This simple sugar may alleviate chronic gum disease

The simple sugar D-mannose may treat chronic gum disease by affecting how certain cells function, possibly changing gene activity related to immune response. This study was recently published in BMC Oral Health.

Furthermore, in animal models, D-mannose was found to reduce bone loss in the upper jaw caused by periodontitis, the authors wrote.

"D-mannose can alleviate chronic periodontitis in rats by regulating the functions of neutrophils, potentially associated with the expression of TET2 and glycolysis, providing new insights into the potential application of D-mannose to chronic periodontitis," wrote the authors, led by Xue Li of Fudan University in China (BMC Oral Health, November 1, 2024, Vol. 24, 1336).

To investigate the protective effects of D-mannose on chronic periodontitis, researchers analyzed 18 rats with periodontitis induced by lipopolysaccharide (LPS) that were given D-mannose orally. To assess how D-mannose protects against bone loss in the gums, they used methylene blue staining, hematoxylin and eosin staining, and micro-CT scanning.

Next, immunofluorescence (IF) and Western blot (WB) techniques were used to measure levels of inflammatory markers, including proinflammatory cytokines (interleukin [IL]-1 beta [IL-1β], IL-6, IL-17), anti-inflammatory cytokine (IL-10), tumor necrosis factor alpha (TNF-α), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), tet methylcytosine dioxygenase 2 (TET2), and key glycolysis enzymes (HK1, HK2, PFKFB3).

These methods also helped examine how D-mannose affected neutrophil recruitment and activity in the gums. Additionally, neutrophils from the healthy rats' blood were treated with LPS and D-mannose, and changes in the expression of IL-1β, IL-6, IL-17, IL-10, and TET2 were observed through IF, according to the study.

D-mannose reduced inflammation-related bone loss in rats with LPS-induced periodontitis. After D-mannose treatment, IF revealed a decrease in IL-17 (p <0.01) and TET2 (p <0.01) levels, while WB showed reduced IL-1β (p <0.05), IL-17 (p <0.05), and TET2 (p <0.01), according to the results.

Additionally, D-mannose lowered expression levels of several markers, including IL-1β (p <0.05), IL-6 (p <0.01), IL-17 (p <0.01), TNF-α (p <0.01), G-CSF (p <0.01), GM-CSF (p <0.01), TET2 (p <0.01), and key glycolytic enzymes (HK1, HK2, and PFKFB3) (all p <0.01).

Furthermore, D-mannose reduced the recruitment and activation of neutrophils in inflamed gum tissues. In cell-based experiments, IF analysis showed that D-mannose suppressed neutrophil activation by LPS, lowered IL-1β (p <0.05), IL-6, IL-17 (p <0.01), and TET2 (p <0.01), and increased IL-10 (p <0.01), according to the results.

However, additional research is needed to confirm how D-mannose affects glycolysis and TET2 in the treatment of periodontitis, the authors wrote.

"These findings indicated that D-mannose may be effective to alleviate the chronic periodontitis," they concluded.