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Gao L, Guo H, Ye N, Bai Y, Liu X, Yu P, Xue Y, Ma S, Wei K, Jin Y, Wen L, Xuan K. Oral and craniofacial manifestations and two novel missense mutations of the NTRK1 gene identified in the patient with congenital insensitivity to pain with anhidrosis. PLoS One 2013; 8:e66863. [PMID: 23799134 PMCID: PMC3682965 DOI: 10.1371/journal.pone.0066863] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 05/10/2013] [Indexed: 01/25/2023] Open
Abstract
Congenital insensitivity to pain with anhidrosis (CIPA) is a rare inherited disorder of the peripheral nervous system resulting from mutations in neurotrophic tyrosine kinase receptor 1 gene (NTRK1), which encodes the high-affinity nerve growth factor receptor TRKA. Here, we investigated the oral and craniofacial manifestations of a Chinese patient affected by autosomal-recessive CIPA and identified compound heterozygosity in the NTRK1 gene. The affected boy has multisystemic disorder with lack of reaction to pain stimuli accompanied by self-mutilation behavior, the inability to sweat leading to defective thermoregulation, and mental retardation. Oral and craniofacial manifestations included a large number of missing teeth, nasal malformation, submucous cleft palate, severe soft tissue injuries, dental caries and malocclusion. Histopathological evaluation of the skin sample revealed severe peripheral nerve fiber loss as well as mild loss and absent innervation of sweat glands. Ultrastructural and morphometric studies of a shed tooth revealed dental abnormalities, including hypomineralization, dentin hypoplasia, cementogenesis defects and a dysplastic periodontal ligament. Genetic analysis revealed a compound heterozygosity- c.1561T>C and c.2057G>A in the NTRK1 gene. This report extends the spectrum of NTRK1 mutations observed in patients diagnosed with CIPA and provides additional insight for clinical and molecular diagnosis.
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Affiliation(s)
- Li Gao
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Hao Guo
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Nan Ye
- Department of Dentistry, Hospital of PLA 309, Beijing, People's Republic of China
| | - Yudi Bai
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Xin Liu
- Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Ping Yu
- Institute of Genomic Medicine, Wenzhou Medical College, Wenzhou, Zhejiang Province, People's Republic of China
| | - Yang Xue
- Department of Oral Biology, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Shufang Ma
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Kewen Wei
- Department of Endodontics, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
| | - Yan Jin
- Department of Oral Histology and Pathology, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
- * E-mail: (YJ); (LYW); (KX)
| | - Lingying Wen
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
- * E-mail: (YJ); (LYW); (KX)
| | - Kun Xuan
- Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China
- * E-mail: (YJ); (LYW); (KX)
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Keinan D, Cohen RE. The Significance of Epithelial Rests of Malassez in the Periodontal Ligament. J Endod 2013; 39:582-7. [DOI: 10.1016/j.joen.2013.01.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 01/18/2013] [Accepted: 01/30/2013] [Indexed: 11/26/2022]
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Kimura A, Yoshizawa K, Sasaki T, Uehara N, Kinoshita Y, Miki H, Yuri T, Uchida T, Tsubura A. N-methyl-N-nitrosourea-induced changes in epithelial rests of Malassez and the development of odontomas in rats. Exp Ther Med 2012; 4:15-20. [PMID: 23060916 DOI: 10.3892/etm.2012.559] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 04/04/2012] [Indexed: 01/13/2023] Open
Abstract
Morphological changes in the epithelial rests of Malassez (ERM) and the development of odontogenic tumors in the molars of female Lewis rats treated at 4 weeks of age with a single intraperitoneal injection of 50 mg/kg of N-methyl-N-nitrosourea (MNU) were examined at 12, 18 and 30 weeks of age. Following MNU exposure, the total number and average area of ERM in the cervical and furcational regions of the first, second and third molars of the mandible and maxilla were compared with age-matched control animals. The number of ERM at each time point was significantly greater in the MNU-treated group compared to the control group, but there was no time-dependent increase in the number of ERM in either group. The area of ERM was significantly larger in the MNU-treated group compared to the control group at each time point, and it increased in a time-dependent manner in the MNU-treated group. No increases in the number or area of ERM were observed in the control group. At 30 weeks of age, 23% of the MNU-treated rats had developed odontomas (complex type) in the molar region as well as in the incisor region. Immunohistochemically, the expression of tyrosine receptor kinase A (TrkA) and cytokeratin 14 (CK14) decreased, whereas p63 expression remained high during ERM enlargement. In tumors, ameloblast-like cells were positive for amelogenin, TrkA and CK14 but negative for p63, whereas odontoblast-like cells were negative for all antigens examined. In conclusion, a single intraperitoneal injection of MNU caused the development of odontomas in the molar region; these tumors were possibly derived from ERM.
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Affiliation(s)
- Ayako Kimura
- Department of Pathology II, Kansai Medical University, Morguchi, Osaka 570-8506
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Tadokoro O, Kawahara I, Vandevska-Radunovic V. Reactions of periodontal ligament epithelial cell clusters and OX6-immunopositive cells to experimental tooth movement and periodontitis. J Periodontal Res 2011; 46:584-91. [PMID: 21615410 DOI: 10.1111/j.1600-0765.2011.01376.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to investigate reactions of periodontal ligament epithelial cell clusters and major histocompatibility complex class II (OX6)-immunopositive cells to simultaneously induced tooth movement and periodontitis employing Waldo's method. MATERIAL AND METHODS Elastic gums were inserted between the right upper first and second molars of rats. Animals were killed by intracardiac perfusion on days 1, 3, 7 and 14 after the experimental procedures, and maxillary molars were decalcified and processed for OCT compound. Cytokeratin and OX6 antibodies to detect epithelial and immunocompetent cells were used for double-fluorescence immunohistochemistry. Immunostained sections of rat upper molar regions were examined with a fluorescence microscope. RESULTS Large periodontal ligament epithelial cell clusters appeared and became contiguous with each other, and OX6-immunopositive cells surrounded the clusters over time in the periodontal ligament near the gum insertion site. In the periodontal ligament distant from the gum insertion site, epithelial cell clusters and OX6-immunopositive cells were scattered. After 14 d, thickened epithelium and elongated rete pegs were found close to large epithelial cell clusters in the periodontal ligament near the gum insertion site. CONCLUSION These findings suggest proliferation and/or aggregation of periodontal ligament epithelial cells, and interaction between OX6-immunopositive cells and the periodontal ligament epithelial cells, in response to tooth movement and periodontal inflammation. This method may be a useful experimental model to elucidate the relationship between rete pegs and periodontal ligament epithelial cell clusters in inflammatory conditions.
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Affiliation(s)
- O Tadokoro
- Department of Oral Anatomy 1, School of Dentistry, Matsumoto Dental University, Nagano, Japan.
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Yamawaki K, Matsuzaka K, Kokubu E, Inoue T. Effects of epidermal growth factor and/or nerve growth factor on Malassez's epithelial rest cells in vitro: expression of mRNA for osteopontin, bone morphogenetic protein 2 and vascular endothelial growth factor. J Periodontal Res 2010; 45:421-7. [PMID: 20337888 DOI: 10.1111/j.1600-0765.2009.01254.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Malassez's epithelial rest (MER) cells are involved in the maintenance and homeostasis of the periodontal ligament (PDL). The purpose of this study was to determine the effects of epidermal growth factor (EGF) and/or nerve growth factor (NGF) in vitro on these functions of MER cells. MATERIAL AND METHODS MER cells from porcine PDL were incubated for 3 or 9 h after the addition of EGF and/or NGF to final concentrations of 10 ng/mL. Cells cultured without those growth factors were used as controls. The expression of mRNA for osteopontin, bone morphogenetic protein 2 (BMP-2) and vascular endothelial growth factor (VEGF) was analyzed using quantitative RT-PCR. RESULTS There was a decrease in the expression of osteopontin mRNA by MER cells treated for 9 h with NGF and the level of mRNA expressed was lower than that of the control and EGF-treated groups. The expression of BMP-2 mRNA by MER cells treated with NGF for 9 h also decreased, and was lower than that of the control and EGF-treated groups. The expression of VEGF mRNA by MER cells treated with EGF for 3 or 9 h was higher than in the control and NGF-treated groups. The expression of VEGF mRNA was lower in MER cells treated with NGF for 3 and 9 h than in the control and EGF-treated groups, and decreased from 3 to 9 h of treatment. EGF stimulated MER cells to secrete VEGF, which suggests that EGF plays an important role in maintaining the homeostasis of the PDL. NGF acts on MER cells to inhibit calcification in the PDL. Furthermore, in the EGF+NGF-treated MER cells, expression of mRNA for BMP-2 and VEGF was similar to that of the NGF-treated group, but cell proliferation and expression of osteopontin mRNA were similar to that of the EGF-treated group. CONCLUSION EGF and NGF play important roles in maintaining the PDL.
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Affiliation(s)
- K Yamawaki
- Department of Clinical Pathophysiology, Tokyo Dental College, Masago, Mihama-ku, Chiba, Japan
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Tadokoro O, Kawahara I, Vandevska-Radunovic V, Inoue K. Distribution of epithelial cells and their relationship to immunocompetent cells in rat molars: a confocal and transmission electron microscope study. J Histochem Cytochem 2008; 57:315-25. [PMID: 19029402 DOI: 10.1369/jhc.2008.952788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study sought to investigate the distribution of cytokeratin (CK)-immunopositive cells and their relationship to immunocompetent ED1- and OX6-immunopositive cells in rat periodontium by immunohistochemistry and electron microscopy. CK-immunopositive cells were generally distributed along the surface of the tooth root. They could also be found between root dentin and cementum, in the perivascular space, and close to or in the alveolar bone lacunae. ED1-immunopositive cells exhibited a compact shape with small processes and were widely distributed in the periodontium. Few sections demonstrated an intimate relationship between the CK- and ED1-immunopositive cells close to the cementum, in the perivascular space, and close to or in the alveolar bone. Numerous OX6-immunopositive cells with long branching processes were widely distributed in the periodontal ligament, surrounding and holding CK-immunopositive cells in the cell clusters, close to the cementum. Transmission electron microscopy revealed OX6-immunopositive cells that extended their cytoplasmic processes, which contained vesicles and occasionally lysosomes in between the epithelial cells. This study demonstrates the close relationship between the epithelial cells and the immunocompetent cells in a rat periodontium, indicating a functional interrelationship. It is possible that in a non-inflammatory periodontium, the epithelial cells act not independently, but through interaction with immunocompetent cells.
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Affiliation(s)
- Osamu Tadokoro
- Department of Oral Anatomy 1, Matsumoto Dental University, School of Dentistry, Nagano, Japan.
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Gaspersic R, Kovacic U, Cör A, Skaleric U. Expression of TrkA receptor for neurotrophins in trigeminal neurons innervating the rat gingivomucosal tissue. Neurosci Lett 2007; 418:253-6. [PMID: 17418945 DOI: 10.1016/j.neulet.2007.03.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Revised: 03/02/2007] [Accepted: 03/18/2007] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to characterize and evaluate the expression of TrkA receptor in trigeminal ganglion (TG) neurons that innervate the rat gingivomucosal tissue. A retrograde nerve tracer Fluorogold (FG) was injected into the gingiva (group 1) or applied into the gingival sulcus (group 2) of the first right maxillary molar to identify the neurons in TG that innervate the gingivomucosa. After 10 days TG were dissected and FG fluorescence in neurons was observed under UV light microscope. To draw a comparison, approximately 1000 neurons per ganglion from the entire TG (group 3) and approximately 350 neurons per ganglion from the maxillary region in TG (group 4), were analyzed. Expression of TrkA receptor in TG neurons was investigated by immunohistochemistry. About 70% of neurons in groups 1 and 2 contained TrkA receptor, which was statistically significantly more than in groups 3 (41%) and 4 (38%). FG-labeled TrkA-immunopositive neurons were predominantly small or medium-sized (less than 1200microm(2)). However, the neurons innervating the rat gingivomucosa were on average larger than the neurons in the entire TG or in the maxillary region. In conclusion, the majority of neurons in TG that innervate the rat gingivomucosa are small or medium-sized, contain TrkA receptor and are most probably nociceptive.
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Affiliation(s)
- Rok Gaspersic
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
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Rincon JC, Young WG, Bartold PM. The epithelial cell rests of Malassez--a role in periodontal regeneration? J Periodontal Res 2006; 41:245-52. [PMID: 16827716 DOI: 10.1111/j.1600-0765.2006.00880.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article reviews general aspects about the epithelial cell rests of Malassez (ERM). The historical and general morphological features of the ERM are briefly described. The embryological derivation of the ERM is presented as an important consideration in understanding the events associated with their origin and possible functional roles within the periodontal ligament. The ultrastructural description of the ERM is also included to complement the morphological characteristics which distinguish these cells as the unique epithelial element of the periodontal ligament. The unique ability of these cells to synthesize and secrete a number of proteins usually associated with cells of mesenchymal origin, rather than ectodermal origin, is discussed in light of their role in cementum repair and regeneration. Such considerations lead to our hypothesis that one of the functional roles of the ERM may lie not only their role in maintaining and contributing to the normal periodontal cellular elements and function but also contributing, in a significant manner, to periodontal regeneration.
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Affiliation(s)
- J C Rincon
- Department of Dentistry, University of Queensland, Brisbane, Australia
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Jayawardena CK, Takano Y. Nerve-epithelium association in the periodontal ligament of guinea pig teeth. Arch Oral Biol 2006; 51:587-95. [PMID: 16510117 DOI: 10.1016/j.archoralbio.2006.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Revised: 11/15/2005] [Accepted: 01/16/2006] [Indexed: 11/25/2022]
Abstract
Several lines of evidence have suggested that periodontal nerves have other roles besides sensory function. Exploring the distribution pattern of nerves in relation to other structures within the periodontal ligament of various species should be important to understand their roles within the ligament. This study investigated whether any association exists between the nerves and the epithelial cells in the periodontal ligament of continuously erupting guinea pig molars, which show distinct enamel epithelium layers among the cementum pearls. Ten guinea pigs were fixed by vascular perfusion and jaw sections were processed for immunohistochemistry of protein gene product 9.5 (PGP 9.5), growth-associated protein-43 (GAP-43) and glia-specific S-100 protein, and for enzyme histocytochemistry of cholinesterase. Nerves that were immunopositive for the above neuronal markers were located predominantly in the alveolus-related part of the periodontal ligament. Some nerves, immunoreactive for PGP 9.5 and GAP-43, were also found in the tooth-related part (TRP) of the periodontal ligament close to the tooth surface. PGP 9.5-positive nerves in the TRP appeared very thin and terminated by making loops or plexus-like structures in close apposition to the epithelium layers, overlying the enamel surface in between cementum pearls. Such an intimate association between nerves and the enamel epithelium was not found in the labial periodontal tissue of incisors or the apical growing end of the molar, where periodontal fibre attachment was indistinct. The association between nerves and epithelium in the periodontal ligament of guinea pig molar is site specific and is only seen in the presence of cementum, suggesting that this association is related to the attachment function of the ligament.
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Affiliation(s)
- Chantha K Jayawardena
- Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
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Kurihara H, Shinohara H, Yoshino H, Takeda K, Shiba H. Neurotrophins in cultured cells from periodontal tissues. J Periodontol 2003; 74:76-84. [PMID: 12593600 DOI: 10.1902/jop.2003.74.1.76] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We review the basic functions of neurotrophins and their receptors and discuss the expression and functions of neurotrophins and their specific receptors based on recent data using cultured cells from human periodontal tissues. Neurotrophins, nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3) play crucial roles in the differentiation and survival of neural cells. Neurotrophins activate 2 different receptor classes: the tropomyosin-related kinase (Trk) family of receptor tyrosine kinases (TrkA, TrkB, and TrkC) and the p75 receptor, a member of the tumor necrosis factor receptor superfamily. Neurotrophins regulate both cell death and cell survival through activations of Trk receptors and/or p75 neurotrophin receptor. It has been reported that neurotrophins are also produced from non-neuronal cells, such as leukocytes, osteoblasts, or fibroblasts, and act in many other ways on non-neuronal cells. Neurotrophin expression during bone fracture healing is especially interesting, and neurotrophins are now implicated in hard tissue regeneration. It is well known that neurotrophins and their receptors are expressed in tooth development. Recent studies have found that neurotrophins and Trk receptors are expressed in mouse osteoblastic cell lines. Human periodontal ligament cells, human gingival fibroblasts, and human gingival keratinocytes expressed mRNA for NGF and TrkA. The secretion of bioactive NGF peptides from human periodontal ligament cells and human gingival keratinocytes was confirmed by bioassay using PC12 cells (rat adrenal pheochromocytoma cells). The expression of NGF and TrkA.mRNA was regulated by interleukin (IL)-1beta. NGF increased DNA synthesis and expressions of mRNA for bone-related proteins, alkaline phosphatase, and osteopontin in human periodontal ligament cells. Neurotrophins and Trk receptors expressed in human periodontal tissue may contribute to regeneration as well as innervation of periodontal tissue through local autocrine and paracrine pathways. Recent data suggest that some functions of neurotrophins and Trk receptors relate to periodontal disease and periodontal tissue regeneration. However, in vivo studies will be required to clarify the roles of neurotrophins and their receptors, including p75, in periodontal disease and periodontal tissue regeneration.
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Affiliation(s)
- Hidemi Kurihara
- Department of Periodontal Medicine, Division of Frontier Medical Science, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan.
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