RESUMO
Granulocyte macrophage colony stimulating factor (GM-CSF) is generally recognized as an inflammatory cytokine. Its inflammatory activity is primarily due its role as a growth and differentiation factor for granulocyte and macrophage populations. In this capacity, among other clinical applications, it has been used to bolster anti-tumor immune responses. GM-CSF-mediated inflammation has also been implicated in certain types of autoimmune diseases, including rheumatoid arthritis and multiple sclerosis. Thus, agents that can block GM-CSF or its receptor have been used as anti-inflammatory therapies. However, a review of literature reveals that in many situations GM-CSF can act as an anti-inflammatory/regulatory cytokine. We and others have shown that GM-CSF can modulate dendritic cell differentiation to render them "tolerogenic," which, in turn, can increase regulatory T-cell numbers and function. Therefore, the pro-inflammatory and regulatory effects of GM-CSF appear to depend on the dose and the presence of other relevant cytokines in the context of an immune response. A thorough understanding of the various immunomodulatory effects of GM-CSF will facilitate more appropriate use and thus further enhance its clinical utility.
Assuntos
Citocinas/fisiologia , Fator Estimulador de Colônias de Granulócitos e Macrófagos/fisiologia , Mediadores da Inflamação/fisiologia , Animais , Anti-Inflamatórios/metabolismo , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Autoimunidade , Citocinas/farmacologia , Citocinas/uso terapêutico , Avaliação Pré-Clínica de Medicamentos , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Humanos , Tolerância Imunológica , Imunossupressores/metabolismo , Imunossupressores/farmacologia , Imunossupressores/uso terapêutico , Imunoterapia , Inflamação/tratamento farmacológico , Inflamação/genética , Inflamação/metabolismo , Mediadores da Inflamação/farmacologia , Mediadores da Inflamação/uso terapêuticoRESUMO
When dealing with a pregnant patient, the dental practitioner should keep in mind the various physiological changes that occur in the pregnant female and the potential effects on the fetus in using various types of local anesthesia. This article reviews the current considerations in the use of local anesthesia in the pregnant dental patient, and the safety of local anesthetics, their dosage, and any adverse effect on mother and fetus. It also discusses various dental procedures and the trimester during which they can be performed. Lastly, this article talks about the complications that can occur with a pregnant dental patient in the dental chair.
Assuntos
Anestesia Dentária , Anestesia Local , Assistência Odontológica , Gravidez/fisiologia , Emergências , Feminino , Gengivite , Humanos , Guias de Prática Clínica como Assunto , Gravidez/sangue , Gravidez/psicologia , Complicações na Gravidez , Fatores de RiscoRESUMO
Dental caries is seen frequently in patients diagnosed with dry mouth. Nutritional counseling is important for the effective management of dry mouth and to arrest dental caries. With early intervention and proper individualized care, patients with dry mouth should be able to lead full, comfortable lives.
Assuntos
Cárie Dentária/prevenção & controle , Dieta , Xerostomia/complicações , Cariogênicos/efeitos adversos , Aconselhamento , Deglutição/fisiologia , Carboidratos da Dieta/efeitos adversos , Comportamento Alimentar , Humanos , Mastigação/fisiologia , Terapia Nutricional , Valor Nutritivo , Fatores de Risco , Saliva/fisiologia , Xerostomia/fisiopatologiaRESUMO
To determine whether omega-3 (n-3) increases saliva production in patients with Sjögren's syndrome, 61 patients with Sjögren's received either wheat germ oil (n = 23) or n-3 supplement (TheraTears Nutrition®) (n = 38) in a prospective, randomized, double-masked trial. The outcomes assessed were salivary secretion and markers for oral inflammation. The differences between the n-3 group and wheat germ oil group were not statistically significant for either unstimulated (US) or stimulated (SS) salivary secretion (p= 0.38 and p= 0.346, respectively) nor for the number of sites with probing depth (PD) ≥ 4 mm (p= 0.834). In this pilot study, supplementation with n-3 was not found to be significantly better than wheat germ oil in stimulating saliva production in patients with Sjögren's syndrome.