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A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes (Reprinted from Journal of Clinical Periodontology, vol 40, pg S113-S134, 2013)

Lookup NU author(s): Dr John TaylorORCiD, Professor Philip Preshaw


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Aims: To review the evidence for the molecular and cellular processes that may potentially link periodontal disease and diabetes. The pathogenic roles of cytokines and metabolic molecules (e.g. glucose, lipids) are explored and the role of periodontal bacteria is also addressed. Paradigms for bidirectional relationships between periodontitis and diabetes are discussed and opportunities for elaborating these models are considered.Methods: Database searches were performed using MeSH terms, keywords, and title words. Studies were evaluated and summarized in a narrative review.Results: Periodontal microbiota appears unaltered by diabetes and there is little evidence that it may influence glycaemic control. Small-scale clinical studies and experiments in animal models suggest that IL-1 beta, TNF-alpha, IL-6, OPG and RANKL may mediate periodontitis in diabetes. The AGE-RAGE axis is likely an important pathway of tissue destruction and impaired repair in diabetes-associated periodontitis. A role for locally activated pro-inflammatory factors in the periodontium, which subsequently impact on diabetes, remains speculative.Conclusion: There is substantial information on potential mechanistic pathways which support a close association between diabetes and periodontitis, but there is a real need for longitudinal clinical studies using larger patient groups, integrated with studies of animal models and cells/tissues in vitro.

Publication metadata

Author(s): Taylor JJ, Preshaw PM, Lalla E

Publication type: Article

Publication status: Published

Journal: Journal of Periodontology

Year: 2013

Volume: 84

Issue: 4

Pages: S113-S134

Print publication date: 01/04/2013

ISSN (print): 0022-3492

ISSN (electronic): 1943-3670

Publisher: American Academy of Periodontology


DOI: 10.1902/jop.2013.134005


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