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Aboelmahasen MMF, Othman SS, Dena ASA, Zhran M, Ma M, El-Destawy MT, Bilal AM. Histomorphometric and CBCT comparison of osseointegration around orthodontic titanium miniscrews coated with different nanoparticles: An in-vivo animal study. Int Orthod 2024; 22:100823. [PMID: 37992473 DOI: 10.1016/j.ortho.2023.100823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/16/2023] [Accepted: 10/22/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Temporarily installed titanium orthodontic miniscrews are usually used for many orthodontic applications, especially those cases that need high force, such as skeletally anchored orthodontic appliance cases. Surface modification of titanium miniscrews has proved success in preventing failure and overcoming their limitations. OBJECTIVE The present study aims at the assessment of the quality of osseointegration of surface modified titanium miniscrews installed in the maxilla of albino rabbits with cone-beam computed tomography (CBCT) imaging as well as histomorphometric investigations. MATERIAL AND METHODS The orthodontic titanium miniscrews (TMSs) were coated with silver/hydroxyapatite (Ag/HA) nanoparticles (NPs) or zinc oxide (ZnO) NPs via electrochemical deposition. The coating nanomaterials were then characterized with X-ray diffractometry (XRD) and scanning electron microscopy (SEM) imaging. Moreover, the antimicrobial activity of the coated titanium miniscrews were evaluated in the rabbits' oral cavity to investigate their ability to prevent biofilm formation. RESULTS It was found that the Ag/HA-coated TMSs demonstrated the highest antimicrobial activity and bone area fill, followed by the ZnO NPs-coated TMSs when compared to their uncoated counterparts. In the anterior area surrounding the installed TMSs, the highest osseointegration was demonstrated by ZnO NPs-coated TMSs. However, Ag/HA-coated TMSs showed the highest osseointegration values in the posterior peri-implant area. CONCLUSIONS Ag/HA- and ZnO NPs-coated TMSs may provide a promising solution to overcome the 30% probable failure in temporarily installed orthodontic miniscrews, as they can enhance the osseointegration process and prevent biofilm formation.
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Affiliation(s)
| | - Samer Salim Othman
- Department of Clinical Dental Sciences, College of Dentistry, Ibnsina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq
| | - Ahmed S Abo Dena
- Pharmaceutical Chemistry Department, National Organization for Drug Control and Research (NODCAR), Giza, Egypt; Faculty of Oral and Dental Medicine, Future University in Egypt (FUE), New Cairo, Egypt
| | - Monira Zhran
- Botany and Microbiology Department, Faculty of Science (Girls Branch), Al-Azhar University, Cairo, Egypt
| | - Mohamed Ma
- Oral pathology Department, Faculty of Dental Medicine (Cairo-Boys), Al-Azhar University, Cairo, Egypt
| | - Mahmoud Taha El-Destawy
- Oral medicine Department, Faculty of Dental Medicine (Cairo-Boys), Al-Azhar University, Cairo, Egypt
| | - Ahmed Mohamed Bilal
- Oral medicine Department, Faculty of Dental Medicine (Cairo-Boys), Al-Azhar University, Cairo, Egypt
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Basir A, Muhamad N, Sulong AB, Jamadon NH, Foudzi FM. Recent Advances in Processing of Titanium and Titanium Alloys through Metal Injection Molding for Biomedical Applications: 2013-2022. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16113991. [PMID: 37297124 DOI: 10.3390/ma16113991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/14/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
Metal injection molding (MIM) is one of the most widely used manufacturing processes worldwide as it is a cost-effective way of producing a variety of dental and orthopedic implants, surgical instruments, and other important biomedical products. Titanium (Ti) and Ti alloys are popular modern metallic materials that have revamped the biomedical sector as they have superior biocompatibility, excellent corrosion resistance, and high static and fatigue strength. This paper systematically reviews the MIM process parameters that extant studies have used to produce Ti and Ti alloy components between 2013 and 2022 for the medical industry. Moreover, the effect of sintering temperature on the mechanical properties of the MIM-processed sintered components has been reviewed and discussed. It is concluded that by appropriately selecting and implementing the processing parameters at different stages of the MIM process, defect-free Ti and Ti alloy-based biomedical components can be produced. Therefore, this present study could greatly benefit future studies that examine using MIM to develop products for biomedical applications.
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Affiliation(s)
- Al Basir
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Norhamidi Muhamad
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Abu Bakar Sulong
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Nashrah Hani Jamadon
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Farhana Mohd Foudzi
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
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Zhang Q, Ye J, Zhang Z, Hu Y, Wang X, Jiang W, Guo X, Chen L, Cheng S, Li J, Zhang L. Aristolocholic acid I promotes renal tubular epithelial fibrosis by upregulating matrix metalloproteinase-9 expression via activating the C3a/C3aR axis of macrophages. Toxicol Lett 2023; 381:27-35. [PMID: 37084829 DOI: 10.1016/j.toxlet.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/17/2023] [Accepted: 04/18/2023] [Indexed: 04/23/2023]
Abstract
Aristolochic acid I (AAI) can cause nephrotoxicity and is characterized by interstitial fibrosis. The C3a/C3aR axis of macrophages and matrix metalloproteinase-9 (MMP-9) play important roles in fibrosis, but whether they are involved in AAI-induced renal interstitial fibrosis and are related remains to be elucidated. In this study, we investigated whether C3a/C3aR axis of macrophages promotes renal interstitial fibrosis by regulating MMP-9 in aristolochic acid nephropathy (AAN). Intraperitoneal injection of AAI for 28 days successfully induced AAN in C57bl/6 mice. The content of C3a in the kidney of AAN mice was increased, and there was a significant distribution of macrophages in the renal tubules. The same results were observed in the in vitro experiment. We also explored the role and mechanism of macrophages after AAI administration in the epithelial-mesenchymal transformation (EMT) of renal tubular epithelial cells (RTECs) and found that AAI could activate the C3a/C3aR axis of macrophages to upregulate p65 expression in macrophages. p65 upregulated MMP-9 expression in macrophages not only directly but also by promoting the secretion if interleukin-6 by macrophages and then activating STAT3 in RTECs. The upregulation of MMP-9 expression could promote the EMT of RTECs. Taken together, our study demonstrated that the AAI-activated the C3a/C3aR axis of macrophages, which induced MMP-9 production, was one of the causes of renal interstitial fibrosis. Therefore, targeting the C3a/C3aR axis of macrophages is an effective therapeutic strategy for the prevention and treatment of renal interstitial fibrosis in AAN.
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Affiliation(s)
- Qi Zhang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jing Ye
- School of Life Science, Nanjing University, Nanjing 210023, China
| | - Zhaofeng Zhang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yongkang Hu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Xian Wang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Wenjuan Jiang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Xinlong Guo
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Langqun Chen
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Siyu Cheng
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jian Li
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing, 210009, China; Jinling Pharmaceutical Co., Ltd., Nanjing, 210009, China.
| | - Liang Zhang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
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Albrektsson T, Tengvall P, Amengual L, Coli P, Kotsakis GA, Cochran D. Osteoimmune regulation underlies oral implant osseointegration and its perturbation. Front Immunol 2023; 13:1056914. [PMID: 36761175 PMCID: PMC9902598 DOI: 10.3389/fimmu.2022.1056914] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
In the field of biomaterials, an endosseous implant is now recognized as an osteoimmunomodulatory but not bioinert biomaterial. Scientific advances in bone cell biology and in immunology have revealed a close relationship between the bone and immune systems resulting in a field of science called osteoimmunology. These discoveries have allowed for a novel interpretation of osseointegration as representing an osteoimmune reaction rather than a classic bone healing response, in which the activation state of macrophages ((M1-M2 polarization) appears to play a critical role. Through this viewpoint, the immune system is responsible for isolating the implant biomaterial foreign body by forming bone around the oral implant effectively shielding off the implant from the host bone system, i.e. osseointegration becomes a continuous and dynamic host defense reaction. At the same time, this has led to the proposal of a new model of osseointegration, the foreign body equilibrium (FBE). In addition, as an oral wound, the soft tissues are involved with all their innate immune characteristics. When implant integration is viewed as an osteoimmune reaction, this has implications for how marginal bone is regulated. For example, while bacteria are constitutive components of the soft tissue sulcus, if the inflammatory front and immune reaction is at some distance from the marginal bone, an equilibrium is established. If however, this inflammation approaches the marginal bone, an immune osteoclastic reaction occurs and marginal bone is removed. A number of clinical scenarios can be envisioned whereby the osteoimmune equilibrium is disturbed and marginal bone loss occurs, such as complications of aseptic nature and the synergistic activation of pro-inflammatory pathways (implant/wear debris, DAMPs, and PAMPs). Understanding that an implant is a foreign body and that the host reacts osteoimmunologically to shield off the implant allows for a distinction to be drawn between osteoimmunological conditions and peri-implant bone loss. This review will examine dental implant placement as an osteoimmune reaction and its implications for marginal bone loss.
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Affiliation(s)
- T. Albrektsson
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden
| | - P. Tengvall
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden,*Correspondence: P. Tengvall,
| | - L. Amengual
- Dental Implantology Unit, Hospital Leonardo Guzmán, Antofagasta, Chile
| | - P. Coli
- Edinburgh Dental Specialists, Edinburgh, United Kingdom,Department of Prosthetic Dentistry and Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden,Department of Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - G. A. Kotsakis
- Department of Periodontology, University of Texas, San Antonio, TX, United States
| | - D. Cochran
- Department of Periodontology, University of Texas, San Antonio, TX, United States
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Shirazi S, Ravindran S, Cooper LF. Topography-mediated immunomodulation in osseointegration; Ally or Enemy. Biomaterials 2022; 291:121903. [PMID: 36410109 PMCID: PMC10148651 DOI: 10.1016/j.biomaterials.2022.121903] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.
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Affiliation(s)
- Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | - Sriram Ravindran
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.
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Jiang J, He S, Liu K, Yu K, Long P, Xiao Y, Liu Y, Yu Y, Wang H, Zhou L, Zhang X, He M, Guo H, Wu T, Yuan Y. Multiple plasma metals, genetic risk and serum complement C3, C4: A gene-metal interaction study. CHEMOSPHERE 2022; 291:132801. [PMID: 34752839 DOI: 10.1016/j.chemosphere.2021.132801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/23/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Abstract
Exposure to metals and metalloids is widely related with human health, and could affect the function of immune system. The complement system links innate and adaptive immunity, and is critically involved in the pathogenesis of inflammatory and immune diseases. The third and fourth components of complement (C3, C4) play key roles in the complement system. However, few studies have examined the relations between multiple metals and complement levels. In this study, based on a total of 2977 participants from the Dongfeng-Tongji cohort, China, we investigated 17 plasma metals and serum C3, C4 levels, and calculated C3/C4-associated genetic risk scores (GRSs) using established single nucleotide polymorphisms. We further explored the potential gene-metal interactions on C3 and C4. After multivariable adjustment, an increment of 10-standard deviation increase in natural log-transformed exposure concentrations of plasma copper was associated with 0.549 (0.489, 0.608) (FDR <0.0001), and 1.146 (0.999, 1.294) (FDR <0.0001) higher natural log-transformed serum C3 and C4 levels, respectively. While each increment of 10-standard deviation of natural log-transformed zinc was associated with a difference of 0.083 (0.024, 0.143) (FDR = 0.049) and 0.007 (-0.138, 0.152) (FDR = 0.935) in log-transformed C3 and C4 levels, respectively. Participants with higher GRS had higher C3 and C4 levels. Furthermore, we found a significant interaction between arsenic exposure and C3-GRS in relation to C3 level (Pinteraction = 0.0096). Our results suggested that plasma arsenic would modify the association between C3 genetic predisposition and serum C3 level. We provide new insight into metals exposure on the human immune system. These findings require replication in future research.
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Affiliation(s)
- Jing Jiang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shiqi He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kang Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kuai Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Pinpin Long
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yang Xiao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yiyi Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanqiu Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hao Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lue Zhou
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Meian He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huan Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Kajikawa T, Mastellos DC, Hasturk H, Kotsakis GA, Yancopoulou D, Lambris JD, Hajishengallis G. C3-targeted host-modulation approaches to oral inflammatory conditions. Semin Immunol 2022; 59:101608. [PMID: 35691883 DOI: 10.1016/j.smim.2022.101608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Periodontitis is an inflammatory disease caused by biofilm accumulation and dysbiosis in subgingival areas surrounding the teeth. If not properly treated, this oral disease may result in tooth loss and consequently poor esthetics, deteriorated masticatory function and compromised quality of life. Epidemiological and clinical intervention studies indicate that periodontitis can potentially aggravate systemic diseases, such as, cardiovascular disease, type 2 diabetes mellitus, rheumatoid arthritis, and Alzheimer disease. Therefore, improvements in the treatment of periodontal disease may benefit not only oral health but also systemic health. The complement system is an ancient host defense system that plays pivotal roles in immunosurveillance and tissue homeostasis. However, complement has unwanted consequences if not controlled appropriately or excessively activated. Complement overactivation has been observed in patients with periodontitis and in animal models of periodontitis and drives periodontal inflammation and tissue destruction. This review places emphasis on a promising periodontal host-modulation therapy targeting the complement system, namely the complement C3-targeting drug, AMY-101. AMY-101 has shown safety and efficacy in reducing gingival inflammation in a recent Phase 2a clinical study. We also discuss the potential of AMY-101 to treat peri-implant inflammatory conditions, where complement also seems to be involved and there is an urgent unmet need for effective treatment.
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Affiliation(s)
- Tetsuhiro Kajikawa
- University of Pennsylvania, Penn Dental Medicine, Department of Basic and Translational Sciences, Philadelphia, PA, USA; Tohoku University Graduate School of Dentistry, Department of Periodontology and Endodontology, Sendai, Miyagi, Japan
| | - Dimitrios C Mastellos
- National Center for Scientific Research 'Demokritos', Division of Biodiagnostic Sciences and Technologies, INRASTES, Athens, Greece
| | - Hatice Hasturk
- The Forsyth Institute, Center for Clinical and Translational Research, Cambridge, MA, USA
| | - Georgios A Kotsakis
- University of Texas Health Science Center at San Antonio, School of Dentistry, Department of Periodontics, San Antonio, TX, USA
| | | | - John D Lambris
- University of Pennsylvania, Perelman School of Medicine, Department of Pathology and Laboratory Medicine, Philadelphia, PA, USA
| | - George Hajishengallis
- University of Pennsylvania, Penn Dental Medicine, Department of Basic and Translational Sciences, Philadelphia, PA, USA.
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Hasturk H, Hajishengallis G, Lambris JD, Mastellos DC, Yancopoulou D. Phase 2a clinical trial of complement C3 inhibitor AMY-101 in adults with periodontal inflammation. J Clin Invest 2021; 131:152973. [PMID: 34618684 DOI: 10.1172/jci152973] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Gingivitis and periodontitis are prevalent inflammatory diseases of the periodontal tissues. Current treatments are often ineffective or do not prevent disease recurrence. Uncontrolled complement activation and resulting chronic gingival inflammation is a hallmark of periodontal diseases. We determined efficacy and safety of a complement 3-targeted therapeutic, AMY-101, locally administered in adults with periodontal inflammation. METHODS Thirty-two patients with gingival inflammation were enrolled into a randomized, placebo-controlled, double-blind, split-mouth design phase 2a trial, after dose-escalation study to select safe and effective dose with additional 8 patients. Half of the mouth was randomly assigned to AMY-101 (0.1mg/site) or placebo injections at sites of inflammation, administered on days 0, 7 and 14 and evaluated for safety and efficacy outcomes at days 28, 60 and 90. The primary efficacy outcome was change in gingival inflammation, measured by modified gingival index (MGI), and secondary outcomes included changes in bleeding-on-probing (BOP), amount of plaque, pocket depth, clinical attachment level, and gingival crevicular fluid levels of matrix metalloproteinases (MMPs) over 90 days. RESULTS A once-per-week intragingival injection of AMY-101 for 3 weeks was safe and well-tolerated in all participants resulting in significant (P<0.001) reductions in clinical indices measuring gingival inflammation (MGI and BOP). AMY-101 significantly (P<0.05) reduced MMP-8 and MMP-9 levels, indicators of inflammatory tissue destruction. These therapeutic effects persisted for at least 3 months post-treatment. CONCLUSION AMY-101 causes significant and sustainable reduction in gingival inflammation without adverse events and merits further investigation for the treatment of periodontitis and other oral or peri-implant inflammatory conditions. TRIAL REGISTRATION ClinicalTrials.gov: NCT03694444. FUNDING Amyndas Pharmaceuticals. Amyndas contributed to the design and conducts of the clinical trial and in the writing of the manuscript.
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Affiliation(s)
- Hatice Hasturk
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, United States of America
| | - George Hajishengallis
- Department of Basic and Translational Sciences, University of Pennsylvania, Philadelphia, United States of America
| | - John D Lambris
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Dimitrios C Mastellos
- Division of Biodiagnostic Sciences and Technologies, National Center for Scientific Research 'Demokritos', Athens, Greece
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