Effects of Diabetes and Hypertension on Oral Mucosa and TGFβ1 Salivary Levels.

Lisiane Bernardi,Nicole Canalli Sonda,Marcelo Lazzaron Lamers,Pantelis Varvaki Rados,Fernanda Visioli,Bárbara Capitanio De Souza

doi:10.1590/0103-644020181868

Lisiane Bernardi, Nicole Canalli Sonda + Show 4 more

Open Access

https://doi.org/10.1590/0103-644020181868

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Abstract

in this cross-sectional study, whole stimulated saliva and oral mucosa exfoliative cytology specimens were collected from 39 patients that were healthy (control, n=10) or presented history of arterial hypertension (HAS, n=9), diabetes mellitus (DM, n=10) or both (DM+HAS, n=10). Salivary flow rate (SFR), TGFβ1 level in saliva, AgNORs and the epithelial maturation were evaluated. Non-parametric Kruskal-Wallis test, followed by Dunn's multiple comparison post-test and the Spearman test correlation analysis were used. SFR showed a significant decreased in DM and DM+HAS (0.47±0.11 and 0.64±0.43 mL/min) when compared to control (1.4±0.38 mL/min). DM+HAS presented the highest value of TGFβ1 concentration (24.72±5.89 pg/mL). It was observed a positive correlation between TGFβ1 and glycaemia (R=0.6371; p<0.001) and a negative correlation between TGFβ1 and saliva (R=-0.6162; p<0.001) and glycaemia and SFR (R=-0.5654; P=0.001). AgNORs number and status of maturation of mucosa cells were similar for all conditions. DM and DM+HAS presented the lowest SFR, which correlated with increased TGFβ1 levels. Despite the higher TGFβ1 secretion it was not observed changes in the morphology or proliferation of epithelial cells when diabetes or hypertension was present.

Highlights

Diabetes mellitus (DM) is an important independent risk factor to development of cardiovascular diseases and the association between DM and hypertension has been investigated [1]
During the clinical examination of soft tissues was registered that two subjects from DM group presented white plaque lesions located one in labial mucosa (20 mm of extension), that was biopsied and diagnosed as actinic cheilitis, and other in gingival tissue, that were kept in follow up and at end classified as a frictional hyperkeratosis
It is still unknown if the appearance of these pathologies is due to systemic profile of the DM and hypertension or caused by local manifestations as lower rate of salivary flow, buccal mucosa epithelium alterations or even saliva composition changes

Summary

Introduction

Diabetes mellitus (DM) is an important independent risk factor to development of cardiovascular diseases and the association between DM and hypertension has been investigated [1] These chronic diseases may promote dysfunction in different tissues and cell types [2], including oral health components as the salivary glands. During embryogenesis of salivary gland, TGFβ1 expression is responsible for interrupted glandular branch and has an important role in regulating epithelial cell proliferation and differentiation, and, for this reason may influence the oral mucosa homeostasis [7]. It was already demonstrated in animal models that diabetes influences the production of TGFβ isoforms in the salivary glands [8]

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