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Parry Romberg disease and En Coupe de Sabre Scleroderma are frequently associated disorders that affect the face and can cause severe aesthetic and functional impairment. Systemic immunosuppression is the gold standard of first-line treatment in the pediatric rheumatology standpoint although it is often delayed in the pediatric dermatology clinics and more often used in cases of refractory neurological impairment. We report on a case with dental root resorption and severe periodontal bone inflammation detected on magnetic resonance imaging, which was successfully treated with the anti-IL-6 agent tocilizumab.
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Aim: Periodontitis is the major multi factorial chronic infectious oral diseases in dentate people. Sialic acid regulates innate immunity response that release cytokines. The study aimed to evaluate interleukin-6 levels in periodontittsis and its relation to clinical features, total sialic acid and its fraction and total proteins to clarify its role. Material and Methods: The study was observational case-control study, carried out in periodontology clinic, College of Dentistry / Erbil /Iraq. A total of 60 participants were recruited in this study, They were divided into three groups: control group represent systemically and periodontally healthy subjects, clinically, diagnosed dentate periodontitis group and partial edentulous group.The data was collected through interview questionnaire, clinical periodontal examination, and biochemical tests for salivary; IL-6.total sialic acid and its fraction, and salivary total proteins Statistical analysis was done by statistical Package for Social Sciences. Results: Statistical analysis showed a significant (P≤ 0.01) highest value of total sialic acid in periodontitis. While the highest value of IL-6 was in partial edentulous group. Old ages increased salivary IL-6 significantly. In periodontitis there was significantly association of IL-6 with probe pocket depth, mobility scores of teeth, protein bonund sialic acid and significant negative association with lipid bound sialic acid in precipitate. While in partial edentulous IL-6 associated significantly with gingival index and free sialic acid in precipitate and negatively with probe pocket depth. Conclusions: Salivary sialic acid and IL-6 are periodontitis biomarkers in dentate. Pleiotropic role of IL-6 can be diagnosed by sialic acid levels. It depends on age, (which affects number of teeth and salivary flow rate), and treatment conditions
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Humanos , Masculino , Feminino , Interleucina-6 , Ácido N-Acetilneuramínico , PeriodontiteRESUMO
Periodontitis are infectious diseases characterized by immune-mediated destruction of periodontal supporting tissues and tooth loss. Matrix metalloproteinases (MMPs) are key proteases involved in destructive periodontal diseases. The study and interest in MMP has been fuelled by emerging evidence demonstrating the broad spectrum of molecules that can be cleaved by them and the myriad of biological processes that they can potentially regulate. The huge complexity of MMP functions within the 'protease web' is crucial for many physiologic and pathologic processes, including immunity, inflammation, bone resorption, and wound healing. Evidence points out that MMPs assemble in activation cascades and besides their classical extracellular matrix substrates, they cleave several signalling molecules-such as cytokines, chemokines, and growth factors, among others-regulating their biological functions and/or bioavailability during periodontal diseases. In this review, we provide an overview of emerging evidence of MMPs as regulators of periodontal inflammation.
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Inflamação/enzimologia , Metaloproteinases da Matriz/metabolismo , Doenças Periodontais/enzimologia , Ativação Enzimática , Humanos , Modelos Biológicos , Transdução de SinaisRESUMO
BACKGROUND AND OBJECTIVE: Protease activated receptor type 1 (PAR1 ) seems to play a role in periodontal repair, while PAR2 is associated with periodontal inflammation. As diabetes is a known risk factor for periodontal disease, the aim of this study was to evaluate the influence of type 2 diabetes on PAR1 and PAR2 mRNA expression in the gingival crevicular fluid of patients with chronic periodontitis before and after non-surgical periodontal treatment. MATERIAL AND METHODS: Gingival crevicular fluid samples and clinical parameters consisting of measuring probing depth, clinical attachment level, bleeding on probing and plaque index were collected from systemically healthy patients and patients with type 2 diabetes and chronic periodontitis, at baseline and after non-surgical periodontal therapy. PAR1 and PAR2 , as well as the presence of the proteases RgpB gingipain and neutrophil proteinase-3 were assessed by quantitative polymerase chain reaction in the gingival crevicular fluid. RESULTS: The periodontal clinical parameters significantly improved after periodontal therapy (p < 0.01). Diabetes led to increased expression of PAR1 in gingival crevicular fluid, and in the presence of chronic periodontitis, it significantly decreased the expression of PAR1 and PAR2 (p < 0.05). Moreover, non-surgical periodontal treatment in diabetics resulted in increased expression of PAR1 and PAR2 (p < 0.05), and decreased expression of RgpB gingipain and proteinase-3 (p < 0.05). CONCLUSION: The present data demonstrated that diabetes was associated with an altered expression of PAR1 and PAR2 in the gingival crevicular fluid cells of subjects with chronic periodontitis. Future studies are necessary to elucidate the effects of PAR1 upregulation in periodontally healthy sites and PAR2 downregulation in chronic periodontitis sites on the increased susceptibility and severity of periodontitis in diabetes.
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Periodontite Crônica/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Líquido do Sulco Gengival/química , Receptor PAR-1/análise , Receptor PAR-2/análise , Adulto , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Índice de Placa Dentária , Diabetes Mellitus Tipo 2/complicações , Feminino , Fibroblastos/química , Humanos , Masculino , Pessoa de Meia-Idade , Mieloblastina/análise , Mieloblastina/genética , Mieloblastina/metabolismo , Perda da Inserção Periodontal , Bolsa Periodontal , RNA Mensageiro/biossíntese , Receptor PAR-1/genética , Receptor PAR-1/metabolismo , Receptor PAR-2/genética , Receptor PAR-2/metabolismo , Fatores de RiscoRESUMO
Periodontal disease is an infectious disease of inflammatory character whose pathognomonic sign is the formation of periodontal pocket. Your etiological factor is bacteria; necessary but not sufficient for its development as a susceptible host is necessary, because it is a multifactorial disease that responds to risk factors such as snuff and diabetes. The hyperglycemia promotes the formation of advanced glycation end products (AGEs), they alter the stability of collagen and vascular integrity; reducing chemotaxis, phagocytosis and intracellular killing of PMNN; favoringbacterial persistence in the periodontal pocket and periodontal destruction. Monocytes, macrophages and endothelial cells are associated with these AGEs. They secrete more IL-1 and TNF-a; increasing its concentration in the crevicular fluid. Metalloproteinases (MMP), such as collagenase, diabetics are increased by altering the homeostasis of collagen. Alterations in endotelial cells produce changes in coagulation leading to a focal thrombosis and vasoconstriction. Systemic inflammation has an important role in insulin sensitivity function and glucose dynamics, since swelling induces insulin resistance, and this usually accompanies systemic infections. Similarly, periodontal infection may enhance the systemic inflammatory state and aggravate insulin resistance. These events affect the emergence, evolution and periodontal regeneration; having a bidirectional relationship control Periodontitis and diabetes, as both share the same way of perpetuating the disease, inflammation.
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Humanos , Diabetes Mellitus Tipo 1/complicações , /complicações , Doenças Periodontais/etiologia , Complicações do Diabetes , Periodontite/etiologiaRESUMO
The present report examined the effects of essential oils (EOs) from Satureja hortensis L. and Salvia fruticosa M. on the viability and outer membrane permeability of the periodontopathogen Fusobacterium nucleatum, a key bacteria in oral biofilms, as well as the inhibition of matrix metalloproteinase (MMP-2 and MMP-9) activities in epithelial cells exposed to such bacteria. Membrane permeability was tested by measuring the N-phenyl-1-naphthylamine uptake and bacterial viability by using the commercially available Live/Dead BacLight kit. In addition, gelatin zymography was performed to analyze the inhibition of F. nucleatum-induced MMP-2 and MMP-9 activities in HaCaT cells. We showed that 5, 10, and 25 µL/mL of Sat. hortensis L. EO decreased the ratio of live/dead bacteria and increased the outer membrane permeability in a range of time from 0 to 5 min. Treatments with 10 and 25 µL/mL of Sal. fruticosa M. also increased the membrane permeability and 5, 10, and 25 µL/mL of both EOs inhibited MMP-2 and MMP-9 activities in keratinocytes induced after exposure of 24 h to F. nucleatum. We conclude that antibacterial and antigelatinolytic activities of Sat. hortensis L. EO have potential for the treatment of periodontal inflammation.
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Antibacterianos/farmacologia , Células Epiteliais/microbiologia , Fusobacterium nucleatum/efeitos dos fármacos , Inibidores de Metaloproteinases de Matriz/farmacologia , Óleos Voláteis/farmacologia , Óleos de Plantas/farmacologia , Satureja/química , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/enzimologia , Fusobacterium nucleatum/crescimento & desenvolvimento , Gelatina/metabolismo , Humanos , Queratinócitos/efeitos dos fármacos , Queratinócitos/enzimologia , Queratinócitos/microbiologia , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismoRESUMO
AIMS/INTRODUCTION: Prediabetic conditions, which include impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), might be associated with chronic gingival and/or periodontal inflammation. However, the occurrence of this oral inflammation in prediabetic conditions is poorly understood. The present study aimed to assess the association between prediabetes and gingival and/or periodontal inflammation. MATERIALS AND METHODS: A total of 94 Puerto Rican men and women aged 40-65 years, who were residents of San Juan, Puerto Rico, and free of diabetes, were included in the study. All participants had at least one tooth site with clinical attachment loss ≥3 mm. Fasting and 2-h plasma glucose were collected. Gingival/periodontal inflammation was assessed by bleeding on gentle probing of the sulcus at six sites per tooth. RESULTS: Participants with the percentage of teeth with bleeding on probing (BOP) equal to or greater than the median were compared with those with the percentage of teeth with BOP less than median. Participants with high BOP tended to present higher IFG (odds ratio [OR] 5.5, 95% confidence interval [CI] 1.2-25.3) and/or prediabetic condition (OR 3.6, 95% CI 1.0-13.2) than those with a low percentage of BOP, adjusting for age, sex, smoking, alcohol consumption, waist circumference and number of missing teeth. Using the continuous form of the outcome, the corresponding adjusted least squares means of percentage of BOP were 26.8 (standard error of the mean [SEM] 2.3) and 43.8 (SEM 6.0) in normal and IFG, respectively (P = 0.01), and 27.0 (SEM 2.4) and 39.0 (SEM 5.3) among healthy and prediabetic individuals, respectively (P = 0.05). CONCLUSION: IFG and/or prediabetes are strongly associated with BOP, a marker of chronic gingival/periodontal inflammation.