A novel chitosan-based doxepin nano-formulation for chemotherapy-induced oral mucositis: a randomized, double-blinded, placebo-controlled clinical trial

OBJECTIVES

Considering the prevalence of oral mucositis, we aimed to use the analgesic effects of doxepin with chitosan's antimicrobial and bio-adhesive nature to fabricate a nano-formulation for treating chemotherapy-induced oral mucositis.

MATERIALS AND METHODS

Nanogel was fabricated via ionic gelation and characterized. Sixty patients were randomly divided and received four different treatments for 14 days: diphenhydramine + aluminum-magnesium mouthwash (control), doxepin mouthwash (DOX MW), chitosan nanogel (CN), and doxepin/chitosan nanogel (CN + DOX). Lesions were assessed with four indices, National Cancer Institute (NCI), World Health Organization (WHO), World Conference on Clinical and Research in Nursing (WCCNR) and visual analog scale (VAS) before and 3, 7, and 14 days after interventions. Kruskal-Wallis test was used for pairwise comparison.

RESULTS

CN had semisolid consistency, uniform spherical shape, an average size of 47.93 ± 21.69 nm, and a zeta potential of + 1.02 ± 0.16 mV. CN + DOX reduced WHO, WCCNR, and VAS scores significantly more than the control three days after the intervention. Seven days after the intervention, CN + DOX reduced NCI and WCCNR considerably more than the control; it reduced WCCNR significantly more than CN. Fourteen days after the intervention, CN + DOX decreased NCI markedly more than the control.

CONCLUSION

Chitosan-based doxepin nano-formulation might be a promising alternative for routine treatments of oral mucositis.

Tele-dentistry, its trends, scope, and future framework in oral medicine; a scoping review during January 1999 to December 2021

BACKGROUND

Tele-dentistry has been increasingly used for different purposes of visit, consultation, triage, screening, and training in oral medicine. This study aims to determine the main facilitators, barriers, and participants` viewpoints of applying tele-dentistry in oral medicine and develop a framework indicating the input, process, output, and feedback.

METHOD

This was a scoping review conducted in 2022 applying Arksey and O'Malley (2005) approach. Four databases including ISI web of science, PubMed, Scopus, and ProQuest were searched from January 1999 to December 2021. Inclusion criteria consisted of all original and non-original articles (reviews, editorials, letters, comments, and book chapters), and dissertations in English with a full text electronic file. Excel₂₀₁₆ was used for descriptive quantitative analysis and MAXQDA version 10 was applied for qualitative thematic analysis. A thematic framework was developed customizing the results of the review in a virtual mini expert panel.

RESULTS

Descriptive results show that among 59 included articles, 27 (46%) have addressed the various applications of tele-dentistry during COVID-19 pandemic in the field of oral medicine. From geographical distribution perspective, most of the papers were published in Brazil (n = 13)/ 22.03%, India (n = 7)/11.86% and USA (n = 6)/10.17%. Thematic analysis shows that seven main themes of "information", "skill", "human resource", 'technical", "administrative', 'financial', and 'training and education' are explored as facilitators. 'Individual', 'environmental', 'organizational', 'regulation', 'clinical', and 'technical barriers' are also identified as main barriers of tele-dentistry in oral medicine.

CONCLUSION

According to the results for using tele-dentistry services in oral medicine, a diverse category of facilitators should be considered and at the same time, different barriers should be managed. Users` satisfaction and perceived usefulness of tele-dentistry as final outcomes can be increased considering the system`s feedback and applying facilitator incentives as well as decreasing the barriers.

Epidemiology of obesity and high blood pressure among school-age children from military families: the largest report from our region

BACKGROUND

For the first time, we aimed to determine the epidemiology and associated factors of obesity and hypertension among children of military families in our region.

METHODS

In this multi-centered study, children between the ages of 5 to 12 years old, entered the study. Data on baseline and clinical characteristics, history of disease and anthropometric measurements, were collected.

RESULTS

Among 504 children, 44.2% were males. Mean (SD) age of participants was 7.9 ± 1.9 years. Overall, 5% were obese and 9.9% were overweight. In total, 16.3% had elevated BP, 12.5% had stage one and 0.2% had stage two hypertension. Age (beta = 0.306, OR = 1.35, 95% CI:1.14-1.61), obesity/overweight (OR = 5.58, 95% CI:2.59-12.0), history of hypertension in mother (OR = 43.24, 95% CI:5.99-312.11), low birth weight (OR = 7.96, 95% CI:2.59-12.0), physical activity (OR = 0.27, 95% CI:0.10-0.72), and consumption of fast food more than once a week (OR = 3.36, 95% CI:1.82-6.19), were associated with risk of hypertension. Furthermore, age (beta = 0.346, OR = 1.41, 95% CI:1.21-1.64), history of childhood obesity in the father (OR = 3.78, 95% CI: 1.77-8.06) and mother (OR = 2.44, 95% CI:1.07-5.56), and physical activity (OR = 0.27, 95% CI:0.11-0.66), were associated with obesity.

CONCLUSION

Age, obesity/overweight, history of hypertension in the mother, birth weight, physical activity, and consumption of fast food, were associated with risk of hypertension. Moreover, age, history of childhood obesity in parents, and physical activity, were associated with obesity. Furthermore, we found that school-age children in military families have higher rates of hypertension and overweight compared to other reports from our region.

Evaluation of Lipid Profile and Serum Adiponectin Levels in Patients with Lichen Planus

The Article Abstract is not available.  

Efficacy of Tranexamic Acid in the Treatment of Massive Upper Gastrointestinal Bleeding: A Randomized Clinical Trial

Background Upper gastrointestinal bleeding (GIB) is an important cause of emergency ward admission. Antifibrinolytic agents including tranexamic acid (TXA) have been used for controlling GIB. However, there have been concerns regarding the safety and efficacy of TXA in patients with GIB. Thus, in this study, we aimed to determine the efficacy of TXA in the treatment of massive upper GIB. Methodology This double-blind randomized clinical trial was conducted among 86 consecutive patients who were referred to Imam Hossein Hospital in Tehran, Iran from 2018 to 2019 with the chief complaint of massive upper GIB. Patients were chosen to be in the TXA or placebo groups based on a 1:1 allocation using the block randomization method. The rate of rebleeding, need for blood transfusion, hospital stay, adverse effects, and mortality rate were evaluated and compared across the groups. Results Of the 86 patients enrolled in this study, 55.8% (n = 48) were males. The mean age of all patients was 53.1 ± 10.6 years (TXA group: 54.9 ± 11.5 years, and placebo group: 51.4 ± 9.7 years). Rebleeding was seen in 11 (25.6%) patients in the TXA group and in 20 (46.5%) patients in the control group, which was statistically significant (p = 0.043). Blood transfusion was carried out in only three (7%) patients in the TXA group compared with 14 (32.6%) patients in the placebo group (p = 0.003). Six (14%) patients experienced a hospital stay of longer than five days in the TXA group and 15 (34.9%) patients in the control group, which was statistically significant (p = 0.024). There were no significant differences in the mortality rate across both groups (p > 0.05). Conclusions TXA has no effect on mortality associated with severe upper GIB. However, it was associated with a lower rate of rebleeding and hospitalization time, without significant adverse effects.

Efficiency of sea buckthorn extract in oxidative stability improvement of high oleic sunflower oil

Sea buckthorn (Hippophae rhamnoides) with high antioxidant capacity is distributed all over the world, but has never been used as a natural antioxidant in oils to replace synthetic antioxidants. Therefore, this study was performed to investigate the effectiveness of sea buckthorn extract in comparison to a common natural antioxidant rosemary extract and a synthetic antioxidant on retarding lipid oxidation. First the extracts were characterised, and it was found that sea buckthorn extract had higher polyphenol contents, radical scavenging activity, and higher antioxidant capacity. Then the proper concentrations for the use of these antioxidants were determined. Additionally, the progress of lipid oxidation during cycles of frying was assessed in terms of free fatty acids content, peroxide value, p-anisidine value, TOTOX value, colour, total polar compounds, and Induction period. The general order of effectiveness for inhibition of high oleic sunflower oil degradation during frying was: sea buckthorn > BHT > rosemary > control (P <0.05).

Evaluation of the Serum Level of High Mobility Group Box 1 Protein in Benign and Malignant Salivary Gland Tumors

Despite a low prevalence, salivary gland tumors (SGTs) represent a diverse set of tumors with a broad range of biological behaviors. Implementation of early detection programs has significantly improved the outcome of treatment and patients' survival. High mobility group box one protein (HMGB1) may likely be a candidate for the detection of SGTs due to its background in other human tumors. This study, for the first time, aimed to investigate the clinical value of HMGB1 in patients with benign and malignant SGTs and analyze its correlation with clinicopathologic outcomes. Using an enzyme-linked immunosorbent assay (ELISA), the serum level of HMGB1 was measured in 85 patients with SGTs (30 benign and 55 malignant cases) and 85 age- and sex-matched healthy individuals. HMGB1 levels had a significant difference between patients with SGTs and healthy controls (2041.4±787.1 pg/ml versus 536.3±374.6 pg/ml, P<0.0001) as well as those with benign and malignant tumors (1680.1±429.7 pg/ml versus 2238.6±867.2 pg/ml, P<0.0001). The serum level of HMGB1 was associated with some clinicopathologic factors, such as the size of the main tumor, clinical stage, and the lymph node metastasis, but not with patients' gender, age as well as the site of the lesions. These results suggest that the serum level of HMGB1 has the potential to be a supportive diagnostic marker for SGTs and can provide a precise assessment of the tumor status. There is no published report regarding the serum level of HMGB1 in SGTs; therefore, further studies are warranted.

The effect of indocyanine green-mediated photodynamic therapy in healing of experimentally induced oral mucosal traumatic ulcer in rat

Photodynamic therapy (PDT) is a promising approach for the healing of ulcerative lesions. This study aimed to investigate the effect of PDT using indocyanine green (ICG) in the healing of the experimentally induced oral mucosal traumatic ulcer in rat. Sixty adult male Sprague-Dawley rats were recruited in this experimental study. The ulceration was surgically made in the left cheek mucosa, and the rats were randomly assigned into four equal groups (n = 15). Oral ulcers in groups 1 and 2 were treated with the sterile saline solution (0.9%) and ICG (1 mg/ml). In group 3, laser irradiation was applied using the 810 nm diode laser in the continuous-wave mode for 30 s (light dose: 55 J/cm2, power: 300 mW, spot size: 4.5 mm). Following the topical application of ICG (1 mg/ml) in group 4, laser irradiation was performed in the same way as the previous group. After 24 h, treatments were repeated once more in all groups. The healing process was histopathologically assessed at the 3rd, 7th, and 14th days after ulceration. Wound healing was significantly accelerated in the ICG-mediated PDT group in comparison to the control group at all sampling time points (p < 0.005). However, the other groups displayed a similar healing rate (p > 0.05). Data suggest that ICG-mediated PDT has the potential to accelerate wound healing and prevent clinical infection in oral mucosal traumatic ulcers. However, further studies are required to confirm whether our results can be generalized to other wounds.

The Assessment of Angiogenesis by Microvessel Density in Patients With Atrophic/Erosive or Reticular Oral Lichen Planus

The role of angiogenesis in the development of chronic inflammatory diseases, including oral lichen planus (OLP), is of great concern. The most representative method for the assessment of angiogenesis is the semi-quantification of microvessel density (MVD) using specific markers such as CD105. We aimed to assess the MVD in patients with OLP and find its clinical significance to differentiate the atrophic/erosive forms from reticular ones. This cross-sectional study was conducted on 82 patients with clinically and histopathologically proven cases of OLP, including reticular (n=52) or atrophic/erosive (n=30) lesions. The control group comprised 82 age- and sex-matched subjects without any oral disease. To assess the MVD using CD105, tissue blocks were sliced, and the immunoexpression of CD105 was measured by the standard immunohistochemical staining procedure. The mean value of MVD in OLP patients was significantly higher than that in the controls (14.61±12.48 vs. 8.67±1.76, P<0.0001). Furthermore, there was a significant difference in the mean MVD value between reticular and atrophic/erosive lesions (8.19±7.13 vs. 25.73±12.06, P=0.001). However, no significant difference was observed between the reticular lesions and normal tissues (P=0.58). An increased level of CD105 in OLP patients can improve our knowledge about the causes and mechanisms of the disease. The CD105-MVD assessment might be a useful method for semiquantitative measurement of angiogenesis in OLP patients as well as differentiating its clinical forms; therefore, it can open new vistas for formulating strategies based on antiangiogenic treatments for the management of OLP and other precancerous lesions.

The effects of adipose tissue-derived stem cells seeded onto the curcumin-loaded collagen scaffold in healing of experimentally- induced oral mucosal ulcers in rat

OBJECTIVES

Various therapeutic approaches, including stem-cell-based strategies and tissue engineering, have been proposed for oral ulcerative lesions. We investigated the effects of adipose tissue-derived stem cells (ADSCs) seeded onto the curcumin-loaded collagen scaffold in the mucosal healing of oral ulcers in rats.

MATERIALS AND METHODS

The current experimental study was conducted on 40 male Sprague-Dawley rats. Oral ulcers were created over both sides of buccal mucosa, and the rats were randomly divided into four equal groups: 1) an untreated group (negative control); 2) Teriadent-treated group (positive control); 3) group treated with curcumin-loaded collagen scaffold; and 4) group received the ADSCs (3 × 106 cells) seeded onto the curcumin-loaded collagen scaffold. Rats were sacrificed on 3rd and 7th day after ulceration for histopathological examination as well as measurement of tissue levels of myeloperoxidase (MPO), superoxide dismutase (SOD), and Interleukin-1 beta (IL-1β) activity.

RESULTS

Compared with the negative control, the tissue levels of MPO and IL-1β were significantly decreased in all treated groups (P<0.0001); however, the SOD activity was elevated (P<0.0001). The highest SOD activity as well as the lowest MPO and IL-1β levels were observed in the ADSCs-curcumin-loaded collagen scaffold group. The ulcer healing process at 3rd and 7th day follow-up was much more progressed in the ADSCs-curcumin-loaded collagen scaffold group in comparison with the untreated group (P=0.037 and P=0.004, respectively).

CONCLUSION

According to the findings of this study, ADSCs seeded onto the curcumin-loaded collagen scaffold seems to have a promising potential for oral ulcer healing applications.

Photodynamic antimicrobial chemotherapy using indocyanine green in experimentally induced intraoral ulcers in rats

BACKGROUND

Photodynamic antimicrobial chemotherapy (PACT) is a promising modality for eradication of microorganisms from the wound. This study aimed to investigate the effectiveness of PACT using indocyanine green (ICG) for reduction of bacterial load of oral ulcers in rats and its impact on the healing process.

METHODS

In this experimental study, 50 adult male Sprague Dawley rats were recruited. Oral ulcers were surgically made on the left cheek mucosa, and animals were randomly assigned into five groups (n = 10). Wound site in groups 1, 2, and 3 was irrigated with the sterile saline (0.9%), chlorhexidine (CHX; 0.2%), and ICG solutions (1 mg/mL), respectively. Group 4 was exposed to laser irradiation using 810 nm diode laser on continuous-wave mode for 30 seconds (fluence: 55 J/cm² , power: 300 mW, spot size: 4.5 mm). In group 5, PACT was performed using topical application of ICG followed by laser irradiation in the same way as the previous group. Bacterial load of oral ulcers was assessed before and after each treatment modality. Besides, rats were sacrificed on the 5th day post ulceration and histological features of healing were evaluated.

RESULTS

Bacterial load was significantly reduced merely in the PACT-ICG-treated group by one log (P < .0001). Animals in the PACT-ICG-treated group also showed an accelerated healing in comparison with others on the 5th day of an experiment.

CONCLUSION

Photodynamic antimicrobial chemotherapy using topical application of ICG has a potential to reduce the bacterial load of oral ulcers and accelerate wound repair. Therefore, it can be considered as an alternative to currently available modalities for wound management.

COVID-19 infection recurrence presenting with meningoencephalitis

Coronavirus disease 2019 (COVID-19) infection can involve many organs, such as central nervous system, including in relapse. We describe the case of a 64-year-old woman with microbiologically confirmed COVID-19–induced respiratory distress whose treatment resulted in a negative nasopharyngeal swab reverse transcriptase PCR (RT-PCR) result for COVID-19. However, after a few weeks, relapse occurred, as indicated by symptoms of acute meningoencephalitis. Results of COVID-19 RT-PCR testing from her cerebrospinal fluid, nasopharyngeal and tracheal aspiration specimens became positive again, but COVID-19 serum antibodies were negative. We therefore note that symptoms with neurologic involvement can be one of COVID-19's first presentations, or they can appear at relapse. Regular evaluation of patients during convalescence is therefore necessary.

Expression of nucleostemin in odontogenic cysts and tumors

Considering the unique clinical behavior of odontogenic cysts and tumors, this study aimed to assess the expression of nucleostemin in odontogenic cysts and tumors by immunohistochemical (IHC) staining. This retrospective study evaluated 50 samples including 13 samples of unicystic ameloblastoma (UA), 10 samples of solid ameloblastoma (SA), 10 samples of odontogenic keratocyst (OKC) and 17 samples of dentigerous cyst (DC) by IHC staining. The stained slides were evaluated under a light microscope. Number of positively stained cells for nucleostemin marker was counted in five random areas per 100 cells under x400 magnification. The labeling index (LI) for nucleostemin was calculated by dividing the number of positively stained cells by the total number of counted cells in each lesion multiplied by 100. Positive staining for nucleostemin marker was observed in 100% of SA,100% of UA, 100% of OKC and 5 samples of DC (29.4%). The LI for nucleostemin marker in SA (median: 70.5), UA (median: 50) and OKC (median: 52) samples was significantly higher than that in DC (median: 0.00) (P = .001). This study showed an increased expression of nucleostemin in ameloblastoma and OKC, which suggests that stemness may be related to development of these lesions, their invasive behavior and high rate of recurrence.

Evaluation of the Effect of a Topical Gel Form of Pistacia Atlantica and Trachyspermum Ammi on Induced Oral Mucositis in Male Golden Hamsters by Bio-Marker Indices and Stereological Assessment

STATEMENT OF THE PROBLEM

Oral mucositis (OM) is a common inflammatory complication consequent to chemotherapy or radiotherapy in cancer patients that affects their quality of life. Therefore, finding an effective treatment for OM is always imperative.

PURPOSE

The purpose of this experimental study was to measure the stereological, anti-inflammatory and antioxidant markers of hydro-alcoholic extract of Pistacia Atlantica (P. atlantica) leaves, Trachyspermum Ammi (T. ammi) fruits and their mixture on induced OM in hamsters.

MATERIALS AND METHOD

In Experimental study, OM was generated by the method employed by Tanideh et al., in 90 hamsters, by 5-FU (5-fluorouracil 65 mg/kg, IP). All the animals were divided into 5 groups: control, topical gel base, hydro-alcoholic extract 3% of P. atlantica, hydro-alcoholic extract 1% of T. ammi, and a mixture of the extracts of the two plants. On days 13, 15, and 17, the cheek pouch samples were harvested. Stereological scores and the levels of malondialdehyde (MDA), Superoxide dismutase (SOD), myeloperoxidase (MPO), and interleukin-1B (IL-1B) in the pouch tissue were measured.

RESULTS

Lower levels of MPO, MDA, and IL-1B and an increase of SOD level were discovered in the mixture-treated group in comparison with other groups. As an aspect of MDA, no significant differences were detected between the topical gel form of P. atlantica and T. ammi groups on days 13 (p= 0.648), 15 (p= 0.981) and 17 (p= 0.540). No variations of MPO were detected among P. atlantica and T. ammi groups on days 13 (p= 0.159) and 15 (p= 0.694); however, the MPO activity of the T. ammi group was significantly lower than the P. atlantica group on day 17 (5.57±0.56 vs. 6.48±0.35 U/ml, p< .001). The volume density of the epithelium increased in the mixture- treated group (p< 0.05).

CONCLUSION

The results of this study indicated that the mixture of P. atlantica leaves and T. Ammi fruits might be effective in the treatment of OM.

Comparison of the proteome patterns of adipose-derived stem cells with those treated with selegiline using a two dimensional gel electrophoresis analysis

Adipose derived stem cells (ADSCs) are multipotent and can transdifferentiate into neural stem cells. We investigated the transdifferentiation of ADSCs to neural phenotype (NP) cells using selegiline and two-dimensional electrophoresis (2-DE). The perinephric and inguinal fat of rats was collected and used to isolate ADSCs that were characterized by immunophenotyping using flow cytometry. The ADSCs were differentiated into osteogenic and lipogenic cells. The NP cells were generated using 10^-9 mM selegiline and characterized by immunocytochemical staining of nestin and neurofilament 68 (NF-68), and by qRT-PCR of nestin, neurod1 and NF68. Total protein of ADSCs and NP cells was extracted and their proteome patterns were examined using 2-DE. ADSCs carried CD73, CD44 and CD90 cell markers, but not CD34. ADSCs were differentiated into osteocyte and adipocyte lineages. The differentiated NP cells expressed nestin, neuro d1 and NF-68. The proteome pattern of ADSCs was compared with that of NP cells and eight spots showed more than a two fold increase in protein expression. The molecular weights and isoelectric points of these highly expressed proteins were estimated using Melanie software. We compared these results with those of the mouse proteomic database using the protein isoelectric point database, and the functions of the eight proteins in differentiation of NP cells were predicted using the UniProt database. The probable identities of the proteins that showed higher expression in NP cells included cholinesterase, GFRa2, protein kinase C (PKC-eta) and RING finger protein 121. The sequences of the proteins identified from mouse database were aligned by comparing them with similar proteins in rat database using the Basic Local Alignment Search Tool (BLAST). The E values of all aligned proteins were zero, which indicates consistency of the matched protein. These proteins participate in differentiation of the neuron and their overexpression causes ADSCs transdifferentiation into NP cells.

The Protective Role of Front-Closed and Front-Open Gowns Against Staphylococcus Aureus Contamination of Dental Students before and after Restorative Treatments

STATEMENT OF THE PROBLEM

Due to the close contact with patients during dental treatments, dentists and those affiliated to the dental profession are at higher risk for various infections. Infection prevention in dentistry is an important topic that has gained more interest in recent years.

PURPOSE

We aimed to evaluate the protective role of front-closed and front-open gowns against staphylococcus aureus contamination of dental students before and after restorative treatments.

MATERIALS AND METHOD

Sixty male dental students performed the restorative treatments on the teeth of the patients in the front-closed and front-open gowns groups. Before and after the treatment, the wet sterile swab samples were collected from the students' neck and anterior part of the chest. The samples simultaneously cultured on the blood agar and the Staphylococcus-specific medium using spread plate method. Finally, the colonies were counted within 24-48 hours.

RESULTS

The mean of the total colony count increased in both groups of front-open (787.8 ± 88.91) and front-closed gowns (630 ±122.7), but the changes were significant only in the front-open gown group (p≤ 0.001). Compared to the front-closed gown group (430±71.08), the total colony count of staphylococcus aureus in the front-open gown group (490.3±62.5) was increased significantly (p≤ 0.001).

CONCLUSION

We confirmed that dental students occupationally exposed to the bacterial agents and even simple minor changes in gown could considerably decrease the contamination. Education about bacterial transmission, as well as infection prevention and control measures is necessary for dental students, especially when they participate in clinical practice.

Serum Endostatin Levels in Oral Squamous Cell Carcinoma

INTRODUCTION

Endostatin is a C-terminal proteolytic fragment of collagen XVIII and, as with angiostatin and thrombospondin, is known as an antiangiogenic agent. The aim of this study was to assess the level of serum endostatin in patients with oral squamous cell carcinoma (SCC), and its association with the clinicopathological characteristics of the tumor.

MATERIALS AND METHODS

Using an enzyme-linked immunosorbent assay (ELISA) kit, we investigated the circulating levels of endostatin in the blood serum of 45 patients with oral SCC and 45 healthy controls.

RESULTS

The mean level of serum endostatin in patients was significantly lower (68.8±85 ng/ml) than in healthy controls (175.6±73 ng/ml) (P<0.001). Serum endostatin levels were significantly lower in patients with lymph node metastasis compared with patients without lymph node metastasis (P<0.001). In addition, serum endostatin level was associated with higher histological grade (P<0.001). There were no apparent correlations between serum endostatin concentration and clinicopathological features such as age, gender, and tumor stage (P>0.05).

CONCLUSION

Findings of the present study suggest the prognostic and anti-metastatic role of endostatin, and this may be used as a tool for monitoring tumor progression.

Galectin-3 Serum Levels Could Help Clinicians Screen for Salivary Gland Tumor Patients

Objective:

To identify serum levels of galectin-3 in salivary gland cancer and healthy populations; a prospective analysis was performed on serum specimens from 105 patients with salivary gland cancer and 56 healthy persons.

Methods:

Enzyme-linked immunosorbent assay (ELISA) was used to measure levels of galectin-3 (GAL-3). Serum levels were compared between patients with salivary gland tumors and healthy control. A total of 105 patients were enrolled in the study (55 men, 50 women).

Result:

Mean age was 45.5 years. Thirty-nine patients with malignant and 66 cases with benign tumors were compared with 56 healthy participants with a mean age of 51.7. No statistically significant differences were observed when comparing GAL-3 serum levels between malignant and benign salivary gland tumor patients, but a statistically significant difference was found between case and control patients with p-values of 0.02. Serum levels of galectin-3 protein were elevated in patients with salivary gland cancer compared with the healthy population.

Conclusion:

The difference between benign and malignant tumor patients was significant, but revealed no clinic pathological characteristics in malignant tumors. To the best of the authors’ knowledge, this is the first time a study suggests that GAL-3 serum levels could help clinicians screen for salivary gland cancer.

Comparison of anti-Candida activities of the ancient plants Lawsonia inermis and Ziziphus spina christi with antifungal drugs in Candida species isolated from oral cavity

Context:

Medicinal plants have reportedly fewer side effects, compared to antifungal agents.

Aims:

This study was designed to compare the anti-Candida activity of two medicinal plants with two routine antifungal agents, used in the clinics, on Candida species isolated from the oral cavity of the liver transplant patients.

Subjects and Methods:

Anti-Candida activities of ethanol extracts of Lawsonia inermis leaf and Ziziphus spina christi unripe and ripe fruit (collected from south of Iran) versus nystatin and fluconazole were evaluated using CLSI M27-A3 standard method.

Results:

The minimum inhibitory concentration (MIC) 90 values for L. inermis, Ziziphus spina christi ripe, and unripe fruits in Candida albicans were 0.1 μg/mL, 25 μg/mL, and 0.1 μg/mL, and in Candida glabrata were 0.05 μg/mL, 25 μg/mL, and 0.05 μg/mL, respectively. The MIC90 value for nystatin in both species was 0.035 μg/mL, but MIC90 value for fluconazole in C. albicans was 0.5 μg/mL and in C. glabrata was 2 μg/mL.

Conclusion:

Unripe fruits of Ziziphus spina christi and L. inermis were found more effective than fluconazole on Candida species. Ziziphus spina christi unripe fruit and L. inermis leaf have potential anti-Candida activity and can be considered as a new mouthwash agent to prevent and treat Candida infections. Further studies regarding pharmacokinetics and toxicities of these extracts are needed for their use in humans.

Topical Olive Leaf Extract Improves Healing of Oral Mucositis in Golden Hamsters

STATEMENT OF THE PROBLEM

Oral mucositis (OM) is a common side effect of anti-cancer drugs and needs significant attention for its prevention.

PURPOSE

This study aimed to evaluate the healing effects of olive leaf extract on 5-fluorouracil-induced OM in golden hamster.

MATERIALS AND METHOD

OM was induced in 63 male golden hamsters by the combination of 5-fluorouracil injections (days 0, 5 and 10) and the abrasion of the cheek pouch (days 3 and 4). On day 12, hamsters were received topical olive leaf extract ointment, base of ointment, or no treatment (control) for 5 days. Histopathology evaluations, blood examinations, and tissue malondialdehyde level measurement were performed 1, 3 and 5 days after treatments.

RESULTS

Histopathology score and tissue malondialdehyde level were significantly lower in olive leaf extract treated group in comparison with control and base groups (p= 0.000). Significant decreases in white blood cell, hemoglobin, hematocrit , and mean corpuscular volume and an increase in mean corpuscular hemoglobin concentration were observed in olive leaf extract treated group in comparison with control and base groups (p< 0.05).

CONCLUSION

Our findings demonstrated that daily application of olive leaf extract ointment had healing effect on 5-fluorouracil induced OM in hamsters. Moreover, the beneficial effect of olive leaf extract on OM might be due to its antioxidant and anti-inflammatory properties.

Adenosine A1 receptor modifies P53 expression and apoptosis in breast cancer cell line Mcf-7

BACKGROUND

Breast cancer cells over-express the adenosine receptor A1 and in most of these cells, P53 gene is a wild type. Because of this finding and relationship between A1 receptor and cell apoptosis and proliferation, this study aimed to determine the effect of agonist and antagonist of A1 receptor on cell apoptosis and proliferation and recognize the relationship between this receptor and P53 expression.

METHODS

We used a Real-Time PCR test for measuring expression of p53 gene also flow cytometry assay for apoptotic and survival cell rate after treatment of MCF-7 cells with A1 receptor agonist CPA (N6-Cyclopentyladenosine) and A1 receptor antagonist DPCPX (1,3-dipropyl-8-cyclopentylxanthine) in 24,48 and 72 hours.

RESULTS

Our flow cytometry findings indicate that DPCPX significantly induces apoptosis in MCF-7. Also the expression of P53 becomes upregulated with time of DPCPX treatment. CPA treatment increased the survival cell rate and down-regulated this apoptosis-relevant gene P53 (p > 0.05).

CONCLUSION

DPCPX can induce P53 expression which consequently promotes the cell apoptosis in MCF-7. Therefore, DPCPX could be used as an anti-cancer agent (Tab. 1, Fig. 3, Ref. 5).

Prognostic value of matrix metalloproteinase-9 expression in oral squamous cell carcinoma and its association with angiogenesis

Background

Breakdown of extracellular matrix (ECM) is one of the important hallmarks of cancer progression which facilitates the invasion of tumoral cells to the surrounding tissue. Matrix metalloproteinases (MMPs) can degrade various components of the ECM and basement membrane. The aim of this study was to determine the role of matrix metalloproteinases-9 protein in the biologic behavior of oral squamous cell carcinoma (OSCC) and its relation with tumor angiogenesis.

Material and Methods

In this study 42 OSCC and 15 normal epithelium were reviewed by immunohistochemical staining for matrix metalloproteinases-9 and CD105.

Results

Matrix metalloproteinases-9 expression was detected in 32 OSCC specimens (76.1%), with 28 specimens (66.6%) showing moderate or strong expression. We observed that the expression level of matrix metalloproteinases-9 was positively correlated with the status of lymph node metastasis (N0vs. N1) (P =0.00), and clinical stage (I-II vs. III-IV) in OSCC patients. Microvessel density in intratumoral tissue has an association with lymph node metastasis and advanced clinical stage (P=0.003 and p=0.01, respectively). We observed that tumors with matrix metalloproteinases-9 overexpression had a higher microvessel density counts compared with tumors with absent or focal immunostaining(16.2±5.6 vs 10.3±3.5 respectively, P =0.03).

Conclusions

In conclusion present results demonstrate the marked expression of matrix metalloproteinases-9 and CD105 in OSCC and suggest that the expression of these markers is associated with tumor progression and could offer additional information about the aggressiveness of OSCC. In addition a significant relationship was noted between microvessel density count and expression of matrix metalloproteinases-9 which suggest that MMP9 expression may be closely related to tumor angiogenesis.

Key words:Matrix metalloproteinases-9, CD105, squamous cell carcinoma, immunohistochemistry.

Decreased Serum Monocyte Chemoattractant Protein1 in Salivary Gland Tumor Patients

BACKGROUND

The monocyte chemoattractant protein1 (MCP1/CCL2) is a potent chemoattractant for natural killer cells, monocytes, and memory T lymphocytes. However, any role in the genesis of salivary gland tumors (SGT) is unknown. To assess the diagnostic relevance of chemokines in SGT, MCP1 levels in the serum of patients were investigated in association with tumor progression and clinical aggressiveness.

MATERIALS AND METHODS

Using an ELISA kit, we assessed and compared the circulating levels of MCP1 in blood serum of 70 SGT patients with 44 healthy control samples.

RESULTS

The results of this study showed that the concentration of MCP1 was significantly lower in patients with benign (463.8±158.5pg/ml, P=0.033) and malignant (454.8±190.4pg/ ml, P=0.007) SGT than in healthy subjects (645.7±338.9). No significant difference in mean serum levels of MCP1 was observed between the benign and malignant group (p=0.9). While MCP1 levels were lower in patients with an advanced clinical stage, advanced tumor size, higher tumor grade, or lymph node involvement, but the mean MCP1 level between groups showed no statistically significant difference (p>0.05).

CONCLUSIONS

MCP1 levels in the serum of patients with SGT were decreased, indicating that this might a good marker for discriminating patients with SGT from healthy people. However, no clearcut relationship was detected between MCP1 levels and clinicopathologic factors, and MCP1 is not a good marker for evaluating tumor dissemination.

Comparison of the therapeutic effects of the dietary and topical forms of Zizyphus jujuba extract on oral mucositis induced by 5-fluorouracil: A golden hamster model

Background

Oral mucositis (OM) is a common inflammatory complication among cancerous patients as an adverse effect of chemotherapy and radiotherapy. The aim of this study was to evaluate the effects and identify the appropriate route of administration of extract of Zizyphus jujuba in 5-flurouracile induced OM induction in golden hamster.

Material and Methods

In a prospective randomized double blind animal study, OM was induced in 56 male golden hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on once daily on days 3 and 4. On days 14-17, 300 mg/kg dietary and 20% Z. jujuba gel and gel base groups were treated and then compared with a control group. Microscopic scores and pouch content of malondialdehyde (MDA), plus activities of superoxide dismutase and myeloperoxidase in pouch tissue were evaluated.

Results

Histopathology scores of mucositis were lower in the systemic and 20% Z. jujuba gel groups than the gel base and control groups (P<0.05). Also, lower MDA level and higher activities of MPO and SOD were detected in the systemic and 20% Z. jujuba gel groups in comparison to the gel base and control groups (P<0.001).

Conclusions

The use of Z. jujuba hydroalcoholic extract in systemic and topical forms may be associated with reduced intensity of OM, diminished concentration of MDA, and increased activity of MPO and SOD on induced OM in golden hamster undergoing 5-FU consumption.

Key words:Oral mucositis, 5-flurouracil, Zizyphus jujube, oxidative stress, histopathology score.

Effect of annealing temperature on optical properties of binary zinc tin oxide nano-composite prepared by sol-gel route using simple precursors: structural and optical studies by DRS, FT-IR, XRD, FESEM investigations

Binary zinc tin oxide nano-composite was synthesized by a facile sol-gel method using simple precursors from the solutions consisting of zinc acetate, tin(IV) chloride and ethanol. Effect of annealing temperature on optical and structural properties was investigated using X-ray diffraction (XRD), diffuse reflectance spectra (DRS), field emission scanning electron microscopy (FESEM) and Fourier transform infrared spectroscopy (FTIR). XRD results revealed the existence of the ZnO and SnO2 phases. FESEM results showed that binary zinc tin oxide nano-composites ranges from 56 to 60 nm in diameter at 400°C and 500°C annealing temperatures respectively. The optical band gap was increased from 2.72 eV to 3.11 eV with the increasing of the annealing temperature. FTIR results confirmed the presence of zinc oxide and tin oxide and the broad absorption peaks at 3426 and 1602 cm(-1) can be ascribed to the vibration of absorptive water, and the absorption peaks at 546, 1038 and 1410 cm(-1) are due to the vibration of Zn-O or Sn-O groups in binary zinc tin oxide.

Co-precipitation synthesis of nano-composites consists of zinc and tin oxides coatings on glass with enhanced photocatalytic activity on degradation of Reactive Blue 160 KE2B

Nano-composite containing zinc oxide-tin oxide was obtained by a facile co-precipitation route using tin chloride tetrahydrate and zinc chloride as precursors and coated on glass by Doctor Blade deposition. The crystalline structure and morphology of composites were evaluated by X-ray diffraction (XRD) and field emission scanning electron microscopy (FESEM). The XRD results showed peaks relative to zinc oxide with hexagonal wurtzite structure and tin oxide with tetragonal structure. FESEM observations showed that the nano-composite consisted of aggregates of particles with an average particle size of 18 nm. The photocatalytic activity of the pure SnO2, pure ZnO, ZnSnO3-Zn2SnO4 and ZnO-SnO2 nano-structure thin films was examined using the degradation of a textile dye Reactive Blue 160 (KE2B). ZnO-SnO2 nano-composite showed enhanced photo-catalytic activity than the pure zinc oxide and tin oxide. The enhanced photo-catalytic activity of the nano-composite was ascribed to an improved charge separation of the photo-generated electron-hole pairs.

Serum level of matrix metalloproteinase-9 in patients with salivary gland tumor

STATEMENT OF THE PROBLEM

Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of certain diseases and cancers via tissue destruction and can be secreted into the blood stream. MMP9 expression in the salivary gland tissue was evaluated but their serum level in the salivary gland tumors was not studied.

PURPOSE

The aim of our study was to determine the concentration of serum MMP-9 in healthy participants and in patients with salivary gland tumor.

MATERIALS AND METHOD

Using an ELISA kit, the circulating levels of MMP-9 in sera from 58 patients with salivary gland tumor (31 pleomorphic adenoma, 17 adenoid cystic carcinoma and 10 mucoepidermoid carcinoma) and 30 healthy controls was assessed.

RESULTS

The serum MMP9 level in patients with salivary gland tumors (380.0±301.3 pg/ml) also patients with benign tumors (354.3±218.7 pg/ml) (354.3±218.7 pg/ml) were significantly lower than that in the healthy group (727.4±624.6 pg/ml) (Respectively p= 0.02 and p= 0.01). Mean serum MMP9 concentration in malignant tumors was (402.3±441.8pg/ml) higher than benign tumors (354.3±218.7 pg/ml) but the difference was not significant (p= 0.9).

CONCLUSION

Our results showed that serum level of MMP9 decreased in patients with salivary gland tumors which suggest that MMP9 may not have a potential role in development and pathogenesis of salivary gland tumor.

Serum levels of osteopontin as a prognostic factor in patients with oral squamous cell carcinoma

Osteopontin (OPN) is a multifunctional glycophosphoprotein that was detected in many carcinomas, and it may have a prognostic role. The aim of this study was to determine osteopontin serum levels in patients with oral squamous cell carcinoma (OSCC) and investigated its correlation with clinicopathological features of tumor. Using an ELISA kit, we assessed and compared the circulating levels of OPN in blood serum of 45 oral squamous cell carcinoma patients with 45 healthy control samples. The serum osteopontin level in patients with OSCC was significantly higher (145.8 ± 14.6 ng/ml, n = 45) compared with the healthy controls (53.9 ± 9.6 ng/ml, n = 45, p < 0.001). Mean serum osteopontin level was significantly higher in patients with nodal metastasis (p = 0.03) and higher stage (p = 0.02). Findings of the present study suggest that OPN may have a potential role in pathogenesis of OSCC and it may be used as a tool for monitoring tumor progression.

Serum level of MMP-3 in patients with oral squamous cell carcinoma--lack of association with clinico-pathological features

BACKGROUND

MMP-3 is a proteolytic enzyme of the matrix metalloproteinase family. Protein degradation which is their fundamental action regulates different activities of tumor cell such as their growth, differentiation, apoptosis, migration, invasion, angiogenesis as well as their resistance to the immune system.

AIM

The aim of this study was to determine MMP-3 serum levels in patients with OSCC and investigate if they correlate with clinicopathological features.

METHOD AND MATERIALS

Using an ELISA kit, we assessed and compared the circulating levels of MMP-3 in blood serum of 45 oral squamous cell carcinoma patients with 45 healthy control samples.

RESULTS

The serum MMP-3 level in OSCC patients was significantly higher (9.45±4.6 ng/ml) than healthy controls (5.9±3.6 ng/ml, p<0.001), especially in females and in older patients. However, there was no apparent correlation in serum MMP-3 concentration with the clinico-pathological features such as tumor location, stage, tumor size, nodal status, distant metastasis, histological grade and smoking.

DISCUSSION

This result suggests that the measurement of serum MMP-3 concentration might be helpful to diagnose OSCC but not to predict prognosis.

The apoptotic effects of sirtuin1 inhibitor on the MCF-7 and MRC-5 cell lines

Sirtuin1 (SIRT1) is an enzyme that deacetylates histones and several nonhistone proteins including p53 during stress and plays an important role in the survival of tumor cells. Hereby, this study describes the potency of salermide as a SIRT1 inhibitor to induce apoptosis in the MCF-7 and MRC-5 cell lines. MCF7 and MRC-5 cell lines were cultured in RPMI-1640 and treated with or without salermide at concentration of 80.56 μmol/L, based on the half-maximal inhibitory concentration (IC50) index at different times (24, 48 and72 h). The IC50 value was established for the salermide in MCF-7. The percentage of apoptotic cells was measured by flow cytometry. Real-time quantitative RT-PCR was performed to estimate the mRNA expression of sirtuin1 in MCF-7 and MRC-5 with salermide at different times. ELISA and Bradford protein techniques were used to detect endogenous levels of total and acetylated p53 protein generated in MCF-7 and MRC-5 cells. Our findings indicated that salermide can induce apoptosis in MCF-7 significantly more effective than MRC-5 cells. We showed that the expression of SIRT1 was dramatically down-regulated by increasing the time of salermide treatment in MCF-7 but not MRC-5 and that the acetylated and total p53 protein levels were increased more in MCF-7 than MRC-5. Salermide, by decreasing the expression of sirtuin1 gene, can induce acetylation of P53 protein and consequently induce significant cell death in MCF-7 that was well tolerated in MRC-5.

Serum Level of Vascular Endothelial Growth Factor in Patients with Different Clinical SubtypeS of Oral Lichen Planus

BACKGROUND

Oral lichen planus is a chronic inflammatory disease with a poorly understood etiology. The role of angiogenesis in the development of different chronic inflammatory diseases is of great concern. Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis. We aimed to evaluate the serum level of VEGF in patients with oral lichen planus compared with normal individuals and consider its clinical significance.

METHODS

In this case-control study, 36 serum samples from patients diagnosed with oral lichen planus admitted to the Oral Medicine Department of the School of Dentistry at Shiraz University of Medical Sciences (14 men, 22 women, mean [±SD] age: 38.8 [±6.07] years) and 23 serum samples from healthy individuals (9 men, 14 women, mean [±SD] age: 38.7 [±4.9] years) were collected. VEGF concentration was measured using the ELISA method. The Mann-Whitney test was used for statistical analysis.

RESULTS

The serum VEGF level was significantly higher in patients with oral lichen planus compared with the healthy controls (112.97 [±63.2] vs. 66.21 [±56.2] ngr/ml, P<0.001). A similar difference was also observed between the two types of oral lichen planus, being more pronounced in the erosive form (P<0.001).

CONCLUSION

Serum VEGF can be used as a useful and suitable marker to scrutinize the disease activity.

Serum level of matrix metalloproteinase-3 in patients with oral lichen planus

BACKGROUND

Oral Lichen planus (OLP) is a chronic lesion of the oral mucosa with unknown origin. Basement membrane changes are common in OLP and may be mediated by proteases such as matrix metalloproteinase (MMPs) and mast cell chymase. The aim of our study was to evaluate the level of serum MMP-3 in OLP com-pared to normal individuals and assess its clinical significance.

METHODS

Thirty four serum samples from patients diagnosed with OLP (12 males, 22 females, age: 42.2±10.8 years) and 34 serum samples from healthy control subjects (11 males, 23 females, age: 42.5±13.3 years) were collected and MMP-3 concentration was measured by ELISA.

RESULTS

The serum MMP-3 level in OLP patients was higher (21.64±24.31 ng/ml) compared with healthy con-trols (16.52±23.63 ng/ml), but showed no statistically significant difference. A statistically significant difference was demonstrated between the two types of OLP, being more pronounced in the erosive/atrophic form 6).

CONCLUSION

The different clinical appearances of OLP are associated with significant differences in MMP-3 serum level.

Survey of aflatoxins in Kashkineh: A traditional Iranian food

BACKGROUND AND OBJECTIVES

Aflatoxins are mycotoxins produced by Aspergillus flavus and Aspergillus parasiticus that can contaminate human and animal foods, including corn, wheat, rice, peanuts, and many other crops resulting in the illness or death of human and animal consumers. The aim of this study was to detect aflatoxin B1, B2, G1, G2 and total aflatoxin in Kashkineh, a traditional Iranian food.

MATERIALS AND METHODS

This survey was conducted to detect aflatoxins on 41 samples of Kashkineh. The samples were randomly collected from traditional bazaars and supermarkets of Khorramabad city of Iran. The presence and quantity of aflatoxins was determined by high performance liquid chromatography (HPLC).

RESULTS

The average concentrations of AFB1, AFB2, AFG1, and AFG2 in all samples and in a mixed sample of all samples were not detectable (ND). The only sample that showed aflatoxin contamination was sample number 29 of which the AFB1 concentration was 0.64 ng/g.

CONCLUSION

Although some people believe Kashkineh is carcinogenic due to toxins, this study showed kashkineh is not contaminated with aflatoxins.