Neural regulation of skeletal biology and periodontal disease progression in type

描述(申请人提供)：糖尿病，牙周疾病发展的一个主要危险因素，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750万人患有严重的牙周炎。人们普遍认为，牙周病的严重程度与炎症的存在有关。然而，炎症不能完全解释牙周疾病的快速进展、全身性骨骼丢失和骨髓脂肪堆积，这些都可以在年轻的胰岛素依赖型糖尿病患者中观察到，这些患者的菌斑水平较低，口腔卫生良好。因此，可能还有其他机制参与了骨丢失和糖尿病的联结。自1967年以来，人们反复注意到临床神经病变与糖尿病患者牙周疾病的患病率和严重程度有关。骨骼和牙周复合体是高度神经支配的，神经功能的局部变化具有调节骨骼微环境和上层炎症反应的能力。然而，尽管有显著的证据表明糖尿病患者的神经病变与牙周疾病相关，但局部神经病变对糖尿病患者的骨丢失、骨髓脂肪堆积和牙周疾病发展的作用仍未被探讨。我们的中心假设是，在糖尿病患者中，感觉神经的丧失和骨骼中感觉神经肽的耗尽增强了血管收缩和骨髓脂肪的积累，同时限制了骨再生。这些改变将使糖尿病患者更容易发生骨量减少和牙周病的进展。如果靶向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发生重大演变。我们将在链脲佐菌素的啮齿动物模型中测试我们的假设 诱导的胰岛素依赖型糖尿病，有或没有神经信号的化学、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素，并确定这些发现与糖尿病相关的骨丢失和牙周疾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其他与骨质丢失和骨髓脂肪积累相关的疾病相关，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.