Epigenetic changes underlie the association between diabetes mellitus and oral diseases.

Patients with diabetes mellitus (DM) suffer from oral complications related to oral infections, periodontal diseases, and endodontic lesions. Emerging evidence has revealed the contribution of the epigenetic process as the underlying mechanism of DM complications. DNA methylation, histone modifications, and non-coding RNAs are epigenetic regulators that directly affect gene expression. The present review elaborated on the role of epigenetic dysregulation in the etiology of diabetes-related periodontal and endodontic diseases. The narrative review study was prepared using databases such as PubMed, Google Scholar, Science Direct, and Scopus. The formation of glycation products as a result of hyperglycemic condition increases oxidative stress, and elevates chronic inflammatory mediators that could in turn adversely change the cellular environment and alter the epigenetic status. This process contributes to the alteration of regulatory genes expression, leading to the development of diabetes-induced bone complications and impaired odontogenic capacity of pulp. Indeed, epigenetic mechanisms mediate the interaction between gene expression and DM cellular environment. Further investigations on epigenetic factors involved in DM oral complications may provide novel therapeutic targets.

Ten years evaluation of epidemiology- and mortality-related factors in adults and children with Guillain-Barré syndrome in the north of Iran.

BACKGROUND: Guillain-Barré syndrome (GBS) is the main cause of acute and subacute flaccid paralysis in western nations since the eradication of poliomyelitis. OBJECTIVE: The aim of this study is to investigate epidemiology and mortality characteristics of GBS in the north of Iran. MATERIAL AND METHODS: In this study, the hospital information system (HIS) was used to access each patient's information. The final 174 cases were examined in terms of age, sex, place of residence, the year of referral, the month of referral, the season of referral, client city, accompanying background disease, and the type of GBS. RESULTS: The mean incidence rate in Guilan province was about 0.69 in 100,000 persons, and the case fatality rate was 10.34%. The most reported type of GBS was AIDP (33.90%), and the most common symptom was upper and lower limbs paresis in 65 cases (37%). Respiratory distress (P = < 0.001), complications during hospitalization (P = 0.0001), and ICU requirement (P = 0.001) were significantly higher in dead patients. CONCLUSION: In this study, the incidence of GBS was higher in men than women and the highest number of cases was in the age group of 60 to 75 years. The significant point was the high-case fatality rate in Guilan province compared to the previous studies. The complications during hospitalization such as respiratory distress, ICU requirement, and underlying disease had a significant relation with the fatality of GBS.

High glucose promotes the aging of human dental pulp cells through Wnt/beta-catenin signaling.

BACKGROUND: Diabetes is one of the most common metabolic diseases that disrupt the functioning of different body organs, including oral tissue. Some diabetic complications remain even after the control of the hyperglycemic condition. The adverse effect of hyperglycemia on the pulp structure and function has been shown previously. OBJECTIVES: The purpose of this study was to investigate the effect of the hyperglycemic state on the aging of pulp cells and evaluate the role of Wnt signaling as the underlying mechanism of this process. MATERIAL AND METHODS: The isolated pulp cells were cultured in the Minimum Essential Medium (MEM)-alpha for 7, 14 and 21 days under the influence of glucose at concentrations of 5 mM, 20 mM and 30 mM. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to evaluate cell viability, the beta-galactosidase test was applied to assess cellular senescence and gene expression was measured with quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: The results of this study showed that cell proliferation decreased following exposure to 20 and 30 mM glucose, which was accompanied by an increased number of senescent cells and an increased p21 expression. There was a significant increase in beta-catenin and Wnt1 expression in response to high glucose. Treatment with beta-catenin inducer enhanced cellular aging in the hyperglycemic state, while betacatenin inhibitor decreased the senescence response. CONCLUSIONS: The present study further confirmed the effect of the high-glucose condition on pulp cell aging and suggests a role for beta-catenin in the induction of cellular aging. Targeting the key regulators of cellular aging in pulp tissue might lead to the development of new therapies for the prevention and treatment of endodontic complications in diabetic patients.