Tocilizumab, a Potent Interleukin-6 Receptor Inhibitor, Decreases Bone Resorption and Increases the Rate of Bacterial Infection After Tooth Extraction in Rats.

PURPOSE: Our objective was to evaluate the influence of pretreatment with tocilizumab (TCZ) in bone healing after tooth extraction in rats. METHODS: Wistar male rats were equally divided into sham (ie, nonoperated), saline (both treated with 0.1 ml/kg saline), and six TCZ groups treated with 1, 2, 4, 8, 16, and 32 mg/kg TCZ (TCZ1 to TCZ32, respectively). Twenty-four hours after administration of vehicle or TCZ, exodontia of the first lower left molar was performed, and the animals were euthanized three days later for hematological analysis and organ (liver, spleen, and kidney mass indexes, and histological evaluation), gingiva (myeloperoxidase [MPO] assay), and mandible (radiographic, histomorphometric analysis, and IL-6 immunostaining) evaluation. Analysis of variance/Bonferroni test (statistical significance, P < .05) was performed using GraphPad Prism version 5.0 (GraphPad Inc, San Diego, CA, USA). RESULTS: There was no difference in radiographic results; however, leukopenia (P = .039) and neutropenia (P < .001) were statistically significant in the TCZ16 and TCZ32 groups. Weight loss (P < .001) and reduced liver index (P = .001) were significantly dose-dependent; however, no histological alterations were observed in the other organs. Osteoclast counts were reduced in groups TCZ4 to TCZ32 (P < .001), and IL-6 immunostaining increased in the TCZ8 to TCZ32 groups (P < .001). Alveolar infection rates increased in groups TCZ4 to TCZ32 (P < .001), and MPO had a biphasic response, exhibiting a reduction in groups TCZ2 and TCZ4, and an increase in group TCZ32 (P = .004). CONCLUSION: TCZ-induced immunosuppression led to a reduction in osteoclast function, an increase in alveolar infection, and compensatory neutrophil infiltration.

Mast Cells and Blood Vessels Profile in Oral Carcinogenesis: An Immunohistochemistry Study.

BACKGROUND: The objectives of the present study were to evaluate angiogenesis and mast cell density in oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: This was an observational, retrospective and quantitative study. The samples consisted of 60 tissue specimens from patients with squamous cell carcinoma, epithelial dysplasia and controls (n=20/group). Immunohistochemistry was performed using an anti-tryptase antibody to mast cells and anti-CD31 and anti-CD34 for blood vessels and we count the number of mast cells and determine the percentage of CD31 and CD34 antibody staining (vascular density). RESULTS: The mast cells had lower density in OSCC compared to control and dysplasia (p = 0.009). In angiogenesis, the expression of CD31 showed a higher percentage of blood vessels in OSCC (p < 0.001), however, CD34 showed no difference between groups (p=0.092). The CD31 antibody presented as a high immunostaining in oral mucosa than CD34. CONCLUSIONS: The increased vascularity in squamous cell carcinoma suggests that angiogenesis begins when malignant transformation starts that seems to be inversely associated with the number of mast cells.

Oral tranexamic acid associated with platelet transfusion to prevent hemorrhage in a patient with Glanzmann thrombasthenia.

Glanzmann thrombasthenia (GT) is a rare genetic disorder that alters platelet function. The clinical manifestations include purpura, epistaxis, gingival bleeding, and menorrhagia. For patients with GT, conventional surgical dental treatment may result in hemorrhagic complications. There are many reported ways to prevent hemorrhage in patients with GT during surgical procedures but no standardized recommendations. In this case study, a woman diagnosed with GT required 2 types of surgery (periodontal surgery and third molar extractions), which were performed on separate days. Preoperative evaluation and planning with a hematology service led to the transfusion of 1 pack of platelet concentrate immediately before each surgery. Additionally, the patient was prescribed oral tranexamic acid, which was started 1 day before each surgery and continued for 3 additional days. A distal wedge procedure was performed for the mandibular right third molar, and later the maxillary and mandibular left third molars were extracted. The use of oral tranexamic acid associated with a single platelet bag was effective in the present case, and no bleeding or thrombotic events were observed after either surgery. Although this coagulopathy is rare, dentists must be aware of its implications, which necessitate specific precautions for oral surgical procedures. Multidisciplinary integration and surgical planning can reduce the risk of complications for the patient.

Lesión bucal relacionada con relleno dérmico / Dermal filler-related oral lesion

Introduction: Oral adverse reactions related to natural dermal fillers may originate from infiltration techniques, giving rise to swellings, nodule formation doe to local material entrapment, or displacement or migration of the material used. Objective: describe a case of orofacial foreign body reaction in an elderly patient. Case report: a 65-year-old woman was referred for oral evaluation complaining of an intraoral lesion present for 15 days. Intraoral examination revealed a mobile nodule in the lower lip left portion. After the initial consultation, incisional biopsy was performed under local anesthesia and the surgical specimen was sent for histopathological analysis. Intraoral examination revealed a soft mobile nodule in the lower lip left portion. Clinical pathological and Raman microspectroscopy analysis led to a final diagnosis of calcium hydroxyapatite dermal filler-related reaction. Conclusions: this case reinforces the possibility of dermal filler-related mucosal tissue reactions in oral cavity soft tissues(AU)

Introducción: las reacciones adversas bucales relacionadas con rellenos dérmicos naturales pueden originarse a partir de técnicas de infiltración, lo que ocasiona inflamaciones, formación de nódulos por atrapamiento de material local o desplazamiento o migración del material usado. Objetivo: describir un caso de reacción a cuerpo extraño bucofacial en un adulto mayor. Presentación del caso: una mujer de 65 años de edad fue remitida para evaluación bucal por presentar una lesión intrabucal durante 15 días. El examen intrabucal reveló un nódulo móvil en la porción izquierda del labio inferior. Después de la consulta inicial, se realizó una biopsia incisional bajo anestesia local y se envió la muestra quirúrgica para su análisis histopatológico. El examen intrabucal reveló un nódulo móvil suave en la porción izquierda del labio inferior. El análisis clínico-patológico y de la micro-espectroscopia de Raman condujeron a un diagnóstico final de reacción de hidroxiapatita cálcica relacionada con el relleno dérmico. Conclusiones: este caso refuerza la posibilidad de reacciones cutáneas relacionadas con los rellenos dérmicos en los tejidos mucosos de la cavidad bucal(AU)

Lesión bucal relacionada con relleno dérmico / Dermal filler-related oral lesion

Introduction: Oral adverse reactions related to natural dermal fillers may originate from infiltration techniques, giving rise to swellings, nodule formation doe to local material entrapment, or displacement or migration of the material used. Objective: describe a case of orofacial foreign body reaction in an elderly patient. Case report: a 65-year-old woman was referred for oral evaluation complaining of an intraoral lesion present for 15 days. Intraoral examination revealed a mobile nodule in the lower lip left portion. After the initial consultation, incisional biopsy was performed under local anesthesia and the surgical specimen was sent for histopathological analysis. Intraoral examination revealed a soft mobile nodule in the lower lip left portion. Clinical pathological and Raman microspectroscopy analysis led to a final diagnosis of calcium hydroxyapatite dermal filler-related reaction. Conclusions: this case reinforces the possibility of dermal filler-related mucosal tissue reactions in oral cavity soft tissues(AU)

Introducción: las reacciones adversas bucales relacionadas con rellenos dérmicos naturales pueden originarse a partir de técnicas de infiltración, lo que ocasiona inflamaciones, formación de nódulos por atrapamiento de material local o desplazamiento o migración del material usado. Objetivo: describir un caso de reacción a cuerpo extraño bucofacial en un adulto mayor. Presentación del caso: una mujer de 65 años de edad fue remitida para evaluación bucal por presentar una lesión intrabucal durante 15 días. El examen intrabucal reveló un nódulo móvil en la porción izquierda del labio inferior. Después de la consulta inicial, se realizó una biopsia incisional bajo anestesia local y se envió la muestra quirúrgica para su análisis histopatológico. El examen intrabucal reveló un nódulo móvil suave en la porción izquierda del labio inferior. El análisis clínico-patológico y de la micro-espectroscopia de Raman condujeron a un diagnóstico final de reacción de hidroxiapatita cálcica relacionada con el relleno dérmico. Conclusiones: este caso refuerza la posibilidad de reacciones cutáneas relacionadas con los rellenos dérmicos en los tejidos mucosos de la cavidad bucal(AU)

Vascular smooth muscle relaxation by a lectin from Pisum arvense: evidences of endothelial NOS pathway.

The vasorelaxant effect of the lectin of Pisum arvense (PAL) seeds was investigated in rat aorta. PAL (10-100 µg/ml) was applied on aorta rings, with or without endothelium, pre-contracted with phenylephrine (Phe; 0.1 µM). Participation of endothelium derived relaxant factors was evaluated incubating the tissue with indomethacin (10 µM), L-nitro arginine methyl ester (L-NAME, 100 µM) and tetraethylammonium (TEA, 5 mM) before addition of PAL. The role of the lectin domain was investigated by addition of PAL into tissue in presence of glucose (3x 10⁻5 M), or N-acetyl Dglucosamine (GlcNAc; 3 x 10⁻4 M). The importance of extracellular calcium (Ca²âºe) or interaction with muscarinic receptors in the relaxant effect was evaluated by addition of PAL into aorta rings containing calcium free solution (OCa) and atropine (1 µ M), respectively. PAL induced concentration-dependent relaxation in endothelized aorta (IC50 =58.38 ± 1.87 µg/ml), which was reversed by L-NAME and glucose. The lectin effect was totally inhibited when the preparation was inserted in OCa, but not in presence of atropine. Summarizing, our data showed a relaxant effect of PAL in isolated rat aorta rings in presence of endothelium, suggestive of interaction between the lectin carbohydrate binding sites with specific receptors located in vascular endothelial cells leading to nitric oxide synthase activation. This effect seems to require Ca²âºe but is independent on muscarinic receptors interaction.

Purification and biological effects of Araucaria angustifolia (Araucariaceae) seed lectin.

This paper describes the purification and characterization of a new N-acetyl-d-glucosamine-specific lectin from Araucaria angustifolia (AaL) seeds (Araucariaceae) and its anti-inflammatory and antibacterial activities. AaL was purified using a combination of affinity chromatography on a chitin column and ion exchange chromatography on Sephacel-DEAE. The pure protein has 8.0kDa (SDS-PAGE) and specifically agglutinates rabbit erythrocytes, effect that was independent of the presence of divalent cations and was inhibited after incubation with glucose and N-acetyl-d-glucosamine. AaL showed antibacterial activity against Gram-negative and Gram-positive strains, shown by scanning electron microscopy. AaL, intravenously injected into rats, showed anti-inflammatory effect, via carbohydrate site interaction, in the models of paw edema and peritonitis. This lectin can be used as a tool for studying bacterial infections and inflammatory processes.

Native crystal structure of a nitric oxide-releasing lectin from the seeds of Canavalia maritima.

Here, we report the crystallographic study of a lectin from Canavalia maritima seeds (ConM) and its relaxant activity on vascular smooth muscle, to provide new insights into the understanding of structure/function relationships of this class of proteins. ConM was crystallized and its structure determined by standard molecular replacement techniques. The amino acid residues, previously suggested incorrectly by manual sequencing, have now been determined as I17, I53, S129, S134, G144, S164, P165, S187, V190, S169, T196, and S202. Analysis of the structure indicated a dimer in the asymmetric unit, two metal binding sites per monomer, and loops involved in the molecular oligomerization. These confer 98% similarity between ConM and other previously described lectins, derived from Canavalia ensiformis and Canavalia brasiliensis. Our functional data indicate that ConM exerts a concentration-dependent relaxant action on isolated aortic rings that probably occurs via an interaction with a specific lectin-binding site on the endothelium, resulting in a release of nitric oxide.