1
|
Cai SY, Li P, Hu SX, Cai HQ, Li WJ, Peng GL. Cohen syndrome due to a novel VPS13B mutation in a Chinese family. JOURNAL OF NEURORESTORATOLOGY 2022. [DOI: 10.1016/j.jnrt.2022.100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
2
|
"Oral Manifestations of Patients with Inherited Defect in Phagocyte Number or Function" a systematic review. Clin Immunol 2021; 229:108796. [PMID: 34271191 DOI: 10.1016/j.clim.2021.108796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/10/2021] [Accepted: 07/11/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Inherited phagocyte defects are one of the subgroups of primary immunodeficiency diseases (PIDs) with various clinical manifestations. As oral manifestations are common at the early ages, oral practitioners can have a special role in the early diagnosis. MATERIALS AND METHODS A comprehensive search was conducted in this systematic review study and data of included studies were categorized into four subgroups of phagocyte defects, including congenital neutropenia, defects of motility, defects of respiratory burst, and other non-lymphoid defects. RESULTS Among all phagocyte defects, 12 disorders had reported data for oral manifestations in published articles. A total of 987 cases were included in this study. Periodontitis is one of the most common oral manifestations. CONCLUSION There is a need to organize better collaboration between medical doctors and dentists to diagnose and treat patients with phagocyte defects. Regular dental visits and professional oral health care are recommended from the time of the first primary teeth eruption in newborns.
Collapse
|
3
|
Kapferer-Seebacher I, Foradori L, Zschocke J, Schilke R. Rare Genetic Disorders Affecting the Periodontal Supporting Tissues in Adolescence. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In adolescents periodontal destruction may be the primary manifestation of an as yet unrecognized rare systemic disease, and it may be up to the periodontist to make the correct tentative diagnosis. Many genetic diseases that present with primary periodontal manifestations in adolescence affect immune function, sometimes with only mild or absent systemic features. They include periodontal Ehlers-Danlos syndrome (lack of attached gingiva, various connective tissue abnormalities), Papillon-Lefèvre syndrome (palmoplantar hyperkeratosis), and plasminogen deficiency (fibrin deposition within mucous membranes). Other immune disorders with severe periodontitis manifesting in adolescence are usually diagnosed in early childhood due to unmistakeable systemic features. They include Cohen syndrome (developmental disorder, truncal obesity, and microcephaly), Hermansky-Pudlak Syndrome (oculocutaneous albinism, bleeding diathesis, and other systemic manifestations), glycogen storage disease type 1b, and Chediak-Higashi syndrome (pyogenic infections, albinism, and neuropathy). The structural integrity of periodontal tissue is affected in genodermatoses such as Kindler syndrome, a type of epidermolysis bullosa. In primary hyperoxaluria, inflammatory periodontal destruction is associated with renal calculi. Breakdown of periodontal tissues independent of dental plaque biofilm-induced periodontitis is found in hypophosphatasia (highly variable skeletal hypomineralization) or isolated odontohypophosphatasia, hypophosphatemic rickets and primary hyperparathyroidism. Finally, alveolar osteolysis mimicking localized periodontitis may be due to neoplastic processes, e.g., in neurofibromatosis type 1 (typical skin features including café au lait macules and neurofibromas), Langerhans cell histiocytosis (locally destructive proliferation of bone marrow-derived immature myeloid dendritic cells), and Gorham-Stout disease (diffuse cystic angiomatosis of bone).
Collapse
|
4
|
Lafon A, Faivre L, Seux D, Gautier E, Duplomb L, Grogogeat B, Marcelet A, Laforest L. Periodontal disorders in a cohort of patients with Cohen syndrome. SPECIAL CARE IN DENTISTRY 2020; 41:118-124. [PMID: 33202072 DOI: 10.1111/scd.12544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/01/2020] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
AIMS Cohen syndrome (CS) is an uncommon autosomal recessive disorder due to mutations in vacuolar protein sorting 13B, with an intermittent presence of neutropenia. Contrary to other clinical phenotypic features, oral health has been little investigated in CS. We described oral health and dental hygiene in a cohort of CS patients. METHODS AND RESULTS Twelve CS patients with neutropenia (<1500/mm3 ) were recruited in the dental department of Dijon University Hospital (France). Patients underwent oral examination, and blood samples were collected. Oral health markers were described and compared between patients with moderate and severe neutropenia (<500/mm3 ). In 12 patients (mean age = 21.1 years, SD = 13.7, six females), 45.5% brushed at least twice daily their teeth, and the same percentage annually visited a dentist. Dental plaque index was high (mean = 1.7, SD = 1.4). So was the number of lost teeth per patient, notably among adults (mean = 13.8, SD = 9.8). Elevated markers of periodontitis were noted as percentage of bleeding dental sites (mean = 70.2%, SD = 45.2%) or Gingival Index (mean = 2.2, SD = 1.0). The severity of neutropenia was correlated to the level of tooth-loss (P = .03). CONCLUSION This study highlighted in CS patients worrisome oral health and dental follow-up in the context of intellectual disability with behavioural anomalies. More attention is needed by care-givers on oral condition in CS.
Collapse
Affiliation(s)
- Arnaud Lafon
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France.,Enseignant chercheur du Laboratoire Parcours de Santé Systémique EA 4129-Ecole Doctorale EDISS, Université Claude Bernard Lyon 1, Lyon, France
| | - Laurence Faivre
- Inserm UMR1231, Team Génétique des Anomalies du Développement, Université de Bourgogne Franche Comté, Dijon, France.,FHU TRANSLAD, Département de Génétique, CHU Dijon, Université de Bourgogne Franche-Comté, Dijon, France.,Centre de référence Anomalies du Développement et Syndromes Malformatifs, Hôpital d'Enfants, CHU Dijon, Dijon, France
| | - Dominique Seux
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France.,Université de Lyon, LMI UMR CNRS 5615, Lyon, France
| | - Elodie Gautier
- FHU TRANSLAD, Département de Génétique, CHU Dijon, Université de Bourgogne Franche-Comté, Dijon, France.,Centre de référence Anomalies du Développement et Syndromes Malformatifs, Hôpital d'Enfants, CHU Dijon, Dijon, France
| | - Laurence Duplomb
- Inserm UMR1231, Team Génétique des Anomalies du Développement, Université de Bourgogne Franche Comté, Dijon, France.,FHU TRANSLAD, Département de Génétique, CHU Dijon, Université de Bourgogne Franche-Comté, Dijon, France
| | - Brigitte Grogogeat
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France.,Université de Lyon, LMI UMR CNRS 5615, Lyon, France
| | | | - Laurent Laforest
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France
| |
Collapse
|
5
|
Reddy RN, Dandu SP, Sravanthi G, Mohammed S, Narahari S, Sistla S. Terminalia arjuna – A possible alternative to commercial mouthwashes, against periodontopathic bacteria: An in vitro study. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2020. [DOI: 10.4103/jdrntruhs.jdrntruhs_81_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
6
|
Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations. J Clin Periodontol 2019; 45 Suppl 20:S171-S189. [PMID: 29926486 DOI: 10.1111/jcpe.12947] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/14/2017] [Accepted: 10/21/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This review proposes case definitions and diagnostic considerations of systemic disorders and conditions that affect the periodontal attachment apparatus. IMPORTANCE Periodontal diseases and certain systemic disorders share similar genetic and/or environmental etiological factors, and affected patients may show manifestations of both diseases. Characterizing these diseases and the nature of the association between them could have important diagnostic value and therapeutic implications for patients. FINDINGS Numerous systemic disorders and certain medications can affect the periodontal attachment apparatus and cause loss of periodontal attachment and alveolar bone. Although many of these disorders are rare or uncommon, they often cause significant loss of periodontal tissue by influencing periodontal inflammation or through mechanisms distinct from periodontitis. Most of these disorders are due to innate mechanisms and some are acquired via environmental factors or lifestyle. Several disorders affect periodontal inflammation through alterations in the host immune response to periodontal infection; others cause defects in the gingiva or periodontal connective tissue, instigate metabolic changes in the host that affect various tissues of the periodontal apparatus, or operate by other mechanisms. For some systemic disorders that are more common, their contribution to the loss of periodontal tissue is modest, while for others, contribution is not supported by clear evidence. Few systemic medications are associated with increased loss of periodontal tissue, and these are typically medications used in the treatment of malignancies. CONCLUSIONS This review identifies systemic diseases and conditions that can affect the periodontal attachment apparatus and cause loss of periodontal supporting tissues and, where possible, presents case definitions for these. Many of these diseases are associated with a profound loss of periodontal attachment and alveolar bone, and for some of these disorders the periodontal manifestations may be among the first signs of the disease. These case definitions may be useful in the early diagnosis of these diseases and may contribute to an improvement in the management of periodontal manifestations and improve the quality of life for these patients.
Collapse
Affiliation(s)
- Jasim M Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA, USA
| | - Cristiano Susin
- Department of Periodontics, Augusta University Dental College of Georgia, Augusta, GA, USA
| | - Francis J Hughes
- Unit of Periodontology, Dental Institute, Kings College London, London, UK
| |
Collapse
|
7
|
Rodrigues JM, Fernandes HD, Caruthers C, Braddock SR, Knutsen AP. Cohen Syndrome: Review of the Literature. Cureus 2018; 10:e3330. [PMID: 30473963 PMCID: PMC6248805 DOI: 10.7759/cureus.3330] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cohen syndrome was initially described as a syndrome including obesity, hypotonia, mental deficiency, and facial, oral, ocular and limb anomalies. Leukopenia, especially neutropenia, was later described as a feature of Cohen syndrome. Cohen syndrome is caused by an autosomal recessive (AR) mutation of the vacuolar protein sorting 13 homolog B (VPS13B, also referred to as COH1) gene on chromosome 8q22.2.
Collapse
Affiliation(s)
- Jonathan M Rodrigues
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Bismarck, USA
| | - Hermina D Fernandes
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Bismarck, USA
| | | | | | - Alan P Knutsen
- Pediatrics, Saint Louis University School of Medicine, Saint Louis, USA
| |
Collapse
|
8
|
Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations. J Periodontol 2018; 89 Suppl 1:S183-S203. [DOI: 10.1002/jper.16-0480] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/14/2017] [Accepted: 10/21/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Jasim M. Albandar
- Department of Periodontology and Oral Implantology; Temple University School of Dentistry; Philadelphia PA USA
| | - Cristiano Susin
- Department of Periodontics; Augusta University Dental College of Georgia; Augusta GA USA
| | - Francis J. Hughes
- Unit of Periodontology; Dental Institute; Kings College London; London UK
| |
Collapse
|
9
|
Khocht A, Albandar JM. Aggressive forms of periodontitis secondary to systemic disorders. Periodontol 2000 2015; 65:134-48. [PMID: 24738590 DOI: 10.1111/prd.12015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A number of systemic disorders increase a patient's susceptibility to destructive periodontitis and have impacts on periodontal disease progression and severity. The underlying factors are usually genetic and are mainly related to alterations in the immune response and in certain endocrine functions, leading to various syndromes in which periodontitis and/or early tooth loss are secondary manifestations. Neutrophils are important immune defense cells that play a significant role in controlling the spread of microbial plaque infections in the dentogingival region. This review focuses on a selected group of systemic disorders that are associated with alterations in either neutrophil counts (quantitative disorders) or function (qualitative disorders), and defects in the mineralization of bone and dental tissues. In most of these diseases controlling the periodontal disease progression is very challenging. Proper diagnosis is a prerequisite for proper management of the periodontal problem. Future advances in research, including gene targeting and the resolution of enzyme deficiencies, may bring about remedies of the underlying systemic disorders and may significantly improve the outcome of periodontal treatment in these patients.
Collapse
|
10
|
Limoge F, Faivre L, Gautier T, Petit JM, Gautier E, Masson D, Jego G, El Chehadeh-Djebbar S, Marle N, Carmignac V, Deckert V, Brindisi MC, Edery P, Ghoumid J, Blair E, Lagrost L, Thauvin-Robinet C, Duplomb L. Insulin response dysregulation explains abnormal fat storage and increased risk of diabetes mellitus type 2 in Cohen Syndrome. Hum Mol Genet 2015; 24:6603-13. [PMID: 26358774 DOI: 10.1093/hmg/ddv366] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/03/2015] [Indexed: 12/24/2022] Open
Abstract
Cohen Syndrome (CS) is a rare autosomal recessive disorder, with defective glycosylation secondary to mutations in the VPS13B gene, which encodes a protein of the Golgi apparatus. Besides congenital neutropenia, retinopathy and intellectual deficiency, CS patients are faced with truncal obesity. Metabolism investigations showed abnormal glucose tolerance tests and low HDL values in some patients, and these could be risk factors for the development of diabetes mellitus and/or cardiovascular complications. To understand the mechanisms involved in CS fat storage, we used two models of adipogenesis differentiation: (i) SGBS pre-adipocytes with VPS13B invalidation thanks to siRNA delivery and (ii) CS primary fibroblasts. In both models, VPS13B invalidation led to accelerated differentiation into fat cells, which was confirmed by the earlier and increased expression of specific adipogenic genes, consequent to the increased response of cells to insulin stimulation. At the end of the differentiation protocol, these fat cells exhibited decreased AKT2 phosphorylation after insulin stimulation, which suggests insulin resistance. This study, in association with the in-depth analysis of the metabolic status of the patients, thus allowed us to recommend appropriate nutritional education to prevent the occurrence of diabetes mellitus and to put forward recommendations for the follow-up of CS patients, in particular with regard to the development of metabolic syndrome. We also suggest replacing the term obesity by abnormal fat distribution in CS, which should reduce the number of inappropriate diagnoses in patients who are referred only on the basis of intellectual deficiency associated with obesity.
Collapse
Affiliation(s)
- Floriane Limoge
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Laurence Faivre
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France, FHU TRANSLAD, Département de Génétique, Hôpital d'enfants, CHU Dijon, F-21000 Dijon, France
| | - Thomas Gautier
- LNC UMR866, INSERM, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | - Elodie Gautier
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France, FHU TRANSLAD, Département de Génétique, Hôpital d'enfants, CHU Dijon, F-21000 Dijon, France
| | - David Masson
- LNC UMR866, INSERM, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Gaëtan Jego
- LNC UMR866, INSERM, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Salima El Chehadeh-Djebbar
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France, FHU TRANSLAD, Département de Génétique, Hôpital d'enfants, CHU Dijon, F-21000 Dijon, France
| | - Nathalie Marle
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France, FHU TRANSLAD, Département de Génétique, Hôpital d'enfants, CHU Dijon, F-21000 Dijon, France
| | - Virginie Carmignac
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Valérie Deckert
- LNC UMR866, INSERM, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | - Patrick Edery
- Service de Génétique Clinique, Hôpital Femme Mère Enfant, CHU Lyon, HCL, Lyon, France
| | - Jamal Ghoumid
- Centre de Référence Maladies Rares Anomalies du Développement et Syndromes Malformatifs Nord, Hôpital Jeanne de Flandres, CHRU Lille, Lille, France and
| | - Edward Blair
- Department of Clinical Genetics, Oxford Regional Genetics Service, The Churchill Hospital, Oxford, UK
| | - Laurent Lagrost
- LNC UMR866, INSERM, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Christel Thauvin-Robinet
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France, FHU TRANSLAD, Département de Génétique, Hôpital d'enfants, CHU Dijon, F-21000 Dijon, France
| | - Laurence Duplomb
- Génétique des Anomalies du Développement GAD EA4271, Univeristé de Bourgogne Franche-Comté, F-21000 Dijon, France, FHU TRANSLAD, Département de Génétique, Hôpital d'enfants, CHU Dijon, F-21000 Dijon, France,
| |
Collapse
|
11
|
Moutsopoulos NM, Lionakis MS, Hajishengallis G. Inborn errors in immunity: unique natural models to dissect oral immunity. J Dent Res 2015; 94:753-8. [PMID: 25900229 DOI: 10.1177/0022034515583533] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In recent years, the study of genetic defects arising from inborn errors in immunity has resulted in the discovery of new genes involved in the function of the immune system and in the elucidation of the roles of known genes whose importance was previously unappreciated. With the recent explosion in the field of genomics and the increasing number of genetic defects identified, the study of naturally occurring mutations has become a powerful tool for gaining mechanistic insight into the functions of the human immune system. In this concise perspective, we discuss emerging evidence that inborn errors in immunity constitute real-life models that are indispensable both for the in-depth understanding of human biology and for obtaining critical insights into common diseases, such as those affecting oral health. In the field of oral mucosal immunity, through the study of patients with select gene disruptions, the interleukin-17 (IL-17) pathway has emerged as a critical element in oral immune surveillance and susceptibility to inflammatory disease, with disruptions in the IL-17 axis now strongly linked to mucosal fungal susceptibility, whereas overactivation of the same pathways is linked to inflammatory periodontitis.
Collapse
Affiliation(s)
- N M Moutsopoulos
- Oral Immunity and Inflammation Unit, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | - M S Lionakis
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - G Hajishengallis
- Department of Microbiology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| |
Collapse
|
12
|
Kumar A, Masamatti SS, Virdi MS. Periodontal diseases in children and adolescents: a clinician's perspective part 2. ACTA ACUST UNITED AC 2012; 39:639-42, 645-6, 649-52. [DOI: 10.12968/denu.2012.39.9.639] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ashish Kumar
- Reader, Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh
| | - Sujata Surendra Masamatti
- Reader, Department of Periodontics, ITS – Centre for Dental Studies and Research, Murad Nagar, Ghaziabad, Uttar Pradesh
| | - Mandeep Singh Virdi
- Professor and Head, Department of Pedodontics and Preventive Dentistry, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India
| |
Collapse
|
13
|
|
14
|
Armitage GC, Cullinan MP. Comparison of the clinical features of chronic and aggressive periodontitis. Periodontol 2000 2010; 53:12-27. [DOI: 10.1111/j.1600-0757.2010.00353.x] [Citation(s) in RCA: 174] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
15
|
Deng FY, Zhao LJ, Pei YF, Sha BY, Liu XG, Yan H, Wang L, Yang TL, Recker RR, Papasian CJ, Deng HW. Genome-wide copy number variation association study suggested VPS13B gene for osteoporosis in Caucasians. Osteoporos Int 2010; 21:579-87. [PMID: 19680589 DOI: 10.1007/s00198-009-0998-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2009] [Accepted: 05/29/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED Osteoporotic fracture (OF) is a serious outcome of osteoporosis. Important risk factors for OF include reduced bone mineral density and unstable bone structure. This genome-wide copy number variation association study suggested VPS13B gene for osteoporosis in Caucasians. INTRODUCTION Bone mineral density (BMD) and femoral neck cross-sectional geometric parameters (FNCSGPs) are under strong genetic control. DNA copy number variation (CNV) is an important source of genetic diversity for human diseases. This study aims to identify CNVs associated with BMD and FNCSGPs. METHODS Genome-wide CNV association analyses were conducted in 1,000 unrelated Caucasian subjects for BMD at the spine, hip, femoral neck, and for three FNCSGPs -cortical thickness (CT), cross-section area (CSA), and buckling ratio (BR). BMD was measured by dual energy X-ray absorptiometry (DEXA). CT, CSA, and BR were estimated using DEXA measurements. Affymetrix 500K arrays and copy number analysis tool was used to identify CNVs. RESULTS A CNV in VPS13B gene was significantly associated with spine, hip and FN BMDs, and CT, CSA, and BR (p < 0.05). Compared to subjects with two copies of the CNV, carriers of one copy had an average of 14.6%, 12.4%, and 13.6% higher spine, hip, and FN BMD, 20.0% thicker CT, 10.6% larger CSA, and 12.4% lower BR. Thus, a decrease of the CNV consistently produced stronger bone, thereby reducing osteoporotic fracture risk. CONCLUSIONS VPS13B gene, via affecting BMD and FNCSGPs, is a novel osteoporosis risk gene.
Collapse
Affiliation(s)
- F-Y Deng
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Rezaei N, Moazzami K, Aghamohammadi A, Klein C. Neutropenia and Primary Immunodeficiency Diseases. Int Rev Immunol 2009; 28:335-66. [DOI: 10.1080/08830180902995645] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
17
|
Cheretakis C, Locker D, Dror Y, Glogauer M. Oral health-related quality of life of children with neutropenia. SPECIAL CARE IN DENTISTRY 2007; 27:6-11. [PMID: 17388223 DOI: 10.1111/j.1754-4505.2007.tb00320.x] [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] [Indexed: 11/30/2022]
Abstract
This study evaluated the oral health-related quality of life (OHQoL) in children with neutropenia. Twenty-seven children with neutropenia were compared to 33 healthy, age-matched control subjects. Previously validated age-specific, multidimensional and self-reporting child OHQoL questionnaires were used. Overall and subscale scores were compared between the two groups. Respondents in the group of children with neutropenia reported that their disease had a significant impact on their oral health in terms of oral symptoms (p < 0.0001), functional limitations (p < 0.0001), and social well-being (p < 0.0001). In global ratings, they rated their oral health to be markedly worse than that of the healthy subjects (p < 0.0001). However, there was no difference between the groups in the extent to which their oral condition affected their lives overall. These results, along with responses to individual measures of social and emotional well-being, suggest that children in this group with neutropenia have psychologically adapted to the oral health challenges they experience because of their condition.
Collapse
|
18
|
Kinane DF, Peterson M, Stathopoulou PG. Environmental and other modifying factors of the periodontal diseases. Periodontol 2000 2006; 40:107-19. [PMID: 16398688 DOI: 10.1111/j.1600-0757.2005.00136.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Denis F Kinane
- University of Louisville School of Dentistry, Kentucky, USA
| | | | | |
Collapse
|
19
|
Shapira L, Wilensky A, Kinane DF. Effect of genetic variability on the inflammatory response to periodontal infection. J Clin Periodontol 2005; 32 Suppl 6:72-86. [PMID: 16128831 DOI: 10.1111/j.1600-051x.2005.00810.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To review the association between genetic variability and the inflammatory response induced by periodontal infection. MATERIAL AND METHODS A search of MEDLINE-PubMed was performed from January 2000 up to and including March 2005. The search included all types of publications, published in English without other limitations. The following search terms were used: "cytokine polymorphism", "gene polymorphism", "periodontitis", "gingivitis", "inflammation" and "host-response". The papers resulting from the above search were used as an additional source for relevant articles. RESULTS Genetic variability was examined for the correlation to clinical indicators of inflammation such as bleeding on probing (BOP), gingival inflammation, cytokine in gingival crevicular fluid (GCF) and cytokine production by inflammatory cells. According to the current literature, most of the studies found no association between genetic variability and BOP, gingival inflammation or cytokine concentrations in the GCF. These studies were hampered by inappropriate study designs and the use of inflammatory parameters as secondary rather than primary outcome variables. The data suggest that the production of inflammatory mediators by inflammatory cells may be affected by different genetic traits but further studies are needed in order to establish this association. CONCLUSIONS To date, there is no clear correlation between any of the gene polymorphisms and clinical indicators of inflammation. The powering of studies to reveal associations between single or multiple nucleotide polymorphisms and inflammatory parameters will need to involve a much larger number of subjects than were used in the past. The available data (including the interleukin-1 composite genotype) do not currently support the utility of such tests in the diagnosis and prognostic assessments of periodontal diseases.
Collapse
Affiliation(s)
- Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, The Hebrew University Medical Center, Jerusalem Israel.
| | | | | |
Collapse
|
20
|
Nguyen TN, Der Kaloustian VM, Barsoum-Homsy M, Dembinska O, Koenekoop RK. Congenital microcephaly, juvenile retinal dystrophy and normal mentation in a mildly dysmorphic child. Can J Ophthalmol 2005; 40:195-9. [PMID: 16049536 DOI: 10.1016/s0008-4182(05)80034-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Tuong-Nam Nguyen
- Children's Vision Centre, McGill University Health Centre, Montreal, Que
| | | | | | | | | |
Collapse
|
21
|
Abstract
The two most prevalent and most investigated periodontal diseases are dental plaque-induced gingivitis and chronic periodontitis. The last 10 to 15 years have seen the emergence of several important new findings and concepts regarding the etiopathogenesis of periodontal diseases. These findings include the recognition of dental bacterial plaque as a biofilm, identification and characterization of genetic defects that predispose individuals to periodontitis, host-defense mechanisms implicated in periodontal tissue destruction, and the interaction of risk factors with host defenses and bacterial plaque. This article reviews current aspects of the etiology and pathogenesis of periodontal diseases.
Collapse
Affiliation(s)
- Dimitris N Tatakis
- Section of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH 43218-2357, USA.
| | | |
Collapse
|
22
|
Ming JE, Stiehm ER, Graham JM. Syndromic immunodeficiencies: genetic syndromes associated with immune abnormalities. Crit Rev Clin Lab Sci 2004; 40:587-642. [PMID: 14708957 DOI: 10.1080/714037692] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
In syndromic immunodeficiencies, clinical features not directly associated with the immune defect are prominent. Patients may present with either infectious complications or extra-immune medical issues. In addition to the immunologic abnormality, a wide range of organ systems may be affected. Patients may present with disturbances in skeletal, neurologic, dermatologic, or gastrointestinal function or development. These conditions can be caused by developmental abnormalities, chromosomal aberrations, metabolic disorders, or teratogens. For a number of these conditions, recent advances have resulted in an enhanced understanding of their genetic basis. The finding of immune deficits in a number of defined syndromes with congenital anomalies suggests that an underlying genetic syndrome should be considered in those patients in whom a significant non-immune feature is present.
Collapse
Affiliation(s)
- Jeffrey E Ming
- Department of Pediatrics, Division of Human Genetics and Molecular Biology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
| | | | | |
Collapse
|
23
|
Affiliation(s)
- Gary C Armitage
- Department of Stomatology, School of Dentistry, University of California, San Francisco, California, USA
| |
Collapse
|
24
|
Orbach-Zinger S, Kaufman E, Donchin Y, Perouansky M. Between scylla and charybdis: a bleomycin-exposed patient with Cohen syndrome. Acta Anaesthesiol Scand 2003; 47:1047-9. [PMID: 12904202 DOI: 10.1034/j.1399-6576.2003.00169.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Chemotherapy with bleomycin may cause a syndrome of pulmonary sensitivity to supranormal inspired oxygen concentrations that persists for an unknown period of time after exposure. We present a mentally retarded adolescent patient in whom supranormal inspired oxygen was temporarily necessary to manage her difficult airway. Subsequently her pulmonary function deteriorated acutely and, after intermittent stabilization, irreversibly. In this case, bleomycin exposure may have played a pivotal role in modulating minor insults to trigger fatal acute respiratory distress syndrome (ARDS).
Collapse
Affiliation(s)
- S Orbach-Zinger
- Department of Anesthesiology, Rabin Medical Center, Beilinson Campus, Petach Tikvah, Israel
| | | | | | | |
Collapse
|
25
|
García-Ballesta C, Pérez-Lajarín L, Lillo OC, Bravo-González LA. New oral findings in Cohen syndrome. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 95:681-7. [PMID: 12789148 DOI: 10.1067/moe.2003.138] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cohen syndrome is a hereditary disorder transmitted as an autosomal-recessive trait. Approximately 100 cases have been reported in the genetic and pediatric literature. Despite the fact that oral alterations are often observed in these cases, only 1 work has been published addressing this specific topic, and it tended to concentrate on periodontal abnormalities. The present study details 2 new patients, 2 brothers (8 and 11 years old), and mainly consists of an analysis of the dentomaxillary anomalies that until now have not been studied in depth. In this study, the mandible, characterized as hypoplastic in Cohen syndrome, appears to be in a normal position; what really exists is a maxillary hyperplasia of genetic origin. We also put forward an observation hitherto undescribed in the literature: dental agenesis.
Collapse
|
26
|
Doğan B, Antinheimo J, Cetiner D, Bodur A, Emingil G, Buduneli E, Uygur C, Firatli E, Lakio L, Asikainen S. Subgingival microflora in Turkish patients with periodontitis. J Periodontol 2003; 74:803-14. [PMID: 12886990 DOI: 10.1902/jop.2003.74.6.803] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND No information exists on periodontitis-associated subgingival microbiota from Turkey. We determined the occurrence, interspecies relationships, and clonal characteristics for a group of periodontal bacteria in a Turkish study population. METHODS Subgingival microbial samples were obtained from patients with localized (LAgP, N = 18) or generalized (GAgP, N = 17) types of aggressive periodontitis, generalized chronic periodontitis (GCP, N = 14), and non-periodontitis subjects (N = 20). Culture methods were used to recover 6 periodontal bacterial species and yeasts, and a polymerase chain reaction technique was used to detect Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Intraspecies characterization of A. actinomycetemcomitans was carried out by serotyping and genotyping. RESULTS All species, except for Micromonas micros (formerly Peptostreptococcus micros) occurred more frequently (P < 0.05) in periodontitis than non-periodontitis subjects. Detection frequencies for Tannerella forsythensis (formerly Bacteroides forsythus) and Campylobacter rectus differed among the periodontitis subgroups; the lowest frequency occurred in LAgP. The mean proportions of A. actinomycetemcomitans, P. gingivalis, and C. rectus were higher (P < 0.008) in GAgP than in non-periodontitis subjects. Significant positive associations were seen between 7 of the 22 possible combinations (P < 0.05). A. actinomycetemcomitans serotype c (34%) and non-serotypeable isolates (34%) were the most common antigenic types among the 305 strains analyzed. Eleven arbitrarily primed (AP)-PCR genotypes were distinguished among 273 isolates from 29 subjects. Yeasts were found in 23% of the 69 subjects. CONCLUSIONS The results on the Turkish study population were generally in line with earlier reports on the occurrence and interspecies relationships of certain bacteria in periodontitis. However, A. actinomycetemcomitans was not overrepresented in LAgP, and the serotype distribution resembled that reported from the East. The high frequency of non-serotypeable isolates suggests local characteristics of the species.
Collapse
Affiliation(s)
- Başak Doğan
- Department of Periodontology, Faculty of Dentistry, University of Gazi, Ankara, Turkey.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
White DK, Street CC, Jenkins WS, Clark AR, Ford JE. Panoramic radiograph in pathology. Atlas Oral Maxillofac Surg Clin North Am 2003; 11:1-53. [PMID: 12725098 DOI: 10.1016/s1061-3315(02)00012-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Dean K White
- Division of Oral and Maxillofacial Pathology, College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0298, USA.
| | | | | | | | | |
Collapse
|
28
|
Hurmerinta K, Pirinen S, Kovero O, Kivitie-Kallio S. Craniofacial features in Cohen syndrome: an anthropometric and cephalometric analysis of 14 patients. Clin Genet 2002; 62:157-64. [PMID: 12220454 DOI: 10.1034/j.1399-0004.2002.620209.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cohen syndrome (Mendelian Inheritance in Man [MIM] no. 216550) is a rare, autosomal-recessive inherited disorder with mental retardation and a typical appearance. The condition is relatively common in Finland where 35 patients have been diagnosed. We studied 22 patients in detail, obtaining anthropometric measurements of the head and face, and cephalometric radiographs of 14 patients (14-57 years of age). Measurements of patients were compared to population norms and matched controls. Anthropometric analysis confirmed and quantified the previously described syndrome features: small head size [-4 standard deviations (SD)], with varying cephalic index. Width of the upper face was close to normal, but width of the lower face was small. Philtrum length was shorter than in healthy controls (p = 0.0039 in females and p = 0.0014 in males). The measurements from standardized radiographs revealed short cranial base dimensions (-2.2 and -2.6 SD), but normal cranial base angles. Prognathism of jaws was within normal limits. Reduced head size (microcephaly), short philtrum and small cranial base dimensions are essential features in Cohen syndrome. In addition, most patients had forward-inclined upper incisors and maxillary prognathia. We conclude that exact measurements mostly confirmed the Cohen syndrome description based previously on clinical impression.
Collapse
Affiliation(s)
- K Hurmerinta
- Departments of Pedodontics and Orthodontics, Institute of Dentistry, University of Helsinki, Helsinki, Finland.
| | | | | | | |
Collapse
|
29
|
Lakio L, Kuula H, Dogan B, Asikainen S. Actinobacillus actinomycetemcomitans proportion of subgingival bacterial flora in relation to its clonal type. Eur J Oral Sci 2002; 110:212-7. [PMID: 12120706 DOI: 10.1034/j.1600-0447.2002.201238.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We investigated whether certain Actinobacillus actinomycetemcomitans clones occur in elevated proportions in subgingival flora, and if the proportions relate to other bacteria in the samples. A total of 121 A. actinomycetemcomitans strains from 121 patients with periodontitis were serotyped and 60 strains were also genotyped. The 121 strains were divided into three groups and the 60 strains into two groups according proportion of A. actinomycetemcomitans. The samples from the 60 patients with genotyped strains were cultured for five other species. Among the 121 strains, serotype b occurred significantly more frequently in the high- (n = 14, proportions > 5%, mean = 18.09, SD = 20.07%) than low- (n = 49, proportions < or = 0.1%), mean = 0.04, SD = 0.03%) or intermediate-proportion groups (n = 58, proportions > 0.5%, mean = 1.31, SD = 1.24%). Genotype 3 occurred significantly more frequently in samples with low A. actinomycetemcomitans proportions (n = 28, < or = 0.1%, mean = 0.04, SD = 0.03%) than in those with high proportions (n = 32, > 0.1%, mean = 5.70, SD = 14.60%). No differences were seen in the detection frequencies or proportions of the five bacterial species between the samples with low or high A. actinomycetemcomitans proportions. The results indicate that certain clonotypes of A. actinomycetemcomitans may preferentially occur as low proportions, suggesting their controlled growth. Conversely, some serotype b clones may have a competitive advantage in subgingival flora.
Collapse
Affiliation(s)
- Laura Lakio
- Institute of Dentistry, University of Helsinki, Finland.
| | | | | | | |
Collapse
|
30
|
Ming JE, Stiehm E, Graham JM. Genetic syndromes associated with immunodeficiency. Immunol Allergy Clin North Am 2002. [DOI: 10.1016/s0889-8561(01)00008-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
31
|
Affiliation(s)
- P Hodge
- University of Glasgow Dental Hospital and School, Glasgow, Scotland, United Kingdom
| | | |
Collapse
|
32
|
Kivitie-Kallio S, Norio R. Cohen syndrome: essential features, natural history, and heterogeneity. AMERICAN JOURNAL OF MEDICAL GENETICS 2001; 102:125-35. [PMID: 11477603 DOI: 10.1002/1096-8628(20010801)102:2<125::aid-ajmg1439>3.0.co;2-0] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This article elucidates the clinical picture in Cohen syndrome (MIM 216550), an autosomal recessive disorder that is overrepresented in Finland. The diagnosis is based on the typical clinical picture: nonprogressive psychomotor retardation, motor clumsiness and microcephaly, typical facial features, childhood hypotonia and hyperextensibility of the joints, ophthalmologic findings of retinochoroidal dystrophy and myopia in patients over 5 years of age, and granulocytopenia. In a nationwide study, 29 Finnish patients were investigated. Magnetic resonance images of the brain with quantitative structure analyses revealed a relatively enlarged corpus callosum (CC). The youngest patients had normal EEGs, while all others had low-voltage EEGs. Of the patients, 22% had profound, 61% severe, 6% moderate, and 11% mild retardation. In an adaptive behavior scale (AAMD), patients had high scores in the positive domains (self-direction, responsibility, and socialization), whereas maladaptive behavior was almost lacking. Only the youngest patients had unimpaired visual function. Vision started to deteriorate early but slowly. Progressive myopia and retinochoroidal dystrophy were found in all of the patients over 5 years of age. All of the patients had isolated granulocytopenia. The heart anatomy was normal. However, decreased left ventricular function with advancing age was found. No significant endocrine abnormalities were discovered. Fingers were slender but short, with a typical metacarpophalangeal pattern profile. The manifestations vary at different ages. The Finnish Cohen patients are clinically highly homogeneous, their disease gene being located on chromosome 8. Heterogeneity probably exists among other patients claimed to have Cohen syndrome.
Collapse
Affiliation(s)
- S Kivitie-Kallio
- Department of Pediatrics, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland.
| | | |
Collapse
|
33
|
Hannula J, Dogan B, Slots J, Okte E, Asikainen S. Subgingival strains of Candida albicans in relation to geographical origin and occurrence of periodontal pathogenic bacteria. ORAL MICROBIOLOGY AND IMMUNOLOGY 2001; 16:113-8. [PMID: 11240865 DOI: 10.1034/j.1399-302x.2001.016002113.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clonal diversity of subgingival yeast strains was determined in relation to geographical location and coexistence of selected periodontal pathogenic bacteria. A total of 60 dental patients from Finland, the United States and Turkey each contributed five Candida albicans isolates. C. albicans isolates were serotyped using slide agglutination and genotyped using polymerase chain reaction (PCR) amplification and a random sequence primer. In general, each study subject yielded C. albicans isolates belonging to the same serotype and genotype. C. albicans serotype A occurred more frequently in subjects from Finland and Turkey than in subjects from the United States. A total of 27 PCR-based C. albicans genotypes were identified. One C. albicans genotype occurred with particularly high frequency in subjects from Turkey and another genotype in subjects from the United States. Relationships were identified between C. albicans serotypes and genotypes. Further studies are needed to determine environmental factors of importance for subgingival colonization and persistence of C. albicans.
Collapse
Affiliation(s)
- J Hannula
- Department of Periodontology, Institute of Dentistry, University of Helsinki, FIN-00014 Helsinki, Finland
| | | | | | | | | |
Collapse
|
34
|
Kivitie-Kallio S, Summanen P, Raitta C, Norio R. Ophthalmologic findings in Cohen syndrome. A long-term follow-up. Ophthalmology 2000; 107:1737-45. [PMID: 10964838 DOI: 10.1016/s0161-6420(00)00279-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To determine the nature and course of ophthalmologic abnormalities and their clinical significance in Cohen syndrome. STUDY DESIGN Observational case series. PARTICIPANTS Twenty-two Cohen syndrome patients aged 2 to 57 years were examined, and a retrospective review of ophthalmologic records was carried out for 14 of them. All but one were part of the Finnish study of refined mapping of the Cohen syndrome gene by linkage disequilibrium in chromosome 8. MAIN OUTCOME MEASURES Visual acuity (VA), cycloplegic refraction, biomicroscopy, lens opacitometry, ophthalmoscopy, and fundus photography. RESULTS With the exception of the two youngest patients, all had symptoms such as nyctalopia, impaired vision, and visual field loss. Progressive, often high-grade myopia, astigmatism, and retinochoroidal dystrophy resembling retinitis pigmentosa occurred in all, except for the youngest patients. The earliest fundus changes were pale disc and pale fundus with or without pigment granularity, followed by narrowed vessels, pigment clumps, and bone spiculelike pigment accumulations by 10 to 20 years of age. Pigment deposits increased and approached the posterior pole by 35 to 40 years of age. Patients more than 45 years of age had severe retinochoroidal atrophy. A bull's-eye macula was seen in most patients. Teenagers had peripheral lens opacities, and young adults had early nuclear sclerosis confirmed by lens opacitometry. Older patients also had posterior subcapsular cataracts, iris atrophy, and iridophacodonesis. Vision started to deteriorate at the age of 6 to 10 years, but remained relatively good (VA 0.5-0.1) in most patients until 30 and, in one case, 46 years of age. Older patients were severely visually handicapped (VA hand motion to light perception), but none were completely blind. CONCLUSIONS Progressive myopia and retinochoroidal dystrophy are essential features in Cohen syndrome and, together with early lens opacities, lead to deterioration of vision. Cohen syndrome patients need careful ophthalmologic follow-up at all ages. Nyctalopia and restricted visual fields should be considered when planning the patient's daily activities.
Collapse
Affiliation(s)
- S Kivitie-Kallio
- Department of Child Neurology, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
| | | | | | | |
Collapse
|
35
|
Abstract
Microbial dental plaque is the initiator of periodontal disease but whether it affects a particular subject, what form the disease takes, and how it progresses, are all dependent on the host defenses to this challenge. Systemic factors modify all forms periodontitis principally through their effects on the normal immune and inflammatory defenses. Some good examples of this effect exist such as when there is a reduction in number or function of polymorphonuclear leukocytes (PMNs) that may result in an increased rate and severity of periodontal destruction. Many other systemic factors are much less clear cut and are difficult to causally link to periodontitis. In many cases the literature is insufficient to make definite statements on links between systemic factors and periodontitis. It is also at times difficult to be precise regarding the causative agent in systemic exposures such as smoking and even prescribed drug therapy. The possible role of systemic diseases and systemic exposures in initiating or modifying the progress of periodontal disease is clearly a complex issue. It is however generally agreed that several conditions may give rise to an increased prevalence, incidence, or severity of gingivitis and periodontitis. The categorization of the systemic modifying factors causing periodontitis and the evidence to support the role of these factors are the focus of this review. An attempt has been made to consider the conditions under broad headings, but it will be clear that many conditions fall within more than one category and that for several conditions only case reports exist whereas in other areas an extensive literature is present.
Collapse
Affiliation(s)
- D F Kinane
- Glasgow Dental Hospital and School, Department of Adult Dental Care, Scotland
| |
Collapse
|
36
|
Arvio P, Arvio M, Wolf J, Lukinmaa PL, Saxen L, Pirinen S. Impaired oral health in patients with aspartylglucosaminuria. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 86:562-8. [PMID: 9830648 DOI: 10.1016/s1079-2104(98)90346-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to assess the oral health of patients with aspartylglucosaminuria, a heritable lysosomal storage disorder, and to recommend guidelines for treatment. STUDY DESIGN Eighty-two patients with aspartylglucosaminuria and 122 control subjects were examined clinically; in addition, panoramic radiographs were evaluated in 61 patients with aspartylglucosaminuria and 61 control subjects. RESULTS High prevalences of caries, gingivitis, and oral Candida (P < .001), extensive gingival overgrowths (18%; P < .001), benign odontogenic tumors or tumorlike lesions (8%; P = .057), reduced maxillary sinuses (P < .001), limited mouth opening (P < .001), and food retention in the mouth (45%) were the major oral findings that distinguished the patients with aspartylglucosaminuria from the control subjects. Adults with aspartylglucosaminuria had diverse oral health problems, early loss of several permanent teeth being the most disabling feature. CONCLUSIONS Patients with aspartylglucosaminuria appear to be at a higher risk for a number of oral disorders; however, poor oral hygiene and failure to cooperate increase these patients' risk of dental and periodontal diseases, making successful prevention crucial.
Collapse
Affiliation(s)
- P Arvio
- Lammi Health Care Centre, Helsinki, Finland
| | | | | | | | | | | |
Collapse
|