Fungal footprints in oral cancer: unveiling the oral mycobiome.

Oral squamous cell carcinoma (OSCC) is the most common type of head and neck cancer, with a high mortality rate. There is growing evidence supporting a link between oral cancer and the microbiome. The microbiome can impact various aspects of cancer, such as pathogenesis, diagnosis, treatment, and prognosis. While there is existing information on bacteria and its connection to oral cancer, the fungi residing in the oral cavity represent a significant component of the microbiome that remains in its early stages of exploration and understanding. Fungi comprise a minuscule part of the human microbiome called the mycobiome. Mycobiome is ubiquitous in the human body but a weakened immune system offers a leeway space for fungi to showcase its virulence. The role of mycobiome as a colonizer, facilitator, or driver of carcinogenesis is still ambiguous. Reactivating the mycobiome that undergoes collateral damage associated with cancer treatment can be watershed event in cancer research. The coordinated, virulent, non-virulent behavior of the fungi once they reach a critical density must be hacked, considering its diagnostic, prognostic and therapeutic implications in cancer. This review highlights the diversity of the mycobiome and its potential role in oral cancer.

A set of thoughts on a series of patients with oral viral papillomas caused by the HPV 6 and 11 viruses: A brief review.

Introduction: Papillomas are associated with human papillomaviruses (HPV) and are commonly benign. Typically, the clinical presentation establishes the diagnosis, and treatment comprises excision and histological analysis. Objective: In light of our series of 39 patients with viral papillomas of the oral mucosa, we would like to express our concerns regarding the treatment of patients diagnosed with HPV 6 and 11-positive oral papillomas. Materials and Methods: The research is based on an analysis of 39 patients with oral papillomas who underwent conventional HPV viral testing. The analysis was conducted utilizing the in situ hybridization method. Patients tested positive for HPV subtypes 2, 4, 6, 11, 16, 18, 31, 33, and 51. More than fifty percent of individuals tested positive for HPV 6 and 11. Conclusion: HPV subtypes have been identified in lesions with comparable clinical presentation. Many of our patients carry the HPV subtypes 6 and 11, which have been associated to sexual transmission. However, more transmission routes are also possible. The ideal treatment for us would be a referral to a Venereologist for a thorough sexually transmitted illness examination.

TOPICAL AGENTS FOR THE PREVENTION AND TREATMENT OF ORAL MUCOSITIS.

OBJECTIVE: The aim: To make a narrative assessment of the agents currently in use, with a particular emphasis on the topical agents that we frequently utilize in our practice. PATIENTS AND METHODS: Materials and methods: The main method of this work is a review of literary sources. We reviewed the literature (PubMed, Google Scholar, Web of Science, Scopus) to support and explain the interventions we use in different cases of oral mucositis patients. We decided to combine our experience with evidence-based data. CONCLUSION: Conclusions: Topical treatments alleviate and prevent oral mucositis. Topical medicines can assist maintain oral balance and moistness by modulating oral bacteria and replacing saliva.

Isolated lip dermatitis (atopic cheilitis), successfully treated with topical tacrolimus 0.03% / Dermatitis labial aislada (queilitis atópica), tratado con éxito con tacrolimus tópico al 0,03%

Background: Exfoliative and erosive cheilitis, may be a source of speech and chewing discomfort, but may alsobe an aesthetic issue for the patients affected. Such a clinical presentation may implicate a variety of inflamma-tory conditions, including atopic (eczematous) cheilitis. Topical and systemic agents, e.g. corticosteroids, havebeen used to treat inflammatory lip conditions. Topical tacrolimus has also been used in some inflammatory lipconditions.Material and Methods: We performed a retrospective clinical analysis of atopic cheilitis patients.Results: Between 2015 and 2020, we addressed 7 (seven) patients with atopic dermatitis affecting only lips andwere diagnosed as atopic-eczematous cheilitis. They were treated with 0.03 per cent topical tacrolimus ointmentand responded completely.Conclusions: These cases represent an underreported atopy / eczema event;-few cases of atopic cheilitis withoutconcomitant dermal lesions appear in the literature. We are also showing and discussing yet another applicationof tacrolimus in a local atopic form of inflammation affecting the lips.(AU)

The bright and dark side of skin senescence. Could skin rejuvenation anti-senescence interventions become a "bright" new strategy for the prevention of age-related skin pathologies?

The number of senescent cells in the skin is increasing with age. Numerous studies have attempted to elucidate the role of these cells in normal aging of the skin as well as in age-related skin conditions. In recent years, attempts have also been made to find treatments that aim either to cleanse the skin tissues of senescent cells or to neutralize their effects (referred to as senolytics and senomorphics respectively) and thus prevent the consequences, particularly on the skin's appearance in advanced age. Through this review, we have tried to gather data on the role of senescent cells in the skin, in treatments aimed at removing them, and we are asking a reasonable question as to whether anti-senescence treatments may contribute to the protection against age-related skin pathologies, including skin cancer, such as non-melanoma skin cancer, in addition to their involvement in skin rejuvenation.

Development of Smart Composites Based on Doped-TiO2 Nanoparticles with Visible Light Anticancer Properties.

In this study, the synthesis of smart, polymerically embedded titanium dioxide (TiO2) nanoparticles aimed to exhibit photo-induced anticancer properties under visible light irradiation is investigated. The TiO2 nanoparticles were prepared by utilizing the sol gel method with different dopants, including nitrogen (N-doped), iron (Fe-doped), and nitrogen and iron (Fe,N-doped). The dopants were embedded in an interpenetrating (IP) network microgel synthesized by stimuli responsive poly (N-Isopropylacrylamide-co-polyacrylicacid)-pNipam-co-PAA forming composite particles. All the types of produced particles were characterized by X-ray powder diffraction, micro-Raman, Fourier-transform infrared, X-ray photoelectron, ultra-violet-visible spectroscopy, Field Emission Scanning Electron, Transmission Electron microscopy, and Dynamic Light Scattering techniques. The experimental findings indicate that the doped TiO2 nanoparticles were successfully embedded in the microgel. The N-doped TiO2 nano-powders and composite particles exhibit the best photocatalytic degradation of the pollutant methylene blue under visible light irradiation. Similarly, the highly malignant MDA-MB-231 breast cancer epithelial cells were susceptible to the inhibition of cell proliferation at visible light, especially in the presence of N-doped powders and composites, compared to the non-metastatic MCF-7 cells, which were not affected.

Targeted cancer therapies: Oral health care implications.

BACKGROUND: Targeted treatments have been incorporated into oncology protocols, often with more traditional therapies, and are not totally free of adverse reactions, some of which affect the orofacial region. METHODS: The authors searched PubMed, the Cochrane Library, and the US Food and Drug Administration Approved Drug Products database to identify reported adverse effects of targeted agents in the orofacial region as well as other implications in oral health care. Their principal focus was the relatively newer category of molecularly targeted drugs which are called small molecules (SMs). RESULTS: The authors identified several categories of SMs and biological agents (for example, monoclonal antibodies) with adverse effects in the orofacial region. The oral and perioral regions are also fields for which there are therapeutic applications for targeted therapies, particularly to treat malignant neoplasms such as head and neck cancers. CONCLUSIONS: SMs are the most rapidly growing group of targeted cancer treatments. Patients receiving SMs and other targeted antineoplastic agents may require oral medicine advice and special-care dentistry. PRACTICAL IMPLICATIONS: In this narrative review, the authors focus mainly on the orofacial adverse effects of targeted cancer therapies and outline many of the agents that are in use so the dentally focused reader can familiarize themselves with these adverse effects and agents.

The Immune System: Basis of so much Health and Disease: 4. Immunocytes.

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covers cells of the immune system (immunocytes). Clinical relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.

The Immune System: Basis of so much Health and Disease: 2. Innate Immunity.

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covering innate immunity. Clinical relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.

The Immune System: Basis of so much Health and Disease: 3. Adaptive Immunity.

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system; this article covers adaptive immunity. Clinical relevance: Dental clinicians need a basic understanding of the immune system as it underlies health and disease.

Oral lichenoid lesions of the upper lip.

BACKGROUND: Oral lichen planus is a chronic inflammatory disease of unknown etiology. It is characterized by notable heterogeneity in clinical presentation and behavior. MAIN OBSERVATIONS: We describe 3 patients with lichenoid lesions of the upper lip and upper anterior gingiva. These cases probably represent a clinical subtype of lichenoid lesions associated with microbial antigenicity and are characterized by persistency. All three patients had a long history of previous ineffective treatments and all three showed an excellent response to a combination of clarithromycin (2 x 250 mg/day) and prednisolone (15 mg/day). CONCLUSION: The combination of clarithromycin and prednisolone may be considered as an alternative intervention in patients with lichenoid lesions of the upper lip and upper anterior gingiva.

Age-related EBV positive clonal B-cell Lymphoid proliferation (EBV+-DLBCL).

The Ebstein Barr virus(EBV), herpes virus 5 has been associated with lymphoproliferative disordrers. Age-related EBV+ B-LPD is defined as an EBV+ clonal B-cell lymphoid proliferation or EBV+-DLBCL developing in patients over the age of 40 years in the absence of any known immunodeficiency and without an underlying T-cell lymphoma1. We present a case of EBV+ clonal B-cell lymphoid proliferation. Key words:Oral mucosa ulcer, EBV+-DLBCL, age related.

Apoptosis or senescence? Which exit route do epithelial cells and fibroblasts preferentially follow?

Senescence and apoptosis constitute types of cellular responses that normally ensure homeostasis, when endogenous or exogenous signals occur. Their deregulation is often observed in various pathologies, such as age and non-age related diseases including cancer. Although epithelial cells and fibroblasts are capable to exert both functions, under a plethora of insults, the fact that they exhibit notable intrinsic differences in cell/tissue homeostasis properties, might be a crucial determinant of the mode of response to a certain stress signal. Sparse evidence in the literature reveals that in the same tissue/organ context and under the same conditions, the cell type seems to drive the differential counteraction between epithelia and fibroblasts. Based on the above notion we propose that, upon stress insults, human fibroblasts seem to predominantly respond via senescence, while epithelial cells prefer to exert apoptosis. We suggest that considering the tissue as a whole (epithelium and stroma) would benefit research into new therapeutic strategies for chronic diseases and cancer.

Oral non-Hodgkin's lymphoma in a patient with rheumatoid arthritis treated with etanercept and methotrexate.

Oral non-Hodgkin's lymphomas (O-NHLs) are a rare group of diverse lymphoid tissue malignancies and represent less than 5% of the oral cavity malignancies and 2% of all extra-nodal NHLs. Oral-NHLs affect the Waldeyer's-ring, the salivary glands, the bone of the jaws and the oral mucosa, their clinical appearance is very heterogeneous. Among the risk factors for NHLs are immunosuppression (primary or secondary), autoimmunity and inflammation. O-NHLs share the same risk factors. This case report describes a patient with O-NHL which was possibly linked to the combination of methotrexate and etanercept for the treatment of her rheumatoid arthritis. To our knowledge this is probably among the first cases of O-NHL with possible relation to the use of a Tumor Necrosis Factor (TNF) antagonist biological agent (etanercept). This case could contribute to the sensitization of the dentists for the signs and symptoms of this rare malignancy. It also underlines the need for thorough medical history and medication recording for all the dental patients. Key words:Lymphoma (oral) methotrexate, etanercept.

Orofacial adverse effects of biological agents.

Biological agents (BA) are increasingly used effectively in the treatment of a range of disorders, but to date, their application in diseases affecting the orofacial region has been fairly limited. Several orofacial adverse effects related to BA have been recently reported. However, the evidence for such adverse reactions is not always strong, and some of the adverse effects of BA have only been reported in case reports or case series. Most reactions to BA reported thus far have been in association with antitumor necrosis factor-α agents, which is not surprising, as these are the most widely-used BA. In the present study, the orofacial adverse effects are reported with various BA in order to sensitize clinicians to the possibilities. In addition, we briefly summarize the mode of action and indications of these BA. As the use and range of BA increases, the number and diversity of adverse effects might well increase. Despite the adverse effects of biological agents, these may often be less serious than the adverse effects of the more traditional immunosuppressive agents.

Biologic agents and oral diseases -- an update on clinical applications.

Biologic agents are targeted immune modulating agents that have been widely used in the treatment of inflammatory and neoplastic conditions with favorable results. The purpose of this review is to provide an update on the biologic agents that have been used in the treatment of diseases that affect the oral mucosa. Identification of relevant data, case reports and case series was performed using the PubMed-MEDLINE database and electronic databases of accredited organizations such as the European Medical Agency, US Food and Drug Administration, and clinicaltrials.gov (USA). According to the literature, the use of biologic agents in patients with oral diseases is limited mainly to patients suffering from refractory forms of immune-mediated diseases of the oral cavity. Biologic agents were used in all cases as off-label indications. Patient's response varied, but in general biologic agents could be considered as a therapeutic option in patients with no other alternative. A point requiring extra precaution is their safety profile because severe life threatening infections are among their side effects. Another aspect that limits their broader use is their high economic cost. We aimed to provide a practical update for the clinicians who deal with oral diseases, covering as many aspects as possible of the applications of biologic agents in oral diseases reported to date.

Dental care throughout pregnancy: what a dentist must know.

Pregnancy is a unique period in a woman's lifetime. Good oral health during pregnancy is important to the overall health of both the expectant mother and her baby. Oral health assessment should be part of comprehensive prenatal care for all women and every general medical practitioner and obstetrician should consider referral of a newly pregnant woman to a dentist as routine. Unfortunately, there may be times when pregnant women, obstetricians and-on occasional-dentists are sceptical of dental care during pregnancy owing to prejudices about the safety of dental treatment, resulting in delay of the dental treatment. The aim of this paper is to review the literature for evidence-based answers with regard to the frequent dilemmas of dentists concerning dental treatment of pregnant women. The search was performed using the PubMed database and systematic reviews and original articles (clinical and experimental studies) as well as guidelines produced by scientific organisations. From this review it can be concluded that most dental work is safe during pregnancy. Dentists and health agencies should provide and distribute information to women about the importance of maintaining oral health during pregnancy.

Oral lichen planus as a preneoplastic inflammatory model.

Oral lichen planus (OLP) is a chronic oral inflammatory disease of unknown etiology. According to reports, 1-2% of OLP patients develop oral squamous cell carcinoma (OSCC) in the long run. While World Health Organization (WHO) classifies OLP as "a potentially malignant disorder," it is still a matter of debate which mechanisms drive OLP to such a condition. The current hypothesis connecting OLP and OSCC is that chronic inflammation results in crucial DNA damage which over time results in cancer development. Initial studies investigating the OLP and OSCC link were mainly retrospective clinical studies. Over the past years, several amount of information has accumulated, mainly from molecular studies on the OLP malignant potential. This article is a critical review of whether OLP has a malignant potential and, therefore, represents a model of preneoplastic inflammation.