Gingival crevicular fluid adrenomedullin level in individuals with and without diabetes mellitus type 2

Abstract

An increased adrenomedullin level was found in individuals with chronic periodontitis and also in individuals with diabetes mellitus. It is thought that the effect of diabetes mellitus on the pathogenesis of chronic periodontitis could have been achieved through antimicrobial peptides such as adrenomedullin, or that increased adrenomedullin was released in individuals with diabetes mellitus in order to ensure no further periodontal tissue loss.

Antimicrobial peptides as a possible interlink between periodontal diseases and its risk factors: A systematic review

“…HBD‐3 expression in gingival crevicular fluid and gingival tissue have shown similar results, suggesting that type 2 DM can upregulate gingival crevicular fluid HBD‐3 expression in patients with periodontitis. Similarly, LL‐37 and adrenomedullin, a multifunctional vasopeptide, have also been noted as overexpressed in patients with diabetes with periodontitis. There is however a lack of experimental evidence regarding the effects of DM on mechanistic pathways underlying AMP expression in gingival tissue.…”

“…A few clinic chemical cross‐sectional studies were undertaken to identify the roles of AMPs in patients diagnosed with both type 2 DM and periodontal diseases (Table ). Although these studies used different types of sample (gingival tissues and gingival crevicular fluid) and targeted different AMPs, they obtained similar results indicating an overexpression of AMPs in type 2 DM with periodontitis.…”

“…Increased levels of AGEs can not only induce a thickening of the basal membrane in periodontal tissue and vascular injury, but also impart detrimental effects on endothelial cells, polymorphonuclear neutrophils, monocytes and macrophages . The ensuing deterioration of the vascular structure and dysfunction of cells hinders chemotactic factors migration and activity, consequently impairing the ability of leukocytes to protect periodontal tissues from the effects of microorganisms . The authors proposed that this correspondingly leads to an increased periodontal pathogen burden resulting in an increased response of gingival AMP release to combat the infection and limit periodontal tissue loss but such putative protective functions of the increased AMPs remain inadequate to limit periodontal inflammation and promote proper wound healing .…”

Cationic antimicrobial peptides and periodontal physiopathology: A systematic review

“…Levels of adrenomedullin in GCF has been described to be higher in periodontitis than in healthy patients and positively correlated with the severity of periodontal destruction . Moreover, in diabetes conditions, ADM level in GCF is increased particularly in patients who also suffer from periodontitis and total ADM level in GCF follows HbA1c (%) rising notably when this latter was higher than 7% …”

“…Results revealed that some AMPs could be promising biomarkers and the most documented are LL‐37, α‐defensins, and β‐defensins. Firstly, in saliva, those which were increased in periodontal diseases conditions are LL‐37, HNP1‐3 substance P, neurokinin A, vasoactive intestinal peptide, adrenomedullin, azurocidin, and peptides derived from hemoglobin chain subunit α, β, and δ . Secondly, AMPs which were decreased in saliva in periodontitis conditions like calcitonin gene‐related protein or neuropeptide Y .…”