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Andrade ADO, Mesquita RA, Gordón-Núñez MA, Alves PM, Nonaka CFW. Immunoexpression of CXCL12 and CXCR4 in Radicular Cysts, Dentigerous Cysts, and Odontogenic Keratocysts. Appl Immunohistochem Mol Morphol 2023; 31:113-120. [PMID: 36449693 DOI: 10.1097/pai.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/08/2022] [Indexed: 12/05/2022]
Abstract
The aim of this study was to evaluate the immunoexpression of chemokine CXCL12 and its receptor CXCR4 in radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs), and to correlate the findings with morphologic parameters of RCs (inflammatory infiltrate and cystic epithelium). Twenty RCs, 20 DCs, and 20 OKCs were submitted to immunohistochemistry. The percentages of cytoplasmic (CXCL12 and CXCR4) and nuclear (CXCR4) staining in epithelial and fibrous capsule cells were determined. RCs and DCs exhibited higher epithelial expression of CXCL12 than OKCs ( P <0.05). The expression of CXCL12 in the fibrous capsule was higher in DCs than in RCs and OKCs ( P <0.05). Higher cytoplasmic expression of CXCR4 was observed in the epithelial lining and fibrous capsule of RCs and DCs compared with OKCs ( P <0.05). In the fibrous capsule, DCs exhibited higher nuclear expression of CXCR4 than OKCs ( P <0.05). No significant differences in the immunoexpression of CXCL12 or CXCR4 were observed according to the morphologic parameters of RCs ( P >0.05). Strong positive correlations were found between cytoplasmic and nuclear expression of CXCR4 in the epithelial lining of RCs and DCs and in the fibrous capsule of all groups ( P <0.05). The results suggest the participation of CXCL12 and CXCR4 in the pathogenesis of RCs, DCs, and OKCs. These proteins may be particularly relevant for the development of odontogenic cysts with less aggressive biological behavior, irrespective of their nature (inflammatory or developmental). In RCs, the expression of CXCL12 and CXCR4 may not be related to the intensity of the inflammatory infiltrate or the status of cystic epithelium.
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Affiliation(s)
| | - Ricardo Alves Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Pollianna Muniz Alves
- Department of Dentistry, School of Dentistry, State University of Paraíba, Campina Grande, Brazil
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Release of Matrix Metalloproteinases by Macrophages in Radicular Cysts and Residual Radicular Cysts. Appl Immunohistochem Mol Morphol 2022; 30:291-297. [DOI: 10.1097/pai.0000000000001005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/29/2021] [Indexed: 11/02/2022]
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Valente WAS, Barrocas D, Armada L, Pires FR. Expression of epithelial growth factors and of apoptosis-regulating proteins, and presence of CD57+ cells in the development of inflammatory periapical lesions. J Appl Oral Sci 2022; 30:e20210413. [PMID: 35195153 PMCID: PMC8860407 DOI: 10.1590/1678-7757-2021-0413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022] Open
Abstract
The mechanisms that stimulate the proliferation of epithelial cells in inflammatory periapical lesions are not completely understood and the literature suggests that changes in the balance between apoptosis and immunity regulation appear to influence this process.
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Costa Neto H, Andrade ALDLD, Carmo AFD, Freitas RDA, Galvão HC. Involvement of tryptase-positive mast cells and angiogenesis in the growth of inflammatory odontogenic cysts. Braz Oral Res 2021; 35:e061. [PMID: 34076187 DOI: 10.1590/1807-3107bor-2021.vol35.0061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/01/2021] [Indexed: 11/22/2022] Open
Abstract
Inflammatory periapical lesions are characterized by infiltration of different immune cell types, the functions of which depend on an effective vascular network. This study aimed to evaluate the mast cells density (MCD) in inflamatory odontogenic cysts capsules concerning microvascular density (MVD), microvascular area (MVA), and microvascular perimeter (MVP), and correlate such findings with the type of lesion, intensity of the inflammatory infiltrate, and thickness of the epithelial lining. Twenty inflamatory dentigerous cysts (IDCs), twenty radicular cysts (RCs), and twenty residual radicular cysts (RRCs) were submitted to immunohistochemical analysis using anti-tryptase and anti-CD34 antibodies. RCs exhibited the highest MCD, MVD, MVA, and MVP indexes (p = < 0.001, p = 0.008, p = 0.003 and p = < 0.001, respectively), and lesions with inflammatory infiltrate grade III showed the highest MVD (p = 0.044). Considering epithelial thickness, a higher MVP index was identified in lesions with hyperplastic epithelium (p = 0.018). In IDCs, RCs, and RRCs, a strong positive correlation was observed between MVA and MVP (r = 0.950 and p = < 0.001; r = 0.914 and p = < 0.001; r = 0.713 and p = < 0.001, respectively). In IDCs, a moderate correlation was observed between MCD and both MVA and MVP (r = 0.660 and p = 0.002; r = 0.634 and p = 0.003, respectively). These results suggest that tryptase-positive mast cells might play an important role in the angiogenic activity of IDCs, while RCs had the highest indexes. Our findings also confirmed that the intensity of the inflammatory infiltrate and epithelial thickness influence angiogenesis.
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Affiliation(s)
- Hugo Costa Neto
- Universidade Federal do Rio Grande do Norte - UFRN, Department of Dentistry, Natal, RN, Brazil
| | | | | | | | - Hébel Cavalcanti Galvão
- Universidade Federal do Rio Grande do Norte - UFRN, Department of Dentistry, Natal, RN, Brazil
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Bergamini ML, Mardegan AP, DE Rosa CS, Palmieri M, Sarmento DJDS, Hiraki KRN, Costa ALF, HassÉus B, Jonasson P, Braz-Silva PH. Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis. Braz Oral Res 2020; 34:e108. [PMID: 32876121 DOI: 10.1590/1807-3107bor-2020.vol34.0108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 07/10/2020] [Indexed: 11/22/2022] Open
Abstract
Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.
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Affiliation(s)
- Mariana Lobo Bergamini
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Andressa Pinto Mardegan
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Michelle Palmieri
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Karen Renata Nakamura Hiraki
- Department of Cell Biology, Histology and Embryology, Institute of Biomedical Sciences, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Bengt HassÉus
- Institute of Odontology, The Sahlgrenska Academy, Göteborgs Universitet, Gothenburg, Sweden
| | - Peter Jonasson
- Institute of Odontology, The Sahlgrenska Academy, Göteborgs Universitet, Gothenburg, Sweden
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França GMD, Carmo AFD, Costa Neto H, Andrade ALDLD, Lima KCD, Galvão HC. Macrophages subpopulations in chronic periapical lesions according to clinical and morphological aspects. Braz Oral Res 2019; 33:e047. [DOI: 10.1590/1807-3107bor-2019.vol33.0047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 04/29/2019] [Indexed: 12/26/2022] Open
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Álvares PR, de Arruda JAA, Oliveira Silva LV, da Silva LP, do Nascimento GJF, da Silveira MMF, Sobral APV. Immunohistochemical Analysis of Cyclooxygenase-2 and Tumor Necrosis Factor Alpha in Periapical Lesions. J Endod 2018; 44:1783-1787. [DOI: 10.1016/j.joen.2018.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/22/2018] [Accepted: 09/06/2018] [Indexed: 12/19/2022]
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Immunohistochemical Analysis of Galectins-1, -3, and -7 in Periapical Granulomas, Radicular Cysts, and Residual Radicular Cysts. J Endod 2018; 44:728-733. [PMID: 29510866 DOI: 10.1016/j.joen.2018.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/04/2017] [Accepted: 01/19/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Galectins play important roles in immunoinflammatory responses, but their participation in the development of periapical lesions remains unclear. This study aimed to evaluate the expressions of galectins-1, -3, and -7 in periapical lesions, correlating them with the intensity of the inflammatory infiltrate and the pattern of the cystic epithelium. METHODS Twenty periapical granulomas (PGs), 20 radicular cysts (RCs), and 20 residual radicular cysts (RRCs) were submitted to immunohistochemistry using anti-galectin-1, -3, and -7 antibodies. The percentage of immunopositive cells in epithelial and connective tissues was determined. RESULTS In connective tissue, PGs exhibited higher cytoplasmic/membrane expression of galectins-1 and -7 than RCs and RRCs (P < .05). There was higher nuclear expression of galectin-1 in PGs compared with RCs and RRCs (P < .05). The expression of galectins-1 and -7 in connective tissue was higher in lesions with grade III inflammation (P < .05). No significant differences in galectin-3 immunoexpression were observed for any of the parameters evaluated (P > .05). In the epithelial component, a higher nuclear expression of galectin-7 was detected in RRCs (P < .05), and a higher cytoplasmic/membrane expression of this protein was found in cysts with hyperplastic epithelium (P < .05). Positive correlations were observed between the nuclear and cytoplasmic/membrane expression of galectin-1 in connective tissue (P < .05) as well as between the nuclear and cytoplasmic/membrane expression of galectin-7 in epithelial tissue of cysts (P < .05). CONCLUSIONS Galectins-1 and -7 may play important roles in the pathogenesis of PGs, RCs, and RRCs. On the other hand, the present results suggest only a minor involvement of galectin-3 in the development of these lesions.
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Silva LABD, Sá MAR, Melo RA, Pereira JDS, Silveira ÉJDD, Miguel MCDC. Analysis of CD57+ natural killer cells and CD8+ T lymphocytes in periapical granulomas and radicular cysts. Braz Oral Res 2017; 31:e106. [PMID: 29267667 DOI: 10.1590/1807-3107bor-2017.vol31.0106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/10/2017] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to compare the number of CD57+ natural killer (NK) cells and CD8+ T lymphocytes between periapical granulomas (PGs) and radicular cysts (RCs). Twenty-fives cases of PGs and 25 of RCs were submitted to histological analysis and immunohistochemistry using anti-CD57 and anti-CD8 biomarkers. Positive cells were counted in 10 fields (400× magnification) and the median value was calculated for each case. Statistical tests were used to evaluate differences in the number of CD57+ NK cells and CD8+ T lymphocytes according to type of lesion, intensity of the infiltrate and thickness of the lining epithelium. The number of CD57+ NK cells and CD8+ T lymphocytes was higher in PGs than in RCs (p = 0.129 and p = 0.541, respectively). Comparison of the number of CD57+ NK cells in atrophic and hyperplastic epithelium revealed a larger number of cells in the atrophic epithelium (p = 0.042). A larger number of CD57+ NK cells and CD8+ T lymphocytes were observed in grade III infiltrates compared to grade I/II (p = 0.145 and p = 0.725, respectively). CD8+ T lymphocytes were more prevalent than CD57+ NK cells in most cases when PGs and RCs were analyzed separately or in combination (p < 0.0001). CD57+ NK cells and CD8+ T lymphocytes play a key role in antiviral defense and the presence of these cells supports evidence suggesting the participation of these microorganisms in the pathogenesis of PGs and RCs. The response mediated by CD8+ T lymphocytes was more frequent, indicating greater participation of the adaptive immunity in these chronic lesions.
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Affiliation(s)
| | - Maria Alice Ramalho Sá
- Universidade Federal do Rio Grande do Norte - UFRN, Departament of Dentistry, Natal, RN, Brazil
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Santos SCLT, Couto LA, Fonseca JM, Xavier FCA, Figueiredo ACL, Freitas VS, Freitas RA, Santos JN, Henriques ACG. Participation of osteoclastogenic factors in immunopathogenesis of human chronic periapical lesions. J Oral Pathol Med 2017; 46:846-852. [PMID: 28731540 DOI: 10.1111/jop.12618] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Chronic periapical lesions (CPLs) are common lesions of the oral cavity and are the result of caries, tooth fracture, iatrogenic causes, or factors causing contamination and pulp necrosis. Inflammatory cells participate in the expansion of CPLs by releasing factors that stimulate or inhibit osteolytic activity. The objective of this study was to investigate the participation of RANKL, TNF-α, cathepsin K, IL-33, and OPG in the development of radicular cysts (RCs) and periapical granulomas (PGs). METHODS Paraffin-embedded sections of 30 RCs and 22 PGs were submitted to immunohistochemistry. RESULTS Immunoexpression of the proteins studied was observed in the epithelium and capsule of RCs, as well as in connective tissue of PGs. The expression of the osteoclastogenic factors studied differed significantly in RCs and PGs (P < .001), with lower expression of OPG in RCs. In PGs, the lowest expression was observed for cathepsin K. Comparison of the 2 lesions showed a similar participation of RANKL and IL33, while a significant difference was observed for OPG (P < .001), TNF-α (P = .002), and cathepsin K (P = .016). No association of the expression of the proteins with lesions size was observed. CONCLUSIONS This study demonstrated the participation of RANKL, TNF-α, IL-33, cathepsin K, and OPG in the development of RCs and PGs, with emphasis on the highest immunoreactivity of cathepsin in RCs and TNF-α and OPG in PGs. OPG possibly determines the slower growth of PGs compared to RCs.
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Affiliation(s)
- S C L T Santos
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil
| | - L A Couto
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil
| | - J M Fonseca
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil
| | - F C A Xavier
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil
| | - A C L Figueiredo
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil
| | - V S Freitas
- Postgraduation Program in Public Health, State University of Feira de Santana, Feira de Santana, BA, Brazil
| | - R A Freitas
- Postgraduation Program in Oral Pathology, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - J N Santos
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil
| | - A C G Henriques
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, BA, Brazil
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Andrade ALDL, Santos EM, Carmo AF, Freitas RA, Galvão HC. Analysis of tryptase-positive mast cells and immunoexpression of MMP-9 and MMP-13 in periapical lesions. Int Endod J 2016; 50:446-454. [DOI: 10.1111/iej.12638] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/17/2016] [Indexed: 12/24/2022]
Affiliation(s)
- A. L. D. L. Andrade
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal Brazil
| | - E. M. Santos
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal Brazil
| | - A. F. Carmo
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal Brazil
| | - R. A. Freitas
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal Brazil
| | - H. C. Galvão
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal Brazil
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Bernardi L, Visioli F, Nör C, Rados PV. Radicular Cyst: An Update of the Biological Factors Related to Lining Epithelium. J Endod 2015; 41:1951-61. [PMID: 26603778 DOI: 10.1016/j.joen.2015.08.036] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/16/2015] [Accepted: 08/30/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Radicular cysts are common lesions in daily dentistry practice. However, the mechanisms related to epithelial lining formation and cavity growth are not fully understood. Therefore, the purpose of this article was to review the biological factors implicated in these process. METHODS Literature was selected through a search of PubMed electronic databases matching the following key words in the title or abstract: "cyst" OR "granuloma" OR "abscess" AND "radicular" OR "apical" OR "periapical" AND "epithelium" OR "epithelial" OR "epithelial lining." The PubMed database was searched for articles published between 1975 and 2014. Only English language was applied to the search. RESULTS The literature search yielded a total of 187 articles. After duplicate references were discarded, a subsequent search at the title and abstract level revealed 42 articles for full-text reading. The articles were categorized into 5 main subtopics: (1) cell proliferation, cell cycle, and apoptosis; (2) extracellular matrix constituents; (3) inflammatory components; (4) bone metabolic factors and; (5) others. These subtopics described the characteristics of radicular cysts focusing on the epithelial tissue effects. CONCLUSIONS Several factors from different sources (epithelial cells, stromal cells, extracellular matrix, and bone matrix) were implicated on apical cyst pathogenesis. Probably a combination of many factors involving an epithelial-stromal interaction is responsible for the sustenance and growth of apical cysts.
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Affiliation(s)
- Lisiane Bernardi
- Basic Research Center, Dentistry School, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Fernanda Visioli
- Department of Oral Pathology, Dentistry School, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Carolina Nör
- University Hospital Research Center, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Pantelis Varvaki Rados
- Department of Oral Pathology, Dentistry School, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
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Costa Neto H, de Andrade ALDL, Gordón-Núñez MA, Freitas RDA, Galvão HC. Immunoexpression of tryptase-positive mast cells in periapical granulomas and radicular cysts. Int Endod J 2014; 48:729-35. [DOI: 10.1111/iej.12366] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 08/02/2014] [Indexed: 12/26/2022]
Affiliation(s)
- H. Costa Neto
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal RN Brazil
| | | | | | - R. de A. Freitas
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - H. C. Galvão
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal RN Brazil
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Alcantara BAR, Carli MLD, Beijo LA, Pereira AAC, Hanemann JAC. Correlation between inflammatory infiltrate and epithelial lining in 214 cases of periapical cysts. Braz Oral Res 2014; 27:490-5. [PMID: 24141745 DOI: 10.1590/s1806-83242013005000023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 07/31/2013] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the prevalence of periapical cysts, identify their clinical and microscopic features and correlate their microscopic features with the inflammatory infiltrate present in the lesion site. A total of 214 cases were collected over a 10-year period. Clinical data, including gender, age, race, symptoms and location of the lesion, were recorded. Two independent examiners with no prior knowledge of the patients' clinical data conducted the microscopic evaluations. Statistical analyses were performed using Fisher's or chi-square tests at a 5% level of significance. The results showed that periapical cysts were more prevalent in white women, with a mean age of 35 years, and in the anterosuperior region. The majority of the lesions were lined by atrophic cystic epithelium, which was associated with moderate inflammatory infiltrate in the cystic capsule (p < 0.01), with a diffuse localization pattern (p = 0.03) and absence of neutrophils (p = 0.01). Our findings suggest that periapical cysts lined by atrophic epithelium are related to the presence of moderate mononuclear inflammatory infiltrate.
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Sperandio FF, Carli MLD, Guimaräes EP, Pereira AAC, Hanemann JAC. Noninvasive treatment choice for an aged down syndrome patient presenting a residual periapical cyst. J Contemp Dent Pract 2014; 15:254-7. [PMID: 25095853 DOI: 10.5005/jp-journals-10024-1524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM This is the first report to illustrate the marsupialization as an effective treatment for a Down Syndrome (DS) patient presenting a residual periapical cyst. BACKGROUND These cysts occur within the alveolar ridge, usually at the local site of a previously extracted tooth that did not received proper curettage; usually the surgical excision of a cyst and also the vigorous curettage of a socket is very simple, if not for the fact that mentally disabled patients require rapid and non-stressful procedures. CASE DESCRIPTION The 54-year-old DS patient represented herein received a minimally invasive marsupialization under local anesthesia. Due to the large extent of the lesion, the acrylic resin drain was maintained for 30 days. Through the following period, a daily irrigation of the cystic cavity with saline solution was carried out to prevent a secondary infection within the cystic cavity. A follow-up of 16 months showed no signs of recurrence. CONCLUSION Marsupialization of residual periapical cyst is completely effective and safe, even for a DS patient that is considered to be at an advanced age. CLINICAL SIGNIFICANCE Marsupialization poses as a minimally invasive choice for mentally disabled patients, even when presenting advanced ages; treatment success was stated by the easy clinical conduct, uneventful postoperative situation and the lack of recurrence along 16 months of follow-up.
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Affiliation(s)
- Felipe Fornias Sperandio
- Professor, Department of Pathology, Institute of Biomedical Sciences Alfenas Federal University, Brazil
| | - Marina Lara de Carli
- Postdoctoral Student, Department of Clinic and Surgery, School of Dentistry Alfenas Federal University, Minas Gerais, Brazil
| | - Eduardo Pereira Guimaräes
- MS Student, Department of Clinic and Surgery, School of Dentistry Alfenas Federal University, Minas Gerais, Brazil
| | | | - Joäo Adolfo Costa Hanemann
- Professor, Department of Clinic and Surgery, School of Dentistry Alfenas Federal University, Minas Gerais, Brazil
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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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Andrade ALDLD, Nonaka CFW, Gordón-Núñez MA, Freitas RDA, Galvão HC. Immunoexpression of interleukin 17, transforming growth factor β1, and forkhead box P3 in periapical granulomas, radicular cysts, and residual radicular cysts. J Endod 2013; 39:990-4. [PMID: 23880265 DOI: 10.1016/j.joen.2013.04.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 03/28/2013] [Accepted: 04/03/2013] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Different cell types and cytokines have been identified as contributors to the formation of periapical lesions. In this perspective, this study aimed to evaluate the immunoexpression of interleukin (IL)-17, transforming growth factor (TGF)-β1, and the forkhead box P3 (FoxP3) in periapical lesions, correlating them with the type of lesion, the intensity of the inflammatory infiltrate, and the thickness of the cystic epithelial lining. METHODS Twenty periapical granulomas (PGs), 20 radicular cysts (RCs), and 20 residual radicular cysts (RRCs) were submitted to immunohistochemical analysis using anti-IL-17, anti-TGF-β1, and anti-FoxP3 antibodies. RESULTS In comparison with PGs and RCs, RRCs exhibited a lower immunoexpression of IL-17 and TGF-β1 (P = .021 and P < .001, respectively). The number of FoxP3+ cells increased in this order: RRCs, RCs, and PGs (P < .001). In comparison with lesions with inflammatory infiltrates grades I and II, lesions with inflammatory infiltrate grade III exhibited a higher number of FoxP3+ cells (P = .002). Similarly, in comparison with lesions with inflammatory infiltrates grades II and III, lesions with inflammatory infiltrate grade I showed a tendency for a lower expression of IL-17 and TGF-β1 (P = .085 and P = .051, respectively). For all groups, there was a positive correlation between the immunoexpressions of IL-17 and TGF-β1 (P < .05). Positive correlations between the number of FoxP3+ cells and the immunoexpressions of IL-17 and TGF-β1 (P < .05) were found only in PGs. CONCLUSIONS Th17 and Treg cells seem to interact at the site of injury, suggesting the involvement of proinflammatory and immunoregulatory cytokines in the pathogenesis of periapical lesions.
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Affiliation(s)
- Ana Luiza Dias Leite de Andrade
- Oral Pathology Postgraduate Program, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Peixoto RF, Pereira JDS, Nonaka CFW, da Silveira ÉJD, Miguel MCDC. Immunohistochemical analysis of FoxP3+ cells in periapical granulomas and radicular cysts. Arch Oral Biol 2012; 57:1159-64. [DOI: 10.1016/j.archoralbio.2012.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 02/02/2012] [Accepted: 02/03/2012] [Indexed: 01/03/2023]
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Ruiz PA, Toledo OAD, Nonaka CFW, Pinto LP, Souza LBD. Immunohistochemical expression of vascular endothelial growth factor and matrix metalloproteinase-9 in radicular and residual radicular cysts. J Appl Oral Sci 2011; 18:613-20. [PMID: 21308293 PMCID: PMC3881759 DOI: 10.1590/s1678-77572010000600013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 10/22/2009] [Indexed: 01/03/2023] Open
Abstract
Objective This study assessed and compared the immunoexpression of vascular endothelial
growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in radicular cysts
(RCs) and residual radicular cysts (RRCs), relating them to the angiogenic index
and the intensity of the inflammatory infiltrate. Material and Methods Twenty RCs and 10 RRCs were evaluated by immunohistochemistry using anti-VEGF and
anti-MMP-9 antibodies. The angiogenic index was determined by microvessel count
(MVC) using anti-von Willebrand factor antibody. Results The expression of both VEGF and MMP-9 was higher in RCs than in RRCs. RCs and RRCs
presented strong epithelial expression of VEGF, irrespective of the intensity of
the inflammatory infiltrate. Lesions with strong expression of MMP-9 showed
significantly higher number of immunopositive cells for VEGF (p<0.05) and
higher MVC (p<0.05). Lesions with dense inflammatory infiltrate exhibited
significantly higher MVC (p<0.05) and higher number of immunopositive cells for
VEGF (p<0.05). There was a positive correlation between both MVC (p<0.05)
and the quantity of immunopositive cells for VEGF (p<0.05), with intensity of
the inflammatory infiltrate. In addition, it was observed a positive correlation
between the number of immunopositive cells for VEGF and MVC (p<0.05). Conclusions VEGF and MMP-9 might play important roles in the angiogenesis in RCs and RRCs. In
these lesions, the expression of these molecules and the MVC is closely related to
the intensity of the inflammatory infiltrate. The expression of VEGF in the
epithelial lining of RCs and RRCs might be important for the enlargement of these
lesions.
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Ayoub MS, Baghdadi HM, El-Kholy M. Immunohistochemical detection of laminin-1 and Ki-67 in radicular cysts and keratocystic odontogenic tumors. BMC Clin Pathol 2011; 11:4. [PMID: 21366912 PMCID: PMC3056737 DOI: 10.1186/1472-6890-11-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 03/02/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Odontogenic cysts are those which arise from the epithelium associated with the development of teeth. Some odontogenic cysts were found to have special biological features that make them distinct from other lesions. This study was conducted to detect the immunoepxression of laminin-1 and Ki-67 in both radicular cysts (RCs) and keratocystic odontogenic tumors (KCOTs) and to examine the possible predictive value of these markers. METHODS Thirteen cases of RCs and twelve cases of KCOTs were included in this study. Antibodies against laminin-1 and Ki-67 were used as primary antibodies. RESULTS ten cases out of thirteen cases of RCs were immunopositive to laminin-1. The immunonegative cases of RCs showed high degree of inflammation inside the connective tissue wall. One case out of twelve cases of KCOTs was immunopositive to laminin-1 and the rest were immunonegative. Seven cases out of thirteen cases of RCs showed immunopositivity for Ki-67 with increased numbers of immunopositive cells when the inflammation was severe in the connective tissue wall. All KCOTS were immunopositive to Ki-67. CONCLUSIONS The benign nature of radicular cysts and the aggressive behavior of keratocystic odontogenic tumors could be explained by the expression of laminin and Ki-67. Laminin-1 and Ki-67 could be valuable markers for the prediction of the biologic behavior of cystic lesions.
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Affiliation(s)
- Mohamed S Ayoub
- Professor, Oral Pathology Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
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Santos LCS, Vilas Bôas DS, Oliveira GQV, Ramos EAG, Gurgel CAS, Santos JND. Histopathological study of radicular cysts diagnosed in a Brazilian population. Braz Dent J 2011; 22:449-54. [DOI: 10.1590/s0103-64402011000600002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 10/01/2011] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the histopathological features of radicular cysts (RCs) diagnosed in a Brazilian population. Seventy-three cases of RCs, from a total of 1480 biopsies diagnosed between 2001 and 2008 at the Laboratory of Oral Surgical Pathology of the Dental School of the Federal University of Bahia were investigated regarding their histopathological features. Morphological results showed that exocytosis (n=50), spongiosis (n=40), acanthosis (n=28), atrophic epithelium (n=27) and apoptotic bodies (n=21) were the most common findings. Other morphological findings included: foamy macrophages (n=10), Russell’s bodies (n=7), cholesterol crystals (n=7) and glandular-like odontogenic epithelial rests (n=1). Evidence of exogenous material was seen in 16 samples. It was concluded that the clinical and histopathological findings observed in Brazilian patients were comparable with those described for other populations.
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Nonaka CFW, Maia AP, Nascimento GJFD, de Almeida Freitas R, Batista de Souza L, Galvão HC. Immunoexpression of vascular endothelial growth factor in periapical granulomas, radicular cysts, and residual radicular cysts. ACTA ACUST UNITED AC 2008; 106:896-902. [PMID: 18755620 DOI: 10.1016/j.tripleo.2008.06.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2008] [Revised: 06/30/2008] [Accepted: 06/30/2008] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Our aim was to assess and compare the immunoexpression of vascular endothelial growth factor (VEGF) in periapical granulomas (PGs), radicular cysts (RCs), and residual radicular cysts (RRCs), relating it to the angiogenic index and the intensity of the inflammatory infiltrate. STUDY DESIGN Twenty PGs, 20 RCs, and 10 RRCs were evaluated by immunohistochemistry using anti-VEGF antibody. Angiogenic index was determined by microvessel count (MVC) using anti-von Willebrand factor antibody. RESULTS The PGs and RCs showed higher expression of VEGF than the RRCs. Lesions presenting few inflammatory infiltrate revealed the lowest immunoexpression of VEGF (P < .05). Irrespective of the intensity of the inflammatory infiltrate, most of the RCs and RRCs showed moderate to strong epithelial expression of VEGF. Lesions showing dense inflammatory infiltrate presented higher MVC indices (P < .05). VEGF expression and MVC did not reveal a significant correlation (P > .05). CONCLUSIONS VEGF is present in periapical inflammatory lesions but at a lower level in RRCs. The expression of this proangiogenic factor is closely related to the intensity of the inflammatory infiltrate in these lesions.
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Santos LC, Ramos EAG, Gurgel CAS, de Santana EJB, Dos Santos JN. Immunohistochemical detection of Langerhans cells in dental granulomas and radicular cysts. J Mol Histol 2007; 38:201-5. [PMID: 17427037 DOI: 10.1007/s10735-007-9088-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Accepted: 03/22/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Dental granulomas (DGs) and radicular cysts (RCs) are chronic periapical lesions frequently involving the jaws. Langerhans cells (LCs) are dendritic cells responsible for the presentation of antigens to T lymphocytes. This study examined the expression of LCs in DG and RCs by immunohistochemical staining. STUDY DESIGN Eighteen cases of DGs and 26 cases of RCs were analyzed using anti-CD1a marker. RESULTS CD1a-labeled LCs were observed in 11.1% of DGs and in 69.2% of RCs, showing a significant correlation (P < 0.0001; Fisher's test). In DGs, LCs were only observed in granulation tissue, showing discrete immunostaining density. In RCs, LCs exhibited both a round and a dendritic shape in all epithelial layers. Although a correlation was observed between immunostaining density and epithelial thickness, as well as between immunostaining and inflammatory intensity, the differences were not significant in radicular cysts. CONCLUSION Langerhans cells provide important insight into the immunopathogenesis of chronic periapical lesions.
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Loyola AM, Cardoso SV, Lisa GS, Oliveira LJ, Mesquita RA, Carmo MAV, Aguiar MCF. Apoptosis in epithelial cells of apical radicular cysts. Int Endod J 2005; 38:465-9. [PMID: 15946267 DOI: 10.1111/j.1365-2591.2005.00971.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To investigate the occurrence of apoptotic cell death in the epithelium of radicular cysts and to compare its frequency in lesions presenting a distinct functional state. METHODOLOGY Twenty radicular cysts were selected and arranged into two groups with 10 lesions in each group: atrophic (quiescent) and hyperplastic (active) epithelium. Morphologic investigations of apoptosis were conducted by means of optic microscopy in haematoxylin and eosin slides. Immunohistochemical techniques to detect the bcl-2 protein were carried out by streptavidin-biotin-peroxidase assay. In both instances, 30 sequential high-power microscopic fields were observed to determine apoptotic (AI) and bcl-2 immunostaining (bcl-2I) indexes. The presence of AI and bcl-2I within the two groups was compared using the t-test. Correlation between the AI and the bcl-2I was investigated using the Spearman test. RESULTS Apoptosis was detected in the epithelium of all cysts. Higher AI levels were found in lesions with an atrophic (0.17 +/- 0.19) rather than a hyperplastic (0.10 +/- 0.10) epithelium. The same was found for the bcl-2I levels (0.06 +/- 0.03 vs. 0.04 +/- 0.01, respectively). However, these differences were not statistically significant. A positive and significant correlation was found between AI and bcl-2I. CONCLUSIONS Apoptosis was always present in the epithelium of the lesions and was more frequent in lesions with atrophic (quiescent) epithelium.
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Affiliation(s)
- A M Loyola
- Oral Pathology Laboratory, School of Dentistry, Federal University of Uberlândia, Brazil
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Lukić A, Danilović V, Petrović R. Imunopatogenetski mehanizmi nastanka i razvoja hronicnih zubnih periapeksnih lezija. VOJNOSANIT PREGL 2005; 62:219-26. [PMID: 15790051 DOI: 10.2298/vsp0503219l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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de Sá AR, Pimenta FJGS, Dutra WO, Gomez RS. Immunolocalization of interleukin 4, interleukin 6, and lymphotoxin alpha in dental granulomas. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 96:356-60. [PMID: 12973294 DOI: 10.1016/s1079-2104(03)00067-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the immunolocalization of the interleukin (IL) 4, IL-6, and lymphotoxin (LT) alpha in dental granulomas and correlate their expression with the intensity of the inflammatory infiltrate. Study design Fifteen paraffin specimens of dental granulomas were selected, and the streptavidin-biotin complex stain was used to detect IL-4, IL-6, and LT-alpha. RESULTS Our results revealed a significant statistical correlation between the intensity of inflammatory infiltrate and the percentage of mononuclear cells positive for IL-4. Moreover, we observed a statistically significant correlation between the frequency of cells expressing IL-6 and LT-alpha. CONCLUSION These data suggest that the predominance of a helper T cell subtype 2 response in dental granulomas is correlated with the exacerbation of the inflammatory reaction and its evolution. Moreover, a correlation between the frequency of IL-6-positive and LT-alpha-positive cells suggests that the synergistic activities of these 2 cytokines may be involved in the pathogenesis of this inflammatory condition.
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