Suppression of Tumorigenicity 2 Pro-Inflammatory Biomarker Linking Diabetes Mellitus and Periodontitis: A Pilot Study

Abstract

Background Suppression of tumorigenicity 2 (ST2) is a member of the interleukin (IL)-1 family and has 2 isoforms: ST2L, a transmembrane form, and ST2, a soluble form. IL-33 can act as an immune system alarm signal when released by damaged cells, which in turn activates other cells expressing the ST2 receptor. This can cause inflammatory cytokines to be released and produced, as well as trigger osteoclastogenesis. This study aimed to investigate the levels of soluble ST2 in gingival samples. Material/Methods The study population consisted of 30 individuals. The participants were divided into 3 groups: healthy participants, patients with periodontitis, and patients with periodontitis and diabetes mellitus. Periodontitis was determined using probing depth, clinical attachment loss, and gingival index. Patients with stage 2 to 4 periodontitis met the inclusion criteria. Gingival crevicular fluid (GCF) was collected for quantification of samples for ST2 levels by using an enzyme immunoassay. Results The mean±standard deviation of ST2 GCF concentrations was relatively high (558.87±68.99) in the group with periodontitis and diabetes mellitus, compared with that of the periodontitis group (452.06±54.18) and healthy group (252.82±87.9). Conclusions GCF ST2 values were found to be a marker of inflammatory activities. Thus, GCF ST2 could be a potential biomarker for the diagnosis of periodontitis as well as systemic diseases, such as diabetes mellitus. This pilot study was limited by a small number of participants. To confirm the associations, more large-scale investigations should be conducted.

Salivary IL‐33 and sST2 levels in relation to TLR2 rs111200466 polymorphism and periodontitis

“…Moreover, it can be beneficial to include gingival crevicular fluid in future research to gain insight into the effects of the sST2/IL‐33 axis on site‐level pathology and healing potential following treatment. In fact, one prior study reported elevated ST2 levels in crevicular fluid of periodontitis patients, but that study was conducted in a small sample size due to its pilot nature and the impact of periodontal treatment on ST2 levels was not assessed (Navya et al, 2022). Another drawback of our study is that we used self‐reporting rather than chemical analysis of exposure biomarkers to assess smoking status.…”

“…sST2 levels have been linked to a variety of immune and inflammatory conditions, including cardiovascular events, cancer, rheumatoid arthritis, diabetes, pneumonia, and finally, periodontitis (Bergis et al, 2016; Lin et al, 2016; Navya et al, 2022; Pascual‐Figal & Januzzi, 2015; Watanabe et al, 2015). Our findings regarding the elevation of sST2 levels in periodontitis are consistent with a recent cross‐sectional study, where an association between elevated serum sST2 levels and periodontitis was demonstrated (Torrungruang et al, 2019).…”

“…Periodontitis is an infectious‐inflammatory disease of the tooth‐supporting tissues that is mediated by a disrupted immune‐inflammatory response to a pathogenic biofilm (Könönen et al, 2019). Elevated serum levels of sST2 have been associated with periodontitis (Torrungruang et al, 2019), and two pilot studies recently demonstrated increased gingival and peri‐implant crevicular fluid levels of ST2 in periodontitis and peri‐implant diseases, respectively (Navya et al, 2022; Ozgur et al, 2022). However, there is no prior research on salivary sST2 levels of periodontitis patients or, naturally, on the effect of periodontal treatment on salivary sST2 levels.…”

Exploring the Complex Relationship between Diabetes and Cardiovascular Complications: Understanding Diabetic Cardiomyopathy and Promising Therapies

“…Additionally, RAGE signaling increases the expression of proinflammatory cytokines, causing subsequent cardiac fibrosis [ 66 , 67 ]. This leads to suppression of tumorigenicity 2 (ST2) expression, which is a member of the IL-1 receptor family [ 68 ]. It is present in two isoforms, the ST2 ligand (ST2L) and the soluble form of ST2 (sST2).…”