Clinical Efficacy of Extracellular Vesicle Therapy in Periodontitis: Reduced Inflammation and Enhanced Regeneration.

Periodontitis, a prevalent inflammatory condition, affects the supporting structures of teeth, leading to significant oral health challenges. Traditional treatments have primarily focused on mechanical debridement, antimicrobial therapy, and surgery, which often fail to restore lost periodontal structures. Emerging as a novel approach in regenerative medicine, extracellular vesicle (EV) therapy, including exosomes, leverages nano-sized vesicles known for facilitating intercellular communication and modulating physiological and pathological processes. This study is a proof-of-concept type that evaluates the clinical efficacy of EV therapy as a non-surgical treatment for stage I-III periodontitis, focusing on its anti-inflammatory and regenerative potential. The research involved seven patients undergoing the therapy, and seven healthy individuals. Clinical parameters, including the plaque index, bleeding on probing, probing depth, and attachment level, were assessed alongside cytokine levels in the gingival crevicular fluid. The study found significant improvements in clinical parameters, and a marked reduction in pro-inflammatory cytokines post-treatment, matching the levels of healthy subjects, underscoring the therapy's ability to not only attenuate inflammation and enhance tissue regeneration, but also highlighting its potential in restoring periodontal health. This investigation illuminates the promising role of EV therapy in periodontal treatment, advocating for a shift towards therapies that halt disease progression and promote structural and functional restoration of periodontal tissues.

Harnessing the Stem Cell Niche in Regenerative Medicine: Innovative Avenue to Combat Neurodegenerative Diseases.

Regenerative medicine harnesses the body's innate capacity for self-repair to restore malfunctioning tissues and organs. Stem cell therapies represent a key regenerative strategy, but to effectively harness their potential necessitates a nuanced understanding of the stem cell niche. This specialized microenvironment regulates critical stem cell behaviors including quiescence, activation, differentiation, and homing. Emerging research reveals that dysfunction within endogenous neural stem cell niches contributes to neurodegenerative pathologies and impedes regeneration. Strategies such as modifying signaling pathways, or epigenetic interventions to restore niche homeostasis and signaling, hold promise for revitalizing neurogenesis and neural repair in diseases like Alzheimer's and Parkinson's. Comparative studies of highly regenerative species provide evolutionary clues into niche-mediated renewal mechanisms. Leveraging endogenous bioelectric cues and crosstalk between gut, brain, and vascular niches further illuminates promising therapeutic opportunities. Emerging techniques like single-cell transcriptomics, organoids, microfluidics, artificial intelligence, in silico modeling, and transdifferentiation will continue to unravel niche complexity. By providing a comprehensive synthesis integrating diverse views on niche components, developmental transitions, and dynamics, this review unveils new layers of complexity integral to niche behavior and function, which unveil novel prospects to modulate niche function and provide revolutionary treatments for neurodegenerative diseases.

Cytokine Dynamics in Autism: Analysis of BMAC Therapy Outcomes.

Autism spectrum disorder (ASD) has recently been linked to neuroinflammation and an aberrant immune response within the central nervous system. The intricate relationship between immune response and ASD remains elusive, with a gap in understanding the connection between specific immune mechanisms and neural manifestations in autism. In this study, we employed a comprehensive statistical approach, fusing both overarching and granular methods to examine the concentration of 16 cytokines in the cerebrospinal fluid (CSF) across each autologous bone marrow aspirate concentrate (BMAC) intrathecal administration in 63 male and 17 female autism patients. Following a six-month period post the third administration, patients were stratified into three categories based on clinical improvement: Group 1- no/mild (28 subjects), Group 2-moderate (16 subjects), and Group 3-major improvement (15 subjects). Our integrated analysis revealed pronounced disparities in CSF cytokine patterns and clinical outcomes in autism subjects pre- and post-BMAC transplantation. Crucially, our results suggest that these cytokine profiles hold promise as predictive markers, pinpointing ASD individuals who might not exhibit notable clinical amelioration post-BMAC therapy.

Potential Impact of Polymorphisms in Toll-like Receptors 2, 3, 4, 7, 9, miR-146a, miR-155, and miR-196a Genes on Osteoarthritis Susceptibility.

Osteoarthritis (OA) is a progressive inflammatory disease of synovial joints and a leading cause of disability among adults. Inflammation-related genes, including genes for Toll-like receptors (TLRs), are tightly controlled by several microRNAs that, in addition to their pivotal role in the epigenetic regulation of target genes, are ligands for TLR activation and downstream signaling. Thus, we evaluated the association between OA risk and genetic variants in TLR2, TLR3, TLR4, TLR7, TLR9, and microRNAs that regulate TLRs signaling miR146a, miR155, and miR196a2. Our study group consisted of 95 surgically treated OA patients and a control group of 104 healthy individuals. Genetic polymorphisms were determined using TaqMan real-time PCR assays (Applied Biosystems). Adjusted logistic regression analysis demonstrated that polymorphisms in TLR4 rs4986790 (OR = 2.964, p = 0.006), TLR4 rs4986791 (OR = 8.766, p = 0.00001), and TLR7 rs385389 (OR = 1.579, p = 0.012) increased OA risk, while miR-196a2 rs11614913 (OR = 0.619, p = 0.034) was significantly associated with decreased OA risk. Our findings indicate that polymorphisms in the TLR4 and TLR7 genes might increase OA risk and suggest a novel association of miR-196a2 polymorphism with decreased OA susceptibility. The modulation of TLRs and miRNAs and their cross-talk might be an attractive target for a personalized approach to OA management.

Stem Cell Homing in Intrathecal Applications and Inspirations for Improvement Paths.

A transplanted stem cell homing is a directed migration from the application site to the targeted tissue. Intrathecal application of stem cells is their direct delivery to cerebrospinal fluid, which defines the homing path from the point of injection to the brain. In the case of neurodegenerative diseases, this application method has the advantage of no blood-brain barrier restriction. However, the homing efficiency still needs improvement and homing mechanisms elucidation. Analysis of current research results on homing mechanisms in the light of intrathecal administration revealed a discrepancy between in vivo and in vitro results and a gap between preclinical and clinical research. Combining the existing research with novel insights from cutting-edge biochips, nano, and other technologies and computational models may bridge this gap faster.

A painful symphony: the presence of overuse syndrome in professional classical musicians / Una sinfonía dolorosa: la presencia del síndrome de uso excesivo en músicos clásicos profesionales

Musculoskeletal problems are common in instrumental musicians. Little is known about the factors that place musicians at risk, and the ways in which musicians can prevent these problems. Overuse syndrome is the most reported diagnosis among instrumental musicians suffering from playing related musculoskeletal injuries. The study group comprised 50 musicians employed in Symphony Orchestra of the Serbian National Theatre of Novi Sad. Out of the 50 musicians, 30 (60 %) are male and 20 (40 %) female. Higher frequencies of the presence of musculoskeletal symptoms were neck, region of trapezius, back, shoulder, wrist, hand and arm. A larger number of musicians (81.8 %) had perception of high demand of the profession. This investigation with professional classical musicians should show the music-medical interest.

Los problemas musculo-esqueléticos son comunes en los músicos instrumentales. Poco se sabe sobre los factores que ponen en riesgo a los músicos y las formas en que los ellos pueden prevenir estos problemas. El síndrome de uso excesivo es el diagnóstico más informado entre los músicos instrumentales que sufren lesiones musculo-esqueléticas relacionadas al uso de instrumentos musicales. El grupo de estudio estuvo compuesto por 50 músicos de la Orquesta Sinfónica del Teatro Nacional Serbio de Novi Sad. De los 50 músicos, 30 (60 %) eran hombres y 20 (40 %) mujeres. La frecuencia más alta de presencia de síntomas musculoesqueléticos se produjo en el cuello, músculo trapecio, espalda, hombro, muñeca, mano y brazo. Un mayor número de músicos (81,8 %) tuvo una percepción de alta demanda de la profesión. Esta investigación con músicos clásicos profesionales debería ser de interés médico-musical.

Prevalence of third coronary artery: variation or constant coronary artery? / Prevalencia de la tercera arteria coronaria: ¿variación o arteria coronaria constante?

Third coronary artery or supernumerary coronary artery is a direct branch from right aortic sinus and it supplies pulmonary conus and upper part of right ventricle. Third coronary artery is an important bridge for collateral circulation between right and left coronary system. The aim of this study was to determine the number of arteries that origin from right aortic sinus, their frequency and position. The study included 55 adult human hearts collected from Department of Anatomy. The hearts were morphologically studied by gross dissection for the prevalence and topographical anatomy of supernumerary coronary arteries. Out of 55 hearts, 26 (47.3 %) had one right coronary artery, 23 (41.8 %) had two right coronary arteries, and 6 (10.9 %) had three coronary arteries. The supernumerary arteries arises from the right aortic sinus. Right supernumerary coronary arteries may be present in about 52.7 % of the Serbian population. Interpretation of signs and symptoms of coronary occlusion should therefore consider possible contribution of this blood vessels.

La tercera arteria coronaria o arteria coronaria supernumeraria es una rama directa del seno aórtico derecho y su ministra el cono pulmonar y la parte superior del ventrículo derecho. La tercera arteria coronaria es importante para la circulación colateral entre el sistema coronario derecho e izquierdo. El objetivo de este estudio fue determinar el número de arterias de origen del seno aórtico derecho, su frecuencia y posición. El estudio incluyó 55 corazones humanos adultos pertenecientes al Departamento de Anatomía. Los corazones se estudiaron morfológicamente mediante disección macroscópica para determinar la prevalencia y la anatomía topográfica de las arterias coronarias supernumerarias. De 55 corazones, 26 (47,3 %) tenían una arteria coronaria derecha, 23 (41,8 %) tenían dos arterias coronarias derechas, y 6 (10,9 %) tenían tres arterias coronarias. Las arterias supernumerarias surgen del seno aórtico derecho. Las arterias coronarias supernumerarias derechas pueden estar presentes en aproximadamente el 52,7 % de la población serbia. La interpretación de los signos y síntomas de la oclusión coronaria debería considerar la posible contribución de estos vasos sanguíneos.

An anatomical study of the lumbar external foraminal ligaments: appearance at MR imaging.

PURPOSE: The purpose of this study was to examine the MRI appearance of the ligaments within the external space of the lumbar intervertebral foramen by correlating MR images with the corresponding anatomic dissection of the cadaver lumbar spine. METHODS: This was a two part study. Part I of the anatomic study consisted of the dissection of lumbar specimens from one embalmed adult male cadaver. At each lumbar level the external ligamentous structures were identified and their origin, insertion and position were determined. Part II of the study consisted of the anatomical analysis of the external transforaminal ligaments in the 180 lumbar intervertebral foramina on the MR images (1.5 T) in the sagittal plane. The diagnostic procedure was performed on 18 individuals from 18 to 25 years of age. RESULTS: The external transforaminal ligaments were observed at all levels and from both sides in the lumbar intervertebral foramen. The presence of the superior corporotransverse ligament was found in 45.56% intervertebral foramina, while the inferior corporotransverse ligament was found in 61.67% intervertebral foramina in the MRI. CONCLUSION: Our results confirm that external transforaminal ligaments are common structures in the intervertebral foramen. The results of this study show that the external transforaminal ligaments can be clearly visualized in MR images. It is crucial to have previous knowledge of the cadaveric specimens to recognize the transforaminal ligaments in MR images. The presence of these ligaments is clinically important because the ligaments could be the cause of nerve root compression or the low back pain syndrome.

Ectopic adrenocortical tissue: an incidental finding during inguinal surgery in children.

Adrenal rests are usually unrecognized during operation, and the incidence of ectopic adrenal cortical tissue in pediatric patients during inguinal surgery procedures is unknown. We performed 3028 groin surgical explorations in 2680 patients aged 1 month to 17 years. Ectopic adrenal tissue was found in 69 inguinal operations (2.2%): 37 during 1.524 orchiopexy (2.4%), 23 during 1.115 herniectomy (2.0%), and 9 during 389 hydrocoela operation (2.3%). Statistically there were no significant differences among those three groups. No adrenal rests were detected in females. Although a few reported cases with hormonal activity of ectopic adrenocortical tissue (EACT), the recommendation is to remove them if found.