1
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Thakare P, Prakash NL, Mahajan AM, Bhadage CJ. Appearances can be deceptive - Innocuous swelling on the gingiva masking an aggressive lesion within the maxilla. J Oral Maxillofac Pathol 2024; 28:142-145. [PMID: 38800423 PMCID: PMC11126259 DOI: 10.4103/jomfp.jomfp_205_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 05/29/2024] Open
Abstract
The central giant cell granuloma displays a varied biologic behaviour ranging from simple reactive lesions to aggressive neoplasms. The pathogenicity still remains enigmatic and needs to be differentiated from other giant cell containing lesions. Both maxilla and mandible are affected and 80% involve the region anterior to the first premolar region. CGCL arises centrally within bone, whereas PGCG is a gingival soft tissue lesion. Clinical and radiographic correlation is required to rule out a peripheral giant cell granuloma. The case described here was a rare presentation of a large epulis clinically with involvement of maxilla radiographically and was histologically diagnosed as a central giant cell lesion.
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Affiliation(s)
- Piyush Thakare
- Department of Oral and Maxillofacial Surgery, M.G.V’s K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Nilima L. Prakash
- Department of Oral Pathology and Microbiology, M.G.V’s K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Aarti M. Mahajan
- Department of Oral Pathology and Microbiology, M.G.V’s K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
| | - Chetan J. Bhadage
- Oral Medicine and Radiology, M.G.V’s K.B.H. Dental College and Hospital, Nashik, Maharashtra, India
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2
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Schreuder WH, Meijer EB, Cleven AHG, Edelenbos E, Klop C, Schreurs R, de Jong RT, van Maarle MC, Horsthuis RBG, de Lange J, van den Berg H. Efficacy and Toxicity of Calcitonin Treatment in Children with Cherubism: A Single-Center Cohort Study. J Bone Miner Res 2023; 38:1822-1833. [PMID: 37823782 DOI: 10.1002/jbmr.4922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/19/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023]
Abstract
Cherubism is a rare autosomal dominant disease characterized by expansile osteolytic jawbone lesions. The effect and safety of off-label calcitonin treatment during the progressive phase of the disease are not well described. In this retrospective study, we present data on the radiological response and adverse effects of subcutaneously administered calcitonin in a cohort of nine cherubism children (three female, six male). Two of the nine patients underwent two separate treatment courses with a significant off-treatment interval in between; therefore, a total of 11 treatment courses with a mean duration of 17.9 months (range <1 to 35, SD 10.8) were studied. To measure the response, the cumulative volume of cherubism lesions was calculated from available three-dimensional imaging. The primary outcome was the change in the volume of lesions during calcitonin treatment and only assessed for the eight treatment courses with a minimal duration of 6 months. A statistically significant reduction in the mean cumulative volume of lesions was seen regardless of treatment duration. Average volume reduction was highest in the first half year of treatment, with a gradual, ongoing reduction thereafter. For the secondary outcome, the change in the cumulative volume of lesions after treatment cessation was assessed for the seven treatment courses with follow-up imaging available. After six of these seven treatment courses, the cumulative volume increased again but remained undoubtedly smaller than the initial volume at the start of therapy. Adverse effects were assessed for all 11 treatment courses and occurred in 73% of them. Most adverse effects were mild and low grade, with the most severe being one grade 3 symptomatic hypocalcemia requiring hospitalization and early treatment termination. Calcitonin treatment seems effective and tolerable in treating actively progressing cherubism in children. However, further research is required to better understand the pharmacological treatment of cherubism, including also other drugs, dosing, and protocols. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Willem H Schreuder
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
- Department of Head and Neck Surgery and Oncology, Antoni van Leeuwenhoek, Netherlands Cancer Center, Amsterdam, the Netherlands
| | - Ethan B Meijer
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Arjen H G Cleven
- Department of Pathology, University Medical Center Groningen, Groningen, the Netherlands
| | - Esther Edelenbos
- Department of Pediatric Oncology, Amsterdam University Medical Centers Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Cornelis Klop
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Ruud Schreurs
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Renate T de Jong
- Department of Internal Medicine, Endocrine section, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Merel C van Maarle
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Roy B G Horsthuis
- Department of Oral and Maxillofacial Surgery, Ziekenhuisgroep Twente, Almelo and Medisch Spectrum Twente, Enschede, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk van den Berg
- Department of Pediatric Oncology, Amsterdam University Medical Centers Location AMC, University of Amsterdam, Amsterdam, the Netherlands
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3
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Ekici Ö, Ay S, Açıkalın MF, Paşaoğlu Ö. Immunohistochemical evaluation of IL-1β, IL-6, TNF-α and IL-17 cytokine expression in peripheral giant cell granuloma and peripheral ossifying fibroma of the jaws. Arch Oral Biol 2022; 136:105385. [DOI: 10.1016/j.archoralbio.2022.105385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/16/2022] [Accepted: 02/19/2022] [Indexed: 11/02/2022]
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4
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Miguita L, de Souza JC, Bastos VC, Pereira NB, de Freitas RAB, Guimarães LM, de Avelar GF, Andrade LO, Dutra WO, Nunes FD, Castro WH, de Lacerda JCT, Reis AMS, Bernardes VF, Diniz MG, Gomez RS, Gomes CC. Central giant cell granulomas of the jaws stromal cells harbour mutations and have osteogenic differentiation capacity,
in vivo
and
in vitro. J Oral Pathol Med 2022; 51:206-216. [DOI: 10.1111/jop.13274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/07/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Lucyene Miguita
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Juliana Cristina de Souza
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Victor Coutinho Bastos
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Nubia Braga Pereira
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Raphaela Alvarenga Braga de Freitas
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Leticia Martins Guimarães
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Gleide Fernandes de Avelar
- Department of Morphology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil 31270‐901
| | - Luciana Oliveira Andrade
- Department of Morphology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil 31270‐901
| | - Walderez Ornelas Dutra
- Department of Morphology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil 31270‐901
| | - Fábio Daumas Nunes
- Department of Stomatology School of Dentistry Universidade de São Paulo (USP) São Paulo Brazil 05508‐000
| | - Wagner Henriques Castro
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | | | - Amanda Maria Sena Reis
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Vanessa Fátima Bernardes
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Marina Gonçalves Diniz
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
| | - Carolina Cavalieri Gomes
- Department of Pathology Biological Science Institute Universidade Federal de Minas Gerais (UFMG) Belo Horizonte Minas Gerais Brazil 31270‐901
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5
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Gomes CC, Diniz MG, Bastos VC, Bernardes VF, Gomez RS. Making sense of giant cell lesions of the jaws (GCLJ): lessons learned from next-generation sequencing. J Pathol 2019; 250:126-133. [PMID: 31705763 DOI: 10.1002/path.5365] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/16/2019] [Accepted: 11/06/2019] [Indexed: 01/09/2023]
Abstract
Next-generation sequencing has revealed mutations in several bone-related lesions and was recently used to uncover the genetic basis of giant cell lesions of the jaws (GCLJ). Consistent with their benign nature, GCLJ show a low tumor mutation burden. They also harbor somatic, heterozygous, mutually exclusive mutations in TRPV4, KRAS, or FGFR1. These signature mutations occur only in a subset of lesional cells, suggesting the existence of a 'landscaping effect', with mutant cells inducing abnormal accumulation of non-mutant cells that form the tumor mass. Osteoclast-rich lesions with histological similarities to GCLJ can occur in the jaws sporadically or in association with genetically inherited syndromes. Based on recent results, the pathogenesis of a subgroup of sporadic GCLJ seems closely related to non-ossifying fibroma of long bones, with both lesions sharing MAPK pathway-activating mutations. In this review, we extrapolate from these recent findings to contextualize GCLJ genetics and we highlight the therapeutic implications of this new information. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Carolina C Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Marina G Diniz
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Victor C Bastos
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Vanessa F Bernardes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ricardo S Gomez
- Department of Oral Surgery and Pathology, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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6
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Kadlub N, Sessiecq Q, Mandavit M, L'Hermine AC, Badoual C, Galmiche L, Berdal A, Descroix V, Picard A, Coudert AE. Molecular and cellular characterizations of human cherubism: disease aggressiveness depends on osteoclast differentiation. Orphanet J Rare Dis 2018; 13:166. [PMID: 30236129 PMCID: PMC6148781 DOI: 10.1186/s13023-018-0907-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 09/12/2018] [Indexed: 11/29/2022] Open
Abstract
Background Cherubism is a rare autosomal dominant disorder of the jaws caused by mutation of the SH3BP2 gene. The bone is replaced by a fibrous granuloma containing multinucleated giant cells. Cells of the cherubism granuloma have never been systematically analyzed. Hence, the aim of this study was to characterize the cells in human cherubism granulomas, to determine the osteoclastic characteristics of the multinucleated giant cells and to investigate the potential role of TNF-α in human cherubism. Results Seven granulomas were analyzed in pathology, molecular biology and immunohistochemistry. Granulomas were composed mainly of macrophages or osteoclasts within a fibroblastic tissue, with few lymphoid cells. Myeloid differentiation and nuclear NFATc1 localization were both associated with disease aggressiveness. OPG and RANKL immunohistochemical expression was unexpected in our specimens. Five granuloma cells were cultured in standard and osteoclastogenic media. In culture, cherubism cells were able to differentiate into active osteoclasts, in both osteoclastogenic and standard media. IL-6 was the major cytokine present in the culture supernatants. Conclusion Multinucleated giant cells from cherubism granulomas are CD68 positive cells, which differentiate into macrophages in non-aggressive cherubism and into osteoclasts in aggressive cherubism, stimulated by the NFATc1 pathway. This latter differentiation appears to involve a disturbed RANK-L/RANK/OPG pathway and be less TNF-α dependent than the cherubism mouse model. Electronic supplementary material The online version of this article (10.1186/s13023-018-0907-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Natacha Kadlub
- INSERM, UMRS 1138 Equipe 5, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche de Cordeliers, 75006, Paris, France. .,Université Paris Descartes, 75006, Paris, France. .,APHP, Necker Enfants Malades, service de Chirurgie Maxillo-faciale et Plastique, , Hôpital Necker Enfants Malades, 146 rue de Sèvres, 75015, Paris, France. .,APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015, Paris, France.
| | - Quentin Sessiecq
- CHU de Bordeaux, Service de Chirurgie Maxillofaciale, 33000, Bordeaux, France
| | - Marion Mandavit
- INSERM U 970, Equipe 10, PARCC, faculté Paris Descartes, 75015, Paris, France
| | - Aurore Coulomb L'Hermine
- APHP, Hôpital Armand Trousseau, Service d'Anatomopathologie et cytologie, 75012, Paris, France.,Université Pierre et Marie Curie, 75005, Paris, France
| | - Cecile Badoual
- Université Paris Descartes, 75006, Paris, France.,INSERM U 970, Equipe 10, PARCC, faculté Paris Descartes, 75015, Paris, France.,APHP, Hôpital Européen Georges Pompidou, Service d'Anatomopathologie et cytologie, 75015, Paris, France
| | - Louise Galmiche
- Université Paris Descartes, 75006, Paris, France.,APHP, Necker Enfants Malades, Service d'Anatomopathologie et cytologie, 75015, Paris, France
| | - Ariane Berdal
- INSERM, UMRS 1138 Equipe 5, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche de Cordeliers, 75006, Paris, France.,UFR Odontologie, Garancière, Université Paris Diderot, 75006, Paris, France
| | - Vianney Descroix
- INSERM, UMRS 1138 Equipe 5, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche de Cordeliers, 75006, Paris, France.,UFR Odontologie, Garancière, Université Paris Diderot, 75006, Paris, France.,APHP, Hôpital Pitié Salpétrière, Service d'Odontologie, 75013, Paris, France
| | - Arnaud Picard
- INSERM, UMRS 1138 Equipe 5, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche de Cordeliers, 75006, Paris, France.,Université Paris Descartes, 75006, Paris, France.,APHP, Necker Enfants Malades, service de Chirurgie Maxillo-faciale et Plastique, , Hôpital Necker Enfants Malades, 146 rue de Sèvres, 75015, Paris, France.,APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015, Paris, France
| | - Amélie E Coudert
- INSERM, UMRS 1138 Equipe 5, Laboratoire de Physiopathologie Orale Moléculaire, Centre de Recherche de Cordeliers, 75006, Paris, France.,UFR Odontologie, Garancière, Université Paris Diderot, 75006, Paris, France
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7
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Kadlub N, Sessiecq Q, Dainese L, Joly A, Lehalle D, Marlin S, Badoual C, Galmiche L, Majoufre-Lefebvre C, Berdal A, Deckert M, Vazquez MP, Descroix V, Coudert AE, Picard A. Defining a new aggressiveness classification and using NFATc1 localization as a prognostic factor in cherubism. Hum Pathol 2016; 58:62-71. [PMID: 27498064 DOI: 10.1016/j.humpath.2016.07.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/16/2016] [Accepted: 07/17/2016] [Indexed: 10/21/2022]
Abstract
Cherubism is a rare genetic disease characterized by bilateral giant cell reparative granuloma of the jaws consisting of a fibrotic stroma with giant multinucleated cells (GMCs) and osteoclastic features. Cherubism severity is highly variable, and recurrence after surgery is the most important risk. Currently, there are no prognostic indicators. The aims of this study were to evaluate the osteoclastogenesis phenotype by histologic examination of nuclear factor of activated T cells 1 (NFATc1) localization and tartrate-resistant acid phosphatase (TRAP) activity and to correlate the results to disease aggressiveness to define prognostic indicators. Based on cherubism evolution 1 year after surgery, 3 classes of cherubism aggressiveness were identified: mild (group A), moderate (group B), and severe (group C). Histologically, in grade A and B cherubism lesions, GMCs were negative for both TRAP activity and NFATc1 nuclear localization. In contrast, in grade C cherubism lesions, GMCs were all positive for TRAP activity and NFATc1 nuclear localization and displayed osteoclast-like features. Other histopathologic findings were not different among the 3 groups. Our results establish that TRAP activity and NFTAc1 nuclear localization are associated with aggressive cherubism and therefore could be added to routine pathologic examination to aid in prognosis and management of the disease. The finding of NFATc1 nuclear localization in aggressive tumors supports the addition of anticalcineurin treatment to the therapeutic arsenal for cherubism.
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Affiliation(s)
- Natacha Kadlub
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France.
| | - Quentin Sessiecq
- CHU de Bordeaux, Service de Chirurgie Maxillo-Faciale, 33000 Bordeaux, France
| | - Linda Dainese
- APHP, Hôpital Armand Trousseau, Service d'Anatomopathologie et Cytologie, 75012 Paris, France; Université Pierre et Marie Curie, 75005 Paris, France
| | - Aline Joly
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | | | - Sandrine Marlin
- APHP, Necker Enfants Malades, Service de Génétique, 75015 Paris, France
| | - Cecile Badoual
- Université Paris Descartes, 75006 Paris, France; APHP, Hôpital Européen Georges Pompidou, Service d'Anatomopathologie et Cytologie, 75015 Paris, France
| | - Louise Galmiche
- Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service d'Anatomopathologie et Cytologie, 75015 Paris, France
| | | | - Ariane Berdal
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France
| | - Marcel Deckert
- INSERM, U1035, Université Nice Sophia-Antipolis, Microenvironment, Signaling and Cancer, 06000 Nice, France
| | - Marie-Paule Vazquez
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | - Vianney Descroix
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France; APHP, Hôpital Pitié Salpétrière, Service d'Odontologie, 75013 Paris, France
| | - Amélie E Coudert
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France
| | - Arnaud Picard
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
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8
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Neben CL, Roberts RR, Dipple KM, Merrill AE, Klein OD. Modeling craniofacial and skeletal congenital birth defects to advance therapies. Hum Mol Genet 2016; 25:R86-R93. [PMID: 27346519 DOI: 10.1093/hmg/ddw171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 05/24/2016] [Indexed: 12/12/2022] Open
Abstract
Craniofacial development is an intricate process of patterning, morphogenesis, and growth that involves many tissues within the developing embryo. Genetic misregulation of these processes leads to craniofacial malformations, which comprise over one-third of all congenital birth defects. Significant advances have been made in the clinical management of craniofacial disorders, but currently very few treatments specifically target the underlying molecular causes. Here, we review recent studies in which modeling of craniofacial disorders in primary patient cells, patient-derived induced pluripotent stem cells (iPSCs), and mice have enhanced our understanding of the etiology and pathophysiology of these disorders while also advancing therapeutic avenues for their prevention.
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Affiliation(s)
- Cynthia L Neben
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Ryan R Roberts
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry and Department of Biochemistry and Molecular Biology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Katrina M Dipple
- Departments of Pediatrics and Human Genetics, David Geffen School of Medicine and InterDepartmental Program Biomedical Engineering, Henry Samulei School of Engineering and Applied Sciences, University of California, Los Angeles, CA, USA
| | - Amy E Merrill
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry and Department of Biochemistry and Molecular Biology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ophir D Klein
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA Department of Pediatrics and Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
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9
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Kadlub N, Vazquez MP, Galmiche L, L'Herminé AC, Dainese L, Ulinski T, Fauroux B, Pavlov I, Badoual C, Marlin S, Deckert M, Leboulanger N, Berdal A, Descroix V, Picard A, Coudert AE. The calcineurin inhibitor tacrolimus as a new therapy in severe cherubism. J Bone Miner Res 2015; 30:878-85. [PMID: 25491283 DOI: 10.1002/jbmr.2431] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cherubism is a rare genetic disorder characterized by extensive growth of a bilateral granuloma of the jaws, resulting in facial disfigurement. Cherubism is caused by gain-of-function mutations in the SH3BP2 gene, leading to overactivation of nuclear factor of activated T cells, cytoplasmic 1 (NFATc1)-dependent osteoclastogenesis. Recent findings in human and mouse cherubism have suggested that calcineurin inhibitors might be drug candidates in cherubism medical treatment. A 4-year-old boy with aggressive cherubism was treated with the calcineurin inhibitor tacrolimus for 1 year, and clinical, radiological, and molecular data were obtained. Immunohistologic analysis was performed to compare preoperative and postoperative NFATc1 staining and tartrate resistant acid phosphatase (TRAP) activity. Real-time PCR was performed to analyze the relative expression levels of OPG and RANKL. After tacrolimus therapy, the patient showed significant clinical improvement, including stabilization of jaw size and intraosseous osteogenesis. Immunohistologic analyses on granuloma showed that tacrolimus caused a significant reduction in the number of TRAP-positive osteoclasts and NFATc1 nuclear staining in multinucleated giant cells. Molecular analysis showed that tacrolimus treatment also resulted in increased OPG expression. We present the first case of effective medical therapy in cherubism. Tacrolimus enhanced bone formation by stimulating osteogenesis and inhibiting osteoclastogenesis.
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Affiliation(s)
- Natacha Kadlub
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMRS1138, Team Molecular Oral Pathophysiology, Cordeliers Research Center, University Paris-Diderot, University Paris-Descartes, and University Pierre and Marie Curie, Paris, France; Service de Chirurgie Maxillo-Faciale, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Unités de Formation et de Recherche (UFR) de Médecine Paris Descartes, Université Paris V, Paris, France; Centre de Références des Malformations de la Face et de la Cavité Buccale, Paris, France; Laboratoire de Physiopathologie Orale et Moléculaire, INSERM, UMRS 872, Equipe 5, Centre de Recherche des Cordeliers, Paris, France
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10
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Papanicolaou P, Chrysomali E, Stylogianni E, Donta C, Vlachodimitropoulos D. Increased TNF-α, IL-6 and decreased IL-1β immunohistochemical expression by the stromal spindle-shaped cells in the central giant cell granuloma of the jaws. Med Oral Patol Oral Cir Bucal 2012; 17:e56-62. [PMID: 22157665 PMCID: PMC3448195 DOI: 10.4317/medoral.17205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 05/14/2011] [Indexed: 11/07/2022] Open
Abstract
Objectives: the exp ress ion of the osteoclastogenic cytokines TNF-α, IL-6 and IL-1β were immunohistochemically evaluated in periph eral (PGCG) and central (CGCG) giant cell granulomas of the jaws in order to determine diff erences between these two lesions and between the two distinct tumor cell populations (multinucleated giant cells, MGCs and stromal sp indle-sh aped cells).
Study Design: Paraffin-embedd ed tiss ue sections from 40 PGCG and 40 CGCG were immunohistochemically
stained using antibodies against TNF-α, IL-6 and IL-1β. The percentage of positively stained cells and the staining intensity were ass ess ed to provide a combined immunoreactivity score value.
Results: TNF-α, IL-6 and IL-1β were exp ress ed in all lesions. The CGCG compared to the PGCG sh owed significantly increased exp ress ion of TNF-α and IL-6 and decreased exp ress ion of IL-1β by the sp indle-sh aped cells and increased exp ress ion of IL-1β by the MGCs. The MGCs demonstrated in comparison to the stromal sp indlesh aped cells significantly increased exp ress ion of all three cytokines in both PGCG and CGCG.
Conclusions: The proinflammatory cytokines TNF-α, IL-6 and IL-1β seem to be involved in the growth process
of PGCG and CGCG of the jaws. A poss ible alteration in the sy nthesis or/and activity of these cytokines by the
stromal sp indle cells in the CGCGs may enhance osteolys is through the stimulation of osteoclast progenitor cells, given the fact that the intraoss eous lesions cause bone resorption.
Key words:
Giant cell granuloma, giant cell tumor, multinucleated giant cells, jaw, TNF-alpha, IL-6, IL-1beta,
immunohistochemistry.
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Affiliation(s)
- Panagiota Papanicolaou
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Athens, Athens, Greece.
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de Matos FR, de Moraes M, Nonaka CFW, de Souza LB, de Almeida Freitas R. Immunoexpression of TNF-α and TGF-β in central and peripheral giant cell lesions of the jaws. J Oral Pathol Med 2011; 41:194-9. [DOI: 10.1111/j.1600-0714.2011.01075.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
A classic case of central giant cell lesion (CGCL) is presented with emphasis on clinical, radiologic, and histologic features. The differential is discussed including peripheral giant cell granuloma, brown tumor of hyperparathyroidism, and giant cell tumor of bone. The molecular pathway of osteoclastogenesis is selectively reviewed and applied to suggest possible etiologies of the giant cell lesions. CGCL syndromes and treatment are also discussed.
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Amaral FR, Bernardes VF, Duarte AP, Pereira NB, Vasconcelos AC, Gomez RS, Gomes CC. Quantitative expression analysis of apoptotic/antiapoptotic genes and association with immunolocalization of BAX and BCL-2 in peripheral and central giant cell lesions of the jaws. Tumour Biol 2011; 32:997-1003. [DOI: 10.1007/s13277-011-0201-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 06/03/2011] [Indexed: 10/18/2022] Open
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Duarte AP, Gomes CC, Gomez RS, Amaral FR. Increased expression of NFATc1 in giant cell lesions of the jaws, cherubism and brown tumor of hyperparathyroidism. Oncol Lett 2011; 2:571-573. [PMID: 22866121 DOI: 10.3892/ol.2011.274] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 03/15/2011] [Indexed: 11/05/2022] Open
Abstract
A variety of diseases of the jaws may present multinucleated giant cells. These diseases include central giant cell lesions (CGCL), peripheral giant cell lesions (PGCL), brown tumor of hyperparathyroidism (BTH), and cherubism. The multinucleated giant cells in these lesions are osteoclast-like. Since NFATc1 plays a significant role in osteoclast differentiation, the present study aimed to compare the expression of NFATc1 in CGCL, PGCL, BTH and cherubism. A total of 14 formalin-fixed and paraffin-embedded tissue samples of CGCL (n=4), PGCL (n=5), BTH (n=3) and cherubism (n=2) were included in the study. An immunohistochemical analysis was performed to investigate the NFATc1 protein. The majority of giant cells in all of the cases were positive for nuclear NFATc1 and the immunostaining pattern was similar in all of the groups. Although our study supports the hypothesis that giant cell accumulation in PGCL, CGCL, BTH and cherubism is mediated by NFATc1, functional studies are required to investigate this hypothesis.
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Affiliation(s)
- Alessandra Pires Duarte
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Belo Horizonte-MG, CEP 31270 901, Brazil
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