A prospect of chitosan-crosslinked collagen and recombinant human acidic fibroblast growth factor in diabetes and periodontal disease patients

Diabetes mellitus is a systemic disease due to the increase of blood sugar levels which occur because of the abnormalities in insulin secretion, insulin action, or both. This is the risk factor of periodontal diseases.The prevalence of diabetes mellitus is increasing rapidly throughout the world, compounded by the healing process of the wounds in diabetic patients. In addition to that, changes in the process of wound healing are common problems among those with diabetes. In periodontium there are main cells, namely fibroblasts, which are unable to function in environments with high sugar levels. Besides, the collagen produced by fibroblasts is susceptible to the damage of matrix metalloproteinase (MMP)-enzyme which will significantly increase in diabetic patients. The purpose of this study is to review the potential of chitosan-crosslinked collagen with recombinant human acidic fibroblast growth factor (aFGF) as the accelerator in diabetic patients affected by periodontitis.The process of healing periodontal tissue wounds is different in people with ongoing hyperglycaemia, resulted in increased bone loss and periodontal tissue attachment loss. One of the main characteristics of diabetes complications is changes in microvascular integrity. Previous study saidthat acidic and basic fibroblast growth factors (aFGF and bFGF or FGF-1 and FGF-2) have a high enough biological activity stimulating the proliferation of fibroblasts and cells in capillary endothelium which can help the process of angiogenesis in wound healing, yet the execution of this therapy is not always successful due to the high diffusibility and short half-life.Previous studies showed that to stabilize the growth factors delivery locally in injured tissue, FGF can be applied to accelerate healing. When FGF is added to the chitosan hydrogel, the produced biological effect is good and the vascularity effect increases both significantly and sustainably. Chitosan-crosslinked collagen with recombinant human acidic fibroblast growth factor (aFGF) may possessed potential accelerator in diabetic patients affected by periodontitis.