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Wallace CK, Vernazza CR, Emmet V, Singhal N, Sathyanarayana V, Tse Y, Taylor GD. Evaluation of UK paediatric nephrology teams' understanding, experience and perceptions of oral health outcomes and accessibility to dental care: a mixed-methods study. Pediatr Nephrol 2024; 39:2131-2138. [PMID: 38300268 PMCID: PMC11147922 DOI: 10.1007/s00467-024-06292-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Oral health conditions are common in children and young people (CYP) with kidney disorders. There is currently limited literature on how confident paediatric nephrology teams feel to identify and manage oral health concerns for their patients. METHOD An exploratory mixed-method survey was distributed across all 13 UK specialist paediatric nephrology centres with responses received from consultants, registrars, specialist nurses and special interest (SPIN) paediatricians. RESULTS Responses received from 109 multidisciplinary team members of 13/13 (100%) UK tertiary units. Ninety-two percent (n = 100) of respondents reported they had never received any training in oral health and 87% (n = 95) felt that further training would be beneficial to optimise care for patients and improve communication between medical and dental teams. Most respondents reported that they did not regularly examine, or enquire about, their patients' oral health. Only 16% (n = 17) reported that all their paediatric kidney transplant recipients underwent routine dental assessment prior to transplant listing. Severe adverse oral health outcomes were rarely reported and only 11% (n = 12) of respondents recalled having a patient who had a kidney transplant delayed or refused due to concerns about oral infection. Seventy-eight percent (n = 85) felt that joint working with a dental team would benefit patients at their unit; however, 17% (n = 18) felt that current infrastructure does not currently support effective joint working. CONCLUSIONS Across the UK, paediatric kidney health professionals report lack of confidence and training in oral health. Upskilling subspecialty teams and creating dental referral pathways are recommended to maximise oral health outcomes for CYP with kidney diseases.
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Affiliation(s)
| | | | - Victoria Emmet
- Great North Children's Hospital, Newcastle Upon Tyne, UK
| | - Nidhi Singhal
- Great North Children's Hospital, Newcastle Upon Tyne, UK
| | | | - Yincent Tse
- Great North Children's Hospital, Newcastle Upon Tyne, UK
| | - Greig D Taylor
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK
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2
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Atamna A, Yahav D, Hirzel C. Prevention of Oncogenic Gammaherpesvirinae (EBV and HHV8) Associated Disease in Solid Organ Transplant Recipients. Transpl Int 2023; 36:11856. [PMID: 38046068 PMCID: PMC10689273 DOI: 10.3389/ti.2023.11856] [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: 07/27/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023]
Abstract
Long-term risk for malignancy is higher among solid organ transplant (SOT) recipients compared to the general population. Four non-hepatitis viruses have been recognized as oncogenic in SOT recipients-EBV, cause of EBV-associated lymphoproliferative diseases; human herpes virus 8 (HHV8), cause of Kaposi sarcoma, primary effusion lymphoma and multicentric Castleman disease; human papilloma virus, cause of squamous cell skin cancers, and Merkel cell polyomavirus, cause of Merkel cell carcinoma. Two of these viruses (EBV and HHV8) belong to the human herpes virus family. In this review, we will discuss key aspects regarding the clinical presentation, diagnosis, treatment, and prevention of diseases in SOT recipients associated with the two herpesviruses.
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Affiliation(s)
- Alaa Atamna
- Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Dafna Yahav
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Infectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Cédric Hirzel
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
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3
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Santos PSDS, Granzotto FCN, Antunes HS, de Lima EM, Varanda RDF, Maccari K, Bezinelli LM, Melo WR, Junior LAVS, De Macedo LD, Eduardo FDP. Dentistry consensus on HSCT - Part III: Special topics - Dentistry on HSCT. Hematol Transfus Cell Ther 2023; 45:379-386. [PMID: 37328345 PMCID: PMC10499586 DOI: 10.1016/j.htct.2023.04.004] [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: 03/24/2023] [Accepted: 04/17/2023] [Indexed: 06/18/2023] Open
Abstract
Patients undergoing hematopoietic stem cell transplantation (HSCT) might present acute and late toxicities and the oral tissues are frequently affected. With the survival increasing, patients show late and long-term morbidities, and there is an important association between the general and the oral health. The first and second parts of this Consensus have showed the importance of the adequacy of oral health in the pre-HSCT, and the main alterations and oral care during the period of admission for HSCT. This third part aims to review specific themes of post-HSCT dental care, such as graft-versus-host disease (GVHD) and the pediatric patient. It also aims to review pertinent subjects, both during the HSCT period and post-HSCT, concerning quality of life, pain, cost-effectiveness, and remote care. Based on this review, it is evident the importance of the work of the dental surgeon (DS) in the follow-up and treatment of the HSCT patient, always collaborating with the whole multidisciplinary team.
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Affiliation(s)
- Paulo Sérgio da Silva Santos
- Departamento de Cirurgia, Estomatologia, Patologia e Radiologia da Faculdade de Odontologia de Bauru da Universidade de São Paulo, Bauru, São Paulo, Brazil
| | | | - Héliton Spindola Antunes
- Coordenação de Pesquisa Clínica do Instituto Nacional do Câncer, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Karina Maccari
- Serviço de Odontologia do Hospital de Amor, Barretos, São Paulo, Brazil
| | | | - Walmyr Ribeiro Melo
- Odontologia Hospitalar - Hospital Samaritano do Grupo Américas, São Paulo, Brazil
| | | | - Leandro Dorigan De Macedo
- Serviço de Odontologia e Estomatologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil; Faculdade de Medicina de Ribeirão Preto-USP, Ribeirao Preto, São Paulo, Brazil
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4
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Impact of Immunosuppressive Drugs on Fibroblasts: An In Vitro Study. J Clin Med 2022; 11:jcm11113107. [PMID: 35683494 PMCID: PMC9181118 DOI: 10.3390/jcm11113107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The aim of this study was to compare the direct impact of different agents for immunosuppressive therapy on mouse fibroblasts as a possible cause of drug-induced gingival overgrowth (DIGO). Methods: 3T3 mouse fibroblasts were cultivated in cell-specific media (2 × 104 cells/mL) and treated for 6, 24, 48 and 72 h with one of three immunosuppressive drugs (IsDs): cyclosporin a (CsA), tacrolimus (TaC) and sirolimus (SiR). Different concentrations (10−750 ng/mL) were used to mimic serum levels under active immunosuppressive therapy conditions. Cell population characteristics (cell number, viability and morphology) were assessed using computer-assisted cell analysis. Expression of pro-collagen type I carboxy-terminal propeptide (PICP) was identified using an ELISA assay. Results: The influence of IsDs on the biological status of 3T3 fibroblasts was time- and dose-dependent. Comparing CsA and TaC, the total cell amount was enhanced using concentrations in the range of 10−150 ng/mL (p > 0.05). In contrast, treatment with SiR resulted in a decrease in the average cell number (p < 0.01). PICP and cell diameter of fibroblasts were not susceptible to IsD treatment (p > 0.05). Conclusions: Our results revealed time-dependent effects of IsDs, with distinct influences on cell number. The cell morphology and the PICP balance of the investigated fibroblast cell line remained unaffected. Hence, the potential role of IsDs is not a unilateral mechanism of action but rather a multifactorial process.
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5
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Arduino PG, Gambino A, Giaccone L, Suria M, Carbone M, Carrozzo M, Broccoletti R, Conrotto D. Oral health status after hematopoietic stem cell transplantations: Outcomes from an adult Italian population. SPECIAL CARE IN DENTISTRY 2022; 42:585-591. [PMID: 35325475 DOI: 10.1111/scd.12715] [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: 01/05/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Abstract
AIM To describe oral cavity changes in patients who underwent a hematopoietic stem cell transplantation (HSCT). METHODS AND RESULTS A group of 32 patients was studied after a mean period of 48.8 months (±11.22) from HSCT; oral, dental, and periodontal status were collected and compared with those of healthy matched controls. Unstimulated whole salivary flow (UWS) and salivary pH were also measured. A validated questionnaire (EORTC QLQH&N-35) was used for reported quality of life. Fifty-nine percent of patients were affected by chronic graft-versus-host disease (cGVHD). Dental health and periodontal status were statistically worse than in controls (P = .003 and P = .008, respectively). Regarding the HSCT group, UWS was statistically lower, and EORTC QLQH&N-35 significantly higher than those reported in controls (P = .000 for both). There was no statistical correlation between hypo-salivation and conditioning, presence of cGVHD, type of medication used before and after transplantation, and time of follow-up. A reduction in salivary pH has been noted only for patients with erosive oral lesions. CONCLUSION The oral cavity of HSCT patients appeared to undergo substantial modifications and the quality of life was deeply compromised.
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Affiliation(s)
- Paolo G Arduino
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy
| | - Alessio Gambino
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy
| | - Luisa Giaccone
- Department of Oncology/Hematology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Turin, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Marco Suria
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy
| | - Mario Carbone
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy
| | - Marco Carrozzo
- Centre for Oral Health Disease, Oral Medicine Department, Newcastle University, Newcastle upon Tyne, UK
| | - Roberto Broccoletti
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy
| | - Davide Conrotto
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy
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6
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Ahrodia T, Das S, Bakshi S, Das B. Structure, functions, and diversity of the healthy human microbiome. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 191:53-82. [DOI: 10.1016/bs.pmbts.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Ballardin BS, Mobile RZ, Coracin FL, Ribeiro LL, Bonfim CMS, Schussel JL, Carvalho Torres-Pereira C. A case series of medication-related fibrovascular hyperplasia following hematopoietic stem cell transplantation for Fanconi anemia. Pediatr Transplant 2021; 25:e13947. [PMID: 33350561 DOI: 10.1111/petr.13947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
Systemic medications categorized as diphenylhydantoin, calcineurin inhibitor and calcium channel blocker may have effects on the oral cavity by modifying the inflammatory and immune response and causing undesired tissue proliferative reactions. Calcineurin inhibitors are medications commonly used for long periods in patients undergoing allogeneic hematopoietic stem cell transplant (HSCT) and solid organ transplantation. Medication-related fibrovascular hyperplasia (MRFH) is an extra gingival hyperplastic nodular growth associated with medications use. This study reports five cases of pediatric patients (6 to 12-years-old) diagnosed with Fanconi anemia (FA) after HSCT who presented similar oral mucosal lesions associated with the use of cyclosporine, phenobarbital and amlodipine. After excision of the lesions, histopathological analysis described them as pyogenic granuloma (PG). As the aetiology of the lesions manifested by the patients was associated with the use of medications, the final diagnosis was MRFH. Despite the clinical and histopathological similarity between PG and MRFH, it is fundamental to know the aetiological agent for achieving definitive diagnosis and correct management. Considering the etiologic agent (medication) and histopathological findings, it is suggested that the most appropriate term for this manifestation should be "medication-related fibrovascular hyperplasia". The correct nomenclature related to extra gingival hyperplastic lesions identified in patients on medications with potential to induce hyperplastic reactions should be adopted to facilitate scientific communication and improve the treatment.
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Affiliation(s)
- Bárbara Soldatelli Ballardin
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Rafael Zancan Mobile
- Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
| | | | - Lisandro Lima Ribeiro
- Service of Bone Marrow Transplant, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Carmem Maria Sales Bonfim
- Service of Bone Marrow Transplant, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Juliana Lucena Schussel
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil.,Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
| | - Cassius Carvalho Torres-Pereira
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil.,Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
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8
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Stoopler ET. Mycophenolate mofetil-induced oral ulcers: Another oral mucosal complication in solid organ transplantation. SPECIAL CARE IN DENTISTRY 2020; 41:125-126. [PMID: 33022080 DOI: 10.1111/scd.12528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Eric T Stoopler
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
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9
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Ballardin BS, Mobile RZ, Torres-Pereira CC, Schussel JL. Medication-related fibrovascular hyperplasia lesion in tongue: Case report. SPECIAL CARE IN DENTISTRY 2020; 40:506-510. [PMID: 32691895 DOI: 10.1111/scd.12497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this study is to report the case of a patient who underwent hematopoietic stem cell transplantation for Hodgkin's lymphoma treatment and developed multiple tongue lesions during recovery. METHODS AND RESULTS This is the case report of a patient who developed ulcerated lesions with areas of depapillation on the border and dorsum of the tongue. The ulcer evolved to a reddish fibrous hyperplastic nodule, similar to adjacent mucosa. The patient was using a series of medications, such as antifungals, antibiotics, antivirals, corticosteroids, and analgesics in addition to immunosuppression with cyclosporine. Considering the medical history of the patient, a biopsy was performed. Histopathological analyses describe hyperplasia, granulation tissue, vascular proliferation, and intense inflammatory infiltrate, and the diagnosis was of medication-related fibrovascular hyperplasia (MRFH). CONCLUSION Patients in use of cyclosporine are at risk to develop oral lesions, such as MRFH. The correct diagnosis is important, so the adequate treatment and follow-up are instituted even considering the immunosuppression protocol.
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Affiliation(s)
| | | | - Cassius Carvalho Torres-Pereira
- Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Juliana Lucena Schussel
- Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
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10
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Oliveira CDS, Galdino TM, Limeira FIR, Moreira AN, de Magalhães CS, Abreu LG. Is dental caries associated with liver transplantation? A systematic review and meta-analysis. Oral Dis 2020; 27:1346-1355. [PMID: 32469441 DOI: 10.1111/odi.13439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/06/2020] [Accepted: 05/14/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to evaluate the experience of dental caries in individuals pre- or postliver transplant. MATERIALS AND METHODS Searches in PubMed, Scopus, Web of Science, Ovid, and Lilacs from databases' inception date up to April 2020 were undertaken. Gray literature and manual searches were also conducted. Observational studies were eligible. The retrieved references were evaluated by two independent reviewers. Meta-analysis and risk of bias assessment using the University of Adelaide tool were conducted. The strength of the evidence was assessed with GRADE. RESULTS The search retrieved 1990 references. Twenty-four cross-sectional studies were included. One subgroup analysis demonstrated no significant difference in the number of teeth with dental caries between pre-liver transplant and healthy individuals (mean difference = 1.65, confidence interval = -0.87 to 4.17). The prevalence of dental caries among pre-liver transplant individuals was 73.82% and in the post-transplant individuals was 72.83%. In the included studies, the main concern regarding risk of bias was the absence of control for confounding variables. The strength of the evidence was very low. CONCLUSIONS Dental caries may be a relevant issue in pre- and postliver transplant individuals. Oral health counseling should be included in the care of pre- and/or postliver transplant individuals.
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Affiliation(s)
- Carla de Souza Oliveira
- Post-Graduate Program in Dentistry, University Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tuélita Marques Galdino
- Post-Graduate Program in Dentistry, University Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, Faculty of Dentistry, University Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia Silami de Magalhães
- Department of Restorative Dentistry, Faculty of Dentistry, University Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, Faculty of Dentistry, University Federal de Minas Gerais, Belo Horizonte, Brazil
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11
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Sureda A, Daglia M, Argüelles Castilla S, Sanadgol N, Fazel Nabavi S, Khan H, Belwal T, Jeandet P, Marchese A, Pistollato F, Forbes-Hernandez T, Battino M, Berindan-Neagoe I, D'Onofrio G, Nabavi SM. Oral microbiota and Alzheimer's disease: Do all roads lead to Rome? Pharmacol Res 2019; 151:104582. [PMID: 31794871 DOI: 10.1016/j.phrs.2019.104582] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative pathology affecting milions of people worldwide associated with deposition of senile plaques. While the genetic and environmental risk factors associated with the onset and consolidation of late onset AD are heterogeneous and sporadic, growing evidence also suggests a potential link between some infectious diseases caused by oral microbiota and AD. Oral microbiota dysbiosis is purported to contribute either directly to amyloid protein production, or indirectly to neuroinflammation, occurring as a consequence of bacterial invasion. Over the last decade, the development of Human Oral Microbiome database (HOMD) has deepened our understanding of oral microbes and their different roles during the human lifetime. Oral pathogens mostly cause caries, periodontal disease, and edentulism in aged population, and, in particular, alterations of the oral microbiota causing chronic periodontal disease have been associated with the risk of AD. Here we describe how different alterations of the oral microbiota may be linked to AD, highlighting the importance of a good oral hygiene for the prevention of oral microbiota dysbiosis.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, CIBEROBN (Physiopathology of Obesity and Nutrition), and IdisBa, Palma de Mallorca, Balearic Islands, Spain.
| | - Maria Daglia
- Department of Pharmacy, University of Naples Federico II, Naples, Italy; International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, China
| | | | - Nima Sanadgol
- Department of Biology, Faculty of Sciences, University of Zabol, Zabol, Iran; Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto-SP, Brazil
| | - Seyed Fazel Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Tarun Belwal
- Zhejiang University, College of Biosystems Engineering and Food Science, Zhejiang Key Laboratory for Agri-Food Processing, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Hangzhou, People's Republic of China
| | - Philippe Jeandet
- Induced Resistance and Plant Bioprotection, Faculty of Sciences, University of Reims Champagne-Ardenne, Reims Cedex 51687, France
| | | | - Francesca Pistollato
- Centre for Health & Nutrition, Universidad Europea del Atlantico, Santander, Spain
| | - Tamara Forbes-Hernandez
- Nutrition and Food Science Group, Department of Analytical and Food Chemistry, CITACA, CACTI, University of Vigo - Vigo Campus, Vigo, Spain
| | - Maurizio Battino
- Nutrition and Food Science Group, Department of Analytical and Food Chemistry, CITACA, CACTI, University of Vigo - Vigo Campus, Vigo, Spain; Dept of Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy; International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
| | - Ioana Berindan-Neagoe
- MEDFUTURE - Research Center for Advanced Medicine, "Iuliu-Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, Cluj-Napoca, Romania; Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania; Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", 34-36 Republicii Street, Cluj-Napoca, Romania
| | - Grazia D'Onofrio
- Unit of Geriatrics, Department of Medical Sciences, Fondazione Casa Sollievo della sofferenza, San Giovanni Rotondo, Italy
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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12
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Arasaratnam RJ, Restrepo A. Persistent Mouth Ulceration in a Renal Allograft Recipient. Clin Infect Dis 2019; 64:384-385. [PMID: 28096276 DOI: 10.1093/cid/ciw718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Reuben J Arasaratnam
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas
| | - Alejandro Restrepo
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas
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13
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Lin NC, Chen YL, Tsai KY. Head and neck cancer in living donor liver transplant recipients: Single center retrospective study. Medicine (Baltimore) 2019; 98:e16701. [PMID: 31374062 PMCID: PMC6709202 DOI: 10.1097/md.0000000000016701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The purpose of this study was to investigate the incidence and risk factors of head and neck cancer in living donor liver transplant (LDLT) recipients.This is a retrospective cohort study. A case-matched (1:4) comparison between recipients with and without developed head and neck cancer after LDLT was conducted. The differences between 2 groups were analyzed.The incidence of head and neck malignancy in our cohort was 9 of 453 (1.98%). Their cumulative survival rate was below 60% at 24 months after the diagnosis of head and neck cancer, and no recipients lived for more than 2 years after being diagnosed with stage IV cancer. In the case-control study, univariate analysis revealed that alcohol consumption (odds ratio [OR] = 8.75, 95% confidence interval [CI]: 1.55-49.56) and smoking (OR = 6.71, 95% CI: 1.20- 37.44) were factors associated with the incidence of head and neck cancer after LDLT.In the conclusion, recipients with head and neck cancer after LDLT may have a rather poor prognosis, especially those who are initially diagnosed with advanced-stage disease. Alcohol consumption and smoking may be the predisposing factors to head and neck cancer in LDLT recipients.
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Affiliation(s)
- Nan-Chin Lin
- School of Medicine, China Medical University, Taichung
| | - Yao-Li Chen
- School of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Kuo-Yang Tsai
- School of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
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14
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Abstract
For millions of years, our resident microbes have coevolved and coexisted with us in a mostly harmonious symbiotic relationship. We are not distinct entities from our microbiome, but together we form a 'superorganism' or holobiont, with the microbiome playing a significant role in our physiology and health. The mouth houses the second most diverse microbial community in the body, harbouring over 700 species of bacteria that colonise the hard surfaces of teeth and the soft tissues of the oral mucosa. Through recent advances in technology, we have started to unravel the complexities of the oral microbiome and gained new insights into its role during both health and disease. Perturbations of the oral microbiome through modern-day lifestyles can have detrimental consequences for our general and oral health. In dysbiosis, the finely-tuned equilibrium of the oral ecosystem is disrupted, allowing disease-promoting bacteria to manifest and cause conditions such as caries, gingivitis and periodontitis. For practitioners and patients alike, promoting a balanced microbiome is therefore important to effectively maintain or restore oral health. This article aims to give an update on our current knowledge of the oral microbiome in health and disease and to discuss implications for modern-day oral healthcare.
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15
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Waring E, Villa A. Oral Manifestations of Immunodeficiencies and Transplantation Medicine. Atlas Oral Maxillofac Surg Clin North Am 2017; 25:105-111. [PMID: 28778300 DOI: 10.1016/j.cxom.2017.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Elizabeth Waring
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA.
| | - Alessandro Villa
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA
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Renaud-Vilmer C, Cavelier-Balloy B. [Precancerous lesions of the buccal epithelium]. Ann Dermatol Venereol 2016; 144:100-108. [PMID: 27939087 DOI: 10.1016/j.annder.2016.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 07/01/2016] [Accepted: 07/29/2016] [Indexed: 10/20/2022]
Abstract
Squamous cell carcinomas of the oral cavity and lips consistently have a high incidence (they constitute the fifth most common form of cancer in France) and carry a heavy prognosis, particularly if diagnosed late. According to different studies, between 10 and 80% of such carcinomas occur in a pre-existing or precancerous lesion. The World Health Organisation (WHO) recommends the use of two terms for such lesions: precursor lesions, i.e. histological lesions associated with intraepithelial neoplasia (IEN) and verrucous hyperplasia (VH), frequently resulting clinically in leukoplakia or erythroplakia; "at risk" lesions, which include lichen planus, submucosal oral fibrosis and certain forms of genodermatosis.
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Affiliation(s)
- C Renaud-Vilmer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - B Cavelier-Balloy
- Service de pathologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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17
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Oral Pyogenic Granuloma After Bone Marrow Transplant in the Pediatric/Adolescent Population: Report of 5 Cases. J Pediatr Hematol Oncol 2016; 38:570-3. [PMID: 27271813 DOI: 10.1097/mph.0000000000000593] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pyogenic granuloma (PG) is a benign, neoplastic, soft tissue growth of granulation and fibrous tissue that may rarely occur in the mouth of patients after hematopoietic cell transplant (HCT). This case series describes 5 pediatric/adolescent patients who developed oral PG after HCT for acute lymphoblastic leukemia, Fanconi anemia, nodular sclerosis Hodgkin's lymphoma, or junctional epidermolysis bullosa. The underlying mechanism for the appearance of oral PG after HCT is unknown, but it is suggested that calcineurin inhibitors used for graft versus host disease (GVHD) may play a role, as all patients were on cyclosporine A or tacrolimus at the time of development of oral PG. Three of the patients were being treated for chronic GVHD, and 1 other treated for acute GVHD. Overall, this report illustrates that PG should be considered in the differential diagnoses when encountering oral lesions in pediatric/adolescent patients after undergoing HCT, especially in the context of chronic GVHD and calcineurin inhibitors use.
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18
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Oral polymorphonuclear neutrophil characteristics in relation to oral health: a cross-sectional, observational clinical study. Int J Oral Sci 2016; 8:191-8. [PMID: 27515277 PMCID: PMC5113092 DOI: 10.1038/ijos.2016.23] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 12/31/2022] Open
Abstract
Polymorphonuclear neutrophils (PMNs) have a major role in the innate immune system. However, little is known about PMN contribution in relation to oral health. The objective of this study was to investigate the numbers and functional characteristics of oral PMNs (oPMNs) compared with circulatory PMNs (cPMNs). Oral rinse and venous blood samples were obtained from 268 systemically and orally healthy volunteers in a cross-sectional observational study. PMN counts, cell cycle analysis and cellular activation state were investigated. Also, reactive oxygen species (ROS) production was analyzed, with and without bacterial stimulation (Fusobacterium nucleatum). In males, 1.2 × 106±1.0 × 106 oPMNs were collected, and showed a tendency to correlate with the levels of gingival bleeding (r=0.215, P=0.008). Comparable oPMNs counts were found among females (1.0 × 106±0.7 × 106). More late-stage apoptotic/necrotic cells were found among the oPMNs (53.1%) compared with the cPMNs (8.5% P<0.001). Without additional stimulation, oPMNs were more activated than cPMNs, as indicated by higher expression of CD11b, CD63 and CD66b, and higher constitutive ROS levels (P<0.001). Notably, in response to bacterial stimulation, oPMNs released comparable ROS levels as cPMNs (P=0.042). In conclusion, this study provides data on viable oPMNs showing high levels of activation in orally and systemically healthy individuals, free of apparent caries lesions and periodontal disease. These data suggests that although the oPMNs are in a more mature stage of their life cycle compared with the cPMNs, oPMNs are still responsive to stimulation, which indicates their functional potential and possible contribution to a healthy oral ecosystem.
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Immunohistopathology of the Newly Discovered Giant Papillae Tongue Disorder in Organ-Transplanted Children. Transplantation 2016; 101:1441-1448. [PMID: 27336393 DOI: 10.1097/tp.0000000000001205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Giant papillae tongue disorder (GPTD) is a newly discovered, long-lasting clinical disorder that may develop in organ-transplanted pediatric recipients. The key feature of this disorder is the unique tongue lesion, which comprises swollen fungiform papillae. The aim of this study was to characterize the immunohistopathology of this novel inflammatory condition. METHODS Six organ transplanted children with GPTD were included in the study. Routine histopathology and immunohistochemical stainings for CD3, CD4, CD8, CD25, FOXP3, CD20, CD138, CD68, CD1a, CD15, CD23, and mast cell tryptase were performed. RESULTS Immunohistochemical analyses of the oral lesions revealed a subepithelial infiltrate that was primarily composed of CD3- and CD4-positive T cells, CD20-expressing B cells, macrophages, and CD138-positive plasma cells. The CD20-positive cells did not display the typical B cell morphology, having in general a more dendritic cell-like appearance. The CD138-expressing plasma cells were distinctly localized as a dense infiltrate beneath the accumulation of T cells and B cells. Increased numbers of CD1a-expressing Langerhans cells were detected both in the epithelium and connective tissue. Because no granulomas were observed and only single lesional eosinophils were detected, GPTD does not resemble a granulomatous or eosinophilic condition. CONCLUSIONS We describe for the first time the immunopathological characteristics of a novel inflammatory disorder of the oral cavity, which may develop after solid organ transplantation in children.
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Affiliation(s)
- Bhavik Desai
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine Boston, MA, USA
| | - John Svirsky
- Oral Diagnostic Sciences, Virginia Commonwealth University School of Dentistry Richmond, VA, USA
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21
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Gašpar M, Glavina A, Grubišić K, Sabol I, Bušić M, Mravak M. The Oral Cavity State in Renal Transplant Recipients. Acta Stomatol Croat 2015; 49:204-13. [PMID: 27688404 PMCID: PMC4993595 DOI: 10.15644/asc49/3/2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/25/2015] [Indexed: 12/16/2022] Open
Abstract
AIM Patients with a solid organ transplant can have many different complications in the mouth, as a result of immunosuppression and side effects of drugs. The aim of this study was to examine the frequency and type of oral lesions in renal transplant patients, dental status, oral hygiene, oral lesions related to drugs which patients take and the time of transplantation as well as the frequency of patient's visits to the dentist in the post-transplant period. MATERIAL AND METHODS The study was performed in a period of two years and included 100 subjects with a renal transplant during their regular control visits to the Department of Nephrology and Dialysis, Clinical Hospital Centre Zagreb and the Department of Oral Medicine, School of Dental Medicine, University of Zagreb and 100 randomly selected control subjects at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb. RESULTS Results showed a significantly higher incidence of oral lesions in patients with renal transplant (31%) compared to control subjects. The most frequent were erythematous (inflammatory changes), keratotic lesions and gingival hyperplasia. The average DMFT index was significantly lower in patients with renal transplant than in the control group. One third of patients had a subjective feeling of dry mouth. Oral hygiene was poor overall, and only a small number of subjects used the additional sustainers for oral hygiene. Most patients did not visit the dentist after the transplantation. CONCLUSION Renal transplant patients need a comprehensive and regular dental care during the pre- and post-transplant period and a doctor of dental medicine should be part of a multidisciplinary team of medical specialists.
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Affiliation(s)
- Marija Gašpar
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Glavina
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Ivan Sabol
- National Transplant Coordinator, Ministry of Health, Republic of Croatia
| | - Mirela Bušić
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marinka Mravak
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Rudjer Bošković Institute, Zagreb, Croatia
- National Transplant Coordinator, Ministry of Health, Republic of Croatia
| | - Stipetić
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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22
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Chambers AE, Conn B, Pemberton M, Robinson M, Banks R, Sloan P. Twenty-first-century oral hairy leukoplakia--a non-HIV-associated entity. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:326-32. [PMID: 25600979 DOI: 10.1016/j.oooo.2014.11.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 11/10/2014] [Accepted: 11/19/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study presents the clinicopathologic features of a series (N = 35) of patients with non-human immunodeficiency virus (HIV)-associated oral hairy leukoplakia (OHL). METHODS Patients with non-HIV-associated OHL were identified from three centers. Epstein-Barr virus infection was demonstrated by using EBV early ribonucleic acid in situ hybridization. The presence of Candida co-infection was evaluated by diastase periodic acid-Schiff staining. The clinical features were determined by review of the medical records. RESULTS Twenty-eight patients had intercurrent respiratory problems requiring long-term steroid inhaler use, four suffered from autoimmune diseases requiring immunosuppressant therapy, and four had diabetes. The majority of lesions were located on the tongue, and 24 showed evidence of Candida co-infection. CONCLUSIONS In the twenty-first century, the presence of OHL should not be regarded as pathognomic for HIV infection or significant systemic immunosuppression. Local and systemic immunosuppression, in the form of steroid inhaler use, is a risk factor for the development of OHL.
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Affiliation(s)
- Anne Elizabeth Chambers
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Department of Cellular Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK.
| | - Brenden Conn
- Royal Infirmary of Edinburgh, Department of Pathology, Royal Infirmary Edinburgh, Scotland
| | - Michael Pemberton
- University Dental Hospital of Manchester, Department of Oral Medicine, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK
| | - Max Robinson
- Newcastle University, Centre for Oral Health Research, Newcastle University, Framlington Place, Newcastle upon Tyne, UK
| | - Rob Banks
- Sunderland Royal Hospital, Department of Oral and Maxillofacial Surgery, Sunderland Royal Hospital, Kayll Road, Sunderland, Tyne and Wear, UK
| | - Philip Sloan
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Department of Cellular Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK
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23
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Zaura E, Nicu EA, Krom BP, Keijser BJF. Acquiring and maintaining a normal oral microbiome: current perspective. Front Cell Infect Microbiol 2014; 4:85. [PMID: 25019064 PMCID: PMC4071637 DOI: 10.3389/fcimb.2014.00085] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/08/2014] [Indexed: 12/15/2022] Open
Abstract
The oral microbiota survives daily physical and chemical perturbations from the intake of food and personal hygiene measures, resulting in a long-term stable microbiome. Biological properties that confer stability in the microbiome are important for the prevention of dysbiosis—a microbial shift toward a disease, e.g., periodontitis or caries. Although processes that underlie oral diseases have been studied extensively, processes involved in maintaining of a normal, healthy microbiome are poorly understood. In this review we present our hypothesis on how a healthy oral microbiome is acquired and maintained. We introduce our view on the prenatal development of tolerance for the normal oral microbiome: we propose that development of fetal tolerance toward the microbiome of the mother during pregnancy is the major factor for a successful acquisition of a normal microbiome. We describe the processes that influence the establishment of such microbiome, followed by our perspective on the process of sustaining a healthy oral microbiome. We divide microbiome-maintenance factors into host-derived and microbe-derived, while focusing on the host. Finally, we highlight the need and directions for future research.
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Affiliation(s)
- Egija Zaura
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam Amsterdam, Netherlands
| | - Elena A Nicu
- Department of Periodontology, Academic Centre for Dentistry Amsterdam Amsterdam, Netherlands
| | - Bastiaan P Krom
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam Amsterdam, Netherlands
| | - Bart J F Keijser
- Microbiology and Systems Biology, TNO Earth, Environmental and Life Sciences Zeist, Netherlands ; Top Institute Food and Nutrition Wageningen, Netherlands
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24
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Helenius-Hietala J, Ruokonen H, Grönroos L, Rissanen H, Vehkalahti MM, Suominen L, Isoniemi H, Meurman JH. Oral mucosal health in liver transplant recipients and controls. Liver Transpl 2014; 20:72-80. [PMID: 24142471 DOI: 10.1002/lt.23778] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 10/11/2013] [Indexed: 02/07/2023]
Abstract
Immunosuppressive drugs and other medications may predispose patients to oral diseases. Data on oral mucosal health in recipients of liver transplantation (LT) are limited. We, therefore, recruited 84 LT recipients (64 with chronic liver disease and 20 with acute liver failure) for clinical oral examinations in a cross-sectional, case-control study. Their oral health had been clinically examined before transplantation. The prevalence of oral mucosal lesions (OMLs) was assessed in groups with different etiologies of liver disease and in groups with different immunosuppressive medications, and these groups were compared to controls selected from a nationwide survey in Finland (n = 252). Risk factors for OMLs were evaluated with logistic regression. OMLs were more frequent in LT recipients versus controls (43% versus 15%, P < 0.001), and the use of steroids raised the prevalence to 53%. Drug-induced gingival overgrowth was the single most common type of lesion, and its prevalence was significantly higher for patients using cyclosporine A (CSA; 29%) versus patients using tacrolimus (TAC; 5%, P = 0.007); the prevalence was even higher with the simultaneous use of calcium channel blockers and CSA (47%) or TAC (8%, P = 0.002). Lesions with malignant potential such as drug-induced lichenoid reactions, oral lichen planus-like lesions, leukoplakias, and ulcers occurred in 13% of the patients with chronic liver disease and in 6% of the controls. Every third patient with chronic liver disease had reduced salivary flow, and more than half of all patients were positive for Candida; this risk was higher with steroids. In conclusion, the high frequency of OMLs among LT recipients can be explained not only by immunosuppressive drugs but also by other medications. Because dry mouth affects oral health and OMLs may have the potential for malignant transformation, annual oral examinations are indicated.
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Affiliation(s)
- Jaana Helenius-Hietala
- Institute of Dentistry, University of Helsinki, Helsinki, Finland; Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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25
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Vivas APM, Bomfin LE, Costa WL, Porta G, Alves FA. Oral granulomatosis-like lesions in liver-transplanted pediatric patients. Oral Dis 2013; 20:e97-102. [DOI: 10.1111/odi.12143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 04/22/2013] [Accepted: 05/22/2013] [Indexed: 01/29/2023]
Affiliation(s)
- APM Vivas
- Department of Stomatology; University of São Paulo; São Paulo Brazil
| | - LE Bomfin
- Department of Stomatology; University of São Paulo; São Paulo Brazil
| | - WL Costa
- Department of Abdominal Surgery; A.C. Camargo Hospital; São Paulo Brazil
| | - G Porta
- Department of Liver Transplantation; A.C. Camargo Hospital; São Paulo Brazil
- Pediatrics Department; University of São Paulo; São Paulo Brazil
| | - FA Alves
- Department of Stomatology; University of São Paulo; São Paulo Brazil
- Stomatology Department; A.C. Camargo Hospital; São Paulo Brazil
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