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From Epithelial Barrier Disruption to Gingival Remodeling in Periodontitis: The Roles of Snail1 and Twist1 in Epithelial–Mesenchymal Transition
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Periodontitis is a chronic inflammatory disease initiated by dysbiotic biofilms and sustained by an altered host response, resulting in progressive destruction of the tooth-supporting tissues. Alongside immune-mediated damage, epithelial–mesenchymal transition has been proposed as a contributing mechanism in gingival barrier disruption and periodontal tissue remodeling. This narrative review examines the roles of the EMT-related transcription factors Snail1 and Twist1 in periodontitis, with particular focus on their involvement in epithelial junction loss, mesenchymal activation, and disease-associated tissue change. Relevant literature was identified through targeted searches of PubMed/MEDLINE and Google Scholar using terms related to periodontitis, gingival epithelium, EMT, Snail, and Twist, while selected non-periodontal studies were used only for mechanistic context where direct evidence was limited. Current findings suggest that periodontal disease is commonly associated with reduced epithelial adhesion markers and increased mesenchymal-associated markers, with Snail1 appearing more closely linked to epithelial repression and Twist1 to motility and matrix remodeling. However, the evidence remains largely preclinical or associative. Overall, Snail1 and Twist1 may participate in EMT-like remodeling in periodontitis, but periodontal-specific mechanistic and functional studies are still needed to clarify causality and clinical relevance.

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Publication Date
Tue Dec 27 2022
Journal Name
Journal Of Periodontal Research
Gingival tissue samples from periodontitis patients demonstrate epithelial–mesenchymal transition phenotype
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Abstract<sec><title>Objective

To determine the expression of key epithelial–mesenchymal transition (EMT) markers in gingival tissue samples collected from patients with periodontitis.

Background

Epithelial–mesenchymal transition is a process responsible for shifting epithelial‐phenotype to mesenchymal‐phenotype leading to loss of epithelial‐barrier function. Thus, EMT could be involved as a pathogenic mechanism in periodontitis as both conditions share common promoters and signalling pathways.

Materials and Methods

Gingival tissue samples were collected fro

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Publication Date
Tue Dec 27 2022
Journal Name
Journal Of Periodontal Research
Gingival tissue samples from periodontitis patients demonstrate epithelial–mesenchymal transition phenotype
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Publication Date
Thu Jul 04 2019
Journal Name
Journal Of Research In Medical And Dental Science
The Role of Epithelial Mesenchymal Transition Process in Inflammatory Gingival Hyperplasia
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Publication Date
Fri Apr 27 2018
Journal Name
Journal Of Periodontal Research
Potential role of periodontal pathogens in compromising epithelial barrier function by inducing epithelial‐mesenchymal transition
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Background and Objective

Epithelial‐mesenchymal transition (EMT) is a process by which epithelial cells acquire a mesenchymal‐like phenotype and this may be induced by exposure to gram‐negative bacteria. It has been proposed that EMT is responsible for compromising epithelial barrier function in the pathogenesis of several diseases. However, the possible role of EMT in the pathogenesis of periodontitis has not previously been investigated. The aim of this study therefore was to investigate whether gram‐negati

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Publication Date
Tue Nov 01 2022
Journal Name
Japanese Dental Science Review
Pathogenesis of periodontitis – A potential role for epithelial-mesenchymal transition
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Publication Date
Tue Nov 01 2022
Journal Name
Japanese Dental Science Review
Pathogenesis of periodontitis – A potential role for epithelial-mesenchymal transition
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Epithelial mesenchymal transition (EMT) is a process comprising cellular and molecular events which result in cells shifting from an epithelial to a mesenchymal phenotype. Periodontitis is a destructive chronic disease of the periodontium initiated in response to a dysbiotic microbiome, and dominated by Gram-negative bacteria in the subgingival niches accompanied by an aberrant immune response in susceptible subjects. Both EMT and periodontitis share common risk factors and drivers, including Gram-negative bacteria, excess inflammatory cytokine production, smoking, oxidative stress and diabetes mellitus. In addition, periodontitis is characterized by down-regulation of key epithelial markers such as E-cadherin together with up-regulation of

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Publication Date
Wed Mar 04 2026
Journal Name
Journal Of Molecular Pathology
From Dysbiosis to Tissue Destruction: Periodontal Pathogens as Inducers of Gingival Epithelial–Mesenchymal Transition (A Narrative Review)
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Periodontitis is a dysbiosis-driven inflammatory disease in which a pathogenic subgingival biofilm disrupts the host–microbe equilibrium and promotes progressive loss of tooth-supporting tissues. While periodontal destruction has traditionally been explained mainly through the host immune response, increasing experimental and clinical evidence suggests that epithelial–mesenchymal transition (EMT)-like changes in the gingival epithelium may contribute to barrier failure and tissue remodeling during disease progression. EMT is characterized by reduced epithelial adhesion and polarity, alongside a shift toward a mesenchymal-like phenotype with enhanced motility and impaired epithelial barrier function. This narrative review focuses

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Publication Date
Thu Jan 01 2026
Journal Name
Novel Research In Microbiology Journal
Turning Barrier Cells into Invaders: The Epithelial-Mesenchymal Transition Signature of Porphyromonas gingivalis
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Publication Date
Tue Sep 05 2017
Journal Name
Cell Adhesion &amp; Migration
Periodontal pathogens promote epithelial-mesenchymal transition in oral squamous carcinoma cells <i>in vitro</i>
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Publication Date
Thu Sep 13 2018
Journal Name
Baghdad Science Journal
The Prognostic Value of some Epithelial-Mesenchymal Transition Markers and Metastasis-Related Markers in Human Transitional Cell Carcinoma of the Bladder
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Recent reports provided evidence that epithelial to mesenchymal transition (EMT) and some matrix metalloproteinases (MMPs) contribute to the invasion and metastasis of cancer cells. This study investigated the expression pattern of some EMT markers (E-cadherin and Vimentin) and some MMPs (MMP-2 and MMP-9) in transitional cell carcinoma (TCC). Fifty five paraffin embedded biopsies were included in this study. Expression pattern of E-cadherin and Vimentin was evaluated by immunohistochemistry while cytoplasmic mRNA expression of both MMP-2 and MMP-9 were determined by in situ hybridization. The expression of all markers were significantly increased with the increase of patient's age (? 50 years), and furthermore an increase in men expression

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