Fusobacterium nucleatum-infected periodontitis promotes renal interstitial fibrosis in rats through the TGF-ß/SMAD2/3 and ß-catenin signaling pathways.

OBJECTIVES: Periodontitis is associated with Fusobacterium nucleatum (F.n) infection. Although the colonization of renal tissue by F.n is well documented, its specific role in kidney disease has yet to be determined. This study aimed to investigate the potential association between F.n-induced periodontitis and renal interstitial fibrosis. METHODS: The rat gingival sulcus was injected with F.n suspension, while the control group (NC) was injected with PBS. The levels of total protein (TP), albumin (ALB), creatinine, and urea nitrogen (BUN) in rat serum and/or urine were quantified using the appropriate kits. Renal interstitial fibrosis and epithelial-mesenchymal transition (EMT) were evaluated in rats using Masson staining, Periodic Schiff-Methenamine (PASM) staining, and immunohistochemical staining. The levels of fibrosis- and EMT-related proteins and the TGF-ß/SMAD2/3 and ß-catenin signaling pathways were determined using Western blot analysis. F.n in the kidney tissues was quantitatively determined using bacterial 16S rRNA technology. RESULTS: Serum levels of TP, ALB, creatinine, and BUN were not significantly decreased in F.n-infected rats with periodontitis. The levels of creatinine and ALB in the urine were not statistically different between two groups. Masson and PASM staining showed that F.n-induced periodontitis could promote renal interstitial fibrosis in rats. The levels of collagen I, fibronectin (FN), vimentin, and α-SMA were upregulated in the kidney tissues of rats with F.n-induced periodontitis and in F.n-treated HK-2 cells. However, E-cadherin levels were reduced. F.n promoted renal interstitial and HK-2 cell fibrosis in rats by modulating the TGF-ß/SMAD2/3 and ß-catenin signaling pathways. F.n colonization increased renal interstitial fibrosis in rats. CONCLUSION: F.n-induced periodontitis promoted EMT by activating the TGF-ß/SMAD2/3 and ß-catenin signaling pathways, thus promoting renal interstitial fibrosis in rats.

Evaluation of the relationship among dental fear, scaling and root planing and periodontal status using periodontitis stages: A retrospective study.

BACKGROUND/PURPOSE: Patients with periodontal disease have higher dental fear levels, which may have negative effects on their clinical outcome during scaling and root planing (SRP). The present study used the new classification of periodontitis and validated questionnaires to assess the relationship among dental fear, SRP pain and periodontal status. MATERIALS AND METHODS: A total of 120 periodontitis patients were enrolled and staging according to the new classification of periodontitis. SRP was performed, and the visual analog scale (VAS) to assess pain was used with every patient after treatment. Questionnaires, including Corah's Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and short-form Dental Anxiety Inventory (S-DAI) were implemented from the first attendance and subsequent visits after 6 months. The patients were grouped by DAS scores. The statistical analysis was performed using T-test, chi-square, Pearson and Spearman correlative analysis. RESULTS: Compared to pre-SRP treatment, the dental fear level on DFS was decreased in the posttreatment period for all periodontitis stages. There were no statistically significant differences in S-DAI and DAS between pretreatment and posttreatment periods in stage I and II; meanwhile, there were statistically differences in stage III and IV. The correlation among periodontitis stages, VAS and dental fear level was significant. The proportion of high periodontitis stages was increased in high dental fear group. CONCLUSION: SRP can reduce dental fear levels in all periodontitis stages, especially in stage III and IV. Correlations exist among periodontal status, dental fear and SRP pain. High dental fear is associated with poor periodontal status.