Abstract
Objective:This study evaluated the effects of local vitamin C treatment on tissue advanced glycation end products (AGE), interleukin (IL)-6, 8-hydroxy-2-deoxyguanosine (8-OHdG), and matrix metalloproteinases (MMP)-8 in tissues; serum C-terminal telopeptide fragments (CTX); and alveolar bone loss (ABL) in rats.Methodology:35 male Sprague Dawley rats were divided equally into five groups: 1) control (C), 2) experimental periodontitis (P), 3) experimental diabetes (D), 4) experimental diabetes and experimental periodontitis (D + P), and 5) experimental diabetes–experimental periodontitis–locally applied vitamin C (D + P + LvitC). Diabetes was induced in rats with alloxan monohydrate, after which periodontitis was induced by ligature placement in the right mandibular first molar teeth for 11 days. In the treatment group, vitamin C was administered locally three times with two-days interval after ligature removal. The animals were sacrificed, and the samples were analyzed histometrically and immunohistochemically.Results:CTX, 8-OHdG, and AGE values significantly decreased in the treatment group compared to the D + P group. IL-6 and MMP-8 values decreased in the treatment group compared to the D + P group, but this is not significant. ABL was significantly reduced by the local delivery of vitamin C.Conclusion:This study reveals that vitamin C treatment may be beneficial to reduce serum CTX and gingival MMP-8 levels, oxidative stress, inflammation, and AGE accumulation in periodontal tissue. Vitamin C may be an immunomodulator and antioxidant locally applied in the treatment of periodontitis to reduce the adverse effects of diabetes in periodontal tissues.
Highlights
A large body of studies regarding the potential effect of diabetes mellitus (DM) on periodontal disease are available in the literature
This study aimed to evaluate the effects of local application of vitamin C in tissue levels of advanced glycation end products (AGEs), IL6, 8-OHdG, and matrix metalloproteinases (MMPs)-8, in serum levels of CTX and periodontal attachment loss in diabetic rats with induced periodontitis
The number of MMP-8 positive cells in the D+P+LvitC group presented a statistically insignificant decrease compared to the D+P group (p>0.05) (Figure 2)
Summary
A large body of studies regarding the potential effect of diabetes mellitus (DM) on periodontal disease are available in the literature. The question of which biologic mechanism triggers the destruction of periodontal tissue in DM has not been exactly answered.. One of the potential mechanism is that advanced glycation end products (AGEs) lead to hyperinflammatory response, oxidative stress, and deterioration of the relationship between bone destruction and repair.. AGEs may implement their biological effects on tissues with their cross-link formation or receptor antigen recognition. The most extensively studied receptor for AGE recognition is the multi-ligand receptor for AGE (RAGE). The engagement of RAGE by AGEs in cells stimulates an inflammatory response by upregulating the expression of molecules, such as matrix metalloproteinases (MMPs) and osteolytic activators, potentially damaging the periodontal ligament and alveolar bone, resulting in periodontal disease.
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