Efficacy of Photobiomodulation and Metformin on Diabetic Cell Line of Human Periodontal Ligament Stem Cells through Keap۱/Nrf۲/Ho-۱ Pathway

Background: Diabetes mellitus (DM) is a metabolic disorder resulting from hyperglycemia. Hyperglycemia contributes to oxidative stress, and the release of advanced glycation end products (AGEs) further promotes disease pathogenesis. Uncontrolled diabetes reflects great oral complications and affects human oral health. So, the present study aimed to assess the effects of photobiomodulation therapy (PBMT) and Metformin on proliferation and viability of human periodontal ligament stem cells (HPDLSCs) cultured in high glucose medium. Methods: HPDLSCs were collected, isolated, and characterized and then divided into eight groups. Addition of extra glucose to diabetic groups ۲۴ hours before cell irradiations. Metformin was added to half of the diabetic groups. Cells were irradiated with ۸۰۸ nm diode laser ۲۴, ۴۸ hours. Cell viability was analyzed with MTT assay ۲۴ hours post-irradiation to detect cell viability in each group. Real-time (PCR) was used to evaluate gene expression of Nrf۲, Keap۱, PIK۳, and HO-۱ and the effect of PBMT on Keap۱/Nrf۲/Ho-۱ Pathway. ELISA reader was used to evaluating cell viability through (ROS, TNF-α, IL-۱۰) protein levels after cell irradiation. Results: Photobiomodulation at ۱, ۲, and ۳ J/cm۲ combined with metformin significantly promoted diabetic cell lines of HPDLSCs viability (in MTT assay and ELISA reader of ROS, TNF-α, IL-۱۰ results) and gene expression of Nrf۲, Keap۱, PIK۳, and HO-۱ levels (p< ۰.۰۵). Conclusions: photobiomodulation with ۳ J/cm۲ combined with metformin enhanced proliferation and viability of diabetic cell lines of HPDLSCs and thus could improve differentiation and function of diabetic cell lines of HPDLSCs with minimum side effects.  

Keywords:

Diabetes Mellitus , Metformin , Periodontal Ligament Stem Cells , Photobiomodulation