Gut-Oral Axis In Type 2 Diabetes-Associated Periodontitis

This study aimed to investigate the mechanism of Type 2 diabetes mellitus (T2DM)-associated periodontitis from the perspective of the gut-oral axis, providing novel perspectives for developing adjuvant therapeutic strategies. Four-week-old male C57 mice were used to establish T2DM-associated periodontitis models. The Fecal microbiota transplantation (FMT) technique was used to rebuild gut microbiota. FMT from healthy donors, the administration of an intestinal barrier protectant and the supplementation of the metabolite oleic acid (OA) were used to treat T2DM-associated periodontitis in mice. 16S rRNA sequencing was used to analyze shifts in gut and oral microbiota, while non-targeted metabolomics was used to identify serum metabolites. The integrity of intestinal barrier was assessed through hematoxylin-eosin (HE) staining, Alcian Blue-Periodic Acid Schiff (AB-PAS) staining, immunohistochemistry (IHC), qPCR, and Western blot (WB). Periodontitis severity was evaluated via micro-CT, HE staining, tartrate-resistant acid phosphatase (TRAP) staining, IHC, qPCR, and WB. This research was approved by the ethics committee of the authors' institution. T2DM-induced gut dysbiosis led to intestinal barrier leakage, serum metabolic imbalance, and oxidative stress, ultimately exacerbating periodontitis. Interventions involving FMT from healthy donors, intestinal barrier protection, and OA supplementation significantly improved T2DM-associated periodontitis through the gut-oral axis. This research highlights the gut-oral axis as a critical factor in T2DM-associated periodontitis, providing a scientific foundation for innovative clinical adjunct therapies.