Advances in epithelial kinetics--an oral view

ICRP Publication 131: Stem Cell Biology with Respect to Carcinogenesis Aspects of Radiological Protection

This report provides a review of stem cells/progenitor cells and their responses to ionising radiation in relation to issues relevant to stochastic effects of radiation that form a major part of the International Commission on Radiological Protection's system of radiological protection. Current information on stem cell characteristics, maintenance and renewal, evolution with age, location in stem cell 'niches', and radiosensitivity to acute and protracted exposures is presented in a series of substantial reviews as annexes concerning haematopoietic tissue, mammary gland, thyroid, digestive tract, lung, skin, and bone. This foundation of knowledge of stem cells is used in the main text of the report to provide a biological insight into issues such as the linear-no-threshold (LNT) model, cancer risk among tissues, dose-rate effects, and changes in the risk of radiation carcinogenesis by age at exposure and attained age. Knowledge of the biology and associated radiation biology of stem cells and progenitor cells is more developed in tissues that renew fairly rapidly, such as haematopoietic tissue, intestinal mucosa, and epidermis, although all the tissues considered here possess stem cell populations. Important features of stem cell maintenance, renewal, and response are the microenvironmental signals operating in the niche residence, for which a well-defined spatial location has been identified in some tissues. The identity of the target cell for carcinogenesis continues to point to the more primitive stem cell population that is mostly quiescent, and hence able to accumulate the protracted sequence of mutations necessary to result in malignancy. In addition, there is some potential for daughter progenitor cells to be target cells in particular cases, such as in haematopoietic tissue and in skin. Several biological processes could contribute to protecting stem cells from mutation accumulation: (a) accurate DNA repair; (b) rapidly induced death of injured stem cells; (c) retention of the DNA parental template strand during divisions in some tissue systems, so that mutations are passed to the daughter differentiating cells and not retained in the parental cell; and (d) stem cell competition, whereby undamaged stem cells outcompete damaged stem cells for residence in the niche. DNA repair mainly occurs within a few days of irradiation, while stem cell competition requires weeks or many months depending on the tissue type. The aforementioned processes may contribute to the differences in carcinogenic radiation risk values between tissues, and may help to explain why a rapidly replicating tissue such as small intestine is less prone to such risk. The processes also provide a mechanistic insight relevant to the LNT model, and the relative and absolute risk models. The radiobiological knowledge also provides a scientific insight into discussions of the dose and dose-rate effectiveness factor currently used in radiological protection guidelines. In addition, the biological information contributes potential reasons for the age-dependent sensitivity to radiation carcinogenesis, including the effects of in-utero exposure.

Dormancy activation mechanism of oral cavity cancer stem cells

Radiotherapy and chemotherapy are targeted primarily at rapidly proliferating cancer cells and are unable to eliminate cancer stem cells in the G0 phase. Thus, these treatments cannot prevent the recurrence and metastasis of cancer. Understanding the mechanisms by which cancer stem cells are maintained in the dormant G0 phase, and how they become active is key to developing new cancer therapies. The current study found that the anti-cancer drug 5-fluorouracil, acting on the oral squamous cell carcinoma KB cell line, selectively killed proliferating cells while sparing cells in the G0 phase. Bisulfite sequencing PCR showed that demethylation of the Sox2 promoter led to the expression of Sox2. This then resulted in the transformation of cancer stem cells from the G0 phase to the division stage and suggested that the transformation of cancer stem cells from the G0 phase to the division stage is closely related to an epigenetic modification of the cell.

Epidermal homeostasis and radiation responses in a multiscale tissue modeling framework

The surface of the skin is lined with several thin layers of epithelial cells that are maintained throughout a lifetime by a small population of stem cells. High dose radiation exposures could injure and deplete the underlying proliferative cells and induce cutaneous radiation syndrome. In this work we propose a multiscale computational model for skin epidermal dynamics that links phenomena occurring at the subcellular, cellular, and tissue levels of organization, to simulate the experimental data of the radiation response of swine epidermis, which is very similar to human epidermis. Incorporating experimentally measured histological and cell kinetic parameters, we obtain results of population kinetics and proliferation indices comparable to observations in unirradiated and acutely irradiated swine experiments. At the sub-cellular level, several recently published Wnt signaling controlled cell-cycle models are applied and the roles of key components and parameters are analyzed. This integrated model allows us to test the validity of several basic biological rules at the cellular level and sub-cellular mechanisms by qualitatively comparing simulation results with published research, and enhances our understanding of the pathophysiological effects of ionizing radiation on the skin.

Oral epithelial stem cells in tissue maintenance and disease: the first steps in a long journey

The identification and characterization of stem cells is a major focus of developmental biology and regenerative medicine. The advent of genetic inducible fate mapping techniques has made it possible to precisely label specific cell populations and to follow their progeny over time. When combined with advanced mathematical and statistical methods, stem cell division dynamics can be studied in new and exciting ways. Despite advances in a number of tissues, relatively little attention has been paid to stem cells in the oral epithelium. This review will focus on current knowledge about adult oral epithelial stem cells, paradigms in other epithelial stem cell systems that could facilitate new discoveries in this area and the potential roles of epithelial stem cells in oral disease.

Challenges to the study of asymmetric cell division in corneal and limbal epithelia

Asymmetrical cell division in mammalian corneal epithelia is not widely accepted and it is not well characterized. Although some data led to propose that asymmetrical division occurs along the entire corneal epithelium, evidence from different laboratories implies that asymmetrical cell division in adult individuals could be confined to limbal epithelium, as suggested by the location of the corneal epithelial stem cells and the distribution of some molecular markers involved in regulation of stratification and cell differentiation. Nevertheless, most evidence sustaining the participation of asymmetric mitosis in corneal development and differentiation is merely an inference. Recent results based in cell culture experiments suggest that asymmetric division is part of the differentiation program; in such case, mitotic spindle orientation would be regulated by the structure, composition and active signaling pathways at the stem cell niche. Together, the results support the view that in adults, asymmetric division might be confined to limbus, and hence, the process takes place both in apico-basal oriented cells and in cells in which the mitotic spindle is horizontally oriented. In contrast, during development, asymmetrical divisions would be determined by intrinsic mechanisms involving cell polarity, predominantly occurring in apico-basal oriented cells. Future studies should be oriented to understand the regulation of the asymmetrical/symmetrical division, and the control of cell fate by the niche.

P21cip-overexpression in the mouse beta cells leads to the improved recovery from streptozotocin-induced diabetes

Under normal conditions, the regeneration of mouse β cells is mainly dependent on their own duplication. Although there is evidence that pancreatic progenitor cells exist around duct, whether non-β cells in the islet could also potentially contribute to β cell regeneration in vivo is still controversial. Here, we developed a novel transgenic mouse model to study the pancreatic β cell regeneration, which could specifically inhibit β cell proliferation by overexpressing p21^cip in β cells via regulation of the Tet-on system. We discovered that p21 overexpression could inhibit β-cell duplication in the transgenic mice and these mice would gradually suffer from hyperglycemia. Importantly, the recovery efficiency of the p21-overexpressing mice from streptozotocin-induced diabetes was significantly higher than control mice, which is embodied by better physiological quality and earlier emergence of insulin expressing cells. Furthermore, in the islets of these streptozotocin-treated transgenic mice, we found a large population of proliferating cells which expressed pancreatic duodenal homeobox 1 (PDX1) but not markers of terminally differentiated cells. Transcription factors characteristic of early pancreatic development, such as Nkx2.2 and NeuroD1, and pancreatic progenitor markers, such as Ngn3 and c-Met, could also be detected in these islets. Thus, our work showed for the first time that when β cell self-duplication is repressed by p21 overexpression, the markers for embryonic pancreatic progenitor cells could be detected in islets, which might contribute to the recovery of these transgenic mice from streptozotocin-induced diabetes. These discoveries could be important for exploring new diabetes therapies that directly promote the regeneration of pancreatic progenitors to differentiate into islet β cells in vivo.

Stem cell patterns in cell lines derived from head and neck squamous cell carcinoma

The initiation, growth, recurrence and metastasis of solid tumours, including squamous cell carcinoma of the head and neck region, have been related to the behaviour of a small subpopulation of 'tumour-initiating' cells. Cells with stem cell characteristics have also been identified in cell lines derived from cancers and the aim of the present work was to extend examination of such cells. Established cell lines were examined for their patterns of colony morphologies and staining, the presence of a Hoechst dye-excluding 'side population', expression of the putative stem cell markers CD44, CD133 and CD29, and their ability to grow as 'cancer spheroids'. Two cell lines, CaLH2 and CaLH3, recently generated from HNSCC tumour biopsies, were similarly examined. All cell lines showed a holoclone/meroclone/paraclone series of colony morphologies and cell sorting indicated that CD44 marker expression was related to clonogenicity. FACS analysis after exposure to Hoechst dye indicated that the CA1, H357 and UK1 cell lines contain a dye-excluding 'side population', a property associated with stem-like subpopulations. When held in suspension, all cell lines formed spheroids that could be re-passaged. These observations indicate that cell lines derived from HNSCC contain cells with stem cell properties and that such cell lines may provide experimental systems relevant to the behaviour of stem cells present in the tumours of origin and to their responses to therapy.

Radon exposure of the skin: I. Biological effects

Radon progeny can plate out on skin and give rise to exposure of the superficial epidermis from alpha emitters Po-218 (7.7 MeV, range approximately 66 microm) and Po-214 (6 MeV, range approximately 44 microm). Dose rates from beta/gamma emitters Pb-214 and Bi-214 are low and only predominate at depths in excess of the alpha range. This paper reviews the evidence for a causal link between exposure from radon and its progeny, and deterministic and stochastic biological effects in human skin. Radiation induced skin effects such as ulceration and dermal atrophy, which require irradiation of the dermis, are ruled out for alpha irradiation from radon progeny because the target cells are considerably deeper than the range of alpha particles. They have not been observed in man or animals. Effects such as erythema and acute epidermal necrosis have been observed in a few cases of very high dose alpha particle exposures in man and after acute high dose exposure in animals from low energy beta radiations with similar depth doses to radon progeny. The required skin surface absorbed doses are in excess of 100 Gy. Such effects would require extremely high levels of radon progeny. They would involve quite exceptional circumstances, way outside the normal range of radon exposures in man. There is no definitive identification of the target cells for skin cancer induction in animals or man. The stem cells in the basal layer which maintain the epidermis are the most plausible contenders for target cells. The majority of these cells are near the end of the range of radon progeny alpha particles, even on the thinnest body sites. The nominal depth of these cells, as recommended by the International Commission on Radiological Protection (ICRP), is 70 microm. There is evidence however that some irradiation of the hair follicles and/or the deeper dermis, as well as the inter-follicular epidermis, is also necessary for skin cancer induction. Alpha irradiation of rodent skin that is restricted to the epidermis does not produce skin cancer. Accelerator generated high energy helium and heavy ions can produce skin cancer in rodents at high doses, but only if they penetrate deep into the dermis. The risk figures for radiation induced skin cancer in man recommended by the ICRP in 1990 are based largely on x and beta irradiated cohorts, but few data exist below absorbed doses of about 1 Gy. The only plausible finding of alpha-radiation induced skin cancer in man is restricted to one study in Czech uranium miners. There is no evidence in other uranium miners and the Czech study has a number of shortcomings. This review concludes that the overall balance of evidence is against causality of radon progeny exposure and skin cancer induction. Of particular relevance is the finding in animal studies that radiation exposure of cells which are deeper than the inter-follicular epidermis is necessary to elicit skin cancer. In spite of this conclusion, a follow-on paper evaluates the attributable risk of radon to skin cancer in the UK on the basis that target cells for skin cancer induction are the cells in the basal layer of the inter-follicular epidermis-since this is the conservative assumption made by international bodies such as the International Commission on Radiological Protection (ICRP) for general radiological protection purposes.

Morphological evidence for the role of suprabasal keratinocytes in wound reepithelialization

The process by which wounds reepithelialize remains controversial. Two models have been proposed to describe reepithelialization: the "sliding" model and the "rolling" model. In the "sliding" model, basal keratinocytes are the principal cells responsible for migration and wound closure. In this model, basal and suprabasal keratinocytes remain strongly attached to leading edge basal keratinocytes and are then passively dragged along as a sheet. The "rolling" model postulates that basal keratinocytes remain strongly attached to the basement membrane zone while suprabasal keratinocytes at the wound margin are activated to roll into the wound site. The purpose of this study was to determine which populations of keratinocytes are actively involved in reepithelialization. We evaluated expression of keratins K14, K15, K10, K2e, and K16 as well as the proliferation marker Ki67 in the migrating tongue of normal human incisional 1-hour to 28-day wounds and normal human 3 mm diameter excisional 1- to 7-day wounds. Our results show dramatic changes in phenotype and protein expression of keratins K10, K2e, K14, K15, and K16 in suprabasal keratinocytes in response to injury. We conclude that this large population of suprabasal keratinocytes actively participates in wound closure.

Rare amplicons implicate frequent deregulation of cell fate specification pathways in oral squamous cell carcinoma

Genomes of solid tumors are characterized by gains and losses of regions, which may contribute to tumorigenesis by altering gene expression. Often the aberrations are extensive, encompassing whole chromosome arms, which makes identification of candidate genes in these regions difficult. Here, we focused on narrow regions of gene amplification to facilitate identification of genetic pathways important in oral squamous cell carcinoma (SCC) development. We used array comparative genomic hybridization (array CGH) to define minimum common amplified regions and then used expression analysis to identify candidate driver genes in amplicons that spanned <3 Mb. We found genes involved in integrin signaling (TLN1), survival (YAP1, BIRC2), and adhesion and migration (TLN1, LAMA3, MMP7), as well as members of the hedgehog (GLI2) and notch (JAG1, RBPSUH, FJX1) pathways to be amplified and overexpressed. Deregulation of these and other members of the hedgehog and notch pathways (HHIP, SMO, DLL1, NOTCH4) implicates deregulation of developmental and differentiation pathways, cell fate misspecification, in oral SCC development.

Comparison of Keratinocyte Proliferation in Diabetic and Non-Diabetic Inflamed Gingiva

BACKGROUND

Keratinocytes are chiefly cells of the epidermis but also constitute 90% of the gingival cells. The molecular mechanisms of proliferative activity in keratinization whereby diabetes alters periodontal physiology have not been elucidated. In this study, we aimed to investigate the role of gingival keratinocytes in hyperglycemic subjects by examining their mitotic activities.

METHODS

We tested 30 patients with periodontitis, of whom 15 were type II diabetics and the remainder systemically healthy. Biopsies were obtained from the bottom of the deepest pocket in each subject by reverse beveled incision. Formalin-fixed and paraffin-embedded specimens were then processed for periodic acid-Schiff (PAS)-diastase histochemistry and proliferating cell nuclear antigen (PCNA) (P10). Immunohistochemical studies were employed to determine the presence of PCNA and were used to detect the proliferating potential of keratinocytes needed in synthesizing DNA. The expression of PCNA was evaluated using an immunoperoxidase technique and PC10 monoclonal antibody to PCNA. Mitotic index was calculated from basal cells. Statistical analysis employed the chi-square test.

RESULTS

No significant difference between the diabetic and non-diabetic patients was found in the mitotic index of the oral-gingival epithelium.

CONCLUSION

Although the mitotic index in patients with diabetes was slightly lower, keratinization in the gingival tissues for both groups was essentially identical.

Cell-cycle regulatory proteins in human wound healing

Proper healing of mucosal wounds requires careful orchestration of epithelial cell migration and proliferation. To elucidate the molecular basis of the lack of cellular proliferation in the migrating 'epithelial tongue' during the re-epithelialization of oral mucosal wounds, the expression of cell-cycle regulators critical for G(1)-phase progression and S-phase entry was here analysed immunohistochemically. Compared to normal human mucosa, epithelia migrating to cover 2- or 3-day-old wounds made either in vivo or in an organotypic cell culture all showed loss of the proliferation marker Ki67 and cyclins D(1) and A, and reduced expression of cyclins D(3) and E, the cyclin D-dependent kinase 4 (CDK4), the MCM7 component of DNA replication origin complexes and the retinoblastoma protein pRb. Among the CDK inhibitors (CKIs), p16ink4a and p21Cip1 were moderately increased and decreased, respectively, whereas the abundance of most of the CKIs, including p27Kip1, p57Kip2, p15ink4b and p18ink4c, was relatively maintained in the migrating epithelial tongue. These data indicate that downmodulation of several G(1)/S-phase cyclins and a relative excess of CKIs may cooperate to ensure the quiescent state of migrating keratinocytes during wound healing.

Biology of oral mucosa and esophagus

The mucosal lining of the oral cavity and esophagus functions to protect the underlying tissue from mechanical damage and from the entry of microorganisms and toxic materials that may be present in the oropharynx. In different regions, the mucosa shows adaptation to differing mechanical demands: Masticatory mucosa consists of a stratified squamous keratinized epithelium tightly attached to the underlying tissues by a collagenous connective tissue, whereas lining mucosa comprises a nonkeratinized epithelium supported by a more elastic and flexible connective tissue. The epithelium is constantly replaced by cell division in the deeper layers, and turnover is faster in the lining than in the masticatory regions. Chemotherapeutic agents and radiation limit proliferation of the epithelium so that it becomes thin or ulcerated; this will first occur in the lining regions. The principal patterns of epithelial differentiation are represented by keratinization and nonkeratinization. As keratinocytes enter into differentiation, they become larger and begin to flatten and to accumulate cytokeratin filaments. In addition to the keratins, the differentiating keratinocytes synthesize and retain a number of specific proteins, including profilaggrin, involucrin, and other precursors of the thickening of the cell envelope in the most superficial layers. The concept of epithelial homeostasis implies that cell production in the deeper layers will be balanced by loss of cells from the surface. There is a rapid clearance of surface cells, which acts as a protective mechanism by limiting colonization and invasion of microorganisms adherent to the mucosal surface.

Nuclear morphometry in experimental oral mucosal carcinogenesis

The area, perimeter and diameter of basal cell nuclei of rat palatal epithelium were measured and the deviation of the basal cell nuclear profile from the form of a sphere was assessed after the application of the carcinogen 4-nitroquinoline-1-oxide (4NQO). After a 24-week treatment-free period, designed to eliminate the irritant effect of the carcinogen, the rats were killed, the palatal mucosa was recovered and processed and the nuclear histometry was assessed with image analysis techniques. The basal cell nuclear area increased as the epithelium became dysplastic and then decreased as carcinoma developed, but there were significant variations in this parameter in the control groups. Basal cell nuclei from moderately or severely dysplastic epithelium, and from epithelium adjacent to areas of invasive carcinoma, were significantly less regular in profile by comparison with control nuclei. Variations in nuclear profile, but not nuclear area, perimeter or diameter, might reflect fundamental nuclear alterations of significance during the process of carcinogenesis.

Oral mucosal Langerhans' cells

Langerhans' cells (LC) are dendritic, antigen-presenting cells present within the epithelium of skin and mucosa, including that of the oral cavity. This article reviews the literature on the phenotypic and functional features of oral mucosal Langerhans' cells, and speculates on other aspects by extrapolating from data on their epidermal counterparts.

Distribution of tenascin in healing incision, excision and laser wounds

The distribution of the extracellular matrix glycoprotein, tenascin, was studied in normal mucosa and during healing of scalpel incised or excised and CO2 laser-wounded rat tongue dorsal mucosa in 51 male Sprague-Dawley rats over a period of 21 days. A polyclonal antibody specific for tenascin was applied in indirect immunofluorescence microscopy. In normal mucosa tenascin was sparsely distributed in a discontinuous manner at the tips of the connective tissue papillae in association with the basement membrane (BM) and in the walls of the capillaries. In all the healing wounds there was a marked increase in the distribution of tenascin, particularly close to the BMs at the wound edges beneath the proliferating and migrating epithelium, and later on during healing in the regenerating connective tissue (CT) area. This expression subsided later on during healing. Laser surgery did not alter the ability of fibroblasts to synthesize tenascin. The transient expression of tenascin in the BMs and CT of the healing wounds suggests that this protein could play an important role in providing ideal conditions for cell movement, and in the deposition and organization of other extracellular matrix (ECM) glycoproteins during tissue repair.

The type, origin and function of the odontogenic cells of continuously growing guinea-pig molars

Little is known about which cell types act as the origin of odontogenic stem cells and how these stem cells differentiate to become functional. In the present study 3-day-old guinea-pigs were injected with tritiated thymidine, killed at intervals and their molars studied. The odontogenic cells were found to originate from the stem cells which by autoradiography were shown to be slow cycling and lightly labelled. As they differentiated they became heavily labelled and were designated transit 'dividing cells'. With further differentiation the cells were unlabelled and were designated 'simple transit cells'. It was concluded from the present study that outer enamel epithelium functioned as the source of all odontogenic epithelium; that primitive mesenchyme around the cervical loop functioned as the source of all odontogenic mesenchyme and that all of the transit cells which differentiated to become functional migrated coronally.

Cell surface carbohydrates are markers of differentiation in human oral epithelium

Carbohydrates of the epithelial cell membrane are involved in cell-cell and cell-substrate interaction, and changes are seen in relationship to cell differentiation and neoplastic transformation. The terminal part of carbohydrate structures carried on oral epithelial cells often expresses antigens of the ABO and Lewis blood group systems. The expression of these antigens are in oral mucosa genetically regulated by the A, B, H, Lewis, and secretor genes with subsequent correspondence between the blood group antigens expressed on erythrocytes and on oral epithelial cells. Variation in expression of carbohydrates is also seen in relationship to terminal differentiation in that blood group antigens and their immediate precursor structures are sequentially expressed on cells during their pathway through the epithelium. Various organs and tissues differ in their expression of cell surface carbohydrates. In oral mucosa, a close relationship is seen between the type of tissue differentiation and expression of blood group antigen; keratinized, nonkeratinized, and junctional epithelium all show different patterns of carbohydrate expression.

Architectural organization of human oral epithelium as visualized by keratin staining pattern in tobacco-associated leukoplakias

The keratin staining pattern in clinical normal buccal mucosa in smokers and non-smokers and in tobacco-associated leukoplakias histologically characterized by the chevron type of keratinization were studied. No differences in keratin staining pattern were found in normal buccal mucosa in smokers and non-smokers. In the tobacco-associated leukoplakias we found distinct differences in staining pattern between areas overlying connective tissue papillae and epithelial ridge areas indicating a lateral organization of oral epithelium related to the ridge system. It seems possible to explain this pattern in terms of current hypotheses of the proliferative conditions in squamous epithelia as previously studied in detail in the epidermis and tongue filiform papillae. We conclude, that our results confirm the presence of subpopulations of suprabasal and basal cells and support the presence of proliferative units in oral epithelium. Furthermore, smoking does not seem to influence the keratin staining pattern in clinically normal buccal mucosa.

Basal cell nuclear size in experimental oral mucosal carcinogenesis

It has been suggested that the size of the nuclei of epithelial basal cells can be used in predicting the likelihood of malignant transformation of epithelium. This proposition was assessed in rat palatal epithelium after the carcinogen 4-nitroquinoline-1-oxide had been applied to the epithelium for varying periods of time. No consistent alterations in basal cell nuclear size, including area, perimeter, diameter and regularity of form were found with routine light microscopy as the epithelium passed through various stages of dysplasia to carcinoma. This finding casts doubt on the value of using a variation of basal cell nuclear size as a predictor of malignant transformation.

Epidermal cell kinetics of the pig: a review

Age-related changes in cell kinetic parameters for the epidermis of pigs have been shown to be small, indicating that young pigs may be used for experimental studies. It was not possible to draw any firm conclusions about any strain-related differences in the cell kinetics of the epidermis of the pig. Lower LI values have been quoted for the miniature pig and the Yorkshire pig than for the Large White pig. However, these differences may be related to variations in experimental technique. The cell kinetic data for the Yorkshire pig are not consistent. Very high values for the mitotic index suggested a high rate of cell turnover, whilst data from single pulse labelling and grain count halving studies indicate a relatively low rate of cell turnover. The results from continuous labelling studies on the epidermis of the Yorkshire pig suggest that the basal cell turnover time (TT) is a factor of two or more shorter (136 h) than the estimates obtained using other methods. In the Large White pig estimates of TT were similar using a variety of techniques and were comparable with the TT estimate for the Yorkshire pig obtained using the continuous labelling method. There is some degree of inconsistency in the literature with regard to possible diurnal variations in the cell kinetic parameters for the epidermis. In the study of Archambeau & Bennet (1984) distinct diurnal variations were found in the LI, although the reliability of this finding is questionable due to the small number of animals used. Later studies by Morris et al. (1987) have suggested that diurnal variations are negligible in the epidermis of the pig. The majority of labelled cells (80%) in pig epidermis are located in the basal layer, although a significant proportion (20%) occurs suprabasally, in the cell layer immediately above the basal layer. Therefore, the epidermis can be regarded as having a bilayered proliferative cell compartment. The results from studies on irradiated pig skin (Morris & Hopewell, 1986, 1988, 1989) are not consistent with the presence of a homogeneous proliferative compartment in the epidermis, and are best explained by the occurrence of an heterogeneous proliferative compartment consisting of a stem cell subpopulation and a much larger population of transit proliferative cells.

The skin: its structure and response to ionizing radiation

The response of the skin to ionizing radiation has important implications both for the treatment of malignant disease by radiation and for radiological protection. The structural organization of human skin is described and compared with that of the pig, with which it shows many similarities, in order that the response of the skin to ionizing radiation may be more fully understood. Acute radiation damage to the skin is primarily a consequence of changes in the epidermis; the timing of the peak of the reaction is related to the kinetic organization of this layer. The rate of development of damage is independent of the radiation dose, since this is related to the natural rate of loss of cells from the basal layer of the epidermis. Recovery of the epidermis occurs as a result of the proliferation of surviving clonogenic basal cells from within the irradiated area. The presence of clonogenic cells in the canal of the hair follicle is important, particularly after non-uniform irradiation from intermediate energy beta-emitters. The migration of viable cells from the edges of the irradiated site is also significant when small areas of skin are irradiated. Late damage to the skin is primarily a function of radiation effects on the vasculature; this produces a wave of dermal atrophy after 16-26 weeks. Dermal necrosis develops at this time after high doses. A second phase of dermal thinning is seen to develop after greater than 52 weeks, and this later phase of damage is associated with the appearance of telangiectasia. Highly localized irradiation of the skin, either to a specific layer (as may result from exposure to very low energy beta-emitters) or after exposure to small highly radioactive particles, 'hot particles', produces gross effects that become visibly manifest within 2 weeks of exposure. These changes result from the direct killing of the cells of the skin in interphase after doses greater than 100 Gy. Dose-effect curves have been established for the majority of these deterministic endpoints in the skin from the results of both experimental and clinical studies. These are of value in the establishment of safe radiation dose limits for the skin.

Immunohistochemical study of the heterogeneity of tenascin distribution within the oral mucosa of the mouse

Immunohistochemical labelling of adult mouse oral mucosa revealed a heterogeneous distribution of the extracellular matrix glycoprotein, tenascin. In masticatory mucosa (palate and gingiva), tenascin was selectively localized to the tips of connective tissue papillae, whilst in lining mucosa (ventral tongue, buccal, labial and vestibular) it was more uniformly distributed in the basement membrane. Tenascin was restricted to the connective tissue of specialized papillary tips in the dorsal lingual mucosa. The heterogeneous distribution of tenascin may be linked to mechanical function, proliferative organization within the overlying epithelium or to continuing epithelial-mesenchymal interactions.

A topographical study of the circadian rhythm in labelling index of mouse gingival and floor-of-mouth epithelium, including changes in labelling activity with individual cell position on the epithelial ridges

A continuous strip of epithelium from the mandibular teeth to the ventral surface of the tongue of B6D2F-1 mice was examined autoradiographically after tritiated thymidine flash-labelling. Five areas were defined: area 1, the gingival sulcus epithelium adjacent to tooth enamel; area 2, the free gingival margin epithelium; area 3, the attached gingiva; area 4, the floor of mouth with undulating basement membrane; area 5, the floor of mouth with flat basement membrane. Data for the circadian variation in the proportion of DNA synthetic cells were recorded into a microcomputer, which enabled a large number of cells to be scored. The topographical position of each basal cell along the rete ridges and the incidence of labelling were noted. In each of the five areas a statistically significant circadian variation in labelling index (LI) was demonstrated, with a peak at 04.00-06.00 h and a trough at 20.00 h, although area 1 was slightly out of phase with the rest. The 24-h average LI values were almost double those obtained from a single flash-labelling at 10.00 h. The peak to trough ratio in LI was greatest in area 5 and fell towards area 1. Within the attached gingiva, cells deepest in the epithelial ridges had a larger peak to trough ratio than more superficial basal cells. For a group of mice labelled at 10.00 h the mean LI of the basal epithelial cells in areas 1-5 was 7.5 +/- (3.0)% (SD). Various aspects of the distribution of DNA synthesis in relation to topography were examined.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in the rate of epithelial proliferation of rat oral mucosa in response to acute inflammation induced by turpentine

Inflammatory lesions were produced in the buccal mucosa by a subepithelial injection of turpentine; animals were killed 24 h later, 1 h after an intravenous injection of tritiated thymidine ( [3H]-Tdr). Control rats were given [3H]-Tdr but no turpentine. Lesions comprised a turpentine pool surrounded by a dense layer of inflammatory cells, beyond which the tissues were more diffusely inflamed. The labelling index (L.I.) for mitotic activity in overlying epithelium was determined in a region (C) close to the layer of dense infiltration and in a region (D) more distant. The L.I. in region D was over four times greater than in region C, and nearly four times greater than that of the contralateral, uninjected cheek. The L.I. in the uninjected cheek was significantly lower than that in controls, which may indicate a systemic depression of proliferative activity in the experimental animals, probably due to stress. Thus mild inflammatory injury stimulates epithelial proliferation, whereas more severe inflammation depresses it, perhaps due to more extensive progenitor-cell damage.

Gingival wound healing in the presence of plaque-induced inflammation

An accelerated loss of connective tissue attachment has been reported following surgery in plaque-infected dentitions. It was the purpose of the present study to evaluate histologically the healing of incisional wounds in the gingival supracrestal region in the presence and absence of bacterially induced inflammation. In the experimental group, marginal periodontitis was induced around the teeth by tying plaque-retentive ligatures at the gingival margins and 10 weeks later an incisional wound was made from within the gingival sulcus to the crest of the bone. In the control group, similar incisional wounds were made in normal gingiva. In each group, three specimens were available for histologic and histometric analysis 1, 3, 7 and 21 days after wounding. In the control group, the wound healing sequence in the supracrestal region was similar to that reported following incisional cutaneous wounds. In the experimental group, epithelial continuity across the wound was re-established earlier, and marked invagination of epithelium occurred into the incision. This invagination was significantly greater than in control specimens at all time points. In addition, within the experimental group a second significant epithelial migration into the wound occurred between 7 and 21 days. The epithelial invagination extended through the major portion of the supracrestal area and terminated near the cementum surface. It is conceivable that marked epithelial invagination into a supracrestal wound may predispose to an accelerated loss of connective tissue attachment.

Hemidesmosomal dimensions and frequency in experimental oral carcinogenesis: a stereological investigation

Connective tissue invasion by carcinomas results in a variety of morphological changes at the epithelial-connective tissue junction. In this report, hemidesmosomal size (-delta) and frequency (Ns) were quantified using established stereological methods. Following treatment of hamster cheek pouches with the chemical carcinogen DMBA, lesions defined as hyperplasias, dysplasias and carcinomas were evaluated using electron microscopical techniques. Untreated pouches served as controls. Stereological intersection counting procedures were used to quantify hemidesmosomes at the epithelial-connective tissue junction. During carcinogenesis, hemidesmosomal diameter decreased progressively, although the reductions were not statistically significant. Hemidesmosomal frequency also decreased progressively between control and carcinoma groups. Normal basal plasma membranes possessed approximately 8 hemidesmosomes/micron 2 whereas values were reduced to approximately 3/micron 2 in the carcinoma group. The reductions in hemidesmosomal frequency during carcinogenesis may reflect an increased motility of basal epithelial cells and a decreased adherence of basal cells to the adjacent lamina propria. The specificity of this alteration in the pathogenesis of malignancy can be readily determined by the application of stereological methods to various neoplastic and non-neoplastic lesions.

Heterogeneity in epidermal basal keratinocytes: morphological and functional correlations

Two structurally distinct populations of basal keratinocytes, nonserrated and serrated, were observed in cynomolgus monkey and human palm epidermis. Anatomical location, fine structural features, and kinetic properties suggest that nonserrated cells represent a stem cell population and that serrated cells help anchor the epidermis to the dermis.

A long-lived thymidine pool in epithelial stem cells

The labelling index (LI) of the individual basal cell positions of the anterior column of mouse tongue filiform papillae was assessed with time after an injection of [3H]TdR at 12.00 hours (the minimum point in the circadian LI rhythm). An initial doubling of the LI in the stem cell zone due to cell division was followed by a second rise of 14-16% 16 hr after injection and this occurred even in the presence of vincristine. Although the uptake of [3H]TdR and the initial LI doubling were largely prevented by a preceding injection of hydroxyurea, the 14-16% LI rise was still observed. The possible explanations are discussed, the favoured one being that an average of one of the six or seven cells (the stem cell) in each stem cell zone can store [3H]TdR in a long-lived precursor pool for at least 16 hr before being utilized for DNA synthesis. This complements previously published work which suggested that one cell in each stem cell zone may selectively segregate DNA at mitosis.

The surface structure of the epithelium of the hamster cheek pouch

Cheek pouches were removed from 9 BIO 87.20 adult-male hamsters, pinned out on cork sheets and fixed, then divided into segments and processed. Mallory stain showed complete orthokeratinization of the pouch epithelium with regular keratohyaline granules. With scanning electron microscopy, the morphology of the walls was similar, with ridged areas alternating with flatter areas. In all areas, blunt projections and larger dome-shaped elevations were found. The superficial surfaces of all stratum corneum cells were covered by an interconnecting network of ridges surrounding depressions; their deep surfaces were covered by a complementary array of protuberances separated by narrow grooves. On superficial surfaces in some areas, cell boundaries consisted of double ridges separated by a gap; cell imprints were delineated by single ridges or depressions and involved several cells, suggesting that the cells in these areas were not stacked in vertical columns. Elsewhere, the linear ridges were paralleled by depressions, suggesting that the cells were stacked in columns. The morphology of cell boundaries and imprints on the undersurface of the desquamating squames were complementary to those of the opposing surface. Transmission electron microscopy supported the findings. Although most of the cells of the stratum corneum were electron dense and contained only tonofilaments and interfilamentous material, less electron-dense cells which contained only tonofilaments and small keratohyaline granules were occasionally found.

Immunohistochemical localization of a low molecular weight, soluble protein from bovine lingual epithelium

A low molecular weight (LMW) protein was isolated from bovine tongue epithelium and an antiserum to this protein elicited in rabbits. The indirect peroxidase-antiperoxidase (PAP) technique was used to localize LMW protein in several tissues from six mammalian species: cow, rat, mouse, squirrel, rabbit, and man. Immunoreactivity was demonstrable in stratified squamous epithelia from skin, tongue, cheek, esophagus, vagina, and palate. Epidermal derivatives, such as hair follicles, sebaceous glands and ducts of certain glands were also positively stained. Cornea exhibited weak immunoreactivity as did rabbit bladder. Other types of epithelia including those seen in kidney, thyroid, intestine, trachea, liver, submandibular gland, pancreas and uterus, were not immunoreactive when tested with antiserum to LMW protein. The antiserum was rendered unreactive after absorption with LMW protein but, when absorbed with a keratin polypeptide, most of the immunoreactivity was preserved. It is concluded that the distribution of the soluble LMW protein is similar to that of the insoluble keratin proteins in stratified squamous epithelia but the former is not demonstrable in many simple epithelia that contain keratins.

Autoradiographic demonstration of unscheduled DNA synthesis in oral tissues treated with chemical carcinogens in short-term organ culture

A system in which oral tissues of inbred F344 adult rats and Syrian golden hamster embryos were used in combination with autoradiography was developed for measurement of unscheduled DNA synthesis (UDS). For this, oral mucosa, submandibular gland, tooth germ and mandible in short-term organ cultures were treated with 4-nitroquinoline 1-oxide or N-methyl-N-nitrosourea plus (methyl-3H)thymidine. Significant numbers of silver grains, indicating UDS, were detected over the nuclei of cells of all these tissues except rat salivary gland after treatment with carcinogens. This autoradiographic method is suitable for detection of UDS in oral tissues in conditions mimicking those in vivo. Results obtained in this study indicated a potential use of this system for studies on the mechanism of carcinogenesis at a cellular level comparable to in vivo carcinogenesis studies on oral tissues.

Changes in proliferative activity as cells move along undulating basement membranes in stratified squamous epithelium

The filiform papillae of mouse tongue provide evidence for a flow of interphase basal cells along the basement membrane. This implies that they are aligned on that structure according to age. In addition there is a decrease in proliferative potential as the basal cells age. This is probably due at least in part to a fall in growth fraction. Such a method of basal cell replacement may exist in other stratified squamous epithelia characterized by undulating basement membranes.

Epithelial cell kinetics--A review of methods of study and their application to oral mucosa in health and disease. Part A. Methods for studying cell proliferation and some sources of variation

Despite extensive investigation of cell kinetic parameters in wide range of normal and abnormal tissues and their potential value in understanding the pathogenesis of many disease states, as well as in prognosis and treatment planning, their application to oral epithelia remains limited. In part A the methods most commonly applied to the study of epithelial cell kinetics, i.e., isotope labelling, mitotic arrest and flow cytophotorimetry are reviewed with special emphasis on their technical limitations, sources of variation and inapplicability to humans in vivo. The ability of in vitro methods to reliably reproduce in vivo cell kinetic parameters is also considered. The application of cell kinetic studies to normal and abnormal oral tissues will be discussed in part B.