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Gong Q, Lv X, Liao C, Liang A, Luo C, Wu J, Zhou Y, Huang Y, Tong Z. Single-cell RNA sequencing combined with proteomics of infected macrophages reveals prothymosin-α as a target for treatment of apical periodontitis. J Adv Res 2024:S2090-1232(24)00031-6. [PMID: 38237771 DOI: 10.1016/j.jare.2024.01.018] [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: 10/12/2023] [Revised: 12/22/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION Chronic apical periodontitis (CAP) is a common infectious disease of the oral cavity. Immune responses and osteoclastogenesis of monocytes/macrophages play a crucial role in CAP progression, and this study want to clarify role of monocytes/macrophages in CAP, which will contribute to treatment of CAP. OBJECTIVES We aim to explore the heterogeneity of monocyte populations in periapical lesion of CAP tissues and healthy control (HC) periodontal tissues by single-cell RNA sequencing (scRNA-seq), search novel targets for alleviating CAP, and further validate it by proteomics and in vitro and in vivo evaluations. METHODS ScRNA-seq was used to analyze the heterogeneity of monocyte populations in CAP, and proteomics of THP-1-derived macrophages with porphyromonas gingivalis infection were intersected with the differentially expressed genes (DEGs) of macrophages between CAP and HC tissues. The upregulated PTMA (prothymosin-α) were validated by immunofluorescence staining and quantitative real time polymerase chain reaction. We evaluated the effect of thymosin α1 (an amino-terminal proteolytic cleavage product of PTMA protein) on inflammatory factors and osteoclast differentiation of macrophages infected by P. gingivalis. Furthermore, we constructed mouse and rat mandibular bone lesions caused by apical periodontitis, and estimated treatment of systemic and topical administration of PTMA for CAP. Statistical analyses were performed using GraphPad Prism software (v9.2) RESULTS: Monocytes were divided into seven sub-clusters comprising monocyte-macrophage-osteoclast (MMO) differentiation in CAP. 14 up-regulated and 21 down-regulated genes and proteins were intersected between the DEGs of scRNA-seq data and proteomics, including the high expression of PTMA. Thymosin α1 may decrease several inflammatory cytokine expressions and osteoclastogenesis of THP-1-derived macrophages. Both systemic administration in mice and topical administration in the pulp chamber of rats alleviated periapical lesions. CONCLUSIONS PTMA upregulation in CAP moderates the inflammatory response and prevents the osteoclastogenesis of macrophages, which provides a basis for targeted therapeutic strategies for CAP.
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Affiliation(s)
- Qimei Gong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaomin Lv
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chenxi Liao
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ailin Liang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cuiting Luo
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jie Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanling Zhou
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yihua Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - Zhongchun Tong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Palafox-Sánchez CA, Cruz A, Salazar-Camarena DC, Gascón LG, Cintra LTA, Muñoz-Valle JF, García-Arellano S, Estrela C, Menchaca-Tapia PA. Evaluation of Serum Levels of Cytokines in Acute Apical Abscess: A Longitudinal Observational Study. J Endod 2023; 49:1090-1098. [PMID: 37423583 DOI: 10.1016/j.joen.2023.07.001] [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: 01/24/2023] [Revised: 06/23/2023] [Accepted: 07/02/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Cytokine levels are related to the aethiopathogenia of acute apical abscesses (AAA); however, the specific cytokine profiles in these cases are unclear. This study aimed to investigate the changes in systemic cytokine levels in patients with AAA and trismus onset, postantibiotic treatment, and postroot canal disinfection. METHODS In total, 46 AAA patients with trismus and 32 control subjects were included. After seven days of antibiotic therapy, root canal disinfection was performed in the AAA patients. The serum levels of cytokines were evaluated at basal, seven, and 14 days after endodontic treatment. Quantification of cytokines from T helper (Th) 1, Th2, Th17, and regulatory T cells profiles was determined using the BioPlex MagPix system, and the obtained data were analyzed using SPSS statistical software (P < .05). RESULTS AAA patients showed higher tumor necrosis factor-alpha (TNF-α), interleukin (IL) -6, and IL-10 levels than control subjects, at basal measurement (P < .05); there were similar levels of interferon gamma, IL-1β, IL-4, and IL-17 between groups (P > .05). IL-6 and IL-10 levels decreased after antibiotic treatment (P < .05), which was also associated with clinical improvement in patients with AAA and trismus. Patients with AAA had a positive correlation with higher serum levels of IL-6 and IL-10. In addition, TNF-α levels decreased only after antibiotic and endodontic treatment. CONCLUSIONS In conclusion, patients with AAA had increased systemic serum levels of TNF-α, IL-6, and IL-10. Moreover, increased levels of IL-6 and IL-10 are associated with acute inflammatory symptoms. However, IL-6 and IL-10 levels decreased after antibiotic treatment, while TNF-α levels decreased after antibiotic and endodontic treatment.
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Affiliation(s)
- Claudia Azucena Palafox-Sánchez
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico; Grupo de Inmunología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Alvaro Cruz
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico; Posgrado de Endodoncia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.
| | - Diana Celeste Salazar-Camarena
- Grupo de Inmunología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico; Posgrado de Endodoncia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Luis Gerardo Gascón
- Posgrado de Endodoncia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), and School of Dentistry, Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Samuel García-Arellano
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | - Paula Annahi Menchaca-Tapia
- Doctorado en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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Comparative effects of concentrated growth factors on the biological characteristics of periodontal ligament cells and stem cells from apical papilla. J Endod 2022; 48:1029-1037. [DOI: 10.1016/j.joen.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/30/2022] [Accepted: 05/01/2022] [Indexed: 12/14/2022]
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do Nascimento IV, Rodrigues MIQ, Isaias PHC, Barros‐Silva PG, Sousa FB, Nunes Alves APN, Mota MRL. Chronic systemic corticosteroid therapy influences the development of pulp necrosis and experimental apical periodontitis, exacerbating the inflammatory process and bone resorption in rats. Int Endod J 2022; 55:646-659. [DOI: 10.1111/iej.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Isabelly Vidal do Nascimento
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Maria Imaculada Queiroz Rodrigues
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Pedro Henrique Chaves Isaias
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Paulo Goberlânio Barros‐Silva
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Fabricio Bitu Sousa
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Ana Paula Negreiros Nunes Alves
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
| | - Mário Rogério Lima Mota
- Division of Oral Pathology Department of Dental Clinic Faculty of Pharmacy, Dentistry and Nursing Federal University of Ceará (UFC) Fortaleza, Ceará Brazil
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Differentiated Immunohistochemical Expression of Osteoclastogenic Markers in Radicular Cyst, Odontogenic Keratocyst, and Ameloblastoma. Appl Immunohistochem Mol Morphol 2021; 29:352-358. [PMID: 33944809 DOI: 10.1097/pai.0000000000000911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the osteoclastogenesis process by means of immunohistochemical markers for receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG), interleukin-6 (IL-6), and cathepsin K (CTSK) antigens in osteolytic lesions of maxillary bones. The sample consisted of 23 radicular cysts (RC), 25 odontogenic keratocysts (OKC), and 25 ameloblastomas (AM). RANKL was statistically higher in RC (49.6±15.2/53.7±18) and OKC (48.6±15.1/51.4±16.8) when compared with AM (37.2±12.5/36.4±13) in the epithelium and connective tissue. OPG was lower in OKC (34.8±18.5) only in connective tissue when compared with RC (44.5±11.2). The expression of RANKL was statistically higher than OPG in RC (epithelium and connective tissue) and OKC (connective tissue). For IL-6, a statistical difference was observed only in the connective tissue between groups, with higher expression in RC (48.2±15) and lower in OKC (22±11.9). The expression of IL-6 was correlated with the intensity of the inflammatory infiltrate. CTSK was statistically higher in AM (34±19) and OKC (29±13.8) compared with RC (19±10.5). According to the results of the present research the bone resorption in cysts and odontogenic tumors occurs through different mechanisms. The ostoclastogenic process in lesions with aggressive clinical behavior, as AM and OKC, seems to be associated with the expression of CTSK. In contrast, lesions with inflammatory etiology, as RC, the expression of IL-6 seems to have an important role in the bone resorption process. The highest expression of RANKL under the expression of OPG also seems to contribute to the growth mechanism of RC and OKC.
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Abstract
Conventional root canal therapies yield high success rates. The treatment outcomes are negatively affected by the presence of apical periodontitis (AP), which reflects active root canal infection and inflammatory responses. Also, cross-sectional studies revealed surprisingly high prevalence of AP in the general population, especially in those with prior endodontic treatments. Hence, AP is an ongoing disease entity in endodontics that needs further understanding of the pathogenesis and disease progression. The current Chapter will discuss the basic mechanisms of AP with emphasis on emerging role of epigenetic regulators in regulation of inflammatory mediators.
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Hernández-Caldera A, Vernal R, Paredes R, Veloso-Matta P, Astorga J, Hernández M. Human periodontal ligament fibroblasts synthesize C-reactive protein and Th-related cytokines in response to interleukin (IL)-6 trans-signalling. Int Endod J 2017; 51:632-640. [PMID: 29106735 DOI: 10.1111/iej.12872] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/31/2017] [Indexed: 12/23/2022]
Abstract
AIM To characterize the potential of human periodontal ligament fibroblasts (HPLF) to synthesize CRP and Th-related cytokines in response to IL-6 in periodontal health and apical inflammation. METHODOLOGY Primary HPLF stimulated with IL-6, soluble(s) IL-6 receptor (R) and controls were assayed for CRP, Th1, Th2, Th17 and Treg-related cytokines by quantitative real-time PCR and ELISA, respectively. IL-6R mRNA expression and its soluble protein levels were screened in HPLF cultures, and ex vivo samples of healthy periodontal ligaments (n = 5) and apical lesions (n = 13). Data were analysed with ANOVA or unpaired t-test. RESULTS 0.5 ng mL-1 IL-6 plus 1 ng mL-1 of its soluble receptor (sIL-6R) for 24 h was effective in inducing CRP production. IL-6 alone had a mild dose-dependent effect; co-stimulation with sIL-6R significantly enhanced this effect, whereas it was completely abolished by the addition of IL-6R blocking antibody (P < 0.05). Similarly, higher mRNA expression and protein levels of Th1, Th17 and partially Treg-related cytokines were found for IL-6 combined with its soluble receptor versus the nonstimulated group and IL-6R antibody (P < 0.05). IL-6R mRNA expression was slightly induced by IL-6 compared to THP-1 cells, but sILR-6 protein could not be detected in HPLF. High sIL-6R levels were detected in apical lesions and were immunolocalized to mononuclear inflammatory cells and proliferating epithelium. CONCLUSION IL-6 trans-signalling induced Th1 and Th17-related cytokines and represents an extra-hepatic mechanism for PCR synthesis in human periodontal ligament fibroblasts, contributing to explain the bone-destructive phenotype of apical lesions and eventually its systemic complications.
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Affiliation(s)
- A Hernández-Caldera
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - R Vernal
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | - R Paredes
- Escuela Medicina Veterinaria, Facultad de Ecología y Recursos Naturales, Universidad Andrés Bello, Santiago, Chile
| | - P Veloso-Matta
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - J Astorga
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - M Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
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Hirsch V, Wolgin M, Mitronin AV, Kielbassa AM. Inflammatory cytokines in normal and irreversibly inflamed pulps: A systematic review. Arch Oral Biol 2017; 82:38-46. [PMID: 28600966 DOI: 10.1016/j.archoralbio.2017.05.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/14/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To review the available literature in regard to the inflammatory process and pulpitis. Setting forth to evaluate if differences in the levels of various cytokines (TNF-α, IL-1β, IL-2, IL-6 and IL-8) can be observed in clinically diagnosed normal and irreversibly inflamed pulps that could serve as possible markers and/or diagnostic tools to predict and differentiate between certain states of inflammation. Methods used to measure and assess levels of cytokines have been limited to two protein quantification methods ELISA and/or Multiplex Array. DESIGN The databases PubMed, EMBASE/Ovid, The Cochrane Central Register of Controlled Trials, Cochrane Reviews and Scopus were consulted for the electronic literature search. Screening of titles and abstracts followed the PRISMA guidelines while data extraction and the assessment of the full texts were carried out in accordance to the GRADES assessment. RESULTS The review showed that significant increases in levels of IL-1β, IL-2, IL-6, IL-8 and TNF-α in irreversible pulpitis samples exist, in comparison to normal pulp samples which serve as a good basis for potential markers. Due to larger discrepancies in available literature, IL-2 seems rather unsuitable at the moment, while IL-6 and TNF alpha seem to be more promising. CONCLUSION It may be concluded that even by combining two protein quantification methods inconsistencies between studies exist. At the moment it is difficult to select just one specific cytokine suitable for testing, rather it supports the rationale that further high-quality clinical studies are needed.
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Affiliation(s)
- Vivian Hirsch
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstrasse 124, 3500 Krems, Austria
| | - Michael Wolgin
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstrasse 124, 3500 Krems, Austria.
| | - Aleksandr V Mitronin
- Department of Cariology and Endodontology, Moscow State University of Medicine and Dentistry (MSMSU), ul. Delegatskaya 20/1, 127473 Moscow, Russia
| | - Andrej M Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstrasse 124, 3500 Krems, Austria
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Bahuguna R, Jain A, Khan SA, Arvind MS. Role of odanacatib in reducing bone loss due to endodontic disease: An overview. J Int Soc Prev Community Dent 2017; 6:S175-S181. [PMID: 28217533 PMCID: PMC5285591 DOI: 10.4103/2231-0762.197183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aims and Objectives: Through a comprehensive literature review, this article provides an overview of the potential role of odanacatib (ODN) in reducing bone loss due to endodontic disease. Materials and Methods: A literature review was performed in PubMed Central, MEDLINE, Cochrane Library, and EBSCO databases. The articles identified included those published between 2002 and 2016. Based on the predetermined inclusion and exclusion criteria, out of 237 articles found, 50 were selected for this review. Results: Cathepsin K (CstK), which is indispensible to the immune system, also plays an important role in osteoclastic bone resorption. ODN, which is an orally active, selective, and effective inhibitor of CstK, decreases bone resorption by selectively inhibiting proteolysis of matrix proteins by CstK, without affecting other osteoclastic activity or osteoblast viability. Conclusion: The goal of endodontic treatment is to achieve a clinically asymptomatic state along with formation of reparative bone. This process could take 6 months or longer, hence, an earlier reversal of the resorption process could lead to faster healing and resolution of the periapical lesion. Use of ODN can be of help in achieving this goal.
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Affiliation(s)
- Rachana Bahuguna
- Department of Pedodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Atul Jain
- Department of Conservative Dentistry and Endodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Suleman Abbas Khan
- Department of Pedodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - M S Arvind
- Department of Conservative Dentistry and Endodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
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Sette-Dias AC, Maciel KF, Abdo EN, Brito LC, Carvalho MAR, Vieira LQ, Farias LM, Ribeiro-Sobrinho AP, Magalhães PP. Cytokine Expression in Patients Hospitalized for Severe Odontogenic Infection in Brazil. J Endod 2016; 42:706-10. [DOI: 10.1016/j.joen.2016.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/11/2016] [Accepted: 01/27/2016] [Indexed: 11/24/2022]
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Jakovljevic A, Knezevic A, Karalic D, Soldatovic I, Popovic B, Milasin J, Andric M. Pro-inflammatory cytokine levels in human apical periodontitis: Correlation with clinical and histological findings. AUST ENDOD J 2014; 41:72-7. [DOI: 10.1111/aej.12072] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Aleksandar Jakovljevic
- Clinic of Oral Surgery and Implantology; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Aleksandra Knezevic
- Department of Virology; Institute of Microbiology and Immunology; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - Danijela Karalic
- Department of Virology; Institute of Microbiology and Immunology; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - Ivan Soldatovic
- Institute of Medical Statistics and Informatics; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - Branka Popovic
- Institute of Biology and Human Genetics; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Jelena Milasin
- Institute of Biology and Human Genetics; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Miroslav Andric
- Clinic of Oral Surgery and Implantology; School of Dental Medicine; University of Belgrade; Belgrade Serbia
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Márton IJ, Kiss C. Overlapping Protective and Destructive Regulatory Pathways in Apical Periodontitis. J Endod 2014; 40:155-63. [DOI: 10.1016/j.joen.2013.10.036] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 09/26/2013] [Accepted: 10/24/2013] [Indexed: 02/06/2023]
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Azuma MM, Samuel RO, Gomes-Filho JE, Dezan-Junior E, Cintra LTA. The role of IL-6 on apical periodontitis: a systematic review. Int Endod J 2013; 47:615-21. [PMID: 24224782 DOI: 10.1111/iej.12196] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 09/16/2013] [Indexed: 01/08/2023]
Abstract
The aim of this review was to examine current knowledge of the role of interleukin-6 (IL-6) in apical periodontitis (AP) pathogenesis as an inflammatory or pro-inflammatory cytokine. It also looked at whether IL-6 could serve as a measure for differential diagnosis or as a biomarker that can further predict the progression of bone resorption. A systematic review relating to AP and IL-6 was made via PubMed, BIOSIS, Cochrane, EMBASE and Web of Science databases using keywords and controlled vocabulary. Two independent reviewers first screened titles and abstracts and then the full texts. The reference lists of the identified publications were examined for additional titles. Eighteen papers were studied in total. In vitro studies (n = 6) revealed that IL-6 is present in AP, and its levels are proportional to the size of the periapical lesions. Neutrophils and macrophages resident in these lesions can produce IL-6 in vitro after a bacterial stimulus. Animal studies (n = 5) showed that IL-6 is present in AP and that osteoblasts can produce IL-6 in vivo. On the other hand, two studies using IL-6 knockout mice revealed larger periapical lesions when compared with control groups, demonstrating IL-6's role as an anti-inflammatory cytokine. In human studies (n = 7), IL-6 was identified in AP, and its levels were higher in symptomatic, epithelialized and large lesions than in asymptomatic and small lesions. These data lead to the conclusion that IL-6 may play a pro-inflammatory role, increasing its levels and reabsorbing bone in the presence of infections. When IL-6 is not present, other cytokines such as IL-1 and TNF-α induce bone resorption. Further studies about the relationship between AP development and the cytokine network must be performed to establish the exact role of each cytokine in the inflammatory process.
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Affiliation(s)
- M M Azuma
- Department of Endodontics, Araçatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
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Silva MJB, Kajiya M, AlShwaimi E, Sasaki H, Hong J, Ok P, Rezende TMB, Pagonis TC, White RR, Paster BJ, Stashenko P, Kawai T. Bacteria-reactive immune response may induce RANKL-expressing T cells in the mouse periapical bone loss lesion. J Endod 2012; 38:346-50. [PMID: 22341072 DOI: 10.1016/j.joen.2011.12.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 12/21/2011] [Accepted: 12/22/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The present study investigated whether bacteria infecting the root canal can activate any infiltrating T cells to produce receptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL). METHODS Using a mouse model of periapical lesion induced by artificial dental pulp exposure, the presence of RANKL-positive T cells and osteoclasts in the periapical lesion was examined by an immunohistochemical approach. The bacteria colonizing the exposed root canal were identified by 16S ribosomal RNA (rRNA) sequence analysis. The isolated endodontic bacteria were further immunized to normal mice, and soluble activator of NF-κB ligand (sRANKL) production by the T cells isolated from the immunized mice was evaluated by ex vivo culture system. RESULTS RANKL-positive T cells along with TRAP+ osteoclasts were identified in periapical bone resorption lesions. The gram-negative bacterium Pasteurella pnumotropica, which was most frequently detected from the root canal of exposed pulp, showed remarkably elevated serum immunoglobulin G (IgG)-antibody response in pulp-exposed mice compared with control nontreated mice. Immunization of mice with P. pneumotropica induced not only serum IgG-antibody but also primed bacteria-reactive T cells that produced sRANKL in response to ex vivo exposure to P. pneumotropica. CONCLUSIONS T cells infiltrating the periapical region express RANKL, and the endodontic bacteria colonizing the root canal appear to induce RANKL expression from bacteria-reactive T cells, suggesting the possible pathogenic engagement of the immune response to endodontic bacteria in the context of developing bone resorptive periapical lesions.
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Affiliation(s)
- Marcelo J B Silva
- Department of Immunology, The Forsyth Institute, Cambridge, Massachusetts, USA
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Graunaite I, Lodiene G, Maciulskiene V. Pathogenesis of apical periodontitis: a literature review. J Oral Maxillofac Res 2012; 2:e1. [PMID: 24421998 PMCID: PMC3886078 DOI: 10.5037/jomr.2011.2401] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 09/03/2011] [Indexed: 05/29/2023]
Abstract
OBJECTIVES This review article discusses the host response in apical periodontitis with the main focus on cytokines, produced under this pathological condition and contributing to the degradation of periradicular tissues. The pace of research in this field has greatly accelerated in the last decade. Here we provide an analysis of studies published in this area during this period. MATERIAL AND METHODS Literature was selected through a search of PubMed electronic database. The keywords used for search were pathogenesis of apical periodontitis cytokines, periapical granuloma cytokines, inflammatory infiltrate apical periodontitis. The search was restricted to English language articles, published from 1999 to December 2010. Additionally, a manual search in the cytokine production, cytokine functions and periapical tissue destruction in the journals and books was performed. RESULTS In total, 97 literature sources were obtained and reviewed. The topics covered in this article include cellular composition of an inflammatory infiltrate in the periapical lesions, mechanisms of the formation of the innate and specific immune response. Studies which investigated cytokine secretion and functions were identified and cellular and molecular interactions in the course of apical periodontitis described. CONCLUSIONS The abundance and interactions of various inflammatory and anti-inflammatory molecules can influence and alter the state and progression of the disease. Therefore, periapical inflammatory response offers a model, suited for the study of many facets of pathogenesis, biocompatibility of different materials to periapical tissues and development of novel treatment methods, based on the regulation of cytokines expression.
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Affiliation(s)
- Indre Graunaite
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health SciencesLithuania.
| | - Greta Lodiene
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health SciencesLithuania.
| | - Vita Maciulskiene
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health SciencesLithuania.
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Tang Y, Sun F, Li X, Zhou Y, Yin S, Zhou X. Porphyromonas endodontalis Lipopolysaccharides Induce RANKL by Mouse Osteoblast in a Way Different from That of Escherichia coli Lipopolysaccharide. J Endod 2011; 37:1653-8. [DOI: 10.1016/j.joen.2011.08.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 08/09/2011] [Accepted: 08/09/2011] [Indexed: 01/04/2023]
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Effects of gender on serum biomarkers of systemic inflammation coincident to experimentally-induced periapical lesions. Arch Oral Biol 2010; 56:168-76. [PMID: 20943210 DOI: 10.1016/j.archoralbio.2010.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 08/18/2010] [Accepted: 09/13/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The literature suggests that females have less adverse effects to infection than males, due to the protective effects of oestrogen. The purpose of our study is to compare the systemic effects of induced periapical lesions between groups of animals with various serum concentrations of oestrogen. METHODS To induce periapical inflammation, two molar tooth pulps were exposed in ovariectomized (OVX) and normal female (F) and castrated (Cast-M) and normal male (M) Sprague-Dawley rats (Experimental group, E). Sham-operated control animals from each group were also studied (Control group, C). Twenty-eight days later, serum and maxillas were collected. Serum 17β-oestradiol, testosterone, MMP-9, IL-18, IL-6, TNF-α, and IL-1β concentrations were measured by ELISA. Maxillas were cleaned of residual tissue and digital radiographs were made to verify the presence of periapical lesions. Data were compared by factorial ANOVA, post hoc Tukey, and Pearson correlation tests. Groups were considered to be significantly different when p<0.05. RESULTS The serum concentration of IL-18, TNF-α, IL-1-β, IL-6 and MMP-9 was greatest in OVX-E animals, compared to all other groups (p<0.001). F-E rats had significantly higher serum concentrations of these cytokines, compared to F-C. The fold difference in serum concentration of the biomarkers (between E and C groups) was significantly greater in females than males, even though males had higher baseline concentrations of all these biomarkers. CONCLUSION When females are oestrogen-deficient, their systemic response to periapical lesions is significantly greater than males, suggesting that oestrogen is essential in protecting females from the effects of this type of inflammation.
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Dezerega A, Osorio C, Mardones J, Mundi V, Dutzan N, Franco M, Gamonal J, Oyarzún A, Overall CM, Hernández M. Monocyte chemotactic protein-3: possible involvement in apical periodontitis chemotaxis. Int Endod J 2010; 43:902-8. [DOI: 10.1111/j.1365-2591.2010.01764.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abdolsamadi HR, Vahedi M, Esmaeili F, Nazari S, Abdollahzadeh S. Serum Interleukin-6 as a Serologic Marker of Chronic Periapical Lesions: A Case-control Study. J Dent Res Dent Clin Dent Prospects 2008; 2:43-7. [PMID: 23289057 PMCID: PMC3532733 DOI: 10.5681/joddd.2008.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 03/13/2008] [Indexed: 12/02/2022] Open
Abstract
Background and aims
Chronic periapical disease with pulpal origin is an inflammatory condition caused by bacterial infection. Chronic infection could affect general health by increasing the production of cytokines such as interleukin-6 (IL-6) that probably play a role in pathogenesis of pulpal and periapical diseases. The aim of the present study was a comparative evaluation of the level of serum IL 6 in patients with periapical lesions and healthy controls.
Materials and methods
This analytical case-control study included 40 patients with chronic peri-apical lesions and 40 individuals without any oral diseases. All of the participants were in good general health. After obtaining an informed consent, clinical and radiographic examinations were carried out and blood samples were collected. Serum IL-6 was measured using ELISA. Data were analyzed using t-test by SPSS 14.0 computer software.
Results
Serum IL-6 concentration was significantly higher in test group compared to the controls (P < 0.05).
Conclusion The results of the present study indicate that IL-6 produced in periapical lesions may serve as a marker of pathologic inflammatory activities in chronic periapical lesions.
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Affiliation(s)
- Hamid Reza Abdolsamadi
- Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Hamadan University of Medical Sciences, Iran
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Pršo IB, Kocjan W, Šimić H, Brumini G, Pezelj-Ribarić S, Borčić J, Ferreri S, Karlović IM. Tumor necrosis factor-alpha and interleukin 6 in human periapical lesions. Mediators Inflamm 2006; 2007:38210. [PMID: 17497030 PMCID: PMC1804300 DOI: 10.1155/2007/38210] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 11/06/2006] [Accepted: 11/08/2006] [Indexed: 11/17/2022] Open
Abstract
AIM The aim of this study was to evaluate the presence of the cytokines tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in human periapical lesions. SUBJECTS AND METHODS Samples were obtained from three groups of teeth: symptomatic teeth, asymptomatic lesions, and uninflamed periradicular tissues as a control. RESULTS TNF-alpha levels were significantly increased in symptomatic lesions compared to control. Group with asymptomatic lesions had significantly higher concentrations compared to control. There were no significant differences in TNF-alpha levels between symptomatic and asymptomatic lesions. In group with symptomatic lesions, IL-6 levels were significantly higher than in group with asymptomatic lesions. The IL-6 levels in symptomatic group also showed significantly higher concentration in comparison with control group. In asymptomatic group, the IL-6 level had significantly higher concentrations compared to control. CONCLUSION These results indicate that symptomatic lesions represent an immunologically active stage of disease, and asymptomatic lesions are the point from which the process advances toward healing.
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Affiliation(s)
- Ivana Brekalo Pršo
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Willy Kocjan
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Hrvoje Šimić
- Department of Histology, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Gordana Brumini
- Department of Informatics, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Sonja Pezelj-Ribarić
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
- *Sonja Pezelj-Ribarić:
| | - Josipa Borčić
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Silvio Ferreri
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
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Vernal R, Dezerega A, Dutzan N, Chaparro A, León R, Chandía S, Silva A, Gamonal J. RANKL in human periapical granuloma: possible involvement in periapical bone destruction. Oral Dis 2006; 12:283-9. [PMID: 16700737 DOI: 10.1111/j.1601-0825.2005.01191.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The cytokine receptor activator of nuclear factor kappaB-ligand (RANKL) has been involved in both the physiological and pathological regulation of osteoclast life span and bone metabolism. Periapical granuloma is a periradicular lesion characterized by periapical bone destruction. The aims of this study were to associate the RANKL mRNA levels to periapical granulomas using the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) technique and to determine the specific cell involved in RANKL synthesis. METHODS In eight periapical granuloma and eight periodontal ligament samples from periodontally healthy volunteers, RANKL mRNA was detected by real-time RT-PCR. Expression of RANKL on infiltrate leukocytes was further investigated by flow cytometry in six periapical granulomas. RESULTS Receptor activator of nuclear factor kappaB-ligand mRNA levels were higher in periapical granulomas than in healthy periodontal ligament as its RANKL mRNA cycle threshold (Ct) and DeltaCt were significantly lower than that of controls (33.07 +/- 1.24 vs 36.96 +/- 1.69 and 11.58 +/- 3.02 vs 15.60 +/- 3.31, respectively). A 16.2-fold (2.0-131.6) higher RANKL gene expression was detected in the granulomas compared with the control tissues. We determined by flow cytometry that lymphocytes were the predominant leukocyte cells (53.31%), and monocytes and dendritic cells were the main RANKL synthesizers in granuloma lesions. CONCLUSIONS These data indicate that monocytes synthesized RANKL in periapical granulomas and suggest that RANKL is involved in bone loss associated with periapical lesions.
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Affiliation(s)
- R Vernal
- Periodontal Biology Laboratory, Dentistry Faculty, University of Chile, Santiago, Chile.
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Abstract
Detrimental effects of oral infections on general health have been known for almost 3000 years. Modern studies, however, have cast new light on the pathogenic mechanisms by which oral infections appear to link with morbidity and mortality. In particular, among the elderly, poor dental health seems to associate with all-cause mortality. This review aims to provide an overview of present knowledge of these issues, starting from dental bacteraemia, oral mucosal infections and problems of drug resistance and, briefly, discussing what is known about the link between oral health and some systemic diseases such as atherosclerosis and type-2 diabetes. The main conclusions are that scientific evidence is still weak on these interactions and that the elderly should be better taken into account when planning future studies. Functions of the body differ in the frail and diseased from those of the young. Consequently, novel prevention and treatment strategies should be developed and properly tested for combating oral infections in elderly populations. Specific suggestions for further research are outlined.
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Affiliation(s)
- Jukka H Meurman
- Department of Oral and Maxillofacial Diseases, Institute of Dentistry, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
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Abstract
OBJECTIVE Oral infections may increase the levels of cytokines in the blood which, in turn, are associated with early mortality in the elderly. We investigated the possible association between oral infections and mortality. DESIGN Prospective cohort study over a 5-year follow-up. SETTING Research laboratory. PARTICIPANTS A cohort born in 1910 (n = 94) was examined in the year 1995. Five years later mortality data were obtained from the population register for 49 deceased subjects. MAIN OUTCOME MEASURES Urgent need of dental treatment, lifetime, erythrocyte sedimentation rate (ESR). RESULTS The multivariate analysis adjusted for general health and lifestyle factors showed that the risk for death of subjects in urgent need of dental treatments was 3.9 times higher than that of the other subjects. Among men ESR correlated significantly with urgent need of dental treatment. CONCLUSIONS Oral infections among frail elderly people may be a sign of early mortality.
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Affiliation(s)
- Piia Hämäläinen
- Institute of Dentistry, University of Helsinki, Helsinki, Finland.
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Hämäläinen P, Suominen H, Keskinen M, Meurman JH. Oral health and reduction in respiratory capacity in a cohort of community-dwelling elderly people: a population-based 5-year follow-up study. Gerodontology 2004; 21:209-15. [PMID: 15603280 DOI: 10.1111/j.1741-2358.2004.00029.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Several anaerobic bacteria originating in periodontal pockets have been isolated from infected lungs and pharyngeal microflora. Increased bacterial load in lungs is known to be a risk factor for decline in forced expiratory volume during the first second. The aim was to evaluate both cross-sectionally and longitudinally the association between oral health status and forced expiratory volume during the first second (FEV1) in older residents of the city of Jyväskylä, Finland. DESIGN Cross-sectional and prospective cohort study over a 5-year follow-up. SETTING Research laboratory of the University of Jyväskylä. PARTICIPANTS In 1990 dental status and FEV1 were examined in 203 80-year-old people, of whom 88 survivors were retested 5 years later. MAIN OUTCOME MEASURES Primary: dental status and FEV1. Secondary: existence of pulmonary diseases, height, handgrip strength, smoking, and length of education. RESULTS Participants were regrouped into three categories according to their baseline oral health status. At baseline, men with complete prostheses had the lowest FEV1. Five years later the greatest reduction in FEV1 was seen in subjects with poor periodontal status or complete prostheses (-9.4%) while those with healthy periodontal status showed no reduction in FEV1 values (+1.0%, p = 0.006). CONCLUSIONS Periodontal infections and complete prostheses may be reservoirs for pathogens which may be harmful and partly explain the observed reduction in FEV1 during ageing.
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Affiliation(s)
- Piia Hämäläinen
- Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland.
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Hämäläinen P, Rantanen T, Keskinen M, Meurman JH. Oral health status and change in handgrip strength over a 5-year period in 80-year-old people. Gerodontology 2004; 21:155-60. [PMID: 15369018 DOI: 10.1111/j.1741-2358.2004.00022.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The number of remaining teeth may indicate the extent of life-long exposure to inflammation, a known risk factor for muscle loss and consequent disability. The aim was to study dental health status as a risk factor for muscle strength loss in very old people. DESIGN Cross-sectional and prospective cohort study over a 5-year follow-up. SETTING Research laboratory. PARTICIPANTS One hundred and ninety-three 80-year-old people participated in the baseline examinations. Five years later, 79 survivors were retested. MAIN OUTCOME MEASURES Number of remaining teeth, presence of periodontitis and handgrip strength. RESULTS At baseline, grip strength of men correlated positively with number of teeth but not with the presence of periodontitis. In women, the cross-sectional associations were not statistically significant. In the prospective analyses, the presence of periodontitis at baseline showed a clear association with a steeper decline in handgrip over the 5-year follow-up in both sexes. The values adjusted for gender, height, weight, number of chronic conditions and physical activity were -28.3% (SE 5.7) among those with periodontitis vs. -11.9% (SE 3.1, p = 0.015) among those with healthy gingiva. No association between the number of teeth at baseline and change in grip strength over 5 years was observed. CONCLUSIONS The presence of oral inflammation may lead to loss in muscle strength increasing the risk of disability. Therefore, good dental care throughout the life span may decrease risk of disability in old age.
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Affiliation(s)
- Piia Hämäläinen
- Institute of Dentistry, University of Helsinki, Helsinki, Finland.
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Abstract
AIM To compare the presence of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) infections in samples from 25 symptomatic and 19 asymptomatic periapical lesions. METHODOLOGY Periapical samples were collected by sterile curettes in conjunction with apicectomy. cDNA-based HCMV and EBV identification was performed on total mRNAs extracted from peripapical tissues, using primers for genes transcribed during the productive phase of the herpesvirus infection. Statistical analysis was performed using chi-squared test. RESULTS HCMV was detected in 100% of the symptomatic and in 37% of the asymptomatic study lesions. EBV was identified only in HCMV-infected periapical lesions. The difference in occurrence of HCMV and EBV between symptomatic and asymptomatic periapical lesions was statistically significant (P < 0.0001). CONCLUSIONS The noteworthy finding of this study was the ubiquitous occurrence of HCMV active infection in symptomatic periapical pathosis. EBV may contribute to periapical pathogenesis in a subset of symptomatic lesions. HCMV and EBV infections may cause periapical pathosis by inducing cytokine and chemokine release from inflammatory or connective tissue cells, or by impairing local host defences resulting in heightened virulence of resident bacterial pathogens. Knowledge about the role of herpesviruses in periapical pathosis seems important to fully delineate the pathogenesis of endodontic infectious diseases. HCMV and probably EBV should be added to the list of putative pathogenic agents in symptomatic periapical disease.
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Affiliation(s)
- J Slots
- School of Dentistry, University of Southern California, Los Angeles, CA 90089-0641, USA.
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Slots J, Sabeti M, Simon JH. Herpesviruses in periapical pathosis: an etiopathogenic relationship? ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 96:327-31. [PMID: 12973289 DOI: 10.1016/s1079-2104(03)00352-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Much remains to be learned about the etiopathogenesis of periapical pathosis, especially about the molecular events preceding and causing disease onset. Human cytomegalovirus and Epstein-Barr virus, 2 herpesviruses, are discussed in this review as they relate to apical periodontitis in humans. RESULTS Cytomegalovirus or Epstein-Barr virus active infections are detected in more than 90% of granulomas of symptomatic and large periapical lesions. Dual infection with cytomegalovirus and Epstein-Barr virus is closely associated with symptomatic lesions. Herpes simplex virus active infection has no apparent relationship to periapical disease. DISCUSSION The available evidence suggests the involvement of active cytomegalovirus and Epstein-Barr infections in the etiopathogenesis of apical periodontitis. In periapical pathosis, herpesviruses may cause the release of tissue-destructive cytokines, the overgrowth of pathogenic bacteria, and the initiation of cytotoxic or immunopathologic events. Immune impairment resulting from herpesvirus infection may aid bacteria at several stages of the pathogenesis of periapical lesions, including growth in the periapical environment, possible invasion of tissue, and direct damage to tissue. Unraveling the etiology and pathogenesis of periapical pathosis may require a broadening of our experimental approaches to include studies on interactions among herpesviruses, bacteria, and host immune reactions. Understanding the significance of herpesviruses in the development of periapical lesions may aid in the diagnosis, prevention, and treatment of the diseases.
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Affiliation(s)
- Jørgen Slots
- University of Southern California, Los Angeles, Calif. 90089-0641, USA.
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