Cellular source and tetracycline‐inhibition of gingival crevicular fluid collagenase of patients with labile diabetes mellitus

Abstract

Accelerated periodontal tissue destruction in patients with labile insulin-dependent diabetes mellitus (DM) and localized juvenile periodontitis (LJP) has been suggested to be related to functional abnormalities of neutrophils. We have recently found that collagenase in gingival crevicular fluid (GCF) of adult periodontitis patients is primarily derived from neutrophils and that neutrophil collagenase activity is more sensitive to inhibition by tetracyclines than collagenase produced by fibroblasts. This study is to characterize the cellular sources, activation and inhibition of collagenase in GCF of DM patients and to compare it with collagenase in LJP GCF. We found differences which may have therapeutic implications. Specific doxycycline inhibition tests revealed that GCF collagenase in DM is derived from neutrophils, whereas the enzyme in LJP originates primarily from fibroblasts. Oxidant, sodium hypochlorite, activated efficiently GCF collagenase of DM but not LJP patients. In contrast, plasmin activated LJP GCF collagenase but not that of DM patients. In GCF of DM patients 50-60% of collagenase existed in an active form, whereas in LJP GCF, the enzyme was almost completely in a latent form. The results suggest that collagenase in GCF of periodontitis patients with labile DM is primarily derived from neutrophils and that tetracycline therapy may be an effective adjunct in treatment aimed at controlling the periodontal breakdown in these patients. On the other hand, in LJP the anti-collagenase property of tetracyclines may be less important for control of periodontal tissue destruction because of the tetracycline-resistance of fibroblast collagenase.

Diabetes and periodontal disease: a two way relation – a commentary

“…In addition to decreased synthesis newly formed collagen is susceptible to degradation by collagenase, a matrix metalloproteinase which is elevated in diabetic patients including the periodontium. A greater percentage of this collagenase is in the active form in patients with diabetes mellitus compared to non-diabetics (11). In addition to the decreased collagen production and increased collagenase activity, collagen metabolism is altered by accumulation of advanced glycation end products in the periodontium.…”

Relación entre diabetes mellitus y enfermedad periodontal

“…Sorsa et al (51) demostraron que estos niveles incrementados de colagenasa podian ser inhibidos in vitropor tetraciclinas.…”

The comparison of IL-6, elastase and α-PI expressions in human chronic periodontitis with type 2 diabetes mellitus

“…Gingival fibroblasts from diabetic patients synthesize less collagen compared to non-diabetic subjects 13) . In addition to decreased collagen production, crevicular fluid collagenolytic activity also was increased in diabetic patients 14) . This increased crevicular fluid collagenase activity appears to be primarily of neutrophil origin.…”