Survival and Success of Dental Implants in Patients with Autoimmune Diseases: a Systematic Review.

Objectives: The purpose of this systematic review is to disclose the impact of autoimmune diseases and their medical treatment on dental implant survival and success. Material and Methods: A literature search was conducted using MEDLINE (PubMed), The Cochrane Library and Embase up to December 6th, 2021. Any clinical study on patients with an autoimmune disease in whom implant therapy was performed was eligible. The quality of included studies was assessed using the Newcastle-Ottawa Scale. For each autoimmune disease group, data synthesis was divided into three groups: 1) overall results of the autoimmune disease, 2) overall results of corresponding control groups and 3) overall results of the autoimmune disease with a concomitant autoimmune disease (a subgroup of group 1). Descriptive statistics were used. Results: Of 4,865 identified articles, 67 could be included and mainly comprising case reports and retrospective studies with an overall low quality. Implant survival rate was 50 to 100% on patient and implant level after a weighted mean follow-up of 17.7 to 68.1 months. Implant success was sporadically reported. Data on immunosuppressive medication were too heterogeneously reported to allow detailed analysis. Conclusions: Overall, a high implant survival rate was reported in patients with autoimmune diseases. However, the identified studies were characterized by a low quality. No conclusions could be made regarding implant success and the effect of immunosuppressants due to heterogeneous reporting.

The role of natural salivary defences in maintaining a healthy oral microbiota.

OBJECTIVES: To provide an update on our current understanding of how saliva and its various constituents directly and indirectly affect oral bacteria and thereby play a role in the modulation and maintenance of a healthy oral microbiota and also the associations with symbiosis and dysbiosis. METHODS: The search for biomedical literature on saliva and its antimicrobial activities (years 1966 to 2017) was conducted in PubMed, Embase and Web of Science databases. RESULTS: This review underlines that saliva plays an essential role in shaping and maintaining the ecological equilibrium of the resident oral microbiota. Saliva contributes to the formation of the salivary pellicle, which covers the oral hard and soft tissues, and thereby determines the initial adhesion and colonisation of microorganisms. Saliva facilitates clearance of dietary carbohydrates and microorganisms from the oral cavity, but also supplies bacteria with nutrients through enzymatic breakdown of dietary starch and proteins and salivary glycoproteins. In addition, saliva comprises proteins such as mucins, which block the adherence of certain microorganisms to oral surfaces through binding and aggregating mechanisms. Saliva also provides antimicrobial activity through numerous proteins and peptides including mucins, lactoferrin, lysozyme, lactoperoxidase, statherin, histatins and secretory immunoglobulin A. CONCLUSIONS: A balanced oral microbiome is important for the maintenance of oral health and symbiosis. Conditions associated with salivary gland hypofunction, impaired oral clearance, low salivary pH and altered salivary composition, often lead to perturbation of the function and composition of the oral microbiome causing dysbiosis, and an associated risk of oral disease. CLINICAL SIGNIFICANCE: Saliva plays a significant role in keeping the relationship between the host and oral microbiota in a symbiotic state. In conditions with salivary gland dysfunction, the natural balance of the oral microbiome is often disturbed, leading to dysbiosis and associated risks of gingivitis, caries and fungal infection.

Modifications of cholera toxin subunit B binding to human large intestinal epithelium. An immunohistochemical study.

Binding of cholera toxin subunit B (CTB) to its receptor and toxin transport into the intestinal epithelial cells are the causative events for the potentially lethal disease cholera. The five sugar mono-sialo ganglioside GM1 is the cell surface receptor for cholera toxin B-subunit. CTB binding was determined by use of immobilized GM1 to microtiter plates and by immunohistochemistry. Sections from the human colon and the human soft palate were incubated with FITC-conjugated CTB and with anti-MUC2. Both the luminal surface of the intestine and the secretory goblet cells exhibited strong binding. Addition of simple carbohydrates and milk to the incubation medium showed that a combination of lactose and non-fat dry milk was potent inhibitors of toxin- and mucin binding. Both CTB and ant-MUC2 stained to the cytoplasm (mucin granules) in the goblet cells from the human soft palate. In the colon CTB stained the entire cytoplasm of the goblet cells while anti-MUC2 detected only the supranuclear region of some cells, suggesting carbohydrate heterogeneity between goblet cell mucin granules in different regions of the human body. Both CTB- and MUC2 binding were inhibited when GM1 was added to the incubation medium. It is proposed that the human colonic goblet cells play a role in the secretory diarrhea in patients with cholera and that milk might have a prophylactic or therapeutic application in the management of cholera.

World Workshop on Oral Medicine VI: clinical implications of medication-induced salivary gland dysfunction.

OBJECTIVE: This study aimed to systematically review the available literature on the clinical implications of medication-induced salivary gland dysfunction (MISGD). STUDY DESIGN: The systematic review was performed using PubMed, Embase, and Web of Science (through June 2013). Studies were assessed for degree of relevance and strength of evidence, based on whether clinical implications of MISGD were the primary study outcomes, as well as on the appropriateness of study design and sample size. RESULTS: For most purported xerogenic medications, xerostomia was the most frequent adverse effect. In the majority of the 129 reviewed papers, it was not documented whether xerostomia was accompanied by decreased salivary flow. Incidence and prevalence of medication-induced xerostomia varied widely and was often associated with number and dose of medications. Xerostomia was most frequently reported to be mild-to-moderate in severity. Its onset occurred usually in the first weeks of treatment. There was selected evidence that medication-induced xerostomia occurs more frequently in women and older adults and that MISGD may be associated with other clinical implications, such as caries or oral mucosal alterations. CONCLUSIONS: The systematic review showed that MISGD constitutes a significant burden in many patients and may be associated with important negative implications for oral health.

TH17 cell induction and effects of IL-17A and IL-17F blockade in experimental colitis.

BACKGROUND: T helper (TH) 17 cells are believed to play a pivotal role in development of inflammatory bowel disease, and their contribution to intestinal inflammation has been studied in various models of colitis. TH17 cells produce a range of cytokines, some of which are potential targets for immunotherapy. However, blockade of IL-17A alone with secukinumab was not effective in Crohn's disease. In this regard, the pathogenic impact of IL-17A versus IL-17F during intestinal inflammation is still unresolved. METHODS: Development of IFN-γ-producing, IL-17A-producing, and IL-17F-producing CD4 T cells was analyzed in the CD4CD25 T-cell transfer model of colitis at varying degrees of colitis. The pathogenic roles of IL-17A and IL-17F were investigated by treating colitic mice with neutralizing antibodies against these 2 cytokines. RESULTS: We found that colitis development was associated with an increase in IL-17A-producing TH17 cells in spleen, mesenteric lymph nodes, and lamina propria. In contrast, the relative abundance of IFN-γ-producing TH1 cell was stable in all 3 organs during progression of colitis, and the frequency of IFN-γIL-17A double-positive cells declined in spleen and mesenteric lymph node but not in lamina propria. IL-17F was coexpressed in TH17 cells and IFN-γIL-17A double positive but not in TH1 cells and its expression inversely correlated with colitis development. In vivo neutralization of both IL-17A and IL-17F ameliorated colitis in particular at early administration, whereas neutralization of IL-17A or IL-17F alone was inefficient. CONCLUSIONS: TH17 cell development correlates with colitis progression, and concurrent neutralization of their cytokine products IL-17A and IL-17F ameliorates intestinal inflammation. These findings suggest combined IL-17A and IL-17F blockade as a potential strategy in inflammatory bowel disease therapy.