The relationship between receptor for advanced glycation end products expression and the severity of periodontal disease in the gingiva of diabetic and non diabetic periodontitis patients.

Objective: Activation of receptor for advanced glycation end products (RAGE) has been implicated in many chronic diseases, including diabetic complications. In this study we examined the relationship between RAGE expression and the morphological changes seen in the gingiva of diabetic and periodontitis patients.

Design: Gingival biopsies from 15 diabetic patients with periodontitis, 25 non diabetic patients with periodontitis and 10 healthy individuals were collected. Sections were stained with haematoxylin and eosin, and immunohistochemically to detect RAGE. Samples were examined in light and fluorescence microscopes and histomorphometric analysis was performed.

Results: Increased number of inflammatory cells and changes in collagen and vasculature were observed in diabetic and non diabetic patients with periodontitis. RAGE was weakly expressed in healthy gingiva. The strongest reaction with anti-RAGE antibody was found in the gingiva of diabetic patients with periodontitis followed by the severe periodontitis patients. RAGE expression in inflammatory cells was stronger than in the epithelium. The number of inflammatory cells in the gingiva was higher in the diabetic periodontitis patients than in the non diabetic severe periodontitis patients.

Conclusions: RAGE is strongly expressed in the gingiva of diabetic patients with periodontitis and with severe periodontitis alone, the latter indicating RAGE activation even in the absence of hyperglycemia. However our findings are based on relatively small sample size. With a larger patient population, some of our other findings may have reached statistical significance.