Abstract
Periodontitis is one of the most prevalent oral inflammatory diseases leading to teeth loss and oral health problems in adults. Periodontitis mainly affects periodontal tissue by affecting the host immune system and bone homeostasis. Moreover, periodontitis is associated with various systemic diseases. Diabetes is a metabolic disease with systemic effects. Both periodontitis and diabetes are common inflammatory diseases, and comorbidity of two diseases is linked to exacerbation of the pathophysiology of both diseases. Since bacterial dysbiosis is mainly responsible for periodontitis, antibiotics are widely used drugs to treat periodontitis in clinics. However, the outcomes of antibiotic treatments in periodontitis are not satisfactory. Therefore, the application of anti-inflammatory drugs in combination with antibiotics could be a treatment option for periodontitis-diabetes comorbidity. Anti-diabetic drugs usually have anti-inflammatory properties and have shown beneficial effects on periodontitis. Sulfonylureas, insulin secretagogues, are the earliest and most widely used oral hypoglycemic drugs used for type-2 diabetes. Studies have found that sulfonylurea drugs can play a certain role in the mitigation of periodontitis and inflammation. This article reviews the effects of sulfonylurea drugs on the mitigation of periodontitis-diabetes comorbidity-related inflammation, bone loss, and vascular growth as well as the involved molecular mechanisms. We discuss the possibility of a new application of sulfonylureas (old drug) to treat periodontitis-diabetes comorbidity.
Highlights
Periodontitis refers to the chronic inflammation of toothsupporting tissues
Insulin stimulation leads to the activation of different pathways involved in metabolic regulation, including the phosphatidylinositol-3-kinase (PI3K) cascade
The occurrence and development of periodontal disease are closely related to inflammatory factors, bone metabolism balance, and neovascularization
Summary
Periodontitis refers to the chronic inflammation of toothsupporting tissues. The loss of periodontal attachment, surrounding bone, and teeth are clinical features of periodontitis (Gasner and Schure, 2020). Matrix metalloproteinases (MMPs), interferon-γ (IFN-γ), and receptor activator of nuclear factor-κB ligand (RANKL) in response to bacterial invasion These cytokines respective effects causing tissue damage to the periodontal region (Ramadan et al, 2020). The host’s susceptibility factors, including genetic factors, endocrine, immune function, psychological regulation, and certain diseases such as diabetes, are important in the development and aggravation of periodontitis (Badran et al, 2015). Both diabetes and periodontitis are systemic inflammatory diseases that accelerate the development and progression of each other. The global burden of diabetes is increasing with the increasing incidence rate of the disease
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