Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 76
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Int J Pharm ; 569: 118610, 2019 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-31415875

RESUMO

The aim was to investigate the effect of constant current iontophoresis on the delivery and biodistribution of buflomedil hydrochloride (BUF) in the buccal mucosa. Quantification was by UHPLC-MS/MS; in addition to total delivery, the amounts present in the epithelia and the lamina propria (the target tissue) were also determined. Two-compartment vertical diffusion cells were used to investigate the effect of current density (0.5, 1 and 2 mA/cm2), application time (5, 10 and 20 min) and concentration (5, 10 and 20 mM) on iontophoretic delivery of BUF from aqueous solutions. In contrast to passive delivery, iontophoresis for 10 min at 1 mA/cm2 resulted in statistically equivalent transport from a 20 mM solution and a 2% HEC hydrogel (with equivalent BUF loading; 20 µmol). BUF delivery from the hydrogel using diffusion cells and a new coplanar "side-by-side" set-up was statistically equivalent (304.2 ±â€¯28.9 and 278.2 ±â€¯40.3 µg/cm2) - passive delivery was also similar. Iontophoresis (10 min at 1 mA/cm2) using a thin film (20 µmol BUF) was superior to the passive control (323.3 ±â€¯5.9 and 24.8 ±â€¯5.9 µg/cm2). Concentrations in the LP were ~700-fold > IC50 to block collagen production, potentially providing a new therapeutic strategy for oral submucous fibrosis.


Assuntos
Mucosa Esofágica/metabolismo , Hidrogéis/administração & dosagem , Iontoforese , Fibrose Oral Submucosa/tratamento farmacológico , Pirrolidinas/administração & dosagem , Vasodilatadores/administração & dosagem , Administração Cutânea , Animais , Disponibilidade Biológica , Suínos
2.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(7): 801-804, 2019 Jul 28.
Artigo em Chinês | MEDLINE | ID: mdl-31413219

RESUMO

OBJECTIVE: To evaluate therapeutic effect of combined injection of salvizanolic acid B with triamcinolone acetonide on the treatment of the soft palate with oral submucous fibrosis.
 Methods: Salvizanolic acid B combined with triamcinolone acetonide was consecutively applied once a week for 30 weeks for 33 patients with middle and later periods of oral submucous fibrosis. The response rate of color change in the soft palate and the increase of capillary vessels (determined by degree I-IV visual analog scale) were evaluated at the 12th, 24th, and 36th months after 30 weeks treatment.
 Results: Thirty-three patients were fulfilled the study without obvious adverse reactions and they were followed up for 24 months, while 31 patients were followed up for 36 months. The color change in the soft palatal mucus and the increase of capillary vessels at the 36th month follow-up after treatment were significantly better than those at the 12th month (P=0.004).
 Conclusion: Combined injection of salvizanolic acid B with triamcinolone acetonide in the treatment of the soft palate with oral submucous fibrosis is effective.


Assuntos
Fibrose Oral Submucosa , Triancinolona Acetonida/uso terapêutico , Glucocorticoides , Humanos , Fibrose Oral Submucosa/tratamento farmacológico , Palato Mole , Resultado do Tratamento
3.
Medicine (Baltimore) ; 98(27): e16339, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277186

RESUMO

BACKGROUND: This study was performed to systematically review the efficacy of Salvia miltiorrhiza injection combined with steroids in the treatment of oral submucous fibrosis. METHODS: We searched 9 databases: Web of Science, PubMed, Medline, EBSCO, Embase, The Cochrane Library, WanFang Data, the China National Knowledge Infrastructure (CNKI), and Chinese Scientific Journals Full-text Database (VIP). Randomized controlled trials were collected to study the treatment of oral submucous fibrosis by S miltiorrhiza injection combined with steroids. Each database was searched from inception to November 2018. RevMan 5.3 software was used for the meta-analysis. RESULTS: In total, 13 randomized controlled trials involving 1190 patients were included. The results of the meta-analysis showed that compared with conventional treatment, S miltiorrhiza injection combined with steroids could significantly increase the maximal mouth opening [mean difference (MD), 0.23; 95% confidence interval (CI), 0.16-0.30; P <.0001], decrease the oral mucosal lesion area (MD, -1.35; 95% CI, -2.46 to -0.25; P = .02), improve the subjective symptom burning sensation (MD, -0.77; 95% CI, -1.38 to -0.16; P = .01), and reduce adverse drug reactions (risk ratio, 0.27; 95% CI, 0.14-0.49; P <.0001). CONCLUSIONS: The results of this meta-analysis from current evidence showed that compared with conventional treatment, S miltiorrhiza injection combined with steroid could significantly improve the maximal mouth opening and the subjective symptom burning sensation as well as decrease the oral mucosal lesion area without increasing adverse effects.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Salvia miltiorrhiza , Esteroides/uso terapêutico , Humanos , Injeções
4.
Int J Mol Sci ; 20(6)2019 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-30884781

RESUMO

Oral submucous fibrosis (OSF) is an oral precancerous condition associated with the habit of areca nut chewing and the TGF-ß pathway. Currently, there is no curative treatment to completely heal OSF, and it is imperative to alleviate patients' symptoms and prevent it from undergoing malignant transformation. Arctigenin, a lignan extracted from Arctium lappa, has been reported to have a variety of pharmacological activities, including anti-fibrosis. In the present study, we examined the effect of arctigenin on the cell proliferation of buccal mucosal fibroblasts (BMFs) and fibrotic BMFs (fBMFs), followed by assessment of myofibroblast activities. We found that arctigenin was able to abolish the arecoline-induced collagen gel contractility, migration, invasion, and wound healing capacities of BMFs and downregulate the myofibroblast characteristics of fBMFs in a dose-dependent manner. Most importantly, the production of TGF-ß in fBMFs was reduced after exposure to arctigenin, along with the suppression of p-Smad2, α-smooth muscle actin, and type I collagen A1. In addition, arctigenin was shown to diminish the expression of LINC00974, which has been proven to activate TGF-ß/Smad signaling for oral fibrogenesis. Taken together, we demonstrated that arctigenin may act as a suitable adjunct therapy for OSF.


Assuntos
Furanos/administração & dosagem , Lignanas/administração & dosagem , Miofibroblastos/efeitos dos fármacos , Fibrose Oral Submucosa/tratamento farmacológico , Fator de Crescimento Transformador beta/genética , Areca/química , Arecolina/química , Movimento Celular/efeitos dos fármacos , Transdiferenciação Celular/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Mucosa Bucal/efeitos dos fármacos , Miofibroblastos/metabolismo , Fibrose Oral Submucosa/genética , Fibrose Oral Submucosa/patologia , Proteína Smad2/genética , Fator de Crescimento Transformador beta/biossíntese
5.
Artigo em Inglês | MEDLINE | ID: mdl-30745280

RESUMO

OBJECTIVES: Oral submucous fibrosis (OSF) is a chronic debilitating disease that has a high risk of malignant transformation. Management of OSF is quite challenging, with no definitive cure being available. This systematic review assessed the available evidence for using curcumin for pain alleviation and clinical improvement in patients with OSF. STUDY DESIGN: A comprehensive search of PubMed/Medline, Scopus, and ISI Web of Science databases was conducted to identify all relevant clinical trials comparing patients receiving curcumin treatment to active and/or nonactive controls for the treatment of OSF. RESULTS: Six clinical trials comprising 298 patients were included. All studies found curcumin to be effective in the management of OSF. Three studies found significantly higher improvement in burning sensation in the curcumin group compared with controls, whereas 3 other studies found comparable results. With regard to clinical signs, 2 studies showed better improvement in mouth opening in the curcumin group; 3 studies reported no differences in effectiveness; and only 1 study found curcumin to be inferior to conventional therapy. CONCLUSIONS: The available evidence remains inconclusive but suggests that curcumin is a promising effective treatment option for the management of patients with OSF. Further well-designed clinical trials with large sample sizes and adequate follow-up periods are warranted.


Assuntos
Antineoplásicos , Curcumina , Fibrose Oral Submucosa , Antineoplásicos/uso terapêutico , Transformação Celular Neoplásica , Curcumina/uso terapêutico , Humanos , Fibrose Oral Submucosa/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
6.
J Diet Suppl ; 16(2): 207-214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29624459

RESUMO

Oral submucous fibrosis (OSMF) is one of the "diseases of civilization" because of the large differences in prevalence among races, geographic areas, and individuals at different socioeconomic levels. It is a premalignant condition strongly associated with the habit of chewing areca nuts. This study is to compare the scoring system in relation to the burning sensation of mouth and dysphagia using the visual analog scale (VAS) and Dakkak and Bennett grading system for Indian food, respectively, in OSMF patients. This study was a randomized clinical trial incorporating a total of 50 cases of OSMF divided into a control group (antioxidant therapy) and pentoxifylline test cases. Values for burning sensation of the mouth using the VAS and modified Dakkak and Bennett grading system for Indian food were recorded. Statistical analyses were done using t test, Mann -Whitney U test, and one-way analysis of variance (ANOVA) test. Patients subjected to pentoxifylline when compared to the control group showed significant reduction in dysphagia for Indian food. Burning sensation was recorded according to the visual analogue scale. Significant reduction in burning sensation was seen in the pentoxifylline group when compared to the control group. This grading system provides quantitative and qualitative parameters in patients with OSMF.


Assuntos
Transtornos de Deglutição/etiologia , Alimentos/efeitos adversos , Alimentos/classificação , Fibrose Oral Submucosa/fisiopatologia , Pentoxifilina/uso terapêutico , Antioxidantes/uso terapêutico , Areca/efeitos adversos , Feminino , Humanos , Índia , Masculino , Nozes/efeitos adversos , Fibrose Oral Submucosa/complicações , Fibrose Oral Submucosa/tratamento farmacológico , Medição da Dor
7.
Oral Dis ; 25(1): 73-79, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30059188

RESUMO

OBJECTIVES: To evaluate and compare the therapeutic response of lycopene and curcumin with placebo in patients suffering from oral submucous fibrosis (OSMF) and to correlate the habit variables of smoked and smokeless tobacco products in OSMF. METHODS: A randomized placebo-controlled parallel clinical study was conducted on ninety OSMF patients, who were divided into three treatment groups using computer-generated randomization. Group A patients (n = 30) were given curcumin tablet (300 mg) twice daily, Group B patients (n = 30) received lycopene capsules (8 mg) twice daily, and for Group C (n = 30), placebo capsules were given once daily for a period of six months. Both the participant and outcome assessor were blinded. Pre- and post-treatment comparison of mouth opening, burning sensation, tongue protrusion, and cheek flexibility was analyzed at periodic follow-up of 9 months. RESULTS: The overall improvement in mouth opening, burning sensation, tongue protrusion, and cheek flexibility was 3.9 ± 4.9 mm, 4.8 ± 2.6, 5.0 ± 7.2 mm, & 0.36 ± 0.71 mm, respectively, for curcumin and 4.1 ± 4.2 mm, 5.0 ± 2.3, 2.4 ± 3.5 mm, & 0.66 ± 0.80 mm, respectively, for lycopene with the p value <0.05. CONCLUSION: Statistically significant improvement in clinical findings was observed in both curcumin and lycopene treatment groups in comparison with placebo. However, the therapeutic efficacy of curcumin and lycopene was found to be almost equal in OSMF patients.


Assuntos
Curcumina/uso terapêutico , Licopeno/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Adolescente , Adulto , Areca , Bochecha , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca , Fumar , Tabaco sem Fumaça , Língua , Adulto Jovem
8.
J Oral Pathol Med ; 48(2): 99-107, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30329174

RESUMO

The management of oral submucous fibrosis (OSF) is quite challenging, and as yet, no effective therapy is available for its management. The present systematic review and meta-analysis sought to assess the effectiveness of aloe vera in alleviating pain and clinical signs of OSF. A comprehensive search in PubMed/Medline, Scopus, and Web of Science databases was conducted to identify the relevant randomized clinical trials. RevMan 5.3 software was used for data analysis. Six randomized controlled trials fulfilled the inclusion criteria. The results of meta-analysis showed statistically significant differences between aloe vera and control groups in alleviating pain/burning sensation at the end of the first and second month, in favor of aloe vera, but no significant differences were found at the end of the third month. With regard to objective clinical outcomes, no statistically significant differences were found between the groups. Aloe vera has a promising effect in reducing pain/burning sensation and clinical improvement in patients with OSF. However, owing to the marked heterogeneity of the included studies, conducting well-designed trials with long follow-up periods, standardized outcome measures and adequate sample sizes are warranted.


Assuntos
Aloe , Fibrose Oral Submucosa/tratamento farmacológico , Fitoterapia , Preparações de Plantas/administração & dosagem , Adolescente , Adulto , Bases de Dados Bibliográficas , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Adulto Jovem
9.
Indian J Dent Res ; 29(3): 303-312, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29900913

RESUMO

Background: : Oral submucous fibrosis (OSMF) is a most prevalent potentially malignant disorder associated with betel quid chewing frequently observed in the Indian population. The present study conducted is much of a keen interest because there is much new information, both in the press and the medical literature, about the benefits of fresh fruits and vegetables and antioxidants (such as lycopene and curcumin) for both prevention and treatment of diseases. As clinicians, we often prescribe medications with significant adverse effects, and certainly, if armed with evidence to support using such antioxidants as safer therapeutic alternatives for treatment of OSMF. Aims and Objective: The aim of the study was to compare and evaluate the efficacy of lycopene and curcumin given orally in clinically diagnosed OSMF patients. Materials and Methods: Sixty patients were divided randomly into two groups Group A and Group B. After fulfilling the eligibility criteria, sixty patients were randomly allotted based on fishbowl method into thirty each. This technique eliminated the selection bias arising in the study. Group A individuals were treated with 4 mg of lycopene and Group B individuals were given 300 mg of curcumin thrice daily for 3 months. Both the groups were assessed in terms of mouth opening and burning sensation. The statistical analysis was done using SPSS Version 16.0 statistical Analysis Software. Results: In Group A, the initial burning sensation was 65.83 ± 3.98%, and in Group B, it was 62.33 ± 5.22% (visual analog scale). After 3 months, there was complete cessation of burning sensation in both the groups. Burning sensation between the groups was statistically nonsignificant (P > 0.05). In Group A, mean mouth opening at baseline (1st visit) observed was 3.17 ± 0.08 cm which improved to 3.52 ± 0.07 cm after 3 months of the treatment period. In Group B, mean mouth opening at baseline (1st visit) observed was 3.32 ± 0.07 cm which improved to 3.52 ± 0.08 cm after 3 months of the treatment period. On comparing intergroup, the difference was statistically nonsignificant (P > 0.05). However, on comparing intergroup, average percent change in mean mouth opening from 1st visit to subsequent time intervals across the time period was found to be statistically significant (P < 0.05). Group A showed 11.1 ± 1.0% improvement in mean mouth opening and Group B showed 6.2 ± 0.4% improvement in the mean mouth opening from the 1st visit till the posttreatment period. The change in the mean mouth opening from 1st visit till posttreatment in Group A was 0.35 ± 0.14, and in Group B, it was 0.20 ± 0.09. Conclusion: Lycopene showed better results than curcumin in improving mouth opening; both the drugs were equally effective in decreasing burning sensation in OSMF patients.


Assuntos
Areca , Curcumina/uso terapêutico , Licopeno/uso terapêutico , Fibrose Oral Submucosa/induzido quimicamente , Fibrose Oral Submucosa/tratamento farmacológico , Adulto , Feminino , Humanos , Índia , Masculino , Resultado do Tratamento
10.
Environ Toxicol ; 33(4): 454-462, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29328529

RESUMO

Oral submucous fibrosis (OSF) is a precancerous condition with symptoms of limited mouth opening and areca nut chewing habit has been implicated in its pathogenesis. Hinokitiol, a natural tropolone derived from Chamacyparis taiwanensis, has been reported to improve oral lichen planus and inhibit various cancer cells. Here, we showed that hinokitiol reduced the myofibroblast activities in fBMFs and prevented the arecoline-induced transdifferentiation. Treatment of hinokitiol dose-dependently downregulated the myofibroblast markers as well as various EMT transcriptional factors. In particular, we identified that Snail was able to bind to the E-box in the α-SMA promoter. Our data suggested that exposure of fBMFs to hinokitiol mitigated the hallmarks of myofibroblasts, while overexpression of Snail eliminated the effect of hinokitiol. These findings revealed that the inhibitory effect of hinokitiol on myofibroblasts was mediated by repression of α-SMA via regulation of Snail and showed the anti-fibrotic potential of hinokitiol in the treatment of OSF.


Assuntos
Arecolina/toxicidade , Monoterpenos/uso terapêutico , Miofibroblastos/efeitos dos fármacos , Fibrose Oral Submucosa/tratamento farmacológico , Lesões Pré-Cancerosas/tratamento farmacológico , Fatores de Transcrição da Família Snail/metabolismo , Tropolona/análogos & derivados , Actinas/metabolismo , Animais , Areca , Transdiferenciação Celular , Humanos , Miofibroblastos/metabolismo , Miofibroblastos/patologia , Fibrose Oral Submucosa/induzido quimicamente , Fibrose Oral Submucosa/metabolismo , Fibrose Oral Submucosa/patologia , Lesões Pré-Cancerosas/metabolismo , Lesões Pré-Cancerosas/patologia , Tropolona/uso terapêutico
11.
Oral Dis ; 24(5): 706-716, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28737007

RESUMO

Oral submucous fibrosis (OSMF), a potentially malignant oral cavity disorder that causes speech and mastication problems, lacks an established treatment regimen; moreover, no treatment can effectively reverse the course of OSMF. A meta-analysis was conducted to investigate the efficacy of the peripheral vasodilator, pentoxifylline, in the treatment of OSMF. We searched five different databases for studies meeting our eligibility criteria (up to June 30, 2017). Statistical analyses were performed using RevMan 5.3 software. Three randomized controlled trials (247 OSMF patients) were selected. Pentoxifylline increased the objective sign maximal mouth opening (MMO; WMD: -4.59, 95% CI: -8.65, -0.53; p < 0.05) following short-term (under 1 month; WMD: -1.94, 95% CI: -3.12, -0.77; p < 0.05) and long-term (over 1 month; WMD: -5.44, 95% CI: -6.81, -4.07; p < 0.05) application. Pentoxifylline improved the subjective symptom burning sensation (WMD: -0.11, 95% CI: -0.17, -0.05; p < 0.05) only following long-term application (WMD: 0.42, 95% CI: 0.18, 0.96; p < 0.05). The efficacy on MMO and burning sensation increased with time. Although OSMF lacks definitive treatment modalities, our meta-analysis shows that pentoxifylline effectively improves the objective signs and subjective symptoms of OSMF and its therapeutic efficacy increases with time.


Assuntos
Fibrose Oral Submucosa/tratamento farmacológico , Pentoxifilina/uso terapêutico , Vasodilatadores/uso terapêutico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença
12.
Shanghai Kou Qiang Yi Xue ; 26(2): 188-192, 2017 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-28815250

RESUMO

PURPOSE: To introduce the methods of triamcinolone acetonide (TA) and salvianolic acid B(SA-B) intralesional injection in the treatment of oral submucous fibrosis and evaluate the treatment effects. METHODS: TA combined with SA-B were consecutively applied intralesionally 1 time weekly for 30 times. The technique of intralesional injection was that syringe needle be emptied into submucous tissues 1 cm posterior to the corner of oral cavity running from the front to retromolar area by pushing the injection, then the syringe needle retained to the original point and upward from the front to retromolar area by pushing the injection, finally the syringe needle returned to the starting point and downward from the front to retromolar area by pushing the injection. Mouth opening, the color change of the buccal mucosa and the increase of capillary vessels as determined by degree I-IV visual analog scale were evaluated at 12, 24, and 36 month. The data were analyzed with SPSS 21.0 software package. RESULTS: One hundred and fourteen subjects fulfilled the study without obvious adverse reactions. After treatment for 36 months , the net gain in mouth opening of the early stage group,middle stage group and advanced stage group was (12.0±1.2) mm, (14.5±2.4) mm and (15.5±1.5) mm, respectively. The response rate of color change of the buccal mucosa and the increase of capillary vessels in early stage group, middle stage group and advanced stage group after treatment for 36 months was 100%, 94.7% and 90.7%, respectively. CONCLUSIONS: Triamcinolone acetonide and salvianolic acid B intralesional injection is effective in the treatment of oral submucous fibrosis.


Assuntos
Benzofuranos/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Triancinolona Acetonida/uso terapêutico , Glucocorticoides , Humanos , Injeções Intralesionais , Mucosa Bucal , Medição da Dor , Resultado do Tratamento
13.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 52(1): 16-21, 2017 Jan 09.
Artigo em Chinês | MEDLINE | ID: mdl-28072989

RESUMO

Objective: To evaluate the clinical effectiveness of salvianolic acid B (SA-B) and triamcinolone acetonide (TA) by means of combined intralesional injection in the treatment of oral submucous fibrosis (OSF). Methods: According to clinical findings and symptoms, TA combined with SA-B were consecutively applied intralesionally 1 time weekly for 30 times. Mouth opening degree, color change of the buccal mucosae and numeral increase of the capillary vessels were determined by degree Ⅰ-Ⅳ visual analog scale were evaluated at 12, 24, and 36 months, respectively. Results: One hundred and fourteen subjects fulfilled the study without obvious adverse reactions. After treatment for 1 year, the net gain in mouth opening of the early stage group was (5.5 ± 1.5) mm at 12 months, (8.8 ± 1.6) mm at 24 months and (12.0±1.2) mm at 36 months. The net gain in mouth opening of the middle stage group were (5.3±1.7) mm at 12 months, (10.5±1.5) mm at 24 months and (14.5±2.4) mm at 36 months. The net gain in mouth opening of the advanced stage group were (5.7±1.3) mm at 12 months, (13.7±1.3) mm at 24 months and (15.5±1.5) mm at 36 months. The effective rates of color change of the buccal mucosae and numeral increase of the capillary vessels after treatment for 36 months were 100% in early stage group, 93% (51/55) in middle stage group and 90% (36/40) in advanced stage group. Conclusions: TA and SA-B combined intralesional injection in the treatment of oral submucous fibrosis is effective.


Assuntos
Benzofuranos/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Imunossupressores/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Triancinolona Acetonida/uso terapêutico , Humanos , Resultado do Tratamento , Escala Visual Analógica
14.
J Oral Pathol Med ; 46(1): 50-55, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27314762

RESUMO

BACKGROUND: Oral submucous fibrosis is a chronic disease, treatment of which has largely been symptomatic. Aloe vera has immunomodulatory, anti-inflammatory, wound healing, antioxidant, and antineoplastic activities. All such properties of aloe vera suggest the possibility of its use in the management of oral submucous fibrosis. METHODS: Seventy-four patients of oral submucous fibrosis were randomly divided into 2 groups. Group A patients were treated with systemic (juice) and topical aloe vera (gel) for 3 months. Group B patients were treated with intralesional injection of hydrocortisone and hyaluronidase for 6 weeks with antioxidant supplements for 3 months. Patients were assessed for reduction in burning sensation and increase in mouth opening, cheek flexibility, and tongue protrusion at an interval of 1, 2, and 3 months. RESULTS: Both the groups showed statistically significant improvements in all the study parameters at the end of study period (P < 0.001). The clinical response to aloe vera was comparable to that of intralesional injections of hydrocortisone and hyaluronidase with antioxidant supplementation. CONCLUSION: The study concludes that aloe vera can be an alternative, safe, and effective treatment regime in the management of oral submucous fibrosis. Long-term follow-up studies with larger sample size are recommended.


Assuntos
Aloe , Anti-Inflamatórios/uso terapêutico , Hidrocortisona/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Fitoterapia , Administração Oral , Administração Tópica , Adulto , Quimioterapia Combinada , Feminino , Géis , Humanos , Hialuronoglucosaminidase/uso terapêutico , Injeções Intralesionais , Masculino , Fibrose Oral Submucosa/fisiopatologia , Extratos Vegetais/uso terapêutico
15.
J Investig Clin Dent ; 8(2)2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-26840561

RESUMO

AIM: The aim of the present study was to investigate the in vitro antifibrogenic effects of Centella asiatica Linn (CA) and its bioactive triterpene aglycone asiatic acid (AA) on arecoline-induced fibrosis in primary human buccal fibroblasts (HBF). METHODS: An ethanolic extract of CA was prepared, and AA was purchased commercially. High-performance thin-layer chromatography (HPTLC) was performed to quantify AA in the CA extract; colorimetric assay (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) was performed to determine an half-maximal inhibitory concentration. HBF were cultured and stimulated with arecoline. The inhibitory effects of CA and AA at different concentrations were assessed using gene-expression studies on fibrosis-related markers: transforming growth factor-ß1, collagen 1 type 2, and collagen 3 type 1. The stimulatory effect of arecoline and the inhibitory effect of AA on fibroblast morphology and extracellular matrix were assessed qualitatively using Masson trichrome stain. RESULTS: The HPTLC analysis determined 1.2% AA per 100 g of CA extract. Arecoline produced a concentration-dependent increase in the fibrotic markers, treatment with CA significantly downregulated fibrotic markers at higher concentrations, and AA downregulated at lower concentrations. Arecoline altered fibroblast morphology and stained strongly positive for collagen, and AA treatment regained fibroblast morphology with faint collagen staining. CONCLUSION: CA and AA can be used as antifibrotic agents.


Assuntos
Fibrose Oral Submucosa/tratamento farmacológico , Triterpenos Pentacíclicos/uso terapêutico , Extratos Vegetais/uso terapêutico , Triterpenos/uso terapêutico , Arecolina , Biomarcadores/metabolismo , Cromatografia em Camada Delgada , Relação Dose-Resposta a Droga , Regulação para Baixo , Colágenos Fibrilares/metabolismo , Fibroblastos/efeitos dos fármacos , Humanos , Técnicas In Vitro , Mucosa Bucal/citologia , Fibrose Oral Submucosa/induzido quimicamente , Triterpenos Pentacíclicos/farmacologia , Extratos Vegetais/farmacologia , RNA/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fator de Crescimento Transformador beta1/metabolismo , Triterpenos/farmacologia
16.
J Formos Med Assoc ; 116(2): 107-113, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26922429

RESUMO

BACKGROUND/PURPOSE: Transforming growth factor (TGF)-ß is a key regulator in the pathogenesis of oral submucous fibrosis (OSF). Early growth response (Egr)-1 is essential for fibrotic responses to TGF-ß. Because TGF-ß signaling is cell-type- and context-dependent, we investigated the signaling involved in TGF-ß-induced Egr-1 in primary human buccal mucosal fibroblasts (BMFs). METHODS: TGF-ß-induced Egr-1 and its signaling were assessed by western blotting in BMFs. Egr-1 small interfering RNA was used to define the role of Egr-1 on TGF-ß-induced mRNAs of the α1- and α2-chains of type I collagen (COL1A1 and COL1A2) and acid-soluble collagen production (via Sircol collagen assay). The effects of epigallocatechin-3-gallate (EGCG) on TGF-ß-induced Egr-1 protein and acid-soluble collagen were also evaluated. RESULTS: TGF-ß1 stimulated Egr-1 production in BMFs. Pretreatment with PD98059, SP600125, SB431542, and SIS3, but not SB203580, significantly reduced TGF-ß1-induced Egr-1 protein expression. Genetic targeting of Egr-1 completely inhibited TGF-ß1-induced type I collagen mRNAs and collagen protein expression. EGCG fully inhibited TGF-ß1-induced Egr-1 and TGF-ß1-stimulated production of acid-soluble collagens. CONCLUSION: We conclude that activin receptor-like kinase (ALK)5, Smad3, extracellular signal-regulated kinase, and c-Jun N-terminal kinase are involved in the TGF-ß1-induced Egr-1 protein production in BMFs. Egr-1 mediates TGF-ß1-induced COL1A1 and COL1A2 mRNA expression and acid-soluble collagen production in BMFs. EGCG can block TGF-ß1-induced collagen production by attenuating Egr-1 expression in BMFs. Egr-1 is a key mediator in TGF-ß1-induced pathogenesis of OSF. EGCG may be useful in the prevention or treatment of OSF.


Assuntos
Catequina/análogos & derivados , Colágeno Tipo I/biossíntese , Proteína 1 de Resposta de Crescimento Precoce/metabolismo , Fibroblastos/metabolismo , Fator de Crescimento Transformador beta1/farmacologia , Antracenos/farmacologia , Benzamidas/farmacologia , Catequina/farmacologia , Células Cultivadas , Dioxóis/farmacologia , Proteína 1 de Resposta de Crescimento Precoce/genética , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Fibroblastos/efeitos dos fármacos , Flavonoides/farmacologia , Humanos , Mucosa Bucal/citologia , Fibrose Oral Submucosa/tratamento farmacológico , Transdução de Sinais/efeitos dos fármacos
17.
J Oral Pathol Med ; 46(6): 439-442, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28027413

RESUMO

BACKGROUND: Oral submucous fibrosis (OSF) is a chronic debilitating disease and a premalignant condition of the oral cavity. It is well known for its impervious nature to medical therapy. Omega-3 polyunsaturated fatty acids have been reported to have anti-inflammatory properties. However, its role in OSF is still not known. This preliminary study assessed the efficacy of systemic omega 3 in this disease. METHODS: A randomized single-blinded controlled trial was designed, and a total of 10 clinically confirmed adult patients with OSF were included in the study. Group A was given biweekly intralesional injections of dexamethasone 1.5 ml and hyaluronidase 1500 IU mixed with lignocaine for 6 weeks and a placebo for 3 months. Group B was also given similar intralesional injections but with 1 gm of omega 3 three times daily continuously for 3 months. Patients were followed every month for 3 months and then after 6 months. RESULTS: Significant improvement was noted among all clinical parameters (interincisal distance, tongue protrusion, cheek flexibility, and visual analogue scale) in both the groups. Intergroup comparison showed significant reduction in burning sensation in group B; that is, P value was 0.005, while improvement in rest of the three clinical features was not statistically significant. CONCLUSION: Omega 3 can be used as an adjunctive treatment option in patients with OSF to reduce subjective symptoms. More studies should be conducted with a larger sample size to study the effect of omega 3 in patients with OSF.


Assuntos
Ácidos Graxos Ômega-3/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Adulto , Anestésicos Locais/administração & dosagem , Areca/efeitos adversos , Dexametasona/administração & dosagem , Quimioterapia Combinada , Feminino , Glucocorticoides/administração & dosagem , Humanos , Hialuronoglucosaminidase/administração & dosagem , Injeções Intralesionais , Lidocaína/administração & dosagem , Masculino , Pessoa de Meia-Idade , Medição da Dor , Projetos Piloto , Método Simples-Cego , Resultado do Tratamento , Trismo
18.
J Contemp Dent Pract ; 17(12): 1009-1012, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27965488

RESUMO

INTRODUCTION: Oral submucous fibrosis (OSF) causes progressive debilitating symptoms, such as oral burning sensation (stomatopyrosis) and limited mouth opening. The standard of care (SOC) protocol includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. The objective of the study was to evaluate efficacy of rebamipide in alleviating burning sensation of the oral mucosa in OSF in comparison with SOC intralesional steroid injections. MATERIALS AND METHODS: Twenty OSF patients were divided into two groups [rebamipide (100 mg TID for 21 days) and betamethasone (4 mg/mL biweekly for 4 weeks)] of 10 each by random sampling. Burning sensation was assessed every week for 1 month. Burning sensation scores were analyzed using repeated measures analysis of variance (ANOVA) and paired t-test. RESULTS: Change in burning sensation score was significant (p < 0.05) in the first four visits. However, score between the 4th and 5th visit was not statistically significant (p > 0.05). CONCLUSION: Our study has shown that rebamipide can be considered as an effective modality to manage burning sensation in patients suffering from OSF. CLINICAL SIGNIFICANCE: Considering stomatopyrosis and trismus as a major cause for inability to eat in OSF, use of newer adjunctive modalities, such as rebamipide will ease patients suffering and also encourage them to consume food.


Assuntos
Alanina/análogos & derivados , Anti-Inflamatórios/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Quinolonas/uso terapêutico , Adulto , Idoso , Alanina/uso terapêutico , Betametasona/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibrose Oral Submucosa/etiologia , Medição da Dor , Estudos Prospectivos , Tabaco sem Fumaça/efeitos adversos
19.
Artigo em Inglês | MEDLINE | ID: mdl-27720650

RESUMO

OBJECTIVE: To investigate the effectiveness of turmeric with black pepper and nigella sativa in oral submucous fibrosis (OSMF). STUDY DESIGN: Forty OSMF patients were randomly divided into two groups. The study was performed under a double-blind, randomized design. Group A received turmeric with black pepper and group B received nigella sativa for 3 months. Clinical evaluation was done every 15 days. Patients' serum superoxide dismutase (SOD) levels were assessed before and after treatment and also compared with healthy controls. The response to treatment was analyzed using analysis of variance, paired t test, and unpaired t test. RESULTS: After the treatment, groups A and B showed 3.85 ± 0.22 mm and 3.6 ± 0.07 mm improvement in mouth opening, respectively (P < .01); 87.90% and 78.91% reduction in burning sensation, respectively (P < .01); and +0.62 U/mL and +0.74 U/mL improvement in serum SOD levels, respectively (P < .05). The maximum mouth opening achieved was 8 mm in group A and 7 mm in group B. The mean pretreatment SOD level for controls and patients was 3.61 ± 0.24 U/mL in group A and 2.63 ± 0.18 U/mL in group B. CONCLUSION: Turmeric with black pepper and nigella sativa improved mouth opening, burning sensation, and SOD levels in the present OSMF study patients; however, further investigations are needed.


Assuntos
Curcuma , Nigella sativa , Fibrose Oral Submucosa/tratamento farmacológico , Piper nigrum , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Superóxido Dismutase/sangue , Resultado do Tratamento
20.
Artigo em Inglês | MEDLINE | ID: mdl-27422421

RESUMO

OBJECTIVES: Oral submucous fibrosis (OSF) is a chronic debilitating disease of the oral mucosa, associated with an increased risk of malignancy. The primary objective of this study was to evaluate the effectiveness of intralesional corticosteroid injection as a treatment modality for OSF. We also studied the correlation between the treatment outcome and a number of individual variables. STUDY DESIGN: A total of 230 histologically confirmed patients with OSF were included in the study, of which 116 patients with a 30 mm or less interincisal mouth opening were subjected to intralesional injections of 40 mg methylprednisolone at monthly intervals for 6 consecutive months. The effect of the treatment was assessed by evaluating the degree of improvement in mouth opening. RESULTS: All patients included in the study had a history of chewing areca nut. In paired comparison, statistically significant difference (t = -8.78; df = 115; P < .001) was observed in mouth opening over a period of 12 months in the patients who had corticosteroid injections. CONCLUSIONS: Intralesional corticosteroid injection is one of the most widely implemented interventions for OSF at present, particularly for those patients with palpable fibrous bands. The present study provides justification for the use of corticosteroids in improving mouth opening.


Assuntos
Corticosteroides/uso terapêutico , Areca/efeitos adversos , Metilprednisolona/uso terapêutico , Fibrose Oral Submucosa/tratamento farmacológico , Trismo/tratamento farmacológico , Adulto , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Fibrose Oral Submucosa/induzido quimicamente , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA