Periodontal Diseases and Diabetes: Immunohistochemical Study and Biological Therapeutic Perspectives

Objectives: The association between diabetes mellitus (DM) and periodontal diseases has been extensively studied. Aim of the present study was an immunohistochemical investigation of VEGF, CD44 and CD133 expression in periodontal diseases of healthy (CTRL) and DM patients.

Methods: 64 oral mucosa samples were considered: 16 healthy periodontal gingivae, as controls (CTRL), 16 diseased periodontal gingivae of patients without DM (DPG), 4 diseased periodontal gingivae of patients with type 1 DM (DPG-1DM) and 16 diseased periodontal gingivae of patients with type 2 DM (DPG-2DM). Gingival sections were incubated with the following monoclonal antibodies: anti-VEGF, anti-CD44 and anti-CD133. The number of VEGF, CD44 and CD133 positive cells was counted among at least 1000 cells in the more representative fields. Data were subjected to one way analysis of variance and Bonferroni T test.

Results: In diseased periodontal gingivae of patients with type 1 DM (DPG-1DM) a significant (p<0.05) increased VEGF expression respect to CTRL and to DPG of patients with type 2 DM (DPG-2DM) was found in epithelial and endothelial cells. In all groups a similar strong epithelial CD44 expression was observed, while in connective tissue a significant increase (p<0.05) of CD44 staining was found in PDG-1DM and in PDG-2DM. Epithelial cells and endothelial cells showed a similar CD133 expression in all groups, except for PDG-2DM where CD133 staining was not detected. Conclusion: It could be possible to suggest a successful therapeutic protocol for periodontal disease using CD133 positive stem cells associated to biomolecules as hyaluronic acid (CD44 receptor), even if in older patients this approach could be less effective