Role of tumour-associated macrophages in oral squamous cells carcinoma progression: an update on current knowledge.

BACKGROUND: Oral squamous cell carcinoma (OSCC) accounts over 90% of malignant neoplasms of the oral cavity. This pathological entity is associated to a high mortality rate that has remained unchanged over the past decades. Tumour-associated macrophages (TAMs) are believed to have potential involvement in OSCC progression. However, the molecular networks involved in communication between stroma and cancer cells have not yet been fully elucidated. MAIN BODY: The role of M2 polarized cells in oral carcinogenesis is supported by a correlation between TAMs accumulation into OSCC stroma and poor clinical outcome. Signalling pathways such as the NF-κB and cytokines released in the tumour microenvironment promote a bidirectional cross-talk between M2 and OSCC cells. These interactions consequently result in an increased proliferation of malignant cells and enhances aggressiveness, thus reducing patients' survival time. CONCLUSIONS: Here, we present a comprehensive review of the role of interleukin (IL)-1, IL-4, IL-6, IL-8, IL-10 and the receptor tyrosine kinase Axl in macrophage polarization to an M2 phenotype and OSCC progression. Understanding the molecular basis of oral carcinogenesis and metastatic spread of OSCC would promote the development of targeted treatment contributing to a more favourable prognosis.

Conhecimento, atitudes e práticas dos estudantes de Odontologia com relação a pacientes HIV positivos

Avaliar o perfil sociodemográfico, o conhecimento, as atitudes e práticas de 176 alunos dos cursos de graduação e pós-graduação da Faculdade de Odontologia da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Métodos: foi feito um estudo transversal aplicando-se um questionário por meio da ferramenta on-line Qualtrics, disponibilizado pela PUCRS. Resultados: dos estudantes que compuseram a amostra, 76% eram do sexo feminino, solteiros, com idade média de 28 anos e 6 meses; 80% associavam a elevada frequência da candidíase bucal à imunossupressão promovida pelo vírus; 70% vincularam o eritema gengival linear e a leucoplasia pilosa com a referida doença e 53% dos alunos sabiam da possibilidade de ocorrer, nos portadores, xerostomia, hipossialia e aumento de volume das glândulas salivares maiores. Aproximadamente, 90% dos participantes tratavam todos os pacientes como potencialmente infectados e preocupavam-se com o risco profissional para o HIV, 70% da amostra acreditaram na impossibilidade de recusar o atendimento de soropositivos. Conclusão: os resultados demonstraram múltiplas informações sobre a capacita- ção e as expectativas dos estudantes da graduação e da pós-graduação (oriundos ou não da PUCRS), retratando o perfil dos profissionais que estão sendo formados em distintas universidades, que estarão disponíveis para atender os portadores de tal enfermidade.

Risk factors of HIV-related oral lesions in adults.

OBJECTIVE: To assess the risk factors in the occurrence of oral lesions in HIV-positive adults. METHODS: A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate. RESULTS: CD4+ counts lower than 350 cells/mm³ (p < 0.001), alcohol consumption (p = 0.011) and female gender (p = 0.031) were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029) a viral load above 5,000 copies/mm³ (p = 0.003) and smoking (p = 0.005). CONCLUSIONS: Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy.

Risk factors of HIV-related oral lesions in adults / Fatores de risco de lesões bucais associadas ao HIV em adultos / Factores de riesgo de lesiones bucales asociadas al VIH en adultos

OBJECTIVE: To assess the risk factors in the occurrence of oral lesions in HIV-positive adults. METHODS: A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate. RESULTS: CD4+ counts lower than 350 cells/mm³ (p < 0.001), alcohol consumption (p = 0.011) and female gender (p = 0.031) were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029) a viral load above 5,000 copies/mm³ (p = 0.003) and smoking (p = 0.005). CONCLUSIONS: Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy.

OBJETIVO: Analisar fatores de risco para a ocorrência de lesões bucais em adultos soropositivos para o HIV. MÉTODOS: Estudo transversal, descritivo analítico de prontuários médicos/odontológicos de 534 pacientes com lesões bucais associadas ao HIV em Porto Alegre, RS, no período de 1996 a 2011. Os dados foram coletados em cinco centros de referência em saúde para o atendimento de portadores do HIV e comorbidades associadas. Os dados sociodemográficos e clínico-laboratoriais foram coletados em formulários padronizados. Foram incluídos dados exclusivamente de lesões com diagnóstico definitivo e classificadas de acordo com os critérios da ECC on Oral Problems Related to HIV Infection. A análise dos dados foi realizada mediante a aplicação de tabulações cruzadas, teste do Qui-quadrado e modelos de regressão logística. RESULTADOS: Níveis de CD4+ < 350 células/mm³ (p < 0,001), consumo de álcool (p = 0,011) e sexo feminino (p = 0,031) foram predisponentes para candidíase bucal. A ocorrência de leucoplasia pilosa foi associada com contagens de CD4+ < 500 células/mm³ (p = 0,029), cargas virais > 5.000 cópias/mm³ (p = 0,003) e tabagismo (p = 0,005). CONCLUSÕES: Graus de imunodeficiência moderados e severos e cargas virais detectáveis foram fatores de risco para o desenvolvimento de lesões bucais. O consumo de tabaco e álcool aumentou a suscetibilidade de desenvolver infecções oportunistas em adultos HIV positivos, independentemente do uso de terapia antirretroviral.

OBJETIVO: Analizar factores de riesgo para la ocurrencia de lesiones bucales en adultos seropositivos para VIH. MÉTODOS: Estudio transversal, descriptivo analítico de prontuarios médicos/odontológicos de 534 pacientes con lesiones bucales asociadas al VIH en Porto Alegre, RS, Brasil, en el período de 1996 a 2011. Los datos se colectaron en cinco centros de referencia en salud para la atención de portadores del VIH y comorbilidades asociadas. Los datos sociodemográficos y clínico-laboratoriales se colectaron en formularios estandarizados. Se incluyeron datos exclusivamente de lesiones con diagnóstico y clasificadas de acuerdo con los criterios de la ECC on Oral Problems Related to HIV Infection. El análisis de los datos fue realizado mediante la aplicación de tabulaciones cruzadas, prueba de Chi-cuadrado y modelos de regresión logística. RESULTADOS: Niveles de CD4+ < 350 células/mm³ (p<0,001), consumo de alcohol (p=0,011) y sexo femenino (p = 0,031) predispusieron para candidiasis bucal. La ocurrencia de leucoplasia pilosa estuvo asociada con contaje de CD4+ < 500 células/mm³ (p = 0,029), cargas virales > 5.000 copias/mm³ (p = 0,003) y tabaquismo (p = 0,005). CONCLUSIONES: Grados de inmunodeficiencia moderados y severos y cargas virales detectables fueron factores de riesgo para el desarrollo de lesiones bucales. El consumo de tabaco y alcohol aumentó la susceptibilidad de desarrollar infecciones oportunistas en adultos VIH positivos, independientemente del uso de terapia anti=retroviral.

Microflora associated with primary endodontic infections: correlations among SEM evaluation, clinical features, and radiographic findings.

The aim of the present study was to characterize, by means of SEM, primary endodontic infections and to correlate with clinical and radiographic findings. Twelve (12) human extracted teeth (19 roots) presenting primary endodontic infection were examined. SEM qualitative observations of bacterial and defense cells, their features and distribution within the root canal lumen and root dentine were recorded for association with clinical and radiographic tabled data. Although a direct correlation between biofilm composition and clinical/radiographic findings was not established, structural organization and distribution of the biofilm, as well as the characteristics of host response, could be easily related to those features. Bacterial biofilm was predominant at the apical third. Symptomatic apical periodontitis was related to presence of bacterial biofilm all thirds. Defense cells could be seen in the apical third of some samples. These cells were present in all thirds in some of the cases with open cavities. The correlations performed in this study allowed a better understanding of the picture of primary endodontic infection, host response and relevant clinical features. The combined use of scanning electron microscopy with clinical and radiographic evaluation has the potential to overcome some limits of the current knowledge related to pulpal and periapical diseases, providing important insights for improving treatment strategies.