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      Periodontal Inflammation and Systemic Diseases: An Overview

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          Abstract

          Periodontitis is a common inflammatory disease of infectious origins that often evolves into a chronic condition. Aside from its importance as a stomatologic ailment, chronic periodontitis has gained relevance since it has been shown that it can develop into a systemic condition characterized by unresolved hyper-inflammation, disruption of the innate and adaptive immune system, dysbiosis of the oral, gut and other location's microbiota and other system-wide alterations that may cause, coexist or aggravate other health issues associated to elevated morbi-mortality. The relationships between the infectious, immune, inflammatory, and systemic features of periodontitis and its many related diseases are far from being fully understood and are indeed still debated. However, to date, a large body of evidence on the different biological, clinical, and policy-enabling sources of information, is available. The aim of the present work is to summarize many of these sources of information and contextualize them under a systemic inflammation framework that may set the basis to an integral vision, useful for basic, clinical, and therapeutic goals.

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          Periodontal diseases

          Periodontal diseases comprise a wide range of inflammatory conditions that affect the supporting structures of the teeth (the gingiva, bone and periodontal ligament), which could lead to tooth loss and contribute to systemic inflammation. Chronic periodontitis predominantly affects adults, but aggressive periodontitis may occasionally occur in children. Periodontal disease initiation and propagation is through a dysbiosis of the commensal oral microbiota (dental plaque), which then interacts with the immune defences of the host, leading to inflammation and disease. This pathophysiological situation persists through bouts of activity and quiescence, until the affected tooth is extracted or the microbial biofilm is therapeutically removed and the inflammation subsides. The severity of the periodontal disease depends on environmental and host risk factors, both modifiable (for example, smoking) and non-modifiable (for example, genetic susceptibility). Prevention is achieved with daily self-performed oral hygiene and professional removal of the microbial biofilm on a quarterly or bi-annual basis. New treatment modalities that are actively explored include antimicrobial therapy, host modulation therapy, laser therapy and tissue engineering for tissue repair and regeneration.
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            The cytokine storm and COVID‐19

            Abstract Coronavirus disease 2019 (COVID‐19), which began in Wuhan, China in December 2019 has caused a large global pandemic and poses a serious threat to public health. More than four million cases of COVID‐19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), have been confirmed as of May 11, 2020. SARS‐CoV‐2 is a highly pathogenic and transmissible coronavirus that primarily spreads through respiratory droplets and close contact. A growing body of clinical data suggests that a cytokine storm is associated with COVID‐19 severity and is also a crucial cause of death from COVID‐19. In the absence of antivirals and vaccines for COVID‐19, there is an urgent need to understand the cytokine storm in COVID‐19. Here, we have reviewed the current understanding of the features of SARS‐CoV‐2 and the pathological features, pathophysiological mechanisms, and treatments of the cytokine storm induced by COVID‐19. Additionally, we suggest that the identification and treatment of the cytokine storm are important components for rescuing patients with severe COVID‐19. This article is protected by copyright. All rights reserved.
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              Periodontitis: from microbial immune subversion to systemic inflammation.

              Periodontitis is a dysbiotic inflammatory disease with an adverse impact on systemic health. Recent studies have provided insights into the emergence and persistence of dysbiotic oral microbial communities that can mediate inflammatory pathology at local as well as distant sites. This Review discusses the mechanisms of microbial immune subversion that tip the balance from homeostasis to disease in oral or extra-oral sites.
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                Author and article information

                Contributors
                URI : http://loop.frontiersin.org/people/1038226/overview
                URI : http://loop.frontiersin.org/people/49930/overview
                Journal
                Front Physiol
                Front Physiol
                Front. Physiol.
                Frontiers in Physiology
                Frontiers Media S.A.
                1664-042X
                27 October 2021
                2021
                : 12
                : 709438
                Affiliations
                [1] 1Sociomedical Research Unit, National Institute of Cardiology “Ignacio Chávez” , Mexico City, Mexico
                [2] 2Computational Genomics Division, National Institute of Genomic Medicine (INMEGEN) , Mexico City, Mexico
                [3] 3Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de Mèxico , Mexico City, Mexico
                Author notes

                Edited by: Nephtali Marina, University College London, United Kingdom

                Reviewed by: Ioannis Papaioannou, University College London, United Kingdom; Mohammad Tariqur Rahman, University of Malaya, Malaysia; Aurobind Vidyarthi, Yale University, United States

                *Correspondence: Enrique Hernández-Lemus ehernandez@ 123456inmegen.gob.mx

                This article was submitted to Integrative Physiology, a section of the journal Frontiers in Physiology

                Article
                10.3389/fphys.2021.709438
                8578868
                34776994
                3489eb3a-495d-4cf8-a184-4adcdb4a1b2c
                Copyright © 2021 Martínez-García and Hernández-Lemus.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 13 May 2021
                : 28 September 2021
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 243, Pages: 26, Words: 23591
                Funding
                Funded by: Consejo Nacional de Ciencia y Tecnolog�a, doi 10.13039/501100003141;
                Award ID: 2115
                Award ID: 232647
                Award ID: 285544
                Funded by: Fundaciín Marcos Moshinsky, doi 10.13039/100012047;
                Award ID: CMM2016
                Categories
                Physiology
                Review

                Anatomy & Physiology
                periodontitis,systemic inflammation,systemic diseases,molecular mechanisms,chronic inflammation,cytokines,oral pathogens

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