The Process of Acclimation to Chronic Hypoxia Leads to Submandibular Gland and Periodontal Alterations: An Insight on the Role of Inflammatory Mediators

Figure 8

Proposed mechanism that leads to hyposalivation (a) and alveolar bone resorption (b) during exposure to intermittent hypoxia. The schemes contain the molecular mediators analyzed in this study (PGE₂, HIF-1α, and AQP-5: full arrow). However, multiple factors not included in the study participate in salivary secretion and alveolar bone metabolism, such as NF-κB and COX-2 (dotted arrow). We hypothesize that more degradation of HIF-1α due to the intermittent normoxic periods in the CIH group would be related with upregulation of NF-κB, leading to higher concentrations of PGE₂, which is associated with lower levels of saliva and osteoclast genesis and activity. Furthermore, the decreased levels of saliva would constitute an indirect mechanism which increases alveolar bone resorption.

(a)

(b)