Fig. 2.

Mechanism underlying β-cell dysfunction induced by periodontitis-derived virulence factors. a β-cell compensation. Virulence factors promote insulin synthesis and secretion. b β-cell decompensation. Virulence factors induce β-cell transdifferentiation or apoptosis, leading to β-cell decompensation. Black arrows represent activating events; red arrows represent inhibitory events. INS1 insulin gene 1, INS2 insulin gene 2, TLRs Toll-like receptors, IL-1β interleukin-1β, IL-6 interleukin-6, STAT3 signal transducer and activator of transcription 3, HIF1α hypoxia inducible factor 1α, NF-κB nuclear factor κB, PAI1 plasminogen activator inhibitor-1, MEK MAP kinse-ERK kinase, ERK extracellular regulated MAP kinase, IL-12 interleukin-12, H3K4me3 histone 3 trimethylated at lysine 4, DNMT1 DNA methyltransferase 1, PDX1 pancreatic and duodenal homeobox 1, NKX6.1 NK6 homeobox 1, Bid BH3 interacting domain death agonist, Bax Bcl-2 associated X