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Year : 2013  |  Volume : 5  |  Issue : 1  |  Page : 58-59

Oxidative stress in diabetes and periodontitis

Department of Clinical Analysis, Laboratory of Clinical Mycology, Faculty of Pharmaceutical Sciences, Univ Estadual Paulista, Araraquara, São Paulo, Brazil

Date of Web Publication17-Jan-2013

Correspondence Address:
Janaina de Cássia Orlandi Sardi
Department of Clinical Analysis, Laboratory of Clinical Mycology, Faculty of Pharmaceutical Sciences, Univ Estadual Paulista, Araraquara, São Paulo
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Source of Support: None, Conflict of Interest: None

PMID: 23378958

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How to cite this article:
Sardi JO. Oxidative stress in diabetes and periodontitis. North Am J Med Sci 2013;5:58-9

How to cite this URL:
Sardi JO. Oxidative stress in diabetes and periodontitis. North Am J Med Sci [serial online] 2013 [cited 2023 Feb 2];5:58-9. Available from: https://www.najms.org/text.asp?2013/5/1/58/106209

Oxidative stress is an imbalance between the production of a reactive oxygen species and the antioxidant defense, leading to tissue damage. The produced reactive oxygen species, such as superoxide anion, hydroxyl radical, and peroxyl radical result in damage to many biological molecules (including DNA, lipids, and protein), and the prolonged existence of these reactive oxygen species promotes severe tissue damage and cell death. [1],[2] It has been proposed that there is a causal relationship between insulin resistance, oxidative stress, and periodontitis and that hyperglycemia is a major factor responsible for the activation of oxidative stress. [1],[2]

The presence of malondialdehyde, the products of the hydroxylation of DNA bases such as 8-hydroxy-2′-deoxyguanosine (8-OHdG) were found in crevicular fluid and periodontal pockets. [3] Cell damage is a consequence of the effect of free radicals and chronic oxidative stress. [3] Furthermore, Sawamoto et al., [4] proposed a close relationship between 8-OHdG and periodontal pathogens. When further considering periodontal disease, hypoxia of the tissue occurs at the onset of periodontitis, [5] which stimulates the production of cytokines and inflammatory mediators involved in alveolar bone resorption, including IL-6 and IL-1. With re-oxygenation after hypoxic events, there is an increased level of superoxide anions and other reactive oxygen species, which in turn induce degradation of the NF-kB inhibitor, resulting in greater tissue destruction. Therefore, periodontal disease associated with diabetes, smoking, and/or occlusal trauma leads to periodontal tissue hypoxia and re-oxygenation events, a situation that hypothetically increases the morbidity of periodontal pathology.

Neutrophils in poorly controlled diabetic patients released significantly more superoxide than neutrophils from patients with good glycemic control and from non-diabetic healthy individuals. [6] Neutrophils increased protein kinase C activity, elevated amounts of diacylglycerol, and enhanced nicotinamide adenine dinucleotide phosphate oxidase activity. This suggests that hyperglycemia can lead to neutrophil activation and elevated protein kinase C activity, resulting in increased oxidative stress. [6]

Pendyala et al., [7] demonstrated that increasing oxidative stress can be an important contributing factor in the pathogenesis of diabetes and periodontal disease. Therefore, the co-existence of these conditions could pathologically increase the effect of oxidative stress.

  References Top

1.Nassar H, Kantarci A, van Dyke TE. Diabetic periodontitis: A model for activated innate immunity and impaired resolution of inflammation. Periodontol 2000 2007;43:233-44.  Back to cited text no. 1
2.Mahadev K, Wu X, Zilbering A, Zhu L, Lawrence JT, Goldstein BJ. Hydrogen peroxide generated during cellular insulin stimulation is integral to activation of the distal insulin signaling cascade in 3T3-L1 adipocytes. J Biol Chem 2001;276:48662-9.  Back to cited text no. 2
3.Marfella R, Quagliaro L, Nappo F, Ceriello A, Giugliano D. Acute hyperglycemia induces an oxidative stress in healthy subjects. J Clin Invest 2001;108:635-6.  Back to cited text no. 3
4.Sawamoto Y, Sugano N, Tanaka H, Ito K. Detection of periodontopathic bacteria and an oxidative stress marker in saliva from periodontitis patients. Oral Microbiol Immunol 2005;20:216-20.  Back to cited text no. 4
5.Motohira H, Hayashi J, Tatsumi J, Tajima M, Sakagami H, Shin K. Hypoxia and reoxygenation augment bone-resorbing factor production from human periodontal ligament cells. J Periodontol 2007;78:1803-9.  Back to cited text no. 5
6.Karima M, Kantarci A, Ohira T, Hasturk H, Jones VL, Nam B-H, et al. Enhanced superoxide release and elevated protein Kinase C activity in neutrophil from diabetic patients: Association with periodontitis. J Leukocyte Biol 2005;78:1-9.  Back to cited text no. 6
7.Pendyala G, Thomas B, Joshi SR. Evaluation of Total Antioxidant Capacity of Saliva in Type 2 Diabetic Patients with and without Periodontal Disease: A Case-Control Study. N Am J Med Sci 2013;5:51-7.  Back to cited text no. 7

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