Gu Ying, Golub Lorne M, Lee Hsi-Ming, Walker Stephen G
Department of General Dentistry, School of Dental Medicine, Stony Brook University, Stony Brook, NY, United States.
Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, United States.
Front Clin Diabetes Healthc. 2025 Mar 3;6:1529086. doi: 10.3389/fcdhc.2025.1529086. eCollection 2025.
Diabetes mellitus is a much-studied disorder, characterized by hyperglycemia and numerous oral and medical complications. The latter includes (above all) decreased life-span - and these are widely discussed in the dental and medical literature. The oral complications include impaired wound healing; increased severity of periodontal disease and peri-implantitis; dry mouth (xerostomia); and dental caries. The relationship between diabetes and oral health is bi-directional: Optimal management of local oral disease can profoundly affect the systemic metabolic control of the diabetic patient, and strict management of the patient's hyperglycemia can reduce its impact on oral disease. The only host modulation therapy (HMT), approved by the U.S. Food and Drug Administration (FDA) to treat periodontal disease, is a novel NON-antimicrobial (low-dose) formulation of doxycycline (Periostat; 20 mg b.i.d). A publication in Scientific Reports (2017), which supported the clinical rationale of efficacy and safety of low-dose doxycycline in diabetics, stated: "doxycycline not only ameliorated insulin resistance, fasting blood glucose, and insulin levels, and lipid profiles in the circulation and liver, but also improved islet morphology and increased glucose-stimulated insulin secretion." Additional developments include the biphenolic chemically-modified curcumins, as HMT for managing oral diseases. A lead compound, chemically-modified curcumin 2.24 (CMC2.24), has demonstrated safety and efficacy , in cell culture, and using mouse, rat, rabbit, and dog models of disease. In conclusion, novel host-modulation compounds have shown significant promise as adjuncts to traditional local therapy in the clinical management of periodontal and other oral diseases.
糖尿病是一种经过大量研究的疾病，其特征为高血糖以及众多口腔和医学并发症。后者尤其包括寿命缩短，这在牙科和医学文献中已有广泛讨论。口腔并发症包括伤口愈合受损；牙周病和种植体周围炎的严重程度增加；口干（口腔干燥症）；以及龋齿。糖尿病与口腔健康之间的关系是双向的：局部口腔疾病的最佳管理可深刻影响糖尿病患者的全身代谢控制，而严格控制患者的高血糖可减轻其对口腔疾病的影响。美国食品药品监督管理局（FDA）批准的唯一一种用于治疗牙周病的宿主调节疗法（HMT）是一种新型非抗菌（低剂量）强力霉素制剂（Periostat；每日两次，每次20毫克）。《科学报告》（2017年）上发表的一篇支持低剂量强力霉素对糖尿病患者有效性和安全性的临床理论依据的文章指出：“强力霉素不仅改善了胰岛素抵抗、空腹血糖、胰岛素水平以及循环系统和肝脏中的血脂状况，还改善了胰岛形态并增加了葡萄糖刺激的胰岛素分泌。”其他进展包括双酚化学修饰姜黄素，作为管理口腔疾病的宿主调节疗法。一种先导化合物，化学修饰姜黄素2.24（CMC2.24），在细胞培养以及使用小鼠、大鼠、兔子和狗的疾病模型中均已证明其安全性和有效性。总之，新型宿主调节化合物作为传统局部治疗的辅助手段，在牙周病和其他口腔疾病的临床管理中显示出了巨大的前景。
