Modulation of host cell signaling pathways as a therapeutic approach in periodontal disease

Recently, new treatment approaches have been developed to target the host component of periodontal disease. This review aims at providing updated information on host-modulating therapies, focusing on treatment strategies for inhibiting signal transduction pathways involved in inflammation. Pharmacological inhibitors of MAPK, NFκB and JAK/STAT pathways are being developed to manage rheumatoid arthritis, periodontal disease and other inflammatory diseases. Through these agents, inflammatory mediators can be inhibited at cell signaling level, interfering on transcription factors activation and inflammatory gene expression. Although these drugs offer great potential to modulate host response, their main limitations are lack of specificity and developments of side effects. After overcoming these limitations, adjunctive host modulating drugs will provide new therapeutic strategies for periodontal treatment

Regulation of Ghrelin Receptor by Periodontal Bacteria In Vitro

Ghrelin plays a major role in obesity-related diseases which have been shown to be associated with periodontitis. This study sought to analyze the expression of the functional receptor for ghrelin (GHS-R1a) in periodontal cells and tissues under microbial conditions in vitro and in vivo. The GHS-R1a expression in human periodontal cells challenged with the periodontopathogen Fusobacterium nucleatum, in gingival biopsies from periodontally healthy and diseased individuals, and from rats with and without ligature-induced periodontitis was analyzed by real-time PCR, immunocytochemistry, and immunofluorescence. F. nucleatum induced an initial upregulation and subsequent downregulation of GHS-R1a in periodontal cells. In rat experimental periodontitis, the GHS-R1a expression at periodontitis sites was increased during the early stage of periodontitis, but significantly reduced afterwards, when compared with healthy sites. In human gingival biopsies, periodontally diseased sites showed a significantly lower GHS-R1a expression than the healthy sites. The expression of the functional ghrelin receptor in periodontal cells and tissues is modulated by periodontal bacteria. Due to the downregulation of the functional ghrelin receptor by long-term exposure to periodontal bacteria, the anti-inflammatory actions of ghrelin may be diminished in chronic periodontal infections, which could lead to an enhanced periodontal inflammation and tissue destruction

Efeito da movimentação ortodôntica na progressão da doença periodontal induzida em ratos

O movimento ortodôntico ocorre por meio da remodelação dos tecidos periodontais em resposta à aplicação de uma força mecânica, sendo que vários mediadores químicos são sintetizados e liberados para seu início e manutenção. Dentre esses mediadores, o óxido nítrico (NO) atua como modulador da atividade de osteoclastos e osteoblastos na remodelação óssea. Interleucina-1_ (IL-1-_), interleucina-6 (IL-6) e fator de necrose tumoral-_ (TNF-_) estimulam a reabsorção óssea e encontram-se aumentados no movimento ortodôntico. Estes mesmos mediadores também encontram-se aumentados e participam da destruição tecidual na doença periodontal. O objetivo deste estudo é avaliar in vivo a expressão de IL-1b, IL-6, TNF-_, NO sintase constitutiva endotelial (ecNOS), e NO sintase indutível (iNOS) nos tecidos periodontais de dentes sob movimentação ortodôntica em condições de saúde e doença periodontal, correlacionando-as às alterações histomorfométricas nesses tecidos. Para isso, 88 ratos foram divididos nos grupos: 1-controle (CONTR), 2- doença periodontal experimental induzida por ligaduras (DP), 3- movimento ortodôntico (MO), 4- doença periodontal experimental induzida por ligaduras, seguido de movimento ortodôntico (MODP). Biópsias dos tecidos gengivais ao redor 13 dos primeiros molares foram removidas para análise da expressão protéica e de mRNA, respectivamente, por Western blot e RT-PCR em tempo real. Cortes histológicos foram obtidos para avaliação histomorfométrica da perda óssea alveolar. Análise estatística foi realizada através do one-way ANOVA e a comparação entre os grupos foi feita com o teste de Tukey (nível de significância de 5%). Resultado: Máxima expressão gênica de todas as proteínas avaliadas foi observada no grupo MODP, nos períodos de 3h (eNos) ou de 1 dia (citocinas e iNOS) (p<0.05)...Orthodontic tooth movement (OTM) occurs in response to mechanical forces through periodontal tissues remodeling. Several chemical mediators are synthesized and released for the beginning and maintenance of tissue remodeling. Among these mediators, nitric oxide (NO) acts as modulator of osteoclasts and osteoblasts activities in bone turnover. Interleukin-1_ (IL-1_), interleukin-6 (IL-6) and tumor necrosis factor-_ (TNF-_) stimulate bone resorption and are increased in orthodontic movement. These same signaling molecules are also increased and play an important role on tissue destruction in periodontal disease. Objectives: The aim of this study was to assess in vivo the expression of IL-1ß, IL-6, TNF-_, NO synthase constitutive endothelial (ecNOS), and inducible NO synthase (iNOS) in dental tissues during orthodontic tooth movement in rats suffering from ligature-induced periodontal disease or in periodontally health animals. Cytokines expressions were correlated to histomorphometric changes on alveolar bone and other periodontal tissues. Methods: Eighty-eight rats were divided into four groups: 1- negative control (sham operated), 2 - ligature-induced periodontal disease (PD), 3 - orthodontic movement (OM), 4 - ligature-induced periodontal disease, followed by orthodontic movement (OMPD). Biopsies of gingival tissue around the first molars were removed for protein and mRNA expression analysis, respectively by, Western blot and Real Time RT-PCR. Histologic tissue sections were obtained for histomorphometric evaluation of alveolar bone loss. Statistical analysis was performed by one-way ANOVA and Tukey´s posthoc tests for all parameters (5% significance level). Results: Maximum mRNA expression of all evaluated proteins was observed in the OMPD group, on 3h (eNos) or day 1 (citokines and iNos) periods (p<0.05). Also on day 1, all proteins were expressed in high levels for all groups... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Inflammatory bowel disease and oral health: systematic review and a meta-analysis

BACKGROUND: The objective of this systematic review was to systematically investigate whether there is an association between inflammatory bowel disease (IBD) and oral health. METHODS: Literature searches for randomized and non-randomized studies were performed up to January 2017. Risk of bias within studies was assessed with the Downs and Black checklist. Across-studies risk of bias was assessed with the GRADE framework. Quantitative synthesis was conducted with random-effects meta-analyses. RESULTS: A total of 9 cross-sectional studies including 1297 patients were included. IBD was associated with increased risk of periodontitis (332 more patients per 1000 patients; 95% confidence interval (CI): 257-388 patients; p < 0.001) compared to non-IBD patients. Additionally, the Decayed-Missing-Filled-Teeth index of IBD patients was significantly worse than non-IBD patients (mean difference: 3.85; 95% CI: 2.36-5.34; p = 0.005). Patients with ulcerative colitis had considerably worse oral health for most of the assessed factors, while the quality of overall evidence ranged from high to low, due to the observational nature of contributing studies. CONCLUSIONS: Inflammatory bowel disease was associated with significantly higher risk of periodontitis and worse oral health compared to non-IBD patients. However, longitudinal studies are needed in order to establish a causality link between IBD and periodontal disease

Burning mouth syndrome: A discussion about possible etiological factors and treatment modalities

Although several studies discuss the contributing factors associated with the burning mouth syndrome (BMS), there is still controversy with regard to its etiology. Therefore, in the majority of cases, the establishment of an adequate diagnosis and consequently the best treatment modality is complicated. In order to assist the clinician in the establishment of the correct diagnosis and management of BMS, this article reviews the literature, providing a discussion on the various etiologic factors involved in BMS, as well as the best treatment modalities for this condition that have showed to be the most effective ones in randomized clinical trials. In addition, the authors discuss some clinical characteristics in the differential diagnosis of BMS and other oral diseases. It is important for the clinician to understand that BMS should be diagnosed only after all other possible causes for the symptoms have been ruled out