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Mierzwinska-Nastalska E, Lomzynski L, Jaworska-Zaremba M, Kostrzewa-Janicka J. Vascular endothelial growth factor in gingival crevicular fluid around dental implants. Eur J Med Res 2011; 15 Suppl 2:88-91. [PMID: 21147629 PMCID: PMC4360367 DOI: 10.1186/2047-783x-15-s2-88] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Angiogenesis occurs under physiological and pathological conditions and is regulated by cytokines and growth factors. Vascular endothelial growth factor (VEGF) is a multifunctional angiogenic cytokine that plays a significant role in inflammation and immune responses implicated in the pathogenesis of inflammatory processes in the implant- surrounding tissues. OBJECTIVE The study investigated the concentration of VEGF in gingival crevicular fluid (GCF) in healthy and diseased soft tissues surrounding implants. MATERIAL AND METHODS Clinical examinations were focused on assessing the periodontal status of soft tissues around dental implants with the use of Florida Probe. Bone loss was examined radiologically. VEGF concentrations were assessed by enzyme-linked immunoabsorbent assay (ELISA). RESULTS VEGF concentrations were found higher in crevicular fluid around implants than in clinically healthy sites. They were also strongly correlated with the pocket depth. CONCLUSIONS The presence of VEGF in gingival crevicular fluid in patients with peri-implants can be implicated in the progression of peri-implantitis, possibly by promoting the formation of new blood vessels during angiogenic processes.
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Gültekin SE, Sengüven B, Karaduman B. The effect of smoking on epithelial proliferation in healthy and periodontally diseased marginal gingival epithelium. J Periodontol 2008; 79:1444-50. [PMID: 18672994 DOI: 10.1902/jop.2008.070645] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Smoking causes an increase in the thickness of gingival epithelium, which is the outcome of increased keratinocyte proliferation or loss. Smoking-related changes in the proliferative activity of the gingival epithelium are largely uncharacterized for periodontal diseases. The aim of the present study was to determine the effects of smoking on the proliferation of the epithelium in periodontally diseased marginal gingiva by comparing the expression patterns of two different proliferation markers. METHODS Gingival biopsies (N=60) were obtained from smokers who had clinically healthy gingiva (n=10), smokers with gingivitis (n=10), smokers with periodontitis (n=10), non-smokers with clinically healthy gingiva (n=10), non-smokers with gingivitis (n=10), and non-smokers with periodontitis (n=10). The quantitative measurement of maximum epithelial thickness was performed on hematoxylin and eosin-stained sections. The expression patterns for proliferating cell nuclear antigen (PCNA) and Ki67 were evaluated immunohistochemically. RESULTS The percentage of PCNA-positive cells was higher than the percentage of Ki67-positive cells in all groups (P<0.001). When the mean values of PCNA and Ki67 were compared in each group, a statistically significant difference was observed only in the healthy smoker group (P=0.003). Significant differences in PCNA proliferation indices were only found between the smoker group and the non-smoker healthy group (P=0.015). CONCLUSIONS Smoking had an affect on the proliferation of cells in the oral gingival epithelium, regardless of periodontal status. The increase in thickness of the epithelium was not associated with smoking; periodontal status and inflammation seemed to be more important factors. Smoking induced the replication activity of gingival epithelium and induced DNA repair.
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Affiliation(s)
- Sibel Elif Gültekin
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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Cetinkaya BO, Keles GC, Ayas B, Sakallioglu EE, Acikgoz G. The Expression of Vascular Endothelial Growth Factor in a Rat Model at Destruction and Healing Stages of Periodontal Disease. J Periodontol 2007; 78:1129-35. [PMID: 17539728 DOI: 10.1902/jop.2007.060397] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The major role of vascular endothelial growth factor (VEGF), an angiogenic mediator, in promoting the progression or the healing of periodontal disease is still unclear. The aim of this study was to evaluate the VEGF expression in the destruction and healing stages of periodontal disease and to investigate the association between VEGF expression and vascularization with regard to the number and diameters of blood vessels. METHODS Thirty rats were distributed equally into two test groups and a control group. Experimental periodontal disease was induced in the test groups by silk ligatures, which were kept in position for 40 days. On the 40th day, ligatures were removed from the healing group, whereas ligatures were left in position in the destruction group. On the 60th day, rats were sacrificed; histomorphometric and biochemical analyses were carried out to determine the number and diameters of blood vessels and the assessment of VEGF concentration by enzyme-linked immunosorbent assay, respectively. RESULTS There was a statistically significant increase in the number of blood vessels in the healing group and in the diameters of blood vessels in the destruction group compared to the control group (P <0.001). In vivo VEGF expressions were highest in the healing group (P <0.001) and correlated significantly with the number of blood vessels (r(2) = 0.814; P = 0.001). CONCLUSION VEGF expression may be related more to the healing stage of periodontal disease than to the destruction stage of the lesion.
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Affiliation(s)
- Burcu Ozkan Cetinkaya
- Department of Periodontology, Faculty of Dentistry, Ondokuzmayis University, Samsun, Turkey.
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Tu HP, Chen YT, Shieh YS, Chin YT, Huang RY, Yang SF, Gau CH, Fu E. Cyclosporin-induced downregulation of the expression of E-cadherin during proliferation of edentulous gingival epithelium in rats. J Periodontol 2006; 77:832-9. [PMID: 16671876 DOI: 10.1902/jop.2006.050316] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND To examine the role of E-cadherin in epithelial hyperplasia of cyclosporin A (CsA)-induced gingival enlargement, mRNA and protein levels of E-cadherin, beta-catenin, proliferating cell nuclear antigen (PCNA), and Cyclin D1 were examined in the edentulous gingiva of rats following CsA treatment. METHODS Three weeks after the extraction of all maxillary molars, 20 male Sprague-Dawley rats were assigned to a CsA-fed group (30 mg/kg daily) or a control group. Five rats per group were sacrificed at weeks 1 and 4. Edentulous ridge specimens were taken, and the expression levels of E-cadherin, beta-catenin, Cyclin D1, and PCNA mRNAs were estimated by reverse transcription-polymerase chain reaction (RT-PCR). Tissue specimens of the week 4 groups were examined using immunohistochemical (IHC) staining for proteins. RESULTS The mRNA expression of E-cadherin was significantly weaker in the CsA-treated group than the control group at both times. Using IHC staining, a weaker level of membrane-bonded E-cadherin was also observed in the gingival epithelial cells in the CsA group than in controls. By contrast, significantly stronger beta-catenin and Cyclin D1 mRNA expressions and protein levels were found in CsA-treated rats than controls by RT-PCR and immunohistochemistry at week 4, whereas PCNA production was stronger at both times. CONCLUSIONS CsA treatment reduced the production of E-cadherin but increased the production of beta-catenin, Cyclin D1, and PCNA. Thus, CsA may downregulate E-cadherin gene expression, leading to the epithelial cell proliferation of gingival overgrowth.
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Affiliation(s)
- Hsiao-Pei Tu
- Institute of Oral Biology, National Yang-Ming University, Taipei, Taiwan, Republic of China
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Chen YT, Tu HP, Chin YT, Shen EC, Chiang CY, Gau CH, Fu E. Upregulation of Transforming Growth Factor-β1 and Vascular Endothelial Growth Factor Gene and Protein Expression in Cyclosporin-Induced Overgrown Edentulous Gingiva in Rats. J Periodontol 2005; 76:2267-75. [PMID: 16332239 DOI: 10.1902/jop.2005.76.12.2267] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND To examine the effects of cyclosporin A (CsA) on the expression of growth factors in induced gingival overgrowth with limited contributing factors arising from local inflammation caused by bacterial plaque, this study of gingival overgrowth was designed on the edentulous ridge of rats. METHODS After a 3-week healing period following maxillary molar extractions, 16 five-week-old male Sprague-Dawley rats were assigned to CsA and control groups. Animals in the CsA group were fed 30 mg/kg CsA daily, whereas the control rats received a mineral oil vehicle instead. After 4 weeks, all animals were sacrificed, and the morphology of edentulous ridges was recorded by dental impression. The gingivae on the left-hand side were dissected and stored for mRNA analysis, whereas the gingivae on the right-hand side were fixed in 4% paraformaldehyde for immunohistochemistry (IHC) analysis of transforming growth factor-beta1 (TGF-beta1), platelet-derived growth factor beta (PDGF-beta), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF). RESULTS The edentulous gingivae were enlarged and the body weights were reduced in the CsA-treated animals compared to controls. The mRNA expressions of TGF-beta1, IGF-1, and VEGF were higher in the gingivae of the CsA group than in the control group. In addition, a greater mRNA expression (7.21-fold) of VEGF was demonstrated in the CsA group than in the control group by real-time polymerase chain reaction (PCR). The percentages of cells staining positive for TGF-beta1 and VEGF were significantly greater in the CsA rats than in the control rats. CONCLUSIONS Greater mRNA expression and positive staining for TGF-beta1 and VEGF were observed in the edentulous gingivae of rats that received CsA. Therefore, CsA may upregulate TGF-beta1 and VEGF gene expression and protein secretion in CsA-induced gingival overgrowth.
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Affiliation(s)
- Yen-Teen Chen
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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Abstract
The inflammatory and immune processes in periodontitis are complex and, although a great deal of information is available, many questions remain. Variation in human susceptibility to periodontitis has long been accepted, but the pathological basis of this is poorly understood. Similarly, we know little of the differences, if any, between the pathology of chronic and aggressive periodontitis. Genetics and environmental influences play a role in the susceptibility process, but if and how that translates through the immune and inflammatory processes to produce the plasma cell-dominated lesions seen in periodontitis remain to be elucidated. This review will focus on immunological aspects of the inflammatory changes seen in gingivitis and periodontitis, addressing both humoral and cellular responses to the microbial insult from dental plaque. A tendency for an individual or site to form an extensive plasma cell infiltrate may indicate an inability to defend against periodontopathogens and thus a predisposition to periodontitis. The issues to be considered include: 1) homing of immune and inflammatory cells to target tissues; 2) their local proliferation and synthetic activity; 3) the cytokine profile of the leukocytes; 4) the immunoglobulin subclasses of locally produced antibodies; 5) mucosal and systemic immune characteristics of the response; 6) the humoral immune response in periodontal health and disease states; and 7) the antigenic target of the immune response in periodontal lesions.
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Affiliation(s)
- Denis F Kinane
- University of Glasgow Dental School, Glasgow, Scotland, United Kingdom
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Cornelini R, Rubini C, Fioroni M, Favero GA, Strocchi R, Piattelli A. Transforming growth factor-beta 1 expression in the peri-implant soft tissues of healthy and failing dental implants. J Periodontol 2003; 74:446-50. [PMID: 12747448 DOI: 10.1902/jop.2003.74.4.446] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Transforming growth factor-beta (TGF-beta) is composed of a family of multifunctional polypeptide growth factors involved in embryogenesis, inflammation, regulation of immune response, angiogenesis, wound healing, and extracellular matrix formation. TGF-beta1 is the most common isoform found in human tissues. A role of TGF-beta in the pathogenesis of periodontal disease has been suggested. The aim of the present study was a comparative immunohistochemical evaluation of TGF-beta1 in normal keratinized gingiva and in the peri-implant soft tissues surrounding failing non-submerged implants. METHODS Twenty patients participated in this study. Ten biopsies from healthy keratinized mucosa and 10 biopsies from peri-implant soft tissues surrounding failing implants were obtained (one biopsy per patient). The biopsies were obtained from different patients. RESULTS In 5 cases of healthy mucosa, the stromal cells were positive between 1 to 5. In 7 cases, the epithelial layers were positive, between 1 and 18 cells. The superficial epithelial layer was negative in all cases. In 9 cases, there was a positivity of the vascular component, between 2 and 16 vessels. In failing implants, the stromal cells were positive in 6 cases, between 1 and 4. In all cases, cells of the epithelial layers were positive, between 15 and 40. The vascular component was positive in all cases, between 12 and 30 vessels. The differences between TGF-beta1 expression in the epithelium around healthy and failing implants were statistically significant (P < 0.0001). The differences between TGF-beta1 expression in the blood vessels in the soft tissues around healthy and failing implants were also statistically significant (P < 0.0001). No statistically significant difference was observed between the 2 groups in the TGF-beta1 expression in the stromal cells (P = 0.88). CONCLUSION TGF-beta1 may be one of the most important factors in the regulation of the infiltrate, and in the production of tissue repair with a stimulation of fibroblasts and endothelial cells.
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Lappin DF, MacLeod CP, Kerr A, Mitchell T, Kinane DF. Anti-inflammatory cytokine IL-10 and T cell cytokine profile in periodontitis granulation tissue. Clin Exp Immunol 2001; 123:294-300. [PMID: 11207661 PMCID: PMC1905981 DOI: 10.1046/j.1365-2249.2001.01448.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Th2 cells are more abundant than Th1 cells in periodontitis lesions, but the relative importance of the Th1 and Th2 subsets in periodontal disease is not understood. In addition, the role of proinflammatory and anti-inflammatory cytokines in this disease process is unclear. Biopsies were obtained from 10 patients with early onset periodontitis (EOP) and 10 patients with adult periodontitis (AP). From all of the patients in the AP group we were able to obtain and section the gingival tissue to serve as controls. We used polyclonal monospecific antibodies to detect cells expressing IL-2, IL-4, IL-6, IL-10 and IL-15, tumour necrosis factor (TNF-alpha) and interferon-gamma (IFN-gamma) in formalin-fixed, paraffin-embedded sections of granulation tissue from periodontitis lesions. We also employed a series of oligonucleotide probes to detect cells expressing the cytokine transcripts in the same tissue biopsies. Cells that expressed IL-4 or IL-6 were more numerous than cells expressing either IL-2 or IFN-gamma. Th2 cells were more numerous in EOP and AP tissues. IL-15 substitutes for IL-2 in a number of biological activities related to the Th1 immune response, and interestingly, in periodontal lesions the IL-15-expressing cells outnumbered IL-2-expressing cells, suggesting that this is the pattern of immune regulation by T cells in the periodontium. The functional balance in the T cell subsets detected by their cytokine profiles underlies the importance of the anti-inflammatory mechanisms taking place in the diseased tissue. The numbers of inflammatory leucocytes that express the anti-inflammatory cytokine IL-10 are much more widely distributed than those that express the proinflammatory cytokines IL-6 and TNF-alpha. This study suggests that large numbers of infiltrating inflammatory cells as well as accessory cells are involved in the down-regulation of the inflammatory and immune response in periodontitis.
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Affiliation(s)
- D F Lappin
- Periodontology and Oral Immunology Group, Glasgow University Dental School, University of Glasgow, Glasgow, UK
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Takahashi K, MacDonald D, Murayama Y, Kinane D. Cell synthesis, proliferation and apoptosis in human dental periapical lesions analysed by in situ hybridisation and immunohistochemistry. Oral Dis 1999; 5:313-20. [PMID: 10561720 DOI: 10.1111/j.1601-0825.1999.tb00096.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The role of structural and host defensive cells in periapical lesions has been assessed previously by morphometric and immunohistochemical studies. The aim of this study was to investigate the function of peri- apical cells by employing molecular techniques to estimate the cell synthetic activity, proliferation and apoptosis in these lesions. We specifically sought answers to the following questions. Which cells of the periapical lesions are quiescent or actively synthesising proteins? Do immune cells proliferate in this region in the same way as epithelial cells proliferate? Furthermore do cells in peri- apical lesions undergo apoptosis, and if so which cells exhibit this programmed cell death? MATERIALS Twenty-five periapical tissue samples (15 granulomas and 10 radicular cysts) were assessed. Poly-adenosine (poly (A)) RNA and ribosomal RNA (rRNA) bearing cells in formalin-fixed/paraffin-embedded peri- apical tissues were analysed by in situ hybridization (ISH) using digoxigenin-labelled oligo d (T) and 28S rRNA probes respectively in order to estimate cell synthetic activity. Furthermore, S-phase proliferating and cycling cells were examined by ISH using a histone probe and Ki-67 immunostaining so as to assess cellular proliferation. Mononuclear cells were further differentiated by immunohistochemistry (IHC) as T cells, B cells and macrophages. Apoptotic cells were determined by in situ end-labelling methodology for detecting fragmented DNA. RESULTS Poly (A) RNA (mostly messenger RNA) and 28S rRNA-expressing cells were detected in all samples. Plasma cells exhibited strongest staining for the two probes, with slight to moderate staining found in the epithelium, fibroblasts, macrophages, endothelial cells and lymphocytes, whereas almost all polymorphonuclear leucocytes (PMN) were negative for these probes. A few histone mRNA-expressing cells were detected in basal and suprabasal epithelial cells and mononuclear cells in 15/25 cases but their reactivity was weak. Ki-67 positive cells were found in all samples and their numbers were generally higher than histone mRNA positive cells. Apo- ptotic cells were detected in 23/25 cases and the majority of apoptotic cells were PMN which were engulfed by large cytophagocytic macrophages. CONCLUSION This study indicates that in dental periapical lesions, apoptosis occurs predominantly in PMN. It is evident that most cells apart from PMN are exhibiting synthetic activity but only epithelial cells undergo proliferation which implies that immune cells must proliferate at distant lymph nodes and travel to the periapical lesion rather than proliferating within the lesion. These results suggest considerable advantages in estimating gene expression within cells in addition to the immunohistochemical detection of cells to determine cell activity at inflamed sites. Clearly, functional cell synthetic activity, resolution and clearance systems operate in peri- apical cystic and granuloma lesions.
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Affiliation(s)
- K Takahashi
- Periodontology Unit, Glasgow Dental Hospital and School, Glasgow, Scotland, UK
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Zadeh HH, Nichols FC, Miyasaki KT. The role of the cell-mediated immune response to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in periodontitis. Periodontol 2000 1999; 20:239-88. [PMID: 10522228 DOI: 10.1111/j.1600-0757.1999.tb00163.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- H H Zadeh
- Department of Periodontology, School of Dentistry, University of Southern California, Los Angeles, USA
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Takahashi K, Lappin DF, MacDonald GD, Kinane DF. Relative distribution of plasma cells expressing immunoglobulin G subclass mRNA in human dental periapical lesions using in situ hybridization. J Endod 1998; 24:164-7. [PMID: 9558579 DOI: 10.1016/s0099-2399(98)80175-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Immunoglobulin G (IgG)-producing plasma cells are the predominant immunoglobulin secreting plasma cells in human dental periapical lesions, compared with immunoglobulin A- and immunoglobulin M-producing plasma cells. In this study, the cells expressing mRNA, that encoded the distinct IgG subclasses, were detected using an in situ hybridization technique in 25 periapical lesions. These lesions consisted of 14 periapical granulomas and 11 radicular cysts. Four oligonucleotide probes were chemically synthesized from IgG subclass-specific hinge region genes to ensure specificity of the probes. Plasma cells expressing mRNA, which coded for the IgG subclasses, were detected in formalin-fixed/paraffin wax-embedded sections. Background staining was negligible in all of the sections tested. The in situ hybridization method used in this study was both specific and sensitive for the detection of mRNA encoding each of the four distinct IgG subclasses, whereas the cells retained good morphology. The relative proportions of plasma cells expressing each of the IgG subclass-specific mRNAs in both granulomas and cysts were as follows: IgG1 (57.4 and 55.5%); IgG2 (34.1 and 34.6%); IgG3 (4.0 and 4.3%); and IgG4 (4.0 and 5.5%). There were no significant differences between the percentages of plasma cells expressing each of the IgG subclass mRNAs between the two types of lesions. IgG1 producing plasma cells comprised the highest proportion of IgG-producing plasma cells in both types of periapical lesion. IgG2-producing plasma cells were next in abundance, followed by plasma cells for either IgG3 or IgG4, which were in roughly equivalent numbers.
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Affiliation(s)
- K Takahashi
- Periodontology Unit, Glasgow Dental Hospital and School, Scotland
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