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Submitted on September 18, 2003
Accepted on September 22, 2003
1 Department of Periodontology and Oral Biology, Boston University School of Dental Medicine, Boston, MA 02118 Department of Orthopedics, School of Medicine, 700 Albany Street, Boston Medical Center, Boston, MA 02118
* To whom correspondence should be addressed. E-mail: dgraves{at}bu.edu.
The most common cause of inflammatory bone loss is periodontal disease. Following bacterial insult inflammation induces bone resorption which is followed by new reparative bone formation. Since diabetics have a higher incidence and more severe periodontitis, we examined mechanisms by which diabetes alters the response of bone to bacterial challenge. This was accomplished with db/db mice, which naturally develop type 2 diabetes. Following inoculation of bacteria osteoclastogenesis and bone resorption was measured. Both parameters were decreased in the diabetic group. Diabetes also suppressed reparative bone formation measured histologically and by the expression of osteocalcin. The impact of diabetes on new bone formation coincided with the effect of diabetes on apoptosis of bone lining cells. Within 5 days of bacterial challenge, apoptosis declined in the wild-type animals yet remained significantly higher in the diabetic group. Thus, diabetes may cause a net loss of bone because the suppression of bone formation is greater than the suppression of bone resorption. The diminished formation may be due in part to prolonged apoptosis of bone lining cells.
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