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1.
Biomed Pharmacother ; 138: 111538, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34311536

RESUMO

Oral mucositis is a side effect hard to treat following high dose chemotherapy or radiotherapy. Adenosine A2A receptor stimulation blocks NF-κB and boosts the Wnt/ß-catenin signaling, thus blunting inflammation and triggering growth factor codifying genes. Polydeoxyribonucleotide (PDRN) is a registered drug that activates the A2A receptor. Therefore, the aim of this study was to evaluate PDRN effects in an "in vitro" model of oral mucositis induced by prompting an inflammatory phenotype in human gingival fibroblasts (GF) and human oral mucosal epithelial cells (EC). GF and EC were stimulated with LPS (2 µg/ml) alone or in combination with i) PDRN (100 µg/ml); ii) PDRN plus ZM241385 (1 µM) as an A2AR antagonist; iii) CGS21680 (1 µM) as an A2AR agonist. LPS boosted NF-κB, TNF-α and IL-6 expression, decreased IL-10 levels and downregulated both Wnt/ß-catenin, VEGF and EGF expression. PDRN reverted the LPS-induced phenotype as well as CGS21680. Co-incubation with ZM241385 abolished PDRN effects, thus confirming A2A receptor involvement in PDRN mechanism of action. These results suggest that PDRN efficacy may be due to a "dual mode" of action: NF-κB inhibition and Wnt/ß-catenin signaling activation. However, these interesting findings need to be confirmed by animal and clinical studies.


Assuntos
Anti-Inflamatórios/farmacologia , Células Epiteliais/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Gengiva/efeitos dos fármacos , Mucosa Bucal/efeitos dos fármacos , Polidesoxirribonucleotídeos/farmacologia , Estomatite/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Células Cultivadas , Citocinas/genética , Citocinas/metabolismo , Fator de Crescimento Epidérmico/metabolismo , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Fibroblastos/metabolismo , Fibroblastos/patologia , Gengiva/metabolismo , Gengiva/patologia , Humanos , Mediadores da Inflamação/metabolismo , Mucosa Bucal/metabolismo , Mucosa Bucal/patologia , Estomatite/genética , Estomatite/metabolismo , Estomatite/patologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Via de Sinalização Wnt
2.
Acta Cytol ; 65(5): 403-410, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34120116

RESUMO

INTRODUCTION: Tobacco contains several genotoxic agents including N-nitrosamine which has the potential to cause significant nuclear damage. Nuclear blebbing is a form of protrusion on the nuclear membrane and could potentially be caused by tobacco-induced genotoxicity and is closely associated with malignancy. Thus, the present study aimed to assess if tobacco-associated oral potentially malignant disorders including oral submucous fibrosis (OSF) and oral leukoplakia have a higher nuclear blebbing frequency than patients with normal oral mucosa with no history of tobacco use. METHODS: The sample consisted of patients with OSF (n = 30) and oral leukoplakia (n = 10) and normal oral mucosa (n = 10). Exfoliated cells collected from the study groups were smeared on a clean microscopic slide and stained by May-Grunwald-Giemsa stain. A baseline frequency of nuclear blebbing was evaluated using a bright-field microscope with a ×100 objective. The number of nuclear blebbing per 1,000 epithelial cells was recorded and expressed in percentage. ANOVA, the Mann-Whitney U test, and Spearman's correlation were used to analyze the data. RESULTS: The mean rank of distribution of nuclear blebbing showed significant difference between all 3 groups, with the highest frequency noted in leukoplakia, followed by oral submucous and normal oral mucosa. Within OSF, the frequency of nuclear blebbing significantly increased from early stage to advanced stage. In OSF, a statistically significant positive linear correlation was noted between duration (in years), frequency (per day) of tobacco use, clinical grading, and nuclear blebbing. DISCUSSION/CONCLUSIONS: The frequency of nuclear blebbing was significantly higher in oral potentially malignant disorders than normal mucosa. Nuclear blebbing also exhibited a strong dose- and time-dependent correlation with tobacco usage and clinical staging in OSF. The nuclear blebbing frequency could be a noninvasive, economic tool to assess malignant risk in tobacco-induced oral potentially malignant disorders.


Assuntos
Transformação Celular Neoplásica/patologia , Mucosa Bucal/patologia , Neoplasias Bucais/etiologia , Fibrose Oral Submucosa/etiologia , Uso de Tabaco/efeitos adversos , Adulto , Núcleo Celular/patologia , Humanos , Leucoplasia Oral/patologia , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Fibrose Oral Submucosa/patologia , Tabaco
3.
Int J Mol Sci ; 22(11)2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34071720

RESUMO

The oral cavity is a portal into the digestive system, which exhibits unique sensory properties. Like facial skin, the oral mucosa needs to be exquisitely sensitive and selective, in order to detect harmful toxins versus edible food. Chemosensation and somatosensation by multiple receptors, including transient receptor potential channels, are well-developed to meet these needs. In contrast to facial skin, however, the oral mucosa rarely exhibits itch responses. Like the gut, the oral cavity performs mechanical and chemical digestion. Therefore, the oral mucosa needs to be insensitive, to some degree, in order to endure noxious irritation. Persistent pain from the oral mucosa is often due to ulcers, involving both tissue injury and infection. Trigeminal nerve injury and trigeminal neuralgia produce intractable pain in the orofacial skin and the oral mucosa, through mechanisms distinct from those seen in the spinal area, which is particularly difficult to predict or treat. The diagnosis and treatment of idiopathic chronic pain, such as atypical odontalgia (idiopathic painful trigeminal neuropathy or post-traumatic trigeminal neuropathy) and burning mouth syndrome, remain especially challenging. The central integration of gustatory inputs might modulate chronic oral and facial pain. A lack of pain in chronic inflammation inside the oral cavity, such as chronic periodontitis, involves the specialized functioning of oral bacteria. A more detailed understanding of the unique neurobiology of pain from the orofacial skin and the oral mucosa should help us develop novel methods for better treating persistent orofacial pain.


Assuntos
Dor Crônica , Mucosa Bucal , Boca , Animais , Face/fisiologia , Dor Facial , Humanos , Camundongos , Boca/patologia , Boca/fisiologia , Mucosa Bucal/patologia , Mucosa Bucal/fisiologia , Neuralgia , Periodontite , Pele , Fenômenos Fisiológicos da Pele , Traumatismos do Nervo Trigêmeo , Neuralgia do Trigêmeo
4.
J Med Life ; 14(2): 181-197, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104241

RESUMO

The present study investigated the capacity of Suprathel® (a copolymer membrane, so far validated for skin regeneration) to also regenerate oral tissue - mucosa and bone, by comparing this biomaterial, in a split-mouth rabbit model, to Mucoderm®, a xenogeneic collagen matrix certified for keratinized oral mucosa healing. The clinical reason behind this experimental animal model was to determine whether the benefits of this advanced skin regeneration product (Suprathel®) could be conveyed for future evaluation in clinical trials of oral tissue regeneration in humans. The outcomes of this study validated the use of Suprathel®, a terpolymer of polylactide with trimethylene carbonate and ε-caprolactone, for stimulation of oral epithelium and alveolar bone regeneration in rabbits. Both Suprathel® and Mucoderm® exhibited comparable results and the null hypothesis stating a comparable regenerating effect of these two materials could not be rejected.


Assuntos
Osso e Ossos/patologia , Epitélio/patologia , Boca/fisiologia , Poliésteres/química , Regeneração , Cicatrização , Animais , Materiais Biocompatíveis/farmacologia , Regeneração Óssea/efeitos dos fármacos , Regeneração Óssea/fisiologia , Osso Esponjoso/patologia , Regeneração Tecidual Guiada , Masculino , Mucosa Bucal/patologia , Neovascularização Fisiológica/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Coelhos , Cicatrização/efeitos dos fármacos
5.
Rev. ADM ; 78(3): 167-175, mayo-jun. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1254949

RESUMO

La actual pandemia de COVID-19 provocada por el virus SARS-CoV-2 es un problema de salud que afecta a la población globalmente. Su desarrollo puede ser asintomático o exhibir manifestaciones clínicas moderadas o severas dependiendo en gran medida de la respuesta inmune de quien la padece. Esta enfermedad afecta principalmente a los pulmones a través del desarrollo del síndrome respiratorio agudo severo (SRAS), tanto como por la «tormenta de citocinas¼, una respuesta inflamatoria exacerbada que podría provocar una falla multisistémica y, en casos severos, la muerte. Se conoce que la enzima convertidora de angiotensina 2 (ECA-2), presente en diversos tejidos del cuerpo, actúa como receptor funcional del virus SARS-CoV-2 facilitando la entrada de éste a las células. Se ha demostrado la presencia de dicho receptor en varios tejidos orales, por lo que se puede considerar a la cavidad bucal como una vía latente de infección por dicho coronavirus, ya que su mecanismo de transmisión es a través de la inhalación de partículas virales, ya sea por vía nasal u oral. Así mismo, la presencia de carga vírica en la saliva y algunos de los síntomas de la COVID-19, por ejemplo la ageusia, pueden indicar la presencia de contagio viral en etapas tempranas. La presente revisión muestra evidencia que sugiere que diversos tejidos en la cavidad oral podrían ser considerados sitios potenciales de contagio por el SARS-CoV-2, teniendo un papel importante en el mecanismo de transmisión y en el desarrollo de coinfecciones (AU)


The COVID-19 pandemic caused by the SARS-CoV-2 virus is currently a global healthcare problem. The onset of this disease can exhibit several clinical manifestations ranging from mild to severe symptoms, depending on the individual's immune response. COVID-19 primarily affects the lungs by developing the Severe Acute Respiratory Syndrome (SARS) and the «cytokine storm¼, an exacerbated inflammatory reaction that can lead to multiorgan failure and consequently death. The angiotensin-converting enzyme 2 (ACE-2), present in several tissues in the human body, is known to act as the functional receptor of the SARS-CoV-2 germ facilitating its entrance into the cells. Such receptor is also present in diverse oral cavity tissues, indicating a latent route of infection due to its influence in the transmission mechanism by inhalation, either oral or nasal, of virus particles. Also, viral load in saliva and taste disorder symptoms like ageusia could indicate a viral infection in its early stages. This article presents evidence suggesting that several tissues in the oral cavity can be considered potential sites of SARS-CoV-2 infection, thus playing an essential role in the transmission mechanism and development of co-infections (AU)


Assuntos
Humanos , SARS-CoV-2 , COVID-19 , Mucosa Bucal/patologia , Manifestações Bucais , Sinais e Sintomas , Distúrbios do Paladar , Peptidil Dipeptidase A , Carga Viral , Inflamação
6.
Medicine (Baltimore) ; 100(20): e25955, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011077

RESUMO

RATIONALE: Mucous membrane pemphigoid (MMP) is a rare, autoimmune bullous disease that affects mucosal surfaces and skin. Early and aggressive treatment initiation may be warranted due to the risks of serious complications. However, it can be challenging to make an initial diagnosis. Viral infection such as hepatitis B virus (HBV) infection has been found to be associated with the formation of autoimmune bullous diseases. PATIENT CONCERNS: The patient was a 43-year-old male with gingivitis and recurrent swelling over the neck, cheeks, lips, and eyelids. The patient presented at oral medicine, otolaryngology, plastic surgery, and ophthalmology sequentially, and was later referred to the rheumatology, dermatology, and family medicine departments. Recurrent hemorrhagic bullae on oral mucosa and skin scarring occurred 2 years after the onset of the initial symptoms. DIAGNOSIS: Skin biopsy with direct immunofluorescence was performed under the suspicion of MMP. Lesional hematoxylin and eosin stain and perilesional direct immunofluorescence were consistent with MMP. INTERVENTIONS: Systemic Prednisolone and topical corticosteroid were used to control the disease. OUTCOMES: A flare-up of hepatitis B developed as a result of systemic prednisolone use. The disease went through relapses and remissions. The patient is on low-dose prednisolone (5 mg/day) with a monthly outpatient visit in the family medicine department. LESSONS: It would be useful for medical practitioners in different specialties to be alert of the heterogeneous presentations of MMP. Chronic HBV infection might be a risk factor for MMP. In patients with chronic HBV infection, treatment of MMP must be closely monitored for the risk of reactivation of HBV.


Assuntos
Hepatite B Crônica/complicações , Penfigoide Mucomembranoso Benigno/diagnóstico , Prednisolona/administração & dosagem , Adulto , Biópsia , Relação Dose-Resposta a Droga , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/imunologia , Humanos , Masculino , Mucosa Bucal/imunologia , Mucosa Bucal/patologia , Penfigoide Mucomembranoso Benigno/tratamento farmacológico , Penfigoide Mucomembranoso Benigno/imunologia , Penfigoide Mucomembranoso Benigno/patologia , Prednisolona/efeitos adversos , Pele/imunologia , Pele/patologia , Exacerbação dos Sintomas
7.
J Urol ; 206(3): 655-661, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33904760

RESUMO

PURPOSE: Previous studies have elucidated the unique macroscopic and histological properties of buccal mucosa that make it a viable and durable graft for urethral augmentation. However, no prior literature has directly investigated the impact of preoperative oral health on these features. MATERIALS AND METHODS: We analyzed all consenting patients who underwent buccal mucosal graft (BMG) urethroplasty at our institution from 2018 to 2020. Validated oral health surveys, the Oral Health Impact Profile (OHIP-14) and the Kayser-Jones Brief Oral Health Status Examination (BOHSE) were completed preoperatively. A staff pathologist analyzed BMG histology and quantified oral mucositis using a modified Oral Mucosa Rating Scale. RESULTS: We analyzed 51 patients with a median age of 40 years (IQR 31-58). Mean BOHSE score was 1.1 and OHIP-14 score was 1.4. Median epithelial thickness was 530 µm and lamina propria thickness was 150 µm. On age-adjusted analysis, increasing BOHSE and OHIP-14 were associated with decreasing epithelial thickness (p values <0.05). Higher BOHSE scores also correlated with thinner lamina proprias (p=0.05) and increased graft stretch (p=0.03). The 2 patients with postoperative urine leaks and available graft histology had lamina propria thicknesses well below the cohort median, at 50 µm and 60 µm. CONCLUSIONS: This is the first study to demonstrate that oral health conditions impact graft histology and stretch. Although much remains to be learned, our findings shed light on the potential importance of optimizing oral health prior to BMG urethroplasty, and raise the question of if preoperative mucosal biopsy could help inform surgical decision making and discussions regarding surgical success.


Assuntos
Mucosa Bucal/transplante , Saúde Bucal/estatística & dados numéricos , Complicações Pós-Operatórias/diagnóstico , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Estreitamento Uretral/cirurgia , Adulto , Autoenxertos/diagnóstico por imagem , Autoenxertos/patologia , Autoenxertos/transplante , Biópsia , Tomada de Decisão Clínica , Meios de Contraste/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/prevenção & controle , Período Pré-Operatório , Estudos Prospectivos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Inquéritos e Questionários/estatística & dados numéricos , Coleta de Tecidos e Órgãos/métodos , Coleta de Tecidos e Órgãos/estatística & dados numéricos , Resultado do Tratamento , Uretra/anormalidades , Uretra/diagnóstico por imagem , Uretra/patologia , Uretra/cirurgia , Urografia/métodos
8.
Medicine (Baltimore) ; 100(16): e25507, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879685

RESUMO

BACKGROUND: Long noncoding RNA (lncRNA) is reported to be upregulated in many tumors. Although the expression of lncRNA in oral squamous cell carcinoma has been assessed, the association between lncRNA expression and prognosis or clinicopathological feature still remains controversial. Therefore, we conducted a meta-analysis to verify whether lncRNA expression was related to prognosis or clinicopathological features in patients with oral squamous cell carcinoma. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library, Chinese National Knowledge Infrastructure, and Wanfang databases from inception to February 2021. The language included Chinese and English. The published literature on lncRNA expression and prognosis or clinicopathological characteristics of patients with oral squamous cell carcinoma was statistically analyzed. The combination of hazard ratios (HRs), odds ratios (OR), and 95% confidence intervals (95% CIs) were applied to evaluate the effects of lncRNA on the prognosis and clinicopathological features of oral squamous cell carcinoma. RESULTS: This study could provide a comprehensive review of the available evidence of lncRNA on the prognosis and clinicopathological features of oral squamous cell carcinoma. CONCLUSION: The conclusion of our study will provide the updated evidence to judge the lncRNA on the prognosis and clinicopathological features of oral squamous cell carcinoma.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Bucais/mortalidade , RNA Longo não Codificante/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Biomarcadores Tumorais/análise , Regulação Neoplásica da Expressão Gênica , Humanos , Metanálise como Assunto , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/genética , Neoplasias Bucais/terapia , Estadiamento de Neoplasias , Prognóstico , RNA Longo não Codificante/análise , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Revisões Sistemáticas como Assunto
9.
Anticancer Res ; 41(4): 1849-1858, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33813390

RESUMO

BACKGROUND/AIM: Epidemiological studies showed an increased risk of developing laryngeal head and neck squamous cell carcinoma (HNSCC) for employees working in the construction business. This suggested a causal link between exposure to cement particles and development of HNSCC but data were missing. MATERIALS AND METHODS: We established an Organisation for Economic Co-operation and Development (OECD) guideline 487-conform micronucleus assay (MNA) using oropharyngeal mucosa-derived primary epithelial cells (OPCs) ex vivo. OPCs from healthy mucosa of 52 donors were cultured in vitro and incubated with serial concentrations of two common cement particles. Mitomycin C was used as a soluble positive control, and TiO2 and DQ12 were used as negative and positive particle controls. Bi-nucleated cells were counted and the mitotic index (MI) was determined. Subsequently, micronuclei-containing bi-nucleated cells (MN+) were counted. RESULTS: Cement particles, in concentrations not significantly reducing ex vivo proliferation according to mitotic index, dose-dependently increased micronuclei formation. CONCLUSION: Through the establishment of an OECD guideline 487 conform MNA, we demonstrate the mutagenic effects of cement on human OPCs.


Assuntos
Materiais de Construção/toxicidade , Poeira , Células Epiteliais/efeitos dos fármacos , Micronúcleos com Defeito Cromossômico/induzido quimicamente , Mucosa Bucal/efeitos dos fármacos , Células Cultivadas , Relação Dose-Resposta a Droga , Células Epiteliais/patologia , Feminino , Humanos , Neoplasias Laríngeas/induzido quimicamente , Neoplasias Laríngeas/patologia , Masculino , Testes para Micronúcleos , Mucosa Bucal/patologia , Cultura Primária de Células , Medição de Risco , Carcinoma de Células Escamosas de Cabeça e Pescoço/induzido quimicamente , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
10.
Medicine (Baltimore) ; 100(17): e22387, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33907086

RESUMO

INTRODUCTION: Drug induced oral erythema multiforme a rare clinical entity which involves only the lips and oral mucosa without skin involvement. These lesions are difficult in diagnosing with other oral ulcerative lesions with similar clinical manifestations. PATIENT CONCERNS: This article presents 2 case reports of Oral erythema multiforme in which drugs were the precipitating factor. Its etiopathogenesis, differential diagnosis and treatment modalities of the disease is discussed. DIAGNOSIS: Based on patient's complaints, drug history and clinical appearance, provisional diagnosis of drug induced erythema multiforme was considered. INTERVENTION: For case 1, patient was instructed to discontinue usage of drug and prescribed systemic steroid (Prednisolone 10 mg/d) for a week along with germicidal drugs to prevent secondary infection. Medication was tapered to 5 mg/d after first week.For case 2, patient was instructed to discontinue the drug and systemic steroid prednisolone 20 mg /d for 1 week with tapering dose of 10 mg/d for the second week was administered. OUTCOME: For case 1 and case 2 healing of the lesions were evident on third week of follow up. CONCLUSION: Medications should be taken under medical supervision. Over the counter drugs might lead to allergic reactions like drug induced oral erythema multiforme, which is a rare variant and needs to be differentiate from other oral ulcerative lesion for prompt management and follow-up.


Assuntos
Acetaminofen/efeitos adversos , Diclofenaco/efeitos adversos , Eritema Multiforme/induzido quimicamente , Úlceras Orais/induzido quimicamente , Adolescente , Adulto , Diagnóstico Diferencial , Eritema Multiforme/diagnóstico , Humanos , Lábio/patologia , Masculino , Mucosa Bucal/patologia , Úlceras Orais/diagnóstico
11.
Sultan Qaboos Univ Med J ; 21(1): e34-e41, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33777421

RESUMO

Objectives: The post-mortem interval (PMI) refers to the amount of time elapsed between death and discovery of the body. This study aimed to evaluate light microscopic cellular changes in the oral mucosa and identify the potential of this method for predicting PMI. Methods: This prospective study was conducted between July 2016 and January 2018 at the Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, India. A total of 150 post-mortem (including 75 gingival and 75 buccal mucosa samples) and 40 ante-mortem (including 20 gingival and 20 buccal mucosa samples) tissue samples were compared using haematoxylin and eosin, periodic acid-Schiff (PAS) and van Gieson stains. Microscopic changes in the epithelium and connective tissue were categorised according to PMI stage as early (<12.5 hours since death), intermediate (12.5-20.5 hours since death) or late (>20.5 hours since death). Results: Most epithelial cellular changes occurred early, except for arc-shaped nuclei and epithelial shredding which were intermediate and late changes, respectively. However, microscopic changes in the connective tissue were only observable at ≥12.5 hours. There was a progressive decrease in intensity in van Gieson stains and an increase in intensity in PAS stains as PMI increased. Several microscopic features were found to be significant predictors of PMI including epithelial homogenisation, cytoplasmic vacuolation, nuclear degeneration, arc-shaped nuclei, chromatin clumping, red blood cell clumping and lysis, melanin incontinency, myofibril degeneration, salivary gland acini degeneration and epithelial connective tissue separation (P <0.050 each). Conclusion: These findings indicate that microscopic evaluation of the oral mucosa may be helpful for PMI prediction.


Assuntos
Mucosa Bucal/patologia , Mudanças Depois da Morte , Glândulas Salivares/patologia , Histocitoquímica , Humanos , Índia , Estudos Prospectivos
12.
Front Immunol ; 12: 623805, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33717129

RESUMO

Celiac disease (CD) is a chronic autoimmune disease characterized by an immune-triggered enteropathy upon gluten intake. The only current treatment available is lifelong Gluten Free Diet (GFD). Several extraintestinal manifestations have been described in CD, some affecting the oral mucosa. Thus, we hypothesized that oral mucosa could potentially be a target for novel biomarkers and an administration route for CD treatment. Six de novo diagnosed and seven CD patients under GFD for at least 1 year were recruited. Non-celiac subjects (n = 8) were recruited as control group. Two biopsies of the cheek lining were taken from each subject for mRNA analysis and immunohistochemical characterization. We observed a significant decrease in the expression of epithelial junction proteins in all CD patients, indicating that oral mucosa barrier integrity is compromised. FoxP3+ population was greatly increased in CD patients, suggesting that Tregs are recruited to the damaged mucosa, even after avoidance of gluten. Amphiregulin mRNA levels from Peripheral Blood Mononuclear Cells (PBMCs) and epithelial damage in the oral mucosa correlated with Treg infiltration in all the experimental groups, suggesting that recruited Tregs might display a "repair" phenotype. Based on these results, we propose that oral mucosa is altered in CD and, as such, might have diagnostic potential. Furthermore, due to its tolerogenic nature, it could be an important target for oral immunotherapy.


Assuntos
Doença Celíaca/imunologia , Quimiotaxia de Leucócito , Células Epiteliais/imunologia , Imunidade nas Mucosas , Mucosa Bucal/imunologia , Linfócitos T Reguladores/imunologia , Adulto , Idoso , Anfirregulina/genética , Anfirregulina/metabolismo , Estudos de Casos e Controles , Doença Celíaca/dietoterapia , Doença Celíaca/metabolismo , Doença Celíaca/patologia , Citocinas/sangue , Citocinas/genética , Dieta Livre de Glúten , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Feminino , Fatores de Transcrição Forkhead/genética , Fatores de Transcrição Forkhead/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/metabolismo , Mucosa Bucal/patologia , Permeabilidade , Fenótipo , Linfócitos T Reguladores/metabolismo , Proteínas de Junções Íntimas/genética , Proteínas de Junções Íntimas/metabolismo
14.
Cancer Radiother ; 25(5): 507-513, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33685809

RESUMO

Purpose of this review of medical literature is to present the immediate side effects of radiation therapy for head and neck cancer and their treatment. The likelihood and severity of these immediate side effects depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. Early side effects include: inflammation of the oropharyngeal mucosa (mucositis), painful swallowing (odynophagia), difficulty swallowing (dysphagia), hoarseness, lack of saliva (xerostomia), orofacial pain, laryngeal radionecrosis, dermatitis, hair loss, nausea, vomiting, inadequate nutrition and hydration, and weight loss. These complications can interfere with, and delay treatment. Most of these side effects generally dissipate over time. In conclusion, radiation treatment for the head and neck cancer causes significant early side effects. Many of these side effects present difficult challenges to the patients. Their recognition and treatment can significantly improve the patients' health, long-term survival and quality of life. The review provides information that can assist head and cancer survivors deal with radiation side effects.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia/efeitos adversos , Alopecia/etiologia , Encéfalo/efeitos da radiação , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/prevenção & controle , Desidratação/etiologia , Desidratação/prevenção & controle , Disgeusia/etiologia , Disgeusia/prevenção & controle , Dor Facial/etiologia , Dor Facial/terapia , Fadiga/etiologia , Fadiga/prevenção & controle , Humanos , Cartilagens Laríngeas/patologia , Mucosa Bucal/patologia , Mucosite/etiologia , Mucosite/prevenção & controle , Náusea/etiologia , Náusea/prevenção & controle , Necrose/etiologia , Necrose/terapia , Doenças Periodontais/etiologia , Doenças Periodontais/prevenção & controle , Radiodermatite/etiologia , Radiodermatite/prevenção & controle , Vômito/etiologia , Vômito/prevenção & controle , Perda de Peso , Xerostomia/etiologia , Xerostomia/prevenção & controle
15.
Int J Mol Sci ; 22(4)2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33672311

RESUMO

Oral submucous fibrosis (OSF) is known as a potentially malignant disorder, which may result from chemical irritation due to areca nuts (such as arecoline). Emerging evidence suggests that fibrogenesis and carcinogenesis are regulated by the interaction of long noncoding RNAs (lncRNAs) and microRNAs. Among these regulators, profibrotic lncRNA H19 has been found to be overexpressed in several fibrosis diseases. Here, we examined the expression of H19 in OSF specimens and its functional role in fibrotic buccal mucosal fibroblasts (fBMFs). Our results indicate that the aberrantly overexpressed H19 contributed to higher myofibroblast activities, such as collagen gel contractility and migration ability. We also demonstrated that H19 interacted with miR-29b, which suppressed the direct binding of miR-29b to the 3'-untranslated region of type I collagen (COL1A1). We showed that ectopic expression of miR-29b ameliorated various myofibroblast phenotypes and the expression of α-smooth muscle actin (α-SMA), COL1A1, and fibronectin (FN1) in fBMFs. In OSF tissues, we found that the expression of miR-29b was downregulated and there was a negative correlation between miR-29b and these fibrosis markers. Lastly, we demonstrate that arecoline stimulated the upregulation of H19 through the transforming growth factor (TGF)-ß pathway. Altogether, this study suggests that increased TGF-ß secretion following areca nut chewing may induce the upregulation of H19, which serves as a natural sponge for miR-29b and impedes its antifibrotic effects.


Assuntos
Colágeno Tipo I/genética , MicroRNAs/genética , Fibrose Oral Submucosa/genética , RNA Longo não Codificante/genética , Arecolina/farmacologia , Biomarcadores , Transdiferenciação Celular/genética , Células Cultivadas , Regulação para Baixo , Fibroblastos/efeitos dos fármacos , Fibroblastos/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Inativação Gênica , Humanos , Mucosa Bucal/patologia , Mucosa Bucal/fisiologia , Miofibroblastos/patologia , Miofibroblastos/fisiologia , Fibrose Oral Submucosa/patologia , Lesões Pré-Cancerosas , Fator de Crescimento Transformador beta/metabolismo
16.
Am J Surg Pathol ; 45(5): 694-700, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33739792

RESUMO

Epstein-Barr virus (EBV)-associated lymphoproliferative disorder may resemble nonspecific inflammation. We report 3 cases of immunosuppressed adult patients with small lymphocytic EBV ulcers in the skin and oral mucosa, characterized by a lack of atypical lymphocytic infiltration. All 3 cases were diagnosed in routine practice. For comparisons, cases of conventional Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) were reviewed which were extracted from our pathology archives (n=11). The present patients were 2 females and 1 male, aged above 70 years. The primary disease was rheumatoid arthritis (n=2) and dermatitis herpetiformis (n=1). The main source of immunosuppression was prednisolone (n=2) and methotrexate (n=1). The ulcers were located in the oral cavity, buttock, and/or external genitalia. Histology evaluation revealed nonspecific lymphocytic infiltration. Epstein-Barr virus-encoded small RNA (EBER)-positive cells were small and coexpressed CD20. The number of EBER-positive cells ranged from 52 to 132/HPF, which was within the range of that observed in the reviewed conventional EBVMCUs (range, 48 to 1328; median, 121). All 3 cases regressed spontaneously or by the reduction of immunosuppressants. Although the present cases lacked cytologic atypia, those clinical course and loads of EBER-positive cells (>50/HPF) suggested EBV involvement. Current cases of EBVMCU with small lymphocytic infiltration underscore the need for EBER in situ hybridization when an etiology of ulcer with predominant lymphocytes in an immunosuppressed patient is unclear.


Assuntos
Infecções por Vírus Epstein-Barr/patologia , Herpesvirus Humano 4/patogenicidade , Linfócitos/patologia , Mucosa Bucal/patologia , Infecções Oportunistas/patologia , Úlceras Orais/patologia , Úlcera Cutânea/patologia , Idoso , Infecções por Vírus Epstein-Barr/imunologia , Infecções por Vírus Epstein-Barr/virologia , Feminino , Herpesvirus Humano 4/imunologia , Interações Hospedeiro-Patógeno , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Linfócitos/imunologia , Linfócitos/virologia , Masculino , Mucosa Bucal/imunologia , Mucosa Bucal/virologia , Infecções Oportunistas/imunologia , Infecções Oportunistas/virologia , Úlceras Orais/imunologia , Úlceras Orais/virologia , Fatores de Risco , Úlcera Cutânea/imunologia , Úlcera Cutânea/virologia , Carga Viral
17.
Medicine (Baltimore) ; 100(9): e24934, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655959

RESUMO

ABSTRACT: Oral cancer is one of the leading causes of cancer death, which are mostly preceded by oral potentially malignant disorders (OPMDs). Taiwanese government launched a free oral cancer screening program. The aim of this study was to analyze the malignant transformation rate of OPMDs.This study was based on national-wide oral screening databases. 3,362,232 people were enrolled. Patients clinically diagnosed with leukoplakia, erythroplakia, oral submucosal fibrosis (OSF), oral verrucous hyperplasia (OVH), and oral lichen planus (OLP), from 2010 to 2013, were identified. We followed up OPMD patients in cancer registry databases to analyze the malignant transformation rate.The malignant transformation rates from the highest to the lowest were: OVH > OSF > erythroplakia > OLP > leukoplakia. The malignant transformation rate was 24.55, 12.76, 9.75, 4.23, and 0.60 per 1000 person-years in the OVH, OSF, erythroplakia, leukoplakia, and comparison cohort. The hazard ratio was 8.19 times higher in the OPMD group compared with comparison cohort group, after age and habit adjustment. Female patients with OPMDs had a high risk of malignant transformation.Nationwide screening is very important for early diagnosis. OVH had the highest malignant transformation possibility. Female OPMD patients are a rare but have a relatively high malignant transformation rate.


Assuntos
Transformação Celular Neoplásica/patologia , Detecção Precoce de Câncer/métodos , Mucosa Bucal/patologia , Neoplasias Bucais/epidemiologia , Vigilância da População/métodos , Lesões Pré-Cancerosas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Neoplasias Bucais/patologia , Taiwan/epidemiologia
18.
Neurosci Lett ; 748: 135694, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33600902

RESUMO

Patients with COVID-19 often complain of smell and taste disorders (STD). STD emerge early in the course of the disease, seem to be more common in SARS-CoV-2 infection than in other upper respiratory tract infections, and could in some cases persist for long after resolution of respiratory symptoms. Current evidence suggests that STD probably result from a loss of function of olfactory sensory neurons and taste buds, mainly caused by infection, inflammation, and subsequent dysfunction of supporting non-neuronal cells in the mucosa. However, the possible occurrence of other mechanisms leading to chemosensory dysfunction has also been hypothesized, and contrasting data have been reported regarding the direct infection of sensory neurons by SARS-CoV-2. In this mini-review, we summarize the currently available literature on pathogenesis, clinical manifestations, diagnosis, and outcomes of STD in COVID-19 and discuss possible future directions of research on this topic.


Assuntos
COVID-19/complicações , Transtornos do Olfato/etiologia , SARS-CoV-2/patogenicidade , Distúrbios do Paladar/etiologia , COVID-19/imunologia , COVID-19/virologia , Humanos , Mucosa Bucal/imunologia , Mucosa Bucal/patologia , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/fisiopatologia , Mucosa Olfatória/imunologia , Mucosa Olfatória/patologia , Neurônios Receptores Olfatórios/imunologia , Neurônios Receptores Olfatórios/patologia , SARS-CoV-2/imunologia , Olfato/fisiologia , Paladar/fisiologia , Papilas Gustativas/imunologia , Papilas Gustativas/patologia , Distúrbios do Paladar/diagnóstico , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/fisiopatologia
19.
J Med Case Rep ; 15(1): 97, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33632292

RESUMO

BACKGROUND: Lichen planus is a rare autoimmune disease primarily affecting the skin and mucous membranes of the oral mucosa, vulva, and vagina. Diagnosis is difficult and often delayed as the clinicians do not associate the oral symptoms with the genital symptoms. This has a negative impact on the out-of-pocket expenditure and quality of life of the patients. We report this case, as only anecdotal cases have been reported so far from a developing country such as India. We highlight the unindicated hysterectomy that the patient had undergone because of lack of awareness regarding this condition. Our case report also highlights the importance of the multidisciplinary team approach to optimize outcomes and avoid unnecessary morbidity to such patients. CASE PRESENTATION: We report a North-Indian patient with oro-vaginal-vulvar lichen planus who presented to us with complaints of recurrent vulvovaginal symptoms for the last 5 years. She had been previously treated with multiple courses of antibiotics, antifungals, and topical steroids over the course of 3 years and finally offered laparoscopic-assisted vaginal hysterectomy (LAVH) by a private practitioner but got no relief. She also had complained of oral symptoms in the form of a burning sensation after eating spicy food, but did not seek any treatment for this. After multidisciplinary team discussion, a final diagnosis of oro-vaginal-vulvar lichen planus was made at our institute based on the clinical and histopathological findings. The patient was immediately started on oral prednisolone to which she responded with improvement in her symptoms. CONCLUSION: Lichen planus is a chronic painful condition with significant impact on the quality of life. Women often suffer for several years before an accurate diagnosis is made. Treatment is challenging and needs to be individualized with a multidisciplinary approach to prevent progressive anatomical distortion and associated morbidity.


Assuntos
Histerectomia Vaginal , Líquen Plano/diagnóstico , Líquen Plano/tratamento farmacológico , Líquen Plano/cirurgia , Prednisolona/uso terapêutico , Procedimentos Desnecessários , Adulto , Feminino , Humanos , Índia/epidemiologia , Mucosa Bucal/patologia , Qualidade de Vida , Resultado do Tratamento , Doenças Vaginais/diagnóstico , Doenças da Vulva/diagnóstico
20.
Medicine (Baltimore) ; 100(6): e23626, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578511

RESUMO

BACKGROUND: The number of adult patients affected by the human immunodeficiency virus (HIV) still remains high, mainly in the developing countries. However, only a few affected patients fail to experience oral lesions in the course of their experience with the virus. In particular, oral mucosa ulcers detected among HIV patients may be severe, which depictions may inhibit oral functioning and change patients' quality of life. Thus, it can result in considerable morbidity among this group of patients. To this end, the present study aims to examine the topical agent's clinical therapeutic efficacy among adult patients suffering from HIV-related oral mucosa ulcers. METHODS: For the investigation, only randomized controlled trials on any topical agent used to treat adult patients with HIV oral mucosa ulcers are to be explored from different databases: PubMed, the Cochrane Library, PsycINFO, EMBASE, SCOPUS, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, VIP, and WanFang databases. All databases will be searched from their inceptions to October 2020. Additionally, 2 independent authors will evaluate the possibly eligible studies to be included in the study. They will also perform data's trial extraction and risk of bias assessment. Accordingly, all data will be analysed by means of the RevMan 5.3 software. RESULTS: The present study seeks to evaluate the topical agents' clinical therapeutic efficacy to treat adult patients with HIV-related oral mucosa ulcers. CONCLUSION: The study can be applicable in providing evidence of any topical agents for treating adult patients with HIV-related oral mucosa ulcers for clinical practice. PROTOCOL REGISTRATION NUMBER: DOI 10.17605/OSF.IO/5CYR2 (https://osf.io/5cyr2/).


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Infecções por HIV/complicações , Mucosa Bucal/patologia , Úlceras Orais/tratamento farmacológico , Adulto , Anti-Infecciosos Locais/administração & dosagem , Estudos de Casos e Controles , HIV/efeitos dos fármacos , Infecções por HIV/epidemiologia , Humanos , Mucosa Bucal/virologia , Úlceras Orais/psicologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
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