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Chen Y, Liang C, Li J, Ma L, Wang B, Yuan Z, Yang S, Nong X. Effect of artesunate on cardiovascular complications in periodontitis in a type I diabetes rat model and related mechanisms. J Endocrinol Invest 2023; 46:2031-2053. [PMID: 36892740 DOI: 10.1007/s40618-023-02052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/24/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE Both cardiovascular disease and periodontitis are complications of diabetes that have a great impact on human life and health. Our previous research found that artesunate can effectively improve cardiovascular disease in diabetes and has an inhibitory effect on periodontal disease. Therefore, the present study aimed to explore the potential therapeutic possibility of artesunate in the protection against cardiovascular complications in periodontitis with type I diabetes rats and to elucidate the possible underlying mechanisms. METHODS Sprague‒Dawley rats were randomly divided into the healthy, diabetic, periodontitis, diabetic with periodontitis, and artesunate treatment groups (10, 30, and 60 mg/kg, i.g.). After artesunate treatment, oral swabs were collected and used to determine changes in the oral flora. Micro-CT was performed to observe changes in alveolar bone. Blood samples were processed to measure various parameters, while cardiovascular tissues were evaluated by haematoxylin-eosin, Masson, Sirius red, and TUNEL staining to observe fibrosis and apoptosis. The protein and mRNA expression levels in the alveolar bone and cardiovascular tissues were detected using immunohistochemistry and RT‒PCR. RESULTS Diabetic rats with periodontitis and cardiovascular complications maintained heart and body weight but exhibited reduced blood glucose levels, and they were able to regulate blood lipid indicators at normal levels after artesunate treatment. The staining assays suggested that treatment with 60 mg/kg artesunate has a significant therapeutic effect on myocardial apoptotic fibrosis. The high expression of NF-κB, TLR4, VEGF, ICAM-1, p38 MAPK, TGF-β, Smad2, and MMP9 in the alveolar bone and cardiovascular tissue in the type I diabetes and type I diabetes with periodontitis rat models was reduced after treatment with artesunate in a concentration-dependent manner. Micro-CT showed that treatment with 60 mg/kg artesunate effectively alleviated alveolar bone resorption and density reduction. The sequencing results suggested that each model group of rats had vascular and oral flora dysbiosis, but artesunate treatment could correct the dysbacteriosis. CONCLUSIONS Periodontitis-related pathogenic bacteria cause dysbiosis of the oral and intravascular flora in type I diabetes and aggravate cardiovascular complications. The mechanism by which periodontitis aggravates cardiovascular complications involves the NF-κB pathway, which induces myocardial apoptosis, fibrosis, and vascular inflammation.
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Affiliation(s)
- Y Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No. 10 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - C Liang
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No. 10 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - J Li
- Life Science Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Medical Science Research Center, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - L Ma
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No. 10 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - B Wang
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No. 10 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Z Yuan
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No. 10 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - S Yang
- School of Information and Management, Nanning, 530021, Guangxi, China
| | - X Nong
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No. 10 Shuangyong Road, Nanning, 530021, Guangxi, China.
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, 530021, Guangxi, China.
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Oliveira LS, Lira-Junior R, Figueredo CM, Gomes MB, Fischer RG. Self-Reported Periodontitis and Complications in Type 1 Diabetes Patients: A Brazilian Nationwide Survey. Braz Dent J 2016; 27:599-603. [DOI: 10.1590/0103-6440201601054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 07/15/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to evaluate the possible association between periodontitis and systemic complications in a Brazilian type 1 diabetes population. A multicentre, sectional study was carried out in 28 public clinics located in 20 Brazilian cities. Data from 3,591 patients were obtained (56.0% females, 57.2% Caucasians), with an average age of 21.2 ± 11.7 years and whose mean duration of type 1 diabetes was 9.6 ± 8.1 years. Periodontitis was evaluated through self-report. Odds ratios (OR) and 95% confidence intervals were calculated to evaluate the association between periodontitis and systemic diabetes complications (chronic micro and macrovascular complications and hospitalizations by hyperglycemia and diabetic ketoacidosis). The prevalence of periodontitis was 4.7% (n=170). Periodontitis patients had mean age of 27.4 ± 12.9. This group was older (p<0.001), exhibited longer diabetes duration (p<0.0001) and had elevated total cholesterol (p<0.05), triglycerides (p<0.001) and lower HDL (p<0.05) values than patients without periodontitis. Systolic and diastolic blood pressures were significantly increased in periodontitis patients (p<0.01). Periodontitis patients had increased odds of microvascular complications (2.43 [1.74-3.40]) and of hospitalizations related to hyperglycemia (2.76 [1.72-4.42]) and ketoacidosis (2.72 [1.53-4.80]). In conclusion, periodontitis was associated to systemic complications in Brazilian type 1 diabetes patients.
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Merchant AT, Nahhas GJ, Wadwa RP, Zhang J, Tang Y, Johnson LR, Maahs DM, Bishop F, Teles R, Morrato EH. Periodontal Microorganisms and Cardiovascular Risk Markers in Youth With Type 1 Diabetes and Without Diabetes. J Periodontol 2015; 87:376-84. [PMID: 26616842 DOI: 10.1902/jop.2015.150531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND A subset of periodontal microorganisms has been associated with cardiovascular disease (CVD), which is the leading complication of type 1 diabetes (t1DM). The authors therefore evaluated the association between periodontal microorganism groups and early markers of CVD in youth with t1DM. METHODS A cross-sectional analysis was conducted among youth aged 12 to 19 years at enrollment; 105 had t1DM for ≥5 years and were seeking care at the Barbara Davis Center, University of Colorado, from 2009 to 2011, and 71 did not have diabetes. Subgingival plaque samples were assessed for counts of 41 periodontal microorganisms using DNA-DNA hybridization. Microorganisms were classified using cluster analysis into four groups named red-orange, orange-green, blue/other, and yellow/other, modified from Socransky's color scheme for periodontal microorganisms. Subsamples (54 with t1DM and 48 without diabetes) also received a periodontal examination at the University of Colorado School of Dental Medicine. RESULTS Participants were ≈15 years old on average, and 74% were white. Mean periodontal probing depth was 2 mm (SE 0.02), and 17% had bleeding on probing. In multivariable analyses, glycated hemoglobin (HbA1c) was inversely associated with the yellow/other cluster (microorganisms that are not associated with periodontal disease) among youth with t1DM. Blood pressure, triglycerides, low-density lipoprotein, high-density lipoprotein, and total cholesterol were not associated with microorganism clusters in this group. HbA1c was not associated with periodontal microorganism clusters among youth without diabetes. CONCLUSION Among youth with t1DM who had good oral health, periodontal microorganisms were not associated with CVD risk factors.
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Affiliation(s)
- Anwar T Merchant
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Georges J Nahhas
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - R Paul Wadwa
- University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Yifan Tang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | | | - David M Maahs
- University of Colorado, Anschutz Medical Campus, Aurora, CO
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Antonoglou GN, Knuuttila M, Niemelä O, Raunio T, Karttunen R, Vainio O, Hedberg P, Ylöstalo P, Tervonen T. Low serum level of 1,25(OH)2
D is associated with chronic periodontitis. J Periodontal Res 2014; 50:274-80. [DOI: 10.1111/jre.12207] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2014] [Indexed: 12/19/2022]
Affiliation(s)
- G. N. Antonoglou
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
| | - M. Knuuttila
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
| | - O. Niemelä
- Medical Research Unit; Seinäjoki Central Hospital and University of Tampere; Tampere Finland
| | - T. Raunio
- Specialist Dental Health Care Unit; Oulu Finland
| | - R. Karttunen
- Department of Medical Microbiology and Immunology; Institute of Diagnostics; University of Oulu; Oulu Finland
- Department of Bacteriology and Immunology; Haartman Institute; Laboratory Division (HUSLAB); Helsinki University Central Hospital; Helsinki Finland
| | - O. Vainio
- Department of Medical Microbiology and Immunology; Institute of Diagnostics; University of Oulu; Oulu Finland
- Clinical Microbiology Laboratory; Oulu University Hospital; Oulu Finland
| | | | - P. Ylöstalo
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
| | - T. Tervonen
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
- Oral and Maxillofacial Department; Oulu University Hospital; Oulu Finland
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Domingues JEG, Vettore MV, Lima ES. Association between markers of cardiovascular risk and clinical parameters of periodontitis. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000500004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Periodontal disease is an inflammatory response to bacteria that reside in the gum tissue and can have systemic repercussion. OBJECTIVE: The aim of this study was to assess the relationship between periodontitis and markers of cardiovascular risk. MATERIAL AND METHOD: Ninety selected patients were assigned into two groups in accordance with their levels of probing pocket depth (PPD) and Clinical Attachment Level (CAL): control group, n= 45 (< 4 sites with PPD ≥ 4.0 mm and CAL ≥ 3.0 mm) and case group, n= 45 (≥ 30% of sites with PPD ≥ 4.0 mm and CAL ≥3.0 mm). Plasma concentrations of C-reactive protein, high sensitive CRP, high-density lipoproteins (HDL-c) and electronegative low density lipoproteins (LDL) were assessed in all participants. Data from medical history and socioeconomic level were also collected from patients. RESULT: Plasma levels of HDL-c were lower in subjects with periodontal disease (p = 0.016) and were inversely associated with the number of sites with PPD ≥ 3 mm (rho= -0.325) and number of sites with PPD ≥ 3 mm and CAL ≥ 3 mm (rho= -0.216). These associations remained significant after adjustments for dental plaque and smoking using Univariate Analysis of Covariance (p < 0.05). Adjusted odds ratio between periodontal disease and levels of HDL-c was 0.94 (CI95% 0.88-0.99) after adjusting for age, smoking and dental plaque. Other investigated markers of cardiovascular risk were not related to periodontal disease. CONCLUSION: Clinical parameters of periodontitis were inversely associated with plasma concentrations of HDL-c.
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