Beneficial Effects of Adiponectin on Periodontal Ligament Cells Under Normal and Regenerative Conditions
Total Page:16
File Type:pdf, Size:1020Kb
Hindawi Publishing Corporation Journal of Diabetes Research Volume 2014, Article ID 796565, 11 pages http://dx.doi.org/10.1155/2014/796565 Research Article Beneficial Effects of Adiponectin on Periodontal Ligament Cells under Normal and Regenerative Conditions Marjan Nokhbehsaim,1,2 Sema Keser,2 Andressa Vilas Boas Nogueira,2,3 Joni Augusto Cirelli,3 Søren Jepsen,2,4 Andreas Jäger,2,5 Sigrun Eick,6 and James Deschner1,2 1 Experimental Dento-Maxillo-Facial Medicine, University of Bonn, 53111 Bonn, Germany 2 Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany 3 Department of Diagnosis and Surgery, School of Dentistry, UNESP, 14801-903 Araraquara, SP, Brazil 4 Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany 5 Department of Orthodontics, University of Bonn, 53111 Bonn, Germany 6 Department of Periodontology, Laboratory of Oral Microbiology, University of Bern, 3010 Bern, Switzerland Correspondence should be addressed to James Deschner; [email protected] Received 16 April 2014; Revised 24 June 2014; Accepted 25 June 2014; Published 13 July 2014 Academic Editor: Ronald G. Tilton Copyright © 2014 Marjan Nokhbehsaim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Type 2 diabetes and obesity are increasing worldwide and linked to periodontitis, a chronic disease which is characterized by the irreversible destruction of the tooth-supporting tissues, that is, periodontium. The mechanisms underlying the association of diabetes mellitus and obesity with periodontal destruction and compromised periodontal healing are not well understood, but decreased plasma levels of adiponectin, as found in diabetic and obese individuals, might be a critical mechanistic link. The aim of this in vitro study was to examine the effects of adiponectin on periodontal ligament (PDL) cells under normal and regenerative conditions, and to study the regulation of adiponectin and its receptors in these cells. Adiponectin stimulated significantly the expression of growth factors and extracellular matrix, proliferation, and in vitro wound healing, reduced significantly the constitutive tumor necrosis factor- expression, and caused a significant upregulation of its own expression. The beneficial actions of enamel matrix derivative on a number of PDL cell functions critical for periodontal regeneration were partially enhanced by adiponectin. The periodontopathogen Porphyromonas gingivalis inhibited the adiponectin expression and stimulated the expression of its receptors. In conclusion, reduced levels of adiponectin, as found in type 2 diabetes and obesity, may compromise periodontal health and healing. 1. Introduction ligament (PDL), root cementum, and alveolar bone. Microor- ganisms, such as Fusobacterium nucleatum, Aggregatibacter The prevalence of diabetes mellitus and its associated comor- actinomycetemcomitans, Porphyromonas gingivalis,andTre- bidities is increasing worldwide [1]. Obesity is considered ponema denticola, in the subgingival plaque on the tooth a major risk factor for type 2 diabetes and has also risen surfaces are essential for the initiation and progression of substantially throughout the globe over the past decades periodontitis [8, 9]. Several cofactors, such as smoking, [2, 3]. A number of meta-analyses have demonstrated that can increase the risk for periodontitis [10]. The periodon- diabetes mellitus and obesity are linked to periodontitis, a topathogenic microorganisms provoke an inflammatory host chronic disease characterized by the irreversible destruction response, which involves inflammatory mediators, such as of the tooth-supporting tissues, that is, periodontium [4– interleukin- (IL-) 1,IL-6,IL-8,tumornecrosisfactor(TNF) 7]. The periodontium consists of the gingiva, periodontal , and cyclooxygenase (COX) 2 in the periodontal tissues. If 2 Journal of Diabetes Research the periodontal inflammation is exaggerated and sustained, increased and associated with proinflammatory effects42 [ ]. matrix degradation, bone resorption, periodontal pocket Asshowninourpreviousstudies,proinflammatorysignals formation, and even tooth loss can follow [10, 11]. can reduce the regenerative capacity of periodontal cells and Periodontitis can be successfully treated by either non- therefore inhibit regenerative healing [43–46]. So far, little surgical or surgical approaches, sometimes combined with is known about the actions of adiponectin on periodontal antibiotics. The main goal of periodontal therapy is to arrest homeostasis and regeneration. The aim of this in vitro study inflammation and periodontal tissue destruction by reducing was to examine the effects of adiponectin on periodontal cells or even eliminating the periodontopathogenic microorgan- under normal and regenerative conditions and to study the isms in the periodontal pockets [12]. In order to promote regulation of adiponectin and its receptors in these cells. regenerative healing, bioactive molecules, such as enamel matrix derivative (EMD), are applied during periodontal surgery [13–15]. EMD stimulates periodontal cells to produce 2. Materials and Methods growth factors, such as transforming growth factor (TGF) 2.1. Culture and Stimulation of Cells. PDL cells were obtained 1 and vascular endothelial growth factor (VEGF), matrix from 18 periodontally healthy donors, who underwent tooth molecules, such as periostin (POSTN), and osteogenesis- extractions for orthodontic reasons. Written informed con- related factors, such as runt-related transcription factor sent and approval of the Ethics Committee of the University (RUNX) 2. Moreover, EMD has been shown to accelerate the of Bonn were obtained. PDL cells (passages 3–5) were seeded in vitro wound healing [16, 17]. The beneficial effects of EMD on culture plates (50,000 cells/well) and grown to 80% con- on periodontal regeneration are accomplished, at least in part, fluence in Dulbecco’s minimal essential medium (DMEM, by bone morphogenetic protein (BMP) and TGF,which Invitrogen, Karlsruhe, Germany) supplemented with 10% trigger SMAD (sma- and mad-related protein) and non- fetal bovine serum (FBS, Invitrogen), 100 units penicillin, and SMAD signaling cascades [18–22]. Interestingly, microbial, ∘ 100 g/mL streptomycin (Invitrogen) at 37 Cinahumidified inflammatory, and biomechanical signals can interfere with atmosphere of 5% CO2. Before the experiments, the FBS the regeneration-promotive effects of EMD on periodontal concentration was reduced to 1%, and medium was changed cells, which highlights the critical role of the cell microen- every other day. vironment for regenerative healing [23–25]. In order study the effects of adiponectin on PDL cells, Interestingly, diabetes mellitus and obesity are associated physiological concentrations of adiponectin (0.3, 1, and not only with the initiation and progression of periodontitis, 3 g/mL; HMW oligomers, R&D Systems, Minneapolis, MN, but also with compromised healing after periodontal therapy USA) were added to the cells [47]. Cells were also treated [26–28]. The mechanisms underlying the associations of with EMD (Emdogain, Straumann, Freiburg, Germany) diabetes mellitus and obesity with periodontitis and com- used to mimic regenerative conditions at a concentration promised periodontal healing are not well understood so of 100 g/mL. To simulate inflammatory conditions, cells far. However, altered plasma levels of adipokines, as found were incubated with IL-1 (1 ng/mL; Calbiochem, San Diego, in diabetic and obese individuals, might be a critical mech- CA, USA). An infectious environment was mimicked by anistic link in these associations. Adipokines are bioactive treating cells with the inactivated oral periodontopathogens molecules, which are produced in the adipose tissue. In F. nucleatum ATCC 25586 (optical density: 0.1), A. actino- diabetes mellitus and obesity, plasma levels of proinflam- mycetemcomitans ATCC 43718 (OD: 0.1), P. g ing iv ali s ATCC matory adipokines, such as visfatin, leptin, and resistin, are 33277 (OD: 0.025–0.2), or T. denticola ATCC 35405 (OD: 0.1). increased, whereas the levels of adiponectin, which is an Bacteria were suspended in PBS (OD660 nm = 1, equivalent anti-inflammatory adipokine, are decreased. The imbalance 9 to 1.2 × 10 bacterial cells/mL) and subjected two times to between pro- and anti-inflammatory adipokines contributes ultrasonication (160 W for 15 min) resulting in a complete to the low-grad inflammatory state, as observed in diabetes killing. In order to ensure that results were comparable, EMD, mellitus and obesity [29–32]. IL-1, and the periodontopathogens were applied at the same Adiponectin is mainly synthesized by adipocytes. By physiological doses as in our previous experiments [43–46, binding to its receptors (AdipoR1 and AdipoR2), adiponectin 48–50]. activates the adenosine monophosphate-activated protein In order to unravel the intracellular signaling involved kinase (AMPK) and other pathways [33–35]. Like other in possible actions of adiponectin, PDL cells were also adipokines, adiponectin has both metabolic and immune preincubated with a specific inhibitor against the AMPK functions. Adiponectin enhances fatty acid oxidation, insulin signaling pathway (dorsomorphin; 5 M; Calbiochem, San sensitivity, and glucose uptake and inhibits the hepatic glu- Diego, CA, USA) 45 min before the experiments.