DHEA Induces Sex-Associated Differential Patterns in Cytokine and Antibody Levels in Mice Infected with Plasmodium berghei ANKA.

Malaria is the most lethal parasitic disease worldwide; the severity of symptoms and mortality are higher in men than in women, exhibiting an evident sexual dimorphism in the immune response; therefore, the contribution of 17ß-estradiol and testosterone to this phenomenon has been studied. Both hormones differentially affect several aspects of innate and adaptive immunity. Dehydroepiandrosterone (DHEA) is the precursor of both hormones and is the sexual steroid in higher concentrations in humans, with immunomodulatory properties in different parasitic diseases; however, the involvement of DHEA in this sexual dimorphism has not been studied. In the case of malaria, the only information is that higher levels of DHEA are associated with reduced Plasmodium falciparum parasitemia. Therefore, this work aims to analyze the DHEA contribution to the sexual dimorphism of the immune response in malaria. We assessed the effect of modifying the concentration of DHEA on parasitemia, the number of immune cells in the spleen, cytokines, and antibody levels in plasma of CBA/Ca mice infected with Plasmodium berghei ANKA (P. berghei ANKA). DHEA differentially affected the immune response in males and females: it decreased IFN-γ, IL-2 and IL-4 concentrations only in females, whereas in gonadectomized males, it increased IgG2a and IgG3 antibodies. The results presented here show that DHEA modulates the immune response against Plasmodium differently in each sex, which helps to explain the sexual dimorphism present in malaria.

Testosterone induces sexual dimorphism during infection with Plasmodium berghei ANKA.

Malaria is the most lethal parasitic disease worldwide; men exhibit higher mortality and more severe symptomatology than women; however, in most studies of immune response in malaria, sex is not considered a variable. Sex hormones 17ß-oestradiol and testosterone are responsible for the main physiological differences between sexes. When interacting with their receptors on different immune cells, they modify the expression of genes that modulate cell proliferation, differentiation, and synthesis of cytokines. The immunosuppressive activity of testosterone is well accepted; however, its participation in the sexual dimorphism of the immune response to malaria has not been studied. In this work, we analysed whether altering the concentration of testosterone, through increasing the concentration of this hormone for exogenous administration for three weeks, or gonadectomy before infection with Plasmodium berghei ANKA affects different cells of the immune response necessary for parasite clearance. We also assessed the concentration of pro-and anti-inflammatory cytokines in male and female CBA/Ca mice infected or not with the parasite. Our results show that testosterone changes affect females more than males, resulting in sex-associated patterns. Testosterone administration increased parasitaemia in intact males while reducing it in intact females leading to a dimorphic pattern. In addition, gonadectomy increased parasitaemia in both sexes. Moreover, testosterone administration prevented both weight loss caused by the infection in females and hypothermia in gonadectomized mice of both sexes. Boosting testosterone concentration increased CD3+ and CD8+ populations but decreased the B220+ cells exclusively in females. Additionally, testosterone reduced IFN-γ concentration and increased IL-6 levels only in females, while in males, testosterone increased the number of NK cells. Finally, gonadectomy decreased TNF-α concentration in both sexes. Our results demonstrate that testosterone induces different patterns depending on sex and testosterone concentration. The results of this work contribute to understanding the impact of modifying testosterone concentration on the immune response specific against Plasmodium and the participation of this hormone in sexual dimorphism in malaria.

Tamoxifen Suppresses the Immune Response to Plasmodium berghei ANKA and Exacerbates Symptomatology.

Malaria is the most lethal parasitic disease in the world. Mortality and severity in symptoms are higher in men than women, suggesting that oestrogens, which are in higher concentration in females than in males, may regulate the immune response against malaria. Tamoxifen, a selective oestrogen receptor modulator used in breast cancer treatment due to its antagonistic effect on oestrogen receptors α and ß, is also studied because of its potential therapeutic use for several parasitic diseases. However, most studies, including one in malaria, have not addressed the immunomodulatory role of tamoxifen. In this work, we evaluated the effect of tamoxifen on the immune response of CBA/Ca mice against Plasmodium berghei ANKA. This study showed for the first time that tamoxifen increased parasite load, aggravated symptoms by decreasing body temperature and body weight, and worsened anaemia. Additionally, tamoxifen significantly increased the splenic index and the percentages of CD4+ and NK+ cells on day eight post-infection. By contrast, tamoxifen decreased both CD8+ and B220+ populations in the spleen and decreased the serum levels of IL-2, IL-6, and IL-17. Our findings support the notion that tamoxifen is a potent immunomodulator in malaria-infected mice and suggest caution when administering it to malaria-infected women with breast cancer.

Dimorphic effect of 17ß-oestradiol on pathology and oxidative stress in experimental malaria.

Malaria is the parasitic disease with the highest mortality worldwide; males exhibit higher mortality and more severe symptomatology than females, suggesting the participation of sexual hormones in protection and pathology. We have documented that gonadectomy modifies oxidative stress in Plasmodium berghei ANKA-infected mice in a dimorphic manner. However, gonadectomy decreases all sexual steroids levels, making it difficult to determine the contribution of each hormone to the results. This study aimed to explore the participation of 17ß-oestradiol (E2) in oxidative stress in the blood, spleen, liver and brain of P. berghei-infected female and male mice. E2 was administered to intact or gonadectomized (GX) male and female mice to assess their effects on parasitaemia, body weight loss and hypothermia. We also measured the effect of E2 on the specific activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) and on malondialdehyde (MDA) levels in the blood, spleen, liver and brain of CBA/Ca male and female mice infected with P. berghei ANKA. We detected the effects of E2 and sexual dimorphism on all tissues and variables analysed. Administration of E2 increased parasitaemia in intact mice. However, reconstitution of GX female mice with E2 decreased parasitaemia. E2 decreased body weight and differentially modulated oxidative stress depending on the sex, infection and tissue analysed. Low antioxidant activity was detected in the brain, suggesting additional protective antioxidant mechanisms in the brain independent of antioxidant enzymes. Our results explained, at least in part, the sexual dimorphism in this experimental model of malaria.

Fluoruro de estaño en el control de cavidades sin restauración en dientes temporales / Stannous fluoride in nonrestorative cavity control in primary teeth

Introducción: el control de cavidades sin restauración (NRCC, por sus siglas en inglés), es una opción de tratamiento conservador y no invasivo para dentina cariosa, sobre todo en dentición temporal. Una de las estrategias del NRCC es la remineralización. El fluoruro de estaño (FDE) puede considerarse, como una opción viable ya que existe evidencia de su eficacia cariostática. Objetivo: valorar al FDE como remineralizante alternativo en dentina de molares temporales, asociado al NRCC. Material y métodos: se efectuó un estudio clínico, epidemiológico, y descriptivo con preescolares voluntarios de 3 a 5 años de edad con consentimiento firmado de participación en el estudio, y que presentaron molares con ICDAS 5 y 6. La aplicación del FDE a 0.8%, la evaluación de la dureza de la dentina con los criterios de Nyvad, y el diagnóstico del estado pulpar, la efectuó un operador entrenado para esta finalidad. Se aplicó un análisis estadístico descriptivo y uno no paramétrico. Resultados: el efecto cariostático producido por el FDE a 0.8%, sobre dentina afectada de molares temporales de niños mexicanos fue estadísticamente significativo durante cinco meses. Conclusiones: la aplicación de fluoruro de estaño puede considerarse como una alternativa de tratamiento cariostático asociado al NRCC para niños de 3 a 5 años de edad (AU)

Introduction: nonrestorative cavity control (NRCC), is a conservative and non-invasive treatment option for carious dentin, especially in primary dentition. One of the NRCC strategies is remineralization. Stannous Fluoride (SDF) can be considered as a viable option since there is evidence of its cariostatic efficacy. Objective: to evaluate FDE as an alternative remineralizing agent in the dentin of primary molars, associated with NRCC. Material and methods: a clinical, epidemiological, and descriptive study was carried out with preschool volunteers aged 3 to 5 years with signed consent to participate in the study, and who presented molars with ICDAS 5 and 6. The application of FDE at 0.8%, the evaluation of dentin hardness with the Nyvad criteria, and the diagnosis of pulp status, was carried out by an operator trained for this purpose. A descriptive and non-parametric statistical analysis was applied. Results: the cariostatic effect produced by 0.8% FDE on affected dentin of primary molars of Mexican children was statistically significant for five months. Conclusions: the application of stannous fluoride can be considered as an alternative cariostatic treatment associated with NRCC for children 3 to 5 years of age (AU)

Potencial remineralizante del fluoruro diamino de plata al 38% en dentina de dientes temporales afectada por caries / Remineralizing potential of 38% silver diamine fluoride in dentin affected by dental caries

Introducción: la caries es una enfermedad compleja que afecta a cualquier edad. La prevalencia es mayor en la primera dentición, sobre todo en población con baja percepción económica. El fluoruro diamino de plata (FDP) al 38% ha sido utilizado como una alter- nativa de tratamiento para esta enfermedad. Funciona como una solución remineralizante y cariostática. Objetivo: evaluar el efecto remineralizante del FDP al 38% en dentina afectada por lesiones de caries en molares temporales. Material y métodos: estudio clínico, epidemiológico, descriptivo, longitudinal y experimental. Se llevó a cabo en molares de primera dentición de niños de tres a cinco años de edad. Los niños seleccionados tenían molares con lesiones cariosas dentinarias, Pitts las denomina D3. No se incluyeron niños con dientes que presentaron patologías pulpares irreversibles. La aplicación del FDP al 38% la efectuó un operador entrenado para esta finalidad. Se utilizaron los criterios de Nyvad para determinar el grado de dureza de la dentina y con ello deducir su remineraliza- ción. Se observó la permanencia de la remineralización efectuada por un periodo de cinco meses. Resultado y conclusión: el FDP es un compuesto eficaz en 91% de los casos en un periodo de cinco meses o más (AU)

Introduction: dental caries is a complex disease that affects any age. The prevalence is higher in primary dentition, especially in a population with low economic perception. 38% silver diamine fluoride (FDP) has been used as an alternative treatment for this disease. It works as a remineralizing and cariostatic solution. Objective: to evaluate the remineralizing effect of 38% FDP on dentin affected by dental caries, in temporary molars. Material and methods: clinical, epidemiological, descriptive, longitudinal and experimental study. It was carried out in temporary molars of children between three and five years of age. The selected children presented molars with dental carious lesions, Pitts calls them D3. Children with teeth that presented irreversible pulp pathologies were not included. The application of the FDP to 38% was carried out by an operator trained for this purpose. The Nyvad criteria were used to determine the degree of hardness of the dentin and thereby deduce its remineralization. The permanence of the remineralization carried out was observed for a period of five months. Result and conclusion: the FDP is an effective compound in 91% of the cases, in a period of five months or more (AU)

Eficacia del uso de un enjuague con aceites esenciales para el control del biofilm dental / Efficacy of the use of a rinse with essential oils for the control of dental biofilm

Introducción: Se ha documentado que, para tener mejores resultados en el control del biofilm oral, es necesario el uso de controles químicos, antes o después del cepillado dental. Entre éstos, encontramos los enjuagues de aceites esenciales. Objetivo: Determinar la actividad del enjuague con aceites esenciales antes o después del cepillado, en el control del biofilm dental. Material y métodos: El estudio se realizó con 27 voluntarios. Los participantes fueron seleccionados y agrupados. El grupo 1 fue el control, que empleó su técnica de cepillado habitual y dos grupos experimentales que, además del cepillado con dentífrico, usaron un enjuague de aceites esenciales durante ocho días, ya sea antes (grupo 2) o después del cepillado dental (grupo 3). La cuantificación del número de superficies teñidas en los tres grupos, tanto el estado inicial como posterior al uso de los enjuagues, se hizo con el índice de O'Leary y un revelador de placa tritonal, el cual permitió la observación del biofilm de forma clínica, así como su grado de patogenicidad. Resultados y conclusión: El análisis estadístico estableció que no existe diferencia significativa entre no usar y usar el enjuague con aceites esenciales antes o después del cepillado (AU)

Introduction: It has been documented that, to have better results in the control of oral biofilm, it is necessary to use chemical control, before or after tooth brushing. Among these, we find the essential oil rinses. Objective: To determine the activity of the rinse with essential oils before or after brushing, in the control of the dental biofilm. Material and methods: The study was conducted with 27 volunteers. The participants were selected and grouped. Group 1 was the control, which used its usual brushing technique and two experimental groups that, in addition to brushing with toothpaste, used a mouthwash of essential oils, for eight days, either before (group 2) or after tooth brushing (group number 3). For the quantification of the number of stained surfaces in the three groups, to record both the initial and subsequent state of the use of the rinses, it was done with the O'Leary index and a tritonal developer, which allowed the observation of the biofilm of clinical form, as well as its degree of pathogenicity. Results and conclusion: The statistical analysis established that there is no significant difference between not using and using the rinse with essential oils before or after brushing (AU)

Contenido de fluoruro en dentífricos de venta en el mercado nacional / Fluoride content in toothpastes sold in the national market

Introducción: Actualmente, existe una gran variedad de pastas dentales que se pueden encontrar en el mercado nacional, para diferentes propósitos. Entre éstas se hallan las empleadas para la prevención de caries. Éstas contienen fluoruro en diversas concentraciones como agente terapéutico, y casi en su totalidad estipulan en sus marbetes un contenido de 1,000 a 1,450 partes por millón (ppm) de fluoruro. Algunos estudios han mostrado que las concentraciones de fluoruro especificadas en la etiqueta y lo encontrado en el dentífrico no coinciden. Objetivo: Evaluar la concentración de fluoruro total con base en la Norma Mexicana NMX-K-539-CNCP-2013, que establece que los dentífricos no deben contener más de 1,500 ppm de fluoruro. Así como determinar si lo declarado en el marbete de sus empaques corresponde al contenido real de fluoruro. Material y métodos: El estudio se realizó, por triplicado, en 37 pastas dentífricas. El método para determinar la concentración de fluoruro fue el de ion selectivo, descrito por la Farmacopea de los Estados Unidos Mexicanos. Resultados: El promedio de concentración de este elemento fue de 1,262 ppm F- (± 170.7). El 59% de los dentífricos analizados no contienen la cantidad estipulada en el marbete. Conclusiones: Las concentraciones de fluoruro de los dentífricos se encuentran dentro de la Norma. Las concentraciones no corresponden a lo estipulado en el empaque (AU)

Introduction: Currently, there is a wide variety of toothpastes, which can be found in the national market, for different purposes. Among these are those used for the prevention of dental caries. These, contain fluoride in various concentrations as a therapeutic agent, and almost in their entirety, stipulate in their labels a content of 1,000 to 1,450 ppm of fluoride. Some studies have shown that the fluoride concentrations specified on the label, and what is found in the toothpaste do not match. Objective: To evaluate the concentration of total fluoride based on the Mexican Standard NMX-K-539-CNCP-2013, which establishes that toothpastes should not contain more than 1,500 ppm of fluoride. As well as determining if what is stated on the label of their packaging corresponds to the actual content of fluoride. Material and methods: The study was carried out, in triplicate, on 37 toothpastes. The method for determining the fluoride concentration was that of selective ion, described by the Pharmacopoeia of the United Mexican States. Results: The average concentration of this element was 1,262 ppm F- (± 170.7). Fifty nine percent of the dentifrices analyzed do not contain the amount stipulated in the label. Conclusions: The fluoride concentrations of dentifrices are within the Standard. The concentrations do not correspond to what is stipulated in the package (AU)

Prevalencia de caries dental asociada a tabaquismo en una población de universitarios / Prevalence of smoking-related dental caries in a college population

Diversos estudios han asociado un mayor riesgo de desarrollar cariesdental al consumo de tabaco. No obstante, la relación entre el consumode tabaco y la caries dental permanece poco investigada. Conforme a la Encuesta de Tabaquismo en Jóvenes en México, este hábito representaun grave problema de salud pública. Asimismo, se ha señalado al grupode adultos jóvenes de 18 a 25 años, como la franja etaria que muestra latendencia más acentuada de crecimiento de adicción al tabaco en ambos sexos. Objetivo: Hacer una valoración inicial de la posible asociación entre tabaquismo y caries en jóvenes de 18 a 25 años. Material y métodos: Se realizó un estudio epidemiológico, descriptivo, observacional, retrospectivo, analítico y transversal. Se revisaron 320 expedientes incluidos en la base de datos recopilada del proyecto Promoción de la salud para universitarios como medio innovador para fomentar el desarrollo humano y agregar condiciones que favorezcan al proceso enseñanza-aprendizaje (Proyecto PAPIME 212812). Se seleccionaron 274 expedientes que reunían todos los datos de los criterios de inclusión: edad, sexo, si fumaba o no, ingreso familiar y el índice de caries dental de Klein y Palmer por superfi cie (CPO). Se llevó a cabo un análisisde razón de momios (odds ratio) para corroborar la asociación entrecaries y hábito de fumar. Resultados: Se encontró que en la poblaciónque declaró tener hábito tabáquico se duplica la experiencia de cariesy específi camente en el sexo masculino se cuadriplica. Asimismo, losparticipantes fumadores con mayores ingresos, presentan el SIC másalto. En cambio tenemos, que para aquéllos con el ingreso más bajo,no hay una diferencia signifi cativa entre los que fuman y los que no.De ello, se concluye que en la población estudiada, el tabaquismo representa un factor asociado a caries.

Various studies have reported an association between tobacco use andan increased risk of developing dental caries. However, little researchhas been carried out into the relationship between the two. According tothe Youth Tobacco Survey in Mexico, smoking is a habit that representsa serious public health problem. What is more, young adults aged 18to 25 years have been identifi ed as the age group showing the mostmarked trend of increasing tobacco addiction in both sexes. Objective:To perform an initial assessment of the possible association betweensmoking and caries in young people aged 18 to 25 years. Materialand methods: A descriptive, observational, retrospective, analytical,cross-sectional epidemiological study was performed, which included areview of 320 records from the database compiled in the project PAPIME212812 (Promoting health in college students as an innovative means topromote human development and add conditions that favor the teachinglearningprocess). A total of 274 records were selected as meeting theinclusion criteria: age, sex, smoker or nonsmoker, household income,and Klein and Palmer’s decayed, missing, and fi lled surfaces (DMFS)index. Odds ratios were analyzed to verify the association betweencaries and smoking. Results: Caries experience was found to be twiceas high in those who defi ned themselves as smokers and indeed fourtimes higher in male smokers. Furthermore, higher-income smokerswere found to have the highest SIC, while among those on the lowestincomes, no signifi cant diff erence was found between smokers andnonsmokers. We therefore conclude that smoking is a factor associatedwith caries in the population studied.

Potencial predictivo de un modelo reducido del cariograma en estudiantes universitarios de la Facultad de Estudios Superiores Zaragoza / Predictive potential of a reduced cariogram model in college students at the Zaragoza Faculty of Higher Studies (FES)

Antecedentes: La caries dental constituye una de las enfermedades máscomunes en el ser humano. Conocer los factores que intervienen en el desarrollo de la caries dental en una población determinada representa un área de oportunidad para establecer esquemas de tratamiento que modifi quen las variables que están infl uyendo en su estado de salud bucal en general. Por este motivo, se han presentado diversos programas para determinar el riesgo de caries que tiene un individuo. El Cariograma es uno de los más completos y una herramienta muy útil en la prevención de la caries. Objetivo: Observar el funcionamiento de un modelo reducido del Cariograma en una zona fl uorurada con el que podamos tener la misma fuerza predictiva que con el modelo completo, pero con la ventaja de ser más ágil y económico. Material y métodos: Se realizó un estudio transversal de 30 estudiantes universitarios elegidos al azar, con una edad entre 18 y 21 años. Se realizaron pruebas salivales y se utilizó el índice de dientes con caries, perdidos y obturados (CPO), IP y un cuestionario sobre hábitos alimenticios para estructurar las variables que conforman el Cariograma, para así predecir el riesgo que existe en cada individuo de cursar con caries en un futuro. Posteriormente, se compararon los resultados con un modelo reducido y se evaluó su potencial predictivo.

Background: Tooth decay is one of the most common diseases in humans. Knowing the factors involved in the development of dental caries in any given population represents an area of opportunity to establish treatment regimens to modify the variables that infl uence the overall oral health status of that population. For this reason, various programs have been designed to determine the risk of an individual developing caries. The cariogram is one of the most useful and comprehensive tools for preventing caries. Objective: To observe the functioning of a reduced cariogram model in a fl uoridated area, one that can offer us the same predictive power as the full model but with the advantage of being more fl exible and economical. Material and methods: We performed a cross-sectional study of 30 randomly selected college students aged between 18 and 21 years. Salivary tests were performed, the DMFT Index and PI calculated, and a question-naire on eating habits was applied to structure the variables that make up the cariogram and so enable us to predict the risk that each individual has of developing caries in the future.

Equations for predicting height for elderly Mexican Americans are not applicable for elderly Mexicans.

Common indices for the assessment of nutritional status take height into account. Elderly individuals are frequently unable to assume the position needed for this measurement. Therefore, equations have been developed for predicting height in elderly American Whites, American Blacks, and Mexican Americans using knee height as a predictor. These equations may not be applicable for the elderly in other populations. A sample of 736 individuals was studied (186 males, 550 females) with a mean age of 74.7 +/- 8 years. Height and knee height (without shoes) were measured in millimeters. Multiple regression and cross-validation was performed. The correlation between knee height and standing height was similar in women (r = 0.86; P < 0.0001) and men (r = 0.83; P < 0.0001). The equations obtained were as follows: men (height in cm) = 52.6 + (2.17 x knee height in cm) and women (height in cm) = 73.7 + (1.99 x knee height in cm) - (0.23 x age in years). Cross-validation showed that the pure error was less than the root mean square error (RMSE) in both sexes. Mean heights, based on the equations of Chumlea et al. (1998) for Mexican Americans significantly differ from the reference values for females and males. Therefore, the equations developed by Chumlea et al. (1998) for elderly Mexican Americans do not appear to be applicable for elderly Mexicans.