1
|
Mehta CH, Velagacherla V, Manandhar S, Nayak Y, Pai SRK, Acharya S, Nayak UY. Development of Epigallocatechin 3-gallate-Loaded Hydrogel Nanocomposites for Oral Submucous Fibrosis. AAPS PharmSciTech 2024; 25:66. [PMID: 38519779 DOI: 10.1208/s12249-024-02787-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024] Open
Abstract
Oral submucous fibrosis (OSF) is a chronic progressive disease associated with increased collagen deposition and TGF-β1 release. The current therapy and management have been a limited success due to low efficacy and adverse drug reactions. This study aimed to evaluate epigallocatechin 3-gallate (EGCG) encapsulated nanoparticles loaded mucoadhesive hydrogel nanocomposite (HNC) for OSF. Developed HNC formulations were evaluated for their permeation behaviour using in vitro as well as ex vivo studies, followed by evaluation of efficacy and safety by in vivo studies using areca nut extract-induced OSF in rats. The disease condition in OSF-induced rats was assessed by mouth-opening and biochemical markers. The optimized polymeric nanoparticles exhibited the required particle size (162.93 ± 13.81 nm), positive zeta potential (22.50 ± 2.94 mV) with better mucoadhesive strength (0.40 ± 0.002 N), and faster permeation due to interactions of the positively charged surface with the negatively charged buccal mucosal membrane. HNC significantly improved disease conditions by reducing TGF-β1 and collagen concentration without showing toxicity and reverting the fibroid buccal mucosa to normal. Hence, the optimized formulation can be further tested to develop a clinically alternate therapeutic strategy for OSF.
Collapse
Affiliation(s)
- Chetan Hasmukh Mehta
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Varalakshmi Velagacherla
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Suman Manandhar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Yogendra Nayak
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Sreedhara Ranganath K Pai
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Usha Yogendra Nayak
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| |
Collapse
|
2
|
Gopinath D, Hui LM, Veettil SK, Balakrishnan Nair A, Maharajan MK. Comparative Efficacy of Interventions for the Management of Oral Submucous Fibrosis: A Systematic Review and Network Meta-Analysis. J Pers Med 2022; 12:jpm12081272. [PMID: 36013221 PMCID: PMC9409832 DOI: 10.3390/jpm12081272] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: Oral submucous fibrosis (OSMF) is a chronic premalignant condition and is characterized by fibroblastic change of lamina propria and stiffness of oral mucosa. Though there are several treatment options available, the best agent is not yet identified. This study assessed the comparative efficacy and safety of medical interventions in the management of OSMF. Methods: A systematic review was performed to identify randomized controlled trials (RCTs) that compared the efficacy of interventions for OSMF with each other, or placebo. A network meta-analysis was performed, and the interventions were ranked according to their efficacy based on the surface under the cumulative ranking. (PROSPERO Registration no: CRD42021255094). Results: Thirty-two RCTs comprising 2063 patients were eligible for quantitative analysis. In terms of therapeutic efficacy in the improvement of mouth opening Oxitard, a herbal formulation was ranked as the most efficacious agent, [MD, 10.29 (95%CI 6.34–14.25)] followed by combination therapy of Lycopene with corticosteroids and hyaluronidase [MD, 7.07 (95%CI 1.82–12.31)]. For improvement of burning sensation aloe vera was ranked first [MD, 6.14 (95%CI 4.58–7.70)] followed by corticosteroids with antioxidants [MD, 6.13 (95%CI 4.12–8.14)] and corticosteroids in combination with hyaluronidase with antioxidants [MD, 5.95 (95%CI 3.79–8.11)]. In terms of safety, most of the drugs were reported to cause mild adverse effects only. Significant inconsistencies could be identified in the analysis for both the outcomes assessed and were further explored. Conclusions: Our study highlighted the potential efficacy of several agents over placebo in the improvement of mouth opening and burning sensation in OSMF patients. However, the RCTs lacked methodological soundness. Well-designed studies with a larger number of participants with a rigorous randomization process and stringent methodology are recommended to strengthen the results obtained, which may help to construct a clinical guideline for OSMF management.
Collapse
Affiliation(s)
- Divya Gopinath
- Clinical Oral Health Sciences, International Medical University, Kuala Lumpur 57000, Malaysia
- Correspondence:
| | - Lai Mong Hui
- School of Postgraduate Studies, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Sajesh K. Veettil
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA;
| | | | | |
Collapse
|
3
|
Mehta CH, Narayan R, Acharya S, Nayak UY. Design and development of surface modified epigallocatechin 3-gallate NanoCubogel for localized delivery to oral submucous fibrosis therapy. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
4
|
Sung JY, Kim JM, Lee JU, Lee YH, Lee SB. Multiple facial candidal abscesses after self-administered acupuncture in a patient with undiagnosed diabetes mellitus: a case report. BMC Complement Med Ther 2021; 21:170. [PMID: 34112168 PMCID: PMC8193879 DOI: 10.1186/s12906-021-03343-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/03/2021] [Indexed: 01/12/2023] Open
Abstract
Background Facial abscess caused by Candida albicans infection is a rare condition even in immunocompromised patients, and only a few cases have been reported. To our knowledge, this is the first case of multiple facial candidal abscesses caused by self-administered acupuncture in an undiagnosed diabetes mellitus patient. Case presentation A 57-year-old woman who had self-acupuncture treatment 2 weeks previously, presented with a 1-week history of progressive left eyelid swelling, erythema, and pain. Despite the antibiotic treatment, the lesion progressed. Surgical incision and drainage was performed and Candida albicans was isolated from the obtained pus culture. The patient was diagnosed with type 2 diabetes mellitus based on a random serum glucose level of 350 mg/dl and 9.2% HbA1c. The abscess resolved after seven incision and drainage cycles and 4 weeks of intravenous fluconazole treatment with an appropriate control of diabetes mellitus. Conclusion Unusual organisms and underlying immunocompromised condition should be suspected in cases of recurrent abscess showing an inadequate response to antibiotic treatment.
Collapse
Affiliation(s)
- Jae Yun Sung
- Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Republic of Korea.,Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Ju Mi Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jong Uk Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Yeon Hee Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Sung Bok Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
| |
Collapse
|
5
|
Ray JG, Chatterjee R, Chaudhuri K. Oral submucous fibrosis: A global challenge. Rising incidence, risk factors, management, and research priorities. Periodontol 2000 2019; 80:200-212. [PMID: 31090137 DOI: 10.1111/prd.12277] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Oral submucous fibrosis is a potentially malignant disorder of the oral cavity, with a high rate of malignant transformation. It is very common among habitual areca nut chewers. The pathogenesis of oral submucous fibrosis is not well established, but it is believed to be a disease of multifactorial origin, including areca nut chewing, ingestion of chilies, genetic factors, immunologic processes and nutritional deficiencies. Genetically susceptible individuals when exposed to areca nut chewing develop this disease over a variable period of time. Oral submucous fibrosis is considered to be a disease of collagen metabolism. Several genetic factors are reported but there is no consensus about the exact mechanism of disease initiation. Variations in histopathological presentation are noted among oral submucous fibrosis patients with habitual areca nut chewing in different forms and other additive agents, eg betel quid, pan masala and gutkha, together with a variety of tobacco habits. The role of epigenetic modifications, such as miRNA regulation, and DNA methylation is also being reported as part of the pathogenesis of oral submucous fibrosis. A combined approach, including analysis of genetic and epigenetic regulations with different habits, might be helpful to better understand the contributory factors and pathogenesis of this serious disorder.
Collapse
Affiliation(s)
- Jay Gopal Ray
- Department of Oral Pathology, Dr. R. Ahmed Dental College & Hospital, Kolkata, India
| | | | - Keya Chaudhuri
- Molecular Genetics Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| |
Collapse
|
6
|
Agarwal P, Chug A, Kumar S, Gupta S, Jain K. Facial candidiasis after maxillofacial trauma: A rare encounter. Dent Traumatol 2018; 34:464-467. [PMID: 30106233 DOI: 10.1111/edt.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 11/27/2022]
Abstract
Facial oedema after maxillofacial trauma is a common occurrence, but those that soon resolve only to appear again do invoke interest! A rare case is presented of a recurring facial swelling occurring after a maxillofacial injury that did not resolve subsequent to medication and repeated aspirations. Cytospin preparations of the aspirate stained with Giemsa revealed candidiasis. The patient's symptoms resolved soon with antifungal medications and he has been asymptomatic since. Such a scenario has never been reported in the literature and can pose a diagnostic dilemma. It gives insight into the unusual clinical presentation of facial candidiasis, the importance of thorough debridement of soft tissue wounds at primary care centres and the need to consider mycoses as a differential diagnosis for nonresolving soft tissue facial swellings after maxillofacial trauma.
Collapse
Affiliation(s)
| | - Ashi Chug
- Department of Dentistry, AIIMS, Rishikesh, India
| | | | - Shruti Gupta
- Department of Pathology, AIIMS, Rishikesh, India
| | - Kanav Jain
- Department of Dentistry, AIIMS, Rishikesh, India
| |
Collapse
|
7
|
Jiang X, Zhang Y, Li F, Zhu Y, Chen Y, Yang S, Sun G. Allicin as a possible adjunctive therapeutic drug for stage II oral submucous fibrosis: a preliminary clinical trial in a Chinese cohort. Int J Oral Maxillofac Surg 2015; 44:1540-6. [PMID: 26165773 DOI: 10.1016/j.ijom.2015.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 04/23/2015] [Accepted: 06/22/2015] [Indexed: 02/06/2023]
Abstract
The objective of this study was to investigate the efficacy and safety of allicin in the treatment of stage II oral submucous fibrosis (OSF) in a Chinese patient cohort. A randomized clinical trial was performed. Triamcinolone acetonide (TA) or allicin was injected intralesionally weekly for 16 weeks. Improvements in mouth opening, burning sensation, and oral health-related quality of life were evaluated. Forty-eight subjects completed the study without obvious adverse reactions. At 40 weeks, the net gain in mouth opening was 2.27 ± 0.84 mm in the TA group and 5.16 ± 1.04 mm in the allicin group. Burning sensation improved by 2.79 ± 0.87 in the TA group and by 4.33 ± 1.04 in the allicin group. The OHIP-14 score improved by 4.67 ± 2.94 in the TA group and by 12.58 ± 9.82 in the allicin group. Allicin intralesional injections improved mouth opening, burning sensation, and oral health-related quality of life in these stage II OSF patients. Allicin appears to be a potential adjunctive therapeutic drug.
Collapse
Affiliation(s)
- X Jiang
- Department of Stomatology, First People's Hospital of Chenzhou, University of China South, Chenzhou, Hunan, China; Institute of Translation Medicine of University of South China, Chenzhou, Hunan, China.
| | - Y Zhang
- Institute of Translation Medicine of University of South China, Chenzhou, Hunan, China
| | - F Li
- Department of Stomatology, First People's Hospital of Chenzhou, University of China South, Chenzhou, Hunan, China
| | - Y Zhu
- Department of Stomatology, First People's Hospital of Chenzhou, University of China South, Chenzhou, Hunan, China
| | - Y Chen
- Department of Stomatology, First People's Hospital of Chenzhou, University of China South, Chenzhou, Hunan, China
| | - S Yang
- Department of Stomatology, First People's Hospital of Chenzhou, University of China South, Chenzhou, Hunan, China
| | - G Sun
- Department of Stomatology, First People's Hospital of Chenzhou, University of China South, Chenzhou, Hunan, China
| |
Collapse
|
8
|
Esen A, Işık K, Dolanmaz D. Treatment of mouth and jaw diseases with intralesional steroid injection. World J Stomatol 2015; 4:87-95. [DOI: 10.5321/wjs.v4.i2.87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 12/11/2014] [Accepted: 01/19/2015] [Indexed: 02/06/2023] Open
Abstract
Many lesions of the oral region are treated with surgical methods such as curettage and resection. Chemotherapy and radiation therapy with or without surgical intervention can be used as an adjunct in some cases. Intralesional steroid injection is a conservative procedure which is already used in various regions of the body and joints. This technique is used also for a number of mouth and jaw lesions. Localized langerhans cell histiocytosis, central giant cell granuloma, oral submucous fibrosis, oral lichen planus, lichen sclerosus of the oral mucosa, lymphatic malformations and orofacial granulomatosis can be considered among these diseases. The purpose of this review is to investigate the effects of intralesional steroid injections in the treatment of oral diseases.
Collapse
|
9
|
Peker E, Zor F, Toprak ME, Bariş E. Facial Candidal Abscess in a Patient with Unknown Type 2 Diabetes Mellitus. J Maxillofac Oral Surg 2014; 14:995-8. [PMID: 26604475 DOI: 10.1007/s12663-014-0680-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 07/30/2014] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Facial candidal abscess is an infection with a fungal cause which was presented in this case such a rarity. We report a rare case of facial abscess due to Candida species in a patient with unknown diabetes. MATERIALS AND METHODS The patient presented with a longstanding firm swelling which occurred 2 weeks ago and did not show any improvement of healing process in spite of surgical and medical treatments. MRI examinations were conclusive and compatible with abscess, so she underwent surgical intervention. Facial candidal abscess was the final diagnosis. CONCLUSIONS We concluded that, in persistent abscesses, invasive candidiasis should be considered in the differential diagnosis of bacterial infections as it generally affects individuals with diabetes or general defects in the immune system, or those who use widespread antibiotics and steroids.
Collapse
Affiliation(s)
- Elif Peker
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Fatma Zor
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Mehmet Emin Toprak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Emre Bariş
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| |
Collapse
|
10
|
Liu C, Xie B, Yang Y, Lin D, Wang C, Lin M, Ge L, Zhou H. Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: a randomized, controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:584-90. [DOI: 10.1016/j.oooo.2013.07.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 07/21/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023]
|
11
|
Ramanathan A, Baliga M, Kumar R. Dentoalveolar surgery in oral submucous fibrosis: need for caution. J Maxillofac Oral Surg 2012; 12:341-2. [PMID: 24431865 DOI: 10.1007/s12663-012-0421-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 06/26/2012] [Indexed: 11/26/2022] Open
Abstract
Performing exodontia in patients with the precancerous condition of oral submucous fibrosis is difficult but frequently necessary. There is mucositis and trismus, faulty wound healing and predisposition to infection. Exodontia and dentoalveolar surgery in these patients may result in distressing sequelae and diagnosis of any subsequent complications like space infection is difficult. Hence, these patients must be treated as a special care group and measures adopted to ease distress. Literature has been reviewed with an eye to understand the underlying nature of the disease and factors that contribute to these problems.
Collapse
Affiliation(s)
- Arvind Ramanathan
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Lighthouse Hill Road, Mangalore, 575 001 Karnataka India
| | - Mohan Baliga
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Lighthouse Hill Road, Mangalore, 575 001 Karnataka India
| | - Rammohan Kumar
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Lighthouse Hill Road, Mangalore, 575 001 Karnataka India
| |
Collapse
|
12
|
Xia J, Li C, Hong Y, Yang L, Huang Y, Cheng B. Short-term clinical evaluation of intralesional triamcinolone acetonide injection for ulcerative oral lichen planus. J Oral Pathol Med 2006; 35:327-31. [PMID: 16762012 DOI: 10.1111/j.1600-0714.2006.00441.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Efforts are made in a continued searching for novel therapies for symptomatic oral lichen planus (OLP). This study aimed to evaluate the efficacy and safety of intralesional triamcinolone acetonide (TA) injection for ulcerative OLP. METHODS Forty-five patients with clinical and histologically confirmed ulcerative OLP on bilateral buccal mucosa, one for treatment and the other for control, were studied. All participants received 0.5 ml TA (40 mg/ml) on experimental sites. Visual analogue scale score and lesion areas were recorded at the time of injection and 1-week interval. After 2 weeks, if the treated ulceration reduced < 81% in size, a second injection was given. RESULTS The treated group gave rapid relief of signs and symptoms, while the control group showed minimal decrease. 38 (84.4%) patients demonstrated complete response in ulceration size. No complications were noted with TA injections. CONCLUSIONS Intralesional TA injection in ulcerative OLP is effective and safe in achieving lesion and pain regression.
Collapse
Affiliation(s)
- Juan Xia
- Department of Oral Medicine, Guanghua School of Stomatology, Sun Yat-sen University, No. 56 Lingyuanxi Road, Guangzhou, Guangdong 510 055, China
| | | | | | | | | | | |
Collapse
|