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Abdulhadi ZT, Mahdee AF, Gul SS. Accuracy of Gingival Crevicular Fluid Biomarkers of MMP8, TIMP1, RANK, RANKL, and OPG in Differentiating Symptomatic and Asymptomatic Apical Periodontitis. Diagnostics (Basel) 2024; 14:1872. [PMID: 39272657 PMCID: PMC11394092 DOI: 10.3390/diagnostics14171872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/14/2024] [Accepted: 08/22/2024] [Indexed: 09/15/2024] Open
Abstract
Apical periodontitis (AP) is the most prevalent chronic inflammatory disease of the teeth. Bone resorption dynamics in symptomatic and asymptomatic AP are still unrecognized. This study examined different inflammatory markers within gingival crevicular fluid, including matrix metalloproteinases 8 (MMP8), tissue inhibitors of metalloproteinases 1 (TIMP1), receptor activator of nuclear factor κB (RANK), its ligand (RANKL), and osteoprotegerin (OPG), to be used in comparing symptomatic apical periodontitis (SAP) and asymptomatic apical periodontitis (AAP) versus healthy teeth. Subjects with SAP, AAP, and a control group were recruited and GCF samples were collected by Periopaper strips. Clinical and radiographical measures were used for diagnosing AP. Levels of MMP8, TIMP, RANK, RANKL, and OPG were determined by ELISA and their abilities to discriminate between examined sites were evaluated by receiver operator characteristic (ROC) curves. All examined biomarkers were statistically significant higher (p < 0.05) in SAP than AAP and the control group, apart from RANK. Significant positive correlations (p < 0.05) were identified between all SAP and AAP biomarkers except TIMP1 and RANK in AAP teeth. TIMP1 and OPG exhibited the highest ability to distinguish between SAP and AAP with areas under the curve of 0.824 and 0.763 in comparing SAP and the control group, and 0.732 and 0.73 when comparing AAP and the control group, respectively. Additionally, TIMP1 and OPG showed the highest AUC of 0.778 and 0.747 when SAP and AAP were compared, respectively. This study concluded that GCF levels of TIMP1 and OPG can be used to differentiate between SAP, AAP, and healthy teeth.
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Affiliation(s)
- Zeena Tariq Abdulhadi
- Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad 10071, Iraq
| | - Anas Falah Mahdee
- Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad 10071, Iraq
| | - Sarhang Sarwat Gul
- Medical Laboratory Department, College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaymaniyah 46001, Iraq
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq
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Tater J, Diajil AR. Immunohistochemical analysis of osteoclastic and osteoblastic activity in ossifying fibroma and juvenile ossifying fibroma: A comparative study. J Med Life 2023; 16:1369-1374. [PMID: 38107708 PMCID: PMC10719798 DOI: 10.25122/jml-2023-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 12/19/2023] Open
Abstract
Cemento-ossifying fibroma (COF) and juvenile ossifying fibroma (JOF) have been considered distinct entities within the category of fibro-osseous lesions. This study aimed to assess osteoblast and osteoclast activity in COF and JOF by investigating bone resorption markers, specifically receptor activator of nuclear factor-kB (RANK), RANK ligand (RANKL), and its inhibitor osteoprotegerin (OPG). A comparative analysis of these markers was performed on all lesions. Immunohistochemistry was employed to evaluate and quantify the expression of these biomarkers in a sample of 20 cases of cemento-ossifying fibroma (COF), 15 cases of psammomatoid juvenile ossifying fibroma (PsJOF), and 10 cases of trabecular juvenile ossifying fibroma (TrJOF). The expression of osteoprotegerin was significantly higher in cemento-ossifying fibroma (33.9±13.0) compared to trabecular juvenile ossifying fibroma (27.3±9.2) and psammatoid ossifying fibroma (25.2±14.9), with the COF showing the highest expression followed by the latter two (p=0.037). There was a higher percentage (80%) of stromal fibroblast cells that showed positive expression of RANKL in cemento-ossifying fibroma (COF) compared to psammomatoid juvenile ossifying fibroma (PsJOF) (33.3%) and trabecular juvenile ossifying fibroma (TrJOF) (30.0%) when considering a positive expression score of 3 (p=0.024). Cemento-ossifying fibroma demonstrated the highest expression of osteoprotegerin and RANKL-positive stromal fibroblast cells, followed by psammomatoid juvenile ossifying fibroma and trabecular juvenile ossifying fibroma. These findings provide valuable insights into the pathogenesis of these lesions.
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Affiliation(s)
- Jawaher Tater
- Department of Oral and Maxillofacial Pathology, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Ameena Ryhan Diajil
- Department of Oral Medicine, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Hong CY, Lin SK, Wang HW, Shun CT, Yang CN, Lai EHH, Cheng SJ, Chen MH, Yang H, Lin HY, Wu FY, Kok SH. Metformin Reduces Bone Resorption in Apical Periodontitis Through Regulation of Osteoblast and Osteoclast Differentiation. J Endod 2023; 49:1129-1137. [PMID: 37454872 DOI: 10.1016/j.joen.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION We have previously demonstrated that auxiliary metformin therapy promotes healing of apical periodontitis. Here we aimed to investigate the effects of metformin on osteoblast differentiation and osteoclast formation in cultured cells and rat apical periodontitis. METHODS Murine pre-osteoblasts MC3T3-E1 and macrophages RAW264.7 were cultured under hypoxia (2% oxygen) or normoxia (21% oxygen) and stimulated with receptor activator of nuclear factor-κB ligand (RANKL) when indicated. Metformin was added to the cultures to evaluate its anti-hypoxic effects. Expressions of osteoblast differentiation regulator runt-related transcription factor 2 (RUNX2), RANKL, and osteoclast marker tartrate-resistant acid phosphatase (TRAP) were assessed by Western blot. Apical periodontitis was induced in mandibular first molars of 10 Sprague-Dawley rats. Root canal therapy with or without metformin supplement was performed. Periapical bone resorption was measured by micro-computed tomography. Immunohistochemistry was used to examine RUNX2, RANKL, and TRAP expressions. RESULTS Hypoxia suppressed RUNX2 expression and enhanced RANKL synthesis in pre-osteoblasts. TRAP production increased in macrophages after hypoxia and/or RANKL stimulation. Metformin reversed hypoxia-induced RUNX2 suppression and RANKL synthesis in pre-osteoblasts. Metformin also inhibited hypoxia and RANKL-enhanced TRAP synthesis in macrophages. Intracanal metformin diminished bone loss in rat apical periodontitis. Comparing with vehicle control, cells lining bone surfaces in metformin-treated lesions had significantly stronger expression of RUNX2 and decreased synthesis of RANKL and TRAP. CONCLUSIONS Alleviation of bone resorption by intracanal metformin was associated with enhanced osteoblast differentiation and diminished osteoclast formation in rat apical periodontitis. Our results endorsed the role of metformin as an effective medicament for inflammatory bone diseases.
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Affiliation(s)
- Chi-Yuan Hong
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan
| | - Sze-Kwan Lin
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Han-Wei Wang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Tung Shun
- Department of Forensic Medicine and Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Ning Yang
- Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Eddie Hsiang-Hua Lai
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Jung Cheng
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mu-Hsiung Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiang Yang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Ying Lin
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Fang-Yu Wu
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Sang-Heng Kok
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Bansal D, Kamboj M, Narwal A, Devi A, Marwah N. Interplay of collagen and mast cells in periapical granulomas and periapical cysts: a comparative polarizing microscopic and immunohistochemical study. Restor Dent Endod 2022; 47:e12. [PMID: 35284324 PMCID: PMC8891460 DOI: 10.5395/rde.2022.47.e12] [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: 06/06/2021] [Revised: 06/30/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives This pilot study aimed to establish the interrelationship between collagen and mast cells in periapical granulomas and periapical cysts. Materials and Methods An observational cross-sectional study was conducted on the paraffin-embedded tissue sections of 68 specimens (34 periapical granulomas and 34 periapical cysts). The specimens were stained with picrosirius to observe collagen fiber birefringence and anti-tryptase antibody to evaluate the mast cell count immunohistochemically. The mean number and birefringence of collagen fibers, as well as the mean number of mast cells (total, granulated, and degranulated), and the mean inflammatory cell density were calculated. The data obtained were analyzed using the Kruskal Wallis test, Mann Whitney U test, and Spearman correlation test (p < 0.05). Results The mean number of thick collagen fibers was higher in periapical cysts, while that of thin fibers was higher in granulomas (p = 0.00). Cysts emitted orange-yellow to red birefringence, whereas periapical granulomas had predominantly green fibers (p = 0.00). The mean inflammatory cell density was comparable in all groups (p = 0.129). The number of total, degranulated, and granulated mast cells exhibited significant results (p = 0.00) in both groups. Thick cyst fibers showed significant inverse correlations with inflammation and degranulated mast cells (p = 0.041, 0.04 respectively). Conclusions Mast cells and inflammatory cells influenced the nature of collagen fiber formation and its birefringence. This finding may assist in the prediction of the nature, pathogenesis, and biological behavior of periapical lesions.
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Affiliation(s)
- Deepty Bansal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Mala Kamboj
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Anjali Narwal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Anju Devi
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Nisha Marwah
- Department of Pathology, Post Graduate Institute of Medical Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
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Rezende TMB, Ribeiro Sobrinho AP, Vieira LQ, Sousa MGDC, Kawai T. Mineral trioxide aggregate (MTA) inhibits osteoclastogenesis and osteoclast activation through calcium and aluminum activities. Clin Oral Investig 2020; 25:1805-1814. [PMID: 32789653 DOI: 10.1007/s00784-020-03483-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/29/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the effect(s) of mineral trioxide aggregate (MTA) on in vitro RANKL-mediated osteoclast-dependent bone resorption events and the influence of Ca2+ and Al3+ on the osteoclastogenesis inhibition by MTA. MATERIALS AND METHODS Two types of osteoclast precursors, RAW 264.7 (RAW) cell line or bone marrow cells (obtained from BALB/c mice and stimulated with recombinant (r) macrophage colony stimulation factor (M-CSF), were stimulated with or without recombinant (r) activator of nuclear kappa B ligand (RANKL), in the presence or absence of MTA for 6 to 8 days. White Angelus MTA and Bios MTA (Angelus, Londrina, Paraná, Brazil) were prepared and inserted into capillary tubes (direct contact surface = 0.50 mm2 and 0.01 mm2). Influence of MTA on these types of osteoclast precursors was measured by the number of differentiated tartrate-resistant acid phosphatase (TRAP)-positive multinuclear cells (RAW and bone marrow cells), TRAP enzyme activity (RAW cells), cathepsin K gene expression (RAW cells), and resorptive pit formation (RAW cells) by mature osteoclasts. Besides, RAW cells were also stimulated with Ca2+ and Al3+ to evaluate the influence of these ions on MTA anti-osteoclastogenic potential. RESULTS In bone marrow and RAW cells, the number of TRAP-positive mature osteoclast cells induced by rRANKL was significantly inhibited by the presence of MTA compared with control rRANKL stimulation without MTA (p < 0.05), along with the reduction of TRAP enzyme activity (p < 0.05) and the low expression of cathepsin K gene (p < 0.05). In contrast, to control mature osteoclasts, the resorption area on dentin was significantly decreased for mature osteoclasts incubated with MTA (p < 0.05). rRANKL-stimulated RAW cells treated with Ca2+ and Al3+ decreased the number of osteoclasts cells. Besides, the aluminum oxide was the dominant suppressor of the osteoclastogenesis process. CONCLUSIONS MTA significantly suppressed RANKL-mediated osteoclastogenesis and osteoclast activity and, therefore, appears able to suppress bone resorption events in periapical lesions. This process might be related to Ca2+ and Al3+ activities. CLINICAL RELEVANCE MTA is an important worldwidely acknowleged biomaterial. The knowledge about its molecular activities on osteoclasts might contribute to improving the understanding of its clinical efficacy.
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Affiliation(s)
- Taia Maria Berto Rezende
- Programa de Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil. .,Curso de Odontologia, Universidade Católica de Brasília, Brasília, DF, Brazil. .,Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, DF, Brazil.
| | - Antônio Paulino Ribeiro Sobrinho
- Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Leda Quercia Vieira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Toshihisa Kawai
- Department of Oral Science and Translational Research, College of Dental Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA.,Cell Therapy Institute, Center for Collaborative Research, NOVA Southeastern University, Fort Lauderdale, FL, USA
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Gandhi Y, Bhatavadekar N. Cystic epithelial lining seen around a dental implant: A case report of a rare finding. J Oral Biol Craniofac Res 2020; 10:369-373. [PMID: 32714790 DOI: 10.1016/j.jobcr.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 10/23/2022] Open
Abstract
Dental implants have been successfully used for over 30 years, with a low complication rate. Peri-implant pathologies have recently seen an increase in incidence. This case report elucidates a rare case implant failure that occurred shortly after prosthetic loading, where the clinical signs mimicked peri-implant disease and attending bone loss, but the final histological report confirmed presence of a cystic lining around the implant. The manuscript also emphasizes the possible causes and management of such complications. To the best of our knowledge, this represents one of the first publication of an evident peri-implant cystic lining in a case exhibiting no radiographic evidence of the same.
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Affiliation(s)
- Yazad Gandhi
- Consultant Maxillofacial Surgeon, Saifee Hospital, Mumbai, India
| | - Neel Bhatavadekar
- Clarus Dental Specialities, Pune. Adjunct Faculty: University of North Carolina at Chapel Hill, USA
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Sarmento EB, Gomes CC, Pires FR, Pinto LC, Antunes LAA, Armada L. Immunoexpression of bone resorption biomarkers in apical periodontitis in diabetics and normoglycaemics. Int Endod J 2020; 53:1025-1032. [DOI: 10.1111/iej.13305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/31/2020] [Indexed: 12/19/2022]
Affiliation(s)
- E. B. Sarmento
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - C. C. Gomes
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - F. R. Pires
- School of Dentistry Estácio de Sá University Rio de Janeiro Brazil
| | - L. C. Pinto
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - L. A. A. Antunes
- School of Dentistry Fluminense Federal University Nova Friburgo Brazil
| | - L. Armada
- School of Dentistry Estácio de Sá University Rio de Janeiro Brazil
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Fouad AF, Khan AA, Silva RM, Kang MK. Genetic and Epigenetic Characterization of Pulpal and Periapical Inflammation. Front Physiol 2020; 11:21. [PMID: 32116745 PMCID: PMC7010935 DOI: 10.3389/fphys.2020.00021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022] Open
Abstract
Pulpal and periapical diseases affect a large segment of the population. The role of microbial infections and host effector molecules in these diseases is well established. However, the interaction between host genes and environmental factors in disease susceptibility and progression is less well understood. Studies of genetic polymorphisms in disease relevant genes have suggested that individual predisposition may contribute to susceptibility to pulpal and periapical diseases. Other studies have explored the contribution of epigenetic mechanisms to these diseases. Ongoing research expands the spectrum of non-coding RNAs in pulpal disease to include viral microRNAs as well. This review summarizes recent advances in the genetic and epigenetic characterization of pulpal and periapical disease, with special emphasis on recent data that address the pathogenesis of irreversible pulpal pathosis and apical periodontitis. Specifically, proinflammatory and anti-inflammatory gene expression and gene polymorphism, as well as recent data on DNA methylation and microRNAs are reviewed. Improved understanding of these mechanisms may aid in disease prevention as well as in improved treatment outcomes.
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Affiliation(s)
- Ashraf F Fouad
- Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Asma A Khan
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Renato M Silva
- Department of Endodontics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mo K Kang
- Section of Endodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
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De Rossi A, Lucisano MP, De Rossi M, Nelson‐Filho P, Silva RAB, Silva LAB, Saraiva MCP, Fukada SY. Effect of intercellular adhesion molecule 1 deficiency on the development of apical periodontitis. Int Endod J 2019; 53:354-365. [DOI: 10.1111/iej.13228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 09/30/2019] [Indexed: 12/11/2022]
Affiliation(s)
- A. De Rossi
- Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto University of São Paulo Ribeirao PretoBrazil
| | - M. P. Lucisano
- Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto University of São Paulo Ribeirao PretoBrazil
| | - M. De Rossi
- Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto University of São Paulo Ribeirao PretoBrazil
| | - P. Nelson‐Filho
- Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto University of São Paulo Ribeirao PretoBrazil
| | - R. A. B. Silva
- Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto University of São Paulo Ribeirao PretoBrazil
| | - L. A. B. Silva
- Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto University of São Paulo Ribeirao PretoBrazil
| | - M. C. P. Saraiva
- Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto University of São Paulo Ribeirao PretoBrazil
| | - S. Y. Fukada
- Department of Physics and Chemistry School of Pharmaceutical Sciences of Ribeirao Preto University of São Paulo Ribeirao Preto Brazil
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Gegen T, Zhu Y, Sun Q, Hou B. Role of interleukin-33 in the clinical pathogenesis of chronic apical periodontitis. J Int Med Res 2019; 47:3332-3343. [PMID: 31218936 PMCID: PMC6683938 DOI: 10.1177/0300060519854630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This study investigated interleukin (IL)-33 expression in chronic apical periodontitis (CAP) lesions and possible relationships with receptor activator of nuclear factor κ-Β ligand (RANKL) and osteoprotegerin (OPG). Methods Inflammatory cell infiltration in CAP lesions and samples of healthy periapical tissue (n = 30 each) was evaluated by hematoxylin and eosin staining. IL-33, RANKL, and OPG expression levels were assessed by immunohistochemistry and real-time PCR. In CAP lesions alone, relationships between mRNA level of IL-33 and mRNA levels of both RANKL and OPG were analyzed by Spearman rank correlation. Results Histological analysis revealed a large number of inflammatory cells in CAP lesions, and immunohistochemistry revealed IL-33-positive cells. There were more IL-33- and RANKL-positive cells in CAP lesions than in healthy periapical tissue, whereas there were fewer OPG-positive cells in CAP lesions than in healthy periapical tissue. In CAP lesions alone, IL-33 mRNA level was negatively correlated with mRNA level of RANKL and positively correlated with mRNA level of OPG. Conclusions IL-33 is highly expressed in CAP lesions, where it is negatively correlated with RANKL and positively correlated with OPG expression. IL-33 may protect against bone resorption via RANKL suppression and OPG induction, and constitutes a potential target for CAP treatment.
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Affiliation(s)
- Tana Gegen
- Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
- Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yanxia Zhu
- Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Qinnuan Sun
- Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Benxiang Hou
- Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
- Benxiang Hou, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China.
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Aksoy U, Savtekin G, Şehirli AÖ, Kermeoğlu F, Kalender A, Özkayalar H, Sayıner S, Orhan K. Effects of alpha-lipoic acid therapy on experimentally induced apical periodontitis: a biochemical, histopathological and micro-CT analysis. Int Endod J 2019; 52:1317-1326. [PMID: 30900747 DOI: 10.1111/iej.13121] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 03/18/2019] [Indexed: 12/23/2022]
Abstract
AIM To investigate the possible therapeutic effects of alpha-lipoic acid (ALA) in a model of chronic apical periodontitis in rats by analysing biochemical, histopathological and micro-CT parameters. METHODOLOGY The study was approved by the Animal Ethics Committee of the Near East University. Thirty-two Wistar rats were divided into four groups of eight rats each: Control Group; ALA Group; AP Group; AP + ALA Group. In the AP and AP + ALA groups, the pulp chambers of the mandibular first molars were surgically exposed and were left open to the oral environment for 4-weeks to allow the establishment of periapical lesions. The rats in the Control and AP groups were treated intraperitoneally with saline solution (with a daily dose of 100 mg kg-1 , for 28 days after periapical lesion induction). The rats in the ALA and AP + ALA groups were treated intraperitoneally with ALA (with a daily dose of 100 mg kg-1 , for 28 days after periapical lesion induction). After decapitation, the trunk blood was collected for the assessment of biochemical parameters. The mandibles were surgically removed and dissected for histopathologic analysis and further scanned with micro-CT. Groups of data were compared with a two-way analysis of variance (two-way anova) followed by Sidak's multiple comparison tests. Values of P < 0.05 were regarded as significant. RESULTS TNF-α, IL-1β, MMP-1, MMP-2 levels were significantly lower in AP + ALA group compared with AP group (P < 0.05). There was a significant difference between the AP and AP + ALA groups according to assessment of the inflammatory scores (P < 0.05). The periapical inflammatory infiltrates were significantly more severe (P < 0.05) in the AP group. The AP + ALA group exhibited lower values both in terms of surface area and volume of resorption cavities than the AP group and this difference was significant (P < 0.05). CONCLUSION alpha-lipoic acid treatment provided therapeutic effects on the inhibition of periapical bone loss.
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Affiliation(s)
- U Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - G Savtekin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - A Ö Şehirli
- Departments of Pharmacology, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - F Kermeoğlu
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - A Kalender
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - H Özkayalar
- Department of Pathology, Faculty of Medicine, Near East University, Mersin 10, Turkey
| | - S Sayıner
- Department of Biochemistry, Faculty of Veterinary Medicine, Near East University, Mersin 10, Turkey
| | - K Orhan
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Production of Soluble Receptor Activator of Nuclear Factor Kappa-Β Ligand and Osteoprotegerin by Apical Periodontitis Cells in Culture and Their Modulation by Cytokines. Mediators Inflamm 2019; 2019:8325380. [PMID: 31011287 PMCID: PMC6442274 DOI: 10.1155/2019/8325380] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/05/2019] [Indexed: 01/16/2023] Open
Abstract
RANKL, a bone-destructive cytokine, and OPG, its osteoprotective counterpart, are expressed in periapical lesions (PLs), which represent hystopatological manifestations of apical periodontitis. However, their regulation in PLs has not been elucidated yet. Therefore, our aim was to study the production of RANKL and OPG and their modulation by pro- and anti-inflammatory cytokines in PL cell cultures. Isolated PL cells were cultured alone or with addition of TNF-α, IFN-ϒ, IL-17, IL-4, IL-10, and IL- 33, respectively. The levels of RANKL and OPG in supernatants were measured by ELISA. The proportion of CD3+ (T cells) and CD19+/CD138+ (B cells/plasma cells) within isolated PLs was determined by immunocytochemistry. The levels of RANKL were higher in cultures of symptomatic PLs compared to asymptomatic PLs and PLs with the dominance of T cells (T-type lesions) over B cells/plasma cells (B-type lesions). A higher proportion of osteodestructive processes (RANKL/OPG ratio > 1.0) were detected in symptomatic PLs. The production of RANKL was upregulated by IFN-ϒ and IL-17 and higher concentrations of IL-33. IL-10 and lower concentrations of IL-33 augmented the production of OPG. The addition of either RANKL or anti-RANKL antibody to the cultures did not modify significantly the production of OPG. In conclusion, this original PL cell culture model suggests that increased bone destruction through upregulated production of RANKL could be associated with exacerbation of inflammation in PLs with the predominance of Th1 and Th17 responses and increased secretion of IL-33. In contrast, IL-10 and lower levels of IL-33, through upregulation of OPG, may suppress osteolytic processes.
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Howait M, Albassam A, Yamada C, Sasaki H, Bahammam L, Azuma MM, Cintra LTA, Satoskar AR, Yamada S, White R, Kawai T, Movila A. Elevated Expression of Macrophage Migration Inhibitory Factor Promotes Inflammatory Bone Resorption Induced in a Mouse Model of Periradicular Periodontitis. THE JOURNAL OF IMMUNOLOGY 2019; 202:2035-2043. [PMID: 30737274 DOI: 10.4049/jimmunol.1801161] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/15/2019] [Indexed: 12/23/2022]
Abstract
Locally produced osteoclastogenic factor RANKL plays a critical role in the development of bone resorption in periradicular periodontitis. However, because RANKL is also required for healthy bone remodeling, it is plausible that a costimulatory molecule that upregulates RANKL production in inflammatory periradicular periodontitis may be involved in the pathogenic bone loss processes. We hypothesized that macrophage migration inhibitory factor (MIF) would play a role in upregulating the RANKL-mediated osteoclastogenesis in the periradicular lesion. In response to pulp exposure, the bone loss and level of MIF mRNA increased in the periradicular periodontitis, which peaked at 14 d, in conjunction with the upregulated expressions of mRNAs for RANKL, proinflammatory cytokines (TNF-α, IL-6, and IL-1β), chemokines (MCP-1 and SDF-1), and MIF's cognate receptors CXCR4 and CD74. Furthermore, expressions of those mRNAs were found significantly higher in wild-type mice compared with that of MIF-/- mice. In contrast, bacterial LPS elicited the production of MIF from ligament fibroblasts in vitro, which, in turn, enhanced their productions of RANKL and TNF-α. rMIF significantly upregulated the number of TRAP+ osteoclasts in vitro. Finally, periapical bone loss induced in wild-type mice were significantly diminished in MIF-/- mice. Altogether, the current study demonstrated that MIF appeared to function as a key costimulatory molecule to upregulate RANKL-mediated osteoclastogenesis, leading to the pathogenically augmented bone resorption in periradicular lesions. These data also suggest that the approach to neutralize MIF activity may lead to the development of a therapeutic regimen for the prevention of pathogenic bone loss in periradicular periodontitis.
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Affiliation(s)
- Mohammed Howait
- School of Dental Medicine, Harvard University, Boston, MA 02115.,Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia.,The Forsyth Institute, Cambridge, MA 02142
| | - Abdullah Albassam
- School of Dental Medicine, Harvard University, Boston, MA 02115.,Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia.,The Forsyth Institute, Cambridge, MA 02142
| | - Chiaki Yamada
- College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, FL 33324
| | - Hajime Sasaki
- School of Dental Medicine, Harvard University, Boston, MA 02115.,The Forsyth Institute, Cambridge, MA 02142.,School of Dentistry, University of Michigan, Ann Arbor, MI 48109
| | - Laila Bahammam
- Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mariane Maffei Azuma
- The Forsyth Institute, Cambridge, MA 02142.,School of Dentistry, University of Michigan, Ann Arbor, MI 48109
| | | | - Abhay R Satoskar
- Department of Microbiology, The Ohio State University, Columbus, OH 43210; and
| | - Satoru Yamada
- Graduate School of Dentistry, Tohoku University, Tohoku, Sendai 980-8575, Japan
| | - Robert White
- School of Dental Medicine, Harvard University, Boston, MA 02115
| | - Toshihisa Kawai
- College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, FL 33324
| | - Alexandru Movila
- School of Dental Medicine, Harvard University, Boston, MA 02115; .,The Forsyth Institute, Cambridge, MA 02142.,College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, FL 33324
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Abstract
Conventional root canal therapies yield high success rates. The treatment outcomes are negatively affected by the presence of apical periodontitis (AP), which reflects active root canal infection and inflammatory responses. Also, cross-sectional studies revealed surprisingly high prevalence of AP in the general population, especially in those with prior endodontic treatments. Hence, AP is an ongoing disease entity in endodontics that needs further understanding of the pathogenesis and disease progression. The current Chapter will discuss the basic mechanisms of AP with emphasis on emerging role of epigenetic regulators in regulation of inflammatory mediators.
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15
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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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16
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Salinas-Muñoz M, Garrido-Flores M, Baeza M, Huamán-Chipana P, García-Sesnich J, Bologna R, Vernal R, Hernández M. Bone resorptive activity in symptomatic and asymptomatic apical lesions of endodontic origin. Clin Oral Investig 2017; 21:2613-2618. [PMID: 28261746 PMCID: PMC5632344 DOI: 10.1007/s00784-017-2062-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/25/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this study is to assess the levels and diagnostic accuracy of a set of bone resorption biomarkers, including TRAP-5, RANKL, and OPG in symptomatic and asymptomatic apical lesions and controls. MATERIALS AND METHODS Apical tissues from symptomatic and asymptomatic apical periodontitis patients and periodontal ligaments from healthy teeth extracted for orthodontic reasons were processed for tissue homogenization and the levels of TRAP-5, RANKL, and OPG were determined by multiplex assay. Marker levels were analyzed by Kruskal Wallis test, and diagnostic accuracy was analyzed with ROC curves. RESULTS Higher levels of RANKL, OPG, and RANKL/OPG ratio were determined in both types of apical lesions compared to healthy periodontal ligament, whereas higher TRAP-5 levels were found only in symptomatic apical lesions (p < 0.05). OPG, RANKL, and RANKL/OPG ratio showed diagnostic potential to identify apical lesions versus healthy controls (AUC = 0.69, p < 0.05); while TRAP-5 showed a potential to discriminate symptomatic versus asymptomatic apical periodontitis (AUC = 0.71, p < 0.05) and healthy controls (AUC = 0.83, p < 0.05). CONCLUSIONS Apical lesions showed higher RANKL and OPG levels than healthy tissues. TRAP-5 levels were the highest in symptomatic apical lesions, suggesting that these represent a progressive state, and showed diagnostic potential. CLINICAL RELEVANCE Clinically symptomatic apical periodontitis might represent biologically progressive apical lesions based on TRAP5 levels. TRAP5 has diagnostic potential to identify these lesions, representing a candidate prognostic biomarker.
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Affiliation(s)
- M Salinas-Muñoz
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - M Garrido-Flores
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - M Baeza
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - P Huamán-Chipana
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - J García-Sesnich
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - R Bologna
- Molecular Pathology Area, School of Dentistry, Universidad de la República UDELAR, Montevideo, Uruguay
| | - R Vernal
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
- Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | - M Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
- Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile.
- Department of Oral Pathology and Medicine, Faculty of Dentistry, Universidad de Chile, Av. Sergio Livingstone 943, Independencia, Santiago, Chile.
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17
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Bahuguna R, Jain A, Khan SA, Arvind MS. Role of odanacatib in reducing bone loss due to endodontic disease: An overview. J Int Soc Prev Community Dent 2017; 6:S175-S181. [PMID: 28217533 PMCID: PMC5285591 DOI: 10.4103/2231-0762.197183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aims and Objectives: Through a comprehensive literature review, this article provides an overview of the potential role of odanacatib (ODN) in reducing bone loss due to endodontic disease. Materials and Methods: A literature review was performed in PubMed Central, MEDLINE, Cochrane Library, and EBSCO databases. The articles identified included those published between 2002 and 2016. Based on the predetermined inclusion and exclusion criteria, out of 237 articles found, 50 were selected for this review. Results: Cathepsin K (CstK), which is indispensible to the immune system, also plays an important role in osteoclastic bone resorption. ODN, which is an orally active, selective, and effective inhibitor of CstK, decreases bone resorption by selectively inhibiting proteolysis of matrix proteins by CstK, without affecting other osteoclastic activity or osteoblast viability. Conclusion: The goal of endodontic treatment is to achieve a clinically asymptomatic state along with formation of reparative bone. This process could take 6 months or longer, hence, an earlier reversal of the resorption process could lead to faster healing and resolution of the periapical lesion. Use of ODN can be of help in achieving this goal.
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Affiliation(s)
- Rachana Bahuguna
- Department of Pedodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Atul Jain
- Department of Conservative Dentistry and Endodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Suleman Abbas Khan
- Department of Pedodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - M S Arvind
- Department of Conservative Dentistry and Endodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
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18
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Trombone APF, Cavalla F, Silveira EMV, Andreo CB, Francisconi CF, Fonseca AC, Letra A, Silva RM, Garlet GP. MMP1-1607 polymorphism increases the risk for periapical lesion development through the upregulation MMP-1 expression in association with pro-inflammatory milieu elements. J Appl Oral Sci 2016; 24:366-75. [PMID: 27556208 PMCID: PMC4990366 DOI: 10.1590/1678-775720160112] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/06/2016] [Indexed: 02/08/2023] Open
Abstract
Increased matrix metalloproteinases (MMPs) activity is a hallmark of periapical granulomas. However, the factors underlying the MMPs expression modulation in healthy and diseased periapical tissues remains to be determined.
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Affiliation(s)
- Ana Paula Favaro Trombone
- - Universidade do Sagrado Coração, Departamento de Ciências Biológicas e da Saúde, Bauru, SP, Brasil
| | - Franco Cavalla
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil.,- Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile
| | | | - Camile Bermejo Andreo
- - Universidade do Sagrado Coração, Departamento de Ciências Biológicas e da Saúde, Bauru, SP, Brasil
| | - Carolina Favaro Francisconi
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Angélica Cristina Fonseca
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Ariadne Letra
- - University of Texas Health Science Center at Houston, School of Dentistry, Department of Endodontics, Houston, USA
| | - Renato Menezes Silva
- - University of Texas Health Science Center at Houston, School of Dentistry, Department of Endodontics, Houston, USA
| | - Gustavo Pompermaier Garlet
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
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19
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De Rossi A, Fukada SY, De Rossi M, da Silva RAB, Queiroz AM, Nelson-Filho P, da Silva LAB. Cementocytes Express Receptor Activator of the Nuclear Factor Kappa-B Ligand in Response to Endodontic Infection in Mice. J Endod 2016; 42:1251-7. [DOI: 10.1016/j.joen.2016.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/26/2016] [Accepted: 05/14/2016] [Indexed: 10/21/2022]
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20
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Jakovljevic A, Andric M, Miletic M, Beljic-Ivanovic K, Knezevic A, Mojsilovic S, Milasin J. Epstein-Barr virus infection induces bone resorption in apical periodontitis via increased production of reactive oxygen species. Med Hypotheses 2016; 94:40-2. [PMID: 27515196 DOI: 10.1016/j.mehy.2016.06.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 06/17/2016] [Indexed: 12/12/2022]
Abstract
Chronic inflammatory processes in periapical tissues caused by etiological agents of endodontic origin lead to apical periodontitis. Apart from bacteria, two herpesviruses, Epstein-Barr virus (EBV) and Human cytomegalovirus (HCMV) are recognized as putative pathogens in apical periodontitis. Although previous reports suggest the involvement of EBV in the pathogenesis of apical periodontitis, its exact role in periapical bone resorption has not yet been fully elucidated. We hypothesize that EBV infection in apical periodontitis is capable of inducing periapical bone resorption via stimulation of reactive oxygen species (ROS) overproduction. Increased levels of ROS induce expression of receptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL). RANKL binding to receptor activator of nuclear factor κB (RANK) present on the surface of preosteoclasts induces their maturation and activation which consequently leads to bone resorption. The potential benefit of antiviral and antioxidant-based therapies in periapical bone resorption treatment remains to be assessed.
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Affiliation(s)
- Aleksandar Jakovljevic
- Clinic of Oral Surgery and Implantology, School of Dental Medicine, University of Belgrade, Dr Subotica 4, 11 000 Belgrade, Serbia; Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Dr Subotica 1, 11 000 Belgrade, Serbia.
| | - Miroslav Andric
- Clinic of Oral Surgery and Implantology, School of Dental Medicine, University of Belgrade, Dr Subotica 4, 11 000 Belgrade, Serbia
| | - Maja Miletic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Dr Subotica 1, 11 000 Belgrade, Serbia
| | - Katarina Beljic-Ivanovic
- Clinic of Restorative Dentistry and Endodontics, School of Dental Medicine, University of Belgrade, Rankeova 4, 11 000 Belgrade, Serbia
| | - Aleksandra Knezevic
- Department of Virology, Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Dr. Subotica 1, 11 000 Belgrade, Serbia
| | - Slavko Mojsilovic
- Department of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Dr. Subotica 1, 11 000 Belgrade, Serbia
| | - Jelena Milasin
- Institute for Medical Research, University of Belgrade, Dr Subotic 4, PO Box 102, 11 000 Belgrade, Serbia
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21
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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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22
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Silva N, Abusleme L, Bravo D, Dutzan N, Garcia-Sesnich J, Vernal R, Hernández M, Gamonal J. Host response mechanisms in periodontal diseases. J Appl Oral Sci 2015. [PMID: 26221929 PMCID: PMC4510669 DOI: 10.1590/1678-775720140259] [Citation(s) in RCA: 254] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Periodontal diseases usually refer to common inflammatory disorders known as gingivitis and periodontitis, which are caused by a pathogenic microbiota in the subgingival biofilm, including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Treponema denticola that trigger innate, inflammatory, and adaptive immune responses. These processes result in the destruction of the tissues surrounding and supporting the teeth, and eventually in tissue, bone and finally, tooth loss. The innate immune response constitutes a homeostatic system, which is the first line of defense, and is able to recognize invading microorganisms as non-self, triggering immune responses to eliminate them. In addition to the innate immunity, adaptive immunity cells and characteristic cytokines have been described as important players in the periodontal disease pathogenesis scenario, with a special attention to CD4+ T-cells (T-helper cells). Interestingly, the T cell-mediated adaptive immunity development is highly dependent on innate immunity-associated antigen presenting cells, which after antigen capture undergo into a maturation process and migrate towards the lymph nodes, where they produce distinct patterns of cytokines that will contribute to the subsequent polarization and activation of specific T CD4+ lymphocytes. Skeletal homeostasis depends on a dynamic balance between the activities of the bone-forming osteoblasts (OBLs) and bone-resorbing osteoclasts (OCLs). This balance is tightly controlled by various regulatory systems, such as the endocrine system, and is influenced by the immune system, an osteoimmunological regulation depending on lymphocyte- and macrophage-derived cytokines. All these cytokines and inflammatory mediators are capable of acting alone or in concert, to stimulate periodontal breakdown and collagen destruction via tissue-derived matrix metalloproteinases, a characterization of the progression of periodontitis as a stage that presents a significantly host immune and inflammatory response to the microbial challenge that determine of susceptibility to develop the destructive/progressive periodontitis under the influence of multiple behavioral, environmental and genetic factors.
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Affiliation(s)
- Nora Silva
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Loreto Abusleme
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Denisse Bravo
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Nicolás Dutzan
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jocelyn Garcia-Sesnich
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Rolando Vernal
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Marcela Hernández
- Department of Pathology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jorge Gamonal
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
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23
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Kubono Y, Mayahara M, Otsuka H, Kataoka R, Takagi Y, Asari J, Nonaka N, Inoue M, Nakamura M. Analysis of periapical alveolar bone resorption after the removal of interdental wire ligation. PEDIATRIC DENTAL JOURNAL 2015. [DOI: 10.1016/j.pdj.2014.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Hu S, Shang W, Yue H, Chen R, Dong Z, Hu J, Mao Z, Yang J. Differentiated embryonic chondrocytes 1 expression of periodontal ligament tissue and gingival tissue in the patients with chronic periodontitis. Arch Oral Biol 2014; 60:517-25. [PMID: 25575296 DOI: 10.1016/j.archoralbio.2014.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/20/2014] [Accepted: 12/08/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the DEC1 expression of periodontal ligament tissue and gingival tissue in the patients with chronic periodontitis. METHODS 20 non-smoking patients with chronic periodontitis and 20 healthy individuals were enrolled. Periodontal ligament tissue and gingival tissue samples from healthy subjects were collected during teeth extraction for orthodontic reason or the third molar extraction. The parallel samples from patients with chronic periodontitis were obtained during periodontal flap operations or teeth extraction as part of periodontal treatment. The DEC1 expression and the alkaline phosphatase (ALP) activity of both the periodontal ligament tissue and gingival tissue were determined by Western blot, Immunohistochemistry and ALP Detection Kit. RESULTS The DEC1 expression of periodontal ligament tissue in the patients with chronic periodontitis decreased significantly along with the decreased ALP activity. On the contrary, the DEC1 expression of gingival tissue in the patients with chronic periodontitis increased significantly. Further study found that the DEC1 expression of gingival tissue increased mainly in the suprabasal layer of gingival epithelial cells but decreased in the gingival connective tissue of the patients with chronic periodontitis. CONCLUSION The DEC1 expression decreases in the periodontal ligament tissue which is related to the osteogenic capacity, whereas the DEC1 expression increases in the suprabasal layer of gingival epithelial cells which are involved in immune inflammatory response in the patients with chronic periodontitis. The findings provide a new target to explore the pathology and the therapy of periodontitis.
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Affiliation(s)
- Shenlin Hu
- Department of Stomatology, Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Shang
- Department of Pharmacology, Nanjing Medicine University, Nanjing, China
| | - Haitao Yue
- Department of Pharmacology, Nanjing Medicine University, Nanjing, China
| | - Ruini Chen
- Department of Pharmacology, Nanjing Medicine University, Nanjing, China
| | - Zheng Dong
- Department of Stomatology, Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Jinhua Hu
- Department of Pharmacology, Nanjing Medicine University, Nanjing, China
| | - Zhao Mao
- Department of Stomatology, Jinling Hospital, Nanjing Medical University, Nanjing, China.
| | - Jian Yang
- Department of Pharmacology, Nanjing Medicine University, Nanjing, China.
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Araujo-Pires AC, Francisconi CF, Biguetti CC, Cavalla F, Aranha AMF, Letra A, Trombone APF, Faveri M, Silva RM, Garlet GP. Simultaneous analysis of T helper subsets (Th1, Th2, Th9, Th17, Th22, Tfh, Tr1 and Tregs) markers expression in periapical lesions reveals multiple cytokine clusters accountable for lesions activity and inactivity status. J Appl Oral Sci 2014; 22:336-46. [PMID: 25141207 PMCID: PMC4126831 DOI: 10.1590/1678-775720140140] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 05/20/2014] [Indexed: 01/08/2023] Open
Abstract
UNLABELLED Previous studies demonstrate that the balance between pro- and anti-inflammatory mediators determines the stable or progressive nature of periapical granulomas by modulating the balance of the osteoclastogenic factor RANKL and its antagonist OPG. However, the cytokine networks operating in the development of periapical lesions are quite more complex than what the simple pro- versus anti-inflammatory mediators' paradigm suggests. Here we simultaneously investigated the patterns of Th1, Th2, Th9, Th17, Th22, Thf, Tr1 and Tregs cytokines/markers expression in human periapical granulomas. METHODS The expression of TNF-α, IFN-γ, IL-17A, IL23, IL21, IL-33, IL-10, IL-4, IL-9, IL-22, FOXp3 markers (via RealTimePCR array) was accessed in active/progressive (N=40) versus inactive/stable (N=70) periapical granulomas (as determined by RANKL/OPG expression ratio), and also to compare these samples with a panel of control specimens (N=26). A cluster analysis of 13 cytokine levels was performed to examine possible clustering between the cytokines in a total of 110 granulomas. RESULTS The expression of all target cytokines was higher in the granulomas than in control samples. TNF-α, IFN-γ, IL-17A and IL-21 mRNA levels were significantly higher in active granulomas, while in inactive lesions the expression levels of IL-4, IL-9, IL-10, IL-22 and FOXp3 were higher than in active granulomas. Five clusters were identified in inactive lesion groups, being the variance in the expression levels of IL-17, IL-10, FOXp3, IFN-γ, IL-9, IL-33 and IL-4 statistically significant (KW p<0.05). Three clusters were identified in active lesions, being the variance in the expression levels of IL-22, IL-10, IFN-γ, IL-17, IL-33, FOXp3, IL-21 and RANKL statistically significant (KW p<0.05). CONCLUSION There is a clear dichotomy in the profile of cytokine expression in inactive and active periapical lesions. While the widespread cytokine expression seems to be a feature of chronic lesions, hierarchical cluster analysis demonstrates the association of TNF-α, IL-21, IL-17 and IFN-γ with lesions activity, and the association of FOXP3, IL-10, IL-9, IL-4 and IL-22 with lesions inactivity.
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Affiliation(s)
- Ana Claudia Araujo-Pires
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Claudia Cristina Biguetti
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Franco Cavalla
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Andreza Maria Fabio Aranha
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Ariadne Letra
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, USA
| | | | - Marcelo Faveri
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Renato Menezes Silva
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, USA
| | - Gustavo Pompermaier Garlet
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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OPG/RANKL/RANK axis is a critical inflammatory signaling system in ischemic brain in mice. Proc Natl Acad Sci U S A 2014; 111:8191-6. [PMID: 24847069 DOI: 10.1073/pnas.1400544111] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Osteoprotegerin (OPG) is a soluble secreted protein and a decoy receptor, which inhibits a receptor activator of nuclear factor κB (NF-κB) ligand (RANKL)/the receptor activator of NF-κB (RANK) signaling. Recent clinical studies have shown that a high-serum-OPG level is associated with unfavorable outcome in ischemic stroke, but it is unclear whether OPG is a culprit or an innocent bystander. Here we demonstrate that enhanced RANKL/RANK signaling in OPG(-/-) mice or recombinant RANKL-treated mice contributed to the reduction of infarct volume and brain edema via reduced postischemic inflammation. On the contrary, infarct volume was increased by reduced RANKL/RANK signaling in OPG(-/-) mice and WT mice treated with anti-RANKL neutralizing antibody. OPG, RANKL, and RANK mRNA were increased in the acute stage and were expressed in activated microglia and macrophages. Although enhanced RANKL/RANK signaling had no effects in glutamate, CoCl2, or H2O2-stimulated neuronal culture, enhanced RANKL/RANK signaling showed neuroprotective effects with reduced expression in inflammatory cytokines in LPS-stimulated neuron-glia mixed culture, suggesting that RANKL/RANK signaling can attenuate inflammation through a Toll-like receptor signaling pathway in microglia. Our findings propose that increased OPG could be a causal factor of reducing RANKL/RANK signaling and increasing postischemic inflammation. Thus, the OPG/RANKL/RANK axis plays critical roles in controlling inflammation in ischemic brains.
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Garrido M, Dezerega A, Castro-Martínez A, Hernández M. Host-derived biomarkers in gingival crevicular fluid for complementary diagnosis of apical periodontitis. World J Stomatol 2014; 3:19-24. [DOI: 10.5321/wjs.v3.i2.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/07/2014] [Accepted: 05/14/2014] [Indexed: 02/07/2023] Open
Abstract
Apical periodontitis (AP) develops as a result of the host’s immune inflammatory response to pulpal infection of the dental root canals that leads to the generation of an apical lesion of endodontic origin (ALEO) and potentially to systemic metabolic alterations. Misdiagnosed ALEO is not infrequent due to the lack of diagnostic tools to differentiate apical lesions of different natures. Despite the conservative endodontic treatment shows a high success rate, there are refractory cases that can not be identified early enough during follow up. This evidences the need to develop complementary diagnostic tools, such as oral fluid biomarker analysis. Gingival crevicular fluid (GCF) is a serum transudate that becomes an exudate under inflammatory conditions, carrying molecules from local periodontal tissues and general circulation than can be harvested non-invasively. We aimed to review the available literature analyzing GCF composition in AP patients to evaluate whether GCF has any potential for complementary diagnosis. To the date, only few studies addressing changes of GCF components in AP are available. Most studies support GCF modifications in specific components in AP-affected teeth, suggesting that it might reflect periapical inflammation. GCF has potential for diagnostic tool, treatment follow-up and eventually to assess systemic comprise.
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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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Bezerra da Silva RA, Nelson-Filho P, Lucisano MP, De Rossi A, de Queiroz AM, Bezerra da Silva LA. MyD88 knockout mice develop initial enlarged periapical lesions with increased numbers of neutrophils. Int Endod J 2013; 47:675-86. [DOI: 10.1111/iej.12204] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/10/2013] [Indexed: 12/13/2022]
Affiliation(s)
- R. A. Bezerra da Silva
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - P. Nelson-Filho
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - M. P. Lucisano
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - A. De Rossi
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - A. M. de Queiroz
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - L. A. Bezerra da Silva
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
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Noh MK, Jung M, Kim SH, Lee SR, Park KH, Kim DH, Kim HH, Park YG. Assessment of IL-6, IL-8 and TNF-α levels in the gingival tissue of patients with periodontitis. Exp Ther Med 2013; 6:847-851. [PMID: 24137277 PMCID: PMC3786859 DOI: 10.3892/etm.2013.1222] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/02/2013] [Indexed: 01/10/2023] Open
Abstract
In periodontal diseases, inflammatory mediators, including interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α), may promote the degeneration of inflamed periodontal tissues. In previous studies, levels of these three cytokines were demonstrated to be elevated in inflammatory gingival tissues and gingival crevicular fluid. The aim of the present study was to quantify IL-6, IL-8 and TNF-α levels in the human gingival tissues of patients with periodontitis and to assess the correlation of these three cytokines with each other. In this study, human gingival tissues from 19 patients with periodontitis (male, n=14; female, n=5) were collected. The tissues were homogenized, centrifuged and the protein in the supernatant was quantified. Enzyme-linked immunosorbent assay (ELISA) was used in the measurement of the IL-6, IL-8 and TNF-α levels, and the mean levels were observed to be 8.41±0.25, 34.01±1.09 and 20.70±0.31 pg/ml, respectively. The mean levels of IL-8 were higher than those of the other two cytokines. In each sample, the level of TNF-α expression was consistently high, with little difference between the results, which contrasted with the fluctuations in IL-6 and IL-8 levels. The expression of the two ILs (IL-6 and IL-8) showed a positive correlation (r=0.932, P=0.01), whereas TNF-α levels were not correlated with IL-6 or IL-8 levels. These results suggest that IL-6, IL-8 and TNF-α may be relevant in the pathophysiology of periodontitis, and the measurement of these cytokines may be beneficial in the identification of patients with periodontitis.
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Affiliation(s)
- Min Ki Noh
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul 130-701, Republic of Korea
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Kim KA, Chung SB, Hawng EY, Noh SH, Song KH, Kim HH, Kim CH, Park YG. Correlation of expression and activity of matrix metalloproteinase-9 and -2 in human gingival cells of periodontitis patients. J Periodontal Implant Sci 2013; 43:24-9. [PMID: 23507779 PMCID: PMC3596630 DOI: 10.5051/jpis.2013.43.1.24] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 01/18/2013] [Indexed: 01/30/2023] Open
Abstract
Purpose Matrix metalloproteinases (MMPs) are capable of degrading extracellular matrix, and they are inducible enzymes depending on an inflammatory environment such as periodontitis and bacterial infection in periodontal tissue. Gingival inflammation has been postulated to be correlated with the production of MMP-2 and MMP-9. The objective of this study was to quantify the expression and activity of MMP-9 and -2, and to determine the correlation between activity and expression of these MMPs in human gingival tissues with periodontitis. Methods The gingival tissues of 13 patients were homogenized in 500 µL of phosphate buffered saline with a protease inhibitor cocktail. The expression and activity of MMP-2 and -9 were measured by enzyme-linked immunosorbent assay and Western blot analysis, and quantified by a densitometer. For the correlation line, statistical analysis was performed using the Systat software package. Results MMP-9 was highly expressed in all gingival tissue samples, whereas MMP-2 was underexpressed compared with MMP-9. MMP-9 activity increased together with the MMP-9 expression level, with a positive correlation (r=0.793, P=0.01). The correlation was not observed in MMP-2. Conclusions The expression of MMP-2 and -9 might contribute to periodontal physiological and pathological processes, and the degree of MMP-9 expression and activity are predictive indicators relevant to the progression of periodontitis.
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Affiliation(s)
- Kyung-A Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
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Lima SMF, Grisi DC, Kogawa EM, Franco OL, Peixoto VC, Gonçalves-Júnior JF, Arruda MP, Rezende TMB. Diabetes mellitus and inflammatory pulpal and periapical disease: a review. Int Endod J 2013; 46:700-9. [PMID: 23442003 DOI: 10.1111/iej.12072] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 01/12/2013] [Indexed: 12/12/2022]
Abstract
Diabetes mellitus (DM) is one of the most common metabolic disorders. DM is characterized by hyperglycaemia, resulting in wound healing difficulties and systemic and oral manifestations, which have a direct effect on dental pulp integrity. Experimental and clinical studies have demonstrated a higher prevalence of periapical lesions in patients with uncontrolled diabetes. The influence of DM on periapical bone resorption and its impact on dental intervention of such patients are reviewed, and its aetiology and pathogenesis are analysed at molecular level. Pulps from patients with diabetes have the tendency to present limited dental collateral circulation, impaired immune response, increased risk of acquiring pulp infection (especially anaerobic ones) or necrosis, besides toothache and occasional tendency towards pulp necrosis caused by ischaemia. In regard to molecular pathology, hyperglycaemia is a stimulus for bone resorption, inhibiting osteoblastic differentiation and reducing bone recovery. The relationship between poorly controlled diabetes and bone metabolism is not clearly understood. Molecular knowledge about pulp alterations in patients with diabetes could offer new therapeutic directions. Knowledge about how diabetes affects systemic and oral health has an enduring importance, because it may imply not only systemic complications but also a higher risk of oral diseases with a significant effect on pulp and periapical tissue.
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Affiliation(s)
- S M F Lima
- Center of Proteomic and Biochemical Analyzes, Post graduation in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília, DF, Brazil
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Belibasakis GN, Rechenberg DK, Zehnder M. The receptor activator of
NF
‐κ
B
ligand‐osteoprotegerin system in pulpal and periapical disease. Int Endod J 2012; 46:99-111. [DOI: 10.1111/j.1365-2591.2012.02105.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/03/2012] [Indexed: 01/15/2023]
Affiliation(s)
- G. N. Belibasakis
- Institute of Oral Biology University of Zürich Center of Dental Medicine ZürichSwitzerland
| | - D. K. Rechenberg
- Department of Preventive Dentistry, Periodontology, and Cariology University of Zürich Center of Dental Medicine Zürich Switzerland
| | - M. Zehnder
- Department of Preventive Dentistry, Periodontology, and Cariology University of Zürich Center of Dental Medicine Zürich Switzerland
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da Silva RAB, Ferreira PDF, De Rossi A, Nelson-Filho P, Silva LAB. Toll-like receptor 2 knockout mice showed increased periapical lesion size and osteoclast number. J Endod 2012; 38:803-13. [PMID: 22595116 DOI: 10.1016/j.joen.2012.03.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 03/13/2012] [Accepted: 03/13/2012] [Indexed: 01/27/2023]
Abstract
INTRODUCTION The aim of this study was to characterize the formation and progression of experimentally induced periapical lesions in TLR2 knockout (TLR2 KO) mice. METHODS Periapical lesions were induced in molars of 28 wild type (WT) and 27 TLR2 KO mice. After 7, 21, and 42 days, the animals were euthanized, and the mandibles were subjected to histotechnical processing. Hematoxylin-eosin-stained sections were examined under conventional light microscopy for the description of pulpal, apical, and periapical features and under fluorescence microscopy for the determination of the periapical lesion size. The subsequent sections were evaluated by tartrate resistant acid phosphatase histoenzymology (osteoclasts), Brown and Brenn staining (bacteria), and immunohistochemistry (RANK, RANKL, and OPG). Data were analyzed by the Mann-Whitney U and Kruskal-Wallis tests (α = 0.05). RESULTS The WT group showed significant differences (P < .05) in the periapical lesion size and the osteoclast number between 7 and 42 days and between 21 and 42 days. In the TLR2 KO group, significant differences (P < .05) in the periapical lesion size and the osteoclast number were found between 7 days and the other periods. There was a significant difference (P < .05) between the 2 types of animal regarding the periapical lesion size, which was larger in the TLR2 KO animals. No significant differences (P > .05) were found between WT and TLR2 KO mice related to the pulpal, apical, and periapical features; bacteria localization; and immunohistochemical results (except for RANK expression). CONCLUSIONS TLR2 KO animals developed larger periapical lesions with a greater number of osteoclasts, indicating the important role of this receptor in the host's immune and inflammatory response to root canal and periradicular infection.
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Affiliation(s)
- Raquel Assed Bezerra da Silva
- Department of Pediatric Clinics, Preventive and Community Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Dezerega A, Madrid S, Mundi V, Valenzuela MA, Garrido M, Paredes R, García-Sesnich J, Ortega AV, Gamonal J, Hernández M. Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response. JOURNAL OF INFLAMMATION-LONDON 2012; 9:8. [PMID: 22436166 PMCID: PMC3358239 DOI: 10.1186/1476-9255-9-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 03/21/2012] [Indexed: 01/22/2023]
Abstract
Background Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP)-affected teeth at baseline and after endodontic treatment. Methods Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Results Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p < 0.05). Total oxidant status correlated positively with matrix metalloproteinase-2 and lesion size (p < 0.05). Gingival crevicular fluid showed significantly lower levels of total antioxidant status in diseased teeth at baseline compared to controls and endodontically-treated groups. Conclusions Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic of apical status in GCF.
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Affiliation(s)
- Andrea Dezerega
- Laboratorio de Biología Periodontal, Facultad de Odontología, Avenida Sergio Livingstone 943, Comuna de Independencia, Santiago, Chile.
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Silva MJB, Kajiya M, AlShwaimi E, Sasaki H, Hong J, Ok P, Rezende TMB, Pagonis TC, White RR, Paster BJ, Stashenko P, Kawai T. Bacteria-reactive immune response may induce RANKL-expressing T cells in the mouse periapical bone loss lesion. J Endod 2012; 38:346-50. [PMID: 22341072 DOI: 10.1016/j.joen.2011.12.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 12/21/2011] [Accepted: 12/22/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The present study investigated whether bacteria infecting the root canal can activate any infiltrating T cells to produce receptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL). METHODS Using a mouse model of periapical lesion induced by artificial dental pulp exposure, the presence of RANKL-positive T cells and osteoclasts in the periapical lesion was examined by an immunohistochemical approach. The bacteria colonizing the exposed root canal were identified by 16S ribosomal RNA (rRNA) sequence analysis. The isolated endodontic bacteria were further immunized to normal mice, and soluble activator of NF-κB ligand (sRANKL) production by the T cells isolated from the immunized mice was evaluated by ex vivo culture system. RESULTS RANKL-positive T cells along with TRAP+ osteoclasts were identified in periapical bone resorption lesions. The gram-negative bacterium Pasteurella pnumotropica, which was most frequently detected from the root canal of exposed pulp, showed remarkably elevated serum immunoglobulin G (IgG)-antibody response in pulp-exposed mice compared with control nontreated mice. Immunization of mice with P. pneumotropica induced not only serum IgG-antibody but also primed bacteria-reactive T cells that produced sRANKL in response to ex vivo exposure to P. pneumotropica. CONCLUSIONS T cells infiltrating the periapical region express RANKL, and the endodontic bacteria colonizing the root canal appear to induce RANKL expression from bacteria-reactive T cells, suggesting the possible pathogenic engagement of the immune response to endodontic bacteria in the context of developing bone resorptive periapical lesions.
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Affiliation(s)
- Marcelo J B Silva
- Department of Immunology, The Forsyth Institute, Cambridge, Massachusetts, USA
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Graunaite I, Lodiene G, Maciulskiene V. Pathogenesis of apical periodontitis: a literature review. J Oral Maxillofac Res 2012; 2:e1. [PMID: 24421998 PMCID: PMC3886078 DOI: 10.5037/jomr.2011.2401] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 09/03/2011] [Indexed: 05/29/2023]
Abstract
OBJECTIVES This review article discusses the host response in apical periodontitis with the main focus on cytokines, produced under this pathological condition and contributing to the degradation of periradicular tissues. The pace of research in this field has greatly accelerated in the last decade. Here we provide an analysis of studies published in this area during this period. MATERIAL AND METHODS Literature was selected through a search of PubMed electronic database. The keywords used for search were pathogenesis of apical periodontitis cytokines, periapical granuloma cytokines, inflammatory infiltrate apical periodontitis. The search was restricted to English language articles, published from 1999 to December 2010. Additionally, a manual search in the cytokine production, cytokine functions and periapical tissue destruction in the journals and books was performed. RESULTS In total, 97 literature sources were obtained and reviewed. The topics covered in this article include cellular composition of an inflammatory infiltrate in the periapical lesions, mechanisms of the formation of the innate and specific immune response. Studies which investigated cytokine secretion and functions were identified and cellular and molecular interactions in the course of apical periodontitis described. CONCLUSIONS The abundance and interactions of various inflammatory and anti-inflammatory molecules can influence and alter the state and progression of the disease. Therefore, periapical inflammatory response offers a model, suited for the study of many facets of pathogenesis, biocompatibility of different materials to periapical tissues and development of novel treatment methods, based on the regulation of cytokines expression.
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Affiliation(s)
- Indre Graunaite
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health SciencesLithuania.
| | - Greta Lodiene
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health SciencesLithuania.
| | - Vita Maciulskiene
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health SciencesLithuania.
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Comparative immunohistochemical expression of RANK, RANKL and OPG in radicular and dentigerous cysts. Arch Oral Biol 2011; 56:1256-63. [DOI: 10.1016/j.archoralbio.2011.05.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 05/17/2011] [Accepted: 05/19/2011] [Indexed: 01/09/2023]
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Chuang FH, Tsai CC, Chen JH, Chen KK, Chen YK, Lin YC. Long-term sequential receptor activator of NF-κB ligand (RANKL) and osteoprotegrin (OPG) expression in lipopolysaccharide-induced rat periapical lesions. J Oral Pathol Med 2011; 41:186-93. [DOI: 10.1111/j.1600-0714.2011.01065.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Silva MJB, Sousa LMA, Lara VPL, Cardoso FP, Júnior GM, Totola AH, Caliari MV, Romero OB, Silva GAB, Ribeiro-Sobrinho AP, Vieira LQ. The role of iNOS and PHOX in periapical bone resorption. J Dent Res 2011; 90:495-500. [PMID: 21441224 DOI: 10.1177/0022034510391792] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Nitric oxide (NO) and reactive oxygen species (ROS) are key molecules in resistance to pathogens. Little is known about their role in pathogenesis of periapical lesions. To address this issue, we induced periapical lesions in mice lacking nitric oxide synthase (iNOS(-/-)) or phagocyte oxidase (PHOX(-/-)). iNOS(-/-) mice expressed higher levels of IL-1β, TNF-α, RANK, RANKL, and MCP-1 than C57BL/6 and PHOX(-/-). Apical thickening of the periodontal ligament was also greater in iNOS(-/-) compared with other groups. Interestingly, ROS production did not interfere in periapical lesion progression, but seemed to be essential for the appearance of multinucleated TRAP-positive cells. Thus, periapical lesion progression in iNOS(-/-) was associated with an imbalance of pro-inflammatory cytokines (IL-1β and TNF-α), bone-resorptive modulators (RANK and RANKL), and MCP-1. We conclude that NO, but not ROS, controls progression of bone resorption in a murine experimental model of apical periodontitis.
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Affiliation(s)
- M J B Silva
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, CP 486, 30161-970 Belo Horizonte, MG, Brazil
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Mundi Burgos V, Dezerega Piwonka A, Osorio Alfaro C, Dutzan Muñoz N, Franco Martínez M, Ortega Pinto A, Hernández Ríos M. Inmunodetección de metaloproteinasas de matriz extracelular (MMPs)-2, -9, -13 y -14 en lesiones apicales asociadas con periodontitis apical asintomática. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s0718-5391(11)70060-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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A controversial role for IL-12 in immune response and bone resorption at apical periodontal sites. Clin Dev Immunol 2011; 2010:327417. [PMID: 21350602 PMCID: PMC3042606 DOI: 10.1155/2010/327417] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 12/06/2010] [Accepted: 12/22/2010] [Indexed: 12/24/2022]
Abstract
Periapical lesions are inflammatory conditions of tooth periapical tissues, triggered by dental pulp infection and characterized by exudation of immune cells to the affected tissues and production of inflammatory mediators such as cytokines. The inflammatory periapical reaction is mainly driven by Th1, Th2, and Th17 responses, and such polarization may modulate progression of the disease and expression of bone proresorptive cytokines. IL-12 is a potent inducer of IFN-γ production, which stimulates Th1 effector cells. Many evidences have shown a positive correlation between the bone resorptive cytokine IL-1β and the production of IL-12 and IFN-γ. Furthermore, IL-12 may have a potential role in the release of bone resorptive mediators and blockade of Th2 cytokines, affecting the progression of periapical bone loss. Nevertheless, IL-12 and IFN-γ have also been described as suppressors of osteoclast differentiation and activation, favoring bone maintenance. This paper focuses on the controversial roles of IL-12 in periapical lesions.
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Dezerega A, Osorio C, Mardones J, Mundi V, Dutzan N, Franco M, Gamonal J, Oyarzún A, Overall CM, Hernández M. Monocyte chemotactic protein-3: possible involvement in apical periodontitis chemotaxis. Int Endod J 2010; 43:902-8. [DOI: 10.1111/j.1365-2591.2010.01764.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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AlShwaimi E, Purcell P, Kawai T, Sasaki H, Oukka M, Campos-Neto A, Stashenko P. Regulatory T cells in mouse periapical lesions. J Endod 2009; 35:1229-33. [PMID: 19720221 PMCID: PMC2778286 DOI: 10.1016/j.joen.2009.06.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 06/08/2009] [Accepted: 06/12/2009] [Indexed: 01/08/2023]
Abstract
INTRODUCTION T-regulatory (Treg, CD4+ FOXP3+) cells constitute a unique subpopulation of CD4+ T cells that inhibit T-cell responses and prevent disease development/exacerbation in models of autoimmunity. In the present study, we tested the hypothesis that Treg cells are induced in periapical lesions by dental pulp infection. METHODS In situ hybridization (ISH) was used to localize FOXP3+ cells on day 21 after pulp exposure of the first molar teeth and infection with bacteria from the oral environment. FOXP3/GFP knock-in transgenic mice were used to quantify FOXP3+ Treg cells that infiltrate into periapical lesions by flow cytometry on days 7, 14, and 21 after infection. Periodontal ligament from uninfected teeth served as a negative control. RESULTS ISH showed strong signals that showed the presence of FOXP3+ cells mainly at the periphery of periapical lesions. In contrast, no positive cells were present in the periodontal ligament of uninfected controls. Flow cytometry showed an increase in the number of FOXP3+ Treg beginning between day 7 and day 14 (0.69% of the infiltrate) after infection and increased to day 21 (0.94%) (p < 0.05 and p < 0.001, respectively, vs uninfected controls). Treg were also increased in number in draining cervical lymph nodes after pulpal infection. CONCLUSIONS These results show that Treg cells are induced to infiltrate into periapical lesions by pulpal infection and suggest that they increase in a time-dependent manner.
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Affiliation(s)
- Emad AlShwaimi
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
- Department of Restorative Dentistry, College of Dentistry, King Faisal University, Dammam, Saudi Arabia
| | | | | | - Hajime Sasaki
- Department of Cytokine Biology, The Forsyth Institute, Boston, MA
| | - Mohamed Oukka
- Center for Neurologic Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Philip Stashenko
- Department of Cytokine Biology, The Forsyth Institute, Boston, MA
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Immunolocalization of matrix metalloproteinases-2 and -9 during apical periodontitis development. Arch Oral Biol 2009; 54:764-71. [PMID: 19497558 DOI: 10.1016/j.archoralbio.2009.04.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 04/15/2009] [Accepted: 04/17/2009] [Indexed: 01/27/2023]
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Fukada SY, Silva TA, Garlet GP, Rosa AL, da Silva JS, Cunha FQ. Factors involved in the T helper type 1 and type 2 cell commitment and osteoclast regulation in inflammatory apical diseases. ACTA ACUST UNITED AC 2009; 24:25-31. [DOI: 10.1111/j.1399-302x.2008.00469.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fukada SY, Silva TA, Saconato IF, Garlet GP, Avila-Campos MJ, Silva JS, Cunha FQ. iNOS-derived nitric oxide modulates infection-stimulated bone loss. J Dent Res 2009; 87:1155-9. [PMID: 19029085 DOI: 10.1177/154405910808701207] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Nitric oxide (NO) derived from inducible nitric oxide synthase (iNOS) plays an important role in host defense, as well as in inflammation-induced tissue lesions. Here we evaluated the role of NO in bone loss in bacterial infection-induced apical periodontitis by using iNOS-deficient mice (iNOS(-/-)). The iNOS(-/-) mice developed greater inflammatory cell recruitment and osteolytic lesions than WT mice. Moreover, tartrate-resistant acid-phosphatase-positive (TRAP(+)) osteoclasts were significantly more numerous in iNOS(-/-) mice. Furthermore, the increased bone resorption in iNOS(-/-) mice also correlated with the increased expression of receptor activator NF-kappaB (RANK), stromal-cell-derived factor-1 alpha (SDF-1 alpha/CXCL12), and reduced expression of osteoprotegerin (OPG). These results show that NO deficiency was associated with an imbalance of bone-resorption-modulating factors, leading to severe infection-stimulated bone loss.
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Affiliation(s)
- S Y Fukada
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes 3900, Monte Alegre, 14049-900, Ribeirão Preto SP, São Paulo, Brazil
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Menezes R, Garlet TP, Letra A, Bramante CM, Campanelli AP, Figueira RDC, Sogayar MC, Granjeiro JM, Garlet GP. Differential patterns of receptor activator of nuclear factor kappa B ligand/osteoprotegerin expression in human periapical granulomas: possible association with progressive or stable nature of the lesions. J Endod 2008; 34:932-8. [PMID: 18634923 DOI: 10.1016/j.joen.2008.05.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Revised: 04/24/2008] [Accepted: 05/05/2008] [Indexed: 12/15/2022]
Abstract
Receptor activator of nuclear factor kappa B ligand (RANKL) and osteoprotegerin (OPG) are expressed in apical periodontitis, suggesting a role for these molecules during lesion development. However, the profiles of RANKL/OPG expression in periapical lesions remain unknown. In this study we investigated the patterns of RANKL and OPG mRNA expression by real-time polymerase chain reaction in human periapical granulomas (N = 44) and compared them with sites presenting characteristic bone resorbing activity: healthy (n = 14) and orthodontically stretched and compressed periodontal ligament (n = 26), healthy gingiva (n = 24), chronic gingivitis (n = 32), and chronic periodontitis (n = 34) samples. Both RANKL and OPG mRNA expression was higher in periapical granulomas when compared with healthy periodontal ligament. Distinct patterns of RANKL and OPG expression ratio were found in the granulomas and in different physiologic and pathologic conditions, with characteristic bone resorption activity potentially being indicative of the stable or progressive nature of the lesions. Lesions with radiographic image smaller than 5 mm showed higher RANKL/OPG expression than images greater than 5 mm. Periapical granulomas presented heterogeneous patterns of RANKL and OPG expression, ranging from samples with RANKL/OPG ratio similar to that seen in sites with minimal or absent bone resorption to samples with RANKL/OPG expression pattern comparable with active bone resorption sites.
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Affiliation(s)
- Renato Menezes
- Department of Endodontics, Bauru Dental School, University of Sao Paulo, Sao Paulo, Brazil
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Andrade FR, Sousa DP, Mendonça EF, Silva TA, Lara VS, Batista AC. Expression of bone resorption regulators (RANK, RANKL, and OPG) in odontogenic tumors. ACTA ACUST UNITED AC 2008; 106:548-55. [DOI: 10.1016/j.tripleo.2008.05.042] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 05/09/2008] [Accepted: 05/16/2008] [Indexed: 11/27/2022]
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