The role of phosphatase and tensin homolog in drug-induced gingival overgrowth

The PTEN hamartoma tumor syndrome: how oral clinicians may save lives

INTRODUCTION

Patients with the PTEN hamartoma tumor syndrome (PHTS) have an 81%-90% cumulative lifetime risk of developing cancer. Around 90% of these patients have recognizable oral features. Receiving a diagnosis may save these patients' lives. This is the first presentation of a family with the PHTS diagnosis with focus on the oral and periodontal findings and treatments.

CASE PRESENTATION

All three children (one son and two daughters) inherited the same heterozygous variant in the PTEN gene from their father. Gingival overgrowth was observed in all patients in addition to macrocephaly. Other findings included fissured tongue, high arched palate, papules, and trichilemmomas. The father had experienced severe tooth loss. Surgery was performed to treat the gingival overgrowth and periodontal pockets; however, the treatment was characterized by multiple recurrences of the overgrowth.

CONCLUSIONS

Oral changes, macrocephaly, tumors, and/or a family history of benign or malignant lesions are important features that oral clinicians should be aware of for a possible PHTS diagnosis. Patients suspected of having PHTS should be referred to a medical practitioner, specifically a geneticist, for further diagnostic investigations. The periodontal problems seemed to be difficult to control for these patients. They will likely need an active and frequent maintenance therapy to control the persistent inflammation and gingival overgrowth. In addition, they need a thorough monitoring for benign or malignant changes in the orofacial regions. Why are these cases new information? Oral features are found in 90% of the cases with the PHTS diagnosis. The periodontal findings showed a persistent recurrence of gingival overgrowth with a strong probability of serious periodontal diseases. What are the keys to successful management of these cases? A suspicion of a PHTS diagnosis with a referral to a medical practitioner, specifically a geneticist, for complete workup may help save these patients' lives. Close monitoring during maintenance therapy with re-treatment as needed to prevent further periodontal complications. Continued monitoring and treatment throughout the patient's lifetime for development of recurrent or new, benign or malignant lesions at relevant sites. What are the primary limitations to success in these cases? A failure to identify the PHTS syndrome with the accompanying oral and periodontal complications. Complications may lead to a delay in appropriate treatment. Inability to control the persistent gingival overgrowth and a deteriorating periodontal condition. A failure to discover benign and malignant lesions in the orofacial region.

Exosomes derived from idiopathic gingival fibroma fibroblasts regulate gingival fibroblast proliferation and apoptosis

OBJECTIVE

Exosomes have been proved to play an essential role in intercellular information transmission. However, few researches focused on exosomes derived from gingival fibroblasts (GFs) of IGF. The aim of this study is to investigate the effect of exosomes derived from GFs of IGF (IGF-GFs) on the proliferation and apoptosis of normal gingival fibroblasts (N-GFs).

METHODS

Gingival fibroblasts were cultured and identified using immunocytochemistry. Exosomes were isolated with exosomes extraction kit and characterized by transmission electron microscopy (TEM) and flow cytometry. PKH67 labeling was further used to trace the intracellular distribution of the exosomes. And MTS assay was used to test the effective concentration and time course of IGF-GFs-derived exosomes. Furthermore, the expression of PCNA, Ki67, Bcl-2, and Bax in N-GFs was analyzed by qRT-PCR and Western blot.

RESULTS

Exosomes were isolated from IGF-GFs; the identification of exosomes and gingival fibroblasts was successfully finished. Moreover, we found that N-GFs co-cultured with exosomes showed a great increase in PCNA and Bcl-2 levels, and a moderate increase in Ki67 levels. By contrast, the levels of Bax were significantly reduced.

CONCLUSION

These results suggest that exosomes derived from idiopathic gingival fibroma fibroblasts are involved in the regulation of gingival fibroblast proliferation and apoptosis.

Identification of Aberrantly Expressed lncRNAs Involved in Orthodontic Force Using a Subpathway Strategy

Background

The aim of the study was to identify key long noncoding RNAs (lncRNA) and related subpathways in the periodontal ligament tissue following orthodontic force.

Methods

We adopt a novelty subpathway strategy to identify lncRNAs competitively regulated functions and the key competitive lncRNAs in periodontal ligament disorders after undergoing orthodontic force. To begin with, patients with orthodontics in our hospital were enrolled in our research. The relationship of lncRNA-mRNA was established through shared predicted miRNA by using the hypergeometric test, Jaccard coefficient standardization, and the Pearson coefficient to determine the valid interaction relationship. After embedding screened lncRNA interactions to pathways, the significant subpathways were recognized by lenient distance and Wallenius approximation methods to calculate the false discovery rate value of each subpathway.

Results

The lncRNA-mRNA intersections including 263 lncRNAs, 1,599 mRNAs, and 3,762 interacting pairs were obtained. The enriched mRNAs were further enriched into various candidate pathways such as the PI3K-Akt signaling pathway. Several subpathways were screened, including the PI3K-Akt signaling pathway, 04510_1 focal adhesion, and p53 signaling pathway, respectively. The network of pathway-lncRNA-mRNA was constructed. Several key lncRNAs including DNAJC3-AS1, WDFY3-AS2, LINC00482, and DLEU2 were screened.

Conclusions

DNAJC3-AS1, WDFY3-AS2, LINC00482, and DLEU2 as aberrantly expressed lncRNAs involved in orthodontic force might play crucial roles in periodontal ligament disease pathogenesis.