Microchimerism: A new concept.

Microchimerism is the presence of cells from one individual in another genetically distinct individual. Pregnancy is the main cause of natural microchimerism through transplacental bi-directional cell trafficking between mother and fetus. In addition to a variety of cell-free substances, it is now well-recognized that some cells are also exchanged in pregnancy. Furthermore, it is now known that microchimerism persists decades later both in mother and in her progeny. The consequences of pregnancy-related microchimerism are under active investigation. However, many authors have suggested a close relationship linking fetal microchimerism and the development of autoimmune diseases. Fetal microchimerism is emerging as a potential contributing factor in certain diseases, including cancer. Parallel studies in animal and human pregnancy suggest that microchimeric fetal cells play a role in wound healing. Role of these microchimeric cells in human health and disease is discussed here.

Expression of p63 in tooth germ, dentigerous cyst and ameloblastoma.

CONTEXT: To assess the role of p63, a p53 homolog, in the cytodifferentiation (odontogenesis) and oncogenesis of odontogenic epithelium. AIM: The present study aimed to compare the expression pattern of p63 in the epithelium of tooth germ, dentigerous cyst (DC) and ameloblastoma (AB). MATERIALS AND METHODS: Tissue specimens of thirty tooth germs, thirty ABs and thirty DCs were examined by immunohistochemistry for the expression of p63. Results: p63 labeling index (LI) was observed in descending order in epithelial cells of ABs, tooth germs and DCs. p63 LI was statistically nonsignificant among all the three groups. ABs revealed the highest p63 expression, but, surprisingly, tooth germs showed higher expression than DCs. CONCLUSION: p63 plays a role in the cytodifferentiation and proliferation of odontogenic epithelial cells irrespective of the tissue (normal developing or lesional tissue). This implies that p63 cannot be used as a diagnostic marker. However, our results indicate p63 overexpression as a mark of increased proliferation. Thus, it can be stipulated that p63 can be used as a prognostic marker in odontogenic lesions with more aggressive and invasive phenotype. Our results also suggest the differential function of p63 in both developing and lesional odontogenic tissues, which, however, depends on p63 isoform predominantly being expressed. Therefore, identification of p63-predominant isoform in a particular lesion is more important than the presence or absence of p63. Consequently, we suggest the performance of polymerase chain reaction analysis along with immunohistochemical evaluation in further studies.

Antiadherence and antimicrobial property of herbal extracts (Glycyrrhiza glabra and Terminalia chebula) on Streptococcus mutans: An in vitro experimental study.

BACKGROUND: Herbal agents are used for treating different forms of diseases since decades. In the current study, the antiadhesive property of herbal extracts has been evaluated using Glycyrrhiza glabra (GG) and Terminalia chebula (TC) herbal extracts on Streptococcus mutans. MATERIALS AND METHODS: The plant extracts (GG and TC) were powdered in mechanical grinder. Ten gram of each plant extract in powder form was placed in porous bag or thimble. The extract was placed in a round-bottom flask and was transferred into clean preweighed universal tubes. The yield strength of the extract was calculated. The antiadherence property of the herbal extract was evaluated using glass surface adherence test. STATISTICAL ANALYSIS: The statistical analysis was done using one-way analysis of variance followed by post hoc Tukey's test. RESULTS: Both herbal extracts have significant antiadhesive and antimicrobial activity against S. mutans, however, high antiadherence property was seen with TC than GG. CONCLUSION: Both the plant extracts exhibit inhibitory activity against S. mutans. However, TC had more clinically significant results than GG, but it was found statistically insignificant.

Comparative evaluation of micronuclei in exfoliated oral epithelial cells in potentially malignant disorders and malignant lesions using special stains.

INTRODUCTION: Micronuclei (MNs) are extranuclear cytoplasmic DNA bodies which are induced in cells by numerous genotoxic agents that damage chromosome. The MN assay in exfoliated buccal cells is a useful and minimally invasive method for monitoring genetic damage. AIM: The aim of present study was to detect and assess MNs in oral exfoliated cells in patients diagnosed with leukoplakia with dysplasia, oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC) using special stains and to determine the most appropriate staining technique for the evaluation of MNs along with a comparative evaluation of MNs with histological grading. MATERIALS AND METHODS: The study was conducted in the Department of Oral Pathology and Microbiology, CDCRI, Rajnandgaon, and a total of 45 subjects were included in the study who were subsequently divided into three groups (15 each). Four smears were obtained from each subject which were taken from the lesional tissue and stained simultaneously. ANALYSIS: The results were analyzed via Statistical Package for the Social Sciences, version 23.0 (SPSS). RESULTS: The results confirmed the association of MNs with genotoxic agents and showed an elevated number in OSCC followed by OSMF and leukoplakia. The frequency also increased with the severity of the lesion. Besides this, Papanicolaou (PAP) stain was found to be the most suitable stain for detection of MNs. CONCLUSION: Based on the above pretext, we can conclude that PAP stain was the most suitable stain for valuation of MNs and that the MN assay holds promise as a specific biomarker of genotoxicity, for screening of oral cancer and can be used as a prognostic indicator.

Cytomorphometric analysis of gingival epithelium and buccal mucosa cells in type 2 diabetes mellitus patients.

BACKGROUND: The global prevalence of type 2 diabetes continues to rise. Interest has been increasing recently in noninvasive diagnostic procedure. Hence, an attempt has been made by the present study to analyze the changes in cytomorphometry in exfoliated buccal and gingival mucosa cells in type 2 diabetic patients. AIM: The aim of this study was to analyze the cytomorphometric changes in exfoliated cells of gingiva and buccal mucosa as an adjunct to diagnosis of diabetes. MATERIALS AND METHODS: In the present study, fifty known type 2 diabetic patients were taken as study group, and the control group was comprised of fifty healthy individuals. Smear was prepared from buccal mucosa and gingival epithelium of both study and control groups and was stained by rapid Papanicolaou (Pap) stain. Stained smears were subjected to cytomorphometric analysis using Lynx Biolux (Lawrence and Mayo) image analysis software. In each Pap smear, 100 cells were evaluated for nuclear area (NA), cytoplasmic area (CA) and cytoplasm to nuclear ratio (CNR). RESULTS: Mean NA was significantly higher (P < 0.05) in study group whereas mean CA did not exhibit any statistically significant difference (P > 0.05). The mean CNR was significantly lower in the study group (P < 0.05). CONCLUSION: This study contributes to the general understanding of the alterations in the cellular pattern of buccal and gingival mucosa cells in diabetic patients and can be used as an additional tool to aid in the evaluation of oral mucosal alterations in diabetes mellitus.

Darier disease: A rare genodermatosis.

Darier disease (DD), also known as keratosis follicularis or dyskeratosis follicularis, is a rare autosomal dominant genodermatosis with high penetrance and variable expressivity. It is caused by mutations of ATP2A2 gene which encodes the sarco/endoplasmic reticulum Ca2+ ATPase isoform 2. It is clinically manifested by hyperkeratotic papules primarily affecting seborrheic areas on the head, neck and thorax, with less frequent involvement of the oral mucosa. When oral manifestations are present, they primarily affect the palatal and alveolar mucosa, are usually asymptomatic and are discovered in routine dental examination. Histologically, the lesions show suprabasal clefts with acantholytic and dyskeratotic cells. We present a case of 35-year-old female patient with typical clinical and histological features of DD.

Curcuma longa extract - Haldi: A safe, eco-friendly natural cytoplasmic stain.

BACKGROUND: Eosin is most widely used synthetic dye belonging to the xanthene group. These dyes are efficient but are hazardous to human and animal health. With the increasing awareness of a green earth, it is advisable to use more of eco-friendly and biodegradable material which can be effectively achieved by the use of natural dyes obtained from plants and other natural sources. Turmeric, available as Curcuma longa (domestic), has long been in use in the subcontinent as a spice and flavoring agent in most food preparations. Its health benefit as a natural antibiotic and anti-inflammatory has been successfully established by several researchers. The intense yellow color imparted by turmeric inspired us to explore its efficacy as a potential alternative for eosin in routine histopathological procedures. AIM: The aim of this was to explore the efficacy of turmeric extract as a stand-alone counterstain for hematoxylin and its comparative assessment with routine H and E staining. MATERIALS AND METHODS: The rhizomes of C. longa were cut into small pieces, dried and milled. This powder was dissolved into alcohol and centrifuged using a centrifugal machine. The supernatant was then collected with the help of micropipette. This supernatant was used as a counterstain for hematoxylin. RESULTS: The data were analyzed using Mann-Whitney U test with Statistical Package for the Social Sciences version 15.0 (SPSS Inc.,). The P value obtained was statistically insignificant (P > 0.05). CONCLUSION: Although eosin is the most efficient counterstain for hematoxylin, turmeric can also be used as an alternative for eosin.

Treatment Emergent Agranulocytosis with Skin and Gingival Lesions in a Chronic Lymphocytic Leukemia Patient: A Case Report.

Chronic Lymphocytic Leukaemia (CLL) is a monoclonal lymphoid malignancy characterized by progressive accumulation of small, mature but functionally incompetent neoplastic lymphocytes in the peripheral blood, bone marrow and lymphoid organs. Patients present a variable course and may not require early intervention unlike other malignancies. Patients with rapidly deteriorating blood counts, and organomegaly need treatment. Alkylating agent live Bendamustine combined with Rituximab, anti-CD 20 monoclonal antibody have shown promising results in such patients. Anaemia, neutropenia and thrombocytopenia have been reported as treatment emergent events with this combination therapy. Neutrophils are the major innate defense and their depletion can result in a wide range of opportunistic infections. This case report discusess the oral and dermal lesions which emerged with the Rituximab and Bendamustine combination therapy in a patient with CLL and their management.

Oropharyngeal candidosis relative frequency in radiotherapy patient for head and neck cancer.

BACKGROUND: Radiation given during treatment of oral and pharyngeal malignancy frequently causes alteration of the oral environment predisposing to the colonization of the oral mucosa by yeast species most frequently Candida. OBJECTIVE: Thus, this study was undertaken in 107 patients to find out association between radiation therapy and frequency of oropharyngeal candidosis, to quantitate colony forming units (CFUs) to identify Candida at species level and to check the incidence of serotype A and B in C. albicans. MATERIALS AND METHODS: The study was done on patients suffering from oropharyngeal cancer who were advised radiotherapy. The oral rinse collection method was used to collect the sample. Sabourauds Dextrose Agar (SDA) was used as primary culture media and subsequently speciation was done using standard techniques. The strains of C. albicans were serotyped employing the method described by Hansclever and Mitchell (1961, J Bacteriol 1961;82:570-3). RESULTS: 26.16% patients were mycologically positive for candida before radiotherapy with CFUs 100. 14 ± 59.11 that increased to 60.74% patients during radiotherapy with an increase in CFUs to 490.15 ± 207.97. Clinically, grading of mucositis was done and also individual signs and symptoms were noted in each patient. The occurrence of erythmatous lesions, ulceration, and xerostomia were found to be statistically significant (P<0.05). C. albicans was the most frequently encountered species with higher prevalence of serotype A suggesting higher virulent species. CONCLUSION: It is proposed that in such patients taking radiotherapy prophylactic antifungal treatment should be given specially in patients showing development of oral mucosal lesions such as erythmatous lesions, ulcerations, and complaining about dryness of mouth, that is, xerostomia irrespective of presence or absence of clinical oral candidosis.