Neural regulation of skeletal biology and periodontal disease progression in type

描述（由申请人提供）：糖尿病是牙周病发展的主要危险因素，自1980年以来患病率增加了400%。在美国的2500万糖尿病患者中，估计有750万患有严重的牙周炎。一般认为牙周病的严重程度与炎症的存在相关。然而，炎症不能完全解释牙周病的快速进展，全身骨骼骨丢失和骨髓脂肪积累，这些都可以在具有低牙菌斑水平和良好口腔卫生的年轻胰岛素依赖型糖尿病患者中观察到。因此，很可能是其他机制介导了骨丢失和糖尿病的耦合。自1967年以来，人们一再指出，临床神经病变与糖尿病患者牙周病的患病率和严重程度相关。骨骼和牙周复合体高度受神经支配，神经功能的局部变化具有调节骨微环境和覆盖的炎症反应的能力。然而，尽管有显著的相关证据将糖尿病中的神经病变和牙周病联系起来，但糖尿病中局部神经病变改变促成骨丢失、骨髓脂肪积聚和牙周病发展的能力仍未被探索。我们的中心假设是，在糖尿病中，感觉去神经支配和骨骼中感觉神经肽的消耗增强了血管收缩和骨髓脂肪的积累，同时限制了骨再生。这些变化将使糖尿病患者易于发生骨质减少和牙周病进展。如果有针对性的神经功能障碍被确定为骨丢失和牙周病的根本原因，治疗和预防策略将有可能取得重大进展。我们将在链脲佐菌素的啮齿动物模型中检验我们的假设 诱导的胰岛素依赖性糖尿病，有或没有神经信号传导的化学、物理或转基因抑制。当这项工作完成后，我们希望确定骨骼代谢的神经调节因子，并确定这些发现与糖尿病相关的骨丢失和牙周病进展的体内相关性。这些结果预计将产生广泛的积极影响，因为骨骼的神经调节与骨质流失和骨髓脂肪积累相关的其他疾病有关，包括骨质疏松症，衰老，性腺功能障碍和厌食症。

DESCRIPTION (provided by applicant): Diabetes, a major risk factor for development of periodontal disease, has increased in prevalence by 400% since 1980. Of the 25 million diabetic patients in the United States, it is estimated that 7.5 million have severe periodontitis. It is generally accepted that the severity of periodontal disease is correlated with the presence of inflammation. However, inflammation fails to completely explain the rapid progression of periodontal disease, generalized skeletal bone loss, and marrow fat accumulation that can be observed in young insulin-dependent diabetics with low plaque levels and good oral hygiene. Therefore, it is likely that other mechanisms are mediating the coupling of bone loss and diabetes. Since 1967 it has been repeatedly noted that clinical neuropathy is correlated with both the prevalence and severity of periodontal disease in diabetic patients. The skeleton and periodontal complex are highly innervated and local changes in nerve function have the capacity to regulate both the bone microenvironment and the overlying inflammatory response. However, despite significant correlative evidence linking neuropathy and periodontal disease in diabetes, the ability of local neuropathic change to contribute to bone loss, marrow fat accumulation and periodontal disease development in diabetes remains unexplored. Our central hypothesis is that in diabetes, sensory denervation and depletion of sensory neuropeptides in the skeleton enhances vasoconstriction and accumulation of marrow fat while limiting bone regeneration. These changes would predispose diabetic patients to development of osteopenia and progression of periodontal disease. If targeted neural dysfunction is identified as an underlying cause of bone loss and periodontal disease, treatment and prevention strategies will have the potential for significant evolution. We will test our hypothesis in rodent models of streptozotocin induced insulin-dependent diabetes with or without chemical, physical or transgenic inhibition of neural signaling. When this work is completed we expect to identify neural regulators of skeletal metabolism and determine the in vivo relevance of these findings to progression of diabetes-associated bone loss and periodontal disease. These outcomes are expected to have a broad positive impact because neural regulation of the skeleton is relevant to other conditions associated with bone loss and marrow fat accumulation including osteoporosis, aging, gonadal dysfunction and anorexia.