ALDH1 expression and potential clinical implications in chronic inflammatory periapical lesions

Abstract: Aldehyde dehydrogenase 1 (ALDH-1) is a marker of stem cells in a variety of diseases, but its role in individuals with chronic inflammatory periapical lesions remains unknown. The aim of this study was to investigate the presence of cells with a stem cell profile based on the immunoexpression of ALDH-1 in periapical granulomas (PGs) and radicular cysts (RCs). A total of 51 cases of periapical lesions (25 PGs and 26 RCs) were subjected to immunohistochemical study. The anti-ALDH-1 antibody was applied using the immunoperoxidase technique. An immunoexpression score (intensity vs. percentage of cells) was used, with the cases being classified as low expression (score: 0 to 4) and high expression (score: 6 to 9). The Chi-square test was used with a 5% level of significance. Immunoexpression of ALDH-1 was detected in all cases of PGs and RCs. In PG cases, the expression was diffuse in connective tissue cells, with most cases exhibiting high expression (n = 18; 69.2%), while in RC cases the expression revealed focal distribution in cells of the capsule and epithelial cells of the cystic lining, with most cases classified as low expression (n = 18; 72%). Significant differences in the expression scores of ALDH-1 were observed in PGs (p = 0.003). The variable expression of ALDH-1 suggests the presence of cells with stem cell profiles in PGs and RCs. These findings suggest that periapical tissues infiltrated by chronic inflammation can recruit important cells for the repair or evolution of periapical lesions.

Polymorphisms of matrix metalloproteinase-7 and -9 are associated with oral tongue squamous cell carcinoma

Abstract Matrix degradation is an important event in the progression, invasion and metastasis of malignant head and neck lesions. Imbalances, mutations and polymorphisms of MMPs and their inhibitors are observed in several cancer subtypes. The aim of this study was to evaluate the association of the MMP-7 gene promoter (181 A/G) and MMP-9 (-1562 C/T) polymorphisms in oral tongue squamous cell carcinoma (OTSCC). MMP-7 (rs11568818) and MMP-9 (rs3918242) single-nucleotide polymorphisms (SNPs) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis in 71 cases of OTSCC. Normal tissue specimens were obtained from 60 healthy volunteers to serve as the control. The MMP-7 G allele and MMP-9 T allele were more frequent in the OTSCC group than the control group, but only when these two SNPs were taken together was a significant association found with the nodal metastasis of OTSCC (p < 0.001). Based on our results, SNPs in the promoter region of MMP-7 and MMP-9 appear to be associated with greater risk of developing OTSCC, and with a higher propensity to form metastatic tumors. In this respect, molecular studies investigating polymorphisms may be useful in predicting tumor behavior.

Expression of urokinase-type plasminogen activator and its receptor in squamous cell carcinoma of the oral tongue

Abstract Urokinase-type plasminogen activator (uPA) and its receptor (uPAR) act in the proteolysis of basement membrane and extracellular matrix structures, facilitating tumor invasion. The purpose of this study was to evaluate the relationship between these proteins and clinicopathological parameters in squamous cell carcinoma of the oral tongue (SCCOT). Sixty cases of SCCOT were submitted to immunohistochemistry and analyzed semiquantitatively at the invasion front and in the tumor core. The results were associated with lymph node metastasis, clinical stage, locoregional recurrence, clinical outcome and histological grade of malignancy. A higher expression of uPA was observed in cases of tumors of high-grade versus low-grade malignancy (p = 0.010). Moreover, the cases with the worst pattern of invasion presented an overexpression of uPA (p = 0.011). The presence of locoregional recurrence was associated with uPAR (p = 0.039), and the expression of both biomarkers was much higher at the invasion front than in the tumor core (p < 0.001). The results suggest uPA and uPAR are involved in the progression and aggressiveness of SCCOT, mainly at the tumor-host interface.

Immunohistochemical expression of TGF-ß1 and MMP-9 in periapical lesions

Abstract The objective of this study was to evaluate the expression of matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta (TGF-β1) in periapical lesion samples correlated with the intensity of the inflammatory infiltrate and thickness of the epithelial lining. Forty-five cases of periapical lesions (23 periapical granulomas and 22 radicular cysts) were subjected to morphological and immunohistochemical analyses using anti-MMP-9 and anti-TGF-β1 antibodies. The data were analyzed using the following tests: non-parametric Mann-Whitney, chi-square, Fisher's exact test and Spearman's correlation test (P<0.05). Analysis of inflammatory infiltrate revealed that 78% of periapical granulomas presented infiltrate grade III, in contrast with 32% of radicular cysts (P<0.001). Morphological evaluation of the epithelial thickness in radicular cysts revealed the presence of atrophic epithelium in 86% of the cysts. The immunostaining of MMP-9 was score 2 in 67% of the granulomas and 77% of the cysts. Both lesions were predominantly score 1 for TGF-β1. Significant differences were confirmed between the expression scores of TGF-β1 and MMP-9 in periapical granulomas (p = 0.004) and in radicular cysts (p < 0.001). Expression of TGF-β1 was different for periapical granulomas and radicular cysts. This immunoregulatory cytokine seems more representative in asymptomatic lesions. The extracellular matrix remodeling process dependent on MMP-9 seems to be similar for both periapical granulomas and radicular cysts. TGF-β1 and MMP-9 may play an important role in the maintenance of periapical lesions.

Reabilitação com oftalmopróteses em dois pacientes com distintas etiologias de perda ocular / Rehabilitation with ophthalmic prosthesis in two patients with different from lost eye etiologies

A tentativa do homem em restaurar aloplasicamente a região bucomaxilofacial mutilada é tão antiga quanto a formação das civilizações, tendo em vista a importância do olho como uma das estruturas mais importantes na individualização e harmonia da face. Na atualidade, algumas entidades públicas promovem atendimentos a pacientes mutilados que necessitam de uma reabilitação por meio de Prótese Bucomaxilofacial (PBMF), sendo a maior procura pelas oftalmopróteses devido ao grande número de traumas nessa região da face. A prótese ocular é importante para reconstruir a estética, embelezar o rosto cuja harmonia está comprometida, promover a sustentação e a tonicidade muscular palpebral, proteger a cavidade anoftálmica, evitar atresias, entre outros. Tal reabilitação faz parte dos cuidados necessários e representa uma conquista de melhor qualidade de vida para os pacientes e suas famílias. Neste trabalho, os relatos de dois casos clínicos visam apresentar duas reabilitações com oftalmopróteses individualizadas em pacientes com idades diferentes e etiologia da anoftalmia também distintas que resultaram em estéticas favoráveis. Após a confecção das próteses, foi observado que a reabilitação protética anterior ao desenvolvimento ou agravamento de dificuldades de relações interpessoais tende a melhorar a qualidade de vida, visto que a queixa principal quando inexistente melhora o desenvolvimento psicossocial dos pacientes... (AU)

Man’s attempt to restore so alloplastic the maxillofacialregion is as old as the formation of civilizations. Given the importance of the eye as the most significant structure in the individualization and harmony of the face. Nowadays some public entities promote special care to patients who need a mutilated rehabilitation through Maxillofacial Prosthodontics (MFP), the highest demand is for eye prosthesis due to the large number of injuries in this region of the face. The ocular prosthesis aims to reconstruct the aesthetic, beautify the face whose harmony is committed to promote and support the eyelid muscle tone, protect the anophthalmic socket, avoid closure, among others.Such rehabilitation is part of palliative care and is an achievement of better quality of life for patients and their families. In this study, reports of two cases aim to present two eye prosthesis individualized rehabilitation in patients with different ages and different etiology of anophthalmic also resulted in favorable aesthetic. Thus it can be concluded that the prosthetic rehabilitation prior to the development or worsening of interpersonal difficulties relations tends to improve the quality of life of patients, since the main complaint nonexistent improves psychosocial development of these... (AU)

Expressão da metaloproteinase 9 no carcinoma de células escamosas oral / Expression of matrix metalloproteinase 9 in oral squamous cell carcinoma

A metaloproteinase-9 (MMP-9) ou gelatinase B pertence à família das metaloproteinases da matriz, enzimas que degradam componentes da matriz extracelular (MEC) e da membrana basal e estão implicadas no processo de carcinogênese, contribuindo para a progressão tumoral, invasão e metástase. Neste trabalho, a MMP-9 foi utilizada como marcador imuno-histoquímico, a fim de correlacionar sua expressão com a gradação histológica de 28 casos de carcinoma de células escamosas oral (CCEO) obtidos do Laboratório de Patologia Bucal da Faculdade de Odontologia de Pernambuco (FOP/UPE). As amostras foram classificadas quanto ao grau de malignidade em carcinoma in situ, baixo grau, grau moderado e alto grau de malignidade. A técnica imuno-histoquímica foi realizada através do método estreptavidina-biotina, utilizando o anticorpo anti-MMP9. Na análise estatística, foi utilizado o teste Exato de Fischer, com nível de significância de p=0.05. Verificou-se que a MMP-9 apresentou positividade em 24 casos (85.7%) de CCEO, sendo observada correlação estatisticamente significativa entre a expressão da MMP-9 e o grau de malignidade (p=0.002). Os resultados indicam que a expressão da MMP-9 pode ser sugerida como fator preditivo de comportamento biológico agressivo no CCEO... (AU)

The metalloproteinase-9 (MMP-9) or gelatinase B belongs to the family of matrix metalloproteinases, enzymes which degrade extracellular matrix (ECM) and basement membrane components and are implicated in the carcinogenesis process, contributing to tumor progression, invasion and metastasis. In this work, MMP-9 was used as an immunohistochemical marker in order to correlate its expression with histological grading of 28 cases of oral squamous cell carcinoma (OSCC) obtained from the Laboratory of Oral Pathology, School of Dentistry of Pernambuco (FOP / UPE). The samples were classified according to the malignancy grade as in situ carcinoma, low grade, intermediate grade and high grade of malignancy. The immunohistochemistry technique was performed by the streptavidin-biotin method using the antibody anti-MMP9. The statistical analysis used the Fisher's exact test, with a significance level of p=0.05. It was verified that MMP-9 expression was positive in 24 OSCC cases (85.7%). Significant statistical correlation was observed between the expression of MMP-9 and the degree of malignancy (p=0.002). The results indicate that expression of MMP-9 may be suggested as a predictor of aggressive biological behavior in OSCC... (AU)

Estudo da expressão imuno-histoquímica da metaloproteinase – 9 (MMP-9) em lesões periapicais / Study of the immunohistochemical expression of metalloproteinase –9 (MMP-9) in periapical lesion

Objetivo: avaliar através da técnica imuno-histoquímica a expressão da metaloproteinase-9 (MMP-9) em granulomas periapicais e cistosradiculares. Metodologia: Foram selecionados 47 casos de lesõesperiapicais dos quais 26 eram granulomas periapicais e 21 cistosradiculares no período de 14 anos no Laboratório de Patologia Cirúrgica Profº Rildege Accioly, da Faculdade de Odontologia de Pernambuco FOP/UPE. Os dados demográficos analisados foram: sexo, raça, idade, sintomatologia, aspecto radiográfico e localizaçãoanatômica. A amostra composta por47 casos foi submetida à técnicaimuno-histoquímica que foi realizada através do método estreptavidina -biotina, utilizando o anticorpo anti-MMP9. O teste estatístico utilizado foi o exato de Fisher (p≤0,05). Resultado: 55,3% das lesões encontradas corresponderam a granuloma periapical. A faixa etária prevalente foi de 31 a 40 anos de idade(40,9%). Observou-se maior número de casos da raça branca (68,2%) e do sexo feminino (59,6%). Quanto à sintomatologia 72,1% corresponderam a lesões assintomáticas, e quanto ao aspecto radiográfico radiolúcida em 88,6% dos casos, sendo a maxila alocalização anatômica mais acometida (59,1%). Em relação à expressão imuno- histoquímica da MMP-9, 19 cistos (90,5%) e 25granulomas (96,2%) foram positivos, exibindo intensidade de expressão variada. Conclusão: O granuloma periapical é a lesão periapical inflamatória de origem odontogênica mais comum em indivíduos da raça branca na faixa etária entre 31– 40 anos. A MMP-9 parece participardo processo de desenvolvimento e manutenção dos cistos e granulomas periapicais, participando do processo inicial de osteólise principalmente por degradar vários componentes damatriz extracelular.

Purpose: evaluate the immunohistochemical technique using the expression of metalloproteinase-9 (MMP-9) in periapical granulomasand cysts root. Methods: We selected 60 cases of periapical lesions of which 31 were peria pical granulomas and 29 radicular cysts in 14 years in the Laboratory of Surgical Pathology Professor, Rildege Accioly, Faculty of Dentistry of Pernambuco FOP / UPE. Demographic data were collected through biopsy referral sheets on file in the laboratory. The sample comprised47 cases were subjected to immuno histochemical technique that was performed using the streptavidin- biotin method, using anti-MMP7. The statistical test used was Fisher's exact test (p≤0.05). Results: 55.3% of the lesions corresponded to periapical granuloma while 44.7% corresponded tocysts. The most prevalent age group was 31-40 years old (40.9%).There was a higher number of cases were white (68.2%) and females(59.6%). Regarding symptoms accounted for 72.1% of asymptomaticlesions and radiographic radiolucent (88.6%), and the jaw anatomiclocation most affected (59.1%). Regarding the immunohistochemicalexpression of MMP-9 in periapical lesions, 19 cysts (90.5%) and 25 granulomas (96.2%) were positive showing intensities. Conclusion:The periapical granuloma is inflammatory periapical lesion odontogenic more common in Caucasians aged 31-40 years. TheMMP-9 seems to participate in the process of development and maintenance of periapical cysts and granulomas, participating in the initial process of osteolysis primarily degrade various components of the extracellular matrix.