Periodontitis and Gestational Diabetes Mellitus: A Potential Inflammatory Vicious Cycle

Periodontitis is a chronic inflammatory immune disease associated with a dysbiotic state, influenced by keystone bacterial species responsible for disrupting the periodontal tissue homeostasis. Furthermore, the severity of periodontitis is determined by the interaction between the immune cell response in front of periodontitis-associated species, which leads to the destruction of supporting periodontal tissues and tooth loss in a susceptible host. The persistent bacterial challenge induces modifications in the permeability and ulceration of the sulcular epithelium, which facilitates the systemic translocation of periodontitis-associated bacteria into distant tissues and organs. This stimulates the secretion of pro-inflammatory molecules and a chronic activation of immune cells, contributing to a systemic pro-inflammatory status that has been linked with a higher risk of several systemic diseases, such as type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM). Although periodontitis and GDM share the common feature of systemic inflammation, the molecular mechanistic link of this association has not been completely clarified. This review aims to examine the potential biological mechanisms involved in the association between periodontitis and GDM, highlighting the contribution of both diseases to systemic inflammation and the role of new molecular participants, such as extracellular vesicles and non-coding RNAs, which could act as novel molecular intercellular linkers between periodontal and placental tissues.

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Impact of Systemic Inflammation on the Progression of Gestational Diabetes Mellitus

Current Diabetes Reports ◽

10.1007/s11892-016-0715-9 ◽

2016 ◽

Vol 16 (4) ◽

Cited By ~ 39

Author(s):

Tove Lekva ◽

Errol R. Norwitz ◽

Pål Aukrust ◽

Thor Ueland

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Systemic Inflammation

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Immunobiology of Gestational Diabetes Mellitus in Post-Medawar Era

Frontiers in Immunology ◽

10.3389/fimmu.2021.758267 ◽

2022 ◽

Vol 12 ◽

Author(s):

Surendra Sharma ◽

Sayani Banerjee ◽

Paula M. Krueger ◽

Sandra M. Blois

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Immune Responses ◽

Gestational Diabetes Mellitus ◽

Systemic Inflammation ◽

Pregnancy Complication ◽

Low Grade ◽

Autoimmune Pathology ◽

Treg Population ◽

Maternal Fetal Interface

Although the concepts related to fetal immune tolerance proposed by Sir Peter Medawar in the 1950s have not withstood the test of time, they revolutionized our current understanding of the immunity at the maternal-fetal interface. An important extension of the original Medawar paradigm is the investigation into the underlying mechanisms for adverse pregnancy outcomes, including recurrent spontaneous abortion, preterm birth, preeclampsia and gestational diabetes mellitus (GDM). Although a common pregnancy complication with systemic symptoms, GDM still lacks understanding of immunological perturbations associated with the pathological processes, particularly at the maternal-fetal interface. GDM has been characterized by low grade systemic inflammation that exacerbates maternal immune responses. In this regard, GDM may also entail mild autoimmune pathology by dysregulating circulating and uterine regulatory T cells (Tregs). The aim of this review article is to focus on maternal-fetal immunological tolerance phenomenon and discuss how local or systemic inflammation has been programmed in GDM. Specifically, this review addresses the following questions: Does the inflammatory or exhausted Treg population affecting the Th17:Treg ratio lead to the propensity of a pro-inflammatory environment? Do glycans and glycan-binding proteins (mainly galectins) contribute to the biology of immune responses in GDM? Our understanding of these important questions is still elementary as there are no well-defined animal models that mimic all the features of GDM or can be used to better understand the mechanistic underpinnings associated with this common pregnancy complication. In this review, we will leverage our preliminary studies and the literature to provide a conceptualized discussion on the immunobiology of GDM.

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FEATURES OF MICROBIOLOGICAL AND IMMUNE STATE IN PREGNANT WOMEN WITH INFLAMMATORY PERIODONTAL DISEASES AGAINST THE BACKGROUND OF GESTATIONAL DIABETES MELLITUS

Journal of Volgograd State Medical University ◽

10.19163/1994-9480-2020-3(75)-83-86 ◽

2020 ◽

Vol 75 (3) ◽

pp. 83-86

Author(s):

Ye.I. Alexandrov ◽

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Oral Cavity ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Periodontal Diseases ◽

Main Group ◽

Control Group ◽

Periodontal Health ◽

Periodontal Tissues

90 pregnant women with inflammatory periodontal diseases, aged 27 to 35 years were examined. The main group consisted of 60 pregnant women with gestational diabetes mellitus and the control one consisted of 30 patients with physiological pregnancy. All patients were examined before providing treatment and preventive measures at 14–15 weeks of pregnancy and after them at 37–38 weeks. Studies have shown deterioration in periodontal health, oral hygiene and increase in contamination of the oral cavity in patients of the main group as compared with patients of the control group. The use of the anti-inflammatory succinic acid based preparation is effective for inflammatory periodontal diseases in pregnant women with gestational diabetes. The improvement of periodontal tissues health was confirmed by the posttreatment indices of hygiene, immunoglobulins, microbiocenosis and periodontal indices that promote normalization of the oral cavity.

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