Periodontal Lesions in Hypercitricemia: Effect of Adrenal Cortical Hormones on the Blood Citric Acid Level and the Periodontal Tissues

Abstract

It is an interesting fact that the citric acid content in blood has apparently increased in patients with advanced alveolar atrophy.1 Insofar as this hypercitricemia appears to be associated with some types of periodontal disease, it was thought to be of interest to investigate the effect of the many factors that influence the citric acid.Numerous workers have studied the effect of fluoroacetate2, 3 vitamin D,4 5 and parathyroid hormone6 on the citric acid and enzyme systems that may be concerned in the formation or destruction of citric acid. Recently, Banerjee, Biswas, and Singh7 have found that the citric acid content in the tissues has significantly increased in scurvy and that treatment with insulin in such cases has brought the level of citric acid to normal. Agrell, Lindell, and Westling8 have found that adrenalectomy has been followed by a significant increase in the citric acid content of blood serum in guinea pigs and that this increase could have been prevented by cortisone or desoxycorticosterone.However, few workers have studied in detail the effect of adrenal cortical hormone on citric acid and have observed simultaneously the periodontal tissues. This paper deals with the influence of adrenocorticotropic hormone (ACTH), cortisone, and desoxycorticosterone (DOC) on the blood citric acid content in normal and scorbutic animals. It also demonstrates the histologic changes in the periodontal tissues which acompany the changes in blood citric acid. MATERIALS AND METHODSFemale guinea pigs weighing 320-70 gm. were initially fed on a vitamin C-deficient diet, made adequate by the addition of fresh vegetables. This diet plus water was continued ad libitum for 10 days. Then they were divided into 8 groups, 4 groups continuing with the adequate diet and 4 groups restricted to the vitamin C-deficient diet. Animals in 3 groups with adequate nutrition and 3 groups on the scorbutic diet were given intraperitoneal injections of hormones each day for 17 days. The other 2 groups were continued on the respective diets only. The groups and the hormones injected were as follows-Division A = normal adequate diet: 1 no injections, 2 ACTH 5 units daily, 3 = cortisone 5 mg. daily, 4 DOC 5 mg. daily; Division B vitamin C-deficient diet: 5 = no injections, 6 ACTH 5 units daily, 7 cortisone 5 mg. daily, 8 = DOC 5 mg. daily.On the seventeenth day, the animals were allowed water but no food for 15-18 hours. Then blood was collected by heart puncture. Blood citric acid was determined

Periodontal Lesions in Hypercitricemia: Effect of Insulin and Some Aconitase-activating Substances on the Blood Citric-Acid Level and the Periodontal Tissues

“…Citric acid is not only an important intermediate in energy metabolism but is also closely associated with bone formation and destruction.2 It is well known that fluoroacetate,3' 4vitamin D,5, 6 parathyroid,7' 8and adrenal-cortical hormone9' 10 have a profound effect on the citric-acid metabolism. Banerjee, Biswas, and Singh" have demonstrated that scorbutic animals exhibited an increased amount of blood citric acid and that citric acid accumulated significantly in the body tissues of such animals.…”