Orthodontic tensile strain induces angiogenesis via type IV collagen degradation by matrix metalloproteinase-12.

BACKGROUND AND OBJECTIVE: During orthodontic tooth movement (OTM), periodontal ligament (PDL) is remodeled dynamically, which requires sufficient blood supply for the regeneration of PDL. However, little is known about the remodeling of blood vessels during OTM. In this study, we hypothesized that the orthodontic tensile strain upregulates matrix metalloproteinase-12 (MMP-12) expression in the tension zone and induces angiogenesis via degradation of type IV collagen (Col-IV) in vascular endothelial basement membrane during the early stage of OTM. MATERIAL AND METHODS: Temporal and spatial MMP-12 expression in the tension zone of PDL, during the early stage of OTM, were examined by immunohistochemistry in rats. Continuous tensile strain was applied to cultured human immortalized PDL cell lines (HPL cells) and MMP-12 expression was examined in vitro. Colocalization of MMP-12 and Col-IV in vivo were examined by immunohistochemistry. To investigate whether MMP-12 produced by HPL cells could degrade Col-IV, recombinant Col-IV was incubated in the culture supernatants of HPL cells. Intact Col-IV in vitro was also examined by western blot analysis. Finally, the changes in blood vessels in the PDL were examined by micro-computed tomography analysis with perfused contrast agents and by conventional histological analysis. RESULTS: Orthodontic tensile strain induced MMP-12 expression in PDL cells in vivo and in vitro. Immunohistochemistry revealed that MMP-12-positive cells were observed adjacent to the Col-IV-positive tubular area in the tension zone of PDL. MMP-12 in culture supernatant of HPL cells degraded recombinant Col-IV, and specific MMP-12 inhibitor blocked the Col-IV degradation. Micro-computed tomography analysis and conventional histological analysis demonstrated that the areas of blood vessels were increased in the tension zone of the PDL after OTM. CONCLUSION: We discovered that the orthodontic tensile strain upregulates MMP-12 expression in the tension zone of PDL and induces angiogenesis via degradation of Col-IV in the vascular endothelial basement membrane.

Early tissue reaction in the tension zone of PDL during orthodontic tooth movement.

OBJECTIVE: The aim of the study was to examine the early tissue reaction in the tension zone of periodontal ligament (PDL) during orthodontic tooth movement. DESIGN: Upper first molars of rats were moved buccally with fixed appliances. The PDL in the tension zone was examined histologically, immunohistochemically and at a molecular level after 24h, 3 days and 7 days. RESULTS: After 24h of orthodontic force loading, the periodontal space appeared considerably expanded. The periodontal fibers were stretched between the bone and the root. Three days after loading, the expanded periodontal space had slightly narrowed, the periodontal fiber arrangement was relaxed, and the blood vessels did not appear elongated. A considerable layer of osteoid was formed on the bone surface. The total cross-sectional areas of the PDL in experimental groups were significantly larger than control group. The total cross-sectional areas of the blood vessels were not significantly different among the groups. Significantly high expressions of IL-1ß and PTX3 were characteristically observed not only in the endothelial cells and cells around the blood vessel, but also in fibroblasts throughout the PDL of the tension zone 24h after orthodontic force loading. Three and 7 days after loading, these showed tendencies to return to control levels. CONCLUSIONS: The present results suggest that the early reaction in the tension zone of the PDL during tooth movement consists of two phases: first, inflammation and second, rapid recovery and renovation of the PDL with bone formation.

Levodopa challenge test and (123) I-metaiodobenzylguanidine scintigraphy for diagnosing Parkinson's disease.

OBJECTIVES: To explore the possibility of a generally applicable tool for the immediate diagnosis of Parkinson's disease (PD) in its early stage, we compared the sensitivity and specificity of an acute levodopa challenge test with that of (123) I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. MATERIALS AND METHODS: A consecutive series of 45 patients with extrapyramidal symptoms were recruited to the acute levodopa challenge and evaluated for improvement by use of the Unified Parkinson's Disease Rating Scale motor scores. Of these patients, 32 of them were also examined by MIBG scintigraphy. The patients were followed up for at least 24 months, and 22 patients were diagnosed as having clinically definite PD. RESULTS: The sensitivity and specificity of the acute levodopa challenge test to predict clinical diagnosis of PD were 81.8% and 81.8%, respectively, which were better than those obtained by MIBG scintigraphy (62.5% and 62.5%). In both early- and middle-stages of PD, the test gave better sensitivity than MIBG scintigraphy. CONCLUSIONS: Considering that the well-established and frequently referred clinical diagnostic criteria require longitudinal observation for at least 24 months, the acute levodopa challenge test can be used as an immediate diagnostic tool for PD with sensitivity and specificity comparable to those of MIBG.