Influence of T2DM and prediabetes on blood DC subsets and function in subjects with periodontitis

Objective: To compare the myeloid and plasmacytoid DC counts and maturation status among subjects with/without generalized periodontitis (GP) and type 2 diabetes mellitus (T2DM).

Methods: The frequency and maturation status of myeloid and plasmacytoid blood DCs were analyzed by flow cytometry in four groups of 15 subjects: healthy controls, T2DM with generalized CP (T2DM + GP), prediabetes with GP (PD + GP), and normoglycemics with GP (NG + GP). RT-PCR was used to determine levels of Porphyromonas gingivalis in the oral biofilms and within panDCs. The role of exogenous glucose effects on differentiation and apoptosis of healthy human MoDCs was explored in vitro.

Results: Relative to controls and to NG + GP, T2DM + GP showed significantly lower CD1c + and CD303 + DC counts, while CD141 + DCs were lower in T2DM + GP relative to controls. Blood DC maturation required for mobilization and immune responsiveness was not observed. A statistically significant trend was observed for P. gingivalis levels in the biofilms of groups as follows: controls <NG+GP < PD+GP < T2DM+GP. Moreover, significantly higher P. gingivalis levels were observed in blood DCs of NG + GP than controls, whereas no differences were observed between controls and PD + GP/T2DM + GP. In vitro differentiation of MoDCs was significantly decreased, and apoptosis was increased by physiologically relevant glucose levels.

Conclusion: Type 2 diabetes mellitus appears to inhibit important DC immune homeostatic functions, including expansion and bacterial scavenging, which might be mediated by hyperglycemia.