Loricrin expression and its implication in oral submucous fibrosis, hyperkeratosis and normal mucosa with association to habits - An immunohistochemical study

Impairment of Intermediate Filament Expression Reveals Impact on Cell Functions Independent from Keratinocyte Transformation

Although cytoplasmic intermediate filaments (cIFs) are essential for cell physiology, the molecular and cell functional consequences of cIF disturbances are poorly understood. Identifying defaults in cell function-controlled tissue homeostasis and understanding the interrelationship between specific cIFs and distinct cell functions remain key challenges. Using an RNAi-based mechanistic approach, we connected the impairment of cell-inherent cIFs with molecular and cell functional consequences, such as proliferation and differentiation. To investigate cIF disruption consequences in the oral epithelium, different cell transformation stages, originating from alcohol-treated oral gingival keratinocytes, were used. We found that impairment of keratin (KRT) KRT5, KRT14 and vimentin (VIM) affects proliferation and differentiation, and modulates the chromatin status. Furthermore, cIF impairment reduces the expression of nuclear integrity participant lamin B1 and the terminal keratinocyte differentiation marker involucrin (IVL). Conversely, impairment of IVL reduces cIF expression levels, functionally suggesting a regulatory interaction between cIFs and IVL. The findings demonstrate that the impairment of cIFs leads to imbalances in proliferation and differentiation, both of which are essential for tissue homeostasis. Thus, targeted impairment of cIFs appears promising to investigate the functional role of cIFs on cell-dependent tissue physiology at the molecular level and identifies putative interactions of cIFs with epithelial differentiation.

"Ayoub-Shklar" as a Special Stain for Keratin: A Histopathological Study

Background

Special stains in histopathological studies are used to identify the structures with different dyes apart from the routine stain hematoxylin and Eosin (H and E). The component which is present in the special stains will have a specific bond and affinity for particular tissue components in the histological specimen. Structures like keratin takes up an eosinophilic stain in routine (H and E) staining. Most of the potentially malignant disorders and carcinomas arise due to the keratinization defect, which makes keratin an important diagnostic tool. There are different stains such as Ayoub-Shklar (A-S), Dane-Herman (D-H), and rapid Papanicolaou (PAP) which is used to identify keratin. In A-S stain, keratins can be stained in magenta-red and orange colors.

Aim

we compared A-S special stain and routine stain in terms of staining intensity or quality, the pattern of staining, and specificity for staining keratin.

Materials and Methods

Thirty cases from the department archives that included 10 well-differentiated squamous cell carcinoma, 10 verrucous carcinoma, and 10 epithelial dysplasia were taken and each case was stained with both A-S and H and E stain.

Results

A-S showed an almost equal distribution of uniform and patchy staining patterns, but H and E showed more patchy staining patterns in the three groups. H and E stain shows good staining quality than A-S. A-S shows almost 90% of satisfactory staining specificity.

Conclusion

Special stain like A-S stain can be used to stain keratin in different color, but H and E always remain gold standard stain.

Requisite instruments for the establishment of three-dimensional epidermal human skin equivalents-A methods review

Human skin equivalents (HSEs) are three-dimensional skin organ culture models raised in vitro. This review gives an overview of common techniques for setting up HSEs. The HSE consists of an artificial dermis and epidermis. 3T3-J2 murine fibroblasts, purchased human fibroblasts or freshly isolated and cultured fibroblasts, together with other components, for example, collagen type I, are used to build the scaffold. Freshly isolated and cultured keratinocytes are seeded on top. It is possible to add other cell types, for example, melanocytes, to the HSE-depending on the research question. After several days and further steps, the 3D skin can be harvested. Additionally, we show possible markers and techniques for evaluation of artificial skin. Furthermore, we provide a comparison of HSEs to human skin organ culture, a model which employs human donor skin. We outline advantages and limitations of both models and discuss future perspectives in using HSEs.

Correlation Between Clinical and Histopathological Stagings of Oral Submucous Fibrosis: A Clinicopathological Cognizance of 238 Cases From South India

Background  This paper aims to descriptively present the clinico-demographic and pathological profile of 238 cases of oral submucous fibrosis (OSMF) with emphasis on the correlation between clinical and histopathological classification systems and the incidence of malignant transformation. Methods A total of 7098 oral biopsies were retrospectively retrieved over a period of 13 years, out of which 238 cases of OSMF were included in the present study. Data were analyzed for age, gender, habits, clinical symptoms, functional staging, histological staging, type and nature of epithelium, signet-ring cell changes, presence/absence of dysplasia or transformation squamous cell carcinoma, and treatment. Results Clinically and histologically, most cases were moderately advanced. Men outnumbered women. The prevalence of dysplasia was found to be 23.94% and the malignant transformation rate was estimated to be 13.8%. There was a significant correlation between clinical staging with age and histological grading. No correlation was found between histological staging and the age of the patients. Conclusions OSMF is a habit-related progressive chronic oral condition with a high malignant transformation rate. Multimodal treatment with auxiliary physiotherapy helps in the improvement of the clinical symptoms.

Molecular pathways of oral submucous fibrosis and its progression to malignancy

OBJECTIVE

The review aims to comprehend various factors engaged in the alteration of molecular events resulting in Oral submucous fibrosis (OSMF) and its malignant transformation.

DESIGN

Literature pertinent to pathways involved in OSMF were explored in databases such as PubMed, Scopus and Google Scholar. The relevant literature was reviewed and critically appraised in this narrative review.

RESULTS

Areca nut components influence myriad of cellular molecules such as cytokines, growth factors, myofibroblasts, non-coding RNAs and alter their expression. These aberrantly expressed molecules drive the progression of OSMF from localized inflammation to fibrosis of buccal mucosa. The oral tissue suffers from oxidative stress, hypoxia, autophagy, aberration of cell cycle and DNA damage. Apoptosis of epithelial layer results in its atrophy facilitating deeper penetration of areca nut elements. With the advance of disease, epithelial-mesenchymal transition eventuates and promotes dysplasia. The jeopardized expression of various cellular molecules, suppressed apoptosis, along with increased genetic alterations and neovascularization favors the malignant transformation.

CONCLUSION

OSMF is a progressive disorder with complex mechanism of pathogenesis initiated by inflammation of oral mucosa. Continuous habit of areca nut chewing and the resulting insult to the tissues prevents healing process and is destined to debilitating disease which affects the quality of life with a higher probability of progression to malignancy.

Immunohistochemical biomarkers in oral submucous fibrosis: A scoping review

INTRODUCTION

This scoping review was done to study the immunohistochemical biomarkers involved in the pathogenesis and malignant transformation of oral submucous fibrosis (OSF), in literature published from 2010 to 2021.

METHOD

The protocol was adapted from the Joanna Briggs Institute Reviewer's Manual (2017), and reported according to the PRISMA guidelines for Scoping Reviews.

RESULTS

Eighty-six studies included in this review reported 84 immunohistochemical (IHC) biomarkers in OSF: 10 epithelial markers, 28 connective tissue markers, 22 proliferative markers, and 24 other biomarkers that are transcription factors, cancer stem cell markers, cell signaling markers, proteins, and enzymes. The commonly reported IHC biomarkers were alpha-smooth muscle actin (α-SMA) and E-cadherin (seven articles each) followed by vascular endothelial growth factor (VEGF) and CD34 (six articles each), p53, p63, and Ki67 (five articles each). α-SMA, Ki67, CD105, and hTERT were significantly increased in oral squamous cell carcinoma arising in a background of OSF (OSCC-OSF) compared with OSF and normal subjects.

CONCLUSION

The identified surrogate IHC biomarkers reported in OSF in this scoping review require validation with long-term prospective studies to facilitate early diagnosis, for use in risk assessment, and plan appropriate treatment for OSF in clinical practice. Open Science Framework ID: osf.io/epwra.

Co-expression network-based identification of biomarkers correlated with the lymph node metastasis of patients with head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) is ranked as one of the most frequent malignancies worldwide with a high risk of lymph node metastasis, which serves as a main reason for cancer deaths. Identification of the potential biomarkers for lymph node metastasis in HNSCC patients may contribute to personalized treatment and better therapeutic effect. In the present study, GSE30788 microarray data and corresponding clinical parameters were downloaded from Gene Expression Omnibus (GEO) and Weighted Gene Co-expression Network Analysis (WGCNA) was performed to investigate significant modules associated with clinical traits. As a result, the genes in the blue module were determined as candidate genes related with HNSCC lymph node metastasis and ten hub genes were selected from the PPI network. Further analysis validated the close associations of hub gene expression with lymph node metastasis of HNSCC patients. Furthermore, survival analysis suggested the level of Loricrin (LOR) was statistically significantly associated with the disease-free survival of HNSCC patients, indicating the potential of utilizing it as prognosis predictor. Overall, our study conducted a co-expression network-based analysis to investigate significant genes underlying HNSCC metastasis, providing promising biomarkers and therapeutic targets.

Which Factors, Smoking, Drinking Alcohol, Betel Quid Chewing, or Underlying Diseases, Are More Likely to Influence the Severity of COVID-19?

The global outbreak of the coronavirus disease 2019 (COVID-19) pandemic occurred in late 2019 and early 2020. The factors that influence disease severity should be of clinical concern. Existing findings on the effects of smoking on COVID-19 are also controversial and need to be confirmed by further research. In addition, the effects of alcohol consumption and betel quid (BQ) chewing on COVID-19 are unclear. The aim of this study was to examine the demographic characteristics of COVID-19 patients and the effects of smoking, drinking, BQ chewing, and underlying diseases on the severity of COVID-19. A retrospective study was conducted on 91 patients with confirmed cases of COVID-19 hospitalized in Yueyang, Hunan Province, China from 21 January to 8 March, 2020. Patient demographic data, and information on smoking, drinking and BQ chewing, and underlying diseases were extracted from the patient electronic medical records (EMR) and telephone interviews. The chi-square test was used to conduct a univariate analysis of the factors influencing the severity of COVID-19, and ordinal logistic regression analysis was used to identify the factors related to the severity of COVID-19. The results showed that the rates of smoking, drinking and BQ chewing were 15.4, 26.4, and 7.1%, respectively, there was no significant relationship between these lifestyle factors and the severity of COVID-19 (P > 0.05). However, underlying diseases such as diabetes [odds ratio (OR) = 7.740, 95% confidence interval (CI):1.000-60.740, P = 0.050], source of infection (OR = 0.180, 95% CI: 0.030-0.980, P = 0.049), and employment status (retired/unemployed vs. employed: OR = 29.430, 95% CI, 1.050 - 822.330, P = 0.047) were significant independent predictors of severe COVID-19 infection. These individuals should be informed of methods to increase personal protection, and doctors should prevent these individuals from developing serious diseases. It is important to pay attention to the source of infection and timely medical treatment. This study showed that the clinical classification of COVID-19 was associated with patients with diabetes, source of infection, and retired/unemployed. Therefore in the clinical practice of COVID-19 should be more concern these factors. Although no statistical significance was found in smoking, drinking alcohol, BQ chewing, and severity of COVID-19 patients, more studies have confirmed that are harmful and risk factors for underlying diseases in the population. Health authorities should formulate policies to publicize the harmful effects of smoking, drinking, and betel nut chewing and promote a healthy lifestyle.

Comprehensive analysis and identification of key genes and signaling pathways in the occurrence and metastasis of cutaneous melanoma

Background

Melanoma is a malignant tumor of melanocytes, and the incidence has increased faster than any other cancer over the past half century. Most primary melanoma can be cured by local excision, but metastatic melanoma has a poor prognosis. Cutaneous melanoma (CM) is prone to metastasis, so the research on the mechanism of melanoma occurrence and metastasis will be beneficial to diagnose early, improve treatment, and prolong life survival. In this study, we compared the gene expression of normal skin (N), primary cutaneous melanoma (PM) and metastatic cutaneous melanoma (MM) in the Gene Expression Omnibus (GEO) database. Then we identified the key genes and molecular pathways that may be involved in the development and metastasis of cutaneous melanoma, thus to discover potential markers or therapeutic targets.

Methods

Three gene expression profiles (GSE7553, GSE15605 and GSE46517) were downloaded from the GEO database, which contained 225 tissue samples. R software identified the differentially expressed genes (DEGs) between pairs of N, PM and MM samples in the three sets of data. Subsequently, we analyzed the gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway of the DEGs, and constructed a protein-protein interaction (PPI) network. MCODE was used to seek the most important modules in PPI network, and then the GO function and KEGG pathway of them were analyzed. Finally, the hub genes were calculated by the cytoHubba in Cytoscape software. The Cancer Genome Atlas (TCGA) data were analyzed using UALCAN and GEPIA to validate the hub genes and analyze the prognosis of patients.

Results

A total of 134, 317 and 147 DEGs were identified between N, PM and MM in pair. GO functions and KEGG pathways analysis results showed that the upregulated DEGs mainly concentrated in cell division, spindle microtubule, protein kinase activity and the pathway of transcriptional misregulation in cancer. The downregulated DEGs occurred in epidermis development, extracellular exosome, structural molecule activity, metabolic pathways and p53 signaling pathway. The PPI network obtained the most important module, whose GO function and KEGG pathway were enriched in oxidoreductase activity, cell division, cell exosomes, protein binding, structural molecule activity, and metabolic pathways. 14, 18 and 18 DEGs were identified respectively as the hub genes between N, PM and MM, and TCGA data confirmed the expression differences of hub genes. In addition, the overall survival curve of hub genes showed that the differences in these genes may lead to a significant decrease in overall survival of melanoma patients.

Conclusions

In this study, several hub genes were found from normal skin, primary melanoma and metastatic melanoma samples. These hub genes may play an important role in the production, invasion, recurrence or death of CM, and may provide new ideas and potential targets for its diagnosis or treatment.

Evaluation of the Efficacy of Loricrin as a Diagnostic Marker in Patients with Oral Submucous Fibrosis

INTRODUCTION

Loricrin is usually observed in abundance in keratinizing epithelium in response to mechanical stress, which may be associated with development and malignant transformations in conditions such as oral submucous fibrosis (OSMF). Therefore, understanding of various molecular mechanisms associated with difference in gene expressions between OSMF and that of normal oral tissue is important.

AIM

The aim of this study was to evaluate of the efficacy of loricrin as a diagnostic marker in patients with OSMF.

MATERIALS AND METHODS

Fifty formalin-fixed paraffin-embedded tissue blocks were obtained from the archives of the department. The study sample was grouped into two groups of normal mucosa (group I; n = 20) and OSMF (group II; n = 30) specimens. The study tissues were immunohistochemically stained with loricrin antibody and were further graded on basis of staining intensity.

RESULTS

Loricrin immunostaining was observed significantly more in OSMF cases and even in stratum granulosum in comparison to normal mucosa.

CONCLUSION

Loricrin can act as an early indicator and a prognostic marker for detection of deleterious changes within epithelium in OSMF.