Evaluation of immunohistochemical subtypes in diffuse large B-cell lymphoma and its impact on survival.

BACKGROUND AND AIM: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma in Indian population. The disease could be divided into the prognostically important subtypes, germinal center B-cell (GCB)-like and activated B-cell-like, using gene expression profiling (GEP). The molecular subtype as defined by GEP could also be predicted by using immunohistochemistry (IHC) based algorithms using three biomarkers CD10, BCL-6, and multiple myeloma oncogene-1 (MUM1). It has been confirmed that patients belonging to the GCB subtype have a better outcome and survival than those belonging to the second subtype. The present study was conducted to study the prevalence of these two subgroups and their correlation with survival of the patients. MATERIALS AND METHODS: A total of 83 patients of DLBCL were included in the study. Hematoxylin- and eosin-stained sections were prepared from the paraffin-embedded tissue blocks. The staining for all the three antibodies was considered positive when more than 30% cells were stained with the respective antibody. RESULTS: The results showed that 44 patients (53%) had GCB immunophenotype and 39 patients (47%) had non-GCB phenotype. However, no statistically significant difference in overall and disease-free survival was noted between the subgroups. CONCLUSION: This study demonstrated that frequency of GCB subtype of DLBCL is significantly higher than the non-GCB subtype, and the non-GCB immunophenotype has better relapse-free survival 78% (standard error = 0.10) at the end of 3 years, while GCB has 56% (standard error = 0.23). Further studies should be performed with larger number of patients to show difference in clinical outcome between GCB and non-GCB subgroups.

The effect of docosahexaenoic acid (DHA) on expression of IL-1ß, IL-6, IL-8, and TNF-α in normal and lipopolysaccharide (LPS)-stimulated macrophages.

OBJECTIVE: Differentiated macrophages (MØ) are the resident tissue phagocytes and sentinel cells of the innate immune response. These cells are major constituents of periapical granulomas. Current studies indicate these activated cells as the source of bone-resorbing cytokines in the periapical granuloma. Periapical inflammation can be mediated by proinflammatory cytokines like interleukin 1ß (IL-1ß), tumor necrosis factor α (TNF-α), IL-6, and IL-8. Reducing the production of these cytokines may be beneficial for the treatment of periapical lesions. Oils rich in omega-3 fatty acids like docosahexaenoic acid (DHA) have been linked with anti-resorptive and bone-protective effects. The purpose of this investigation was to study the effect of DHA on the expression of these cytokines by normal and lipopolysaccharide (LPS)-treated MØ. We hypothesized that pretreatment of MØ with DHA decreases the expression of pro-inflammatory cytokines induced by LPS-treated MØ. METHOD AND MATERIALS: THP-1 monocytes were cultured and differentiated into MØ. DHA was added to MØ in a dose-dependent manner. MØ samples were added to the following groups: Group 1, ethanol alone as a solvent control; Group 2, 10 µg/ml of DHA (D1); Group 3, 20 µg/ml of DHA (D2); Group 4, 10 µg/ml of DHA + LPS (DL1); Group 5, 20 µg/ml of DHA + LPS (DL2); Group 6, LPS alone. Reverse transcriptase-PCR (RT-PCR) followed by ImageJ analysis was used to measure cytokine expression. RESULTS: The results show that IL-1ß and TNF-α levels for DL and DHA (basal) were significantly lower than the levels in LPS alone. IL-6 was increased in the DL groups. There was no significant change for IL-8. CONCLUSION: DHA at higher concentrations may selectively decrease proinflammatory cytokine production of IL-1ß and TNF-α. More studies are needed to verify the anti-inflammatory therapeutic action of agents like DHA omega-3 fatty acids.

Introduction of implants into postdoctoral endodontic residency programs.

The purpose of this study was to survey the directors of postdoctoral endodontic programs in the United States to ascertain their attitudes and approaches regarding incorporation of implants into the endodontic curriculum. We hypothesized that program directors would agree that implant training should be incorporated into the endodontic curriculum. We also hypothesized that they would all prefer apical surgeries and retreatment over implants when plausible. A twenty-item online survey was emailed to all fifty-two postdoctoral endodontic program directors in the United States. A 100 percent response was received. The results showed that 78.6 percent agreed that implant training should be incorporated, 85.7 percent preferred the didactic approach, and 42.9 percent preferred clinical implant training. One hundred percent preferred apical surgeries and retreatment over implants when plausible, and 53.8 percent did not prefer implants over endodontic treatment for teeth with a questionable prognosis. This survey indicates that implant training has been incorporated into postdoctoral endodontic programs and that the Commission on Dental Accreditation standards are being met. The trend may be to become more hands-on in the future if program directors believe there is a need to provide training in actual placement of implants.