GLUCOSE MODULATES GROWTH OF GINGIVAL FIBROBLASTS AND PERIODONTAL-LIGAMENT CELLS - CORRELATION WITH EXPRESSION OF BASIC FIBROBLAST GROWTH-FACTOR

Diabetes mellitus is a systemic disease with profound effects on oral health and periodontal wound healing. Uncontrolled diabetes adversely affects surgical wound healing and is often associated with abnormal p roliferation of fibroblasts, excessive angiogenesis and poor bone rege neration. Human gingival fibroblasts and periodontal ligament cells fr om both diabetics and non-diabetics were evaluated for growth response s following culture in 20 mM glucose, a concentration compatible with blood glucose levels in uncontrolled diabetics. Gingival fibroblasts d erived from 9 non-diabetic patients and 3 insulin-dependent diabetics either proliferated or showed little change of growth in elevated gluc ose. Enhanced proliferation was observed following 1 wk of culture in glucose. Growth of periodontal ligament cells from 5 non-diabetic pati ents was inhibited by 20 mM glucose. Fibroblasts that were markedly gr owth stimulated were probed for expression of basic fibroblast growth factor (bFGF) using a reverse-transcribed polymerase chain reaction (R T-PCR). Results indicate that fibroblasts exhibiting the greatest incr ease in growth in response to high glucose also exhibited increased ex pression of bFGF. No changes were observed in mRNA expression for plat elet-derived growth factor-AA, platelet-derived growth factor-BB, insu lin-like growth factor and transforming growth factor-beta(1). Mitogen ic effects induced by the cytosol of fibroblasts exhibiting increases of growth in 20 mM glucose were abrogated by neutralizing antibodies t o bFGF. In addition, some periodontal ligament cells that were growth inhibited by high glucose had reduced expression of bFGF. These data s uggest that bFGF may play a role in the abnormal wound healing associa ted with periodontal surgery of uncontrolled diabetics.