ANTI-HYPERGLYCEMIANT, ANTI-BONE LOSS AND ANTI-INFLAMMATORY EFFECTIVENESS OF PROBIOTIC LACTOBACILLUS RHAMNOSUS EM1107 IN AN EXPERIMENTAL MODEL OF PERIODONTITIS ASSOCIATED WITH DIABETES.
probiotics, periodontitis, diabetes, metformin, rats.
Periodontal disease (PD) and diabetes mellitus (DM) have a well-established bidirectional relationship as they share similar chronic inflammatory mechanisms. Due to its microbial and immunological effects, probiotic therapy has been suggested as an adjuvant to non-surgical periodontal treatment. Considering metformin (MET) as the standard drug for the treatment of diabetes, the aim of this study was to evaluate the anti-hyperglycemic, anti-bone loss and anti-inflammatory efficacy of the probiotic Lactobacillus rhamnosus EM1107 in an experimental model of ligature-induced periodontitis in diabetic rats treated with metformin. This pre-clinical, in vivo, randomized, blinded and controlled trial consisted of 114 male Wistar rats randomly divided into six groups of 19 animals each: control, ligation, ligation/DM, ligation/Prob, ligation/DM/Prob and ligation /DM/Prob/Met. For 30 days the animals received a probiotic via oral gavage. DM was induced on the 14th day of the experiment with injection of Streptozotocin (STZ) into the penile vein, followed by ligation for PD induction and MET gavage on the 19th day, and euthanasia on the 30th day. An extremely significant reduction in serum glucose was observed in both the Prob and Metformin groups (p<0.001) by biochemical analysis. Microtomographic analysis (μCT) in the maxilla showed that diabetic animals treated with probiotic and metformin had significantly lower linear and volumetric bone loss than those that had no treatment at all. By histomorphological analysis (HE), all groups that received probiotics had a reduction in inflammatory infiltrate, in addition to preservation of cementum and alveolar bone. The TRAP analysis revealed that the Ligature/DM/Prob/Met group had the greatest reduction in osteoclast count (p<0.01). There was a significant reduction in IL-1β and TNF-α in the Ligature/Prob (p<0.05) and Ligature/DM/Prob (p<0.01) groups by means of the ELISA assay in gingival tissue. Our findings suggest the anti-hyperglycemic, anti-bone loss and anti-inflammatory efficacy of the probiotic Lactobacillus rhamnosus EM1107 administered either alone or in association with Metformin in DM with PD.