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It is widely reported that hyperglycemia causes numerous systemic changes, including altered innate immune\u2010cell function and metabolic changes. The aim of this review was to summarize and discuss the evidence for mechanisms that probably play a role in the altered local inflammatory reactions in the periodontium of patients with diabetes, focusing on local changes in cytokine levels, matrix metalloproteinases, reactive oxygen species, advanced glycation end\u2010products, immune\u2010cell functions, the <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content>\/osteoprotegerin axis and toll\u2010like receptors. Apart from the systemic effects of diabetes, recent evidence suggests that local changes in the periodontal tissues are characterized by enhanced interactions between leukocytes and endothelial cells and by altered leukocyte functions [resulting in increased levels of reactive oxygen species and of proinflammatory cytokines (interleukin\u20101\u03b2, interleukin\u20106 and tumor necrosis factor\u2010\u03b1)]. These local changes are amplified by the enhanced accumulation of advanced glycation end\u2010products and their interaction with receptors for advanced glycation end\u2010products. Furthermore, the increased levels of proinflammatory cytokines lead to an up\u2010regulation of <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content> in periodontal tissues, stimulating further periodontal tissue breakdown.<\/jats:p>","DOI":"10.1111\/prd.12089","type":"journal-article","created":{"date-parts":[[2015,8,7]],"date-time":"2015-08-07T21:04:16Z","timestamp":1438981456000},"page":"221-254","source":"Crossref","is-referenced-by-count":75,"title":["Local inflammatory reactions in patients with diabetes and periodontitis"],"prefix":"10.1111","volume":"69","author":[{"given":"Sarah 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