鉺雅鉻雷射改善糖尿病性牙周病發炎老化之基礎研究

糖尿病被視為重要的公共衛生問題，被視為是影響牙周炎的危險因子。高血糖之下牙周組織易堆積糖化終產物，會引起發炎老化，視為一種低度慢性炎症與老化，發炎老化會導致糖尿病之併發症，例如牙周病即是一種牙齒底層支撐結構持續發炎之炎症。鉺雅鉻雷射因具有治療牙周疾病之潛力，能夠有效地清除牙結石與淨化已感染的牙根表面，其具有抗菌的特性，且能夠以非常小的熱能移除軟組織與硬組織。由於目前很少有研究提及鉺雅鉻雷射能有效地提供慢性牙周炎方面之床改善，其對於糖尿病患者改善牙周病的療效仍未知，因此本研究旨在探討鉺雅鉻雷射對於糖尿病牙周炎之功效及其分子機制。本研究利用流式細胞儀分析發現鉺雅鉻雷射照射可抑制人類牙周韌帶纖維母細胞產生氧化壓力。鉺雅鉻雷射照射可促進牙齦卟啉單胞菌脂多醣/糖化終產物處理人類牙周韌帶纖維母細胞之移動性及傷口癒合力。鉺雅鉻雷射照射可抑制人類牙周韌帶纖維母細胞之發炎細胞激素如Interleukin-6 (IL-6)及NF-κB分子訊號 。本研究運用細胞實驗證實鉺雅鉻雷射照射可改善糖尿病性牙周炎發老化情形及促進傷口癒合。

Diabetes mellitus (DM) is a major public health concern, which poses a massive risk for periodontitis. Hyperglycaemia in DM is linked to production of advanced glycation end products (AGEs) which is known to trigger inflamm-aging, a condition of low-grade chronic inflammation and pre-aging. Inflamm-aging is known to contribute to DM’s complications for instance, periodontitis which is a persisting inflammation of the underlying supporting structures of teeth. Erbium-doped yttrium-aluminum-garnet laser (ErL) is renowned for its potential in treating periodontal diseases, owing to its ability to efficiently eradicate calculus and decontaminate infected root surface. Few studies have demonstrated its efficacy in providing additional clinical improvements in patients with chronic periodontitis and peri-implantitis, however its influence on diabetic periodontitis remains uncertain. Therefore, this research hoped to investigate the impact of ErL on diabetic periodontitis. To imitate diabetic periodontitis, human periodontal ligament fibroblast (PDLFs) were stimulated with AGEs and lipopolysaccharides from P. gingivalis (Pg-LPS). The influence of ErL on the ROS production and wound healing capability were assessed using flow cytometry analysis and wound healing assay. The senescence activity in the stimulated PDLFs was evaluated using SA-ß-Gal staining. While interleukin-6 (IL-6) ELISA kit and Western blot respectively were employed to detect the laser’s influence on IL-6 protein expression and the phosphorylation of p65 in the PDLFs. Our results revealed that ErL dose-dependently inhibited the Pg-LPS/AGEs-stimulated ROS production and has a direct effect in promoting migration, and wound healing capabilities in them. ROS production in PDLFs. ErL also represses the Pg-LPS/AGEs-elicited increased senescence activity, inflammatory cytokine secretion, interleukin-6 (IL-6) and NF-κB activity in PDLFs. In conclusion, ErL could ameliorate inflamm-aging and promote wound healing in diabetic periodontal tissue.