Abreu I S, Euzebio Alves V T, Benedete A P S, Bueno da Silva H A, França B N, Saraiva L, Lima L A, Carvalho M H, Holzhausen M
Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil.
J Periodontal Res. 2016 Oct;51(5):577-85. doi: 10.1111/jre.12336. Epub 2015 Nov 13.
Protease activated receptor type 1 (PAR1 ) seems to play a role in periodontal repair, while PAR2 is associated with periodontal inflammation. As diabetes is a known risk factor for periodontal disease, the aim of this study was to evaluate the influence of type 2 diabetes on PAR1 and PAR2 mRNA expression in the gingival crevicular fluid of patients with chronic periodontitis before and after non-surgical periodontal treatment.
Gingival crevicular fluid samples and clinical parameters consisting of measuring probing depth, clinical attachment level, bleeding on probing and plaque index were collected from systemically healthy patients and patients with type 2 diabetes and chronic periodontitis, at baseline and after non-surgical periodontal therapy. PAR1 and PAR2 , as well as the presence of the proteases RgpB gingipain and neutrophil proteinase-3 were assessed by quantitative polymerase chain reaction in the gingival crevicular fluid.
The periodontal clinical parameters significantly improved after periodontal therapy (p < 0.01). Diabetes led to increased expression of PAR1 in gingival crevicular fluid, and in the presence of chronic periodontitis, it significantly decreased the expression of PAR1 and PAR2 (p < 0.05). Moreover, non-surgical periodontal treatment in diabetics resulted in increased expression of PAR1 and PAR2 (p < 0.05), and decreased expression of RgpB gingipain and proteinase-3 (p < 0.05).
The present data demonstrated that diabetes was associated with an altered expression of PAR1 and PAR2 in the gingival crevicular fluid cells of subjects with chronic periodontitis. Future studies are necessary to elucidate the effects of PAR1 upregulation in periodontally healthy sites and PAR2 downregulation in chronic periodontitis sites on the increased susceptibility and severity of periodontitis in diabetes.
1型蛋白酶激活受体（PAR1）似乎在牙周组织修复中发挥作用，而PAR2与牙周炎症相关。由于糖尿病是牙周病的已知危险因素，本研究旨在评估2型糖尿病对慢性牙周炎患者非手术牙周治疗前后龈沟液中PAR1和PAR2 mRNA表达的影响。
从全身健康的患者以及患有2型糖尿病和慢性牙周炎的患者中，在基线和非手术牙周治疗后收集龈沟液样本以及包括测量探诊深度、临床附着水平、探诊出血和菌斑指数在内的临床参数。通过定量聚合酶链反应评估龈沟液中PAR1和PAR2以及蛋白酶RgpB牙龈蛋白酶和中性粒细胞蛋白酶-3的存在情况。
牙周治疗后牙周临床参数显著改善（p < 0.01）。糖尿病导致龈沟液中PAR1表达增加，并且在存在慢性牙周炎的情况下，它显著降低PAR1和PAR2的表达（p < 0.05）。此外，糖尿病患者的非手术牙周治疗导致PAR1和PAR2表达增加（p < 0.05），以及RgpB牙龈蛋白酶和蛋白酶-3表达降低（p < 0.05）。
目前的数据表明，糖尿病与慢性牙周炎患者龈沟液细胞中PAR1和PAR2的表达改变有关。未来有必要开展研究，以阐明牙周健康部位PAR1上调和慢性牙周炎部位PAR2下调对糖尿病患者牙周炎易感性增加和病情严重程度的影响。
