title: Systemic inflammatory responses in patients with type 2 diabetes with chronic periodontitis.
abstract: OBJECTIVE
  The objective of this case-control study was to quantify the immune responsiveness in individuals with type 2 diabetes (T2D) as compared with patients without diabetes (NT2D) diagnosed with periodontitis.
  
  
  METHODS
  Peripheral blood was collected from 20 patients with moderate-to-severe chronic periodontitis (10 T2D, 10 NT2D). Blood samples were stimulated with ultrapure Porphyromonas gingivalis and Escherichia coli lipopolysaccharide (LPS) for 24 hours. 14 cytokines/chemokines were quantified in culture supernatants using multiplex technology.
  
  
  RESULTS
  T2D individuals demonstrated higher unstimulated levels of interleukin 6 (IL-6), IL-1β, tumor necrosis factor α, interferon γ, IL-10, IL-8, macrophage inflammatory protein 1α (MIP1α), and 1β (MIP1β), and higher stimulated levels of IL-6, IL-8, IL-10, MIP1α and MIP1β, along with lower unstimulated and stimulated levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) when compared with NT2D (p<0.05). Importantly, the LPS-induced levels of IL-6, IL-8, IL-10 and MIP1α strongly correlated with severity of disease, measured by pocket depths (PD), within the T2D group (r(2)≥0.7, p<0.05), but not within NT2D.
  
  
  CONCLUSIONS
  Among patients with chronic periodontitis, patients with T2D seem to have an enhanced LPS-induced immune responsiveness than individuals without diabetes, which correlates with periodontal disease severity, concomitant with a less robust GM-CSF response. This data may in part explain the higher predisposition to periodontitis in this population.
authors.affiliation: Department of Periodontology , University of Florida College of Dentistry , Gainesville, Florida , USA.
authors.forename: Ruben
authors.initials: R
authors.lastname: Mesia
authors.affiliation: Department of Periodontology , University of Florida College of Dentistry , Gainesville, Florida , USA.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Gholami
authors.affiliation: Department of Periodontology , University of Florida College of Dentistry , Gainesville, Florida , USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism , University of Florida College of Medicine , Gainesville, Florida , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Clare-Salzler
authors.affiliation: Department of Periodontology , University of Florida College of Dentistry , Gainesville, Florida , USA.
authors.forename: Ikramuddin
authors.initials: I
authors.lastname: Aukhil
authors.affiliation: Department of Oral Biology , University of Florida College of Dentistry , Gainesville, Florida , USA.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Wallet
authors.affiliation: Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA; Department of Oral Biology, University of Florida College of Dentistry, Gainesville, Florida, USA.
authors.forename: Luciana M
authors.initials: LM
authors.lastname: Shaddox
keywords: Chronic Diabetic Complications; Chronic Inflammation; Cytokine(s); Immunology