Good dental care is extremely important for diabetics as according to a recent study, the disease can risk a patient’s oral health.
The University of Pennsylvania researchers found that the oral microbiome is affected by diabetes, causing a shift to increase its pathogenicity.
The research not only showed that the oral microbiome of mice with diabetes shifted but that the change was associated with increased inflammation and bone loss.
“Up until now, there had been no concrete evidence that diabetes affects the oral microbiome,” said senior author Dana Graves. “But the studies that had been done were not rigorous.”
Just four years ago, the European Federation of Periodontology and the American Academy of Periodontology issued a report stating there is no compelling evidence that diabetes is directly linked to changes in the oral microbiome.
But Graves and colleagues were skeptical and decided to pursue the question, using a mouse model that mimics Type 2 diabetes. “My argument was that the appropriate studies just hadn’t been done, so I decided, We’ll do the appropriate study,” Graves said. The team began by characterizing the oral microbiome of diabetic mice compared to healthy mice. They found that the diabetic mice had a similar oral microbiome to their healthy counterparts when they were sampled prior to developing high blood sugar levels, or hyperglycemia. But, once the diabetic mice were hyperglycemic, their microbiome became distinct from their normal littermates, with a less diverse community of bacteria.
“We were able to induce the rapid bone loss characteristic of the diabetic group into a normal group of animals simply by transferring the oral microbiome,” said Graves. With the microbiome now implicated in causing the periodontitis, Graves and colleagues wanted to know how. Suspecting that inflammatory cytokines, and specifically IL-17, played a role, the researchers repeated the microbiome transfer experiments, this time injecting the diabetic donors with an anti-IL-17 antibody prior to the transfer. Mice that received microbiomes from the treated diabetic mice had much less severe bone loss compared to mice that received a microbiome transfer from untreated mice. The findings “demonstrate unequivocally” that diabetes-induced changes in the oral microbiome drive inflammatory changes that enhance bone loss in periodontitis, the authors wrote. Though IL-17 treatment was effective at reducing bone loss in the mice, it is unlikely to be a reasonable therapeutic strategy in humans due to its key role in immune protection. But Graves noted that the study highlights the importance for people with diabetes of controlling blood sugar and practicing good oral hygiene. The study is published in the journal Cell Host & Microbe.