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OBJECTIVE: The objective of this study was to evaluate the frequency of upper aerodigestive tract involvement in patients with mucous membrane pemphigoid associated with desquamative gingivitis. SUBJECTS AND METHODS: Data from 25 patients were collected by retrospective chart review. Their upper aerodigestive had been evaluated using a conventional flexible fiberscope. Oral disease activity was quantified on the basis of the Mucous Membrane Pemphigoid Disease Area Index activity score. RESULTS: Lesions of the upper aerodigestive tract were confirmed in nine symptomatic patients (9/25, 36%), of which five (5/25, 20%) had laryngeal involvement. No lesions were seen in the asymptomatic patients on fiberscope examination. There was a statistically significant difference in the symptoms, high oral disease activity score, and linear IgA deposition on direct immunofluorescence between patients with and without upper aerodigestive tract lesions (p = .001, .001, .002, respectively). CONCLUSION: The high frequency of considerable complications highlights the importance of confirming the presence of upper aerodigestive tract involvement in patients with mucous membrane pemphigoid having desquamative gingivitis. Signs including the presence of symptoms, high oral disease activity score, or linear IgA deposition on direct immunofluorescence might indicate a higher risk of upper aerodigestive tract involvement.
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Gengivite , Penfigoide Mucomembranoso Benigno , Penfigoide Bolhoso , Gengivite/complicações , Gengivite/patologia , Humanos , Imunoglobulina A , Mucosa , Penfigoide Mucomembranoso Benigno/patologia , Penfigoide Bolhoso/complicações , Estudos RetrospectivosRESUMO
Sclerosing mucoepidermoid carcinoma (SMC) is described as a "sclerosing variant" of mucoepidermoid carcinoma, and it is characterized by dense fibrosis and sclerosis of the stroma. SMC with eosinophilia (SMCE) is another and more rare subtype characterized by eosinophilia in addition to the sclerotic stroma common to SMC. However, unlike SMC, SMCE is not listed in the current 4th edition of WHO classification. Here, we describe three cases: one SMC in the parotid gland, one SMCE in the submandibular gland and one SMCE in the minor salivary gland of the oral cavity. The patients included a 71-year-old Japanese male, a 74-year-old Japanese female, and an 81-year-old Japanese female. They each complained of mass formation and underwent surgical resection. Histologically, the tumors mainly consisted of squamous cells with scarce keratinization that formed irregular large and small nests along with cystic structures containing mucous cells against the background of sclerotic stroma. One oral SMCE showed fine nesting and trabecular invasion. The two SMCEs included dense aggregates of eosinophils as well as more prominent lymphoid infiltration. Fluorescence in situ hybridization for MAML2 confirmed split signals in SMC, but not in SMCE.
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Carcinoma Mucoepidermoide/diagnóstico , Eosinofilia/complicações , Neoplasias das Glândulas Salivares/diagnóstico , Esclerose , Idoso , Idoso de 80 Anos ou mais , Carcinoma Mucoepidermoide/complicações , Carcinoma Mucoepidermoide/patologia , Carcinoma Mucoepidermoide/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Masculino , Neoplasias das Glândulas Salivares/complicações , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/cirurgia , TransativadoresRESUMO
INTRODUCTION: The aim of this study was to investigate the mechanism of how micro-osteoperforations (MOPs) accelerate tooth movement. We focused on inflammation, cell proliferation, and apoptosis of periodontal ligament cells and performed immunostaining of MOPs exposed to tumor necrosis factor-alpha (TNF-α), proliferating cell nuclear antigen (PCNA), and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) during experimental tooth movement. METHODS: Eleven-week-old male Wistar rats were divided into 2 groups: (1) 10 g of orthodontic force applied to the maxillary first molar (TM) and (2) force application plus 3 small perforations of the cortical plate (TM + MOPs). On days 1, 4, 7, 10, and 14 after force application, we investigated tooth movement and alveolar bone microstructure using microcomputed tomography (n = 5). We also determined the expression of TNF-α and PCNA in the pressure sides of periodontal ligaments via an immunohistochemical analysis. The expression of apoptotic cells was also determined by the TUNEL method. RESULTS: The tooth movement in the TM + MOPs group was significantly greater on days 4 to 14 than in the TM group. The TM + MOPs group showed statistically significant decreases in bone volume/tissue volume ratio and bone mineral density compared with the TM group. The ratios of TNF-α positive cells in the TM + MOPs group were increased on days 1, 4. 7, and 10 compared with the TM group. The ratios of PCNA positive cells in the TM + MOPs group were increased on days 1, 4, and 7 compared with the TM group, and the ratios of TUNEL positive cells in the TM + MOPs group were increased on days 1 and 7 compared with the TM group. CONCLUSIONS: These results suggest that MOPs may accelerate tooth movement through activation of cell proliferation and apoptosis of periodontal ligament cells.
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Ciclo Celular , Ligamento Periodontal/citologia , Técnicas de Movimentação Dentária/métodos , Animais , Apoptose , Proliferação de Células , Imuno-Histoquímica , Marcação In Situ das Extremidades Cortadas , Inflamação , Masculino , Antígeno Nuclear de Célula em Proliferação/análise , Ratos , Ratos Wistar , Fator de Necrose Tumoral alfa/análise , Microtomografia por Raio-XRESUMO
Human angiosarcoma is a rare malignant vascular tumor associated with extremely poor clinical outcome and generally arising in skin of the head and neck region. However, little is known about the molecular pathogeneses and useful immunohistochemical markers of angiosarcoma. To investigate the mechanisms of angiosarcoma progression, we collected 85 cases of human angiosarcoma specimens with clinical records and analyzed ISO-HAS-B patient-derived angiosarcoma cells. As control subjects, 54 cases of hemangioma and 34 of pyogenic granuloma were collected. Remarkably, consistent with our recent observations regarding the involvement of survivin expression following Hippo pathway inactivation in the neoplastic proliferation of murine hemangioendothelioma cells and human infantile hemangioma, nuclear survivin expression was observed in all cases of angiosarcoma but not in hemangiomas and pyogenic granulomas, and the Hippo pathway was inactivated in 90.3% of yes-associated protein (YAP) -positive angiosarcoma cases. However, survivin expression modes and YAP localization (Hippo pathway activation modes) were not correlated with survival. In addition, we confirmed that survivin small interference RNA (siRNA) transfection and YM155, an anti-survivin drug, elicited decreased nuclear survivin expression and cell proliferation in ISO-HAS-B cells which expressed survivin consistently. Conclusively, these findings support the importance of survivin as a good marker and critical regulator of cellular proliferation for human angiosarcoma and YM155 as a potential therapeutic agent.
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Proteínas Adaptadoras de Transdução de Sinal/genética , Biomarcadores Tumorais/genética , Hemangiossarcoma/genética , Proteínas Inibidoras de Apoptose/genética , Fosfoproteínas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/genética , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Hemangiossarcoma/patologia , Via de Sinalização Hippo , Humanos , Imidazóis , Proteínas Inibidoras de Apoptose/antagonistas & inibidores , Masculino , Pessoa de Meia-Idade , Naftoquinonas , Proteínas Serina-Treonina Quinases/genética , Transdução de Sinais/genética , Survivina , Fatores de Transcrição , Proteínas de Sinalização YAPRESUMO
Carcinoma cuniculatum (CC) is a rare neoplasm of oral squamous cell carcinoma (OSCC) and remains a histopathological challenge to pathologists because of its low incidence and unique architecture. Therefore, the purpose of this study was to illustrate the clinicopathological findings and biological behavior about this distinctive lesion. Clinical and follow-up information were retrieved from medical charts, and histopathological analyses were performed. Our series included 15 cases of CC, and the study included seven men and eight women, age 44-92. The tongue and mandible were the most frequently affected sites. There were three lymph node metastasis cases, and three local recurrences; one of the patients died of lung metastasis from oral CC. Histopathologically, the point of differential diagnosis with other subtypes of OSCC included unique, cuniculatum architecture and branching crypts. Because of its well-differentiated status, the prognosis of CC is usually optimistic. However, recurrent cases in our study might have possessed invasive biological characters that were not well controlled by conventional treatment; in one case, a portion of the CC transformed into conventional squamous cell carcinoma (SCC). This might suggest that transformed CC rather than primary CC should be further emphasized.
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Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/secundário , Causas de Morte , Transformação Celular Neoplásica/patologia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/secundário , Metástase Linfática/patologia , Masculino , Neoplasias Mandibulares/patologia , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias da Língua/patologia , Resultado do TratamentoRESUMO
INTRODUCTION: The aim of this study was to investigate the ability of anti-bone morphogenetic protein 2 monoclonal antibody (anti-BMP-2 mAb) to functionalize scaffolds to mediate bone regeneration in a canine model. MATERIALS AND METHODS: The mandibular right premolar 4 (PM4) was extracted in eight beagle dogs and grafted with anti-BMP-2 mAb+anorganic bovine bone mineral with 10% collagen (ABBM-C) and porcine bilayer native collagen membrane (CM). The ABBM-C and CM were functionalized with either anti-BMP-2 mAb (test group) or an isotype matched control mAb (control group). Animals were euthanized at 12 weeks for radiographic, histologic, and histomorphometric analyses. Outcomes were compared between groups. RESULTS: 3D imaging using cone beam computed tomography (CBCT) revealed that sites treated with ABBM-C and CM functionalized with anti-BMP-2 mAb exhibited significantly more remaining bone width near the alveolar crest, as well as buccal bone height, compared with control groups. Histologic and histomorphometric analyses demonstrated that in anti-BMP-2 mAb-treated sites, total tissue volume was significantly higher in the coronal part of the alveolar bone crest compared with control sites. In anti-BMP-2 mAb-treated sites, bone formation was observed under the barrier membrane. CONCLUSION: Functionalization of the ABBM-C scaffold and CM appeared to have led to bone formation within healing alveolar bone sockets.
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Processo Alveolar/patologia , Anticorpos Monoclonais/farmacologia , Proteína Morfogenética Óssea 2/imunologia , Alicerces Teciduais/química , Processo Alveolar/efeitos dos fármacos , Pontos de Referência Anatômicos , Animais , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/patologia , Tomografia Computadorizada de Feixe Cônico , Modelos Animais de Doenças , Cães , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Membranas , Tamanho do Órgão/efeitos dos fármacosRESUMO
A dentigerous cyst is a cyst that encloses part or the entire crown of an impacted or late-erupting tooth and occurs with comparatively high frequency in humans. In animals, there are three different lesions that are similar to dentigerous cyst and this complexity has led to confusion. In order to clarify the dentigerous cyst most similar to that in humans especially with regard to characteristics of the lining epithelium, this report describes the clinical, pathological, and immunohistochemical features of a dentigerous cyst in a dog. Further, approaches to the surgical and dental management of this cyst in dogs are also discussed and the literature is reviewed. Extraction of an embedded right mandibular first premolar tooth and debridement of the dentigerous cyst soft tissue lining were performed in a 4-year-old female mixed-breed dog. Radiography showed a well-defined unilocular and radiolucent area associated with the crown of the unerupted tooth. Histologically, the unilocular cyst wall was mainly lined by non-keratinized stratified flattened epithelium. As in humans, canine dentigerous cyst can be appropriately treated by cyst enucleation after accurate diagnosis. The radiographic appearance of an unerupted tooth embedded in an osseous cyst wall is a significant characteristic finding. Moreover non-keratinized epithelium is immunoreactive for amelogenin and ssDNA, which might be associated with deregulation of cell death in the lining epithelium, derived from odontogenic origin. When encountering any questionable lesions, an accurate diagnosis and immediate treatment can avoid malignant transformation.
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Cisto Dentígero/veterinária , Doenças do Cão/patologia , Imuno-Histoquímica/veterinária , Doenças Mandibulares/veterinária , Animais , Cisto Dentígero/diagnóstico , Cisto Dentígero/patologia , Cisto Dentígero/cirurgia , Doenças do Cão/diagnóstico , Doenças do Cão/cirurgia , Cães , Feminino , Doenças Mandibulares/diagnóstico , Doenças Mandibulares/patologia , Doenças Mandibulares/cirurgia , Radiografia , Dente não Erupcionado/diagnóstico por imagem , Resultado do TratamentoRESUMO
Pemphigus vulgaris (PV) is an autoimmune, blistering disease that affects the mucosa and skin. The current theory favors the concept that anti-desmoglein (Dsg) 3 autoimmunity is the only pathogenic event needed to induce acantholysis. However, a few cases of active PV in the oral cavity had no detectable anti-Dsg 3 antibody. The aim of this study was to evaluate the differences in clinical and laboratory findings, whether or not the anti-Dsg 3 antibodies were present. This study was based on a retrospective review of 10 PV cases. The evaluation of the circulating autoantibody titers to Dsg 3 was conducted by using enzyme-linked immunosorbent assay (ELISA). An index value of 20 or more was used as the cutoff for a positive reaction. Only five of the 10 PV cases had a positive Dsg 3 ELISA. There were no differences in clinical, cytological, histopathological, and direct immunofluorescence findings, whether or not the anti-Dsg 3 antibodies were present. Of the five patients with a negative reaction at the time of diagnosis, the Dsg 3 ELISA became positive in the follow-up period in three cases. In the remaining two cases, the Dsg 3 ELISA was consistently negative for 18 months. Dsg 3 ELISA was negative early in some PV cases. Therefore, PV acantholysis may precede the elevation of circulating anti-Dsg 3 antibody levels. The diagnosis of PV should be considered based on comprehensive clinical, histopathological, and immunofluorescent criteria.
Assuntos
Acantólise/imunologia , Autoanticorpos/imunologia , Desmogleína 3/imunologia , Gengivite/imunologia , Pênfigo/imunologia , Acantólise/etiologia , Adulto , Idoso , Ensaio de Imunoadsorção Enzimática , Feminino , Gengivite/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pênfigo/complicações , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Pemphigus vulgaris (PV) frequently begins with oral lesions and progresses to skin lesions. A patient is described who developed skin lesions during follow-up and whose only initial symptom was desquamative gingivitis (DG). METHODS: A 31-year-old woman presented with a 2-month history of painful gingiva. The diagnosis of PV was made according to clinical, histopathological, and immunofluorescent criteria. Topical corticosteroid (0.1% triamcinolone acetonide) was provided for the treatment of DG. Evaluation of the circulating autoantibody titers to desmoglein (Dsg)1 and Dsg3 was conducted by enzyme-linked immunosorbent assay (ELISA). RESULTS: The gingival PV lesions went into remission with the use of topical corticosteroid, although the patient experienced occasional recurrent oral lesions that required retreatment. She had regular follow-ups and remained relatively stable for several months. However, relapse and worsening of the oral lesions and the onset of skin lesions occurred after 26 months. Using ELISA, a change in the autoantibody profile corresponding to the transition from mucosal PV to mucocutaneous PV was confirmed. In all ELISA studies conducted throughout the course of the patient's disease, the Dsg3 ELISA was consistently high ranging from 150 to 200. However, the Dsg1 ELISA remained low, ranging from 10 to 30. After 26 months, Dsg3 (index value of 150) and Dsg1 (index value of 114) ELISA levels were elevated, consistent with the transition to mucocutaneous PV. CONCLUSIONS: In cases in which the lesions are limited to the oral cavity, PV sometimes may be managed successfully using only topical corticosteroids. However, it may not be possible to reduce the circulating Dsg autoantibody titers without systemic immunosuppression. The sustained high Dsg3 antibody level may cause "epitope spreading" and induce skin lesions. It may be prudent to determine post-treatment levels of Dsg using ELISA and, in consultation with the physician, recommend the addition of systemic therapy if Dsg3 levels remain elevated.
Assuntos
Doenças da Gengiva/tratamento farmacológico , Glucocorticoides/uso terapêutico , Pênfigo/tratamento farmacológico , Dermatopatias/etiologia , Triancinolona Acetonida/uso terapêutico , Adulto , Desmogleína 1/sangue , Desmogleína 3/sangue , Progressão da Doença , Feminino , Doenças da Gengiva/complicações , HumanosRESUMO
OBJECTIVE: Orthodontic root resorption (ORR) due to orthodontic tooth movement is a difficult treatment-related adverse event. Caspases are important effector molecules for apoptosis. At present, little is known about the mechanisms underlying ORR and apoptosis in the cementum. The aim of the present in vivo study was to investigate the expression of tartrate-resistant acid phosphatase (TRAP), caspase 3, caspase 8, and receptor activator of nuclear factor kappa-B ligand (RANKL) in the cementum in response to a heavy or an optimum orthodontic force. METHODS: The maxillary molars of male Wistar rats were subjected to an orthodontic force of 10 g or 50 g using a closed coil spring. The rats were sacrificed each experimental period on days 1, 3, 5, and 7 after orthodontic force application. And the rats were subjected to histopathological and immunohistochemical analyses. RESULTS: On day 7 for the 50-g group, hematoxylin and eosin staining revealed numerous root resorption lacunae with odontoclasts on the root, while immunohistochemistry showed increased TRAP- and RANKL-positive cells. Caspase 3- and caspase 8-positive cells were increased on the cementum surfaces in the 50-g group on days 3 and 5. Moreover, the number of caspase 3- and caspase 8-positive cells and RANKL-positive cells was significantly higher in the 50-g group than in the 10-g group. CONCLUSIONS: In our rat model, ORR occurred after apoptosis was induced in the cementum by a heavy orthodontic force. These findings suggest that apoptosis of cementoblasts is involved in ORR.
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Peculiar findings of orofacial actinomycosis mimicking the clinical appearance of a tumor of the upper gingiva are reported. An 83-year-old man with bleeding of the gingiva visited our hospital. The clinical diagnosis was a benign gingival tumor, and the lesion was surgically removed. Histologically, the excised specimens showed an ulcerative granuloma lesion covered by bacterial colonies consisting of club-shaped filaments. DNA samples were extracted from paraffin sections and examined by polymerase chain reaction (PCR) for Actinomyces species. The PCR products examined by direct DNA sequencing demonstrated the presence of Actinomyces israelii. Finally, a pathological diagnosis was made of a pyogenic granuloma associated with actinomycosis. The PCR method aided the early and exact diagnosis of the paraffin-embedded sample of oral mucosal infectious diseases including actinomycosis.
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Secretory leukocyte protease inhibitor (SLPI) is a serine protease inhibitor whose expression level is positively correlated with tumor aggressiveness and metastatic potential. However, the mechanism underlying SLPI-induced enhancement of malignant phenotype is not completely understood. The malignancy of cancer cells is highly dependent on cell migration activity. Our previous study revealed that gingival carcinoma Ca9-22 cells, but not colorectal adenocarcinoma HT-29 cells, expressed SLPI. Therefore, we investigated the migration activity of these two cell types to understand the nature of SLPI-mediated tumor aggressiveness and metastatic potential. In vitro wound healing assay indicated that HT-29 cells and SLPI-deleted Ca9-22 cells showed lower migration activity than wild-type Ca9-22 cells, suggesting that SLPI-induced cell migration plays an important role in tumor aggressiveness and metastatic potential. In addition, our gene expression profiling study based on microarray data for the three cell types identified a number of candidates, including LCP1 and GLI, that could be key molecules in the mechanism of SLPI-induced cell migration.
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Adenocarcinoma/genética , Movimento Celular/fisiologia , Neoplasias Colorretais/genética , Perfilação da Expressão Gênica , Neoplasias Gengivais/genética , Inibidor Secretado de Peptidases Leucocitárias/fisiologia , Adenocarcinoma/patologia , Neoplasias Colorretais/patologia , Neoplasias Gengivais/patologia , Células HT29 , Humanos , Metástase Neoplásica , Inibidor Secretado de Peptidases Leucocitárias/genéticaRESUMO
The dental follicle is an ectomesenchymal tissue surrounding the developing tooth germ. Human dental follicle cells (hDFCs) have the capacity to commit to differentiation into multiple cell types. Here we investigated the capacity of hDFCs to differentiate into neural cells and the efficiency of a two-step strategy involving floating neurosphere-like bodies for neural differentiation. Undifferentiated hDFCs showed a spindle-like morphology and were positive for neural markers such as nestin, ß-III-tubulin, and S100ß. The cellular morphology of several cells was neuronal-like including branched dendrite-like processes and neurites. Next, hDFCs were used for neurosphere formation in serum-free medium containing basic fibroblast growth factor, epidermal growth factor, and B27 supplement. The number of cells with neuronal-like morphology and that were strongly positive for neural markers increased with sphere formation. Gene expression of neural markers also increased in hDFCs with sphere formation. Next, gene expression of neural markers was examined in hDFCs during neuronal differentiation after sphere formation. Expression of Musashi-1 and Musashi-2, MAP2, GFAP, MBP, and SOX10 was upregulated in hDFCs undergoing neuronal differentiation via neurospheres, whereas expression of nestin and ß-III-tubulin was downregulated. In conclusion, hDFCs may be another optimal source of neural/glial cells for cell-based therapies to treat neurological diseases.
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The aim of this study was to characterize the clinical and diagnostic features of mucous membrane pemphigoid (MMP). Five MMP patients were evaluated, and biopsies were obtained for routine histopathology and direct immunofluorescence. Circulating autoantibodies were verified by indirect immunofluorescence. Circulating immunoglobulin G autoantibody specific for 180 kDa bullous pemphigoid antigen (BP180) was evaluated by enzyme-linked immunosorbent assay (ELISA). All 5 patients complained of erythematous gingiva. Two patients had extraoral lesions involving the nasal mucosa, eyes, and skin. Histopathological confirmation was established for 4 of the patients, while direct immunofluorescence findings were positive in all 5. Although circulating autoantibodies were not identified by indirect immunofluorescence, the BP180 ELISA was positive in 3 cases. Both histopathological and direct immunofluorescence examinations are essential to establish a definitive diagnosis. Identification of circulating BP180 specific autoantibody shows promise.
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Doenças da Boca/diagnóstico , Penfigoide Mucomembranoso Benigno/diagnóstico , Idoso , Autoanticorpos/sangue , Autoantígenos/análise , Proteínas de Transporte , Proteínas do Citoesqueleto , Distonina , Eritema/diagnóstico , Feminino , Técnica Direta de Fluorescência para Anticorpo , Técnica Indireta de Fluorescência para Anticorpo , Doenças da Gengiva/diagnóstico , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Doenças da Boca/patologia , Proteínas do Tecido Nervoso , Colágenos não Fibrilares , Penfigoide Mucomembranoso Benigno/patologia , Colágeno Tipo XVIIRESUMO
Secretory leukocyte protease inhibitor (SLPI) is a serine protease inhibitor that diminishes tissue destruction during inflammation. A recent report revealed high levels of SLPI expression in the oral carcinoma cell. In addition, overexpression of SLPI up-regulates metastasis in lung carcinoma cells. On the other hand, matrix metalloproteinases (MMPs) are proteinases that participate in extracellular matrix degradation. SLPI and MMPs are involved as accelerators of the tumor invasion process; however, their exact roles are not fully understood. Understanding the mechanism of tumor invasion requires models that take the effect of microenvironmental factors into account. In one such in vitro model, different carcinoma cells have been shown to invade myoma tissue in highly distinct patterns. We have used this myoma model, as it provides a more natural stroma-like environment, to investigate the role of SLPI in tumor invasion. Our results indicate that the model provides a relevant matrix for tumor invasion studies, and that SLPI is important for the invasion of oral carcinoma Ca9-22 cells in conjunction with MMPs. Furthermore, using bioinformatics analysis, we have identified candidates as key molecules involved in SLPI-mediated tumor invasion.
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Movimento Celular , Perfilação da Expressão Gênica , Leiomioma/enzimologia , Neoplasias Bucais/enzimologia , Inibidor Secretado de Peptidases Leucocitárias/metabolismo , Neoplasias Uterinas/enzimologia , Linhagem Celular Tumoral , Técnicas de Cocultura , Biologia Computacional , Bases de Dados Genéticas , Feminino , Perfilação da Expressão Gênica/métodos , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Leiomioma/patologia , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Neoplasias Bucais/genética , Neoplasias Bucais/patologia , Invasividade Neoplásica , Análise de Sequência com Séries de Oligonucleotídeos , Inibidor Secretado de Peptidases Leucocitárias/genética , Transdução de Sinais , Fatores de Tempo , Técnicas de Cultura de Tecidos , Transfecção , Microambiente Tumoral , Neoplasias Uterinas/patologiaRESUMO
BACKGROUND: Pemphigus vulgaris (PV) is an autoimmune disease characterized by acantholysis in the epithelium. PV is often difficult to diagnose in the early stages, since the oral lesions are relatively nonspecific. We report on a case with a favorable outcome due to early diagnosis and effective treatment of oral lesions. METHODS: A 53-year-old Japanese woman presented with a month-long history of painful gingiva. PV was diagnosed using clinical, histopathological, and direct immunofluorescence criteria 1 month after the first visit. Evaluation of the circulating autoantibody titers to desmoglein (Dsg)1 and Dsg3 was conducted by enzyme-linked immunosorbent assay (ELISA). Occlusive steroid therapy (OST) using a topical corticosteroid (0.1% triamcinolone acetonide) was provided for 8 weeks. After OST was completed, a buccal frenectomy was performed to eliminate localized toothbrushing trauma. RESULTS: There were no adverse effects on wound healing after the procedure. No oral PV lesions were detectable at the 9-month reevaluation, and the patient remains in complete remission. The Dsg1 ELISA was negative while the Dsg3 ELISA was indeterminate at the first visit. The Dsg1 ELISA was also negative at reevaluation, but Dsg3 ELISA reactivity had increased 9 months after completion of treatment. CONCLUSION: Large scale clinical trials will be required to validate the clinical benefits of the OST treatment regimen, and further research is necessary to determine the importance of ELISA antibody examination in long-term management of oral PV.
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Doenças da Gengiva/patologia , Pênfigo/patologia , Corticosteroides/uso terapêutico , Caderinas/análise , Proteínas do Citoesqueleto/análise , Desmogleína 1 , Desmogleína 3 , Desmogleínas , Desmoplaquinas , Ensaio de Imunoadsorção Enzimática , Feminino , Doenças da Gengiva/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Pênfigo/tratamento farmacológicoRESUMO
OBJECTIVE: To examine the frequency of apoptosis in oral leukoplakia and its relationship with pathological parameters, including Ki-67 expression, and with the expression of p53, Bcl-2 and Bax proteins. MATERIAL AND MEHODS: Clinical, histopathological and immunohistochemical studies were carried out and the terminal deoxynucleotide transferase-mediated dUTP nick-end labeling method was used to verify the apoptosis and its mechanism of genetic control of the development, progression and promotion of lesions. The material consisted of five normal mucosal epithelia. six leukoplakias without malignant transformation and seven leukoplakias with malignant transformation. Based on counts of 10 fields at a magnification of x 400, mitotic, apoptotic and Ki-67 indices were calculated, and p53, Bcl-2 and Bax expressions were recorded. RESULTS: The peak of the mitotic and Ki-67 indices and p53 expression shifted basally, possibly as a result of malignant transformation, whilst the peak of apoptosis and the expression of apoptotic-related proteins in oral leukoplakia showed no transformation. CONCLUSION: The frequent expression of Bcl-2 in oral leukoplakia with malignant transformation combined with the reduction in the number of apoptotic cells indicated that malignancy occurred as a result of the avoidance of apoptosis. In addition, high levels of Bax expression in oral leukoplakia without malignant transformation indicated that the Bcl family may play a role in the progression of the disease.
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Transformação Celular Neoplásica/metabolismo , Transformação Celular Neoplásica/patologia , Leucoplasia Oral/metabolismo , Leucoplasia Oral/patologia , Proteínas Proto-Oncogênicas c-bcl-2 , Idoso , Idoso de 80 Anos ou mais , Apoptose/fisiologia , Divisão Celular/fisiologia , Transformação Celular Neoplásica/genética , Feminino , Genes bcl-2/fisiologia , Humanos , Marcação In Situ das Extremidades Cortadas , Antígeno Ki-67/biossíntese , Leucoplasia Oral/genética , Masculino , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas/biossíntese , Proteína Supressora de Tumor p53/biossíntese , Proteína X Associada a bcl-2RESUMO
BACKGROUND: Desquamative gingivitis (DG) is a clinical manifestation common to several diseases. It is known that most cases of DG are caused by mucous membrane pemphigoid (MMP), oral lichen planus (OLP), or pemphigus vulgaris (PV). Early recognition and treatment of these diseases can improve the prognosis, but diagnostic delays are common in patients with DG because obtaining a diagnostic biopsy is technically challenging. A biopsy technique designed to maintain the gingival epithelium for patients with DG was developed. The usefulness of this technique is discussed. METHODS: This study is based on a retrospective review of 27 DG cases. A stab-and-roll technique was used to obtain gingival tissue. This technique is designed to reduce lateral forces on the epithelium during the procedure and to thereby prevent the inadvertent removal of the epithelium from the biopsy specimen. A total of 52 biopsies comprising 27 for hematoxylin and eosin (H&E)-stained samples and 25 for direct immunofluorescence (DIF) testing were reviewed. RESULTS: Fifty-one of the 52 biopsies (98.1%) maintained the epithelium. Only one biopsy (1.9%) showed that the epithelium was totally absent. Therefore, H&E and DIF features of 51 biopsies were analyzed. Definitive diagnoses of the diseases causing DG included MMP (13 cases), PV (eight cases), and OLP (six cases). CONCLUSIONS: A diagnostic biopsy was obtained from the gingiva of patients with DG using the stab-and-roll technique. The gingival epithelium was well maintained, and the relationship with the underlying connective tissue was diagnostic. In the future, this stab-and-roll biopsy technique may facilitate early diagnosis and treatment of diseases causing DG.
Assuntos
Biópsia/métodos , Gengiva/patologia , Gengivite/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia/instrumentação , Corantes , Complemento C3/análise , Epitélio/patologia , Feminino , Fibrinogênio/análise , Técnica Direta de Fluorescência para Anticorpo/métodos , Corantes Fluorescentes , Seguimentos , Humanos , Imunoglobulina A/análise , Imunoglobulina G/análise , Líquen Plano Bucal/patologia , Masculino , Pessoa de Meia-Idade , Penfigoide Mucomembranoso Benigno/patologia , Pênfigo/patologia , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVES: To examine the histopathological characteristics of inflammatory lesions containing Actinomyces based on DNA sequencing. Furthermore, case reports of actinomycosis in the maxillofacial region are summarized by a review of the literature. STUDY DESIGN: The study comprised 12 cases of inflammatory lesions containing Actinomyces as diagnosed by DNA analysis. The average age of the subjects was 59 ± 15 years (6 males; 6 females). RESULTS: The distribution of causative bacteria was: Actinomyces israelii in 9 cases, Actinomyces gerencseriae in 2 cases, and Actinomyces naeslundii in 1 case. Four cases diagnosed by DNA sequencing were positive for "Druse," a known morphological diagnostic characteristic of actinomycosis, and 8 cases lacked typical colony formation. CONCLUSIONS: DNA analysis using paraffin-embedded samples is effective for both early and accurate diagnosis of oral lesions containing Actinomyces.
Assuntos
Actinomyces/genética , Actinomicose/microbiologia , Genes de RNAr , Boca/microbiologia , RNA Ribossômico 16S/análise , Actinomyces/classificação , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca/patologia , Reação em Cadeia da Polimerase , Análise de Sequência de DNARESUMO
Pemphigus Vulgaris (PV) is an autoimmune intraepithelial blistering disease involving the skin and mucous membranes. Oral mucosa is frequently affected in patients with PV, and oral lesions may be the first sign of the disease in majority of patients. In some patients, oral lesions may also be followed by skin involvement. Therefore, timely recognition and therapy of oral lesions is critical as it may prevent skin involvement. Early oral lesions of PV are, however, often regarded as difficult to diagnose, since the initial oral lesions may be relatively nonspecific, manifesting as superficial erosions or ulcerations, and rarely presenting with the formation of intact bullae. Lesions may occur anywhere on the oral mucosa including gingiva; however; desquamtive gingivitis is less common with PV than other mucocutaneous conditions such as pemphigoid or lichen planus. This paper describes the case of a patient presenting with a one-year history of painful gingival, who is finally diagnosed as having PV.