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Li Y, Li X, Guo D, Meng L, Feng X, Zhang Y, Pan S. Immune dysregulation and macrophage polarization in peri-implantitis. Front Bioeng Biotechnol 2024; 12:1291880. [PMID: 38347915 PMCID: PMC10859439 DOI: 10.3389/fbioe.2024.1291880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
The term "peri-implantitis" (peri-implantitis) refers to an inflammatory lesion of the mucosa surrounding an endosseous implant and a progressive loss of the peri-implant bone that supports the implant. Recently, it has been suggested that the increased sensitivity of implants to infection and the quick elimination of supporting tissue after infection may be caused by a dysregulated peri-implant mucosal immune response. Macrophages are polarized in response to environmental signals and play multiple roles in peri-implantitis. In peri-implantitis lesion samples, recent investigations have discovered a considerable increase in M1 type macrophages, with M1 type macrophages contributing to the pro-inflammatory response brought on by bacteria, whereas M2 type macrophages contribute to inflammation remission and tissue repair. In an effort to better understand the pathogenesis of peri-implantitis and suggest potential immunomodulatory treatments for peri-implantitis in the direction of macrophage polarization patterns, this review summarizes the research findings related to macrophage polarization in peri-implantitis and compares them with periodontitis.
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Affiliation(s)
- Yue Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xue Li
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing, China
| | - Danni Guo
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Lingwei Meng
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yi Zhang
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing, China
| | - Shaoxia Pan
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
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Tayman MA, Koyuncu İ. Differential gene expression of ADAMTS-1, ADAMTS-9 and TIMP-3 in periodontitis. Biotech Histochem 2023; 98:126-131. [PMID: 36093887 DOI: 10.1080/10520295.2022.2121857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) are metalloproteinases that bind to components of the extracellular matrix (ECM) to regulate tissue remodeling and homeostasis. ADAMTS can be inhibited by tissue inhibitors of metalloproteinases (TIMPs). Expression of ADAMTS increases under inflammatory conditions. We investigated the mRNA expression of ADAMTS-1, ADAMTS-9 and TIMP-3 genes in both healthy gingival tissues and periodontitis. Clinical periodontal measurements were conducted and gingival biopsies were obtained from stage IIIgrade C generalized periodontitis and healthy (control) groups. mRNA expression was evaluated using real-time quantitative polymerase chain reaction (RTqPCR). All clinical periodontal parameters were significantly higher in the periodontitis group than for the control group. ADAMTS-1 levels were significantly higher in the periodontitis group and were significantly correlated with clinical attachment level and probing pocket depth. Differences in ADAMTS-9 and TIMP-3 mRNA in the periodontitis group compared to the control group were not statistically significant. Increased ADAMTS-1 mRNA expression in periodontitis indicates that members of the ADAMTS family of metalloproteinases are associated with pathogenesis and progression of periodontal disease. Maintaining balance between ADAMTS and TIMP is important for limiting ECM catabolism and preventing tissue damage.
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Saremi L, Shafizadeh M, Ghaffari ME, Aliniagerdroudbari E, Amid R, Kadkhodazadeh M. Evaluation of interleukin 10, interleukin 1-beta, and tumor necrosis factor-alpha gene polymorphisms in patients with periodontitis and healthy controls. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00371-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Chronic periodontitis (CP) is a prevalent infectious disease caused by an interplay between pathogens and immune responses. Gene polymorphisms are among the factors that affect susceptibility to CP. This study aimed to assess the association between CP and single nucleotide polymorphisms (SNPs) of interleukin-10 (IL-10), interleukin 1ß (IL-1ß), and tumor necrosis factor-α (TNF-α) genes.
Methods
A total of 87 patients with CP and 89 healthy controls were included in this study. Venous blood samples were obtained, and DNA was extracted and purified. Segments containing the relevant genes were amplified by polymerase chain reaction (PCR). Electrophoresis was performed after restriction fragment length polymorphism (RFLP) to determine genotype and allele frequencies.
Results
The CP group showed significantly different allele and genotype frequencies for three out of five SNPs: IL-10 ─ 592 C/A, IL-10 ─ 819 C/T, and IL-1ß + 3954 C/T (p < 0.05). Additionally, the frequency of the TNF-α ─ 857 AA genotype was significantly lower in patients compared with controls (p = 0.034); however, no significant differences were found in allele frequencies (p > 0.05). Logistic regression analysis revealed that carriers of IL-10 ─ 592 A allele and IL-1ß + 3954 T allele are at higher risk of CP (p < 0.001). Allele and genotype frequencies for TNF-α ─ 308 G/A did not differ significantly between patients and controls (p > 0.05).
Conclusions
This study showed specific genotypes of IL-10 ─ 592 C/A, IL-10 ─ 819 C/T, IL-1ß + 3954 C/T, and TNF-α ─ 857 G/A SNPs may be associated with an increased risk of CP development.
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Lashari DM, Aljunaid M, Lashari Y, Qaid HR, Ridwan RD, Diyatri I, Kaid N, Alkadasi BA. The use of mucoadhesive oral patches containing epigallocatechin-3-gallate to treat periodontitis: an in vivo study. J Taibah Univ Med Sci 2022; 17:1014-1020. [PMID: 36212598 PMCID: PMC9519795 DOI: 10.1016/j.jtumed.2022.06.006] [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: 03/17/2022] [Revised: 05/15/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives The application of topical drugs such as mucoadhesive oral patches (MOPs) do not irritate the mucosa and are able to increase the permeability of drugs to oral tissue. Epigallocatechin-3-gallate (EGCG) is an active ingredient that exhibits significant antibacterial and anti-inflammatory effects. The purpose of this study was to analyze the therapeutic potential of a mucoadhesive oral patch containing EGCG (MOP-EGCG) in a model of periodontitis and investigate its effects on the expression of osteoprotegerin (OPG), receptor activator of nuclear factor-kappa Β ligand (RANKL) and receptor activator of nuclear factor-κB (RANK). Methods A model of periodontitis was induced in Rattus novergicus used Porphyromonas gingivalis by applying 0.03 ml of bacteria locally with 1 × 1010 colony-forming units (CFU) seven times at 2-day intervals in the central lower incisors. Periodontitis was then treated with MOP (control), a mucoadhesive oral patch containing doxycycline (MOP-doxy) or MOP-EGCG for 1 h/day for 21 days. On days 3, 5, 7, 14 and 21 after treatment, the central lower incisor was biopsied and analyzed by immunohistochemistry for RANK/RANKL and OPG expression in the gingiva tissue. Results MOP-EGCG extract significantly reduced the expression of RANKL and increased the expression of OPG and RANK (p < 0.05) when compared to the MOP-doxy and MOP groups. Conclusion MOP-EGCG extract reduced the expression of RANKL and increased the expression of OPG and RANK, thus suggesting that MOP-EGCG can inhibit the loss of alveolar bone in periodontitis.
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Affiliation(s)
- Dur Muhammad Lashari
- Doctoral Program of Dental Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Oral Biology Dental Department Bolan Medical College Quetta, Pakistan
| | - Mohammed Aljunaid
- Doctoral Program of Dental Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Oral and Dental Medicine, Faculty of Medicine, Taiz University, Taiz, Yemen
- Faculty of Oral and Dental Medicine, AL-saeed University, Taiz, Yemen
| | - Yasmeen Lashari
- Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Bolan Medical College & Hospital Quetta, Department of Microbiology (Pathology), Quetta, Pakistan
| | - Huda Rashad Qaid
- Doctoral Program of Dental Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Oral and Dental Medicine, AL-saeed University, Taiz, Yemen
| | - Rini Devijanti Ridwan
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Corresponding address: Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Jalan. Prof. Dr. Moestopo No 47, Surabaya, 60132, Indonesia.
| | - Indeswati Diyatri
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Nejva Kaid
- Master Program of Drug and Cosmetic Manufacturing Technology, Department of Pharmaceutical Technology, Faculty of Pharmacy, Yeditepe University, Istanbul, Turkey
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Techniques and Materials for Treatment of Bone
Loss Due to Periodontitis: A Review. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2022. [DOI: 10.52547/jrdms.7.3.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Miyashita Y, Kuraji R, Ito H, Numabe Y. Wound healing in periodontal disease induces macrophage polarization characterized by different arginine-metabolizing enzymes. J Periodontal Res 2021; 57:357-370. [PMID: 34918843 DOI: 10.1111/jre.12965] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/09/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Macrophages play important roles from the initiation of inflammation to wound healing. Two phenotypes of macrophages, namely pro-inflammatory type macrophages (M1-MΦ) and anti-inflammatory type macrophages (M2-MΦ), have been reported. Two contrasting metabolic enzymes that use arginine as a substrate, inducible nitric oxide synthase (iNOS), and arginase-1 (Arg-1), have been identified as M1-MΦ and M2-MΦ markers, respectively. The purpose of this study was to elucidate the temporal dynamics of the macrophage phenotype during the progression and healing phases of experimental periodontitis in mice. MATERIAL AND METHODS A total of 63 C57BL/6J mice were divided into the following 3 groups: control (C), periodontitis (P), and healing (H). To induce periodontitis, a silk ligature was placed around the maxillary bilateral second molars of mice in the periodontitis and healing groups. In the healing group, the ligature was removed 3 days after ligation to induce tissue healing. Maxillary tissue was collected on day 0 for the control group, days 1, 3, 5, and 7 for the periodontitis group (P1, P3, P5, and P7), and days 5 and 7 for the healing group (H5 and H7: 3 days with the ligation + 2 days or 4 days following ligature removal). The left side of the maxilla was subjected to bone structure analysis using micro-computed tomography and gene expression analysis using polymerase chain reaction. On the right side, immunohistochemistry was performed to histopathologically evaluate the localization of macrophages by phenotype in the periodontal tissue. RESULTS In the alveolar bone structure analysis, the linear distance of bone height increased significantly in the P5 and P7 groups, whereas bone volume fraction and bone mineral density decreased over time after ligature placement; in the healing group (H5 and H7), these parameters improved significantly compared with the periodontitis group (P5 and P7). Expression of genes encoding pro-inflammatory cytokines and iNOS increased in the periodontitis group, and expression of anti-inflammatory cytokine genes and Arg-1 increased in the healing group. Furthermore, the iNOS/Arg-1 expression ratio increased with ligation, whereas the ratio in the healing groups (H5 and H7) significantly decreased compared with the periodontitis groups (P5 and P7). Immunofluorescence staining revealed a significant increase in the number of iNOS-positive macrophages in the periodontitis group and decrease in the healing group. In contrast, the number of Arg-1-positive macrophages decreased in the periodontitis group and increased in the healing group. CONCLUSION The results of the present study suggest that wound healing in periodontal disease induces macrophage polarization from M1-MΦ to M2-MΦ characterized by iNOS and Arg-1.
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Affiliation(s)
- Yukihiro Miyashita
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Ryutaro Kuraji
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan.,Department of Life Science Dentistry, The Nippon Dental University, Tokyo, Japan
| | - Hiroshi Ito
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
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Ng E, Tay JRH, Ong MMA. Minimally Invasive Periodontology: A Treatment Philosophy and Suggested Approach. Int J Dent 2021; 2021:2810264. [PMID: 34257659 PMCID: PMC8245214 DOI: 10.1155/2021/2810264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 01/20/2023] Open
Abstract
Severe periodontitis is a highly prevalent dental disease. With the advent of implant dentistry, teeth are often extracted and replaced. Periodontal surgery, where indicated, could also result in increased trauma to the patient. This literature review discusses different treatment modalities for periodontitis and proposes a treatment approach emphasizing maximum preservation of teeth while minimizing morbidity to the patient. Scientific articles were retrieved from the MEDLINE/PubMed database up to January 2021 to identify appropriate articles that addressed the objectives of this review. This was supplemented with hand searching using reference lists from relevant articles. As tooth prognostication does not have a high predictive value, a more conservative approach in extracting teeth should be abided by. This may involve repeated rounds of nonsurgical periodontal therapy, and adjuncts such as locally delivered statin gels and subantimicrobial-dose doxycycline appear to be effective. Periodontal surgery should not be carried out at an early phase in therapy as improvements in nonsurgical therapy may be observed up to 12 months from initial treatment. Periodontal surgery, where indicated, should also be minimally invasive, with periodontal regeneration being shown to be effective over 20 years of follow-up. Biomarkers provide an opportunity for early detection of disease activity and personalised treatment. Quality of life is proposed as an alternative end point to the traditional biomedical paradigm focused on the disease state and clinical outcomes. In summary, minimally invasive therapy aims to preserve health and function of the natural dentition, thus improving the quality of life for patients with periodontitis.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
| | - Marianne Meng Ann Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
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Association of IL-10 -1082A>G, -819C>T, and -592C>A polymorphisms with susceptibility to chronic and aggressive periodontitis: a systematic review and meta-analysis. Inflamm Res 2021; 70:509-524. [PMID: 33666703 DOI: 10.1007/s00011-021-01448-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/12/2021] [Accepted: 02/24/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Several epidemiological studies have evaluated association of interleukin 10 (IL-10) polymorphisms with risk of periodontitis. However, the results remain conflicting and inconclusive. Here, we carried out a comprehensive systematic review and meta-analysis to evaluate the association of IL-10 -1082A>G, -819C>T, and -592C>A polymorphisms with risk of chronic (CP) and aggressive (CP) periodontitis. METHODS Electronic databases including PubMed, Science Direct, SciELO, and CNKI were systematically searched to identify all relevant studies published up to 01 June 2020. RESULTS A total of 60 case-control studies with 5313 cases and 6528 controls met our inclusion criteria. Overall, the pooled data showed that the IL-10 -592C>A polymorphism was statistically associated with increased risk of periodontitis in the overall population, while no significant association was identified for IL-10 -1082A>G and IL-10 -819C>T polymorphisms. The subgroup analysis by ethnicity revealed that the IL-10 -1082A>G polymorphism was significantly associated with periodontitis risk in Caucasians, IL-10 -819C>T polymorphism in mixed population, and IL-10 -592C>A polymorphism in both Asians and mixed populations. When further analyzed by periodontitis type, only the IL-10 -592C>A polymorphism was associated with CP risk, but not AgP; and the IL-10 -1082A>G and -819C>T polymorphisms have not positive association neither in the CP and AgP. CONCLUSIONS The current meta-analysis showed that the IL-10 -592C>A polymorphism was statistically associated with periodontitis risk in the overall population. Moreover, the IL-10 -1082A>G, IL-10 -819C>T, and IL-10 -592C>A polymorphisms were associated with periodontitis risk by ethnicity. Therefore, the IL-10 polymorphisms are of high clinical relevance by ethnicity and would be a useful marker to identify patients who are at higher risk for periodontitis.
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Gattani D, Sahu J, Kar N, Gattani R. Salivary profile of matrix metalloproteinase-8, tissue inhibitors of matrix metalloproteinase-1, myeloperoxidase, and nitrous oxide in smokers versus nonsmokers with chronic periodontitis. JOURNAL OF THE INTERNATIONAL CLINICAL DENTAL RESEARCH ORGANIZATION 2021. [DOI: 10.4103/jicdro.jicdro_4_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ghinassi B, Di Baldassarre A, D’Addazio G, Traini T, Andrisani M, Di Vincenzo G, Gaggi G, Piattelli M, Caputi S, Sinjari B. Gingival Response to Dental Implant: Comparison Study on the Effects of New Nanopored Laser-Treated vs. Traditional Healing Abutments. Int J Mol Sci 2020; 21:ijms21176056. [PMID: 32842709 PMCID: PMC7504205 DOI: 10.3390/ijms21176056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/14/2020] [Accepted: 08/21/2020] [Indexed: 12/15/2022] Open
Abstract
The health of peri-implant soft tissues is important for the long-term success rate of dental implants and the surface topography is pivotal in influencing it. Thus, the aim of this study was to evaluate, in human patients, the inflammatory mucosal microenvironment in the tissue surrounding a new, nanoscale, laser-treated healing abutment characterized by engineered nanopores versus a standard machined-surface. Analyses of anti- and pro-inflammatory markers, cytokeratins, desmosomal proteins and scanning electron microscopy were performed in 30 soft-tissue biopsies retrieved during second-stage surgery. The results demonstrate that the soft tissue surrounding the laser-treated surface was characterized by a lower grade of inflammation than the one facing the machined-surface, which, in turn, showed a disrupted epithelium and altered desmosomes. Moreover, higher adhesion of the epithelial cells on the laser-treated surface was detected compared to the machined one. In conclusion, the laser-treated surface topography seems to play an important role not only in cell adhesion, but also on the inflammatory makers’ expression of the soft tissue microenvironment. Thus, from a clinical point of view, the use of this kind of topography may be of crucial importance not only on healing abutments but also on prosthetic ones.
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Affiliation(s)
- Barbara Ghinassi
- Human Anatomy and Cell Differentation Lab, Department of Medicine and Aging Sciences, University “G.d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (B.G.); (A.D.B.)
| | - Angela Di Baldassarre
- Human Anatomy and Cell Differentation Lab, Department of Medicine and Aging Sciences, University “G.d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (B.G.); (A.D.B.)
| | - Gianmaria D’Addazio
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (T.T.); (M.A.); (M.P.); (S.C.); (B.S.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Tonino Traini
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (T.T.); (M.A.); (M.P.); (S.C.); (B.S.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Mauro Andrisani
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (T.T.); (M.A.); (M.P.); (S.C.); (B.S.)
| | - Giorgio Di Vincenzo
- Department of Periodontics & Implant Dentistry, New York University, E 40th St #508, New York, NY 10016, USA;
| | - Giulia Gaggi
- Human Anatomy and Cell Differentation Lab, Department of Medicine and Aging Sciences, University “G.d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
| | - Maurizio Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (T.T.); (M.A.); (M.P.); (S.C.); (B.S.)
| | - Sergio Caputi
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (T.T.); (M.A.); (M.P.); (S.C.); (B.S.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Bruna Sinjari
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (T.T.); (M.A.); (M.P.); (S.C.); (B.S.)
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
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Branco-de-Almeida LS, Franco GCN, Castro ML, Vieira MS, Galvão-Moreira LV, Cortelli SC, Anbinder AL, Kawai T, Rosalen PL. Protective effects of desipramine on alveolar bone in experimental periodontitis. J Periodontol 2020; 91:1694-1703. [PMID: 32294250 DOI: 10.1002/jper.19-0569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Desipramine is a tricyclic antidepressant with immune-modulatory activity, whose effects on ligature-induced periodontitis are yet to be investigated. Hence, its actions on alveolar bone resorption, gingival collagen content and key inflammatory mediators were herewith analyzed. METHODS A total of 60 male Wistar rats were randomly assigned into three groups: 1) control: rats without ligature treated with vehicle (saline); 2) ligature: rats with ligature-induced periodontitis treated with vehicle; 3) ligature + desipramine: rats with ligature-induced periodontitis treated with desipramine (20 mg/kg/d in vehicle). Mandibles and gingival tissues were collected 3 or 15 days after ligature insertion (or no ligature insertion for controls) and treatments. Alveolar bone resorption and gingival collagen fibers were histologically analyzed using either HE or picrosirius red staining. Gingival mRNA expressions of interleukin (IL)-1β, inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2, matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 were obtained through reverse transcription polymerase chain reaction. MMP-9 activity was analyzed by zymography. RESULTS Alveolar bone loss was significantly reduced in the ligature + desipramine group (P < 0.05), whereas gingival collagen degradation was like the ligature group (P > 0.05). Desipramine administration downregulated mRNA expressions of IL-1β, iNOS, COX-2, and TIMP-1 when compared to vehicle alone in the ligature group (P < 0.05). MMP-9 expression and MMP-9/TIMP-1 ratio were similar among rats with ligature-induced periodontitis (P > 0.05); however, MMP-9 activity was lower in the group treated with desipramine (P < 0.05). CONCLUSION Desipramine administration reduced alveolar bone loss as histologically observed, and modulated key bone remodeling and inflammatory mediators in rats with ligature-induced periodontitis.
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Affiliation(s)
| | - Gilson C N Franco
- Department of General Biology, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | - Mayana S Vieira
- Post Graduate Program in Dentistry, Universidade CEUMA, São Luís, Maranhão, Brazil
| | | | - Sheila C Cortelli
- Nucleus of Periodontal Research, University of Taubaté, Taubaté, São Paulo, Brazil
| | - Ana L Anbinder
- Department of Bioscience and Oral Diagnosis, São Paulo State University, São José dos Campos, São Paulo, Brazil
| | - Toshihisa Kawai
- College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Pedro L Rosalen
- Biological Sciences Graduate Program, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
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Torre E, Iviglia G, Cassinelli C, Morra M, Russo N. Polyphenols from grape pomace induce osteogenic differentiation in mesenchymal stem cells. Int J Mol Med 2020; 45:1721-1734. [PMID: 32236566 PMCID: PMC7169659 DOI: 10.3892/ijmm.2020.4556] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/19/2020] [Indexed: 12/13/2022] Open
Abstract
Polyphenols are increasingly investigated for the treatment of periodontitis and research on their use in dental biomaterials is currently being conducted. Grape pomace extracts are a rich source of polyphenols. In the present study, the polyphenols of two different types of grape pomace were characterized and identified by high-performance liquid chromatography-diode array detector, and the effect of polyphenol-rich grape pomace extracts on mesenchymal stem cell (MSC) osteogenic differentiation was investigated. Solid-liquid extraction was used to recover polyphenols from red and white grape pomace. The two extracts have been characterized through the phenolic content and antioxidant power. Human MSCs (hMSCs) from the bone marrow were cultured both with and without given amounts (10 or 20 µg/ml) of the obtained pomace extracts. Their effects on cell differentiation were evaluated by reverse transcription-quantitative polymerase chain reaction, compared with relevant controls. Results showed that both pomace extracts, albeit different in phenolic composition and concentration, induced multiple effects on hMSC gene expression, such as a decreased receptor activator of nuclear factor κ-B ligand/osteoprotegerin ratio and an enhanced expression of genes involved in osteoblast differentiation, thus suggesting a shift of hMSCs towards osteoblast differentiation. The obtained results provided data in favor of the exploitation of polyphenol properties from grape pomace extracts as complementary active molecules for dental materials and devices for bone regeneration in periodontal defects.
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Affiliation(s)
- Elisa Torre
- Nobil Bio Ricerche srl, I‑14037 Portacomaro, Italy
| | | | | | - Marco Morra
- Nobil Bio Ricerche srl, I‑14037 Portacomaro, Italy
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Çalışır M, Akpınar A, Poyraz Ö, Göze F, Çınar Z. Humic Acid, a Polyphenolic Substance, Decreases Alveolar Bone Loss in Experimental Periodontitis in Rats. J Vet Dent 2020; 36:257-265. [PMID: 32207389 DOI: 10.1177/0898756420910531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to evaluate the biochemical, morphometric, and histopathological changes associated with experimental periodontitis in rats in response to local administration of humic acid. Thirty-eight Wistar rats were divided into 5 experimental groups: nonligated (NL) group, ligature-only (LO) group, and ligature + local administration of humic acid (20, 80, and 150 mg/kg body weight per day for 15 days, respectively; L-20, L-80, and L-150 groups). Changes in alveolar bone levels were clinically measured as the distance from the cementoenamel junction to the alveolar bone crest with a stereomicroscope. Tissues were histopathologically examined to assess the osteoclast numbers, osteoblastic activity, and inflammatory cell infiltration among the study groups. Enzyme-linked immunosorbent assay interleukin1β (IL-1β) and IL-10 levels in serum and gingival homogenates were evaluated. At the end of 15 days, the alveolar bone loss was significantly higher in the LO group compared to the NL, L-20, and L-150 groups (P < .05). The osteoclast number in the LO group was significantly higher than the NL, L-20, and L-150 groups (P < .05). Inflammatory cell infiltration was significantly higher in the LO and L-80 groups than the other groups (P < .05). The highest serum and gingival homogenate IL-10 levels were determined in the NL group (P < .05). The serum and gingival homogenate IL-1β levels in LO group were significantly higher than the NL, L-20, and L-150 groups (P < .05). Within the limits of this study, it can be suggested that humic acid, when administered locally at 20 and 80 mg/kg doses, may prevent alveolar bone loss in the rat model.
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Affiliation(s)
- Metin Çalışır
- Department of Periodontology, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Aysun Akpınar
- Department of Periodontology, Faculty of Dentistry, Cumhuriyet University, Sivas, Turkey
| | - Ömer Poyraz
- Department of Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Fahrettin Göze
- Department of Pathology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Ziynet Çınar
- Department of Biostatistics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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Cirano FR, Pimentel SP, Ribeiro FV, Casati MZ, Casarin RC, Gallafassi DF, Nishii D, Corrêa MG. Impact of history of periodontitis on gene expression of bone-related factors in young patients. Braz Oral Res 2020; 34:e014. [PMID: 32074214 DOI: 10.1590/1807-3107bor-2020.vol34.0014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 11/11/2019] [Indexed: 12/11/2022] Open
Abstract
Although dental implants and bone regenerative procedures are important approaches for the reestablishment of esthetics and function in young patients with a history of generalized aggressive periodontitis (GAP), no predictable outcomes have been reported, and the host osteo-immunoinflammatory response may play a relevant role in this context. In view of the lack of molecular investigations into the bone tissue condition of young patients with periodontitis, the aim of this study was to evaluate the gene expression of bone-related factors in this population. Bone biopsies were obtained from the posterior mandible in 16 individuals previously diagnosed with GAP and on periodontal support therapy and from 17 periodontally healthy (PH) patients. The gene expression of tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, receptor activator of the NF-κB ligand (RANKL), osteoprotegerin (OPG), osteocalcin (OC), bone sialoprotein (BSP), and type I collagen (COL-I), important biomarkers of bone turnover, was evaluated by qRT-PCR. Lower TGF-β and OPG mRNA levels were observed in GAP patients compared to PH individuals (p ≤ 0.05). There were no between-group differences in levels of TNF-α, BSP, RANKL, OC, or COL-I mRNA (p>0.05). In young adults, a history of periodontal disease can negatively modulate the gene expression of important bone-related factors in alveolar bone tissue. These molecular outcomes may contribute to the future development of therapeutic approaches to benefit bone healing in young patients with history of periodontitis via modulation of osteo-immuno-inflammatory biomarkers.
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Affiliation(s)
- Fabiano Ribeiro Cirano
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Suzana Peres Pimentel
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fernanda Vieira Ribeiro
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Renato Corrêa Casarin
- Universidade Estadual de Campinas - Unicamp, School of Dentistry at Piracicaba, Department of Prosthodontics and Periodontics, Piracicaba, SP, Brazil
| | - Daniel Freire Gallafassi
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Denise Nishii
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Mônica Grazieli Corrêa
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
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López Roldán A, García Giménez JL, Alpiste Illueca F. Impact of periodontal treatment on the RANKL/OPG ratio in crevicular fluid. PLoS One 2020; 15:e0227757. [PMID: 31986169 PMCID: PMC6984681 DOI: 10.1371/journal.pone.0227757] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 12/28/2019] [Indexed: 11/19/2022] Open
Abstract
Aim Alveolar resorption is one of the most important events in periodontitis. Osteoclast activity is regulated by the ratio between receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG). The aim of this study was to evaluate changes in the RANKL/OPG ratio in crevicular fluid after periodontal treatment. Material and methods A total of 15 patients with periodontitis were included in the study group. Samples were collected from an area with active periodontitis and a healthy area. The RANKL and OPG levels were measured before and after periodontal scaling and root planing (SRP) treatment. The study group was compared to the control group, which included 10 patients without periodontitis. ID Clinicaltrial.gov: NCT03787875. Results A decrease in the RANKL level was found in areas with active periodontitis after periodontal treatment, but no change in the OPG level was observed. Therefore, the treatment induced a decrease in the RANKL/OPG ratio in sites with destructive periodontal activity. Conclusions Periodontal treatment acts on the RANKL/OPG ratio by decreasing osteoclastogenesis. These results encourage the use of these molecules for periodontal diagnosis, monitoring and treatment. ID Clinicaltrial.gov NCT03787875.
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Affiliation(s)
- Andrés López Roldán
- Dept. of Periodontics, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - José Luis García Giménez
- Center for Biomedical Network Research on Rare Diseases (CIBERER), CIBER-ISCIII, Madrid, Spain.,Dept. of Physiology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.,INCLIVA Health Research Institute, Valencia, Spain.,Epigenetics Research Platform, CIBERER-UV, Valencia, Spain
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16
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Neppelenbroek KH, Honório HM, Garlet GP. To P or not to P, is that the question? Rethinking experimental design and data analysis to improve biological significance beyond the statistical significance. J Appl Oral Sci 2019; 27:e2019ed001. [PMID: 31596371 PMCID: PMC7700743 DOI: 10.1590/1678-7757-2019-ed001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Yildirim TT, Ozan G, Dundar S, Bozoglan A, Karaman T, Dildes N, Kaya CA, Kaya N, Erdem E. The effects of morus nigra on the alveolar bone loss in experimentally-induced periodontitis. Eur Oral Res 2019; 53:99-105. [PMID: 31579889 PMCID: PMC6761488 DOI: 10.26650/eor.20190021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/22/2018] [Accepted: 01/25/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose The aim of this study is to evalute the anti-inflammatory effects of morus migra on experimentally-induced periodontitis in rats. Materials and methods Twenty-four Wistar-albino rats were randomly divided into three groups: control group (C, n=8), experimental periodontitis (PER, n=8), experimental periodontitis and treated with Morus nigra (MN+PER, n=8) (50 mg/kg per day for 21 days). After 21 days, the rats were sacrificed, and alveolar bones were evaluated histopathologically and histometrically analyzed to obtain level of alveolar bone loss. The detection of RANKL and OPG were immunohistochemically performed. Serum and tissue levels of MMP-8 and MMP-13 were also analyzed. Results Morus nigra treatment decreased tissue MMP-8 and MMP-13 levels and there were significant differences in the case of tissue levels of MMP-8 and MMP-13 between groups PER and MN+PER (p=0.035, p=0.041). There were no significant differences among all the groups serum levels of MMP-8 and MMP-13 (p=0.067, p=0.082). In the histometric evaluation, alveolar bone loss was greater in the PER group compared to C and MN groups (p=0.035). Immuno-histochemical staining of RANKL activities were found significantly lower (p=0.037) and OPG activities were found significantly higher in MN+PER group when compared to PER group (p=0.021). Conclusion The present study reveals that systemic administration of Morus nigra significantly inhibited the regional alveolar bone resorption and contributes to periodontal healing in the rat experimental-periodontitis models.
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Affiliation(s)
- Tuba Talo Yildirim
- Department of Periodontology, Faculty of Dentistry, Firat University,Elazig, Turkey
| | - Gonca Ozan
- Department of Biochemistry, Faculty of Veterinary Medicine, Firat University,Elazig, Turkey
| | - Serkan Dundar
- Department of Periodontology, Faculty of Dentistry, Firat University,Elazig, Turkey
| | - Alihan Bozoglan
- Department of Periodontology, Faculty of Dentistry, Firat University,Elazig, Turkey
| | - Tahir Karaman
- Department of Prosthodontics, Faculty of Dentistry,Firat University,Elazig, Turkey
| | - Neval Dildes
- Department of Orthodontics, Faculty of Dentistry, Firat University,Elazig, Turkey
| | - Can Ayhan Kaya
- Diyarbakır Vocational High School, Dicle University,Diyarbakir,Diyarbakir, Turkey
| | - Nalan Kaya
- Department of Histology and Embriology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Elif Erdem
- Department of Histology and Embriology, Faculty of Medicine, Firat University, Elazig, Turkey
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Sulijaya B, Takahashi N, Yamazaki K. Host modulation therapy using anti-inflammatory and antioxidant agents in periodontitis: A review to a clinical translation. Arch Oral Biol 2019; 105:72-80. [PMID: 31288144 DOI: 10.1016/j.archoralbio.2019.07.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/26/2019] [Accepted: 07/02/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To highlight the shifting paradigm of periodontitis, describe mechanism of periodontal bone destruction, and propose an updated host modulation therapy (HMT) strategy. To add further clinical relevance, related studies investigating the efficacy of several HMT agents in periodontitis will be discussed. DESIGN Literature searches were conducted from articles published in PubMed using keywords "periodontal disease AND periodontitis AND host modulation therapy AND anti-inflammatory AND antioxidant", and then the findings were comprehensively summarized and elaborated. RESULT Accumulating evidence indicates that periodontitis is no longer defined solely as a pathogen-induced disease; rather, it is now recognized as a consequence of uncontrolled immune response and oxidative stress leading to periodontal tissue damage. Although periodontopathic bacteria initiate the disease, inflammation and oxidative stress were reported to be the main causes for the severity of tissue destruction. Thus, since the concept of periodontitis has shifted, our approach to its management needs to be adjusted to accommodate the latest paradigm. Nowadays, the modulation of inflammation and oxidative stress is considered a target of HMT. HMT agents, such as probiotics, anti-inflammatory drugs, anti-chemokines, lipid mediators, and bio-active fatty acids, have been extensively investigated for their remarkable functions in modulating the immune response and providing antioxidant effects. CONCLUSION Findings from in vitro, in vivo, and human studies frequently demonstrate positive association by the administration of HMT in periodontitis. HMT strategy targeted on anti-inflammatory and antioxidant in periodontitis might serve as an excellent therapeutic approach to reach the level of clinical benefit.
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Affiliation(s)
- Benso Sulijaya
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Naoki Takahashi
- Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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Effects of Er,Cr:YSGG and Diode Lasers on Clinical Parameters and Gingival Crevicular Fluid IL-1 β and IL-37 Levels in Generalized Aggressive Periodontitis. Mediators Inflamm 2019; 2019:2780794. [PMID: 31308830 PMCID: PMC6594306 DOI: 10.1155/2019/2780794] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/26/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022] Open
Abstract
Aim The objective of the current study is to analyze the correlation between cytokine levels and periodontal parameters in aggressive periodontitis patients before and after periodontal treatment that was performed by using two different laser therapies. Materials and Methods Twenty-six generalized aggressive periodontitis patients were treated with three different methods (SRP, SRP+diode laser, and SRP+Er,Cr:YSGG laser) applied to three different half-jaws in the same patients. Pre- and posttreatment clinical periodontal parameters and GCF IL-1β and IL-37 levels were measured. Results There was a statistically significant decrease (p < 0.05) between pretreatment and posttreatment clinical periodontal parameters and IL-1β and IL-37 levels. When the reduction rates of IL-37 and IL-1β levels after treatment were evaluated, the decrease in IL-37 and IL-1β levels after treatment was lowest in the SRP group and highest in the SRP+Er,Cr:YSGG group. In addition, the amount of decrease in IL-1β in SRP+diode and SRP+Er,Cr:YSGG groups was found to be higher than that in IL-37. Furthermore, there was a positive correlation between IL-37 and IL-1β in all groups (p < 0.01). Conclusion Er,Cr:YSGG laser is more effective than diode laser for the treatment of aggressive periodontitis. IL-37 and IL-1β are cytokines that function together and thus must be evaluated together.
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20
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Bi CS, Sun LJ, Qu HL, Chen F, Tian BM, Chen FM. The relationship between T-helper cell polarization and the RANKL/OPG ratio in gingival tissues from chronic periodontitis patients. Clin Exp Dent Res 2019; 5:377-388. [PMID: 31944625 PMCID: PMC7938418 DOI: 10.1002/cre2.192] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 12/24/2022] Open
Abstract
This study aimed to investigate the relationship between inflammation‐related T‐helper cell polarization and the receptor activator for nuclear factor‐κB ligand (RANKL)/osteoprotegerin (OPG) ratio, which is associated with bone resorption or remodeling of chronic periodontitis patients. Gingival crevicular fluid (GCF) and gingival tissues were obtained from periodontally healthy individuals (PH group) and chronic periodontitis patients (CP group). The GCF levels of IFN‐γ, IL‐4, IL‐17, and IL‐10 linked to T‐helper cell polarization toward the Th1, Th2, Th17, and Treg phenotypes, respectively, were determined by ELISA. The expression levels of these cytokines and the polarized T‐helper cells in gingival tissues were assessed through immunohistochemical and immunofluorescence assays. In addition, the RANKL and OPG expression levels in gingival tissues were detected by immunohistochemical assays, and linear regression analysis was used to identify the potential relationship between T‐helper cell polarization and the RANKL/OPG ratio. In total, 22 individuals and 35 patients were enrolled in the present study. In both GCF and gingival tissues, increased levels of IL‐17 and the decreased levels of IL‐4 and IL‐10 were observed in the CP group. When polarized T‐helper cells were identified in gingival tissues, more Th1 and Th17 cells were found in the CP group, whereas more Th2 and Treg cells were found in the PH group. Although there was no significant difference in OPG expression between the two groups, the RANKL/OPG ratio in the CP group was higher than that in the PH group. The linear regression analysis showed that the presence of more Th1 and Th17 cells correlated with a higher RANKL/OPG ratio, whereas the presence of more Th2 cells correlated with a lower RANKL/OPG ratio. Th1 and Th17 cells are positively correlated and Th2 cells are negatively correlated with the RANKL/OPG ratio. Our data suggest that T‐helper cell polarization is closely linked to the RANKL/OPG ratio in gingival tissues from chronic periodontitis patients.
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Affiliation(s)
- Chun-Sheng Bi
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Li-Juan Sun
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Hong-Lei Qu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Fang Chen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Bei-Min Tian
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Fa-Ming Chen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Pigossi SC, Anovazzi G, Finoti LS, de Medeiros MC, Mayer MP, Rossa Junior C, Scarel-Caminaga RM. Functionality of the Interleukin 8 haplotypes in lymphocytes and macrophages in response to gram-negative periodontopathogens. Gene 2019; 689:152-160. [DOI: 10.1016/j.gene.2018.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/01/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022]
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22
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Heidari Z, Moudi B, Mahmoudzadeh-Sagheb H. Immunomodulatory factors gene polymorphisms in chronic periodontitis: an overview. BMC Oral Health 2019; 19:29. [PMID: 30755190 PMCID: PMC6373099 DOI: 10.1186/s12903-019-0715-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 01/14/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Chronic periodontitis (CP), defines as destruction of the supporting tissues of the teeth and resorption of the alveolar bone. It is widespread in human populations and represent an important problem for public health. CP results from inflammatory mechanisms created by the interaction between environmental and host genetic factors that confer the individual susceptibility to the disease. AIM The aim of the current study was to explore and summarize some functional biomarkers that are associated with CP susceptibility. METHODS CP is considered to be a multifactorial disease. The pathogenesis of multifactorial diseases is characterized by various biological pathways. The studies revealed that polymorphisms were associated with susceptibility to periodontal diseases. In other word, genetic variations can change the development of CP. However, there are some conflicting results, because there are different variations in frequency of some alleles in any populations. Therefore, we conducted the current review to completely understanding the special biomarkers for CP. RESULTS There is some evidence that SNPs in the IL-1α, IL-1β, IL1RN, IL-6, IL-10, TNF-α, TGF-β1, IFN-γ and VDR may be associated with CP susceptibility. CONCLUSION In conclusion, numerous studies have reported the host genetic factors associated with CP susceptibility and related traits. Therefore, it is prevail to study the multiple SNPs and their effects to find the useful diagnosis methods. The current study will investigate the relationship between polymorphisms in cytokine genes and the susceptibility to the chronic periodontitis.
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Affiliation(s)
- Zahra Heidari
- 0000 0004 0612 8339grid.488433.0Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran ,0000 0004 0612 8339grid.488433.0Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 98167-43175 Iran
| | - Bita Moudi
- 0000 0004 0612 8339grid.488433.0Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran ,0000 0004 0612 8339grid.488433.0Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 98167-43175 Iran
| | - Hamidreza Mahmoudzadeh-Sagheb
- 0000 0004 0612 8339grid.488433.0Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran ,0000 0004 0612 8339grid.488433.0Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 98167-43175 Iran
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23
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Nikolic N, Jakovljevic A, Carkic J, Beljic-Ivanovic K, Miletic M, Soldatovic I, Andric M, Ivanovic V, Milasin J. Notch Signaling Pathway in Apical Periodontitis: Correlation with Bone Resorption Regulators and Proinflammatory Cytokines. J Endod 2019; 45:123-128. [DOI: 10.1016/j.joen.2018.10.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 09/25/2018] [Accepted: 10/28/2018] [Indexed: 02/06/2023]
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Borges CD, Ricoldi MS, Messora MR, Palioto DB, Souza SLSD, Novaes Júnior AB, Taba Jr M. Clinical attachment loss and molecular profile of inflamed sites before treatment. J Appl Oral Sci 2019; 27:e20180671. [PMID: 31508795 PMCID: PMC9648953 DOI: 10.1590/1678-7757-2018-0671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/26/2019] [Indexed: 12/30/2022] Open
Abstract
Objective: To monitor early periodontal disease progression and to investigate clinical and molecular profile of inflamed sites by means of crevicular fluid and gingival biopsy analysis. Methodology: Eighty-one samples of twenty-seven periodontitis subjects and periodontally healthy individuals were collected for the study. Measurements of clinical parameters were recorded at day −15, baseline and 2 months after basic periodontal treatment aiming at monitoring early variations ofthe clinical attachment level. Saliva, crevicular fluid and gingival biopsies were harvested from clinically inflamed and non-inflamed sites from periodontal patients and from control sites of healthy patients for the assessment of IL-10, MMP-8, VEGF, RANKL, OPG and TGF-β1 protein and gene expression levels. Results: Baseline IL-10 protein levels from inflamed sites were higher in comparison to both non-inflamed and control sites (p<0.05). Higher expression of mRNA for IL-10, RANK-L, OPG, e TGF-β1 were also observed in inflamed sites at day −15 prior treatment (p<0.05). After the periodontal treatment and the resolution of inflammation, seventeen percent of evaluated sites still showed clinically detectable attachment loss without significant differences in the molecular profile. Conclusions: Clinical attachment loss is a negative event that may occur even after successful basic periodontal therapy, but it is small and limited to a small percentage of sites. Elevated inflammation markers of inflamed sites from disease patients reduced to the mean levels of those observed in healthy subjects after successful basic periodontal therapy. Significantly elevated both gene and protein levels of IL-10 in inflamed sites prior treatment confirms its modulatory role in the disease status.
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25
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Valerio MS, Kirkwood KL. Sexual Dimorphism in Immunity to Oral Bacterial Diseases: Intersection of Neutrophil and Osteoclast Pathobiology. J Dent Res 2018; 97:1416-1423. [PMID: 30205018 DOI: 10.1177/0022034518798825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Sex is a biological variable that affects immune responses to bacterial and other types of infectious agents. Males and females are known to have differential oral bacterial disease burden in periodontal and endodontic disease. Understanding that there is a contribution from both sex and gender to these oral diseases, we discuss in this review recent sex-based findings that provide a pathobiological basis for differences observed between males and females. Sexual dimorphism of immune responses with respect to neutrophil trafficking and osteoclast differentiation and formation is presented as a plausible mechanism to explain the sexual differences. We also emphasize that sex, as a biological variable, should be considered in these types of oral immunologic studies.
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Affiliation(s)
- M S Valerio
- 1 Extremity Trauma and Amputation Center of Excellence, Walter Reed National Military Medical Center, Department of Defense and Department of Veterans Affairs, Bethesda, MD, USA
| | - K L Kirkwood
- 2 Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA.,3 Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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26
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Costa LC, Fonseca MAD, Pinheiro ADR, Aguiar TRDS, Machado AN, Quinelato V, Bonato LL, Aguiar DP, Vieira T, Almeida FLDD, Lobo JC, Jordão M, Lomardo PG, Granjeiro JM, Casado PL. Chronic Periodontitis and RANKL/OPG Ratio in Peri-Implant Mucosae Inflammation. Braz Dent J 2018; 29:14-22. [PMID: 29267518 DOI: 10.1590/0103-6440201801241] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/23/2017] [Indexed: 11/21/2022] Open
Abstract
tHistory of chronic periodontitis (CP) is a risk factor for oseointegration failure. The osteoclastogenesis system (RANK, RANKL and OPG) is critical for bone homeostatic control. We investigated the levels of OPG and RANKL in peri-implant tissues from volunteers with and without a history of CP and their association with mucosae inflammation. This is a single-blind case-contro study. Diagnosis of a history of CP and peri-implant examination was performed on 46 volunteers, divided into control (without history of CP, n=26) and CP group (with history of CP, n=20). Gingival biopsies were harvested during implant exposure. Quantitative PCR evaluated OPG/RANKL mRNA expressions. OPG and RANKL proteins were analyzed by western blot and immunohistochemistry assay. The chi-square test analyzed the significance of nominal variables between groups while continuous variables were analyzed by T-test or Mann-Whitney test, after Shapiro-Wilk test evaluation. The 2-ΔΔCT Livak method calculation evaluated the gene expression. Values of p<0.05 were considered statistically significant. Volunteers with CP history had 23 times higher chance of developing mucosae inflammation. High mucosae levels of RANKL (p=0.04) and RANKL/OPG (p=0.001) mRNA expressions were observed in CP group. CP volunteers showed increased RANKL protein levels in opposition to decreased OPG expression. Even without active periodontitis, volunteers with a history of CP had elevated gingival levels of RANKL/OPG and higher correlation with peri-implant mucosae inflammation and implant loss.
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Affiliation(s)
- Lucas Carneiro Costa
- Postgraduate Program in Dentistry, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | | | | | - Aldir Nascimento Machado
- Postgraduate Program in Oral Implantology, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil.,Department of Dental Clinical, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Valquiria Quinelato
- Postgraduate Program in Dentistry, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Leticia Ladeira Bonato
- Postgraduate Program in Dentistry, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | - Thays Vieira
- Clinical Research Unit and Biology Institute, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | - Julie Calixto Lobo
- Clinical Research Unit and Biology Institute, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Miriam Jordão
- Department of Oral Diagnosis, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | - José Mauro Granjeiro
- National Institute of Metrology, Quality and Technology, Rio de Janeiro, RJ, Brazil.,Department of Periodontology, UFF - Universidade Federal Flum inense, Niterói, RJ, Brazil
| | - Priscila Ladeira Casado
- Postgraduate Program in Dentistry, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil.,Cell Therapy Center, Clinical Research Unit and Biology Institute, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
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Jakovljevic A, Andric M, Nikolic N, Coric V, Krezovic S, Carkic J, Knezevic A, Beljic-Ivanovic K, Pljesa-Ercegovac M, Miletic M, Soldatovic I, Radosavljevic T, Jovanovic T, Simic T, Ivanovic V, Milasin J. Levels of oxidative stress biomarkers and bone resorption regulators in apical periodontitis lesions infected by Epstein-Barr virus. Int Endod J 2018; 51:593-604. [PMID: 29315650 DOI: 10.1111/iej.12886] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 01/04/2018] [Indexed: 02/05/2023]
Abstract
AIM To investigate whether apical periodontitis lesions infected by Epstein-Barr virus (EBV) exhibit higher levels of oxidative stress biomarkers [8-hydroxydeoxyguanosine (8-OHdG) and oxidized glutathione (GSSG)] and bone resorption regulators [receptor activator of nuclear factor (NF-κB) ligand (RANKL) and osteoprotegerin (OPG)] compared to EBV-negative periapical lesions and healthy pulp tissues. METHODOLOGY The experimental group consisted of 30 EBV-positive and 30 EBV-negative periapical lesions collected in conjunction with apicoectomy. The pulp tissues of 20 impacted third molars were used as healthy controls. The qualitative and quantitative analysis of EBV was performed by nested and real-time polymerase chain reaction (PCR), respectively. The levels of RANKL and OPG were analysed by reverse transcriptase real-time PCR. The levels of 8-OHdG and GSSG were determined by enzyme-linked immunosorbent assay (ELISA). Mann-Whitney U-test and Spearman's correlation were used for statistical analysis. RESULTS The levels of RANKL, OPG, 8-OHdG and GSSG were significantly higher in apical periodontitis lesions compared to healthy pulp controls (P = 0.001, P < 0.001, P < 0.001 and P < 0.05, respectively). RANKL and OPG mRNA expression was significantly higher in EBV-positive compared to EBV-negative periapical lesions (P < 0.05). There was no significant correlation between EBV copy numbers and levels of RANKL, OPG, 8OH-dG and GSSG in apical periodontitis. CONCLUSION Levels of bone resorption regulators and oxidative stress biomarkers were increased in apical periodontitis compared to healthy pulp tissues. EBV-positive periapical lesions exhibited higher levels of RANKL and OPG compared to EBV-negative periapical lesions. EBV may contribute to progression of apical periodontitis via enhanced production of bone resorption regulators.
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Affiliation(s)
- A Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.,Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - M Andric
- Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - N Nikolic
- Department of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - V Coric
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - S Krezovic
- Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.,Department of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - J Carkic
- Department of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.,Department of Microbiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - A Knezevic
- Institute of Microbiology and Immunology, Department of Virology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - K Beljic-Ivanovic
- Clinic of Restorative Dentistry and Endodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - M Pljesa-Ercegovac
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - M Miletic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - I Soldatovic
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - T Radosavljevic
- Institute of Pathophysiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - T Jovanovic
- Institute of Microbiology and Immunology, Department of Virology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - T Simic
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - V Ivanovic
- Clinic of Restorative Dentistry and Endodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - J Milasin
- Department of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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28
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Moudi B, Heidari Z, Mahmoudzadeh-Sagheb H, Moudi M. Analysis of interleukin-10 gene polymorphisms in patients with chronic periodontitis and healthy controls. Dent Res J (Isfahan) 2018; 15:71-79. [PMID: 29497450 PMCID: PMC5806433 DOI: 10.4103/1735-3327.223614] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Interleukin-10 (IL-10) is an anti-inflammatory cytokine that has important roles in the periodontal diseases. The IL10-1082, -819, and -592 polymorphisms in the promoter region of IL-10 gene have been associated with various IL-10 expressions. The aim of this study was to investigate the association between these gene polymorphisms with chronic periodontitis in a sample of Iranian populations from Southeast of Iran. MATERIALS AND METHODS IL-10 single nucleotide polymorphisms were analyzed in 210 patients with chronic periodontitis (CP) and 100 individuals without CP by polymerase chain reaction-restriction fragment length polymorphism method. Statistical analysis of data was performed using the Chi-square test. The risk associated with single alleles, genotypes, and haplotypes were calculated by performing a multiple logistic regression analysis to estimate the odds ratio (OR) and 95% confidence interval (CI). P < 0.05 for statistical significance. RESULTS The prevalences of AG and GG genotypes of IL10-1082 were significantly different between CP and control groups in comparison to AA genotype (OR = 2.671; CI = 1.482-4.815; P = 0.001 for AG vs. AA, OR = 4.151; CI = 2.128-8.097; P < 0.001 for GG vs. AA). In addition, subjects with at least one IL10-1082-G allele were significantly had an increased risk for CP (OR = 2.157; CI = 1.531-3.038; P < 0.001). The distribution of the IL10-819 and IL10-592 genotypes was not different between CP and control subjects (P = 0.109 and P = 0.139, respectively). The combination of different genotypes showed that GCC haplotype was significantly different between groups (OR = 4.379; CI = 1.077-17.807; P = 0.039). CONCLUSION The results demonstrated that IL10-1082 polymorphism was a putative risk factor for chronic periodontitis and associated with increased susceptibility to CP.
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Affiliation(s)
- Bita Moudi
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Heidari
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamidreza Mahmoudzadeh-Sagheb
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Histology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehrnoosh Moudi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
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29
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Interleukin-10 −592C/A, but not −1082A/G promoter single nucleotide polymorphism, is associated with a decreased risk of colorectal cancer in an ethnic Kashmiri population: a case–control study. Eur J Cancer Prev 2017; 26:476-490. [DOI: 10.1097/cej.0000000000000370] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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30
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CCR5Δ32 (rs333) polymorphism is associated with decreased risk of chronic and aggressive periodontitis: A case-control analysis based in disease resistance and susceptibility phenotypes. Cytokine 2017; 103:142-149. [PMID: 28969941 DOI: 10.1016/j.cyto.2017.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 09/14/2017] [Accepted: 09/21/2017] [Indexed: 02/06/2023]
Abstract
Chronic and aggressive periodontitis are infectious diseases characterized by the irreversible destruction of periodontal tissues, which is mediated by the host inflammatory immune response triggered by periodontal infection. The chemokine receptor CCR5 play an important role in disease pathogenesis, contributing to pro-inflammatory response and osteoclastogenesis. CCR5Δ32 (rs333) is a loss-of-function mutation in the CCR5 gene, which can potentially modulate the host response and, consequently periodontitis outcome. Thus, we investigated the effect of the CCR5Δ32 mutation over the risk to suffer periodontitis in a cohort of Brazilian patients (total N=699), representative of disease susceptibility (chronic periodontitis, N=197; and aggressive periodontitis, N=91) or resistance (chronic gingivitis, N=193) phenotypes, and healthy subjects (N=218). Additionally, we assayed the influence of CCR5Δ32 in the expression of the biomarkers TNFα, IL-1β, IL-10, IL-6, IFN-γ and T-bet, and key periodontal pathogens P. gingivalis, T. forsythia, and T. denticola. In the association analysis of resistant versus susceptible subjects, CCR5Δ32 mutant allele-carriers proved significantly protected against chronic (OR 0.49; 95% CI 0.29-0.83; p-value 0.01) and aggressive (OR 0.46; 95% CI 0.22-0.94; p-value 0.03) periodontitis. Further, heterozygous subjects exhibited significantly decreased expression of TNFα in periodontal tissues, pointing to a functional effect of the mutation in periodontal tissues during the progression of the disease. Conversely, no significant changes were observed in the presence or quantity of the periodontal pathogens P. gingivalis, T. forsythia, and T. denticola in the subgingival biofilm that could be attributable to the mutant genotype.
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31
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Li C, Yang X, Pan Y, Yu N, Xu X, Tong T, Tang X, Zhang D, Liu J, Lin L. A Sialidase-DeficientPorphyromonas gingivalisMutant Strain Induces Less Interleukin-1β and Tumor Necrosis Factor-α in Epi4 Cells Than W83 Strain Through Regulation of c-Jun N-Terminal Kinase Pathway. J Periodontol 2017; 88:e129-e139. [DOI: 10.1902/jop.2017.160815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Chen Li
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Xue Yang
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Yaping Pan
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Ning Yu
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | - Xiaoyu Xu
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Tong Tong
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Xiaolin Tang
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Dongmei Zhang
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Jingbo Liu
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Li Lin
- Department of Periodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, China
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32
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Abstract
Dysbiosis, or the imbalance in the structural and/or functional properties of the microbiome, is at the origin of important infectious inflammatory diseases such as inflammatory bowel disease (IBD) and periodontal disease. Periodontitis is a polymicrobial inflammatory disease that affects a large proportion of the world's population and has been associated with a wide variety of systemic health conditions, such as diabetes, cardiovascular and respiratory diseases. Dysbiosis has been identified as a key element in the development of the disease. However, the precise mechanisms and environmental signals that lead to the initiation of dysbiosis in the human microbiome are largely unknown. In a series of previous in vivo studies using metatranscriptomic analysis of periodontitis and its progression we identified several functional signatures that were highly associated with the disease. Among them, potassium ion transport appeared to be key in the process of pathogenesis. To confirm its importance we performed a series of in vitro experiments, in which we demonstrated that potassium levels a increased the virulence of the oral community as a whole and at the same time altering the immune response of gingival epithelium, increasing the production of TNF-α and reducing the expression of IL-6 and the antimicrobial peptide human β-defensin 3 (hBD-3). These results indicate that levels of potassium in the periodontal pocket could be an important element in of dysbiosis in the oral microbiome. They are a starting point for the identification of key environmental signals that modify the behavior of the oral microbiome from a symbiotic community to a dysbiotic one. Homeostasis of the human microbiome plays a key role in maintaining the healthy status of the human body. Changes in composition and function of the human microbiome (dysbiosis) are at the origin of important infectious inflammatory diseases such as inflammatory bowel disease (IBD) and periodontal disease. However, the environmental elements that trigger the development of dysbiotic diseases are largely unknown. In previous studies, using community-wide transcriptome analysis, we identified ion potassium transport as one of the most important functions in the pathogenesis of periodontitis and its progression. Here, we confirm with a series of in vitro experiments that potassium can act as an important signal in the dysbiotic process inducing pathogenesis in the oral microbiome and altering the host response in front of the microbial challenge that could lead to microbial immune subversion. Our study provides new insights into the important role that ion potassium plays a signal in oral dysbiosis during periodontitis.
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Affiliation(s)
- Susan Yost
- The Forsyth Institute, Cambridge, Massachusetts, United States of America
| | - Ana E. Duran-Pinedo
- Department of Oral Biology, University of Florida, Gainesville, Florida, United States of America
| | - Keerthana Krishnan
- The Forsyth Institute, Cambridge, Massachusetts, United States of America
| | - Jorge Frias-Lopez
- Department of Oral Biology, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Özden FO, Sakallioğlu EE, Sakallioğlu U, Ayas B, Erişgin Z. Effects of grape seed extract on periodontal disease: an experimental study in rats. J Appl Oral Sci 2017; 25:121-129. [PMID: 28403352 PMCID: PMC5393532 DOI: 10.1590/1678-77572016-0298] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/02/2016] [Indexed: 01/20/2023] Open
Abstract
Objective This study aimed to demonstrate the effect of grape seed extract (GSE) on periodontitis. Material and Methods Ligature induced periodontitis was created in 40 rats and they were assigned to four equal groups. One group was fed laboratory diet (group A) while three groups received GSE additionally. Silk ligatures were placed around the cervical area of the mandibular first molars for four weeks to induce periodontitis. The GSE groups were reallocated regarding GSE consumption as: for two weeks before ligation (group B; totally eight weeks), from ligation to two weeks after removal of the ligature (group C; totally six weeks), and for two weeks from ligature removal (group D; totally two weeks). Sections were assessed histologically and immunohistochemically. Inflammatory cell number (ICN), connective tissue attachment level (CAL), osteoclast density (OD), IL-10 and TGF-β stainings in gingival epithelium (GE), connective tissue (GC), and periodontal ligament (PL) were used as the study parameters. Results Lower ICN, higher CAL, and lower OD were observed in the GSE groups (p<0.05). IL-10 was more intensive in the GSE groups and in the GEs (p<0.05). Group B showed the highest IL-10 for PL (p<0.05). TGF-ß was higher in the GEs of all groups (p<0.017). Conclusions The results suggest anti-inflammatory activities of GSE, but further investigations are needed for clarification of these activities.
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Affiliation(s)
- Feyza Otan Özden
- Ondokuz Mayıs University, School of Dentistry, Department of Periodontology, Samsun, Turkey
| | - Elif Eser Sakallioğlu
- Ondokuz Mayıs University, School of Dentistry, Department of Periodontology, Samsun, Turkey
| | - Umur Sakallioğlu
- Ondokuz Mayıs University, School of Dentistry, Department of Periodontology, Samsun, Turkey
| | - Bülent Ayas
- Ondokuz Mayıs University, Faculty of Medicine, Department of Histology and Embriology, Samsun, Turkey
| | - Züleyha Erişgin
- Giresun University, Faculty of Medicine, Department of Histology and Embriology, Giresun, Turkey
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Li Y, Ma S, Guo J, Jiang J, Luo K, Yan F, Xiao Y. Effect of local hIL-10 gene therapy on experimental periodontitis in ovariectomized rats. Acta Odontol Scand 2017; 75:268-279. [PMID: 28358289 DOI: 10.1080/00016357.2017.1292427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the effect of local hIL-10 gene therapy on experimental periodontitis in rats and to elucidate the mechanism underlying this effect. MATERIAL AND METHODS Experimental periodontitis was induced in ovariectomized (OVX) rats using a silk ligature. We then injected 5 μg of hIL-10 plasmid with 5 μl of liposomes or 5 μg of vector plasmid with 5 μl of liposomes into the palatal side of the gingival mucosa of the upper left second molar once every two days. The rats were killed 48 hours after the seventh injection. The body weight; bone mineral density of the whole body, pelvis and spine; resorption of the alveolar bone; and number of cytokine-positive cells were measured to determine the effects of hIL-10 on the periodontal tissue. RESULTS hIL-10 was expressed in periodontal tissues after local gene delivery. The expressed hIL-10 protein inhibited alveolar bone resorption and downregulated IL-1β, IL-6, TNF-α, RANKL and MMP-8 in the periodontal ligament in the root furcation region. CONCLUSIONS Local hIL-10 gene transfer suppressed alveolar bone resorption in OVX rats, and this effect was probably associated with the decline in the expression of pro-inflammatory cytokines in the periodontal tissues.
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Affiliation(s)
- Yanfen Li
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Souzhi Ma
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Jianbin Guo
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Jun Jiang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Kai Luo
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Fuhua Yan
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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35
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Garg S, Pradeep A. 1.2% Rosuvastatin and 1.2% Atorvastatin Gel Local Drug Delivery and Redelivery in the Treatment of Class II Furcation Defects: A Randomized Controlled Clinical Trial. J Periodontol 2017; 88:259-265. [DOI: 10.1902/jop.2016.160399] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Shruti Garg
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - A.R. Pradeep
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
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36
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Silva TA, Garlet GP, Fukada SY, Silva JS, Cunha FQ. Chemokines in Oral Inflammatory Diseases: Apical Periodontitis and Periodontal Disease. J Dent Res 2016; 86:306-19. [PMID: 17384024 DOI: 10.1177/154405910708600403] [Citation(s) in RCA: 256] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The inflammatory oral diseases are characterized by the persistent migration of polymorphonuclear leukocytes, monocytes, lymphocytes, plasma and mast cells, and osteoblasts and osteoclasts. In the last decade, there has been a great interest in the mediators responsible for the selective recruitment and activation of these cell types at inflammatory sites. Of these mediators, the chemokines have received particular attention in recent years. Chemokine messages are decoded by specific receptors that initiate signal transduction events, leading to a multitude of cellular responses, including chemotaxis and activation of inflammatory and bone cells. However, little is known about their role in the pathogenesis of inflammatory oral diseases. The purpose of this review is to summarize the findings regarding the role of chemokines in periapical and periodontal tissue inflammation, and the integration, into experimental models, of the information about the role of chemokines in human diseases.
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Affiliation(s)
- T A Silva
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, CEP 31.270-901, Belo Horizonte, Minas Gerais, Brazil.
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Lennerås M, Tsikandylakis G, Trobos M, Omar O, Vazirisani F, Palmquist A, Berlin Ö, Brånemark R, Thomsen P. The clinical, radiological, microbiological, and molecular profile of the skin-penetration site of transfemoral amputees treated with bone-anchored prostheses. J Biomed Mater Res A 2016; 105:578-589. [PMID: 27750392 PMCID: PMC5216444 DOI: 10.1002/jbm.a.35935] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 10/06/2016] [Accepted: 10/13/2016] [Indexed: 12/19/2022]
Abstract
The breach of the skin barrier is a critical issue associated with the treatment of individuals with transfemoral amputation (TFA) using osseointegrated, percutaneous titanium implants. Thirty TFA patients scheduled for abutment exchange or removal were consecutively enrolled. The aims were to determine the macroscopic skin signs, the presence of bacteria and the gene expression in abutment‐adherent cells and to conduct correlative and comparative analyses between the different parameters. Redness and a granulation ring were present in 47% of the patients. Bacteria were detected in 27/30 patients, commonly in the bone canal. Staphylococcus aureus, coagulase‐negative staphylococci, streptococci, and Enterococcus faecalis were the most common. A positive correlation was found between TNF‐α expression and the detection of S. aureus. Staphylococcus aureus together with other bacterial species revealed a positive relationship with MMP‐8 expression. A negative correlation was demonstrated between the length of the residual femur bone and the detection of a granulation ring and E. faecalis. A positive correlation was revealed between fixture loosening and pain and the radiological detection of endosteal bone resorption. Fixture loosening was also correlated with the reduced expression of interleukin‐10 and osteocalcin. It is concluded that several relationships exist between clinical, radiological, microbiological, and molecular assessments of the percutaneous area of TFAs. Further long term studies on larger patient cohorts are required to determine the precise cause‐effect relationships and unravel the role of host‐bacteria interactions in the skin, bone canal and on the abutment for the longevity of percutaneous implants as treatment of TFA. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 578–589, 2017.
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Affiliation(s)
- Maria Lennerås
- Department of Biomaterials, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, SE-405 30, Sweden Box 412.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412
| | - Georgios Tsikandylakis
- BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412.,Department of Orthopaedics, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden
| | - Margarita Trobos
- Department of Biomaterials, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, SE-405 30, Sweden Box 412.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, SE-405 30, Sweden Box 412.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412
| | - Forugh Vazirisani
- Department of Biomaterials, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, SE-405 30, Sweden Box 412.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412
| | - Anders Palmquist
- Department of Biomaterials, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, SE-405 30, Sweden Box 412.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412
| | - Örjan Berlin
- BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412.,Department of Orthopaedics, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden.,Centre for Advanced Reconstruction of Extremities (CARE) Sahlgrenska University Hospital, Mölndal, SE-431 30, Sweden
| | - Rickard Brånemark
- BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412.,Department of Orthopaedics, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden.,Centre for Advanced Reconstruction of Extremities (CARE) Sahlgrenska University Hospital, Mölndal, SE-431 30, Sweden.,Department of Orthopaedics, International Center for Osseointegration Research, Education and Surgery (iCORES), University of California, San Francisco
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, SE-405 30, Sweden Box 412.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, SE-405 30, Sweden Box 412
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Vasovic M, Gajovic N, Brajkovic D, Jovanovic M, Zdravkovaic N, Kanjevac T. The relationship between the immune system and oral manifestations of inflammatory bowel disease: a review. Cent Eur J Immunol 2016; 41:302-310. [PMID: 27833449 PMCID: PMC5099388 DOI: 10.5114/ceji.2016.63131] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 07/28/2015] [Indexed: 12/15/2022] Open
Abstract
Inflammatory bowel diseases (IBDs) are chronic, relapsing inflammatory diseases characterized by exacerbations and remissions of the gastrointestinal tract, clinically manifested as Crohn's disease and ulcerative colitis. The etiology of IBDs is considered to be multi factorial, comprising environmental, immune, microbial and genetic factors. Clinical signs may include abdominal pain, frequent bloody diarrheas, mucorrhea, vomiting, fever, fatigue or weight loss. Changes in the oral cavity often precede intestinal symptoms. Inflammatory bowel disease leads to a significant deterioration of oral health, which indicates that cooperation between the dentist and the gastroenterologist is necessary when considering patients' welfare. Patients with IBD have an altered immune response, but microorganisms of the oral cavity may also be responsible for its modification. This review paper discusses the correlation between the immune system and inflammatory bowel disease manifestations in the oral cavity.
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Affiliation(s)
- Miroslav Vasovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Nevena Gajovic
- Center for Molecular Medicine and Stem Cells Research, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Denis Brajkovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Marina Jovanovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Natasa Zdravkovaic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Serbia
| | - Tatjana Kanjevac
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Serbia
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Gaurilcikaite E, Renton T, Grant AD. The paradox of painless periodontal disease. Oral Dis 2016; 23:451-463. [PMID: 27397640 DOI: 10.1111/odi.12537] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 05/04/2016] [Accepted: 06/23/2016] [Indexed: 12/23/2022]
Abstract
Periodontal diseases, primarily gingivitis and periodontitis, are characterised by progressive inflammation and tissue destruction. However, they are unusual in that they are not also accompanied by the pain commonly seen in other inflammatory conditions. This suggests that interactions between periodontal bacteria and host cells create a unique environment in which the pro-algesic effects of inflammatory mediators and factors released during tissue damage are directly or indirectly inhibited. In this review, we summarise the evidence that periodontal disease is characterised by an accumulation of classically pro-algesic factors from bacteria and host cells. We then discuss several mechanisms by which inflammatory sensitisation of nociceptive fibres could be prevented through inactivation or inhibition of these factors. Further studies are necessary to fully understand the molecular processes underlying the endogenous localised hypoalgesia in human periodontal disease. This knowledge might provide a rational basis to develop future therapeutic interventions, such as host modulation therapies, against a wide variety of other human pain conditions.
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Affiliation(s)
- E Gaurilcikaite
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - T Renton
- Department of Oral Surgery, Dental Institute, King's College London, London, UK
| | - A D Grant
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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40
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Smad2 overexpression induces alveolar bone loss and up regulates TNF-α, and RANKL. Arch Oral Biol 2016; 71:38-45. [PMID: 27421098 DOI: 10.1016/j.archoralbio.2016.06.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of the current study was to investigate whether Smad2 overexpression in JE cells induced alveolar bone loss, and to understand the mechanisms regulating the bone loss. METHODS A mouse line was created that used a cytokeratin 14 (K14) promoter to overexpress Smad2 in the epithelium of the transgenic mice (K14-Smad2). Micro CT radiographs (μCT) were used to assess bone loss, bone volume, and bone density. The expression of Tnfα, Il1-β, Ifγ, Rankl, and Opg were assessed by RT-PCR. Western blots were used to detect the protein levels of TNF-α and IL1-β. Tartrate-resistant acid phosphatase (TRAP) was used as a marker for osteoclasts. Wild type (WT) mice were used as controls in all steps of the current study. RESULTS K14-Smad2 mice had 52.5% (±4.2) root exposed compared to 32.4%(±3.2) in the WT mice. There was a significant difference in alveolar bone volume in the K14-Smad2 mice when compared to WT mice 2.65mm3 (±0.3) and 4.3mm3 (±0.35) respectively. K14-Smad2 mice also had reduced bone density 696.8mg/cc (±70) at 12 months when compared to WT mice 845.9mg/cc(±10). The mRNA levels of Tnfα and Rankl increased by 3.26- and 2.5-fold respectively in the K14-Smad2 mice when compared to controls. The protein level of TNF-α was also significantly increased to 2.8-fold in K14-Smad2 mice when compared to WT mice. Smad2 overexpression increased the total numbers of osteoclasts in K14-Smad2 mice (3.4±0.2)-fold when compared to WT mice. CONCLUSION Smad2 overexpression induces alveolar bone loss and increases the numbers of osteoclasts. Also, Smad2 overexpression up-regulates TNF-α and RANKL.
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41
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Chiu YH, Ritchlin CT. DC-STAMP: A Key Regulator in Osteoclast Differentiation. J Cell Physiol 2016; 231:2402-7. [PMID: 27018136 DOI: 10.1002/jcp.25389] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/24/2016] [Indexed: 01/09/2023]
Abstract
Osteoimmunology research is a new emerging research field that investigates the links between the bone and immune responses. Results from osteoimmunology studies suggest that bone is not only an essential component of the musculoskeletal system, but is also actively involved in immune regulation. Many important factors involved in immune regulation also participate in bone homeostasis. Bone homeostasis is achieved by a coordinated action between bone-synthesizing osteoblasts and bone-degrading osteoclasts. An imbalanced action between osteoblasts and osteoclasts often results in pathological bone diseases: osteoporosis is caused by an excessive osteoclast activity, whereas osteopetrosis results from an increased osteoblast activity. This review focuses on dendritic cell-specific transmembrane protein (DC-STAMP), an important protein currently considered as a master regulator of osteoclastogenesis. Of clinical relevance, the frequency of circulating DC-STAMP+ cells is elevated during the pathogenesis of psoriatic diseases. Intriguingly, recent results suggest that DC-STAMP also plays an imperative role in bone homeostasis by regulating the differentiation of both osteoclasts and osteoblasts. This article summarizes our current knowledge on DC-STAMP by focusing on its interacting proteins, its regulation on osteoclastogenesis-related genes, its possible involvement in immunoreceptor tyrosine-based inhibitory motif (ITIM)-mediated signaling cascade, and its potential of developing therapeutics for clinical applications. J. Cell. Physiol. 231: 2402-2407, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ya-Hui Chiu
- Division of Allergy, Immunology and Rheumatology, School of Medicine, University of Rochester, Rochester, New York
| | - Christopher T Ritchlin
- Division of Allergy, Immunology and Rheumatology, School of Medicine, University of Rochester, Rochester, New York
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Gankovskaya LV, Khelminskaya NM, Molchanova EA, Svitich OA. ROLE OF INNATE IMMUNITY FACTORS IN PERIODONTITIS PATHOGENESIS. ACTA ACUST UNITED AC 2016. [DOI: 10.36233/0372-9311-2016-2-100-107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Chronic generalized periodontitis (CGP) is a disease of periodontium tissues supporting tooth induced by bacteria, that is characterized by the presence of processes of inflammation with destruction ofbone tissue. The knowledge of molecular mechanisms of CGP pathogenesis facilitates creation of the most effective methods of therapy of this disease. Bacterial infection is a primary factor in periodontitis etiology, however is not sufficient for its start and subsequent development. It is known, that bacterial factors induce a local inflammation reaction and activate the system of innate immunity through activation of Toll-like receptors (TLR), located on the surface of resident cells and leukocytes. Activation of these cells results in production of pro-inflammatory cytokines and recruitment of phagocytes and lymphocytes into the inflammation zone. In review we examined the known data regarding factors of immune protection of periodontium including cell populations and cytokines, as well as mechanisms of tissue destruction, that support the tooth. Perspectives of therapy are also discussed.
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Abstract
This introductory article examines the potential mechanisms that may play a role in the associations between periodontitis and the systemic conditions being considered in the EFP/AAP Workshop in Segovia, Spain. Three basic mechanisms have been postulated to play a role in these interactions; metastatic infections,inflammation and inflammatory injury, and adaptive immunity. The potential role of each alone and together is considered in in vitro and animal studies and in human studies when available. This is not a systematic or critical review, but rather an overview of the field to set the stage for the critical reviews in each of the working groups.
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Affiliation(s)
- Thomas E Van Dyke
- Department of Applied Oral Sciences, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA.
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Silva N, Abusleme L, Bravo D, Dutzan N, Garcia-Sesnich J, Vernal R, Hernández M, Gamonal J. Host response mechanisms in periodontal diseases. J Appl Oral Sci 2015. [PMID: 26221929 PMCID: PMC4510669 DOI: 10.1590/1678-775720140259] [Citation(s) in RCA: 246] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Periodontal diseases usually refer to common inflammatory disorders known as gingivitis and periodontitis, which are caused by a pathogenic microbiota in the subgingival biofilm, including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Treponema denticola that trigger innate, inflammatory, and adaptive immune responses. These processes result in the destruction of the tissues surrounding and supporting the teeth, and eventually in tissue, bone and finally, tooth loss. The innate immune response constitutes a homeostatic system, which is the first line of defense, and is able to recognize invading microorganisms as non-self, triggering immune responses to eliminate them. In addition to the innate immunity, adaptive immunity cells and characteristic cytokines have been described as important players in the periodontal disease pathogenesis scenario, with a special attention to CD4+ T-cells (T-helper cells). Interestingly, the T cell-mediated adaptive immunity development is highly dependent on innate immunity-associated antigen presenting cells, which after antigen capture undergo into a maturation process and migrate towards the lymph nodes, where they produce distinct patterns of cytokines that will contribute to the subsequent polarization and activation of specific T CD4+ lymphocytes. Skeletal homeostasis depends on a dynamic balance between the activities of the bone-forming osteoblasts (OBLs) and bone-resorbing osteoclasts (OCLs). This balance is tightly controlled by various regulatory systems, such as the endocrine system, and is influenced by the immune system, an osteoimmunological regulation depending on lymphocyte- and macrophage-derived cytokines. All these cytokines and inflammatory mediators are capable of acting alone or in concert, to stimulate periodontal breakdown and collagen destruction via tissue-derived matrix metalloproteinases, a characterization of the progression of periodontitis as a stage that presents a significantly host immune and inflammatory response to the microbial challenge that determine of susceptibility to develop the destructive/progressive periodontitis under the influence of multiple behavioral, environmental and genetic factors.
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Affiliation(s)
- Nora Silva
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Loreto Abusleme
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Denisse Bravo
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Nicolás Dutzan
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jocelyn Garcia-Sesnich
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Rolando Vernal
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Marcela Hernández
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jorge Gamonal
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
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Morelli T, Stella M, Barros SP, Marchesan JT, Moss KL, Kim SJ, Yu N, Aspiras MB, Ward M, Offenbacher S. Salivary biomarkers in a biofilm overgrowth model. J Periodontol 2015; 85:1770-8. [PMID: 25079398 DOI: 10.1902/jop.2014.140180] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The purpose of this study is to determine whether baseline salivary inflammatory biomarkers could discriminate between different clinical levels of disease and/or detect clinical changes over a 3-week stent-induced biofilm overgrowth (SIBO) period. METHODS A total of 168 participants were enrolled in a 21-day experimental gingivitis investigation and grouped according to clinical measures of periodontal status of health and diseased individuals representing each of five biofilm gingival interface (BGI) periodontal groups: 1) health, all probing depth (PD) <3 mm and bleeding on probing (BOP) <10%; 2) gingivitis, all PD <3 mm and BOP ≥10%; 3) periodontitis (P)1, ≥1 site with PD >3 mm and BOP ≤10%; 4) P2, ≥1 site with PD >3 mm and BOP >10% but ≤50%; and 5) P3, ≥1 site with PD >3 mm and BOP >50%. Stents were used to prevent plaque removal during brushing over one maxillary and one mandibular posterior dental sextant for 21 days. Clinical periodontal parameters and unstimulated saliva were collected at screening, baseline, and each week during SIBO. Saliva samples were assessed for levels of 13 different biomarkers by multiplex immunoassay. RESULTS Higher salivary levels of interleukin (IL)-1β, matrix metalloproteinase (MMP)-3, MMP-8, MMP-9, and neutrophil gelatinase-associated lipocalin (NGAL) were found in diseased groups compared with the healthy group at baseline. Conversely, higher IL-1 receptor antagonist (ra) levels were found in healthy patients at baseline. In addition, during SIBO, MMP-1, tissue inhibitor of metalloproteinase (TIMP)-1, and TIMP-2 levels increased across all participant groups. A stepwise linear regression model using all salivary biomarkers demonstrated that, at baseline, increased IL-1ra (P = 0.004) and IL-6 (P = 0.009) were significantly associated with change in PDs during SIBO. CONCLUSIONS In summary, this investigation supports salivary levels of IL-1ra and IL-6 as potential indicators for PD changes during induced gingival inflammation. In addition, participants from the BGI-P3 group (severe periodontitis) demonstrated elevated baseline levels of IL-1β, MMP-3, MMP-8, MMP-9, and NGAL compared with the other study groups, strengthening the relevance of participants' biologic phenotype on expression of salivary biomarkers.
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Affiliation(s)
- Thiago Morelli
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Çalışır M, Akpınar A, Poyraz Ö, Göze F, Çınar Z. The histopathological and morphometric investigation of the effects of systemically administered humic acid on alveolar bone loss in ligature-induced periodontitis in rats. J Periodontal Res 2015; 51:499-507. [DOI: 10.1111/jre.12329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2015] [Indexed: 11/28/2022]
Affiliation(s)
- M. Çalışır
- Department of Periodontology; Faculty of Dentistry; Adıyaman University; Adıyaman Turkey
| | - A. Akpınar
- Department of Periodontology; Faculty of Dentistry; Cumhuriyet University; Sivas Turkey
| | - Ö. Poyraz
- Department of Microbiology; Faculty of Medicine; Cumhuriyet University; Sivas Turkey
| | - F. Göze
- Department of Pathology; Faculty of Medicine; Cumhuriyet University; Sivas Turkey
| | - Z. Çınar
- Department of Biostatistics; Faculty of Medicine; Cumhuriyet University; Sivas Turkey
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Elavarasu S, Suthanthiran T, Thangavelu A, Saravanan J, Selvaraj S, Mohandas L. Comparative analysis of gingival crevicular fluid a disintegrin and metalloproteinase 8 levels in health and periodontal disease: A clinic-biochemical study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2015; 7:S470-3. [PMID: 26538900 PMCID: PMC4606642 DOI: 10.4103/0975-7406.163507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM AND BACKGROUND A disintegrin and metalloproteinase 8 (ADAM8) is a marker belonging to the class of ADAM family of metalloproteinase which is found to be involved in inflammation and bone resorption in periodontal disease by acting as osteoclast stimulating factor. In several systemic inflammatory diseases, elevated levels of ADAM8 are detected in human serum and other body fluids. Recently, ADAM8 was even detected in gingival crevicular fluid (GCF) of patients with periodontal diseases. Hence, the aim of the study was to estimate the levels of ADAM8 in GCF of healthy and chronic periodontitis subjects. MATERIALS AND METHODS Periodontal examination and collection of GCF by the extracrevicular method was performed in 30 subjects selected randomly and categorized into two groups. Group I (healthy, n = 15) and Group II (chronic periodontitis, n = 15). ADAM8 levels in GCF were estimated by enzyme-linked immunosorbent assay. RESULTS ADAM8 was detected in both Group I and II. Highest mean ADAM8 concentration was obtained for Group II, whereas the lowest concentration was seen in Group I. This suggests that ADAM8 levels increase proportionally with the progression of periodontal disease. There was a significant correlation between ADAM8 levels and clinical parameters in the study group. CONCLUSION The results of our study indicate that the ADAM8 levels in GCF are positively associated with periodontal disease, which may provide a useful tool in monitoring its progression. Nevertheless, further longitudinal studies are required with larger sample sizes in which ADAM8 levels are progressively estimated and compared to baseline values.
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Affiliation(s)
- Sugumari Elavarasu
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
| | | | - Arthiie Thangavelu
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
| | - Jayashakthi Saravanan
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
| | - Saranya Selvaraj
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
| | - Lakshmi Mohandas
- Department of Periodontics, J. K. K. Nattraja Dental College, Komarapalayam, Tamil Nadu, India
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Cekici A, Kantarci A, Hasturk H, Van Dyke TE. Inflammatory and immune pathways in the pathogenesis of periodontal disease. Periodontol 2000 2015; 64:57-80. [PMID: 24320956 DOI: 10.1111/prd.12002] [Citation(s) in RCA: 698] [Impact Index Per Article: 77.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The pathogenesis of periodontitis involves a complex immune/inflammatory cascade that is initiated by the bacteria of the oral biofilm that forms naturally on the teeth. The susceptibility to periodontitis appears to be determined by the host response; specifically, the magnitude of the inflammatory response and the differential activation of immune pathways. The purpose of this review was to delineate our current knowledge of the host response in periodontitis. The role of innate immunity, the failure of acute inflammation to resolve (thus becoming chronic), the cytokine pathways that regulate the activation of acquired immunity and the cells and products of the immune system are considered. New information relating to regulation of both inflammation and the immune response will be reviewed in the context of susceptibility to, and perhaps control of, periodontitis.
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Gennaro G, Claudino M, Cestari TM, Ceolin D, Germino P, Garlet GP, de Assis GF. Green Tea Modulates Cytokine Expression in the Periodontium and Attenuates Alveolar Bone Resorption in Type 1 Diabetic Rats. PLoS One 2015; 10:e0134784. [PMID: 26270535 PMCID: PMC4535908 DOI: 10.1371/journal.pone.0134784] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/14/2015] [Indexed: 12/13/2022] Open
Abstract
UNLABELLED Diabetes mellitus comprises a heterogeneous group of disorders with the main feature of hyperglycemia. Chronic hyperglycemia increases the severity of periodontal disease via an exacerbated inflammatory response, activated by advanced glycation end products and their receptor, RAGE. Therefore, anti-inflammatory agents represent potential inhibitors of this pathological interaction. In particular, green tea has been shown to possess anti-inflammatory properties mediated by its polyphenol content. OBJECTIVES This study investigated the mechanisms by which green tea attenuates the spontaneous onset of diabetes-induced periodontitis. METHODS Diabetes was induced in rats via a single intraperitoneal injection of streptozotocin (STZ). Diabetic and control animals were divided into water-treated and green tea-treated subgroups and were analyzed at 15, 30, 60 and 90 days after diabetes induction. Immunohistochemistry was performed to quantitatively evaluate tumor necrosis factor-α (TNF-α), receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin-10 (IL-10) and runt-related transcription factor 2 (RUNX-2) expression in serial sections of each hemimaxilla. Morphometric measurements of the distance from the cementum-enamel junction (CEJ) of the superior distal root of the first molar to the alveolar bone crest (ABC) were performed to assess bone loss. RESULTS Diabetes resulted in significant bone loss and alterations in the number of cells that stained positive for inflammatory mediators. In the diabetic rats treated with green tea, we observed a decreased number of cells expressing RANKL and TNF-α compared with that observed in the diabetic rats treated with water. Additionally, green tea increased the numbers of cells that stained positive for OPG, RUNX-2 and IL-10 in the diabetic rats. CONCLUSION Green tea intake reduces expression of the pro-inflammatory cytokine TNF-α and the osteoclastogenic mediator RANKL to normal levels while increasing expression of the anti-inflammatory cytokine IL-10, the osteogenesis-related factor RUNX-2 and the anti-osteoclastogenic factor OPG. Therefore, green tea represents a potential therapeutic agent for the treatment of diabetes-related periodontal disease.
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Affiliation(s)
- Gabriela Gennaro
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University, Bauru, São Paulo, Brazil
- * E-mail:
| | - Marcela Claudino
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University, Bauru, São Paulo, Brazil
| | - Tania Mary Cestari
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University, Bauru, São Paulo, Brazil
| | - Daniele Ceolin
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University, Bauru, São Paulo, Brazil
| | - Patrícia Germino
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University, Bauru, São Paulo, Brazil
| | - Gustavo Pompermaier Garlet
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University, Bauru, São Paulo, Brazil
| | - Gerson Francisco de Assis
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University, Bauru, São Paulo, Brazil
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50
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Santos CF, Morandini AC, Dionísio TJ, Faria FA, Lima MC, Figueiredo CM, Colombini-Ishikiriama BL, Sipert CR, Maciel RP, Akashi AP, Souza GP, Garlet GP, Rodini CO, Amaral SL, Becari C, Salgado MC, Oliveira EB, Matus I, Didier DN, Greene AS. Functional Local Renin-Angiotensin System in Human and Rat Periodontal Tissue. PLoS One 2015; 10:e0134601. [PMID: 26244896 PMCID: PMC4526652 DOI: 10.1371/journal.pone.0134601] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 07/12/2015] [Indexed: 12/28/2022] Open
Abstract
The initiation or progression of periodontitis might involve a local renin-angiotensin system (RAS) in periodontal tissue. The aim of this study was to further characterize the local RAS in human and rat periodontal tissues between healthy and periodontally-affected tissue. Components of the RAS were investigated using in vitro, ex vivo and in vivo experiments involving both human and Wistar rat periodontium. Although not upregulated when challenged with P. gingivalis-lipopolysaccharide, human gingival and periodontal ligament fibroblasts expressed RAS components. Likewise, healthy and inflamed human gingiva expressed RAS components, some of which were shown to be functional, yet no differences in expression were found between healthy and diseased gingiva. However, in inflamed tissue the immunoreactivity was greater for the AT1R compared to AT2R in fibroblasts. When compared to healthy tissue, ACE activity was increased in human gingiva from volunteers with gingivitis. Human-gingiva homogenates generated Ang II, Ang 1-9 and Ang 1-7 when incubated with precursors. In gingiva homogenates, Ang II formation from Ang I was nearly abolished only when captopril and chymostatin were combined. Ang 1-7 formation was significantly greater when human gingiva homogenates were incubated with chymostatin alone compared to incubation without any inhibitor, only captopril, or captopril and chymostatin. In rat gingiva, RAS components were also found; their expression was not different between healthy and experimentally induced periodontitis (EP) groups. However, renin inhibition (aliskiren) and an AT1R antagonist (losartan) significantly blocked EP-alveolar-bone loss in rats. Collectively, these data are consistent with the hypothesis that a local RAS system is not only present but is also functional in both human and rat periodontal tissue. Furthermore, blocking AT1R and renin can significantly prevent periodontal bone loss induced by EP in rats.
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Affiliation(s)
- Carlos F. Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- * E-mail:
| | - Ana C. Morandini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thiago J. Dionísio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Flávio A. Faria
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marta C. Lima
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Caio M. Figueiredo
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Carla R. Sipert
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Rubens P. Maciel
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ana P. Akashi
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gabriela P. Souza
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gustavo P. Garlet
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Camila O. Rodini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Sandra L. Amaral
- Department of Physical Education, Science Faculty, São Paulo State University, Bauru, São Paulo, Brazil
| | - Christiane Becari
- School of Medicine of Ribeirão Preto, Riberão Preto, University of São Paulo, Riberão Preto, São Paulo, Brazil
| | - Maria C. Salgado
- School of Medicine of Ribeirão Preto, Riberão Preto, University of São Paulo, Riberão Preto, São Paulo, Brazil
| | - Eduardo B. Oliveira
- School of Medicine of Ribeirão Preto, Riberão Preto, University of São Paulo, Riberão Preto, São Paulo, Brazil
| | - Isaac Matus
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Daniela N. Didier
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Andrew S. Greene
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
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