PDF(Pubmed)
Abstract：
Diabetes mellitus (DM) poses a significant challenge to global health, with its prevalence projected to rise dramatically by 2045. This narrative review explores the bidirectional relationship between periodontitis (PD) and type 1 diabetes mellitus (T1DM), focusing on cellular and molecular mechanisms derived from the interplay between oral microbiota and the host immune response. A comprehensive search of studies published between 2008 and 2023 was conducted to elucidate the association between these two diseases. Preclinical and clinical evidence suggests a bidirectional relationship, with individuals with T1DM exhibiting heightened susceptibility to periodontitis, and vice versa. The review includes recent findings from human clinical studies, revealing variations in oral microbiota composition in T1DM patients, including increases in certain pathogenic species such as Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans, along with shifts in microbial diversity and abundance. Molecular mechanisms underlying this association involve oxidative stress and dysregulated host immune responses, mediated by inflammatory cytokines such as IL-6, IL-8, and MMPs. Furthermore, disruptions in bone turnover markers, such as RANKL and OPG, contribute to periodontal complications in T1DM patients. While preventive measures to manage periodontal complications in T1DM patients may improve overall health outcomes, further research is needed to understand the intricate interactions between oral microbiota, host response, periodontal disease, and systemic health in this population.
摘要：
糖尿病（DM）对全球健康构成重大挑战，预计到2045年，其患病率将急剧上升。本综述探讨牙周炎（PD）与1型糖尿病（T1DM）的双向关系，重点关注口腔微生物群与宿主免疫反应之间相互作用的细胞和分子机制。对2008年至2023年之间发表的研究进行了全面搜索，以阐明这两种疾病之间的关联。临床前和临床证据表明存在双向关系，T1DM患者对牙周炎的易感性增加，反之亦然。该综述包括人类临床研究的最新发现，揭示T1DM患者口腔微生物群组成的变化，包括某些病原物种的增加，如牙龈卟啉单胞菌，中间介体普雷沃特拉，和Aggregatibacter放线菌，随着微生物多样性和丰度的变化。这种关联的分子机制涉及氧化应激和失调的宿主免疫反应。由炎性细胞因子如IL-6、IL-8和MMPs介导。此外，骨转换标记的破坏，如RANKL和OPG，有助于T1DM患者牙周并发症的发生。虽然采取预防措施管理T1DM患者的牙周并发症可能会改善整体健康结局。需要进一步的研究来了解口腔微生物群之间复杂的相互作用，主机响应,牙周病,和这个人群的全身健康。
