Natural Bioactive Compounds in the Management of Oral Diseases in Nephropathic Patients

Abstract

Among the chronic non-communicable degenerative diseases (CDNCDs), chronic kidney disease (CKD) represents a global public health problem. Recent studies demonstrate a mutual cause-effect relationship between CKD and oral diseases, in which the presence of one induces the onset and faster progression of the other. In particular, the oral cavity alterations more frequent in CKD patients are: chronic periodontitis diseases, bone lesions, oral infections, and oral cancer lesions. Currently, a standardized therapy for the treatment of oral diseases is lacking. For this reason, natural bioactive compounds (NBCs), characterized by several health effects, such as antioxidant, antimicrobial, anti-inflammatory and anti-cancer actions, represent a new possible adjuvant therapy in the management of these pathological conditions. Among NBCs, polyphenols play a leading role due to positive modulation of oral microbiota, preventing and correcting oral dysbiosis. Moreover, these compounds exert anti-inflammatory effects, such as inhibiting the production of pro-inflammatory cytokines and the expression of cycloxigenase-2. In this light, the formulation of a new mouthwash/gel/gingival paste, with a high content of polyphenols in association with NBCs characterized by antimicrobial action, could represent a future therapy of oral disease in CKD patients.

Keywords: chronic kidney disease; chronic periodontitis diseases; oral microbiota; polyphenols; renal replacement therapy; special care dentistry.

Figure 1

Oral cavity alteration in chromic kidney disease (CKD) patients.

Figure 2

Natural bioactive compounds (NBCs) main actions in oral diseases.

Figure 3

Possible beneficial effects of natural bioactive compounds on oral diseases in chronic kidney disease patients. Abbreviations: AKT, protein kinase B; AMPK, AMP-activated protein kinase; IL-6, interleukin-6; IL-8, interleukin-8; MMPs, matrix metalloproteinases; mTOR, mammalian target of rapamycin; NF-κB, nuclear factor-κB; NOS, nitric oxide synthase; OS, oxidative stress; ROS, reactive oxygen species; TNF-α, tumor necrosis factor α.