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Role of endocrines - sex hormone
1.
2. Role of endocrines -
Sex hormones
Abhay kumar das
PGT 1st year
GUIDED BY :-
DR SMITHA C N
DR MUDIT MITTAL
DR VISHAL SINGH
DR AMIT SINHA
DR ABU NAFE
3. .
The endocrine system is the
collection of glands that
produce hormones that
regulate metabolism, growth
and development, tissue
function, sexual function,
reproduction, sleep, and mood,
among other things
Hormones chemical
messengers which travel through
the body
Effects the target cells in other
organ.
7. SOURCE HORMONE TARGET TISSUE PRINCIPLE
FUNCTION
PERIDONTIUM
HYPOTHALAMUS Prolactin inhibiting
hormone
(dopamine)
ANTERIOR PITUITARY GLAND INHIBITS PROLACTIN
RELEASE
Stimulates periodontal ligament
cell proliferation
ANTERIOR
PITUITARY
Growth hormone
(somatotropin)
Bone, soft tissues and
liver
Promotes growth,
affects lipids and
carbohydrate
metabolism
Presence of growth hormone
associated with protective
effect on periodontium
THYROID Thyroid hormones
(tri
iodothyrosine,
thyroxine)
Most cells of body Regulators of
numerous tissues
including cardiac
and brain involved
with growth and
metabolism
Deficiency may be associated
with destructive periodontal
Diseases
ADRENAL Cortisol,
Weak androgens
and estrogens
Most tissues of body
Sex accessory tissues
Important for
glucose, protein and
lipid metabolism
Low potency of
secreted hormones
diminishes effects
on target tissues
Excess cortisol associated with
destructive periodontal diseases
Known effects on periodontal
tissues including growth as
well as disease progression
PANCREAS Insulin (β cells) Skeletal muscle, liver,
adipose tissue
Lowers the blood
glucose, fatty acid
and amino acid
levels
Decreased insulin production
associated with destructive
periodontal diseases
PARATHYROID PARATHYRIOD
HORMONE
BONE, KIDNEYS,INTESTINE Increases plasma
calcium
Decreased cortical bone density
and increased PDL width no
effect on periodontal
parameters
8. Effects of central endocrine gland
hormones on the periodontium
– Britto et al 2011- LIMITEDEVIDENCE
– M. Partovi et al in 2002
11. Adrenal gland hormones
The hormones produced by the adrenal cortex include mineralo- carticoid
hormones e. g., Aldosterone, Glucocorticoid, hormones e. g., cortisol, gonodal
hormones e. g.,dehydro-epi-androsterone
12. Effects of adrenal gland hormones
on the periodontium
Association between elevated cortisol levels and periodontitis were
demonstratedby clinical studies by Rosania et al and Rai et al in 2009 and 2011.
By
Potential psycho-neuro-immunologicmechanism
Potential behaviouralmechanism
13. Potential psycho-neuro-immunologic
mechanism
Negative emotion
Polypeptides from sympathetic nor adrenaline transmittingand sensory
nerve fibres and from endocrineglands
+
Bacterial antigens trigger immuneresponses
Hypothalamus release corticotropic
hormone
Adreno-carticotropic hormone frompituitary
Adrenal cortexrelease
Cortisol
14. Short term elevations of cortisol reduce inflammation andmobilize immune
components
Glucocorticoids(cortisol)
Decreases immunocompetency by inhibition of IgA, IgGand
neutrophil function.
15. Potential behaviouralmechanism
The higher cortisol and β endorphin concentrations significantly up
regulates expression of MMP-1,2,7,11 and TIMP-1 inhuman gingival
fibroblasts
Increased periodontalbreakdown
Periodontitis
Patricia et al 2007
16. • Various kinds of psychologic stress activate HPA (hypothalamus Pituitary
Aderno cortical) system and SM (sympathetic aderno medullary) system and
consequently induce significant increasesin salivary cortisol and
catecholamine levelsrespectively
• Chromagranin A released by exocytosis from the sympatheticnerve endings
20. The resorption of calcium from bones by PTH isby
Rapid phase
Slow phase
CALCIUM REGULATION
21. Rapidphase
After reaching bone
PTH gets activated to receptors on cell membrane ofosteoblasts
and osteoclasts
Hormone receptor complex
Increases permeability of membranesof these cells forca-ions
Accelerates ca-pumpmechanism
Ca-ions move to bone cells into blood at fasterrate
22. Slowphase
When Osteoclasts are activated by PTH
Lysosomes release enzymes and citric acid and lactic
acid
These substances dissolve organic matrix ofbone
releasing ca ions
Ca ions release to plasma
23. Effect of parathyroid gland hormone on
periodontium
Decreased cortical bone density and increased PDL width no
effect on periodontal parameters
25. Action of sex steroid hormoneson
periodontium
Sex steroid hormones
Microbiota immunecells
Cells of theperiodontium
Altered gene expression Changes
in clinicalphenotype
26. Proposed mechanisms
Sex steroid induced increase in specificmicrobiota
kumare et al in 2013 Immune
Endocrine interactions exaggerateperiodontal responses
Shiau, Reynolds in 2010 Specific
Populations of fibroblasts and epithelial cellsare modulated by
sex steroidhormones:
Mariotti. In1994
27. Sex steroid hormones and the cells
of periodontium
Hormone Fibroblasts
Androgens
(testosterone &
hydrotestosterone)
Decreaseproliferation
DecreaseIL-6 production
Progesterone Decreaseproliferation
Decreaseprotein synthesis Decrease
cytokineproduction
Estradiol Increaseproliferation
Increase cytokine production Increase
growthfactor
29. GENDER
Studies by Lau et al 2001 showed that gender plays an important
role in changes associated with bone density throughout the
entireskeleton.
It was showed that 80% of decreased bone density patients were
females.( 80% osteoporotic patients werefemales)
30. Regarding periodontal anatomicdifferences:
Residual ridge height was lower in women compared to men
Decreased amount of estrogen in post menopausal women was
associated with decreased crestal/subcrestalbone density
31. Age
With regard to age, females undergo more biologicchanges
(hormonal imbalances)compared to males such as during puberty,
menstrual cycle, pregnancy,menopause
32. Hormonesupplements
These are common used drugs that stimulatesa state of
pregnancy to preventovulation.
HRT (HORMONEREPLACEMENT THERAPY) has helped in overcoming
bone loss in menopausal women, it also has been associated with
side effects like thromboembolism, irregular bleeding, fear of
cancer,.
33. Longitudinal studies have examined the transformation of
subgingival flora from pre puberty to puberty and have
demonstrateda significant increase in the frequencyof
Eikenella corrodens,
Prevotella Intermedia,
Bacteroides melaninogenicus,
Prevotella nigrescens,
34. Etiology of gingival responses to elevated
estrogen & progesterone duringpregnancy
Subgingival plaquecomposition
Maternalimmuno-response.
Sex hormoneconcentration
35. Pancreatic hormones
Effect of pancreatic hormoneson periodontium
The metabolic disturbancesand the resulting disease
sequallae of diabetes mellitus are ultimately the result of a completeor
partial reduction in insulin secretion from the β cells
36. Oralmanifestations
Oral changes described in diabetic patientsincluding
Cheilosis
Mucosaldrying
Cracking
Burning mouth andtongue
Diminished salivary flow
Altered oral cavityflora
38. Mechanisms of diabetic influenceon
periodontium
These are primarily related to changes in
GCF glucose level Periodontal
vasculature Collagen
metabolism.
The subgingivalmicrobiota
40. References
Newmann, Takei, Klokkevold, Fermin ACarranza: Carranza’s
clinical Periodontology: 10th Ed: Saunders, Elsevier
Britto IM et al , JCP 2011:38:525-531
Partovi et al. Mitogenic effect of L dopa on human periodontal
ligament fibroblast cells: Jour ofEndodontics. Vol 28(3): 193-196
Eriksen. Cellular mechanism of bone remodelling:Rev Endocr.
Metab Disord 2010: 11:219-227
Amy Romania et al: stress, depression, cortisol and periodontal
disease. J periodontol 2009: 80:260-266
Depression: Psychiatric clinics of North America.March 2012: 35: 1
41. references…
Glassman et al: where there is depression there is inflammation.Biol Psychiatry
2007: 62:280
Kaufman et al: Analysis of saliva for periodontal diagnosis- Areview: JCP 2000: 27:
453-465
Johanssen et a: Dental plaque, gingival inflammation and elevated levels of
IL-6 and cortisol in GCF from women with stress related depression and
excusion: J Periodontol 2006:77:1403
Balwanth Rai et al: salivary stress markers,stress and periodontitis:A
pilot study . J Periodontol 2011: 82:287-292
Patricia R Cury et al: hydrocortisone affects the expression of MMP- 1,2,3,7,11 and
tissue inhibitor of matrix metalloproteinases TIMP-1in human gingival fibroblasts:
J Periodontol 2007: 78:1309-1315
Peruzzo et al. Systemic review of stress and psychological factors as possible
risk factors for periodontal disease. J Periodontol 2007: 78: 1491-1504
42. references…
Persson RE, Hollender et al. assessment of periodontal conditionsand systemic
disease in older subjects. Focus on osteoporosis: J Clin Periodontol 2002: 29:796-
802
Frankenthal S et al: the effect of the secondary hyperthyroidismand
hemodialysis therapy on alveolar bone and periodontium:J Clin Periodontol
2002: 29:479-483
Barros et al: parathyroid hormone protects againstperiodontitis
associated bone loss: J Dent Res 2003: 83:791
Marriotti A: Sex steroid hormones and cell dynamicsinthe
periodontium. Crit Rev Oral Biol Med 1994:5:27-53
Liang et al: effect of estrogen receptor β on osteoblasticdifferentiation function of
human periodontal ligament cells: Arch Oral Biol 2008: 53:553-557
Tang et al: Up regulation of estrogen receptor β expressionduring osteogenic
differentiation of human periodontal ligament cells. J Periodontol Res ;2008:
43:311-321
