Association between concentration of active MMP-9 in pulpal blood and pulpotomy outcome in permanent mature teeth with irreversible pulpitis - a preliminary study.

AIM: To investigate the correlation between the concentration of active-matrix metalloproteinases-9 (aMMP-9) in pulpal blood and the outcome of pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis (SIP). METHODOLOGY: Forty permanent molar teeth with a clinical diagnosis of SIP and normal apical tissues with periapical index (PAI) score ≤ 2 and ten permanent teeth (8 molars and two premolars) with a diagnosis of normal pulp that required root canal treatment for prosthetic reasons from patients between the ages of 15-35 years were recruited. All clinical procedures were performed under local anaesthesia and rubber dam isolation. After access opening, the coronal pulp tissue was amputated up to the canal orifice. A 100 µL volume of the pulpal blood was collected using a micropipette and transported to the laboratory. Sodium hypochlorite (2.5 %) was used as a haemostatic agent, and mineral trioxide aggregate (MTA) was used as the pulp capping material. The tooth was restored with composite at the same visit. Teeth with normal pulps were treated with single-visit root canal treatment. Patients with pulpotomy were recalled at 6 and 12 months. Outcome assessment of teeth with pulpotomy was carried out at 12 months and was categorized as success (asymptomatic patients with PAI score ≤ 2) or failure (symptomatic patients or PAI score ≥ 3). Quantification of aMMP-9 in pulpal blood was achieved using a fluorometric assay. The following statistical analyses were performed to assess the data: t-test, Fisher's exact test, kappa coefficient, non-parametric test, Wilcoxon rank-sum test, Spearman rank correlation test and receiver operating characteristic curve (ROC). RESULT: The success rate of pulpotomy was 88 % at 12-months. There was a significant difference between the median concentrations of aMMP-9 in pulpal blood of teeth with normal pulps (52 (12-96) ng mL-1 :) and SIP (193.3 (25.8-607.7) ng mL-1 :) (P = 0.0003) and successful (132.3 (25.8-548.3) ng mL-1 :) and failed cases (512.4 (334.8-607.7 ng mL-1 :) (P = 0.0015) of MTA pulpotomy. A significant association was established between aMMP-9 concentration and outcome of pulpotomy. The area under the receiver operating characteristics curve (0.9484, 95%CI) suggested excellent discriminatory power of aMMP-9 concentration in pulpal blood to predict the pulpotomy outcome. CONCLUSION: The pulpal blood concentration of aMMP-9 was significantly associated with the outcome of pulpotomy in teeth with symptomatic irreversible pulpitis, where it may be used as a potential prognostic biomarker.

Progesterone concentration when the future ovulatory follicle and corpus luteum are located in ipsilateral or contralateral ovaries in heifers.

Three studies were done on the effects of ipsilateral location (same ovary) versus contralateral location (opposite ovaries) of the future ovulatory follicle and CL in heifers. The numbers of heifers for the ipsilateral and contralateral groups, respectively, were: experiment (Exp) 1 (N = 4 and 4), Exp 2 (N = 6 and 4), and Exp 3 (N = 5 and 10). In the Exps with available data (Exp 2 and 3), the interval between ovulation and the end of luteolysis was significantly shorter in the ipsilateral group than in the contralateral group (Exp 2: 16.8 ± 0.3 vs. 19.8 ± 1.7 days; Exp 3: 16.9 ± 0.2 vs. 19.7 ± 0.9 days). In Exp 3, the interovulatory interval was shorter (P < 0.01) in the ipsilateral group (20.1 ± 0.4 days) than in the contralateral group (22.7 ± 0.7 days), but the interval from the end of luteolysis to ovulation was not altered significantly. Circulating progesterone (P4) concentration for 33 hours normalized to the beginning of luteolysis (Exp 1) and on Days 16 to 20 (Day 0 = ovulation; Exp 3) was significantly lower in the ipsilateral group than in the contralateral group (Exp 1: 3.7 ± 0.2 vs. 4.8 ± 0.3 ng/mL; Exp 3: 1.7 ± 0.4 vs. 5.9 ± 0.4 ng/mL). Area (cm(2)) of the CL and percentage of CL with color Doppler signals of blood flow were lower and resistance index for a CL arteriole was greater in the ipsilateral group (Exp 3). The decreased P4 concentration in the ipsilateral group began by Day 16, but the decreased luteal area and vascular perfusion were not detected until Days 17 or 18. Results supported the hypothesis that the ipsilateral location of the future ovulatory follicle and CL was associated with lower P4 production and a shorter interovulatory interval.

Interrelationships among progesterone, LH, and luteal blood flow during a pulse of a PGF2α metabolite and functional role of LH in the progesterone rebound in heifers.

On Day 16 (Day 0 = ovulation) or before the expected transition into the luteolytic period, heifers were not treated (control group, N = 7) or were treated with a single 0.1-mg dose of estradiol (E2) (E2 group, N = 6) or E2 combined with the GnRH antagonist acyline (E2/Ac group, N = 5). Hourly blood samples were collected from hour of treatment (Hour 0) to Hour 20. Estradiol induced a pulse of PGFM, but the peak of the pulse occurred 2 hours later (P < 0.05) and mean PGFM concentrations during the descending portion of the pulse were lower (P < 0.05) in the E2/Ac group than in the E2 group. In the E2 group, concentration of progesterone (P4) decreased (P < 0.05) during the ascending portion of the PGFM pulse, and increased (rebounded; P < 0.05) along with an LH increase during the descending portion. In the E2/Ac group, a rebound in P4 and an increase in LH were not detected during the descending portion of the PGFM pulse. The percentage of CL with color Doppler signals of blood flow increased (P < 0.04) concurrently with the PGFM increase during Hours 0 to 5 and during the ascending portion of the PGFM pulse. Blood flow and PGFM decreased concurrently. The following hypotheses were supported: (1) LH has a positive effect on PGFM pulses; (2) the rebound in P4 and the increase in LH during the descending portion of a PGFM pulse are functionally related; and (3) the increase in luteal blood flow in association with a PGFM pulse represents a direct effect of PGF2α rather than an effect of P4 or LH.

Role of LH in the progesterone increase during the bromocriptine-induced prolactin decrease in heifers.

The luteotrophic effect of bromocriptine in heifers was studied to determine if the reported posttreatment increase in progesterone (P4) just before or at the beginning of luteolysis was attributable to loss of a luteolytic effect of prolactin (PRL) or to the stimulation of LH, a known luteotropin. Four treatment groups (n = 7) were used: control (Ct), bromocriptine (Bc; 16 mg/heifer), acyline (Ac; 3 µg/kg), and bromocriptine and acyline combined (BcAc). Bromocriptine (inhibitor of PRL) and acyline (antagonist of GnRH and therefore blocker of LH) were given at Hour 0 on Day 16 postovulation, and blood samples were taken hourly at Hours 0 to 8. Concentration of P4 was greater (P < 0.05) in the Bc group than in the Ct group at each of Hours 1 to 8. Concentration of LH increased (P < 0.05) between Hours 0 to 2 in the Bc group but not in the other three groups. The peak of the first posttreatment LH pulse occurred earlier in the Bc group than in the Ct group. Average concentration of PRL was lower (P < 0.05) and number of PRL pulses was less (P < 0.05) in the Bc group than in the Ct group. Acyline inhibited LH in the Ac and BcAc groups as indicated by a decrease (P < 0.05) in concentration between Hours 0 and 2 and a decrease (P < 0.001) in number of pulses/heifer during the 8 h. A decrease in PRL but not an increase in P4 and LH occurred in the BcAc group. Results supported the hypothesis that the P4 increase associated with PRL suppression by bromocriptine treatment is attributable to an increase in LH.

Changes in biochemical composition of follicular fluid during reproductive acyclicity in water buffalo (Bubalus bubalis).

This study describes the changes in biochemical composition of follicular fluid during reproductive acyclicity in buffalo. A total of 73 pairs of ovaries collected from 26 reproductively acyclic and 47 reproductively cyclic buffaloes were used in the investigation. Ovarian follicles were classified into small (5.0-6.9 mm), medium (7.0-9.9 mm) and large (≥10.0 mm) sized categories depending upon their diameter. Follicular fluid was aspirated, processed and assayed for glucose, cholesterol, total protein, acid phosphatase and alkaline phosphatase. Glucose concentration was lesser in reproductively acyclic compared to cyclic buffaloes (19.3 ± 2.59 mg/dl compared to 32.6 ± 2.60 mg/dl; P<0.05), mainly due to difference in concentration between small sized follicles (12.4 ± 2.59 mg/dl compared to 28.0 ± 3.32 mg/dl; P<0.05). Cholesterol concentration was also lesser in reproductively acyclic compared to cyclic buffaloes (32.2 ± 2.14 mg/dl compared to 35.5 ± 2.16 mg/dl; P<0.05) and this was related to the lesser concentration found in large follicles (13.8 ± 3.45 mg/dl compared to 37.2 ± 4.10mg/dl; P<0.001). Total protein and acid phosphatase levels were not affected by either the reproductive cyclicity status or the follicular size (4.9 ± 1.07 g/dl to 6.0 ± 0.28 g/dl and 1.2 ± 0.17 U/dl to 2.5 ± 1.22 U/dl, respectively). An increased alkaline phosphatase activity was, however, observed in reproductively acyclic compared to cyclic buffaloes (27.5 ± 3.08 U/dl compared to 14.0 ± 1.09 U/dl; P<0.0001). In conclusion, results of the present study indicate an alteration in the biochemical composition of follicular fluid during reproductive acyclicity in buffalo. The findings provide further support to the notion that poor nutrition is an important factor triggering reproductive acyclicity in buffalo.