Immune Dysfunction Linking Periodontitis And Diabetes
Harini Venkata Subbiah1, Polani Ramesh Babu2, Usha Subbiah1*, Daniel Rajendran T3, Vinod Kumar P3
Journal of Angiotherapy 5(2) https://doi.org/10.25163/angiotherapy.52221532819191221
Submitted: 28 November 2021 Revised: 08 December 2021 Published: 19 December 2021
Abstract
Periodontitis is a polymicrobial initiated disease but the host inflammatory and immune responses also play a significant role in creating periodontal pockets and irreversible bone loss. The presence of periodontal pathogens and their toxins cause elevations of proinflammatory cytokines such as interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha). Host response is altered by the presence of various factors including diabetes. Periodontitis and diabetes are prevalent chronic diseases with many epidemiological studies implying a two-way or bidirectional relationship between the two diseases. In this review, we focus on how hyperglycemia relates periodontitis and diabetes mellitus.
Keywords: Immune dysfunction, Linking periodontitis, Diabetes, polymicrobial
References
Akkaloori A, Parthasarathi P, Anjum MS, Gadde P, Mocherla M, Rao Y. Association between chronic periodontal disease and cardiovascular risk factor hyperlipidemia. J Dr NTR Univ Heal Sci. 2014;3(4):249.
https://doi.org/10.4103/2277-8632.146628
Betteridge DJ. What is oxidative stress? Metabolism. 2000;49(2):3-8.
https://doi.org/10.1016/S0026-0495(00)80077-3
Celec P. Oxidative stress and antioxidants in the diagnosis and therapy of periodontitis. Front Physiol. 2017;8:1055.
https://doi.org/10.3389/fphys.2017.01055
Choi Y-H, McKeown RE, Mayer-Davis EJ, Liese AD, Song K-B, Merchant AT. Association between periodontitis and impaired fasting glucose and diabetes. Diabetes Care. 2011;34(2):381-386.
https://doi.org/10.2337/dc10-1354
Fentoglu O, Bozkurt FY. The bi-directional relationship between periodontal disease and hyperlipidemia. Eur J Dent. 2008;2(02):142-149.
https://doi.org/10.1055/s-0039-1697370
Goldberg IJ. Diabetic dyslipidemia: causes and consequences. J Clin Endocrinol Metab. 2001;86(3):965-971.
https://doi.org/10.1210/jcem.86.3.7304
Graves D. Cytokines that promote periodontal tissue destruction. J Periodontol. 2008;79:1585-1591.
https://doi.org/10.1902/jop.2008.080183
Grover HS, Luthra S. Molecular mechanisms involved in the bidirectional relationship between diabetes mellitus and periodontal disease. J Indian Soc Periodontol. 2013;17(3):292.
https://doi.org/10.4103/0972-124X.115642
Iacopino AM. Periodontitis and diabetes interrelationships: role of inflammation. Ann Periodontol. 2001;6(1):125-137.
https://doi.org/10.1902/annals.2001.6.1.125
Lalla R V, D'AMBROSIO JA. Dental management considerations for the patient with diabetes mellitus. J Am Dent Assoc. 2001;132(10):1425-1432.
https://doi.org/10.14219/jada.archive.2001.0059
Lan C-CE, Wu C-S, Huang S-M, et al. High-glucose environment inhibits p38MAPK signaling and reduces human β-3 expression in keratinocytes. Mol Med. 2011;17(7):771-779.
https://doi.org/10.2119/molmed.2010.00091
Lei L, Li H, Yan F, Xiao Y. Hyperlipidemia impaired innate immune response to periodontal pathogen Porphyromonas gingivalis in apolipoprotein E knockout mice. PLoS One. 2013;8(8):e71849.
https://doi.org/10.1371/journal.pone.0071849
Liu W, Zhang X. Receptor activator of nuclear factor-κB ligand (RANKL)/RANK/osteoprotegerin system in bone and other tissues. Mol Med Rep. 2015;11(5):3212-3218.
https://doi.org/10.3892/mmr.2015.3152
Lutfioglu M, Aydogdu A, Atabay VE, Sakallioglu EE, Avci B. Gingival crevicular fluid oxidative stress level in patients with periodontal disease and hyperlipidemia. Braz Oral Res. 2017;31.
https://doi.org/10.1590/1807-3107bor-2017.vol31.0110
Mahamed DA, Marleau A, Alnaeeli M, et al. G (−) Anaerobes-Reactive CD4+ T-Cells Trigger RANKL-Mediated Enhanced Alveolar Bone Loss in Diabetic NOD Mice. Diabetes. 2005;54(5):1477-1486.
https://doi.org/10.2337/diabetes.54.5.1477
Manouchehr-Pour M, Spagnuolo PJ, Rodman HM, Bissada NF. Comparison of neutrophil chemotactic response in diabetic patients with mild and severe periodontal disease. J Periodontol. 1981;52(8):410-415.
https://doi.org/10.1902/jop.1981.52.8.410
MR P, Surlin P, Rauten AM, Dragomir L, Olteanu M. Histological analysis of collagen fibers in patients with diabetes mellitus and periodontal disease. J Cytol Histol S. 2014;4:2.
https://doi.org/10.4172/2157-7099.S4-008
Nguyen GT, Green ER, Mecsas J. Neutrophils to the ROScue: mechanisms of NADPH oxidase activation and bacterial resistance. Front Cell Infect Microbiol. 2017;7:373.
https://doi.org/10.3389/fcimb.2017.00373
Ochanji AA, Matu NK, Mulli TK. Association of salivary RANKL and osteoprotegerin levels with periodontal health. Clin Exp Dent Res. 2017;3(2):45-50.
https://doi.org/10.1002/cre2.49
Ohlrich EJ, Cullinan MP, Leichter JW. Diabetes, periodontitis, and the subgingival microbiota. J Oral Microbiol. 2010;2(1):5818.
https://doi.org/10.3402/jom.v2i0.5818
Pietropaoli D, Tatone C, D'Alessandro AM, Monaco A. Possible involvement of advanced glycation end products in periodontal diseases. Int J Immunopathol Pharmacol. 2010;23(3):683-691.
https://doi.org/10.1177/039463201002300301
Preshaw PM, Bissett SM. Periodontitis and diabetes. Br Dent J. 2019;227(7):577-584.
https://doi.org/10.1038/s41415-019-0794-5
Rajeev K, Karthika R, Mythili R, Krishnan V, Nirmal M. Role of receptors of advanced glycation end-products (RAGE) in type 2 diabetic and non-diabetic individuals with chronic periodontal disease: an immunohistochemical study. J Investig Clin Dent. 2011;2(4):287-292.
https://doi.org/10.1111/j.2041-1626.2011.00079.x
Ryan ME, Carnu O, Kamer A. The influence of diabetes on the periodontal tissues. J Am Dent Assoc. 2003;134:34S-40S.
https://doi.org/10.14219/jada.archive.2003.0370
Sharma M, Jindal R, Siddiqui MA, Wangnoo SK. Diabetes and Periodontitis: A medical perspective. J Int Clin Dent Res Organ. 2016;8(1):3.
https://doi.org/10.4103/2231-0754.176244
Shetty N, Thomas B, Ramesh A. Comparison of neutrophil functions in diabetic and healthy subjects with chronic generalized periodontitis. J Indian Soc Periodontol. 2008;12(2):41.
https://doi.org/10.4103/0972-124X.44089
Silva N, Abusleme L, Bravo D, et al. Host response mechanisms in periodontal diseases. J Appl Oral Sci. 2015;23(3):329-355.
https://doi.org/10.1590/1678-775720140259
Tanaka Y, Nakayamada S, Okada Y. Osteoblasts and osteoclasts in bone remodeling and inflammation. Curr Drug Targets-Inflammation Allergy. 2005;4(3):325-328.
https://doi.org/10.2174/1568010054022015
Tawfig N. Proinflammatory cytokines and periodontal disease. J Dent Probl Solut. 2016;3(1):12-17.
https://doi.org/10.17352/2394-8418.000026
Taylor GW, Borgnakke WS. Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis. 2008;14(3):191-203.
https://doi.org/10.1111/j.1601-0825.2008.01442.x
Vieira Ribeiro F, de Mendonça AC, Santos VR, Bastos MF, Figueiredo LC, Duarte PM. Cytokines and bone-related factors in systemically healthy patients with chronic periodontitis and patients with type 2 diabetes and chronic periodontitis. J Periodontol. 2011;82(8):1187-1196.
https://doi.org/10.1902/jop.2011.100643
Vlassara H, Uribarri J. Advanced glycation end products (AGE) and diabetes: cause, effect, or both? Curr Diab Rep. 2014;14(1):1-10.
https://doi.org/10.1007/s11892-013-0453-1
Volpe CMO, Villar-Delfino PH, Dos Anjos PMF, Nogueira-Machado JA. Cellular death, reactive oxygen species (ROS) and diabetic complications. Cell Death Dis. 2018;9(2):1-9.
https://doi.org/10.1038/s41419-017-0135-z
Wu Y-Y, Xiao E, Graves DT. Diabetes mellitus related bone metabolism and periodontal disease. Int J Oral Sci. 2015;7(2):63-72.
https://doi.org/10.1038/ijos.2015.2
Yilmaz D, Caglayan F, Buber E, et al. Gingival crevicular fluid levels of human beta-defensin-1 in type 2 diabetes mellitus and periodontitis. Clin Oral Investig. 2018;22(5):2135-2140.
https://doi.org/10.1007/s00784-018-2469-z
Zainab AJAA, Ashish N, Ragnath V. Salivary Levels of Antimicrobial Peptides in Chronic Periodontitis Patients with Type 2 Diabetes. J Int Acad Periodontol. 2019;21(1):36-44.
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