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Diabetes and periodontitis: the role of a high-glucose microenvironment in periodontal tissue cells and corresponding therapeutic strategies.

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Title:	Diabetes and periodontitis: the role of a high-glucose microenvironment in periodontal tissue cells and corresponding therapeutic strategies.
Authors:	Xiang DD; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China., Sun YX; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China., Jiao C; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China., Guo YQ; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China., Fei YX; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China., Ren BQ; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China., He XT; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China. hexiao__tao@163.com., Li X; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China. li_xuan15@163.com.
Source:	Stem cell research & therapy [Stem Cell Res Ther] 2025 Jul 15; Vol. 16 (1), pp. 366. Date of Electronic Publication: 2025 Jul 15.
Publication Type:	Journal Article; Review
Language:	English
Journal Info:	Publisher: BioMed Central Country of Publication: England NLM ID: 101527581 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-6512 (Electronic) Linking ISSN: 17576512 NLM ISO Abbreviation: Stem Cell Res Ther Subsets: MEDLINE
Imprint Name(s):	Original Publication: London : BioMed Central
MeSH Terms:	Periodontitis/therapy , Periodontitis/metabolism , Periodontitis/pathology , Glucose/metabolism , Cellular Microenvironment* , Diabetes Mellitus/metabolism , Diabetes Mellitus/pathology , Periodontium/metabolism , Periodontium/pathology, Humans ; Animals
Abstract:	Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests. Background: Periodontitis is a chronic inflammatory disease that leads to the destruction of periodontal tissues and diabetes is a metabolic disease characterized by hyperglycemia. Both of these diseases affect many people worldwide. Epidemiological data have revealed a close relationship between periodontitis and diabetes. In particular, the high-glucose microenvironment plays an important role in the relationship between these two chronic inflammatory diseases, which makes it difficult to mitigate the progression of periodontitis and restore periodontal tissue in diabetic patients. Anti-inflammatory and regenerative processes are of fundamental importance for periodontal treatment and are mediated by diverse cell populations, including macrophages, T cells, neutrophils, stem cells, and fibroblasts that reside within periodontal tissues. Main Body: This review summarizes the interaction between diabetes mellitus and periodontitis, and illustrates that the high-glucose microenvironment aggravates periodontal homeostasis. Furthermore, the mechanism by which the high-glucose microenvironment regulates the involvement of various cells in the destruction of periodontal tissue, leading to the significant inhibition of tissue regeneration and recovery, is discussed. On this basis, the current therapeutic strategies that can be used to target cells are summarized to improve the regeneration and repair processes in the high-glucose microenvironment. Conclusion: In this review, we assess how metabolic dysregulation mediated by a high-glucose microenvironment exacerbates inflammatory damage and inhibits tissue repair. A deeper understanding of the effects of a high-glucose microenvironment on periodontal tissue cells is essential for developing new therapeutic strategies to restore the structure and function of periodontal tissue. (© 2025. The Author(s).)
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Grant Information:	82301079 National Natural Science Foundation of China; 82371010 National Natural Science Foundation of China; 2022QNRC001 Young Elite Scientist Sponsorship Program by CAST; 2021PYRC001 Young Elite Scientist Support Program administered by CSA; 2022TQ0134 China Postdoctoral Science Foundation; 2023M734279 China Postdoctoral Science Foundation
Contributed Indexing:	Keywords: High-glucose microenvironment; Immune cells; Periodontitis; Stem cells; Therapeutic strategies
Substance Nomenclature:	IY9XDZ35W2 (Glucose)
Entry Date(s):	Date Created: 20250714 Date Completed: 20250715 Latest Revision: 20250717
Update Code:	20250717
PubMed Central ID:	PMC12261607
DOI:	10.1186/s13287-025-04441-z
PMID:	40660319
Database:	MEDLINE

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Abstract:	Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.<br />Background: Periodontitis is a chronic inflammatory disease that leads to the destruction of periodontal tissues and diabetes is a metabolic disease characterized by hyperglycemia. Both of these diseases affect many people worldwide. Epidemiological data have revealed a close relationship between periodontitis and diabetes. In particular, the high-glucose microenvironment plays an important role in the relationship between these two chronic inflammatory diseases, which makes it difficult to mitigate the progression of periodontitis and restore periodontal tissue in diabetic patients. Anti-inflammatory and regenerative processes are of fundamental importance for periodontal treatment and are mediated by diverse cell populations, including macrophages, T cells, neutrophils, stem cells, and fibroblasts that reside within periodontal tissues.<br />Main Body: This review summarizes the interaction between diabetes mellitus and periodontitis, and illustrates that the high-glucose microenvironment aggravates periodontal homeostasis. Furthermore, the mechanism by which the high-glucose microenvironment regulates the involvement of various cells in the destruction of periodontal tissue, leading to the significant inhibition of tissue regeneration and recovery, is discussed. On this basis, the current therapeutic strategies that can be used to target cells are summarized to improve the regeneration and repair processes in the high-glucose microenvironment.<br />Conclusion: In this review, we assess how metabolic dysregulation mediated by a high-glucose microenvironment exacerbates inflammatory damage and inhibits tissue repair. A deeper understanding of the effects of a high-glucose microenvironment on periodontal tissue cells is essential for developing new therapeutic strategies to restore the structure and function of periodontal tissue.<br /> (© 2025. The Author(s).)
ISSN:	1757-6512
DOI:	10.1186/s13287-025-04441-z