Diabetes and Periodontal Disease: The Tryptophan Metabolism Link

Diabetes is a progressive and life-threatening disease with potentially devastating consequences for health. The associated complications are retinopathy, nephropathy, and neuropathy, altered wound healing and periodontal disease. Conditions which exhibit altered tryptophan metabolism are patients undergoing orthodontic treatment, patients with oral squamous cell carcinoma, renal failure, hypertension or diabetes and periodontal disease. The role of metabolites of tryptophan via kynurenine pathway has been speculated in type 2 diabetes due to its anti-insulin action. In this study the salivary levels of tryptophan and its metabolites were estimated to assess their impact on the severity of periodontal disease in diabetic individuals by High Performance Liquid Chromatography. This study showed that a relation existed between severity of periodontal disease and levels of salivary tryptophan and its metabolites. This may add an insight towards the development of periodontal disease in type 2 Diabetes mellitus individuals and kynurenergic agents may act as new treatment modalities for such cases.