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Lösser L, Ledesma-Colunga MG, Andrés Sastre E, Scholtysek C, Hofbauer LC, Noack B, Baschant U, Rauner M. Transferrin receptor 2 mitigates periodontitis-driven alveolar bone loss. J Cell Physiol 2024; 239:e31172. [PMID: 38214117 DOI: 10.1002/jcp.31172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
Periodontitis is associated with significant alveolar bone loss. Patients with iron overload suffer more frequently from periodontitis, however, the underlying mechanisms remain largely elusive. Here, we investigated the role of transferrin receptor 2 (Tfr2), one of the main regulators of iron homeostasis, in the pathogenesis of periodontitis and the dental phenotype under basal conditions in mice. As Tfr2 suppresses osteoclastogenesis, we hypothesized that deficiency of Tfr2 may exacerbate periodontitis-induced bone loss. Mice lacking Tfr2 (Tfr2-/- ) and wild-type (Tfr2+/+ ) littermates were challenged with experimental periodontitis. Mandibles and maxillae were collected for microcomputed tomography and histology analyses. Osteoclast cultures from Tfr2+/+ and Tfr2-/- mice were established and analyzed for differentiation efficiency, by performing messenger RNA expression and protein signaling pathways. After 8 days, Tfr2-deficient mice revealed a more severe course of periodontitis paralleled by higher immune cell infiltration and a higher histological inflammation index than Tfr2+/+ mice. Moreover, Tfr2-deficient mice lost more alveolar bone compared to Tfr2+/+ littermates, an effect that was only partially iron-dependent. Histological analysis revealed a higher number of osteoclasts in the alveolar bone of Tfr2-deficient mice. In line, Tfr2-deficient osteoclastic differentiation ex vivo was faster and more efficient as reflected by a higher number of osteoclasts, a higher expression of osteoclast markers, and an increased resorptive activity. Mechanistically, Tfr2-deficient osteoclasts showed a higher p38-MAPK signaling and inhibition of p38-MAPK signaling in Tfr2-deficient cells reverted osteoclast formation to Tfr2+/+ levels. Taken together, our data indicate that Tfr2 modulates the inflammatory response in periodontitis thereby mitigating effects on alveolar bone loss.
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Affiliation(s)
- Lennart Lösser
- Department of Medicine III & Center for Healthy Aging, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Maria G Ledesma-Colunga
- Department of Medicine III & Center for Healthy Aging, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Enrique Andrés Sastre
- Department of Medicine III & Center for Healthy Aging, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Carina Scholtysek
- Department of Internal Medicine 3, University of Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), University of Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Lorenz C Hofbauer
- Department of Medicine III & Center for Healthy Aging, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Barbara Noack
- Policlinic of Operative Dentistry, Periodontology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ulrike Baschant
- Department of Medicine III & Center for Healthy Aging, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Martina Rauner
- Department of Medicine III & Center for Healthy Aging, Medical Faculty, Technische Universität Dresden, Dresden, Germany
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Mardhiyah A, Panduragan SL, Mediani HS, Yosep I. Nursing Interventions to Improve Quality of Life Among Children and Adolescents with Thalassemia: A Scoping Review. J Multidiscip Healthc 2023; 16:1749-1762. [PMID: 37383528 PMCID: PMC10295575 DOI: 10.2147/jmdh.s415314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
Thalassemia is an inherited blood disorder affecting hemoglobin synthesis which leads to chronic hemolysis that can reduce the quality of life of children with it due to the disease and the treatment given. However, the intervention still focuses on handling physical problems due to thalassemia. So that an intervention that focuses on improving the quality of life of children with thalassemia is needed. The purpose of this study is to explore interventions that could improve the quality of life of children with thalassemia. A scoping review study design was used in this study. The databases used are CINAHL, PubMed, and Scopus. Articles published from last five years (2018-2022), open access full-text, in English, and with the type of randomized controlled trial (RCT). The keywords used in English are "thalassemia or beta-thalassemia" AND "quality of life OR Life Quality OR Health-Related Quality of Life" AND "nursing intervention OR nursing care". From ten articles analyzed, we found five types of nursing intervention: Health Care Instructions, Psychological Program, Educational Program, Counseling Program, and Self-care Model, which were carried out for 1-7 months. The articles in this study are from Egypt and Iran. The sample in this study is the range of 20-173 respondents. The thalassemia patients in this study were in the age range of 7-35 years, but the average age of the patients was in their 20s. Nursing intervention can potentially improve the quality of life in children and adolescents with thalassemia. Nurses need to pay attention to the patient's age, family and patient knowledge about the disease, length of stay, and the patient's physical and psychological condition in providing nursing care to patients with thalassemia. Implementation of nursing is given by paying attention to the stages of child development and involving the family. Nursing interventions can be carried out by nurses or nurses teach families to intervene at home. This nursing intervention has the potential to improve the quality of life of patients with thalassemia while still taking into account the conditions of the patient and family in a comprehensive manner.
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Affiliation(s)
- Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
- Faculty of Health Science, Lincoln University College, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | | | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
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Raveendran B, Dungarwalla M. Thalassaemia - part 1: a clinical update for the dental team. Br Dent J 2022; 233:931-937. [PMID: 36494532 DOI: 10.1038/s41415-022-5302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/24/2022] [Indexed: 12/13/2022]
Abstract
Thalassaemia is a genetic disorder that affects haemoglobin function. It is an abnormality of haemoglobin caused by mutation of genes related to alpha or beta globin chains that can be further subdivided into categories. These haematological conditions can vary from mild forms, which present as mild anaemia, to severe forms, that can become life-threatening. The window for dental treatment is often limited by several factors involving medical management, such as the need for antibiotic cover or blood transfusions. The lifetime management of the medical conditions are onerous and can place significant physical and psychological burden on the patient. This paper is part of a two-part series on thalassaemia. Part one focuses on the clinical manifestations patients may present with, treatment regimens and dental implications of such presentations. Part two explores the perspectives of thalassaemia patients on their dental experience.
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Affiliation(s)
- Brasanyaa Raveendran
- Dental Core Trainee 1 in Restorative Dentistry and General Duties, Barts Health Trust, Royal London Dental Hospital, Turner Street, Whitechapel, London, E1 1DE, UK.
| | - Mohammed Dungarwalla
- Specialist in Oral Surgery, Barts Health Trust, Royal London Dental Hospital, Turner Street, Whitechapel, London, E1 1DE, UK
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Fadel HT, Zolaly MA, Alharbi MO, Qarah LA, Alrehili MS, Alamri AD, Tarawah AM. Oral Health Profiles and Related Quality of Life in Thalassemia Children in Relation to Iron Overload: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249444. [PMID: 33339305 PMCID: PMC7766577 DOI: 10.3390/ijerph17249444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 05/15/2023]
Abstract
The aim was to assess the oral health of children with β-thalassemia major (BTM) and their oral health-related quality of life (OHRQoL) in relation to the serum ferritin level (SFL). Thirty-nine children with BTM underwent an interview, salivary sampling and an oral clinical examination. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess their OHRQoL. The mean age of the participants was 9 ± 3 years, with 62% females. The body mass index and salivary secretion rate were within normal ranges. The mean plaque index, gingival bleeding index and number of decayed, missing and filled tooth surfaces were 70 ± 29, 38 ± 25 and 3.2 ± 4, respectively, with no significant differences between individuals with SFL below or above 2000 ng/mL (p > 0.05). No significant differences were observed between the two groups in any of the ECOHIS questions (p > 0.05). The mean ECOHIS score was 4.2 ± 4. Individuals with SFL ≥2000 ng/mL had a significantly higher mean score in the family domain "Parent Distress" than those with lower SFL (p ≤ 0.05). Within the study limits, children with β-thalassemia major generally had high dental caries experience and gingival inflammation, yet an acceptable OHRQoL. Those with high SFL had less favorable scores in the domain "Parent Distress".
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Affiliation(s)
- Hani T. Fadel
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, AlMadinah AlMunawwarah 42313, Saudi Arabia
- Correspondence: ; Tel.: +966-55-440-6095
| | - Mohammed A. Zolaly
- Department of Pediatrics, College of Medicine, Taibah University, AlMadinah AlMunawwarah 42353, Saudi Arabia;
| | - Manal O. Alharbi
- Private Practice, AlMadinah AlMunawwarah 42351, Saudi Arabia; (M.O.A.); (L.A.Q.); (M.S.A.); (A.D.A.)
| | - Lujain A. Qarah
- Private Practice, AlMadinah AlMunawwarah 42351, Saudi Arabia; (M.O.A.); (L.A.Q.); (M.S.A.); (A.D.A.)
| | - Maher S. Alrehili
- Private Practice, AlMadinah AlMunawwarah 42351, Saudi Arabia; (M.O.A.); (L.A.Q.); (M.S.A.); (A.D.A.)
| | - Abdulaziz D. Alamri
- Private Practice, AlMadinah AlMunawwarah 42351, Saudi Arabia; (M.O.A.); (L.A.Q.); (M.S.A.); (A.D.A.)
| | - Ahmed M. Tarawah
- Pediatric Hematology, King Abdullah Medical City, AlMadinah AlMunawwarah 42319, Saudi Arabia;
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Ayilavarapu S. Persons With Thalassemia Major May Have Increased Risk of Gingival Inflammation. J Evid Based Dent Pract 2020; 20:101412. [DOI: 10.1016/j.jebdp.2020.101412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Farmakis D, Giakoumis A, Angastiniotis M, Eleftheriou A. The changing epidemiology of the ageing thalassaemia populations: A position statement of the Thalassaemia International Federation. Eur J Haematol 2020; 105:16-23. [PMID: 32198891 DOI: 10.1111/ejh.13410] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 01/19/2023]
Abstract
Therapeutic advances in β-thalassaemia have gradually lead to a significant improvement in prognosis over the past few decades. As a result, patients living in areas where disease-specific programmes offering access to modern therapy are in place experience a new era of prolonged survival that tends to reach that of the normal population. This ageing thalassaemia population, however, faces a new spectrum of comorbidities resulting from increasing age that may jeopardise the advances in prognosis provided by current therapy and thus poses new challenges in diagnosis, monitoring and treatment. In this position paper of the Thalassaemia International Federation, we review the changing epidemiology and clinical spectrum of patients with β-thalassaemia and propose actions to be undertaken in order to address the emerging spectrum of comorbidities resulting from ageing.
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Affiliation(s)
- Dimitrios Farmakis
- University of Cyprus Medical School, Nicosia, Cyprus and Heart Failure Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.,Thalassaemia International Federation, Nicosia, Cyprus
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Al Asmari D, Khan MK. Effect of photodynamic therapy on gingival inflammation in patients with thalassemia. Photodiagnosis Photodyn Ther 2020; 29:101595. [DOI: 10.1016/j.pdpdt.2019.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022]
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