Tumor necrosis factor alpha and interferon gamma--induced cell growth arrest is mediated via insulin-like growth factor binding protein-3

Retinoic acid (RA), and the combination of TNFalpha and Interferon (IFN-gamma) inhibit human salivary gland tumor (HSG) cell growth with the combination of all three being even more inhibitory (P<0. 05). Previous studies have demonstrated that these inhibitory effects of RA, and the combination of TNFalpha and IFN-gamma are associated with increased accumulation of IGFBP-3 in the culture medium of HSG cells. Therefore, we set out to determine if the increase in IGFBP-3 was due to increased production of IGFBP-3 by the cells and whether IGFBP-3 played a causative role in the inhibition of cellular proliferation. TNFalpha and IFN-gamma induced a rise in IGFBP-3 mRNA levels between 4 and 8 h, which returned to control levels after 24 h. IGFBP-3 was shown to inhibit HSG cell growth at concentrations of >/=75 U (P<0.05). When antibodies to IGFBP-3 were used with TNFalpha and IFN-gamma, the inhibitory effect of the cytokines on cell growth was diminished. Retinoic acid with TNFalpha and IFN-gamma had a marked inhibitory effect (P<0.05) which was similarly reversed by increasing concentrations of IGFBP-3 antibody. The present data support the hypothesis that the combination of TNFalpha and IFN-gamma with retinoic acid exert their anti-proliferative effect on HSG cells by reducing the mitogenic effect of IGF-I due to a shift in IGF-I from the free to the IGFBP-3-bound form.

Increased odds ratio for COVID-19 in patients with recurrent aphthous stomatitis

The ACE2 receptor, the binding sites for the COVID-19, is expressed abundantly in the oral cavity, raising the question of whether the mouth is a target for the virus in addition to organs such as kidneys and lungs. Recently, a flurry of individual case reports on oral manifestation of COVID-19 including ulceration, blistering lesions, and stomatitis were published. However, it is not clear whether the oral presentations that are not unique to the virus are indeed related to the virus and appear at a higher prevalence than in the general population. We used the i2b2 platform of hospital patient's registry to determine the odds ratio for COVID-19 in patients that were diagnosed with recurrent aphthous stomatitis, an entity restricted to the oral cavity. The overall odds ratio for COVID-19 in patients with recurrent aphthous stomatitis before adjustments was 14 and after adjustment for gender, race, and age was 13.9, 6.5, and 2.93, respectively. The odds ratio remained increased after adjustments of the comorbidities such as respiratory disease, endocrine disease, obesity, diabetes, circulatory disease, and smoking and was 3.66, 7.46, 4.6, 10.54, 7.37, and 7.52, respectively. When adjusted for recurrent aphthous stomatitis, the respiratory disease had an odd ratio of 8.56 to be associated with COVID-19. African American race and age-group 18-34 were additional significant risk factors. The present study has demonstrated a significant association between COVID-19 and RAS; however, additional longitudinal and laboratory studies are necessary to establish a cause and effect relationship between these 2 conditions.

The impact of HPV vaccination on the prevalence of oropharyngeal cancer (OPC) in a hospital-based population: A cross-sectional study of patient's registry

BACKGROUND

Human papillomavirus (HPV) vaccines have been used for the prevention of cervical cancers, and their clinical efficacy has not been well established in the prevention of oropharyngeal cancer (OPC), in spite of the common viral etiology. Therefore, they are still not routinely prescribed for the prevention of this cancer.

METHODS

We have used the i2b2 data repository to analyze the interrelations between the hospital population, OPC, vaccinated patients, and patients that were both vaccinated and developed OPC.

RESULTS

From a total hospital population of 1 310 334 patients, 23 174 (1.76%) patients were vaccinated for HPV. One third were males, and two thirds were females. The total number of OPC was 4380 (0.3%) from the total population, of which 3013 (69%) were men. The highest prevalence of OPC was found in the age-group of 65-74 (37% of all cases). Four patients (0.017%) of the vaccinated group had developed OPC. Patients who were not vaccinated for HPV had a 19 times increased risk of developing OPC compared with those who were vaccinated (RR 19.3657, 95% CI 7.2655 to 51.6177, P = .0001). The risk was increased in both sexes. The RR in the male group was 23.8 (P = .0015, 95% CI) and in the female group 9.34 (P = .0001, 95% CI 3.0110 to 29.0121). The age distribution in the OPC group was significantly different from the age distribution in the HPV-vaccinated group (P = .0418) by Mann-Whitney test. 4376 non-vaccinated patients have developed OPC.

CONCLUSIONS

The present study showed that HPV-vaccinated group had a reduced prevalence of OPC compared with the non-vaccinated group.

Trismus in a 6 year old child: a manifestation of leukemia?

Trismus is a firm closing of the jaw due to tonic spasm of the muscles of mastication from disease or the motor branch of the trigeminal nerve. Trismus may be produced by a variety of reasons such as dental abscess, trauma, following mandibular block with local anesthesia, as a result of radiation to the facial muscles, and patients after chemotherapy. A case of a referral of a six-year-old boy to a dentist from an ENT due to severe limitation in jaw opening is presented. Intraoral examination and panoramic radiograph demonstrated no signs of infection and/or other pathology. After a diagnosis of trismus was made, due to his icteric appearance, the general fatigue and loss of appetite in the last few days, palpated and sensitive lymph nodes in the submandibular and cervical regions, the child was referred for a complete blood count and sedimentation rate. The laboratory and clinical findings resulted in the diagnosis of acute lymphoblastic leukemia (ALL). Dental and oral manifestations of ALL are discussed, and the trismus may be explained by an intensive infiltration of leukemic cells into the deep portion of the contracting muscles of the face. This case emphasizes the importance of physical examination and independent judgement made by dentists, even when patients are referred to them by other members of the medical communities.

Relationship of blood glucose level to community periodontal index of treatment needs and body mass index in a permanent Israeli military population

BACKGROUND

The goal of this study was to find a possible link between blood glucose levels and periodontal disease.

METHODS

In a prospective study the dental health of 10,590 military service men and women was examined. The relationships of periodontal condition, expressed as CPITN index, and blood glucose levels were tested. The effect of gender, body mass index (BMI), and smoking was also evaluated.

RESULTS

Blood glucose levels were significantly and positively associated with severe periodontal disease, men, and higher BMI. Smoking did not affect blood glucose levels.

CONCLUSIONS

Blood glucose levels might be associated with severe periodontal disease.

Oral squamous cell carcinoma positive for p16/human papilloma virus in post allogeneic stem cell transplantation: 2 cases and review of the literature

Complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) includes the risk of secondary malignancies. This may be related to mechanisms including radiation and chemotherapy regimens, chronic graft-versus-host disease, inflammation, and prolonged imunosuppression. Oral squamous cell carcinoma (OSCC) is a complication associated with chronic graft-versus-host disease after allo-HSCT. Although human papillomavirus (HPV) is known to be associated with OSCC, the role of HPV in development of OSCC in post-HSCT patients has not been studied. We identified 2 cases of OSCC in allo-HSCT recipients. Both biopsy specimens tested positive for p16(INK4A), a surrogate marker for HPV. We propose that the association of OSCC and HPV in patients after allo-HSCT may not be incidental. Clinical implications of these cases may imply the need for a HPV screening, early intervention, and consideration of anti-HPV vaccination in this population. The effectiveness of such interventions could be validated in a prospective clinical study.

Cytokines modulate interleukin-6 production by human salivary gland cell line

The ability of HrTNF-alpha, HrIL-1 beta, and HrIFN-gamma to modulate IL-6 production by cultured human salivary cell line (HSG) was examined. IL-6 activity was measured by the hybridoma growth factor biologic activity. HrTNF-alpha had a significant dose-dependent effect, whereas HrIL-1 beta and HrIFN-gamma had moderate and minor effects, respectively. Maximal effect (920 units) was noted when cytokines were applied in combination (1000 units HrIFN-gamma and 20 units HrTNF-alpha) and incubated with human salivary gland cells for 72 hr. The same combination of cytokines had also a marked inhibitory effect (70% of control) on human salivary gland cell growth. This is the first report of these concomitant phenomena in a human cell line originating from salivary tissue.

IGF-1 and insulin receptor expression in the minor salivary gland tissues of Sjögren's syndrome and mucoceles--immunohistochemical study

OBJECTIVE

To investigate the expression of IGF-1 receptors and insulin receptors on the minor salivary gland (MSG) tissues of patients diagnosed with Sjögren's syndrome (SS) and normal salivary gland tissue surrounding mucoceles.

SUBJECTS AND METHODS

Five MSG tissue sections from SS and seven from mucocele patients were stained immunohistochemically using antibody to IGF-1 receptor and insulin receptor in a horse radish peroxidase and DAB system.

RESULTS

The expression of the insulin receptor was increased in the SS sections compared with controls, while the insulin-like growth factor-1 receptor was more intensely expressed in the controls.

CONCLUSION

The presence of differential expression of receptors for IGF and insulin might suggest a possible role of these growth factors in the pathogenesis of SS.

Gingival and other oral manifestations in measles virus infection

BACKGROUND

Measles is a highly contagious, viral infectious disease affecting mainly children and young adults. It is characterized by high fever, maculopapular rash, keratoconjunctivitis and pathognomonic oral Koplik's spots.

METHODS

During an outbreak of measles among soldiers in the Israeli military, patients were referred to one medical center where they were also examined for oral signs and symptoms of their illness.

RESULTS

We present a case of measles infection with distinct oral findings. These included Koplik's spots, various forms of ulcerations of the free mucosa, -like gingivitis and pericoronitis. All oral lesions resolved after cessation of systemic illness.

CONCLUSIONS

The measles virus is associated with a transient inhibition of the host response. Immunosuppression may create the necessary condition for the proliferation of pathobacteria associated with the observed pericoronitis and the other gingival lesions.

Recurrent oral ulcerations associated with recurrent herpes labialis--two distinct entities?

We investigated the prevalence of recurrent aphthous ulcerations (RAU) and recurrent herpes labialis (RHL) in a young adult population. The study group consisted of 20,689 soldiers (aged 18-21 years, mean 19.8 +/- 1 years). There were 14,991 men and 5,698 women. Every patient was asked to complete a self-report health questionnaire which requested information about the occurrence of either RAU or RHL. Data were analyzed using the chi-square test, and the odds ratio was also determined. The prevalence of RAU and RHL was 6.2% and 5.4%, respectively. The prevalence among women was significantly higher (P<0.001), than among men for both RAU (7.1% and 5.8%, respectively) and RHL (6.8% and 4.9%, respectively). Among women, the chance of having RAU for those who were RHL positive was 6.88 greater than for those RHL negative. Among men, the chance of having RAU for those who were RHL positive was 12.37 greater than for those RHL negative. In women, the chance of having RHL for those who were RAU positive was 6.88 greater than for those who were RAU negative. In men, the chance of having RHL for those who were RAU positive was 12.37 greater than for those who were RAU negative. It is concluded that a similar underlying pathological process or unknown cofactor may be involved in both RAU and RHL.

Isoflavones and gamma irradiation inhibit cell growth in human salivary gland cells

We studied the effects of isoflavones and irradiation on cell cycle in a human salivary gland cell line (HSG). Genistein and a soy isoflavone conjugate (NS) inhibited DNA synthesis. Cells deconjugated the glucoside form of isoflavones in NS to the aglycones genistein and daidzein. NS, genistein and IR increased phosphorylation of p53 and p21 CIP1 at serine 15 (phos-p53). Irradiation and NS also increased levels of p21 CIP1. In a cologenic survival assay, cells in log phase growth had high radio-sensitivity with 2 Gy causing a reduction in survival (SF2=0.45).

CONCLUSION

isoflavones and radiation may interact to sensitize cancer cells to radiation.

Bacterial colonization of the parotid duct in xerostomia

Salivary flow rate and bacterial colonization of the parotid main duct were investigated in 17 patients referred for sialography and in 10 healthy controls. Cultures in the controls were negative whilst the patient group revealed bacterial colonization of the main duct, especially in those with the lowest flow rates. The implications of this finding in patients at high risk of endocarditis who will be undergoing sialography are discussed.

The epidemiology of self-reported TMJ sounds and pain in young adults in Israel

OBJECTIVES

We investigated the prevalence of self-reported temporomandibular joint sounds (TMJS), masticatory muscle pain (MMP), and their interrelation in a young adult population.

METHODS

A large sample (n = 20,869) of young soldiers aged 18-21 years who attended dental clinics were asked about their experience of TMJ sounds and pain.

RESULTS

The overall prevalence of TMJS was 8.4 percent (8.9% in females and 8.2% in males) and for masticatory pain was 4.0 percent for both males and females (P < .001 under chi-square test). Twenty-five percent of patients reporting positive TMJS also reported positive MMP compared to 2 percent in the negative TMJS group (P < .001). Fifty-three percent of patients reporting positive MMP also reported positive TMJS, compared to 6.5 percent in the negative MMP group (P < .001).

CONCLUSIONS

The low prevalence of TMJ sounds and pain found in these study might be attributed to the different cultural and social environment, as well as to the uniformity in age of the study group.

Prevalence of candidiasis and oral candidiasis in COVID-19 patients: a cross-sectional pilot study from the patients' registry in a large health center

OBJECTIVE

Candida albicans in considered to be a marker of immunosuppression in serious chronic condition such as HIV and cancer patients on immunosuppresion medications. The new COVID-19 pandemic has caused acute respiratory distress syndrome in many patients, which poses a risk of super-infections including Candida strains causing oral candidiasis as well as invasive fungal infections. The aim of the study was to examine the association between COVID-19 and oral and general candidiasis.

METHOD AND MATERIALS

The i2b2 data repository platform was used to analyze the interrelations between COVID-19, oral candidiasis, and total candidiasis in a hospital population. ICD diagnoses codes were used to generate queries on total numbers and demographic data on COVID-19, oral candidasis, total candidasis, and COVID-19 with each form of candidasis.

RESULTS

From the 889 patients diagnosed with COVID-19, 106 (12%) were diagnosed with candidiasis at large and 14 (1.6%) had oral candidiasis. The odds ratio (OR) for COVID-19 in the presence of oral candidiasis was 2.01 (95% CI 1.1870 to 3.4143, P = .094) and the OR for COVID-19 in the presence of candidiasis was 3.73 (95% CI 3.0419 to 4.5847, P < .0001 ). African American were disproportionally affected and comprised about 40% of the COVID-19/candidiasis groups.

CONCLUSIONS

Total candidiasis was significantly associated with increased risk for COVID-19, whereas oral candidiasis showed an insignificant trend. The dental practitioner should be aware of the importance of unexplained oral and systemic candidiasis as a potential harbinger of T and B cell immunosuppression associated with viral in-fections. COVID-19 may be a risk factor for total candidiasis.

Tumoral calcinosis associated with early onset periodontitis

A rare case of tumoral calcinosis (TC) with oral manifestations is presented in a 5-year-old child. The possible correlation between prepubertal periodontitis and TC is suggested and discussed.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) associated with a once-yearly IV infusion of zoledronic acid (Reclast) 5 mg: two cases and review of the literature

The use of a once-yearly IV infusion of 5 mg zoledronic acid has become more common, as the drug is being reported as safe, with few to minimal adverse reactions. This one-time annual administration has a favorable outcome for patients with osteoporosis and spares the burden of taking daily oral bisphosphonates. The present literature search found 10 well-documented cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) associated with annual administration of 5 mg zoledronic acid for the treatment of osteoporosis. Two new cases are also described, with underlying risk factors similar to previous reports. These include prior dental surgical procedures, the presence of diabetes, autoimmune conditions, past use of bisphosphonate and steroids, and concomitant immunosuppression. Although the reported incidence of BRONJ related to once-a-year IV administered zoledronic acid is low, it may be plausible. Both medical and dental clinicians should be aware of its manifestation.

Acute streptococcal infection of the gingiva, lower lip, and pharynx--a case report

BACKGROUND

Streptococcal gingivostomatitis is a rare phenomenon in a non-compromised host and not commonly reported in the dental literature. Early diagnosis and distinction from viral infections, especially HSV infection, are of the utmost importance. The early use of penicillin is essential in preventing a cascade of events, resulting in severe fasciitis, destruction of tissues, and subsequent rheumatic fever and rheumatic heart disease.

METHODS

A unique case of group A beta-hemolytic streptococcal infection affecting the pharynx, lower lip, and gingiva of a healthy 19-year-old male is presented.

RESULTS

The streptococcal infection was responsive to penicillin treatment.

CONCLUSIONS

In view of the increased use of antibiotics and the development of aggressive strains, the dental clinician has to consider streptococcal infection in the differential diagnosis of gingival and soft tissue infections.

Advanced glycation endproducts (AGEs) in saliva of patients with multiple myeloma - a pilot study

Multiple myeloma (MM) is a hematological cancer with underlying causes associated with increased oxidative stress. Through signaling of their receptor RAGE, advanced glycation endproducts (AGEs) are known to increase oxidative stress associated with malignant transformation. In the present study, we have demonstrated that the levels of these compounds are increased in the saliva of myeloma patients with bone lesions. This data may provide a potential marker for bone lesions in MM and a potential target for the treatment of myeloma by blocking the AGEs or their receptor.

Familial gingival fibromatosis; no correlation with HLA-antigen. A family study

Familial gingival fibromatosis is generally reported to be inherited as an autosomal dominant trait. We investigated 2 families with few siblings affected with gingival fibromatosis. No linkage between HLA antigen and the phenomenon was found. These results support the idea of the autosomal dominant nature of familial gingival fibromatosis.