Dental Infection and Diabetes: The Cycle
The negative effects of diabetes mellitus on the immune system have been extensively investigated. These effects impact greatly on the host’s ability to prevent the establishment of, and bring resolution to a variety of head and neck infections. The main etiologic factor in diabetes mellitus that leads to dysfunction in the immune system is hyperglycemia. All the major cell types involved in the immune defense are affected. Cellular elements of the innate immune system, including neutrophils and monocytes/macrophages, have altered function. In the neutrophils, functions such as adherence, chemotaxis, and phagocytosis may be down- regulated. This results in a less effective defense against a microbial challenge. The neutrophils from diabetic patients also produce less free oxygen radicals, which reduce their ability to make toxic metabolites for release against microbes. Monocytes and macrophages may have up-regulated catabolism of pro-inflammatory cytokines as well as incre...