Abstract
Aim: To evaluate the role of the high mobility group box-1 (HMGB1)/miR-155 axis in the pathogenesis of stage III/IV periodontitis with and without type 2 diabetes mellitus (T2DM). Materials and Methods: A total of 48 patients were assigned into four groups (12 per group): group 1: systemically and periodontally healthy (PH), group 2: systemically healthy with stage III/IV periodontitis (PD), group 3: PH with T2DM (PH + T2DM), group 4: stage III/IV periodontitis with T2DM, HbA1c ≤ 7 (PD + T2DM). Site-specific plaque index (SS-PI), gingival index (SS-GI), mean probing pocket depth (M-PPD) and clinical attachment loss (M-CAL) were recorded. Gingival tissue samples were analysed for HMGB1 and miR-155 gene expression by real-time polymerase chain reaction. Results: The miR-155 fold change (FC) increased by 10.29, 8.1 and 5.6 times in groups 4, 3 and 2, respectively. Intergroup comparison of miR-155 FC showed a significant difference between the groups ( p < .05). HMGB1 FC increased by 6.5, 5.9 and 5.23 times in groups 4, 2 and 3, respectively, with no significant difference ( p > .05). miR-155 FC is positively and significantly correlated with M-PPD (group 1, 2 and total sample), site-specific plaque score (SS-PS) (group 4) and SS-GI (total sample). miR-155 could discriminate periodontal health from T2DM + PD based on area under the curve 0.82 ( p < .05) with 83.3% sensitivity, 75% specificity, 76.9% positive and 81.8% negative predictive value and 79.2% diagnostic accuracy. Conclusion: miR-155 is significantly upregulated in the diseased periodontium both in the presence and absence of T2DM. Further, miR-155 could be a potential diagnostic biomarker for diabetes-associated PD. However, the significance of HMGB1 and the HMGB1-miR155 axis in the aetiology of diabetes-associated PD is still unclear and warrants additional investigation.
Published Version
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