BRAFV600E mutation in the diagnosis of unicystic ameloblastoma.

BACKGROUND: Unicystic ameloblastoma, an odontogenic neoplasm, presents clinical and radiographic similarities with dentigerous and radicular cysts, non-neoplastic lesions. It is not always possible to reach a final diagnosis with the incisional biopsy, leading to inappropriate treatment. The BRAFV600E activating mutation has been reported in a high proportion of ameloblastomas. The purpose of the study was to assess the utility of the detection of the BRAFV600E mutation in the differential diagnosis of unicystic ameloblastoma with dentigerous and radicular cysts. METHODS: Twenty-six archival samples were included, comprising eight unicystic ameloblastomas (UAs), nine dentigerous and nine radicular cysts. The mutation was assessed in all samples by anti-BRAFV600E (clone VE1) immunohistochemistry (IHC) and by TaqMan mutation detection qPCR assay. Sanger sequencing was further carried out when samples showed conflicting results in the IHC and qPCR. RESULTS: Although all UAs (8/8) showed positive uniform BRAFV600E staining along the epithelial lining length, the mutation was not confirmed by qPCR and Sanger sequencing in three samples. Positive staining for the BRAFV600E protein was observed in one dentigerous cyst, but it was not confirmed by the molecular methods. Furthermore, 2/9 dentigerous cysts and 2/9 radicular cysts showed non-specific immunostaining of the epithelium or plasma cells. None of the dentigerous or radicular cysts cases presented the BRAFV600E mutation in the qPCR assay. CONCLUSIONS: The BRAFV600E antibody (clone VE1) IHC may show non-specific staining, but molecular assays may be useful for the diagnosis of unicystic ameloblastoma, in conjunction with clinical, radiological and histopathological features.

Metalloproteinases 2 and 9 Immunoexpression in Periapical Lesions from Primary Endodontic Infection: Possible Relationship with the Histopathological Diagnosis and the Presence of Pain.

INTRODUCTION: The aim of this study was to evaluate the possible associations among the histopathological diagnosis, the inflammatory infiltrate profile, the presence of pain, and the immunoexpression of matrix metalloproteinases MMP-2 and MMP-9 in periapical lesions from primary endodontic infection. METHODS: Fifty-one primary periapical lesions obtained from extracted teeth were selected for this study. Patients were previously evaluated for the presence of pain and sinus tract related to the tooth to be extracted. Tissues were processed for microscopic examination and MMP-2 and MMP-9 immunoexpression. Microscopically, samples were classified as periapical granulomas or periapical cysts and the inflammatory infiltrate as chronic or mixed. The percentage of immunopositive cells for MMP-2 and MMP-9 of each case was performed based on 10 consecutive microscopic fields. The Student t or chi-square tests were used in the statistical analysis. RESULTS: Of the total, 28 cases were classified as periapical granulomas (54.90%) and 23 cases as periapical cysts (45.10%). Seventeen patients (33.33%) reported pain associated with the extracted tooth, with 12 cases of periapical granulomas (70.58%) and 5 cases of periapical cysts (29.42%). All cases showed immunopositivity for MMP-2 and MMP-9 in a high percentage of cells, mainly in the cytoplasm of the leukocytes. MMP-2 was expressed more in periapical granulomas than periapical cysts (P < .05) and in symptomatic cases (P < .05). CONCLUSIONS: According to the results, we may conclude that MMP-2 and MMP-9 are highly expressed in periapical lesions from a primary endodontic infection. Moreover, we may suggest MMP-2 is expressed more in periapical granuloma and in cases associated with pain.

Gene-expression analysis of matrix metalloproteinases 1 and 2 and their tissue inhibitors in chronic periapical inflammatory lesions.

BACKGROUND: Periapical inflammatory lesions have been investigated previously, but understanding of pathogenesis of these lesions (granulomas and radicular cysts) at the molecular level is still questionable. Matrix metalloproteinases (MMPs) are enzymes involved in the development of periapical pathology, specifically inflammation and tissue destruction. To elucidate pathogenesis of periapical granulomas and radicular cysts, we undertook a detailed analysis of gene expression of MMP-1, MMP-2 and their tissue inhibitors, TIMP-1 and TIMP-2. METHODS: A total of 149 samples were analyzed using real-time PCR (59 radicular cysts, 50 periapical granulomas and 40 healthy gingiva samples as controls) for expression of MMP-1, MMP-2, TIMP-1 and TIMP-2 genes. The determination of best reference gene for expression analysis of periapical lesions was done using a panel of 12 genes. RESULTS: We have shown that ß-actin and GAPDH are not the most stable reference controls for gene expression analysis of inflammatory periapical tissues and healthy gingiva. The most suitable reference gene was determined to be SDHA (a succinate dehydrogenase complex, subunit A, flavoprotein [Fp]). We found that granulomas (n = 50) and radicular cysts (n = 59) exhibited significantly higher expression of all four examined genes, MMP-1, MMP-2, TIMP-1, and TIMP-2, when compared to healthy gingiva (n = 40; P < 0.05). CONCLUSION: This study has confirmed that the expression of MMP-1, MMP-2, TIMP-1, and TIMP-2 genes is important for the pathogenesis of periapical inflammatory lesions. Since the abovementioned markers were not differentially expressed in periapical granulomas and radicular cysts, the challenge of finding the genetic differences between the two lesions still remains.

Comparative analysis of the immunohistochemical expression of vascular endothelial growth factor and matrix metalloproteinase-9 in keratocystic odontogenic tumor, dentigerous cyst and radicular cyst.

BACKGROUND: Vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) have been implicated in the pathogenesis of cysts. Both these factors seem to be interrelated to each other. The importance of the MMPs in the induction of the angiogenic process has recently been described. MMPs, which are produced by microvascular endothelial cells, break down the extracellular matrix. This is one of the earliest and sustained events in the process of new capillary formation. Thus, we studied the expression of VEGF and MMP-9 in Keratocystic odontogenic tumors (KCOTs), dentigerous cysts (DCs) and radicular cysts (RCs). MATERIALS AND METHODS: Ten cases each of KCOTs, DCs and RCs and were included in the study and immunohistochemistry was performed using anti-VEGF and anti-MMP-9 antibody using standard protocol. RESULT: When the data of positive cells in the epithelium of KCOTs was compared with DCs and RCs, it showed highly significant results (P<0.05). Furthermore, the expression of VEGF and MMP-9 in the stroma of KCOTs showed a significant result when compared to DCs and RCs. The expression of VEGF in inflammatory cells was more in RCs when compared to DCs. Also, the expression of MMP-9 was more in RCs and DCs as compared to KCOTs. CONCLUSION: Higher expression of VEGF and MMP-9 in KCOTs could be responsible for the aggressive behavior of this cyst that is currently considered a cystic tumor rather than a developmental cyst.

Immunoexpression of tryptase-positive mast cells in periapical granulomas and radicular cysts.

AIM: To evaluate and compare the immunoexpression of tryptase in samples of periapical granulomas (PGs) and radicular cysts (RCs) correlating it with the type of lesion, localization, intensity of the inflammatory infiltrate and thickness of the cystic epithelial lining, in order to gain insight into the phlogistic role of these cells in the lesions studied. METHODOLOGY: Twenty-five PGs and twenty-five RCs obtained from human teeth without endodontic treatment were submitted to morphological and immunohistochemical analysis using anti-tryptase antibody. Mast cells were identified and counted in three regions: intra-epithelial, central/superficial and deep portions. The data were analysed using the Mann-Whitney U-test (P < 0.05). RESULTS: In comparison with RCs, PGs exhibited higher immunoexpression of tryptase-positive mast cells located in both central/superficial and deep regions (P < 0.001 and P < 0.001, respectively). When considering the total number of mast cells and disregarding the location, the number of tryptase-positive mast cells increased gradually from RCs to PGs (P < 0.001). Lesions with inflammatory infiltrate grade III had greater number of tryptase-positive mast cells located in both central/superficial and deep regions than lesions with inflammatory infiltrates grade II (P = 0.045 and P = 0.025). When the location was ignored, the lesions with inflammatory infiltrate grade III also exhibited higher immunostaining of tryptase-positive mast cells (P = 0.01). CONCLUSIONS: Tryptase-positive mast cells were present in chronic periapical lesions in a larger number in periapical granulomas than in radicular cysts, in both central/superficial and deep regions.

Collagenase-3 expression in periapical lesions: an immunohistochemical study.

Collagenase-3 (matrix metalloproteinase-13) is a metalloproteinase (MMP) that is associated with bone lesions and exhibits variable expression patterns in odontogenic cysts; it may play a role in regulating focal proliferation and maturation of jaw cyst epithelium. We studied the localization, staining intensity and distribution of collagenase-3 in 13 periapical granulomas with epithelium, 16 periapical granulomas without epithelium and 10 radicular cysts using archived formalin fixed, paraffin embedded tissues. A monoclonal antibody against human collagenase-3 was used to evaluate its expression. Immunohistochemical staining intensities of collagenase-3 in all periapical lesions were (-), 4 (10%); (+), 1 (3%); (++), 22 (56%) and (+++), 12 (31%); differences were not statistically significant. Immunohistochemical distribution of collagenase-3 in epithelial cells was (-), 17 (44%); (+), 17 (44%); (++), 5 (13%); in fibroblasts it was (-), 8 (20%); (+), 23 (59%); (++), 8 (21%); in plasma cells it was (-), 7 (18%); (+), 22 (56%); (++), 10 (26%); in macrophages it was (-), 7 (18%); (+), and 15 (38%); and (++), 17 (44%). Statistically significant differences were found in epithelial cells (p = 0.00) and fibroblasts (p = 0.02), whereas differences were not statistically significant for plasma cells and macrophages. Collagenase-3 may play a role in the conversion of a periapical granuloma with epithelium to radicular cyst. MMP's influence not only epithelial rest cell migration, but also invasion of various stromal cells into granulomatous tissue.

Heparanase expression in periapical granulomas and radicular cysts.

Heparanase is an endo-ß-D-glucuronidase enzyme which degrades heparan sulfate glycosaminoglycan side chains of proteoglycans in the extracellular matrix and in basement membranes. The aim of this study was to evaluate the expression of heparanase in periapical granulomas (PGs) and radicular cysts (RCs). Immunohistochemistry was used to assess heparanase expression in PGs and RCs. Parameters including stain intensity, location and cell type were used to characterize heparanase expression in the periapical lesions. Ordered categories (from weak to strong) were used to compare the level of heparanase staining in the PG and RC groups. Both epithelial cells and inflammatory cells were positive for heparanase. The relative staining of the epithelial cells was strong, whereas the relative staining of the inflammatory cells was weak. Significant differences in immunohistochemical staining of epithelial cells were observed between RCs and PGs (p = 0.002). The relative expression of heparanase in epithelial cells in RCs was strong. In PGs, lesions with few or no epithelial cells, heparanase was predominantly expressed weakly by inflammatory cells. PGs and RCs have the same infectious origin. Therefore, the different cellular sources of heparanase in these periapical lesions may imply that this enzyme has specific pathogenetic functions in RCs and PGs.

Comparative analysis of the immunohistochemical expression of collagen IV, MMP-9, and TIMP-2 in odontogenic cysts and tumors.

OBJECTIVE: The aim of this study was to evaluate the immunohistochemical expression of collagen IV, matrix metalloproteinase (MMP) 9 and tissue inhibitor of MMP (TIMP) 2 in dentigerous cysts (DCs), radicular cysts (RCs), keratocystic odontogenic tumors (KOTs), and ameloblastomas. STUDY DESIGN: Twenty cases of DCs, 20 RCs, 20 KOTs, and 20 ameloblastomas were selected and analyzed by immunohistochemistry. RESULTS: Most DCs and RCs showed continuous and >50% staining for collagen IV in the basement membrane of the epithelium, whereas predominantly discontinuous thin and ≤ 50% staining was observed in KOTs and ameloblastomas, with a significant difference in staining percentage (P < .001). MMP-9 was diffusely distributed and localized in both epithelial and mesenchymal cells of all of the lesions analyzed. The staining percentage was higher in the epithelium (P = .058) and mesenchyme (P = .005) of KOTs and ameloblastomas. Moreover, the distribution pattern, location, and percentage of expression of TIMP-2 were similar in the lesions studied, except for ameloblastoma, with a significant difference in staining percentage (P < .001). CONCLUSION: These results demonstrate that the interaction between collagen IV, MMP-9, and TIMP-2 is an important factor for the establishment of differences in the biologic behavior of the odontogenic cysts and tumors studied.

High matrix metalloproteinase activity is a hallmark of periapical granulomas.

INTRODUCTION: The inability to distinguish periapical cysts from granulomas before performing root canal treatment leads to uncertainty in treatment outcomes because cysts have lower healing rates. Searching for differential expression of molecules within cysts or granulomas could provide information with regard to the identity of the lesion or suggest mechanistic differences that may form the basis for future therapeutic intervention. Thus, we investigated whether granulomas and cysts exhibit differential expression of extracellular matrix (ECM) molecules. METHODS: Human periapical granulomas, periapical cysts, and healthy periodontal ligament tissues were used to investigate the differential expression of ECM molecules by microarray analysis. Because matrix metalloproteinases (MMP) showed the highest differential expression in the microarray analysis, MMPs were further examined by in situ zymography and immunohistochemistry. Data were analyzed by using one-way analysis of variance followed by the Tukey test. RESULTS: We observed that cysts and granulomas differentially expressed several ECM molecules, especially those from the MMP family. Compared with cysts, granulomas exhibited higher MMP enzymatic activity in areas stained for MMP-9. These areas were composed of polymorphonuclear cells (PMNs) in contrast to cysts. Similarly, MMP-13 was expressed by a greater number of cells in granulomas compared with cysts. CONCLUSION: Our findings indicate that high enzymatic MMP activity in PMNs together with MMP-9 and MMP-13 stained cells could be a molecular signature of granulomas unlike periapical cysts.

Collagenase-3 (MMP-13) is expressed in periapical lesions: an immunohistochemical study.

AIM: To determine whether or not matrix metalloproteinase 13 (MMP-13) is present in periapical granulomas with and without epithelium. METHODOLOGY: Seventeen open periapical granulomas of pulpal origin (seven lesions without epithelium and 10 with proliferating epithelium) were fixed in formalin and then embedded in paraffin prior to being processed for immunohistochemical analysis. A monoclonal antibody against human MMP-13 was used to evaluate MMP-13 expression. Immunocomplexes were subsequently treated with the secondary antibody and then detected by means of streptavidin peroxidase. Immunoreactivity was visualized by development with 3,3'-diaminobenzidine. RESULTS: An immunopositive cytoplasmatic reaction for MMP-13 was observed in all the specimens, although the immunostaining by anti-MMP-13 antibody was heterogeneous and its levels varied according to histopathological findings. In periapical lesions without epithelium MMP-13 immunolabelling was detected in a few fibroblast-like cells, and in some plasma cells within the granulomatous tissue. A clear upregulation of MMP-13 expression was detected in periapical lesions with epithelium, especially in small island and thin strands of epithelium. CONCLUSIONS: The expression pattern of MMP-13 demonstrates that it is involved in the conversion of a periapical granuloma with epithelium into a radicular cyst. This property is related to the ability of MMP-13 to influence not only the migration of epithelial cell but also the invasion of granulomatous tissue.

Immunohistochemical localization of cyclooxygenase-2 in radicular cysts.

AIM: The purpose of this study was to investigate the expression of cyclooxygenase-2 (COX-2) in radicular cysts. METHODOLOGY: Thirty biopsy specimens of radicular cysts were examined using immunohistochemistry. A peroxidase-labelled streptavidin-biotin technique was used for identification of the COX-2. Fisher's exact test (two-tail) was used for statistical analysis of the results. RESULTS: The result demonstrated that COX-2 expression was significantly higher in radicular cysts with higher levels of inflammatory infiltrates. COX-2 stain was detected in the lining epithelium, subepithelial fibroblasts, macrophages and endothelial cells in all specimens. CONCLUSIONS: COX-2 expression is significantly higher in radicular cysts. COX-2 may play an important role in the pathogenesis of radicular cysts.

Interleukin-1alpha-dependent regulation of matrix metalloproteinase-9(MMP-9) secretion and activation in the epithelial cells of odontogenic jaw cysts.

Interleukin-1alpha (IL-1alpha) and matrix metalloproteinase-9 (MMP-9) are thought to be involved in odontogenic cyst expansion. In this study, we investigated the effects of IL-1alpha on the secretion and activation of MMP-9 in odontogenic jaw cysts. An active form of MMP-9 was present in odontogenic keratocyst (6 of 8 cases) fluids more frequently than dentigerous cyst (3 of 10 cases) and radicular cyst (3 of 10 cases) fluids, although proMMP-9 was present in all cyst fluids. Odontogenic keratocyst fragments in explant culture secreted a larger amount of IL-1alpha than dentigerous cyst and radicular cyst fragments in explant culture, and spontaneously secreted both proMMP-9 and an active form of MMP-9. The fragments of dentigerous cysts and radicular cysts secreted a small amount of proMMP-9, but no active form of MMP-9. Exogenously added recombinant human IL-1alpha (rhlL-1alpha) increased the secretion and activation of proMMP-9 in the fragments of dentigerous cysts and radicular cysts. The epithelial cells isolated from odontogenic keratocysts secreted IL-1alpha and proMMP-9 without stimulation. Under the cultivation on a fibronectin-coated dish, rhIL-1alpha increased the secretion of proMMP-9 from the epithelial cells in a dose-dependent manner. Moreover, rhIL-1alpha induced the secretion of proMMP-3 and plasminogen activator urokinase (u-PA) from the epithelial cells, and converted the secreted proMMP-3 to the active form in the presence of plasminogen. The secreted proMMP-9 was also activated in the presence of rhIL-1alpha and plasminogen. Hence, our results suggest that IL-1alpha may up-regulate not only proMMP-9 secretion but also proMMP-9 activation by inducing proMMP-3 and u-PA production in the cyst epithelial cells by autocrine/paracrine regulatory mechanisms.

Inducible nitric oxide synthase activity by interferon-gamma-producing cells in human radicular cysts.

AIM: In this study, the interaction of interferon-gamma-(IFN-gamma) and inducible nitric oxide synthase (iNOS)-producing cells in human radicular cysts were investigated. METHODOLOGY: Inflamed periapical tissues were obtained from patients at the time of endodontic surgical treatments and were cut into two pieces. After fixing with acetone or 4% paraformaldehyde in phosphate-buffered saline, 5-m-thick paraffin and cryostat sections were prepared. The paraffin sections of the inflamed tissues were evaluated histologically with haematoxylineosin stains. The specimens diagnosed as radicular cysts were then examined by immunostaining. Immunohistochemistry for iNOS and fluoresence microscopy for IFN-gamma using the cryostat sections were performed with a mixture of affinity purified human iNOS antiserum and human IFN-gamma monoclonal antibodies. RESULTS: The results revealed that iNOS-gamma producing cells localized adjacent to IFN-gamma-producing cells. In addition, some of iNOS-producing cells exhibited immunoreactive IFN-gamma. On the other hand, epithelial cells showed significant levels of iNOS production, but not IFN-gamma. CONCLUSIONS: The data would suggest the possibility that iNOS production could be precisely controlled by autocrine or paracrine effects of IFN-gamma producing cells in radicular cysts and might play a pivotal role in periapical lesions. These findings are consistent with a hypothesis suggesting that NO inhibitors could be used through the root canals as a pharmacological treatment for periapical lesions.

Production of human-inducible nitric oxide synthase in radicular cysts.

To examine if nitric oxide (NO) is produced in radicular cysts, NO synthase (NOS) production was analyzed. Periapical tissues were removed from patients at the time of endodontic surgery. Frozen tissue sections were histologically evaluated with hematoxylin-eosin staining. Production of human-inducible NOS (iNOS) in apical cysts was then immunohistochemically examined. Immunoreactive human iNOS was widely distributed in epithelial cells, endothelial cells, fibroblasts, macrophages, or polymorphonuclear leukocytes. Remarkably, iNOS-positive cells were significantly present around blood vessels, and cells residing apart from the blood vessels showed weak or no iNOS production, suggesting that only cells around blood vessels could be stimulated for iNOS synthesis. These data demonstrated the possibility that several, but not all, cells could be stimulated to synthesize iNOS in inflamed tissues. In the presence of iNOS, NO can be produced spontaneously in periapical lesions and may play a crucial role in the regulation of chronic infection.

Mast cell-derived tryptase in odontogenic cysts.

Inflammatory and developmental cysts of the jaws are relatively common bone destructive lesions in the human maxillofacial skeleton but their pathogenesis is still poorly understood. In this study the role of mast cells (MC), and mast cell tryptase in particular, was evaluated in the pathophysiology of bone resorption and jaw cyst formation in different types of cysts. The distribution of MC and the amount of tryptase in histological tissue sections were determined by immunohistochemistry using monoclonal antihuman tryptase antibodies and the results were quantitated by using an image analyzing system. The amount of tryptase was further studied by Western-blotting and measurement of trypsin-like activity from the neutral salt extracts obtained from different types of jaw cysts. In contrast to control tissue, high trypsin-like activities and abundant immunoreactive tryptase were observed in the extracts of all types of cysts studied (radicular, dentigerous and keratocyst). In tissue sections the highest amount of tryptase-positive staining was observed in radicular cysts (mean 6.2% of reference area) and the lowest amount in keratocysts (mean 2.1% of reference area, P < 0.01). MC were found to be located in inflammatory cell-rich tissue areas and just beneath the cyst epithelium. Importantly, MC located at the border of bone were observed to be degranulated, indicating high activity of MC and release of tryptase at the regions of early bone destruction. Based on previous findings addressing the role of mast cell tryptase in proteolytic cascades, and the known association of MC with osteoporosis, we suggest that mast cells and mast cell tryptase may contribute significantly to jaw cyst tissue remodelling during growth of a cyst, and to the destruction of the surrounding bone, resulting in jaw cyst expansion.

In situ determination of different dehydrogenase activity profiles in the linings of odontogenic keratocysts and radicular cysts.

The levels of succinate, lactate, glutamate, glycerophosphate and glucose-6-phosphate dehydrogenases within the linings of keratinizing and non-keratinizing odontogenic cysts were investigated using static end-point and continuously monitored Nitroblue Tetrazolium-based histochemical methods. The use of TV image analysis for quantification of formazan final reaction products was validated by demonstrating significant relationships between the integrated absorbance at 585 nm and the amount of formazan in, and thickness of, gelatin films containing reduced tetrazolium salt (r = 1.0, p < 0.001). Absorbance readings of stained sections gave mean coefficients of variation of 1.8 +/- 0.9% between day of measurement, and of 5.65 +/- 1.32% between serial sections. End-point assays indicated that the linings of odontogenic keratocysts contained higher levels of glucose-6-phosphate dehydrogenases (p < 0.0002) and lower levels of lactate dehydrogenase (p < 0.002) than those of radicular cysts. Succinate, glutamate and glycerophosphate dehydrogenase activities were similar in both cyst types. Results from continuously monitored assays, performed for glucose-6-phosphate and succinate dehydrogenases, demonstrated linear reaction rates over the first 2.75 min of reaction. The calculated enzyme activities from continuous assays were between 1.49 and 3.49 times higher than those determined from end-point assays and confirmed that levels of glucose-6-phosphate dehydrogenase were significantly higher in the linings of odontogenic keratocysts than those of radicular cysts (p < 0.004). By contrast, succinate dehydrogenase activity was significantly higher in radicular cyst linings (p < 0.03). These results highlight the benefits of an approach to in situ determination of enzyme activity using image analysis and continuous monitoring methodologies. Overall, the high level of glucose-6-phosphate dehydrogenase found in keratocyst linings is consistent with their clinical behaviour and higher level of proliferation and synthetic activity whereas the level of lactate dehydrogenase in radicular cysts probably reflects the presence of local tissue damage within these inflammatory lesions.

Characterization of interstitial collagenases in jaw cyst wall.

Neutral salt extracts of 14 specimens of jaw cysts were prepared. Histopathological analysis showed that the specimens consisted of 6 radicular cysts, 6 dentigerous cysts, 1 residual cyst, and 1 odontogenic keratocyst. One periapical granuloma, 1 dental follicle and a sample of clinically healthy oral mucosa were similarly processed and used as controls. Measurement of collagenase activity by monitoring the formation of specific degradation products of type I and II collagen in solution by SDS-PAGE demonstrated that all the cyst extracts contained collagenase, some of which was endogenously activated. Cyst wall collagenase preferably degraded type I over type II collagen, which suggests that the degradation was due to MMP-1 (matrix metalloproteinase-1) rather than the MMP-8 type. This was further supported by the doxycycline-inhibition profile of cyst collagenase, which was similar to that of MMP-1. Part of the cyst wall collagenase was in latent proenzyme form and probably derived, at least in part, from the newly synthesized intracellular collagenase pool. Latent cyst collagenase was efficiently activated with phenylmercuric chloride and to a lesser extent by gold (I) thioglucose and NaOCl. Western-blotting, using specific antibodies against collagenase from human polymorphonuclear neutrophilic leukocytes (MMP-8) and from fibroblasts (MMP-1), revealed a typical 55/45 kDa doublet; also MMP-8 in the latent 80 kDa form and fragmented to 65 kDa active species were found. These results suggest the presence of MMP-1 and, to a lesser extent, MMP-8 type collagenase in the cyst wall.(ABSTRACT TRUNCATED AT 250 WORDS)

[Periapical odontogenic processes of inflammatory origin. Enzyme activity]. / Procesos odontógenos periapicles de origen inflamatorio. Actividad ezimática.

A histoenzymological study was carried out on 40 tissues specimens removed at biopsy and for surgical operations of the following lesions: 5 normal oral mucosa, 5 periapical granulomas, and 30 periapical inflammatory cysts. The purpose of this study was to study some possibly significant variations in levels o activities of oxidative enzymes, and hydrolaxes enzymes. In inflammatory cysts, enzymatic activities were similar to normal epithelium. There was high levels of acid phosphatase LDH and G6PDH activity in the central cells of apical granulomas and in the exfoliating epithelial cells of periapical inflammatory cysts. There were differency in the glycosaminoglicans activity on the different epitelial pattern.

Distribution of factor XIIIa-containing cells and collagenous components in radicular cysts: histochemic and immunohistochemic studies.

The distribution of subunit A of Factor XIII (FXIIIa) and of collagenous components was investigated by the avidin-biotin-peroxidase complex (ABC) method for FXIIIa and by the Sirius red F3BA method, respectively, in 43 cases of radicular cysts. Besides the covering epithelial layer, the radicular cyst wall was composed of the following three layers: an inner granulomatous layer, an outer fibrous connective tissue layer, and an intermediate layer. In each layer, a positive reaction for FXIIIa was observed in certain connective tissue cells. These FXIIIa-containing cells were few in number in the inner layer where collagenous components were also sparse. In the slightly to moderately fibrous intermediate layer, these cells markedly increased in number and were dendritic or stellate in shape. In the outer densely fibrous connective tissue layer, they decreased slightly in number and were slender and spindle-shaped. The results obtained in the present study indicate the close relationship between the distribution of FXIIIa-containing cells and of collagenous components. Such a relationship suggests that these cells play an important role in the process of fibrosis occurring in the radicular cyst wall.

[The levels of alpha-1-antitrypsin in the periapical cyst lesions]. / Periapikal kist lezyonlarinda alfa-1-antitripsin düzeyleri.

Alpha-1-antitrypsin (AAT) is a serum protease inhibitor, with a well established role in bodily defense against destructive inflammatory disease. In order to investigate the role of this protease inhibitor in the periapical lesions, 13 patients were investigated. Serum alpha-1-antitrypsin levels of 13 patients were 871.8 +/- 73.6 mg/dl whereas 296.6 +/- 32.6 mg/dl in the control group. Difference was important between both groups (P less than 0.01). Alpha-1-antitrypsin levels were 40.2 +/- 13.7 mg/dl in the cyst fluid. Although the alpha-1-antitrypsin levels in the patients serum were elevated, it was not found in sufficient levels in the cyst fluid. This results suggest that, the regulation of proteolytic activity afforded by AAT, plays an important role in the pathogenesis of periapical lesions.