Abstract
The aims of this systematic review were to identify and synthesize the evidence for an association in DNA methylation/histone modifications between periodontal diseases and systemic diseases/smoking. Electronic database searches using relevant search terms in PubMed, Embase, MEDLINE, CINAHL, Web of Science, Scopus, and SciELO, and manual searches, were independently conducted to identify articles meeting the inclusion criteria. Nine studies of 1482 participants were included. Periodontitis was compared to metabolic disorders, rheumatoid arthritis (RA), cancer, and smokers, as well as healthy controls. Substantial variation regarding the reporting of sample sizes and patient characteristics, statistical analyses, and methodology was found. IL6 and TNF were modified similarly in RA and periodontitis. While TIMP-3 and GSTP-1 were significantly lower in periodontitis patients and controls than in cancer, SOCS-1, RMI2, CDH1, and COX2 were modified similarly in both cancer and periodontitis. While TLR4 in and CXCL8 were affected in periodontitis independent of smoking habit, smoking might change the transcription and methylation states of ECM organization-related genes, which exacerbated the periodontal condition. There was some evidence, albeit inconsistent, for an association between DNA methylation and periodontal diseases and systemic diseases or smokers compared to healthy patients or non-smokers.
Highlights
IntroductionEpigenetic factors refer to alterations in the gene expression that are not encoded in the DNA sequence [7,8], which include chemical alterations of the DNA and histones, resulting in the remodeling of the chromatin and activation or inactivation of a gene [9,10,11]
Histone acetylation is linked with transcriptional activation [14] and is regulated by histone acetyltransferases (HATs) that add acetyl groups to histones and histone deacetylases (HDACs) that remove acetyl groups [15]
We have developed a systematic review to thoroughly present the potential interactions between epigenetics and periodontal diseases associated with systemic diseases/smoking, which would give a better understanding of this topic to both researchers and clinicians
Summary
Epigenetic factors refer to alterations in the gene expression that are not encoded in the DNA sequence [7,8], which include chemical alterations of the DNA and histones, resulting in the remodeling of the chromatin and activation or inactivation of a gene [9,10,11]. DNA methylation results in gene silencing [8,13] Another form of epigenetic change is post-translational modifications of histones, which form the building blocks of the chromatin (i.e., nucleosomes). While DNA methylation and histone modifications are linked [12,15], DNA methylation offers a more stable form of gene regulation [16]. Excluded: DM, periodontal therapy within the previous 3 months, and the presence of fewer than 15 teeth. Included: Free from systemic or chronic disease, current and past non-smokers, no swelling of the lymph nodes, no TMJ disease, no soft tissue abnormalities or severe dental caries, and no furcation involvement or generalized gingival recession
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