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Mast Cell Stabilizers as Host Modulatory Drugs to Prevent and Control Periodontal Disease
Abstract
Introduction: Mast cells are among the first cells to get involved in periodontal inflammation. Their numbers have been shown to be increased in cases of gingivitis and periodontal disease.
The hypothesis: Since mast cell stabilizers like sodium cromoglycate (SCG) and nedocromil sodium (NS) have been used in the prophylaxis of bronchial asthma without any significant adverse effects and also the fact that drugs like SCG show significant anti-inflammatory activities, it would be logical to use mast cell stabilizers as host modulating drugs for the treatment and prevention of periodontal disease.
Evaluation of the hypothesis: Safety and efficacy of both SCG and NS are well documented. So, it will be systemically safe to use in humans. However, oral administration SCG or delivery of the drug by means local irrigation will not be very useful because SCG may not be secreted in the gingival crevicular fluid (GCF)(as in the case of oral administraion) or the drug may get washed out from periodontal pocket due to the constant flow of GCF(as in the case of irrigation). A local or targeted drug delivery of mast cell stabilizers can be used in patients with periodontal disease. Role of mast cells in periodontal disease has been dealt in-depth in many studies and articles. However, limited amount of research has been done on using mast cell stabilizers in the prevention and control of periodontal diseases. More studies are needed to study the efficacy and effectiveness of mast cell stabilizers as an adjunct to phase I therapy in the control of periodontal disease.
Key words: Mast cell stabilizers; Periodontal disease; Host modulation; Local drug delivery.
doi:10.5436/j.dehy.2011.2.00018
References
Preshaw P M. Host response modulation in periodontics. Periodontol 2000 2008; 48:92-110.
doi:10.1111/j.1600-0757.2008.00252.x
PMid:18715360
Kirkwood KL, Cirelli JA, Rogers JE, Giannobile WV. Novel host response therapeutic approaches to treat periodontal diseases. Periodontol 2000 2007; 43:294-315.
doi:10.1111/j.1600-0757.2006.00166.x
PMid:17214846 PMCid:2570321
Batista AC, Rodini CO, Lara VS. Quantification of mast cells in different stages of human periodontal disease. Oral Diseases 2005; 11: 249-54.
doi:10.1111/j.1601-0825.2005.01113.x
PMid:15984957
Walsh LJ. Mast cells and oral inflammation. Crit Rev Oral Biol Med 2003;14:188-98.
doi:10.1177/154411130301400304
Naesse, E. P., Schreurs, O., Helgeland, K., Schenck, K. & Steinsvoll, S. Matrix metalloproteinases and their inhibitors in gingival mast cells in persons with and without HIV-infection. J Periodontal Res 2003; 38: 575–82.
doi:10.1034/j.1600-0765.2003.00687.x
PMid:14632920
Steinsvoll S, Helgeland K, Schenck K. Mast cells-a role in periodontal diseases? J Clin Periodontol 2004; 31:413-19.
doi:10.1111/j.1600-051X.2004.00516.x
PMid:15142208
Steinsvoll S. A 35-year-old man with aggressive periodontitis. Tidsskr Nor Laegeforen. 2006; 126(5):613-14.
PMid:16550641
Mehta A, Sequeira PS, Sahoo RC, Kaur G. Is bronchial asthma a risk factor for gingival diseases? A control study. NY State Dent J 2009; 75:44-6.
PMid:19280828
Bhatavadekar NB, Williams RC. New direc-tions in host modulation for the management of periodontal disease. J Clin Periodontol 2009; 36:124-6.
doi:10.1111/j.1600-051X.2008.01354.x
PMid:19207887
Steinbacher DM, Glick M. The dental patient with asthma. An update and oral health considerations. J Am Dent Assoc 2001; 132:1229-39.
PMid:11665347
Walsh LJ, Savage NW, Ishii T, Seymour GJ. Immunopathogenesis of oral lichen planus. J Oral Pathol Med 1990; 19:389-96.
doi:10.1111/j.1600-0714.1990.tb00866.x
PMid:2269934
Nuki K, Farnoush A. The inhibition of mast cell degranulation in monkey gingiva by dis-odium cromoglycate. J Periodontal Res 1975; 10:282-7.
doi:10.1111/j.1600-0765.1975.tb00035.x
PMid:129550
Jeffcoat, Williams RC, Johnson HG, Wechter WJ, Goldhaber P. Treatment of periodontal disease in beagles with Iodozamide ethyl, an inhibitor of mast cell release. J Periodontal Res 1985; 20:532-41.
PMid:2934538
Raud J, Konrad D, Dahlén SE. Delayed anti-inflammatory action of nedocromil sodium in the rat paw is dependent on de novo protein synthesis. Eur J Pharmacol 1995;282:207-11.
doi:10.1016/0014-2999(95)00327-H
Andrea Mombelli. Antibiotics in periodontal therapy. In: Niklaus P. Lang,Jan Lindhe, editors: Clinical periodontology and Implant dentistry, 5th edition. Oxford: Munksgaard, 2008:882-93.
Illum L, Jørgensen H, Bisgaard H, Krogsgaard O, Rossing N. Bioadhesive microspheres as a potential nasal drug delivery system. Int J Pharm 1987;39:189-99.
doi:10.1016/0378-5173(87)90216-X
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