Tumor Necrosis Factor-α and Interleukin-6: Potential Interorgan Inflammatory Mediators Contributing to Destructive Periodontal Disease in Obesity or Metabolic Syndrome

Figure 1

A biological working model on the onset of destructive periodontal disease in obesity and metabolic syndrome adapted from Nishimura et al., 2003 [8]. This scheme represents a potential working model in which the systemic elevated levels of TNF-α in obesity and metabolic syndrome potentially contribute to the onset and development of destructive periodontal disease. Specifically, the elevated levels of systemic inflammatory mediators, such as TNF-α or IL-6, in obesity or metabolic syndrome enhance the host response to periodontal pathogens hence increase the chance to develop destructive periodontal disease. In destructive periodontal disease, periodontal pathogens induce inflammation prompting the destruction of connective tissues and bone in the periodontium. The connections between destructive periodontal disease and systemic conditions, such as obesity, are complex and often multidirectional; the working model presented here is a simplified picture of these connections.