [PMID: 35453306 PMCID: PMC9031448 DOI: 10.3390/antiox11040621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 02/01/2023] Open
Abstract
This network meta-analysis (NMA) investigated the effectiveness of antioxidants as adjuncts to non-surgical periodontal therapy (NSPT) in the glycated hemoglobin (HbA1c) control of type 2 diabetes (T2D) patients with periodontitis. PubMed, Cochrane, LILACS, Web of Science, Scopus, Embase, LIVIVO, and grey literature were searched. Risk of bias was assessed with the RoB v2.0 tool. A frequentist NMA assessed HbA1c improvement, through standardized mean difference under a random-effects model. Certainty of evidence was addressed through the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) partially contextualized framework. Ten randomized controlled clinical trials were included, with 234 patients receiving alpha lipoic acid (ALA), cranberry juice, cranberry juice enriched with omega-3, fenugreek, ginger, grape seed, lycopene, melatonin, omega-3, propolis or vitamin C supplementation to NSPT, and 220 patients receiving NSPT alone or with placebo. Nine studies were meta-analyzed. HbA1c improved when NSPT was combined with propolis, ALA and melatonin supplementation (moderate-to-low certainty), compared to NSPT alone or with placebo. Risk of bias issues were found in eight studies. In conclusion, the use of propolis supplementation to NSPT probably results in HbA1c improvement in T2D patients with periodontitis (large effect with moderate certainty), while ALA and melatonin supplementation may contribute to reduce the HbA1c in T2D patients with periodontitis (large effects with low certainty).
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Affiliation(s)
- Elisa Grillo Araújo
- School of Dentistry, University of Brasilia, Brasilia 70910-900, DF, Brazil; (E.G.A.); (D.M.S.L.d.O.)
| | | | - Carolina Castro Martins
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil;
| | - Cristine Miron Stefani
- School of Dentistry, University of Brasilia, Brasilia 70910-900, DF, Brazil; (E.G.A.); (D.M.S.L.d.O.)
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The Effect of Diabetes Mellitus on IGF Axis and Stem Cell Mediated Regeneration of the Periodontium. Bioengineering (Basel) 2021; 8:bioengineering8120202. [PMID: 34940355 PMCID: PMC8698546 DOI: 10.3390/bioengineering8120202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Periodontitis and diabetes mellitus (DM) are two of the most common and challenging health problems worldwide and they affect each other mutually and adversely. Current periodontal therapies have unpredictable outcome in diabetic patients. Periodontal tissue engineering is a challenging but promising approach that aims at restoring periodontal tissues using one or all of the following: stem cells, signalling molecules and scaffolds. Mesenchymal stem cells (MSCs) and insulin-like growth factor (IGF) represent ideal examples of stem cells and signalling molecules. This review outlines the most recent updates in characterizing MSCs isolated from diabetics to fully understand why diabetics are more prone to periodontitis that theoretically reflect the impaired regenerative capabilities of their native stem cells. This characterisation is of utmost importance to enhance autologous stem cells based tissue regeneration in diabetic patients using both MSCs and members of IGF axis.
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Cicalău GIP, Babes PA, Calniceanu H, Popa A, Ciavoi G, Iova GM, Ganea M, Scrobotă I. Anti-Inflammatory and Antioxidant Properties of Carvacrol and Magnolol, in Periodontal Disease and Diabetes Mellitus. Molecules 2021; 26:6899. [PMID: 34833990 PMCID: PMC8623889 DOI: 10.3390/molecules26226899] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/03/2021] [Accepted: 11/13/2021] [Indexed: 12/15/2022] Open
Abstract
Periodontal disease and diabetes mellitus are two pathologies that are extremely widespread worldwide and share the feature of chronic inflammation. Carvacrol is a phenolic monoterpenoid, produced by a variety of herbs, the most well-known of which is Origanum vulgare. Magnolol is a traditional polyphenolic compound isolated from the stem bark of Magnolia officinalis, mainly used in Chinese medicine. The purpose of this paper is to review the therapeutic properties of these bioactive compounds, in the treatment of periodontitis and diabetes. Based on our search strategy we conducted a literature search in the PubMed and Google Scholar databases to identify studies. A total of one hundred eighty-four papers were included in the current review. The results show that carvacrol and magnolol have anti-inflammatory, antioxidant, antimicrobial, anti-osteoclastic, and anti-diabetic properties that benefit both pathologies. Knowledge of the multiple activities of carvacrol and magnolol can assist with the development of new treatment strategies, and the design of clinical animal and human trials will maximize the potential benefits of these extracts in subjects suffering from periodontitis or diabetes.
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Affiliation(s)
- Georgiana Ioana Potra Cicalău
- Doctoral School of Biomedical Science, University of Oradea, 1st University Street, 410087 Oradea, Romania;
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
| | - Petru Aurel Babes
- Doctoral School of Biomedical Science, University of Oradea, 1st University Street, 410087 Oradea, Romania;
| | - Horia Calniceanu
- Department of Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Periodontal and Periimplant Diseases Research Center “Prof. Dr. Anton Sculean”, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adelina Popa
- Department of Orthodontics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Orthodontic Research Center (ORTHO-CENTER), Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Gabriela Ciavoi
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
| | - Gilda Mihaela Iova
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
| | - Mariana Ganea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania;
| | - Ioana Scrobotă
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1st Decembrie Street, 410073 Oradea, Romania; (G.C.); (G.M.I.); (I.S.)
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Aslroosta H, Paknejad M, Davari M, Akbari S, Taheri M, Abdollahi M. Semelil as Adjunctive Therapy in Chronic Periodontitis: A Preliminary Randomized Controlled Clinical Study. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2021; 20:339-347. [PMID: 34400963 PMCID: PMC8170773 DOI: 10.22037/ijpr.2020.113604.14399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Host modulation therapy is recently employed to improve periodontal treatments outcome. This randomized controlled clinical trial aimed to evaluate the effects of Semelil (ANGIPARS) as an adjunct to non-surgical treatment in patients with chronic periodontitis. Forty-four healthy subjects with moderate to severe chronic periodontitis were enrolled in the study. After completion of phase I periodontal therapy, including oral hygiene instruction, scaling, and root planing, the patients were randomly divided into two groups to receive capsules of Semelil (test) or placebo (control), consuming two capsules a day for three months. Clinical parameters (probing depth [PD], clinical attachment level [CAL], modified sulcular bleeding index [MSBI], modified gingival index [MGI], and plaque index [PI]) and biochemical parameters (interleukin-1β [IL-1β], 8-hydroxy-2-deoxyguanosine [8-OHdG]), and lipid peroxidation [LPO]) were measured at baseline and after completion of treatment. Twenty-five patients completed the study: 15 in the test group and 10 in the control group. All clinical and biochemical parameters were significantly improved from baseline to the final measurements in both groups (p < 0.001). The changes were more pronounced in the test group in comparison to the control group. However, the differences between the groups were significant only for MGI, MSBI, PD, and CAL (p < 0.05). Semelil may reveal promising results as an adjunctive treatment for chronic periodontitis.
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Affiliation(s)
- Hoori Aslroosta
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Paknejad
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohaddeseh Davari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Semnan University of Medical Sciences, Semnan, Iran
| | - Solmaz Akbari
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Taheri
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Santonocito S, Polizzi A, Palazzo G, Isola G. The Emerging Role of microRNA in Periodontitis: Pathophysiology, Clinical Potential and Future Molecular Perspectives. Int J Mol Sci 2021; 22:5456. [PMID: 34064286 PMCID: PMC8196859 DOI: 10.3390/ijms22115456] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 02/07/2023] Open
Abstract
During the last few decades, it has been established that messenger ribonucleic acid (mRNA) transcription does not inevitably lead to protein translation, but there are numerous processes involved in post-transcriptional regulation, which is a continuously developing field of research. MicroRNAs (miRNAs) are a group of small non-coding RNAs, which negatively regulate protein expression and are implicated in several physiological and pathological mechanisms. Aberrant expression of miRNAs triggers dysregulation of multiple cellular processes involved in innate and adaptive immune responses. For many years, it was thought that miRNAs acted only within the cell in which they were synthesised, but, recently, they have been found outside cells bound to lipids and proteins, or enclosed in extracellular vesicles, namely exosomes. They can circulate throughout the body, transferring information between cells and altering gene expression in the recipient cells, as they can fuse with and be internalised by the recipient cells. Numerous studies on miRNAs have been conducted in order to identify possible biomarkers that can be used in the diagnosis of periodontal disease. However, as therapeutic agents, single miRNAs can target several genes and influence multiple regulatory networks. The aim of this review was to examine the molecular role of miRNAs and exosomes in the pathophysiology of periodontal disease and to evaluate possible clinical and future implications for a personalised therapeutical approach.
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Affiliation(s)
| | | | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (S.S.); (A.P.); (G.P.)
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Drift of the Subgingival Periodontal Microbiome during Chronic Periodontitis in Type 2 Diabetes Mellitus Patients. Pathogens 2021; 10:pathogens10050504. [PMID: 33922308 PMCID: PMC8145315 DOI: 10.3390/pathogens10050504] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022] Open
Abstract
Since periodontitis and type 2 diabetes mellitus are complex diseases, a thorough understanding of their pathogenesis requires knowing the relationship of these pathologies with other disorders and environmental factors. In this study, the representability of the subgingival periodontal microbiome of 46 subjects was studied by 16S rRNA gene sequencing and shotgun sequencing of pooled samples. We examined 15 patients with chronic periodontitis (CP), 15 patients with chronic periodontitis associated with type 2 diabetes mellitus (CPT2DM), and 16 healthy subjects (Control). The severity of generalized chronic periodontitis in both periodontitis groups of patients (CP and CPT2DM) was moderate (stage II). The male to female ratios were approximately equal in each group (22 males and 24 females); the average age of the subjects was 53.9 ± 7.3 and 54.3 ± 7.2 years, respectively. The presence of overweight patients (Body Mass Index (BMI) 30–34.9 kg/m2) and patients with class 1–2 obesity (BMI 35–45.9 kg/m2) was significantly higher in the CPT2DM group than in patients having only chronic periodontitis or in the Control group. However, there was no statistically significant difference in all clinical indices between the CP and CPT2DM groups. An analysis of the metagenomic data revealed that the alpha diversity in the CPT2DM group was increased compared to that in the CP and Control groups. The microbiome biomarkers associated with experimental groups were evaluated. In both groups of patients with periodontitis, the relative abundance of Porphyromonadaceae was increased compared to that in the Control group. The CPT2DM group was characterized by a lower relative abundance of Streptococcaceae/Pasteurellaceae and a higher abundance of Leptotrichiaceae compared to those in the CP and Control groups. Furthermore, the CP and CPT2DM groups differed in terms of the relative abundance of Veillonellaceae (which was decreased in the CPT2DM group compared to CP) and Neisseriaceae (which was increased in the CPT2DM group compared to CP). In addition, differences in bacterial content were identified by a combination of shotgun sequencing of pooled samples and genome-resolved metagenomics. The results indicate that there are subgingival microbiome-specific features in patients with chronic periodontitis associated with type 2 diabetes mellitus.
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Greabu M, Giampieri F, Imre MM, Mohora M, Totan A, Pituru SM, Ionescu E. Autophagy, One of the Main Steps in Periodontitis Pathogenesis and Evolution. Molecules 2020; 25:E4338. [PMID: 32971808 PMCID: PMC7570503 DOI: 10.3390/molecules25184338] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/12/2020] [Accepted: 09/14/2020] [Indexed: 12/18/2022] Open
Abstract
Periodontitis represents a complex inflammatory disease that compromises the integrity of the tooth-supporting tissue through the interaction of specific periodontal pathogens and the host's immune system. Experimental data help to outline the idea that the molecular way towards periodontitis initiation and progression presents four key steps: bacterial infection, inflammation, oxidative stress, and autophagy. The aim of this review is to outline the autophagy involvement in the pathogenesis and evolution of periodontitis from at least three points of view: periodontal pathogen invasion control, innate immune signaling pathways regulation and apoptosis inhibition in periodontal cells. The exact roles played by reactive oxygen species (ROS) inside the molecular mechanisms for autophagy initiation in periodontitis still require further investigation. However, clarifying the role and the mechanism of redox regulation of autophagy in the periodontitis context may be particularly beneficial for the elaboration of new therapeutic strategies.
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Affiliation(s)
- Maria Greabu
- Department of Biochemistry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Francesca Giampieri
- Department of Agricultural, Food and Environmental Sciences, Università Politecnica delle Marche, Via Ranieri 65, 60131 Ancona, Italy;
| | - Marina Melescanu Imre
- Department of Complete Denture, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Maria Mohora
- Department of Biochemistry, Faculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Alexandra Totan
- Department of Biochemistry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Silviu Mirel Pituru
- Department of Professional Organization and Medical Legislation-Malpractice, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Ecaterina Ionescu
- Department of Orthodontics and Dento-Facial Orthopedics’, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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Association of IL16 polymorphisms with periodontitis in Brazilians: A case- control study. PLoS One 2020; 15:e0239101. [PMID: 32915917 PMCID: PMC7485854 DOI: 10.1371/journal.pone.0239101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/29/2020] [Indexed: 12/24/2022] Open
Abstract
Periodontitis (PD) is a chronic inflammatory process resulting from the relationship of the immune response with the components in dental plaque. Cytokines and their genetic polymorphisms seem to be involved in the immunopathogenesis of this disease. This study aimed to evaluate the correlation of IL16 polymorphism with PD. A case-control study was conducted in a sample of individuals from southern Brazil. The genotyping of IL16, rs11556218 T>G, rs4072111 C>T e rs4778889 T>C, was performed using the PCR-RFLP methodology. The serum level of IL-16 was determined using an IL-16 ELISA kit for humans. SNPStats and OpenEpi software and Wilcoxon's U test were used to perform statistical analysis. IL16 rs11556218 polymorphism was significantly associated to PD in nonsmoking patients: individuals with G/G genotype were less likely to develop PD compared to the T/T genotype (OR = 0.10; Pc = 0.019, codominant model). In addition, the TTT haplotype was associated with a high risk for PD (OR = 2.45; P = 0.01). A low IL-16 serum level was observed among individuals with PD when compared to controls (P = 0.027). Thus, the IL16 rs16556218 polymorphism and the serum levels of IL-16 were associated with periodontitis in a Brazilian sample, and this was influenced by environmental factors such as smoking.
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Al-Rawi NH, Al-Marzooq F, Al-Nuaimi AS, Hachim MY, Hamoudi R. Salivary microRNA 155, 146a/b and 203: A pilot study for potentially non-invasive diagnostic biomarkers of periodontitis and diabetes mellitus. PLoS One 2020; 15:e0237004. [PMID: 32756589 PMCID: PMC7406085 DOI: 10.1371/journal.pone.0237004] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022] Open
Abstract
Dysregulated expression of MicroRNAs (miRNAs) plays substantial role in the initiation and progression of both diabetes and periodontitis. The aim of the present study was to validate four miRNAs in saliva as potential predictive biomarkers of periodontal disease among patients with and without diabetes mellitus (DM). MiRNAs were extracted from the saliva of 24 adult subjects with DM and 29 healthy controls. Each group was subdivided into periodontally healthy or having periodontitis. In silico analysis identified 4 miRNAs (miRNA 155, 146 a/b and 203) as immune modulators. The expression of miRNAs-146a/b, 155, and 203 was tested using quantitative PCR. The expression levels in the study groups were compared to explore the effect of diabetes on periodontal status and vice versa. In our cohort, the four miRNAs expression were higher in patients with periodontitis and/or diabetes. miRNA-155 was the most reliable predictors of periodontitis among non-diabetics with an optimum cut-off value of < 8.97 with accuracy = 82.6%. MiRNA 146a, on the other hand, was the only reliable predictor of periodontitis among subjects with diabetes with optimum cut-off value of ≥11.04 with accuracy = 86.1%. The results of the present study concluded that MiRNA-146a and miRNA155 in saliva provide reliable, non-invasive, diagnostic and prognostic biomarkers that can be used to monitor periodontal health status among diabetic and non-diabetic patients.
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Affiliation(s)
- Natheer H. Al-Rawi
- Department of Oral & Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Farah Al-Marzooq
- Department of Medical Microbiology & Immunology, College of Medicine and Health Sciences, UAE University, Al Ain, UAE
| | | | - Mahmood Y. Hachim
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Rifat Hamoudi
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, UAE
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
- * E-mail:
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Vicente A, Bravo-González LA, Navarro JA, Buendía AJ, Camacho-Alonso F. Effects of diabetes on oxidative stress, periodontal ligament fiber orientation, and matrix metalloproteinase 8 and 9 expressions during orthodontic tooth movement. Clin Oral Investig 2020; 25:1383-1394. [PMID: 32643088 DOI: 10.1007/s00784-020-03446-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/03/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate the influence of diabetes on oxidative stress, periodontal ligament (PDL) orientation, and matrix metalloproteinase (MMP) 8 and 9 expressions during orthodontic tooth movement in a rat model. MATERIALS AND METHODS An orthodontic appliance was placed in 60 Sprague-Dawley rats divided into three groups: normoglycemics (n = 20) and two streptozotocin-induced diabetic groups, one untreated (n = 20) and one insulin-treated (n = 20). At 24, 48, and 72 h and 1 week, rats were sacrificed. At each time point, myeloperoxidase (MPO) and malondialdehyde (MDA) were quantified by spectrophotometry, tooth movement was evaluated by micro-CT analysis, and hematoxylin and eosin staining was used to evaluate PDL fiber orientation and immunohistochemistry staining with semi-quantitative H-score analysis of MMP-8 and MMP-9 was performed.. RESULTS At 24 h, MPO activity was significantly higher in untreated-diabetics than normoglycemics. At 24 and 48 h, the MDA level in untreated-diabetic rats was significantly higher than in normoglycemics and insulin-treated animals. At 72 h and 1 week, PDL fibers were oriented significantly more irregularly in untreated-diabetics than in normoglycemics. At all time points, MMP-8 and MMP-9 expressions were significantly higher in both diabetic groups than in the normoglycemic group. After the second day, tooth movement was significantly greater in untreated-diabetics than in the insulin-treated and normoglycemic groups. CONCLUSIONS Mechanical stress in untreated-diabetic rats produces more inflammatory response, oxidative stress, tooth movement, PDL disorganization, and MMP-8 and MMP-9 expressions than among normoglycemics. Insulin reverses these effects, favoring the reorganization of periodontal ligament. CLINICAL RELEVANCE Our results suggest that the application of orthodontic force in diabetic patients would increase inflammation and delay periodontal restructuring. Insulin would partly reverse this situation although glycemic decompensation episodes may occur. For these reasons, the periods between fixed orthodontic appliance activations should be of sufficient duration to allow adequate tissue recovery.
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Affiliation(s)
- Ascensión Vicente
- Unit of Orthodontics, University Dental Clinic, Faculty of Medicine, University of Murcia, Murcia, Spain
| | | | - J A Navarro
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
| | - A J Buendía
- Department of Histology and Pathological Anatomy, University of Murcia, Murcia, Spain
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Glycosylation end products mediate damage and apoptosis of periodontal ligament stem cells induced by the JNK-mitochondrial pathway. Aging (Albany NY) 2020; 12:12850-12868. [PMID: 32611833 PMCID: PMC7377852 DOI: 10.18632/aging.103304] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 03/30/2020] [Indexed: 12/11/2022]
Abstract
Background: Recent studies have confirmed the bidirectional relationship between the two and the exacerbation of periodontitis by type II diabetes mellitus (T2DM), the pathogenic mechanism has not yet been clarified, AGEs has been linked to the pathogenesis of both periodontitis and T2DM, JNK signaling pathway might play a important role to explain the inner mechanism. Objectives: To study advanced glycation end products (AGEs) activate the innate immune system of the host by activating oxidative stress and affecting cellular signal transduction in periodontal ligament stem cells (PDLSCs); Results: TNF-α and/or AGEs can induce the formation of endogenous ROS in PDLSCs, thereby activating the downstream JNK signalling pathway, leading to the initiation of the mitochondria-mediated apoptotic pathway and the induction of PDLSC apoptosis. Conclusion: we hypothesized that the JNK pathway is a key link in the apoptosis of PDLSCs mediated by TNF-α and/or AGEs. Materials and Methods: PDLSCs from healthy volunteers were extracted, cultured and stimulated with TNF-a and/or AGEs, Flow cytometry, CCK-8, multidifferential assay, RT-PCR, apoptosis assay, Transmission electron microscopy and Western blotting were recruit to detect the internal relations between AGEs and PDLSCs.
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Bogdan M, Meca AD, Boldeanu MV, Gheorghe DN, Turcu-Stiolica A, Subtirelu MS, Boldeanu L, Blaj M, Botnariu GE, Vlad CE, Foia LG, Surlin P. Possible Involvement of Vitamin C in Periodontal Disease-Diabetes Mellitus Association. Nutrients 2020; 12:nu12020553. [PMID: 32093297 PMCID: PMC7071463 DOI: 10.3390/nu12020553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 12/17/2022] Open
Abstract
Ascorbic acid (vitamin C) is an important water-soluble vitamin found in many fruits and vegetables. It has well-documented beneficial effects on the human body and is used as a supplement, alone or in combination with other vitamins and minerals. Over recent years, research has focused on possible new therapeutic actions in chronic conditions including periodontal disease (PD). We conducted a systematic review on clinical trials from four databases (PubMed, Clinical Trials, Cochrane, Web of Science) which measured plasmatic/salivary levels of ascorbic acid in PD–diabetes mellitus (DM) association. Six studies were included in our review, three of them analyzing patients with different grades of PD and DM who received vitamin C as a treatment (500 mg vitamin C/day for 2 months and 450 mg/day for 2 weeks) or as part of their alimentation (guava fruits), in combination with standard therapies and procedures. Decreased levels of vitamin C were observed in PD patients with DM but data about efficacy of vitamin C administration are inconclusive. Given the important bidirectional relationship between PD and DM, there is a strong need for more research to assess the positive effects of ascorbic acid supplementation in individuals suffering from both diseases and also its proper regimen for these patients.
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Affiliation(s)
- Maria Bogdan
- Department of Pharmacology, University of Medicine and Pharmacy, 200349 Craiova, Romania; (M.B.); (A.D.M.)
| | - Andreea Daniela Meca
- Department of Pharmacology, University of Medicine and Pharmacy, 200349 Craiova, Romania; (M.B.); (A.D.M.)
| | - Mihail Virgil Boldeanu
- Department of Immunology, University of Medicine and Pharmacy, 200349 Craiova, Romania
- Correspondence: (M.V.B.); (M.B.)
| | - Dorin Nicolae Gheorghe
- Department of Periodontology, University of Medicine and Pharmacy, 200349 Craiova, Romania; (D.N.G.); (P.S.)
| | - Adina Turcu-Stiolica
- Department of Pharmacoeconomics, University of Medicine and Pharmacy, 200349 Craiova, Romania; (A.T.-S.); (M.-S.S.)
| | - Mihaela-Simona Subtirelu
- Department of Pharmacoeconomics, University of Medicine and Pharmacy, 200349 Craiova, Romania; (A.T.-S.); (M.-S.S.)
| | - Lidia Boldeanu
- Department of Microbiology, University of Medicine and Pharmacy, 200349 Craiova, Romania;
| | - Mihaela Blaj
- Department of Surgery, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
- Correspondence: (M.V.B.); (M.B.)
| | - Gina Eosefina Botnariu
- Department of Internal Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (G.E.B.); (C.E.V.)
| | - Cristiana Elena Vlad
- Department of Internal Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania; (G.E.B.); (C.E.V.)
| | - Liliana Georgeta Foia
- Department of Biochemistry, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania;
| | - Petra Surlin
- Department of Periodontology, University of Medicine and Pharmacy, 200349 Craiova, Romania; (D.N.G.); (P.S.)
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Abstract
PURPOSE OF REVIEW Diabetes has a detrimental effect on bone, increasing the risk of fracture and formation of osteolytic lesions such as those seen in periodontitis. Several diabetic complications are caused by diabetes-enhanced inflammation. This review examines mechanisms by which IL-17 contributes to diabetes-enhanced periodontitis and other effects of IL-17 on bone. RECENT FINDINGS IL-17 upregulates anti-bacterial defenses, yet its expression is also linked to a destructive host response in the periodontium. Periodontal disease is caused by bacteria that stimulate an inflammatory response. Diabetes-enhanced IL-17 increases gingival inflammation, which alters the composition of the oral microbiota to increase its pathogenicity. In addition, IL-17 can induce osteoclastogenesis by upregulation of TNF and RANKL in a number of cell types, and IL-17 has differential effects on osteoblasts and their progenitors. Increased IL-17 production caused by diabetes alters the pathogenicity of the oral microbiota and can promote periodontal bone resorption.
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Affiliation(s)
- Zhen Huang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th St, Philadelphia, PA, 19104, USA
| | - Xiyan Pei
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th St, Philadelphia, PA, 19104, USA
- First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 37 Xishiku Avenue, Xicheng District, Beijing, 100034, China
| | - Dana T Graves
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th St, Philadelphia, PA, 19104, USA.
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Qi J, Luo X, Ma Z, Zhang B, Li S, Duan X, Yang B, Zhang J. Swimming Exercise Protects against Insulin Resistance via Regulating Oxidative Stress through Nox4 and AKT Signaling in High-Fat Diet-Fed Mice. J Diabetes Res 2020; 2020:2521590. [PMID: 32051831 PMCID: PMC6995488 DOI: 10.1155/2020/2521590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 12/26/2019] [Indexed: 12/31/2022] Open
Abstract
Nonpharmaceutical therapies such as exercise training and diet intervention are widely used for the treatment of insulin resistance (IR). Although the skeletal muscle is the major peripheral tissue of glucose metabolism under insulin stimulation, the mechanism underlying muscle IR is poorly understood. Using a high-fat diet-induced IR mouse model, we here show that NADPH oxidase 4 (Nox4) upregulation mediates the production of reactive oxygen species (ROS) that causes metabolic syndrome featuring IR. The Nox4 expression level was markedly elevated in IR mice, and Nox4 overexpression was sufficient to trigger IR. Conversely, downregulation of Nox4 expression through exercise training prevented diet-induced IR by reducing the production of ROS and enhancing the AKT signaling pathway. Thus, this study indicates that exercise might improve IR through a reduction of Nox4-induced ROS in the skeletal muscle and enhancement of AKT signal transduction.
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Affiliation(s)
- Jie Qi
- College of Physical Education, Shanghai Normal University, Shanghai 200234, China
| | - Xue Luo
- Medical College of Yangzhou Polytechnic College, Jiangsu 225009, China
| | - Zhichao Ma
- The School of Physical Education, Wuhan Business University, Hubei 430056, China
| | - Bo Zhang
- College of Physical Education, Shanghai Normal University, Shanghai 200234, China
| | - Shuyan Li
- College of Physical Education, Yangzhou University, Jiangsu 225009, China
| | - Xuyang Duan
- College of Physical Education, Shanghai Normal University, Shanghai 200234, China
| | - Bo Yang
- College of Public Health and Management, Wenzhou Medical University, Zhejiang 325000, China
| | - Jun Zhang
- College of Physical Education, Shanghai Normal University, Shanghai 200234, China
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24
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Zare Javid A, Hosseini SA, Gholinezhad H, Moradi L, Haghighi-zadeh MH, Bazyar H. Antioxidant and Anti-Inflammatory Properties of Melatonin in Patients with Type 2 Diabetes Mellitus with Periodontal Disease Under Non-Surgical Periodontal Therapy: A Double-Blind, Placebo-Controlled Trial. Diabetes Metab Syndr Obes 2020; 13:753-761. [PMID: 32256092 PMCID: PMC7090208 DOI: 10.2147/dmso.s242208] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/10/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIM The imbalance between pro-oxidant and antioxidant systems often leads to further oxidative damage in the pathogenesis of both diabetes and periodontal disease. This study aimed to investigate the antioxidant and anti-inflammatory properties of melatonin in type 2 diabetes mellitus (T2DM) patients with periodontal disease (PD) under non-surgical periodontal therapy (NSPT). MATERIALS AND METHODS In this double-blind clinical trial study, 50 T2DM patients with PD were randomly allocated to intervention and control groups and received 250 mg/day (2 tablets) either melatonin or placebo 1 h before bedtime for 8 weeks. The NSPT was performed for all patients in both groups at the beginning of the study. The serum levels of interleukin-1b (IL-1b), malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured pre- and post-intervention. RESULTS Supplementation with melatonin in adjunct to NSPT significantly increased the serum levels of TAC, SOD, CAT, and GPx in the intervention group (P = 0.02, 0.008, 0.004 and 0.004, respectively). The mean changes of SOD, CAT, and GPx were significantly (P = 0.02, 0.04 and 0.04, respectively) greater in the intervention group compared with the control group. Also, after adjusting for confounding factors, the results did not change in terms of significance (P < 0.05). After the intervention, serum levels of MDA and IL-1b were significantly reduced in the intervention group (P < 0.001 and P = 0.008, respectively). The intervention group exhibited lower mean changes of MDA compared with the control group, and these changes were statistically significant (P = 0.008). In addition, after adjusting for confounding factors, the results did not change in terms of significance. CONCLUSION The adjunctive effects of melatonin and NSPT may improve inflammatory and antioxidant parameters in T2DM patients with PD.
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Affiliation(s)
- Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hassan Gholinezhad
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Moradi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Hadi Bazyar
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Correspondence: Hadi Bazyar Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranTel +98 9136659629 Email
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25
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Wang X, Wang H, Zhang T, Cai L, Kong C, He J. Current Knowledge Regarding the Interaction Between Oral Bone Metabolic Disorders and Diabetes Mellitus. Front Endocrinol (Lausanne) 2020; 11:536. [PMID: 32903738 PMCID: PMC7438828 DOI: 10.3389/fendo.2020.00536] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 07/01/2020] [Indexed: 12/16/2022] Open
Abstract
Diabetes mellitus, a major chronic disease affecting human health, has been increasing in prevalence in recent years. Diabetes mellitus can cause bone metabolic disorders in patients, leading to osteoporosis, a higher risk of traumatic fracture, and other bone diseases. Bone metabolic disorders in the oral cavity principally manifest as periodontitis, loss of alveolar bone, and failure of implant osseointegration. In recent years, numerous studies have shown that there is a complex interaction between bone metabolic disorders and diabetes mellitus. This paper reviews the adverse effects of diabetes on oral bone metabolism disorders such as alveolar osteoporosis and bone loss in patients with periodontitis, discusses the potential mechanisms of diabetic bone loss, and suggests potential ways to prevent and treat oral bone loss in patients with diabetes mellitus.
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Affiliation(s)
- Xiaofeng Wang
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
- Department of Pediatrics, Pediatric Research Institute, The University of Louisville School of Medicine, Louisville, KY, United States
| | - Huiyu Wang
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Tianfu Zhang
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Lu Cai
- Department of Pediatrics, Pediatric Research Institute, The University of Louisville School of Medicine, Louisville, KY, United States
- Departments of Radiation Oncology, Pharmacology, and Toxicology, University of Louisville, Louisville, KY, United States
| | - Chenfei Kong
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Chenfei Kong
| | - Jinting He
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
- Jinting He
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26
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The Connection of Periodontal Disease and Diabetes Mellitus: The Role of Matrix Metalloproteinases and Oxidative Stress. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abstract
Diabetes mellitus, a chronic disease considered by the World Health Organization to be an epidemic, is now recognized as one of the factors behind the onset of periodontal disease. The connection between periodontal disease, which is an irreversible inflammatory disease of the supporting tissue of the teeth, and systemic diseases is reflected in the existence of common risk factors, subgingival dental biofilm, as a constant source of proinflamma-tory cytokines synthesized intensely in inflammatory periodontium. Diabetes mellitus leads to increased oxidative stress in periodontal tissues causing worsening of the disease and periodontopathy exacerbates deficiency of pancreatic β-cells. The most important role in primary inflammatory response in the pathogenesis of periodontopathy is played by neutrophils. Neutrophils cause periodontium destruction by the release of enzymes (matrix metalloproteinases), cytotoxic substances (free radicals, reactive oxygen and nitrogen species) and the expression of membrane receptors. Matrix metalloproteinases within the “protease network” are critical to many physiological and pathological processes, including immunity, inflammation, bone resorption and wound healing. Matrix metalloproteinases levels are elevated in patients with metabolic syndrome and diabetes mellitus, which may contribute to more frequent complications. In this paper, the review of available literature data shows the correlation between periodontal disease and diabetes mellitus, as well as the role of matrix metalloproteinases and oxidative stress in these. In this regard, determining the value of matrix metalloproteinases may be helpful in the diagnosis of periodontal disease complicated by diabetes mellitus. Also, the parameters of oxidative stress could help to clarify the mechanisms of pathogenesis and etiology of periodontal disease, or indicate the potential benefit of antioxidant supplementation in these individuals. As the role of matrix metalloproteinases has not been fully clarified in the pathogenesis of periodontopathy, additional studies will be needed to indicate their importance.
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27
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Nonaka K, Bando M, Sakamoto E, Inagaki Y, Naruishi K, Yumoto H, Kido JI. 6-Shogaol Inhibits Advanced Glycation End-Products-Induced IL-6 and ICAM-1 Expression by Regulating Oxidative Responses in Human Gingival Fibroblasts. Molecules 2019; 24:molecules24203705. [PMID: 31619000 PMCID: PMC6832546 DOI: 10.3390/molecules24203705] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 12/13/2022] Open
Abstract
Advanced glycation end-products (AGEs) cause diabetes mellitus (DM) complications and accumulate more highly in periodontal tissues of patients with periodontitis and DM. AGEs aggravate periodontitis with DM by increasing the expression of inflammation-related factors in periodontal tissues. 6-Shogaol, a major compound in ginger, has anti-inflammatory and anti-oxidative activities. However, the influence of shogaol on DM-associated periodontitis is not well known. In this study, the effects of 6-shogaol on AGEs-induced oxidative and anti-oxidative responses, and IL-6 and ICAM-1 expression in human gingival fibroblasts (HGFs) were investigated. When HGFs were cultured with 6-shogaol and AGEs, the activities of reactive oxygen species (ROS) and antioxidant enzymes (heme oxygenase-1 [HO-1] and NAD(P)H quinone dehydrogenase 1 [NQO1]), and IL-6 and ICAM-1 expressions were investigated. RAGE expression and phosphorylation of MAPKs and NF-κB were examined by western blotting. 6-Shogaol significantly inhibited AGEs-induced ROS activity, and increased HO-1 and NQO1 levels compared with the AGEs-treated cells. The AGEs-stimulated expression levels of receptor of AGE (RAGE), IL-6 and ICAM-1 and the phosphorylation of p38, ERK and p65 were attenuated by 6-shogaol. These results suggested that 6-shogaol inhibits AGEs-induced inflammatory responses by regulating oxidative and anti-oxidative activities and may have protective effects on periodontitis with DM.
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Affiliation(s)
- Kohei Nonaka
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan.
| | - Mika Bando
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan.
| | - Eijiro Sakamoto
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan.
| | - Yuji Inagaki
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan.
| | - Koji Naruishi
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan.
| | - Hiromichi Yumoto
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan
| | - Jun-Ichi Kido
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8504, Japan.
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28
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Kunsongkeit P, Okuma N, Rassameemasmaung S, Chaivanit P. Effect of Vitamin C as an Adjunct in Nonsurgical Periodontal Therapy in Uncontrolled Type 2 Diabetes Mellitus Patients. Eur J Dent 2019; 13:444-449. [PMID: 31280483 PMCID: PMC6890498 DOI: 10.1055/s-0039-1693207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective
The main purpose of this article is to evaluate periodontal parameters of chronic periodontitis patients with uncontrolled type 2 diabetes mellitus after initial periodontal therapy plus vitamin C.
Materials and Methods
A double-blind, placebo-controlled, clinical trial was conducted. Subjects received initial periodontal therapy plus 500 mg/day vitamin C for 2 months (
n
= 15) or placebo (
n
= 16). Fasting blood sugar (FBS), hemoglobin A1c (HbA1C), and plasma vitamin C level were assessed at baseline and 2 months post-treatment. Plaque Index, Sulcus Bleeding Index, Gingival Index, pocket depth, and clinical attachment level were measured at baseline, 1 month, and 2 months post-treatment.
Results
Almost all subjects had low level of plasma vitamin C at baseline. In the test group, plasma vitamin C was significantly increased to an adequate level at the end of 2 months. After periodontal treatment, FBS and HbA1c were not significantly different compared with baseline in the test group. In the control group, FBS was significantly decreased from baseline. However, no significant difference between groups was found either in FBS or HbA1c. All periodontal parameters were significantly improved from baseline in both groups. However, no significant difference was found between groups.
Conclusion
Supplementation of 500 mg/day vitamin C did not give an additional benefit in promoting periodontal status in periodontitis patients with uncontrolled type 2 diabetes mellitus.
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Affiliation(s)
- Piyapat Kunsongkeit
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Nis Okuma
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Supanee Rassameemasmaung
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pechngam Chaivanit
- Internal Medicine Division, Faculty of Medicine, Burapha University, Chonburi, Thailand
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29
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Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, Rengo G. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci 2019; 20:ijms20061414. [PMID: 30897827 PMCID: PMC6470716 DOI: 10.3390/ijms20061414] [Citation(s) in RCA: 218] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease, initiated by the presence of a bacterial biofilm, called dental plaque, which affects both the periodontal ligaments and bone surrounding teeth. In the last decades, several lines of evidence have supported the existence of a relationship between periodontitis and systemic health. For instance, as periodontitis acts within the same chronic inflammatory model seen in cardiovascular disease (CVD), or other disorders, such as diabetes, several studies have suggested the existence of a bi-directional link between periodontal health and these pathologies. For instance, people with diabetes are more susceptible to infections and are more likely to suffer from periodontitis than people without this syndrome. Analogously, it is now evident that cardiac disorders are worsened by periodontitis, both experimentally and in humans. For all these reasons, it is very plausible that preventing periodontitis has an impact on the onset or progression of CVD and diabetes. On these grounds, in this review, we have provided an updated account on the current knowledge concerning periodontal disease and the adverse effects exerted on the cardiovascular system health and diabetes, informing readers on the most recent preclinical studies and epidemiological evidence.
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Affiliation(s)
- Daniela Liccardo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Center for Translational Medicine, Temple University, Philadelphia, PA 19140, USA.
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia.
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100 Siena, Italy.
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
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30
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Enhanced Oxidative Damage and Nrf2 Downregulation Contribute to the Aggravation of Periodontitis by Diabetes Mellitus. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:9421019. [PMID: 30622677 PMCID: PMC6304894 DOI: 10.1155/2018/9421019] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/29/2018] [Indexed: 02/05/2023]
Abstract
Diabetes mellitus is a well-recognized risk factor for periodontitis. The goal of the present study was to elucidate whether oxidative stress and nuclear factor erythroid 2-related factor 2 (Nrf2) participate in the aggravation of periodontitis by diabetes. For this purpose, we assigned Wistar rats to control, periodontitis, diabetes, and diabetic periodontitis groups. Two weeks after induction of diabetes by streptozotocin, periodontitis was induced by ligation. Two weeks later, periodontal tissues and blood were harvested and analyzed by stereomicroscopy, immunohistochemistry, and real-time polymerase chain reaction. We found that ligation induced more severe bone loss and periodontal cell apoptosis in diabetic rats than in normal rats (p < 0.05). Compared with the control group, periodontitis significantly enhanced local oxidative damage (elevated expression of 3-nitrotyrosine, 4-hydroxy-2-nonenal, and 8-hydroxy-deoxyguanosine), whereas diabetes significantly increased systemic oxidative damage and suppressed antioxidant capacity (increased malondialdehyde expression and decreased superoxide dismutase activity) (p < 0.05). Simultaneous periodontitis and diabetes synergistically aggravated both local and systemic oxidative damage (p < 0.05); this finding was strongly correlated with the more severe periodontal destruction in diabetic periodontitis. Furthermore, gene and protein expression of Nrf2 was significantly downregulated in diabetic periodontitis (p < 0.05). Multiple regression analysis indicated that the reduced Nrf2 expression was strongly correlated with the aggravated periodontal destruction and oxidative damage in diabetic periodontitis. We conclude that enhanced local and systemic oxidative damage and Nrf2 downregulation contribute to the development and progression of diabetic periodontitis.
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31
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Predictors for Gingival Index in Middle-Aged Asian Indians with Type 2 Diabetes from South India: A Cross-Sectional Observational Study. ScientificWorldJournal 2018; 2018:9081572. [PMID: 29479293 PMCID: PMC5816844 DOI: 10.1155/2018/9081572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/02/2017] [Accepted: 11/19/2017] [Indexed: 12/25/2022] Open
Abstract
Asian Indians develop type 2 diabetes mellitus (T2DM) much earlier as compared to White Caucasians, due to unique phenotypic and genetic architecture. Periodontitis in T2DM patients is often a neglected clinical feature. This study was conducted to derive predictor variables for gingival index in middle-aged Asian Indians with T2DM in a semiurban population of Dravidian ethnicity from Tamil Nadu, India. T2DM patients (n = 232, mean age: 50.6 ± 10.4 years) with periodontitis (n = 123, mean age: 54.3 ± 2.4 years) and without periodontitis (n = 109, mean age: 55.2 ± 3.1 years) were recruited between 2014 and 2016 by purposive sampling method. Dental examinations for pocket depth (PD) and clinical attachment level (CAL) were performed and gingival index was calculated. Fasting venous blood samples were analysed for measures of glycaemia and cholesterol. Significant positive correlation (p < 0.01) was observed for gingival index with glycosylated haemoglobin (HbA1c), pocket depth, presence of T2DM, and clinical attachment level. Stepwise multiple linear regression analysis derived increased pocket depth (p < 0.01), elevated HbA1c (p < 0.01), clinical attachment level (p < 0.01), and presence of diabetes (p < 0.01) as significant predictors (r2 value = 0.67) for increased gingival index in middle aged patients with T2DM. These variables significantly (p < 0.01) predispose middle-aged T2DM patients to increased gingival index, thus warranting appropriate intervention.
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32
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Qi W, Xinyi Z, Yi D. [Effect of inflammaging on periodontitis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:99-103. [PMID: 29595005 DOI: 10.7518/hxkq.2018.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Inflammaging is the chronic, systematic, and controllable upregulation of a pro-inflammation state with advancing age. Chronic low-grade inflammation accompanied by sustained stimuli is correlated with various age-related diseases (ARDs). Recent studies on ARDs have prompted further research interest in the inner mechanisms underlying inflammaging to establish prevention and treatment plans for inflammatory diseases. In this article, we discuss inflammaging and its significant role in periodontitis.
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Affiliation(s)
- Wang Qi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhou Xinyi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ding Yi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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33
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Liu C, Mo L, Niu Y, Li X, Zhou X, Xu X. The Role of Reactive Oxygen Species and Autophagy in Periodontitis and Their Potential Linkage. Front Physiol 2017; 8:439. [PMID: 28690552 PMCID: PMC5481360 DOI: 10.3389/fphys.2017.00439] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 06/09/2017] [Indexed: 02/05/2023] Open
Abstract
Periodontitis is a chronic inflammatory disease that causes damage to periodontal tissues, which include the gingiva, periodontal ligament, and alveolar bone. The major cause of periodontal tissue destruction is an inappropriate host response to microorganisms and their products. Specifically, a homeostatic imbalance between reactive oxygen species (ROS) and antioxidant defense systems has been implicated in the pathogenesis of periodontitis. Elevated levels of ROS acting as intracellular signal transducers result in autophagy, which plays a dual role in periodontitis by promoting cell death or blocking apoptosis in infected cells. Autophagy can also regulate ROS generation and scavenging. Investigations are ongoing to elucidate the crosstalk mechanisms between ROS and autophagy. Here, we review the physiological and pathological roles of ROS and autophagy in periodontal tissues. The redox-sensitive pathways related to autophagy, such as mTORC1, Beclin 1, and the Atg12-Atg5 complex, are explored in depth to provide a comprehensive overview of the crosstalk between ROS and autophagy. Based on the current evidence, we suggest that a potential linkage between ROS and autophagy is involved in the pathogenesis of periodontitis.
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Affiliation(s)
- Chengcheng Liu
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan UniversityChengdu, China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, China
| | - Longyi Mo
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan UniversityChengdu, China
| | - Yulong Niu
- Key Lab of Bio-resources and Eco-environment of Ministry of Education, College of Life Sciences, Sichuan UniversityChengdu, China
| | - Xin Li
- Institute of Biophysics, Chinese Academy of SciencesBeijing, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan UniversityChengdu, China.,Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan UniversityChengdu, China.,Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, China
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34
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Qi J, Yang B, Ren C, Fu J, Zhang J. Swimming Exercise Alleviated Insulin Resistance by Regulating Tripartite Motif Family Protein 72 Expression and AKT Signal Pathway in Sprague-Dawley Rats Fed with High-Fat Diet. J Diabetes Res 2016; 2016:1564386. [PMID: 27843952 PMCID: PMC5098085 DOI: 10.1155/2016/1564386] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/14/2016] [Accepted: 10/03/2016] [Indexed: 01/07/2023] Open
Abstract
We aimed to investigate whether swimming exercise could improve insulin resistance (IR) by regulating tripartite motif family protein 72 (TRIM72) expression and AKT signal pathway in rats fed with high-fat diet. Five-week-old rats were classified into 3 groups: standard diet as control (CON), high-fat diet (HFD), and HFD plus swimming exercise (Ex-HFD). After 8 weeks, glucose infusion rate (GIR), markers of oxidative stress, mRNA and protein expression of TRIM72, protein of IRS, p-AKTSer473, and AKT were determined in quadriceps muscles. Compared with HFD, the GIR, muscle SOD, and GSH-Px were significantly increased (p < 0.05, resp.), whereas muscle MDA and 8-OHdG levels were significantly decreased (p < 0.05 and p < 0.01) in Ex-HFD. Expression levels of TRIM72 mRNA and protein in muscles were significantly reduced (p < 0.05 and p < 0.01), whereas protein expression levels of IRS-1, p-AKTSer473, and AKT were significantly increased in Ex-HFD compared with HFD (p < 0.01, p < 0.01, and p < 0.05). These results suggest that an 8-week swimming exercise improves HFD-induced insulin resistance maybe through a reduction of TRIM72 in skeletal muscle and enhancement of AKT signal transduction.
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Affiliation(s)
- Jie Qi
- College of Physical Education, Shanghai Normal University, Shanghai 200234, China
| | - Bo Yang
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310053, China
| | - Cailing Ren
- Rehabilitation College of Gannan Medical University, Jiangxi 341000, China
| | - Jian Fu
- College of Physical Education, Yangzhou University, Jiangsu 225009, China
| | - Jun Zhang
- College of Physical Education, Shanghai Normal University, Shanghai 200234, China
- *Jun Zhang:
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