Host Modulation, Diabetes, and Periodontal Disease

In discussing host modulation, scientists refer to the inoculation of healthy individuals with weakened or attenuated strains of disease-causing agents to protect against disease.22 A good example of an attenuated (weakened) virus that serves as a successful vaccine is the influenza vaccine which first became available in 1945. Manipulation of the immune response is desirable in diseases like graft rejection, autoimmunity and allergy, and it aids the host in fighting against infectious agents like periodontal pathogens. Individuals with diabetes get a double dose of inflammatory cascades or events that lead to a host response because the host is not only reacting to the periodontal pathogens but to a prolonged response to hyperglycemia. As we already know, hyperglycemia is often the result of an immune-mediated destruction of islet beta cells of the pancreas. A genetic predisposition in patients with type 1 diabetes contributes to this immune destruction. Type 1 diabetes develops as a result of immune-mediated destruction. In latent autoimmune diabetes in adults (LADA), “The underlying immune-mediated destruction of beta cells in patients with LADA leads to insulin dependency more rapidly than in type 2 diabetes, but the more attenuated genetic and immune factors associated with LADA compared with type 1 diabetes lead to an older age at onset and a slower progression to insulin dependency.”23 The development of type 2 diabetes may have some genetic etiology but is thought to be a combination of genetic predisposition, lifestyle, and environmental factors.