Type 2 diabetes mellitus and risk of oral cancer and precancerous lesions: a meta-analysis of observational studies.

OBJECTIVE: Associations between type 2 diabetes mellitus (type 2 DM) and risk of oral cancer and precancerous lesions have been reported with controversial findings. We performed a meta-analysis to explore these associations. METHODS: We identified studies by a literature search of MEDLINE and EMBASE through May 31, 2014, and by searching the reference lists of pertinent articles. Summary relative risk (SRR) with 95% confidence interval (CI) was calculated with a random-effects model. Between- study heterogeneity was assessed using the Cochran's Q and I(2) statistics. RESULTS: A total of 13 studies (4 case-control and 9 cohort studies) on the association between type 2 DM and oral cancer were included. Overall analysis found that compared with non-diabetic individuals, individuals with type 2 DM had a significantly elevated incidence of oral cancer (SRR=1.15, 95% CI: 1.02-1.29; Pheterogeneity=0.277, I(2)=15.4%; 10 studies). Subgroup analyses found that duration of follow-up (⩾11years) significantly altered this positive association. Type 2 DM was associated with increased oral cancer mortality (SRR=1.41, 95% CI: 1.16-1.72; 4 studies). Meta-analysis of the four case-control studies showed a positive association between type 2 DM and risk of oral precancerous lesions (SRR=1.85, 95%CI: 1.23-2.80; Pheterogeneity=0.038, I(2)=57.5%). No significant public bias was found across these studies. CONCLUSIONS: These findings of this meta-analysis indicate that compared with non-diabetic individuals, individuals with type 2 DM have an elevated risk of oral cancer and precancerous lesions development.

Periodontal disease and risk of preeclampsia: a meta-analysis of observational studies.

BACKGROUND: Many epidemiological studies have found a positive association between periodontal disease (PD) and the risk of preeclampsia, but the magnitude of this association varies and independent studies have reported conflicting findings. We performed a meta-analysis to ascertain the relationship between PD and preeclampsia. METHODS: The PubMed database was searched up to January 12, 2013, for relevant observational studies on an association between PD and the risk of preeclampsia. Data were extracted and analyzed independently by two authors. The meta-analysis was performed using comprehensive meta-analysis software. RESULTS: Thirteen observational case-control studies and two cohort studies, involving 1089 preeclampsia patients, were identified. Based on a random-effects meta-analysis, a significant association between PD and preeclampsia was identified (odds ratio = 2.79, 95% confidence interval CI, 2.01-3.01, P<0.0001). CONCLUSIONS: Although the causality remains unclear, the association between PD and preeclampsia may reflect the induction of PD by the preeclamptic state, or it may be part of an overall exaggerated inflammatory response to pregnancy. Larger randomized controlled trials with preeclampsia as the primary outcome and pathophysiological studies are required to explore causality and to dissect the biological mechanisms involved.

[The function of osteopontin and other cytokines in the diagnosis of Sjoigren's syndrome].

PURPOSE: To explore the relationship of serum concentrations of osteopontin(OPN), TNF-α and TGF-ß1 in Sjoigren's syndrome patients. METHODS: Forty Sjoigren's syndrome (SS) patients were determined by pathological examination, which included 15 primary SS and 25 secondary SS. Serum level of OPN, TNF-alpha and TGF-beta 1 were examined by enzyme linked immunosorbent assay (ELISA). Multiple correlation analysis was performed using SPSS13.0 software package. RESULTS: Serum OPN, TNF-alpha levels increased in SS compared with healthy subjects (P<0.05).Serum TGF-beta 1 level in secondary SS significantly increased than primary SS (P<0.05). On the contrary, serum TGF-beta1 level had no significant change compared with the controls. OPN was correlated with TGF-beta 1. CONCLUSIONS: OPN and TNF-alpha may be used as adjunctive diagnostic parameter. TGF-beta 1 can be used as an index in differential diagnosis of primary and secondary SS. OPN and TGF-beta 1 have different effects and interactions between them, demonstrating mutuality, diversity and integrity of the cytokine network.

Osteopontin expression in oral lichen planus.

To explore circulation levels of osteopontin (OPN), tumour necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta1 from patients with oral lichen planus (OLP) for clinical application. A group of 26 subjects with OLP were compared with 26 sex- and age-matched control (NC) subjects. Local lesion tissue was examined for OPN by immunohistochemical analysis. And, serum OPN, proinflammatory TNF-alpha and TGF-beta1 levels were measured by enzyme-linked immunoabsorbent assay. The serum concentrations of OPN and TNF-alpha were significantly higher in OLP patients than the NC group (P < 0.05). Although serum concentrations of TGF-beta1 increased slightly, they were not statistically significant. Erosive-form OLP exhibited significantly elevated TGF-beta1 serum levels, compared with reticular-form OLP. The above results suggest that the production of OPN is associated with the inflammatory process of OLP development, and may serve as a potential disease marker of OLP.

A metabonomic approach to the diagnosis of oral squamous cell carcinoma, oral lichen planus and oral leukoplakia.

Early diagnosis of oral squamous cell carcinoma (OSCC) and precursor lesions is an attractive strategy to decrease patient morbidity and mortality, but presently there are no satisfied diagnostic approaches. This study proposed a metabonomics-based diagnostic approach for OSCC and its precancerous lesions, including oral lichen planus (OLP) and oral leukoplakia (OLK). Saliva samples were collected from patients and healthy donors, and HPLC/MS analysis was performed to acquire metabolic profiles. Diagnostic model was then constructed with hierarchical principal component analysis (HPCA) and discriminate analysis algorithms. The results indicate that metabolic profiling can properly describe the pathologic characteristics of OSCC, OLP and OLK. HPCA combined with kernel fisher discriminant analysis achieved 100% accuracy in diagnosis of test samples, which is superior to direct principal component analysis and other modeling algorithms. The metabonomic approach based on the integral investigation of oral metabolites enables the detection of OSCC and precancerous lesions on noninvasive saliva samples. The proposed approach is noninvasive, efficient and low-cost, and it can be developed as a promising method for population-based screening of cancers and precancers in the oral cavity.

Regulation of fungal infection by a combination of amphotericin B and peptide 2, a lactoferrin peptide that activates neutrophils.

To establish a novel strategy for the control of fungal infection, we examined the antifungal and neutrophil-activating activities of antimicrobial peptides. The duration of survival of 50% of mice injected with a lethal dose of Candida albicans (5 x 10(8) cells) or Aspergillus fumigatus (1 x 10(8) cells) was prolonged 3 to 5 days by the injection of 10 microg of peptide 2 (a lactoferrin peptide) and 10 microg of alpha-defensin 1 for five consecutive days and was prolonged 5 to 13 days by the injection of 0.1 microg of granulocyte-monocyte colony-stimulating factor (GM-CSF) and 0.5 microg of amphotericin B. When mice received a combined injection of peptide 2 (10 microg/day) with amphotericin B (0.5 microg/day) for 5 days after the lethal fungal inoculation, their survival was greatly prolonged and some mice continued to live for more than 5 weeks, although the effective doses of peptide 2 for 50 and 100% suppression of Candida or Aspergillus colony formation were about one-third and one-half those of amphotericin B, respectively. In vitro, peptide 2 as well as GM-CSF increased the Candida and Aspergillus killing activities of neutrophils, but peptides such as alpha-defensin 1, beta-defensin 2, and histatin 5 did not upregulate the killing activity. GM-CSF together with peptide 2 but not other peptides enhanced the production of superoxide (O2-) by neutrophils. The upregulation by peptide 2 was confirmed by the activation of the O2- -generating pathway, i.e., activation of large-molecule guanine binding protein, phosphatidyl-inositol 3-kinase, protein kinase C, and p47phox as well as p67phox. In conclusion, different from natural antimicrobial peptides, peptide 2 has a potent neutrophil-activating effect which could be advantageous for its clinical use in combination with antifungal drugs.