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Mukherjee S, Chopra A, Karmakar S, Bhat SG. Periodontitis increases the risk of gastrointestinal dysfunction: an update on the plausible pathogenic molecuar mechanisms. Crit Rev Microbiol 2024:1-31. [PMID: 38602474 DOI: 10.1080/1040841x.2024.2339260] [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: 11/04/2023] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
Periodontitis is an immuno-inflammatory disease of the soft tissues surrounding the teeth. Periodontitis is linked to many communicable and non-communicable diseases such as diabetes, cardiovascular disease, rheumatoid arthritis, and cancers. The oral-systemic link between periodontal disease and systemic diseases is attributed to the spread of inflammation, microbial products and microbes to distant organ systems. Oral bacteria reach the gut via swallowed saliva, whereby they induce gut dysbiosis and gastrointestinal dysfunctions. Some periodontal pathogens like Porphyromonas. gingivalis, Klebsiella, Helicobacter. Pylori, Streptococcus, Veillonella, Parvimonas micra, Fusobacterium nucleatum, Peptostreptococcus, Haemophilus, Aggregatibacter actinomycetomcommitans and Streptococcus mutans can withstand the unfavorable acidic, survive in the gut and result in gut dysbiosis. Gut dysbiosis increases gut inflammation, and induce dysplastic changes that lead to gut dysfunction. Various studies have linked oral bacteria, and oral-gut axis to various GIT disorders like inflammatory bowel disease, liver diseases, hepatocellular and pancreatic ductal carcinoma, ulcerative colitis, and Crohn's disease. Although the correlation between periodontitis and GIT disorders is well established, the intricate molecular mechanisms by which oral microflora induce these changes have not been discussed extensively. This review comprehensively discusses the intricate and unique molecular and immunological mechanisms by which periodontal pathogens can induce gut dysbiosis and dysfunction.
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Affiliation(s)
- Sayantan Mukherjee
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shaswata Karmakar
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Subraya Giliyar Bhat
- Department of Preventive Dental Sciences, Division of Periodontology, College of Dental Surgery, Iman Abdulrahman Bin Faizal University, Dammam, Saudi Arabia
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El-Khoueiry AB, Trojan J, Meyer T, Yau T, Melero I, Kudo M, Hsu C, Kim TY, Choo SP, Kang YK, Yeo W, Chopra A, Soleymani S, Yao J, Neely J, Tschaika M, Welling TH, Sangro B. Nivolumab in sorafenib-naive and sorafenib-experienced patients with advanced hepatocellular carcinoma: 5-year follow-up from CheckMate 040. Ann Oncol 2024; 35:381-391. [PMID: 38151184 DOI: 10.1016/j.annonc.2023.12.008] [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: 05/30/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Patients with advanced hepatocellular carcinoma (aHCC) have a poor prognosis and high mortality. Nivolumab monotherapy demonstrated clinical benefit with an acceptable safety profile in patients with aHCC in the CheckMate 040 study. Five-year follow-up of the sorafenib-naive and sorafenib-experienced groups of CheckMate 040 is presented here. PATIENTS AND METHODS Patients received nivolumab monotherapy at dose levels of 0.1-10.0 mg/kg (dose-escalation phase) or 3 mg/kg (dose-expansion phase) every 2 weeks until disease progression or unacceptable toxicity. Primary endpoints were safety and tolerability (dose escalation), and objective response rate (ORR) by blinded independent central review (BICR) and by investigator as per RECIST version 1.1 (dose expansion). RESULTS Eighty sorafenib-naive and 154 sorafenib-experienced patients were treated. Minimum follow-up in both groups was 60 months. ORR as per BICR was 20% [95% confidence interval (CI) 12% to 30%] and 14% (95% CI 9% to 21%) in the sorafenib-naive and sorafenib-experienced groups, respectively. Responses occurred regardless of HCC etiology or baseline tumor cell programmed death-ligand 1 (PD-L1) expression levels. Median overall survival (OS) was 26.6 months (95% CI 16.6-30.6 months) and 15.1 months (95% CI 13.0-18.2 months) in sorafenib-naive and sorafenib-experienced patients, respectively. The 3-year OS rates were 28% in the sorafenib-naive and 20% in the sorafenib-experienced groups; 5-year OS rates were 14% and 12%, respectively. No new safety signals were identified; grade 3/4 treatment-related adverse events were observed in 33% and 21% of patients in the sorafenib-naive and sorafenib-experienced groups, respectively. Biomarker analyses showed that baseline PD-L1 expression ≥1% was associated with higher ORR and longer OS compared with PD-L1 <1%. In the sorafenib-naive group, patients with OS ≥3 years exhibited higher baseline CD8 T-cell density compared with those with OS <1 year. CONCLUSION With 5 years of follow-up, nivolumab monotherapy continued to provide durable clinical benefit with manageable safety in sorafenib-naive and sorafenib-experienced patients with aHCC.
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Affiliation(s)
- A B El-Khoueiry
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Los Angeles, USA.
| | - J Trojan
- Department of Medicine, Goethe University Hospital and Cancer Center, Frankfurt, Germany
| | - T Meyer
- Department of Oncology, Royal Free Hospital, London, UK
| | - T Yau
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - I Melero
- Department of Immunology, Clinica Universidad de Navarra and CIBERONC, Pamplona, Spain
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - C Hsu
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan; Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - T-Y Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - S-P Choo
- Division of Medical Oncology, National Cancer Center and Curie Oncology, Singapore, Republic of Singapore
| | - Y-K Kang
- Department of Oncology, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - W Yeo
- Department of Clinical Oncology, Chinese University of Hong Kong, Hong Kong, China
| | - A Chopra
- Department of Medical Oncology, Johns Hopkins Singapore International Medical Centre, Singapore, Republic of Singapore
| | - S Soleymani
- Global Biometrics & Data Sciences, Bristol Myers Squibb, Princeton, USA
| | - J Yao
- Informatics and Predictive Sciences, Bristol Myers Squibb, Princeton, USA
| | - J Neely
- Translational Medicine, Bristol Myers Squibb, Princeton, USA
| | - M Tschaika
- Oncology Clinical Development, Bristol Myers Squibb, Princeton, USA
| | - T H Welling
- Perlmutter Cancer Center and Department of Surgery, NYU Langone Health, New York, USA
| | - B Sangro
- Liver Unit and HPB Oncology Area, Clinica Universidad de Navarra and CIBEREHD, Pamplona, Spain
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Chopra A, Franco-Duarte R, Rajagopal A, Choowong P, Soares P, Rito T, Eberhard J, Jayasinghe TN. Exploring the presence of oral bacteria in non-oral sites of patients with cardiovascular diseases using whole metagenomic data. Sci Rep 2024; 14:1476. [PMID: 38233502 PMCID: PMC10794416 DOI: 10.1038/s41598-023-50891-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/27/2023] [Indexed: 01/19/2024] Open
Abstract
Cardiovascular diseases (CVDs) encompass various conditions affecting the heart and its blood vessels and are often linked with oral microbes. Our data analysis aimed to identify oral bacteria from other non-oral sites (i.e., gut, arterial plaque and cultured blood) that could be linked with CVDs. Taxonomic profiling identified bacteria to the species level and compared with the Human Oral Microbiome Database (HOMD). The oral bacteria in the gut, cultured blood and arterial plaque samples were catalogued, with their average frequency calculated for each sample. Additionally, data were filtered by comparison with the Human Microbiome Project (HMP) database. We identified 17,243 microbial species, of which 410 were present in the HOMD database and further denominated as "oral", and were found in at least one gut sample, but only 221 and 169 species were identified in the cultured blood and plaque samples, respectively. Of the 410 species, 153 were present solely in oral-associated environments after comparison with the HMP database, irrespective of their presence in other body sites. Our results suggest a potential connection between the presence of specific species of oral bacterial and occurrence of CVDs. Detecting these oral bacterial species in non-oral sites of patients with CVDs could help uncover the link between oral health and general health, including cardiovascular conditions via bacterial translocation.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ricardo Franco-Duarte
- Department of Biology, CBMA (Center of Molecular and Environmental Biology), University of Minho, Braga, Portugal
- Institute of Science and Innovation for Biosustainability (IB-S), University of Minho, Braga, Portugal
| | - Anjale Rajagopal
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Phannaphat Choowong
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, University of Sydney, Sydney, Australia
| | - Pedro Soares
- Department of Biology, CBMA (Center of Molecular and Environmental Biology), University of Minho, Braga, Portugal
- Institute of Science and Innovation for Biosustainability (IB-S), University of Minho, Braga, Portugal
| | - Teresa Rito
- Department of Biology, CBMA (Center of Molecular and Environmental Biology), University of Minho, Braga, Portugal
- Institute of Science and Innovation for Biosustainability (IB-S), University of Minho, Braga, Portugal
| | - Joerg Eberhard
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, University of Sydney, Sydney, Australia
| | - Thilini N Jayasinghe
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, University of Sydney, Sydney, Australia.
- The Charles Perkins Centre, The University of Sydney, University of Sydney, Sydney, Australia.
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Zheng L, Chopra A, Weiner J, Beule D, Dommisch H, Schaefer AS. miRNAs from Inflamed Gingiva Link Gene Signaling to Increased MET Expression. J Dent Res 2023; 102:1488-1497. [PMID: 37822091 PMCID: PMC10683346 DOI: 10.1177/00220345231197984] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
Several array-based microRNA (miRNA) expression studies independently showed increased expression of miRNAs hsa-miR-130a-3p, -142-3p, -144-3p, -144-5p, -223-3p, -17-5p, and -30e-5p in gingiva affected by periodontal inflammation. We aimed to determine direct target genes and signaling pathways regulated by these miRNAs to identify processes relevant to gingival inflammatory responses and tissue homeostasis. We transfected miRNA mimics (mirVana) for each of the 7 miRNAs separately into human primary gingival fibroblasts cultured from 3 different donors. Following RNA sequencing, differential gene expression and second-generation gene set enrichment analyses were performed. miRNA inhibition and upregulation was validated at the transcript and protein levels using quantitative reverse transcriptase polymerase chain reaction, Western blotting, and reporter gene assays. All 7 miRNAs significantly increased expression of the gene MET proto-oncogene, receptor tyrosine kinase (MET). Expression of known periodontitis risk genes CPEB1, ABCA1, and ATP6V1C1 was significantly repressed by hsa-miR-130a-3p, -144-3p, and -144-5p, respectively. The genes WASL, ENPP5, ARL6IP1, and IDH1 showed the most significant and strongest downregulation after hsa-miR-142-3p, -17-5p, -223-3p, and -30e-5p transfection, respectively. The most significantly regulated gene set of each miRNA related to cell cycle (hsa-miRNA-144-3p and -5p [Padj = 4 × 10-40 and Padj = 4 × 10-6], -miR-17-5p [Padj = 9.5 × 10-23], -miR-30e-5p [Padj = 8.2 × 10-18], -miR-130a-3p [Padj = 5 × 10-15]), integrin cell surface interaction (-miR-223-3p [Padj = 2.4 × 10-7]), and interferon signaling (-miR-142-3p [Padj = 5 × 10-11]). At the end of acute inflammation, gingival miRNAs bring together complex regulatory networks that lead to increased expression of the gene MET. This underscores the importance of mesenchymal cell migration and invasion during gingival tissue remodeling and proliferation in restoring periodontal tissue homeostasis after active inflammation. MET, a receptor of the mitogenic hepatocyte growth factor fibroblast secreted, is a core gene of this process.
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Affiliation(s)
- L. Zheng
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A. Chopra
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - J. Weiner
- Core Unit Bioinformatics, Berlin Institute of Health, Berlin, Germany
| | - D. Beule
- Core Unit Bioinformatics, Berlin Institute of Health, Berlin, Germany
| | - H. Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A. S. Schaefer
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Puzhankara L, Banerjee A, Chopra A, Venkitachalam R, Kedlaya MN. Effectiveness of probiotics compared to antibiotics to treat periodontal disease: Systematic review. Oral Dis 2023. [PMID: 37964394 DOI: 10.1111/odi.14781] [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: 07/11/2023] [Revised: 09/11/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Probiotics are promising adjuncts to non-surgical periodontal therapy (scaling and root planing (SRP)) for managing gingival and periodontal diseases. Probiotics are considered alternatives to antibiotics, especially with the emergence of antimicrobial resistance. Hence, the present systematic review aims to generate evidence on the role of probiotics compared to antimicrobial agents for managing periodontal diseases (gingivitis and periodontitis). METHOD Six electronic databases (PubMed, SCOPUS, Web of Science, EBSCO, Cochrane, Clinical Trial Registry) were searched to collect studies comparing the effect of probiotics with antibiotics for periodontal disease. In total, 5530 articles were retrieved from all databases, of which 1891 were included for title and abstract screening. After screening, a total of ten clinical studies were included for data extraction and analysis. Probing pocket depth (PPD), Clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI), gingival index (GI), and microbial profile were recorded. RESULTS Probiotics showed a significant reduction in the PPD and CAL compared to antibiotics. Antibiotics were more effective in reducing the PI and GI. A combination of probiotics and antibiotics superior compared to probiotics and antibiotics alone. CONCLUSION Probiotics can be used as an alternative to antibiotics, however, a combination is more effective for managing periodontal disease.
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Affiliation(s)
- Lakshmi Puzhankara
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Avishikta Banerjee
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | | | - Madhurya N Kedlaya
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
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Thakkar S, Chopra A, Nagendra L, Kalra S, Bhattacharya S. Teplizumab in Type 1 Diabetes Mellitus: An Updated Review. touchREV Endocrinol 2023; 19:22-30. [PMID: 38187075 PMCID: PMC10769466 DOI: 10.17925/ee.2023.19.2.7] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/01/2023] [Indexed: 01/09/2024]
Abstract
Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition characterized by the irreversible destruction of the β cells of the pancreas, which leads to a lifelong dependency on exogenous insulin. Despite the advancements in insulin delivery methods, the suboptimal outcomes of these methods have triggered the search for therapies that may prevent or reverse the disease. Given the autoimmune aetiology of T1DM, therapies counteracting the immune-mediated destruction of the β-cells are the obvious target. Although several treatment strategies have been attempted to target cellular, humoral and innate immunity, very few have had a clinically meaningful impact. Of all the available immunomodulatory agents, cluster of differentiation (CD) 3 antibodies have exhibited the most promising preclinical and clinical results. Muromonab-CD3, which also happened to be a murine CD3 antibody, was the first monoclonal antibody approved for clinical use and was primarily indicated for graft rejection. The adverse effects associated with muromonab-CD3 led to its withdrawal. Teplizumab, a newer CD3 antibody, has a better side-effect profile because of its humanized nature and non-Fc-receptor-binding domain. In November 2022, teplizumab became the first immunomodulatory agent to be licensed by the US Food and Drug Administration for delaying the onset of T1DM in high-risk adults and children over 8 years old. The mechanism seems to be enhancing regulatory T-cell activity and promoting immune tolerance. This article reviews the mechanism of action and the clinical trials of teplizumab in individuals with T1DM or at risk of developing the disease.
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Affiliation(s)
- Simran Thakkar
- Department of Endocrinology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Aditi Chopra
- Department of Endocrinology, Manipal Hospital, Bengaluru, India
| | | | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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Shettigar L, Sivaraman S, Rao R, Akhila Arun S, Chopra A, U Kamath S, Rana R. Correlational analysis between salivary and blood glucose levels in individuals with and without diabetes mellitus: a cross-sectional study. Acta Odontol Scand 2023:1-11. [PMID: 37823574 DOI: 10.1080/00016357.2023.2267678] [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: 07/06/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To estimate the association of patient-related demographic, socioeconomic status, physical activity, stress, and dietary factors influencing the relationship between salivary and blood glucose levels in individuals with and without diabetes mellitus (DM). METHOD This cross-sectional study was conducted on 166 participants with and without DM. Saliva and blood were collected to estimate the glucose levels. Age, gender, occupation, socioeconomic and education level, BMI, hip to waist circumference, stress, dietary pattern, lifestyle, physical activity, family history of diabetes, and type of diabetes were recorded. The association of saliva to predict blood glucose levels was analysed using Spearman Rank Correlation and how these patient-related factors influence the correlation was estimated for future machine learning models. The difference in medians for various groups was calculated using the Mann-Whitney U Test or Kruskal Wallis Test. RESULTS Blood glucose level is not significantly correlated to salivary glucose level. However, a statistically significant difference in the median blood glucose levels for diabetic participants (median = 137) compared to healthy controls (p-value < .05) was noted. The correlation between blood and salivary glucose was more positive for higher levels of glucose (Spearman 0.4). Age, alcohol consumption, monthly wages, intake of vegetables, and socioeconomic status affect blood glucose levels. CONCLUSION A correlation between saliva and blood glucose levels in healthy individuals was weak. Saliva should only be used as a monitoring tool rather than a diagnostic tool and is more reliable for patients with poorly controlled diabetes mellitus.
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Affiliation(s)
- Laasya Shettigar
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sanchita Sivaraman
- UBC School of Population and Public Health, British Columbia, Vancouver, Canada
| | - Rohini Rao
- Department of Data Science and Computer Applications, Manipal Institute of Technology (MIT), Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sanjana Akhila Arun
- Department of Data Science and Computer Applications, Manipal Institute of Technology (MIT), Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Shobha U Kamath
- Department of Biochemistry, Kasturba Medical College and Hospital, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Raju Rana
- Department of Biochemistry, Kasturba Medical College and Hospital, Manipal, Manipal Academy of Higher Education, Manipal, India
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Saha S, Chopra A, Kamath SU, Kashyap NN. Can acid produced from probiotic bacteria alter the surface roughness, microhardness, and elemental composition of enamel? An in vitro study. Odontology 2023; 111:929-941. [PMID: 36995435 PMCID: PMC10492682 DOI: 10.1007/s10266-023-00804-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023]
Abstract
Probiotics are live microorganisms that upon administration in adequate amounts provide various health benefits to the host. Probiotics are "lactic acid-producing bacteria" as they release large amounts of organic acids, particularly lactic acids, in their surrounding environment. Although the acids produced by probiotics are beneficial for gastrointestinal and vaginal health, the acidogenic nature of probiotics has raised concerns among dental professionals, especially concerning their effect on the enamel and dentin. Previous studies have found that probiotics can lower the pH of the saliva and cause essential elements like Calcium and Phosphorus to leach from the enamel. This can alter the surface topography of enamel and increase the risk of enamel defects. Studies have also noted that probiotic bacteria can replace cariogenic bacteria and lower the risk of tooth decay. However, the effect of acid produced by probiotics on the enamel surface remains unclear. Hence, the present study aims to evaluate the effect of probiotics on the surface roughness, microhardness, and elemental composition of enamel compared to 0.1 M Lactic acid (demineralizing agent). Twenty enamel sections were randomly divided into groups and subjected to a pH cycling model using a probiotic suspension and 0.1 M lactic acid. The changes in the surface roughness, microhardness, surface morphology, and elemental composition of the enamel with regard to Carbon, Oxygen, Sodium, Hydrogen, Magnesium, Phosphorus, Fluoride, Chlorine, and Calcium of the enamel were evaluated before and after the emersion in both the groups. The results showed a significant increase in the mean surface roughness in the probiotic group before and after the exposure. The microhardness of the enamel decreased along with altered arrangement of the enamel prisms, increased striations, scratch marks, and pitting after exposure to the probiotic group. A decrease in the atomic/weight% for Calcium, Phosphorous, Fluoride, Aluminium, and Oxygen and an increase in the weight/atomic% for Carbon, Nitrogen, and Sodium were noted compared to the baseline in the probiotic solution. The results in the probiotic group were comparable to the 0.1 M lactic acids. The pH changed from 5.78 to 3.06 at the end of 24 h in the probiotic group. Based on these findings, we conclude that exposure to probiotics can affect microhardness and surface roughness and cause leaching of essential elements like Calcium and Phosphorous from the enamel.
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Affiliation(s)
- Swagata Saha
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India.
| | - Shobha Ullas Kamath
- Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Namita N Kashyap
- Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
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Chopra A, Shiheido-Watanabe Y, Eberhard J. Editorial: Porphyromonas gingivalis: molecular mechanisms of invasion, immune evasion, and dysbiosis. Front Cell Infect Microbiol 2023; 13:1289103. [PMID: 37842000 PMCID: PMC10570826 DOI: 10.3389/fcimb.2023.1289103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023] Open
Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Yuka Shiheido-Watanabe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Joerg Eberhard
- Sydney Dental School and the Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Swarnamali H, Medara N, Chopra A, Spahr A, Jayasinghe TN. Role of Dietary Fibre in Managing Periodontal Diseases-A Systematic Review and Meta-Analysis of Human Intervention Studies. Nutrients 2023; 15:4034. [PMID: 37764817 PMCID: PMC10536522 DOI: 10.3390/nu15184034] [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: 08/23/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Periodontitis is a chronic multifactorial inflammatory disease, that leads to tooth loss and is associated with other systemic diseases. The role of dietary fibre in the prevention and management of periodontal diseases is not well understood. The objective of this systematic review and meta-analysis was to assess how an intake of dietary fibre affects periodontal diseases in humans and any concomitant effects on systemic inflammation. METHODOLOGY Human interventional studies investigating the effects of oral fibre intake on various clinical parameters of periodontal diseases were included. Search strategy with MeSH and free-text search terms was performed on the following database: CINAHL Complete, EMBASE, MEDLINE, SciVerse Scopus®, and Web of Science Core Collection on 21 October 2021 and updated on 19 February 2023 to identify relevant studies. Articles were filtered using the Covidence© web-based platform software. Data were pooled using random effects meta-analysis. RESULTS From all databases, a total of 19,971 studies were obtained. Upon title and abstract screening, 101 studies were included for full-text screening. Upon full-text screening, six studies were included for analysis. Of these, five were randomised controlled trials, and one was a sequential feeding trial involving fibre-rich daily diet for a 4-8 weeks period. Fibre-rich dietary intervention significantly reduced Clinical Attachment Loss/Level by 0.48 mm/tooth (95% CI, -0.63 to -0.33, p < 0.001), Bleeding On Probing by 27.57% sites/tooth (95% CI -50.40 to -4.74, p = 0.02), Periodontal Inflamed Surface Area by 173.88 mm2 (95% CI -288.06 to -59.69, p = 0.003), Plaque Index by 0.02 (95% CI -0.04 to -0.00, p = 0.04), and Gingival Index by 0.41 (95% -0.67 to -0.16, p= 0.002). A non-significant reduction was observed for Probing Depth (-0.17 mm/tooth; 95% CI, -0.37 to 0.02, p = 0.09). CONCLUSIONS Fibre-rich dietary interventions are associated with a reduction of clinical and particularly inflammatory markers of periodontal diseases. This shows a promising effect of dietary fibre as an intervention for inflammatory conditions like periodontal diseases.
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Affiliation(s)
- Hasinthi Swarnamali
- The Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Nidhi Medara
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia; (N.M.); (A.S.); (T.N.J.)
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal 576104, India;
| | - Axel Spahr
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia; (N.M.); (A.S.); (T.N.J.)
| | - Thilini N. Jayasinghe
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia; (N.M.); (A.S.); (T.N.J.)
- The Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
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Tailor R, Medara N, Chopra A, Swarnamali H, Eberhard J, Jayasinghe TN. Role of prebiotic dietary fiber in periodontal disease: A systematic review of animal studies. Front Nutr 2023; 10:1130153. [PMID: 36998913 PMCID: PMC10043215 DOI: 10.3389/fnut.2023.1130153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundPeriodontitis is a chronic inflammatory condition affecting the supporting structures of a tooth in the oral cavity. The relationship between dietary fiber and periodontitis is poorly understood. The objective of this systematic review is to investigate if an intake of dietary fiber modulates periodontal disease in animal models and any concomitant effects on systemic inflammation, microbiota and their metabolites.MethodsAnimal studies using periodontitis models with any form of fiber intervention were included. Studies with comorbidities that were mutually inclusive with periodontitis and animals with physiological conditions were excluded. Search strategy with MeSH and free-text search terms were finalized and performed on the 22nd of September 2021.CINAHL Complete, EMBASE, MEDLINE, SciVerse Scopus® and Web of Science Core Collection databases were used to identify studies. SYRCLE’s risk of bias tool and CAMARADES were used for quality assessment. Results were synthesized utilizing Covidence© web-based platform software to remove duplicates, and the remaining studies were manually filtered.ResultsA total of 7,141 articles were retrieved from all databases. Out of 24 full-text articles assessed for eligibility, four studies (n = 4) were included. Four studies involved the use of β-(1,3/1,6)-glucan (n = 3) and mannan oligosaccharide (n = 1) at differing dosages for different study durations. All studies utilized a ligature-induced model of periodontitis in rats, either Wistar (n = 3) or Sprague–Dawley (n = 1). A dose-dependent relationship between the increased fiber intake and decrease in alveolar bone loss and pro-inflammatory markers was observed.ConclusionThe number of included studies is limited and narrow in scope. They highlight the importance of pre-clinical trials in this field with broader dietary fiber intervention groups before proceeding to clinical trials. The use of dietary fiber as an intervention shows promise in the reduction of inflammatory conditions like periodontitis. However, further research is required to delineate the relationship between diet and its effects on microbiota and their metabolites such as short chain fatty acids in animal models of periodontitis.
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Affiliation(s)
- Rohan Tailor
- The Charles Perkins Centre, The University of Sydney, Darlington, NSW, Australia
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
| | - Nidhi Medara
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Western Province, Sri Lanka
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Darlington, NSW, Australia
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
| | - Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Darlington, NSW, Australia
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Darlington, NSW, Australia
- *Correspondence: Thilini N. Jayasinghe,
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Sanghavi AD, Chopra A, Shah A, Lobo R, Shenoy PA. Antimicrobial, anti-adhesion, anti-biofilm properties of goji berry ( Lycium barbarum) against periodontal bacteria: potential benefits for periodontal diseases. J Complement Integr Med 2023; 20:129-136. [PMID: 36398568 DOI: 10.1515/jcim-2022-0214] [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] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Lycium barbarum, commonly known as goji berry, Himalayan berry, or Tibetian berry, is emerging as a popular "superfood" with anti-inflammatory and antioxidant properties. However, its use for the management of oral inflammatory diseases has not been explored. The present study aims to evaluate the antimicrobial, anti-adhesion, anti-biofilm, and cytotoxic properties of an ethanolic extract of L. barbarum (LBE) against common oral and periodontal pathogens. METHODS The antimicrobial properties of LBE against five potential periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Tanerella forsythia) were tested and compared to chlorhexidine and doxycycline using serial dilution and disc diffusion assay. The MTT Assay was performed for evaluating the cytotoxicity and cell viability of the LBE on the gingival fibroblast and modified keratinocyte cell lines. The anti-adhesion and anti-biofilm properties of LBE against P. gingivalis at its minimal bactericidal value were also assessed. RESULTS LBE inhibited the growth of periodontal pathogens as compared to control, however, the zone of inhibition of LBE was less when compared to doxycycline and chlorhexidine. The de novo extract showed a maximum zone of inhibition against Tf and Aa. The LBE extract was also compatible to gingival fibroblast tissues and oral keratinocytes at 1 mg/mL. CONCLUSIONS L. barbarum is a promising alternative to Chlorhexidine for the management of oral and periodontal infections.
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Affiliation(s)
- Amee Dilip Sanghavi
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashmeet Shah
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Richard Lobo
- Department of Pharmacognosy, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Padmaja A Shenoy
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Chopra A, Xavier D, George B, Bantwal G, Sahay R, Kumar KVSH, Madhu SV, Bhattacharya S. Strategies for Promoting Research among Endocrinologists in Private Practice. Indian J Endocrinol Metab 2023; 27:28-31. [PMID: 37215263 PMCID: PMC10198198 DOI: 10.4103/2230-8210.370909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Affiliation(s)
- Aditi Chopra
- Department of Endocrinology, Fortis Hospital, St. John’s Medical College and Research Institute, Bengaluru, India
| | - Denis Xavier
- Department of Pharmacology and Head, Division of Clinical Research, St. John’s Medical College and Research Institute, Bengaluru, India
| | - Belinda George
- Department of Endocrinology, St. John’s Medical College Hospital, Bengaluru, India
| | - Ganapathi Bantwal
- Department of Endocrinology, St. John’s Medical College Hospital, Bengaluru, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - KVS Hari Kumar
- Department of Endocrinology, Magna Centre and Fernandez Hospitals, Hyderabad, Telangana, India
| | - S V Madhu
- Department of Endocrinology, Centre for Diabetes, Endocrinology and Metabolism, University College of Medical Sciences, New Delhi, India
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Chopra A, Vishnupriya V, Gayathri R, Kavitha S. Knowledge and awareness of dental students on attention deficit hyperactivity disorder. J Adv Pharm Technol Res 2022; 13:S308-S313. [PMID: 36643115 PMCID: PMC9836149 DOI: 10.4103/japtr.japtr_427_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 01/17/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a prevalent psychiatric illness marked by a short span of attention, impulsive decisions, and behavioral issues. They are vulnerable to trauma and dental problems. The dental health team faces a challenge due to behavioral disorders, cognitive deficiencies, and short attention spans. At all stages of prevention and treatment, the management of these children necessitates various changes in approach. To collect data and analyze the awareness level of dental students toward ADHD. An online portal was used for the survey and distributed to 106 dentistry students with self-structured 10 questions. The findings were gathered through the survey portal, and graphs were drawn to compare the results. The SPSS software version 20.0 was used for statistical analysis. The Chi-square test was used to determine the correlation between the variables. Forty percent of those polled are aware of ADHD, which is a mental health condition characterized by excessively active and impulsive behavior. The symptoms of a child with ADHD are aware to 31.43% of voters. About 30.48% of the respondents know the symptoms of an adult with ADHD. About 29.52% of the respondents were aware of the causes of ADHD. To conclude that most dental undergraduates are not aware of the basic characteristics of ADHD. This means that there should be a spreading of knowledge on the subject. A dental student or dentist must know how to manage a patient diagnosed with ADHD. Careful management and treatment will lead to a satisfied and happy patient. Mismanagement may cause problems in the future for both the dentist and the patient.
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Affiliation(s)
- Aditi Chopra
- Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Veeraraghavan Vishnupriya
- Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Veeraraghavan Vishnupriya, Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai - 600 077, Tamil Nadu, India. E-mail:
| | - R. Gayathri
- Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - S. Kavitha
- Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Singh A, Das S, Chopra A, Danda D, Paul BJ, March L, Mathew AJ, Shenoy P, Gotay C, Palmer AJ, Antony B. Burden of osteoarthritis in India and its states, 1990-2019: findings from the Global Burden of disease study 2019. Osteoarthritis Cartilage 2022; 30:1070-1078. [PMID: 35598766 DOI: 10.1016/j.joca.2022.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the burden of osteoarthritis (OA) in India from 1990 to 2019. DESIGN Data from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used. The burden of OA -knee OA, hip OA, hand OA, and other OA- was estimated for India and its states from 1990 to 2019 through a systematic analysis of prevalence, incidence, years lived with disability (YLD), and disability-adjusted life years (DALY) using methods reported in GBD 2019 study. RESULT Around 23.46 million individuals in India had OA in 1990; this increased to 62.35 million in 2019. The age-standardised prevalence of OA increased from 4,895 (95% uncertainty interval (UI):4,420-5,447) in 1990-5313 (95%UI:4,799-5,898) in 2019, per 100,000 persons. Similarly, DALYs due to OA increased from 0.79 million (95%UI:0.40-1.55) to 2.12 million (95%UI:1.07-4.23); while age-standardised DALYs increased from 164 (95%UI:83-325) to 180 (95%UI:91-361) per 100,000 persons from 1990 to 2019. OA was the 20th most common cause of YLDs in India in 2019, accounting for 1.48% (95%UI:0.88-2.78) of all YLDs; increasing from 23rd most common cause in 1990 (1.25%(95%UI:0.74-2.34)). Knee OA was the most common form of OA, followed by hand OA. The prevalence, incidence, and DALYs for OA and knee OA were consistently higher in females than males. CONCLUSION The burden and impact of OA in India are substantial and is increasing. Adopting suitable control and preventive community measures to reduce modifiable risk factors (obesity, injuries, occupational stress) are needed to reduce the current and future burden of OA in India.
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Affiliation(s)
- A Singh
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - S Das
- Era's University, Lucknow, India
| | - A Chopra
- Centre for Rheumatic Diseases, Apollo Jehangir Hospital, Pune University, Pune, India
| | - D Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - B J Paul
- Department of General Medicine, KMCT Medical College, Calicut, Kerala, India
| | - L March
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia; Florance and Cope Professorial Rheumatology Department, University of Sydney Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - A J Mathew
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Copenhagen University Hospital - Rigshospitalet Glostrup, Denmark
| | - P Shenoy
- Centre for Arthritis & Rheumatism Excellence, Kochi, Kerala, India
| | - C Gotay
- University of British Columbia, Vancouver, BC Canada
| | - A J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
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Kaur J, Sanghavi AD, Chopra A, Lobo R, Saha S. Antimicrobial and cytotoxicity properties of Plumeria alba flower extract against oral and periodontal pathogens: A comparative in vitro study. J Indian Soc Periodontol 2022; 26:334-341. [PMID: 35959306 PMCID: PMC9362818 DOI: 10.4103/jisp.jisp_329_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/17/2021] [Accepted: 10/10/2021] [Indexed: 11/13/2022] Open
Abstract
Context: Plumeria alba, commonly known as frangipani or West Indian jasmine, is a traditional and ancient folklore medicine known for its antimicrobial, anti-inflammatory, and antioxidant properties. The extracts from P. alba obtained from the leaves, bark, and flowers, are commonly used to manage bacterial, fungal, and viral infections such as herpes, scabies, and fungal infections. The constituents of the P. alba plant have shown promising antihelmintic, antipyretic, and antirheumatic properties. Although studies have confirmed that extracts from Plumeria species are effective against microbial infections and cancer, its role in managing oral diseases, particularly the chronic inflammatory disease of the gums (gingivitis and periodontitis), has never been explored. Therefore, the current study aimed to explore the antimicrobial and cytotoxic properties of the P. alba flower extract against oral and periodontal pathogens compared to chlorhexidine and doxycycline. Settings and Design: This was an in vitro study. Materials and Methods: The ethanolic extract was prepared from the freshly plucked P. alba flowers. The antimicrobial properties of the extract were evaluated by testing the minimal inhibitory concentration, minimal bactericidal concentration, and well-diffusion assay against Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Tannerella forsythia, Streptococcus mutans, Actinomyces viscosus, Streptococcus salivarius, and Candida albicans. The results were compared to chlorhexidine and doxycycline. The cytotoxicity was checked by the against human-derived gingival fibroblast and keratinocytes. Statistical Analysis Used: One-way ANOVA for the mean zones of inhibition against all the microorganisms was done. Results: P. alba extract inhibited the growth for all the tested oral and periodontal pathogens at 25 μg/ml. The well-diffusion assay of P. alba extract was comparable to chlorhexidine but was not statistically significant compared to doxycycline. Conclusion: P. alba can be used as a promising alternative to chlorhexidine for the management of oral and periodontal infections.
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Affiliation(s)
- Jaskirat Kaur
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Amee Dilip Sanghavi
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Richard Lobo
- Department of Pharmacognosy, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Swagata Saha
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Singh A, Das SK, Chopra A, Danda D, Paul BJ, March L, Mathew AJ, Shenoy P, Gotay C, Palmer AJ, Antony B. POS1425 THE BURDEN OF OSTEOARTHRITIS ACROSS THE STATES OF INDIA, 1990–2019: FINDINGS FROM THE GLOBAL BURDEN OF DISEASE STUDY 2019. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFew studies have reported the burden of osteoarthritis (OA) in different parts of India. However, no study has reported the detailed estimates of incidence, prevalence, and years lived with disability (YLDs) and its trends for OA (and its various sites) across the states of India over a long period of time.ObjectivesWe aim to describe the state-wise prevalence, incidence, and YLDs for osteoarthritis (OA) in India from 1990 to 2019 according to age and sex.MethodsData from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used. The burden of OA –including knee OA, hip OA, hand OA, and other OA– was estimated for India and its states from 1990 to 2019 through a systematic analysis of prevalence, incidence, and YLDs modelled data using the methods reported in the GBD 2019 Study. All estimates are presented as counts and age-standardised rates per 100,000 population, with uncertainty intervals (UIs).ResultsAround 23.46 million individuals in India had OA in 1990; this increased to 62.35 million in 2019. The age-standardised prevalence of OA increased from 4,895 (95% uncertainty interval (UI): 4,420–5,447) in 1990 to 5313 (95%UI: 4,799–5,898) in 2019, per 100,000. OA was the 20th most common cause of YLDs in India in 2019, accounting for 1·48% (95%UI: 0·88–2·78) of all YLDs; increasing from 23rd most common cause in 1990 (1·25% (95%UI: 0·74–2·34)). Knee OA was the most common form of OA, followed by hand OA. The prevalence, incidence, and YLDs for OA and knee OA were consistently higher in females than males. Uttar Pradesh (8.53 million (95%UI: 7.63–9.53), Maharashtra (6.37 million (95%UI: 5.75–7.06), and West Bengal (4.90 million (95%UI: 4.39–5.46) had the three highest levels of OA prevalence. Goa (5689 (95%UI: 5,125–6,282)), Rajasthan (5667 (95%UI: 5,097–6,305)), and Kerala (5658 (95%UI: 5,107–6,263)) had the highest age-standardised prevalence of OA in 2019, per 100,000 (Figure 1 A and B).ConclusionThe burden and impact of OA in India are substantial and is increasing; however, it varied among states. Females were affected more commonly than males. Knee OA was the most prevalent site. With improvement in life expectancy and population ageing, greater increases are expected. Adopting suitable control and preventive community measures to reduce modifiable risk factors (such as obesity, injuries, occupational stress) are needed now to reduce the current and future burden of OA in India.Disclosure of InterestsNone declared
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Bergstra SA, Sepriano A, Chopra A, Winchow LL, Vega-Morales D, Solomon-Escoto K, Matthijssen X, Landewé RBM. OP0035 WHAT EXPLAINS THE WORLDWIDE GRADIENT OF AGE AT ONSET OF RHEUMATOID ARTHRITIS ALONG LATITUDE? A MULTILEVEL ANALYSIS IN THE METEOR REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundIt has been suggested that rheumatoid arthritis (RA) starts at a younger age in cities with a lower latitude (closer to both sides of the equator). This consistent finding still remains to be explained. It has been hypothesized that latitude is a proxy for presence of genetic (eg. ACPA) and environmental risk factors (eg. smoking) for RA onset.ObjectivesTo study how age at RA onset varies with latitude worldwide and to what extent patient and country level factors explain this variability.MethodsRA patients from the worldwide METEOR registry were included. Age at diagnosis as a proxy for age at RA onset, measured at the patient level, was the main outcome. The explanatory variable was the absolute value of latitude, measured as the latitude of the hospital (hospital level). Patient factors considered potentially relevant were gender, RF and ACPA positivity, smoking status, symptom duration (months), year of first visit and BMI (all patient level). Country level factors were socioeconomic indicators (physician density, health expenditure, life expectancy, GDP per capita and gross enrolment in secondary school), derived from country statistics. We hypothesized that both patient and country level factors explain (ie. mediate) a relationship between latitude and age at diagnosis (Figure 1).We applied Bayesian multilevel linear structural equations models, which not only quantify effects at multiple levels but also disentangle at which level the effects take place. For example, they can differentiate whether hospital or country latitude affects age at diagnosis.We examined: 1. the total effect of latitude on age at diagnosis at hospital and country level (Main model); 2. the amount of the total effect that is mediated by patient factors at the patient and hospital level (Model A); and 3. the amount of the total effect that is mediated by country factors at the country level (Model B). In each model we disentangle the effect in different measurement levels. For example, a patient level variable can vary at the patient, hospital and country level.ResultsWe included 39 782 patients nested in 94 hospitals nested in 17 countries. The mean age at diagnosis per country ranged from 39 to 55 years. The study spanned a range of latitude between 9.9 and 55.8 degrees (ie. from Nigeria to the United Kingdom). In the main model, we confirmed the association between latitude and age at diagnosis and found that it only occurred at the country level (not at the hospital level). Per degree increase in country latitude, the average age at diagnosis per country increased by 0.23 years (95% credibility interval 0.07; 0.40). At the hospital level however, this effect was negligible: β= 0.040 (-0.16; 0.31). Associations between latitude and several patient factors were found at the country level, but these patient factors only associated with age at diagnosis at the patient level, not at the country (or hospital) level (Model A). This means patient-factors did not explain the association between latitude and age at diagnosis at the country level (main effect changed from 0.23 before to 0.37 after inclusion of patient factors). In model B latitude associated with most country factors (except GDP per capita). Even though none of these variables separately were significantly associated with age at diagnosis, inclusion of the set of country level factors reduced the country level effect of latitude on age at diagnosis from 0.23 to almost zero: β=-0.033 (-0.51; 0.37). Sensitivity analyses with age at symptom onset as outcome provided similar results.ConclusionPatients living close at the equator indeed get RA far earlier than those living closer to the poles. We here suggest that, rather than due to variation in patients’ characteristics, this latitude gradient is a country level phenomenon explained by indicators of countries’ socioeconomic status, and not by patient specific genetic or environmental factors. This big data analysis in a worldwide prevalence cohort provides a direct link between countries’ levels of welfare and the onset of RA.Disclosure of InterestsSytske Anne Bergstra Grant/research support from: Pfizer, Alexandre Sepriano Speakers bureau: Novartis, Consultant of: UCB, Arvind Chopra: None declared, Lai-Ling Winchow: None declared, David Vega-Morales: None declared, Karen Solomon-Escoto: None declared, Xanthe Matthijssen: None declared, Robert B.M. Landewé Shareholder of: Director of Rheumatology Consultancy BV, Consultant of: Honoraria from AbbVie, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Eli-Lilly, Novartis, Pfizer, UCB Pharma.
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Yadav A, Chopra A, Thomas S, Jain M, Anand R. T151 Hormone profile in benign breast disorder. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.630] [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: 11/03/2022]
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20
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Chopra A, Jayasinghe TN, Eberhard J. Are Inflamed Periodontal Tissues Endogenous Source of Advanced Glycation End-Products (AGEs) in Individuals with and without Diabetes Mellitus? A Systematic Review. Biomolecules 2022; 12:biom12050642. [PMID: 35625570 PMCID: PMC9138899 DOI: 10.3390/biom12050642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022] Open
Abstract
Advanced glycation end-products (AGEs) are heterogeneous compounds formed when excess sugars condense with the amino groups of nucleic acids and proteins. Increased AGEs are associated with insulin resistance and poor glycemic control. Recently, inflamed periodontal tissues and certain oral bacteria were observed to increase the local and systemic AGE levels in both normoglycemic and hyperglycemic individuals. Although hyperglycemia induced AGE and its effect on the periodontal tissues is known, periodontitis as an endogenous source of AGE formation is not well explored. Hence, this systematic review is aimed to explore, for the first time, whether inflamed periodontal tissues and periodontal pathogens have the capacity to modulate AGE levels in individuals with or without T2DM and how this affects the glycemic load. Six electronic databases were searched using the following keywords: (Periodontitis OR Periodontal disease OR Periodontal Inflammation) AND (Diabetes mellitus OR Hyperglycemia OR Insulin resistance) AND Advanced glycation end products. The results yielded 1140 articles, of which 13 articles were included for the review. The results showed that the mean AGE levels in gingival crevicular fluid was higher in individuals with diabetes mellitus and periodontitis (521.9 pg/mL) compared to healthy individuals with periodontitis (234.84 pg/mL). The serum AGE levels in normoglycemic subjects having periodontitis was higher compared to those without periodontitis (15.91 ng/mL vs. 6.60 ng/mL). Tannerella forsythia, a common gram-negative anaerobe periodontal pathogen in the oral biofilm, was observed to produce methylglyoxal (precursor of AGE) in the gingival tissues. Increased AGE deposition and activate of AGE receptors was noted in the presence of periodontitis in both normoglycemic and hyperglycemic individuals. Hence, it can be concluded that periodontitis can modulate the local and systemic levels of AGE levels even in absence of hyperglycemia. This explains the bidirectional relationship between periodontitis and development of prediabetes, incident diabetes, poor glycemic control, and insulin resistance.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, India
- Correspondence:
| | - Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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21
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Jishnu PV, Shenoy US, Sharma M, Chopra A, Radhakrishnan R. Comprehensive analysis of microRNAs and their target genes in oral submucous fibrosis. Oral Dis 2022. [DOI: 10.1111/odi.14219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/06/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Padacherri Vethil Jishnu
- Department of Cell and Molecular Biology Manipal School of Life Sciences Manipal Academy of Higher Education Manipal
| | - U Sangeetha Shenoy
- Department of Cell and Molecular Biology Manipal School of Life Sciences Manipal Academy of Higher Education Manipal
| | - Mohit Sharma
- Department of Oral Pathology SGT Dental College Hospital & Research Institute Gurugram Haryana‐122505
| | - Aditi Chopra
- Department of Periodontology Manipal College of Dental Sciences Manipal Academy of Higher Education Manipal
| | - Raghu Radhakrishnan
- Department of Oral Pathology Manipal College of Dental Sciences Manipal Academy of Higher Education Manipal
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22
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Chopra A, Mohan K, Guddattu V, Singh S, Upasana K. Should dentists mandatorily wear ear protection device to prevent occupational noise-induced hearing loss? A randomized case–control study. J Int Soc Prev Community Dent 2022; 12:513-523. [DOI: 10.4103/jispcd.jispcd_28_22] [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] [Received: 02/02/2022] [Revised: 04/15/2022] [Accepted: 07/14/2022] [Indexed: 11/07/2022] Open
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23
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Abstract
Genome-wide association studies identified various loci associated with periodontal diseases, but assigning causal alleles remains difficult. Likewise, the generation of biological meaning underlying a statistical association has been challenging. Here, we characterized the genetic association at the gene ST8SIA1 that increases the risk for severe periodontitis in smokers. We used CRISPR/dCas9 activation and RNA-sequencing to identify genetic interaction partners of ST8SIA1 and to determine its function in the cell. We used reporter gene assays to identify regulatory elements at the associated single-nucleotide polymorphisms (SNPs) and to determine effect directions and allele-specific changes of enhancer activity. Antibody electrophoretic mobility shift assays proved allele-specific transcription factor binding at the putative causal SNPs. We found the reported periodontitis risk gene ABCA1 as the top upregulated gene following ST8SIA1 activation. Gene set enrichment analysis showed highest effects on integrin cell surface interactions (area under the curve [AUC] = 0.85; q = 4.9 × 10-6) and cell cycle regulation (AUC = 0.89; q = 1.6 × 10-5). We identified 2 associated repressor elements in the introns of ST8SIA1 that bind the transcriptional repressor BACH1. The putative causative variant rs2012722 decreased BACH1 binding by 40%. We also pinpointed ST8SIA1 as the target gene of the association. ST8SIA1 inhibits cell adhesion with extracellular matrix proteins, integrins, and cell cycle, as well as enhances apoptosis. Likewise, tobacco smoke reportedly results in an inhibition of cell adhesion and a decrease in integrin-positive cells and cell growth. We conclude that impaired ST8SIA1 repression, independently caused by reduced BACH1 binding at the effect T allele, as well as by tobacco smoke, contributes to higher ST8SIA1 levels, and in smokers who carry the effect T allele, both factors would be additive with damaging effects on the gingival barrier integrity. The activity of ST8SIA1 is also linked with the periodontitis risk gene ABCA1.
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Affiliation(s)
- A. Chopra
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - R. Mueller
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - J. Weiner
- Core Unit Bioinformatics, Berlin Institute of Health, Berlin, Germany
| | - J. Rosowski
- Department of Medical Biotechnology, Institute of Biotechnology, Technische Universität Berlin, Berlin, Germany
| | - H. Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - E. Grohmann
- Department of Microbiology, Faculty of Life Sciences and Technology, Beuth Hochschule für Technik Berlin, Berlin, Germany
| | - A.S. Schaefer
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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24
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Sanghavi A, Srivatsa A, Adiga D, Chopra A, Lobo R, Kabekkodu SP, Gadag S, Nayak U, Sivaraman K, Shah A. Goji berry (Lycium barbarum) inhibits the proliferation, adhesion, and migration of oral cancer cells by inhibiting the ERK, AKT, and CyclinD cell signaling pathways: an in-vitro study. F1000Res 2022; 11:1563. [PMID: 36761830 PMCID: PMC9887205 DOI: 10.12688/f1000research.129250.3] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
Background: Lycium barbarum (L. barbarum), popularly referred to as Goji berry, is a promising herb known for its powerful anti-antioxidant, antibacterial, and anti-inflammatory properties. It is used in traditional Chinese medicine for treating inflammatory and infectious diseases. It has also shown good anti-cancer properties and has been tested against liver, colon, prostate, breast, and cervical cancers. However, no study has yet evaluated the role of goji berries against oral cancer. Hence, the present paper aims to evaluate the anticancer properties of L. barbarum against oral squamous cell carcinoma. Method: Ethanolic extract of L. barbarum (EELB) was tested for its anticancer properties by performing the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay, colony formation, cell proliferation, and scratch wound test. The impact of EELB on the signaling transduction pathways of Extracellular signal-regulated kinase (ERK1/2), protein kinase (AKT1), cyclin D1 and epithelial-mesenchymal transition (EMT) was also assessed by western blot. Results: The results showed that EELB can impede CAL-27 cell growth, proliferation and migration in-vitro. It even reduced the phosphorylation of ERK1/2 and AKT1 with concomitant downregulation of cyclin D1 (CCND1), cadherin 2 (CDH2), and vimentin (VIM) and upregulation of cadherin 1 (CDH1) expression suggesting its anti-proliferative and anti-EMT effects in oral cancer. Conclusion: Goji berry has good antiproliferative and anti-invasive properties. It affects potential EMT markers and signaling transduction pathways involved in oral cancers. Hence goji berry can be tried as a potential anticancer agent to manage oral squamous cell carcinoma.
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Affiliation(s)
- Amee Sanghavi
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ananth Srivatsa
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Divya Adiga
- Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Aditi Chopra
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Richard Lobo
- Manipal College of Pharmaceutical Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shama Prasada Kabekkodu
- Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shivaprasada Gadag
- Manipal College of Pharmaceutical Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Usha Nayak
- Manipal College of Pharmaceutical Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Karthik Sivaraman
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ashmeet Shah
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Abstract
Periodontitis is a common complex inflammatory disease of the oral cavity. It is characterized by inflammation of gingival tissues and alveolar bone loss. Recently, a genome-wide association study and 2 genome-wide association study meta-analyses found 2 associated regions (haplotype blocks) at the inhibitory immune receptor gene SIGLEC5 to increase the risk for periodontitis. The aims of the current study were the identification of the putative causal variants underlying these associations, characterization of their molecular biological effects, and validation of SIGLEC5 as the target gene. We mapped the associated single-nucleotide polymorphisms to DNA elements with predictive features of regulatory functions and screened the associated alleles for transcription factor (TF) binding sites. Antibody electrophoretic mobility shift assays (EMSAs) with allele-specific probes were used to identify TF binding and to quantify allele-specific effects on binding affinities. Luciferase reporter assays were used to quantify the effect directions and allele-specific strength of the associated regulatory elements. We used CRISPR-dCas9 gene activation to validate SIGLEC5 as a target of the association. EMSA in peripheral blood mononuclear cells showed that E-26 transformation-specific TF-related gene (ERG) binds at rs11084095, with almost complete loss of binding at the minor A-allele. Allele-specific reporter genes showed enhancer function of the DNA sequence at rs11084095, which was abrogated in the background of the A-allele. EMSA in B lymphocytes showed that TF MAF bZIP (MAFB) binds at the common G-allele of rs4284742, whereas the minor A-allele reduced TF binding by 69%, corresponding to 9-fold reduction of luciferase reporter gene activity by the A-allele. Using CRISPR-dCas9, we showed that the enhancer at rs4284742 strongly activated SIGLEC5 expression, validating this gene as the target gene of the association. We conclude that rs11084095 and rs4284742 are putatively causal for the genome-wide significant associations with periodontitis at SIGLEC5 that impair ERG and MAFB binding, respectively.
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Affiliation(s)
- R Mueller
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Biology, Chemistry and Pharmacy, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Berlin, Germany
| | - A Chopra
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - H Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A S Schaefer
- Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Austin A, Pezzano C, Lydon D, Chopra A. Use of external ventilator control panel for mechanical ventilation in patients with severe SARS-CoV-2 infection. QJM 2021; 114:281-282. [PMID: 32692813 PMCID: PMC7454834 DOI: 10.1093/qjmed/hcaa229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- A Austin
- From the Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | | | - D Lydon
- Department of Respiratory Medicine
| | - A Chopra
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Albany Medical College, Albany, NY, USA
- Address correspondence to A. Chopra, Division of Pulmonary and Critical Care Medicine, Department of Medicine, MC-91, Albany Medical College, Albany, NY 12208, USA.
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Abed A, Calapre L, Lo J, Correia S, Bowyer S, Chopra A, Watson M, Khattak M, Millward M, Gray E. FP12.07 Prognostic Value of HLA-I Homozygosity in Non-Small Cell Lung Cancer Patients Treated with Single Agent Immunotherapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.133] [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: 11/28/2022]
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28
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Azar I, Austin A, Jang H, Kim S, Yazpandaneh O, Chopra A, Mehdi S, Mamdani H. MA12.05 Is there a Role for Surgery in Stage I Small Cell Lung Cancer? A National VA Database Analysis. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.257] [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: 11/16/2022]
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29
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Abed A, Calapre L, Lo J, Correia M, Bowyer S, Chopra A, Watson M, Khattak A, Millward M, Gray E. TS01.07 Genomic HLA as a Predictive Biomarker for Survival Among Non-Small Cell Lung Cancer Patient Treated with Single Agent Immunotherapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.099] [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: 10/22/2022]
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Affiliation(s)
- M I Malik
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, 1199 Prince Avenue, Suite 70, Athens, GA 30606, USA
| | - N Fox
- Athens Pulmonary & Sleep Medicine and Piedmont Athens Regional Medical Center, 3320 Old Jefferson Rd # 200a, Athens, GA 30607, USA
- Address correspondence to N. Fox, Athens Pulmonary & Sleep Medicine, 3320 Old Jefferson Rd # 200a, Athens, GA 30607, USA.
| | - A Chopra
- Division of Pulmonary and Critical Care, Albany Medical College, Albany, NY, USA
| | - H Y Hughes
- Division of Infectious Disease Medical University of South Carolina and Ralph H. Johnson VA Medical Center. Charleston, SC
| | - R Washburn
- Division of Infectious Disease Medical University of South Carolina and Ralph H. Johnson VA Medical Center. Charleston, SC
| | - J T Huggins
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina and Ralph H. Johnson VA Medical Center, 171 Ashley Avenue, Charleston, SC 29425, USA
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31
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Abed A, Calapre L, Lo J, Correia S, Bowyer S, Chopra A, Watson M, Khattak M, Millward M, Gray E. 301MO Genomic HLA as a predictive biomarker for survival among non-small cell lung cancer patient treated with single agent immunotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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32
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Sivaraman K, Chopra A, Narayana A, Radhakrishnan RA. A five-step risk management process for geriatric dental practice during SARS-CoV-2 pandemic. Gerodontology 2020; 38:17-26. [PMID: 32978832 PMCID: PMC7537327 DOI: 10.1111/ger.12499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 12/12/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus that causes coronavirus infection (COVID-19). COVID-19 is a highly contagious disease transmitted through respiratory droplets, saliva and other contact routes. Within 10 months of its outbreak, SARS-CoV-2 has infected more than 23 million people around the world. Evidence suggests that older adults are the most vulnerable to infection and have an increased risk of mortality. Reduced immunity and underlying medical conditions make them risk-prone and vulnerable to critical care. Older adults affected with the SARS-CoV-2 virus present with distinct clinical manifestations necessitating specific treatment needs and management protocols. While it is crucial to prevent the spread of novel coronavirus (2019-nCoV), the role of oral healthcare workers in addressing the specific needs of ageing adult patients by adopting specific guidelines and appropriate infection control protocols is timely. This paper aims to develop specific guidelines and protocols for the dental management of geriatric patients during the COVID-19 pandemic.
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Affiliation(s)
- Karthik Sivaraman
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Aparna Narayana
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Raghu A Radhakrishnan
- Department of Oral and Maxillofacial Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
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Chopra A, Bhat SG, Sivaraman K. Porphyromonas gingivalis adopts intricate and unique molecular mechanisms to survive and persist within the host: a critical update. J Oral Microbiol 2020; 12:1801090. [PMID: 32944155 PMCID: PMC7482874 DOI: 10.1080/20002297.2020.1801090] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/10/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 12/17/2022] Open
Abstract
is an obligate, asaccharolytic, gram-negative bacteria commonly associated with increased periodontal and systemic inflammation. P. gingivalis is known to survive and persist within the host tissues as it modulates the entire ecosystem by either engineering its environment or modifying the host's immune response. It interacts with various host receptors and alters signaling pathways of inflammation, complement system, cell cycle, and apoptosis. P. gingivalis is even known to induce suicidal cell death of the host and other microbes in its vicinity with the emergence of pathobiont species. Recently, new molecular and immunological mechanisms and virulence factors of P. gingivalis that increase its chance of survival and immune evasion within the host have been discovered. Thus, the present paper aims to provide a consolidated update on the new intricate and unique molecular mechanisms and virulence factors of P. gingivalis associated with its survival, persistence, and immune evasion within the host.
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Affiliation(s)
- Aditi Chopra
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Subraya G. Bhat
- College of Dentistry, Imam Abdul Rahman Faisal University, Dammam, KSA
| | - Karthik Sivaraman
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kulshreshtha B, Chopra A, Aggarwal A, Baxi K. THYROIDITIS DEVELOPING POST INITIATION OF OCTREOTIDE IN A CASE OF TSH SECRETING TUMOR. Acta Endocrinol (Buchar) 2020; 16:90-94. [PMID: 32685045 DOI: 10.4183/aeb.2020.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Thyroiditis developing post pituitary surgery in a case of TSH secreting tumor has been reported, albeit rarely. A 46 year old female was treated as a case of hypothyroidism for almost five years, however, TSH levels remained unsuppressed in spite of increasing thyroxine doses. A cyclic pattern of TSH with T3 secretion was observed after stopping thyroxine, though T4 levels were normal. T3 suppression test revealed a non suppressed TSH and MRI sella revealed a pituitary mass with Grade 1 cavernous sinus invasion. With a diagnosis of TSH secreting tumor, the patient was initiated on octreotide therapy. TFT normalized within 4 days of initiation of octreotide, tumor size reduced by about 30% within 2 months of therapy and goiter size reduced to almost half with octreotide therapy. Anti TPO levels which were initially negative became positive within a month of octreotide therapy and FNAC thyroid revealed thyroiditis. To the best of our knowledge, this is the second case report of development of thyroiditis after octreotide therapy. The immunomodulatory role of TSH and somatostatin may have a role in the development of thyroiditis in this case.
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Affiliation(s)
- B Kulshreshtha
- "Dr. Ram Manohar Lohia" Hospital, Post Graduate Institute of Medical Education & Research - Endocrinology, New Delhi, India
| | - A Chopra
- "Dr. Ram Manohar Lohia" Hospital, Post Graduate Institute of Medical Education & Research - Endocrinology, New Delhi, India
| | - A Aggarwal
- "Dr. Ram Manohar Lohia" Hospital, Post Graduate Institute of Medical Education & Research - Endocrinology, New Delhi, India
| | - K Baxi
- "Dr. Ram Manohar Lohia" Hospital, Post Graduate Institute of Medical Education & Research - Endocrinology, New Delhi, India
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35
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Mangla P, Gupta S, Chopra A, Bhatia V, Vishwakarma R, Asthana P. Influence of Socio-Economic and Cultural Factors on Type 1 Diabetes Management: Report from a Tertiary Care Multidisciplinary Diabetes Management Center in India. Indian J Pediatr 2020; 87:520-525. [PMID: 32086759 DOI: 10.1007/s12098-020-03227-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/29/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To study the association of socio-economic (SE) and cultural factors with HbA1c and diabetes knowledge of children, adolescents and young adults with T1DM managed in the authors' centre, as these may be unique to a country or a region. METHODS Demographic details, SE scoring, body mass index and mean of the last two HbA1c values were recorded, in 173 eligible patients. A diabetes knowledge test (DKT) was administered. RESULTS Median (range) age was 14.0 (3.25-25.5) y and HbA1c 8.2 ± 1.3%. The patients travelled a median of 124 (range 0.5-850) km and 2.3 (range 0.1-18.3) h each way, to reach the clinic. Only 2 children took insulin at school / college. Insulin adjustment for pre-meal blood glucose was practiced by 88%, but adjustment for meal intake by only 17% patients. Median HbA1c was lower in the participants with age > 18 y [7.7 (5.6-11.0) %] vs. < 10 y [8.3 (6.3-10.6) %, p < 0.02] or 10-18 y [(8.3 (5.9-12.6) %, p < 0.02)]. Overweight /obesity were seen in 35%. On multivariate regression, HbA1c was associated negatively with DKT score (DKTS) and age group, and DKTS was associated positively with urban residence and maternal education > class 12th. HbA1c and DKTS were not associated with income. CONCLUSIONS Low income may be successfully compensated by other factors to obtain good glycemic control. HbA1c did not deteriorate in adolescence in contrast to world experience. Overweight is a worrisome problem. Improved societal awareness about childhood diabetes is crucial.
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Affiliation(s)
- Pragya Mangla
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Suchit Gupta
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Aditi Chopra
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Vijayalakshmi Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
| | - Ruchira Vishwakarma
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Pranjul Asthana
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
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Chopra A, Khadke N, Saluja M, Kianifard T, Venugopalan A. AB0641 MANAGING ANKYLOSING SPONDYLITIS (AS) WITH SHORT TERM BIOSIMILAR ADALIMUMAB REGIMEN IN A RESOURCE STRAPPED SETTING: A PROTOCOL DRIVEN COMMUNITY CLINIC ORIENTED STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:We were handicapped by the exorbitant cost of innovator anti-Tumour Necrosis Factor (TNF) drugs. Despite limited use, we sometimes observed long-term benefits following short term induction like use. Emboldened by advent of biosimilars, we carried out an investigational study.Objectives:To evaluate the effectiveness of a short regimen of biosimilar (Bs) Adalimumab in ASMethods:50 consenting patients (86% B27+) naïve for biologics and negative for latent TB screen were enrolled into an observational design study of one year; Baseline mean values for age, duration, ASDAS and CRP was 31 years, 98.8 months, 4.6 and 64 mg per dl respectively. During the first year, patients were begun with 40 mg Bs Adalimumab (Bs-ADL) (Exemptia™), injected fortnight, for 12-16 weeks. No patient received DMARD or steroid in the first year of study. Patients continued standard of care follow up program in the clinic. The ASAS (Assessment Spondyloarthritis International Society) improvement indices were used. Standard intention-to-treat analysis was performed; significant p <0.05.Results:Optimum ASAS 40 improvement was observed at week 12 (68%); substantial improvement lasted till week 36. At one year, the ASAS 40 was 38%; ASAS partial remission 22% patients. Pro-inflammatory cytokines (IL-6, TNF α and IL-17) showed conspicuous reduction; maximum drop in IL-6 at week 24 (See Figure). 11 patients withdrew in the first year. 30 patients completed two years and 22 patients completed 3 year follow up. Over time, there was substantial loss in the ASAS 20 and 40 responses but patients seemed satisfied with the on-going symptomatic relief and improved function. Admittedly, patients showed more adherences to advice on physical exercise and stress reduction. Flares were more frequent after 1 year requiring short term round the clock NSAID; only 5 patients could afford to repeat a short term Bs-ADL regimen and one patient underwent hip arthroplasty. None received steroids and 5 patients were begun on Sulfasalazine in the second year and monitored. We could not evaluate structural modification (AS). Selected outcomes over 2 and 3 years from the current study will be compared to matched control (derived from the clinic database). None developed TB or any serious drug related toxicity. 2 patients developed recurrent uveitis.Conclusion:This real life documented experience unravelled impressive long term benefits following a kick start short term induction regimen of Biosimilar Adalimumab in AS. Though contrary to standard practice, this seemed a practical solution in our setting. We speculate a psychological and motivational boost rather than a prolonged real time biological effect (Bs-ADL) for this phenomenon. Our study has important socioeconomic bearing and merits validation.Acknowledgement:This was essentially a non-commercial investigator-initiated study. Zydus Cedilla India provided a generous research grant with free of cost Bs_ADL to several patients and a large concession in the cost to the rest.Disclosure of Interests:Arvind Chopra Grant/research support from: Zydus Pharamceutical Ltd India, Nagnath Khadke: None declared, Manjit Saluja: None declared, Toktam Kianifard: None declared, Anuradha Venugopalan: None declared
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Kulkarni N, Venugopalan A, Saluja M, Chopra A. AB0585 SINGLE CENTER EXPERIENCE OF CLINICAL PROFILE OF INFLAMMATORY MYOSITIS FROM INDIA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Clinical profile of myositis differs in respect of the setting. We present a single center experience from a community based referral centerObjectives:STUDY CLINICAL PROFILE OF INFLAMMATORY MYOSITIS (IM)Methods:We present data from 114 patients of connective tissue disorders (CTD) with dominant Inflammatory Myopathy(IM) evaluated in CRD where we have patient database since 1996. Standard investigations & ELISA, immunoblot and nephlometry to assay autoantibodies (AAb) were done. Data extraction done from 2005-2017Results:36 and 28 patients respectively diagnosed as dominant idiopathic dematomyositis (DM) and polymyositis (PM); remaining 41 patients showed overlap (OCTD). Mean onset age range 33-40 years in each subset with women dominance. Exclusive proximal muscle involvement seen 64% DM, 67% PM and 43% OCTD. 12 of OCTD showed classical DM rash. Raynauds’s phenomenon was seen in 38% (25% DM, 10% PM, 65% OCTD). 83% OCTD showed inflammatory polyarthritis; DM 29% and PM 42%. Two patients DM also diagnosed malignancy (ovarian CA). 25% DM, nil PM and 31.7% OCTD showed CT based lung findings. Mean creatinine phosphokinase at diagnosis were DM 1580, PM 2239 & OCTD 830. EMG required in 48 patients confirmed diagnosis (DM 17, PM 16 and OCTD 15). Seven patients with diagnostic dilemma/ poor therapy response required muscle histopathology confirmation. 59% DM,69% PM and 84% OCTD were seropositive ANA positive in 71%(ENA profile available for most). All Patients received steroids. Methotrexate prescribed in (92%), Azthioprine in (28%), hydroxychloroquine in (88%) with majority showing good response. Mycophenolate prescribed in (6%) for aggressive disease, IVIG in 2 patients for acute IIM with interstitial pneumonitis. Rituximab was prescribed in 4 resistant cases; all responding favourably. Mortality data of 4 patients(severe myositis(1), interstitial pneumonitis(1), ovarian cancer(1), septic shock(1)) was available. Antesynthatase syndrome noted in 9 patients.Conclusion:Overlap CTD with myositis seems more common profile than DM or PM. Response to therapy was satisfactory with steroids and methotrexate being the mainstay. Rituximab is a promising biological agent in chronic resistant cases.References:[1]A Kumar. Idiopathic Inflammatory Myopathies. Suppliment to JAPI, JUNE 2006, VOL. 54; Pg 62-66[2]R Porkodi et al Clinical Spectrum of Inflammatory Myositis in South India - A Ten Year Study. J Assoc Physicians India 2002;50:1255-1258[3]Chowdhary V, Aggarwal A, Misra R. Prevalence and clinical association of myositis-specific autoantibodies in North Indian patients with idiopathic inflammatory myopathy. APLAR J Rheumatol 2 001.Acknowledgments :STAFF AND PATIENTS OF CENTER FOR RHEUMATIC DISEASES, PUNEDisclosure of Interests: :NACHIKET KULKARNI Speakers bureau: PFIZER, NOVARTIS, YANSEN, Anuradha Venugopalan: None declared, MANJIT SALUJA: None declared, Arvind Chopra Grant/research support from: Zydus Pharamceutical Ltd India
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Westhovens R, Rigby W, Van der Heijde D, Ching D, Stohl W, Kay J, Chopra A, Bartok B, Matzkies F, Yin Z, Guo Y, Tasset C, Sundy J, Jahreis A, Mozaffarian N, Messina O, Landewé RBM, Atsumi T, Burmester GR. SAT0158 EFFICACY AND SAFETY OF FILGOTINIB IN METHOTREXATE-NAÏVE PATIENTS WITH RHEUMATOID ARTHRITIS: FINCH 3 52-WEEK RESULTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Filgotinib (FIL) is a potent, selective JAK 1 inhibitor. FINCH 3 assessed FIL efficacy and safety in methotrexate (MTX)-naïve patients (pts) with rheumatoid arthritis (RA); week (W)24 primary outcome results were previously presented.1Objectives:To report FINCH 3 (NCT02886728) results through W52.Methods:This global, phase 3, double-blind, active-controlled study randomised MTX-naïve pts with moderately to severely active RA 2:1:1:2 to oral FIL 200 mg once daily + MTX ≤20 mg weekly, FIL 100 mg + MTX, FIL 200 mg monotherapy (mono) + placebo (PBO), or PBO + MTX up to W52. Comparisons at W52 were not adjusted for multiplicity. Safety was assessed from adverse events and laboratory abnormalities.Results:Of 1249 treated pts, 975 received study drug through W52. FIL efficacy was sustained up to W52. Treatment with FIL + MTX or FIL mono increased proportions of pts achieving ACR20/50/70 and clinical disease remission by DAS28(CRP) <2.6 (FIL 200 mg + MTX, 53%; FIL mono, 46%), CDAI, SDAI, and Boolean criteria; improved HAQ-DI; and halted radiographic progression vs MTX alone (Table 1 andFigure). Safety was consistent with W24 data (Table 2).Table 1.Efficacy outcomes at week 52FIL 200 mg + MTX (n = 416)FIL 100 mg + MTX (n = 207)FIL 200 mg(n = 210)MTX(n = 416)ACR20, %75.0***73.4**74.8***61.8ACR50, %62.3***59.4**61.4**48.3ACR70, %47.8***40.1*45.2***29.8mTSSa0.21***0.27*0.23**0.74HAQ-DIb−1.00***−0.97−0.95*−0.88aLeast-squares mean change from baseline.bMean change from baseline.*, p <0.05;**, p <0.01;***, p <0.001 vs MTX alone; not adjusted for multiplicity.FIL, filgotinib; mTSS, van der Heijde modified total Sharp score; MTX, methotrexate.Table 2.Safety outcomes through week 52Event, n (%)FIL 200 mg + MTX(n = 416)FIL 100 mg + MTX(n = 207)FIL 200 mg(n = 210)MTX(n = 416)All AEs318 (76.4)164 (79.2)143 (68.1)305 (73.3)Serious AEs26 (6.3)13 (6.3)17 (8.1)28 (6.7)Infection148 (35.6)76 (36.7)75 (35.7)157 (37.7)Serious infection5 (1.2)3 (1.4)5 (2.4)8 (1.9)Herpes zoster6 (1.4)3 (1.4)4 (1.9)4 (1.0)VTE0004 (1.0)MACE (adjudicated)4 (1.0)1 (0.5)2 (1.0)2 (0.5)Malignancya1 (0.2)004 (1.0)NMSC2 (0.5)001 (0.2)Death3 (0.7)b1 (0.5)c00aExcluding NMSC.b1 lupus cardiomyopathy, 1 atypical interstitial pneumonia, 1 non–treatment-emergent cardiovascular death.cDissecting cerebral and vertebral aneurysm.AE, adverse event; FIL, filgotinib; MACE, major adverse cardiovascular event; MTX, methotrexate; NMSC, nonmelanoma skin cancer; VTE, venous thromboembolism.Conclusion:Efficacy of FIL 200 mg + MTX, FIL 100 mg + MTX, and FIL 200 mg mono was sustained through W52, with faster onset1and consistently numerically greater efficacy for FIL 200 vs 100 mg. No new safety signals were observed.References:[1]Westhovens, et al.Ann Rheum Dis.2019;78(Suppl2):259–60.Disclosure of Interests:Rene Westhovens Grant/research support from: Celltrion Inc, Galapagos, Gilead, Consultant of: Celltrion Inc, Galapagos, Gilead, Speakers bureau: Celltrion Inc, Galapagos, Gilead, William Rigby Consultant of: Gilead Sciences, Inc., Désirée van der Heijde Consultant of: AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead Sciences, Inc., Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma; Director of Imaging Rheumatology BV, Daniel Ching Grant/research support from: AbbVie, Gilead Sciences, Inc., Pfizer, Sanofi, Consultant of: AbbVie, Pfizer, Speakers bureau: AbbVie, William Stohl Grant/research support from: GlaxoSmithKline, Consultant of: Janssen Research & Development, Jonathan Kay Grant/research support from: Gilead Sciences, Inc., Pfizer, Novartis Pharmaceuticals Corporation, Consultant of: Alvotech Suisse AG; Arena Pharmaceuticals, Inc.; Boehringer Ingelheim GmbH; Celltrion Healthcare Co. Ltd.; Merck Sharp & Dohme Corp.; Mylan Inc.; Novartis AG; Samsung Bioepis; Sandoz, Inc; UCB, Inc., Arvind Chopra Grant/research support from: Zydus Pharamceutical Ltd India, Beatrix Bartok Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., Franziska Matzkies Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Zhaoyu Yin Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Ying Guo Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Chantal Tasset Shareholder of: Galapagos (share/warrant holder), Employee of: Galapagos, John Sundy Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Angelika Jahreis Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Neelufar Mozaffarian Shareholder of: Gilead, Employee of: Gilead, Osvaldo Messina Speakers bureau: Amgen; Americas Health Foundation; Pfizer, Robert B.M. Landewé Consultant of: AbbVie; AstraZeneca; Bristol-Myers Squibb; Eli Lilly & Co.; Galapagos NV; Novartis; Pfizer; UCB Pharma, Tatsuya Atsumi Grant/research support from: Eli Lily Japan K.K., Alexion Pharmaceuticals, Inc., Bristol-Myers Squibb Co., AbbVie Inc., Daiichi Sankyo Co., Ltd., Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Astellas Pharma Inc., Consultant of: Gilead Sciences, Inc., Eli Lilly Japan K.K., UCB Japan Co. Ltd., AbbVie Inc., Daiichi Sankyo Co., Ltd., Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Speakers bureau: Eli Lilly Japan K.K., UCB Japan Co. Ltd., Bristol-Myers Squibb Co., AbbVie Inc., Eisai Co. Ltd., Otsuka Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Takeda Pharmaceutical Co., Ltd., Astellas Pharma Inc., Gerd Rüdiger Burmester Consultant of: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma, Speakers bureau: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma
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Chopra A, Radhakrishnan R, Sharma M. Porphyromonas gingivalis and adverse pregnancy outcomes: a review on its intricate pathogenic mechanisms. Crit Rev Microbiol 2020; 46:213-236. [PMID: 32267781 DOI: 10.1080/1040841x.2020.1747392] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Porphyromonas gingivalis (P. gingivalis), a Gram-negative facultative anaerobe of the oral cavity, is associated with the onset of various adverse pregnancy outcomes. P. gingivalis is linked with the development of preeclampsia, preterm labour, spontaneous abortion, gestational diabetes, foetal growth restriction, and misconception. The unique virulence factors, surface adhesions, enzymes of P. gingivalis can directly injure and alter the morphology, microbiome the foetal and maternal tissues. P. gingivalis can even exaggerate the production of cytokines, free radicals and acute-phase proteins in the uterine compartment that increases the risk of myometrial contraction and onset of preterm labour. Although evidence confirms the presence of P. gingivalis in the amniotic fluid and placenta of women with poor pregnancy outcomes, the intricate molecular mechanisms by which P. gingivalis initiates various antenatal and postnatal maternal and foetal complications are not well explained in the literature. Therefore, the present review aims to comprehensively summarise and highlight the recent and unique molecular pathogenic mechanisms of P. gingivalis associated with adverse pregnancy outcomes.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Raghu Radhakrishnan
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Mohit Sharma
- Department of Oral Pathology, Sudha Rustagi College of Dental Sciences & Research, Faridabad, India
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Chopra A, Pappu R, Sivaraman K. Ibuprofen-induced localized frontal and temporal forehead swellings: A rare case report. J Indian Soc Periodontol 2020; 24:178-181. [PMID: 32189848 PMCID: PMC7069112 DOI: 10.4103/jisp.jisp_119_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 09/01/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022] Open
Abstract
Ibuprofen, nonselective nonsteroidal anti-inflammatory drugs (NSAIDs), is one of the most commonly prescribed analgesics for managing musculoskeletal, orofacial, and postoperative pain after periodontal therapy. Although considered as one of the safest analgesic agents, the onset of adverse drug reactions after ibuprofen intake has been recently observed. The present report aims to highlight the development of localized swellings in the temporal and frontal forehead following intake of 200 mg of ibuprofen after routine oral prophylaxis. This is the first case report to document the development of an adverse drug reaction with ibuprofen in a patient following a routine dental procedure. The article also aim to comprehensively describe the most appropriate and effective method to diagnose, manage, and prevent NSAIDs-induced adverse drug reactions in routine dental practice.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rachana Pappu
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Varadan M, Chopra A, Sanghavi A, Sivaraman K, Gupta K. Etiology and clinical recommendations to manage the complications following lingual frenectomy: A critical review. Journal of Stomatology, Oral and Maxillofacial Surgery 2019; 120:549-553. [DOI: 10.1016/j.jormas.2019.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/07/2019] [Accepted: 06/18/2019] [Indexed: 11/25/2022]
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Abstract
A perforation in the furcation area is a potential risk factor for extension of pulpal inflammation into the periodontium and formation of advanced furcation defect with severe loss of clinical attachment and interradicular bone. Furthermore, the management of such furcal perforation is difficult due to poor accessibility, visibility, and regenerative potential. The development of such advanced furcation defects further compromises the prognosis of the treatment as they preclude effective plaque control and maintenance by the patient. Therefore, the management of advanced furcation defects remains an enigmatic and challenging task for the clinician. This case report describes a minimally invasive approach for the treatment of a furcal perforation by a conservative tunnel preparation. The present case report aims to highlight the importance of surgical tunnel preparation as an alternative to conventional flap procedure to repair furcal perforation with advanced furcation defects.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Tandon S, Meher R, Chopra A, Raj A, Wadhwa V, Mahajan N, Jain A. Tongue Base Schwannoma. Indian J Otolaryngol Head Neck Surg 2019; 71:70-73. [PMID: 31741934 DOI: 10.1007/s12070-016-1036-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/01/2015] [Accepted: 12/10/2016] [Indexed: 11/29/2022] Open
Abstract
Intraoral schwannomas account for 1% of head and neck schwannoma, with tongue base schwannoma being reported rarely. In an English literature search from 1988 to 2014, not more than 38 cases of tongue base schwannoma have been reported. Large tongue base schwannomas pose a significant risk to airway, thereby calling for an early intervention. We report a rare case of tongue base schwannoma in a 25 year old female managed surgically by lateral pharyngotomy approach.
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Affiliation(s)
- Swati Tandon
- Department of Otolaryngology and Head, Neck Surgery, BL Taneja Block, MAM College and Assoc. LN Hospital, New Delhi, India
| | - Ravi Meher
- Department of Otorhinolaryngology and Head, Neck Surgery, 3rd Floor BL Taneja Block, MAM College and Assoc. LN Hospital, Delhi, India
| | - Aditi Chopra
- Department of Otorhinolaryngology and Head, Neck Surgery, 3rd Floor BL Taneja Block, MAM College and Assoc. LN Hospital, Delhi, India
| | - Anoop Raj
- Department of Otolaryngology and Head, Neck Surgery, BL Taneja Block, MAM College and Assoc. LN Hospital, New Delhi, India
| | - Vikram Wadhwa
- Department of Otolaryngology and Head, Neck Surgery, BL Taneja Block, MAM College and Assoc. LN Hospital, New Delhi, India
| | - Nidhi Mahajan
- 3Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Avani Jain
- Department of Otolaryngology and Head, Neck Surgery, BL Taneja Block, MAM College and Assoc. LN Hospital, New Delhi, India
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Abed A, Khattak A, Millward M, Chopra A, Gray E. Genomic HLA heterozygosity as a predictive marker for survival in lung cancer patients post immunotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.013] [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: 11/12/2022] Open
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Symons J, Bacchus-Souffan C, Chopra A, Leary S, Cameron D, Cameron P, Hoh R, Ahn H, Deeks S, McCune J, Mallal S, Hunt P, Lewin S. Clonal integration site expansion of infected cells is a main contributor of HIV persistence in more differentiated T cell subsets during suppressive ART. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)31073-6] [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: 10/23/2022] Open
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Rakhimov AV, Barabash AS, Basharina-Freshville A, Blot S, Bongrand M, Bourgeois C, Breton D, Breier R, Birdsall E, Brudanin VB, Burešova H, Busto J, Calvez S, Cascella M, Cerna C, Cesar JP, Chauveau E, Chopra A, Claverie G, De Capua S, Delalee F, Duchesneau D, Egorov VG, Eurin G, Evans JJ, Fajt L, Filosofov DV, Flack R, Garrido X, Gomez H, Guillon B, Guzowski P, Hodák R, Holý K, Huber A, Hugon C, Jeremie A, Jullian S, Karaivanov DV, Kauer M, Klimenko AA, Kochetov OI, Konovalov SI, Kovalenko V, Lang K, Lemière Y, Le Noblet T, Liptak Z, Liu XR, Loaiza P, Lutter G, Maalmi J, Macko M, Mamedov F, Marquet C, Mauger F, Minotti A, Mirsagatova AA, Mirzayev NA, Moreau I, Morgan B, Mott J, Nemchenok IB, Nomachi M, Nova F, Ohsumi H, Oliviero G, Pahlka RB, Pater JR, Palušová V, Perrot F, Piquemal F, Povinec P, Pridal P, Ramachers YA, Rebii A, Remoto A, Richards B, Ricol JS, Rukhadze E, Rukhadze NI, Saakyan R, Sadikov II, Salazar R, Sarazin X, Sedgbeer J, Shitov YA, Šimkovic F, Simard L, Smetana A, Smolek K, Smolnikov AA, Snow S, Söldner-Rembold S, Soulé B, Špavorova M, Štekl I, Tashimova FA, Thomas J, Timkin V, Torre S, Tretyak VI, Tretyak VI, Umatov VI, Vilela C, Vorobel V, Warot G, Waters D, Zampaolo M, Žukauskas A. Development of methods for the preparation of radiopure 82Se sources for the SuperNEMO neutrinoless double-beta decay experiment. RADIOCHIM ACTA 2019. [DOI: 10.1515/ract-2019-3129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
A radiochemical method for producing 82Se sources with an ultra-low level of contamination of natural radionuclides (40K, decay products of 232Th and 238U) has been developed based on cation-exchange chromatographic purification with reverse removal of impurities. It includes chromatographic separation (purification), reduction, conditioning (which includes decantation, centrifugation, washing, grinding, and drying), and 82Se foil production. The conditioning stage, during which highly dispersed elemental selenium is obtained by the reduction of purified selenious acid (H2SeO3) with sulfur dioxide (SO2) represents the crucial step in the preparation of radiopure 82Se samples. The natural selenium (600 g) was first produced in this procedure in order to refine the method. The technique developed was then used to produce 2.5 kg of radiopure enriched selenium (82Se). The produced 82Se samples were wrapped in polyethylene (12 μm thick) and radionuclides present in the sample were analyzed with the BiPo-3 detector. The radiopurity of the plastic materials (chromatographic column material and polypropylene chemical vessels), which were used at all stages, was determined by instrumental neutron activation analysis. The radiopurity of the 82Se foils was checked by measurements with the BiPo-3 spectrometer, which confirmed the high purity of the final product. The measured contamination level for 208Tl was 8–54 μBq/kg, and for 214Bi the detection limit of 600 μBq/kg has been reached.
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Affiliation(s)
- Alimardon V. Rakhimov
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
- Institute of Nuclear Physics of Uzbekistan Academy of Sciences , Tashkent , 100214 , Uzbekistan
| | - A. S. Barabash
- NRC “Kurchatov Institute”, ITEP , 117218 Moscow , Russia
| | | | - S. Blot
- University of Manchester , Manchester M13 9PL , UK
| | - M. Bongrand
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - Ch. Bourgeois
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - D. Breton
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - R. Breier
- Faculty of Mathematics, Physics and Informatics , Comenius University , SK-842 48 Bratislava , Slovakia
| | - E. Birdsall
- University of Manchester , Manchester M13 9PL , UK
| | - V. B. Brudanin
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
- National Research Nuclear University MEPhI , 115409 Moscow , Russia
| | | | - J. Busto
- CPPM, Universite d’Aix Marseille, CNRS/IN2P3 , F-13288 Marseille , France
| | - S. Calvez
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - M. Cascella
- University College London , London WC1E 6BT , UK
| | - C. Cerna
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - J. P. Cesar
- University of Texas at Austin , Austin, TX 78712 , USA
| | - E. Chauveau
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - A. Chopra
- University College London , London WC1E 6BT , UK
| | - G. Claverie
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - S. De Capua
- University of Manchester , Manchester M13 9PL , UK
| | - F. Delalee
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - D. Duchesneau
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc , CNRS/IN2P3, LAPP, 74000 Annecy , France
| | - V. G. Egorov
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - G. Eurin
- University College London , London WC1E 6BT , UK
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - J. J. Evans
- University of Manchester , Manchester M13 9PL , UK
| | - L. Fajt
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - D. V. Filosofov
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - R. Flack
- University College London , London WC1E 6BT , UK
| | - X. Garrido
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - H. Gomez
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - B. Guillon
- LPC Caen, ENSICAEN, Université de Caen , CNRS/IN2P3, F-14050 Caen , France
| | - P. Guzowski
- University of Manchester , Manchester M13 9PL , UK
| | - R. Hodák
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - K. Holý
- Faculty of Mathematics, Physics and Informatics , Comenius University , SK-842 48 Bratislava , Slovakia
| | - A. Huber
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - C. Hugon
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - A. Jeremie
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc , CNRS/IN2P3, LAPP, 74000 Annecy , France
| | - S. Jullian
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - D. V. Karaivanov
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
- Institute for Nuclear Research and Nuclear Energy (INRNE) , 72 Tzarigradsko chaussee, Blvd., BG-1784 Sofia , Bulgaria
| | - M. Kauer
- University College London , London WC1E 6BT , UK
| | - A. A. Klimenko
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - O. I. Kochetov
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | | | - V. Kovalenko
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - K. Lang
- University of Texas at Austin , Austin, TX 78712 , USA
| | - Y. Lemière
- LPC Caen, ENSICAEN, Université de Caen , CNRS/IN2P3, F-14050 Caen , France
| | - T. Le Noblet
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc , CNRS/IN2P3, LAPP, 74000 Annecy , France
| | - Z. Liptak
- University of Texas at Austin , Austin, TX 78712 , USA
| | - X. R. Liu
- University College London , London WC1E 6BT , UK
| | - P. Loaiza
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - G. Lutter
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - J. Maalmi
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - M. Macko
- Faculty of Mathematics, Physics and Informatics , Comenius University , SK-842 48 Bratislava , Slovakia
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - F. Mamedov
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - C. Marquet
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - F. Mauger
- LPC Caen, ENSICAEN, Université de Caen , CNRS/IN2P3, F-14050 Caen , France
| | - A. Minotti
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc , CNRS/IN2P3, LAPP, 74000 Annecy , France
| | - A. A. Mirsagatova
- Institute of Nuclear Physics of Uzbekistan Academy of Sciences , Tashkent , 100214 , Uzbekistan
| | - N. A. Mirzayev
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
- Institute of Radiation Problems of Azerbaijan National Academy of Sciences , AZ1143 B. Vahabzade 9 , Baku , Azerbaijan
| | - I. Moreau
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - B. Morgan
- University of Warwick , Coventry CV4 7AL , UK
| | - J. Mott
- University College London , London WC1E 6BT , UK
| | - I. B. Nemchenok
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - M. Nomachi
- Osaka University , 1-1 Machikaney arna Toyonaka , Osaka 560-0043 , Japan
| | - F. Nova
- University of Texas at Austin , Austin, TX 78712 , USA
| | - H. Ohsumi
- Saga University , Saga 840-8502 , Japan
| | - G. Oliviero
- LPC Caen, ENSICAEN, Université de Caen , CNRS/IN2P3, F-14050 Caen , France
| | - R. B. Pahlka
- University of Texas at Austin , Austin, TX 78712 , USA
| | - J. R. Pater
- University of Manchester , Manchester M13 9PL , UK
| | - V. Palušová
- Faculty of Mathematics, Physics and Informatics , Comenius University , SK-842 48 Bratislava , Slovakia
| | - F. Perrot
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - F. Piquemal
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - P. Povinec
- Faculty of Mathematics, Physics and Informatics , Comenius University , SK-842 48 Bratislava , Slovakia
| | - P. Pridal
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | | | - A. Rebii
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - A. Remoto
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc , CNRS/IN2P3, LAPP, 74000 Annecy , France
| | - B. Richards
- University College London , London WC1E 6BT , UK
| | - J. S. Ricol
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - E. Rukhadze
- Faculty of Mathematics, Physics and Informatics , Comenius University , SK-842 48 Bratislava , Slovakia
| | - N. I. Rukhadze
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - R. Saakyan
- University College London , London WC1E 6BT , UK
| | - I. I. Sadikov
- Institute of Nuclear Physics of Uzbekistan Academy of Sciences , Tashkent , 100214 , Uzbekistan
| | - R. Salazar
- University of Texas at Austin , Austin, TX 78712 , USA
| | - X. Sarazin
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
| | - J. Sedgbeer
- Imperial College London , London SW7 2AZ , UK
| | - Yu. A. Shitov
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - F. Šimkovic
- Faculty of Mathematics, Physics and Informatics , Comenius University , SK-842 48 Bratislava , Slovakia
| | - L. Simard
- LAL, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay , F-91405 Orsay , France
- Institut Universitaire de France , F-75005 Paris , France
| | - A. Smetana
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - K. Smolek
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - A. A. Smolnikov
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - S. Snow
- University of Warwick , Coventry CV4 7AL , UK
| | | | - B. Soulé
- CENBG, Université de Bordeaux, CNRS/IN2P3 , F-33175 Gradignan , France
| | - M. Špavorova
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - I. Štekl
- Institute of Experimental and Applied Physics , Czech Technical University in Prague , CZ-12800 Prague , Czech Republic
| | - F. A. Tashimova
- Institute of Nuclear Physics of Uzbekistan Academy of Sciences , Tashkent , 100214 , Uzbekistan
| | - J. Thomas
- University College London , London WC1E 6BT , UK
| | - V. Timkin
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - S. Torre
- University College London , London WC1E 6BT , UK
| | | | - V. I. Tretyak
- Joint Institute for Nuclear Research (JINR) , Dubna , 141980 , Russian Federation
| | - V. I. Umatov
- NRC “Kurchatov Institute”, ITEP , 117218 Moscow , Russia
| | - C. Vilela
- University College London , London WC1E 6BT , UK
| | - V. Vorobel
- Charles University, Prague, Faculty of Mathematics and Physics , CZ-12116 Prague , Czech Republic
| | - G. Warot
- Univ. Grenoble Alpes, CNRS, Grenoble INP , LPSC-IN2P3, 38000 Grenoble , France
| | - D. Waters
- University College London , London WC1E 6BT , UK
| | - M. Zampaolo
- Univ. Grenoble Alpes, CNRS, Grenoble INP , LPSC-IN2P3, 38000 Grenoble , France
| | - A. Žukauskas
- Charles University, Prague, Faculty of Mathematics and Physics , CZ-12116 Prague , Czech Republic
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Punnose J, Malhotra RK, Sukhija K, Mathew A, Chopra A, Sharma A, Choudhary N. Bimodal distribution of fasting, one and two hour post load plasma glucose in Asian Indian pregnant women without pre-gestational diabetes: Gestational age related changes. J Clin Transl Endocrinol 2019; 16:100195. [PMID: 31193408 PMCID: PMC6529712 DOI: 10.1016/j.jcte.2019.100195] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/13/2019] [Accepted: 05/15/2019] [Indexed: 11/25/2022]
Abstract
•After exclusion of pre-gestational diabetes, Asian Indian pregnant women have bimodal distribution of plasma glucose.•Bimodality is observed for fasting, 1 and 2 h post glucose load plasma glucose distribution.•Cut off values for gestational diabetes diagnosis could not identified for any glucose parameter.•In women with high gestational diabetes risk factors, the bimodality is evident before 24 weeks of gestation.•By third trimester, the bimodality is significant for all glucose parameters.
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Affiliation(s)
- John Punnose
- Department of Endocrinology, St. Stephen's Hospital, Delhi, India
| | | | - Komal Sukhija
- Department of Endocrinology, St. Stephen's Hospital, Delhi, India
| | - Anu Mathew
- Department of Endocrinology, St. Stephen's Hospital, Delhi, India
| | - Aditi Chopra
- Department of Endocrinology, St. Stephen's Hospital, Delhi, India
| | - Asha Sharma
- Department of Obstetrics and Gynaecology, St. Stephen's Hospital, Delhi, India
| | - Naimaa Choudhary
- Department of Obstetrics and Gynaecology, St. Stephen's Hospital, Delhi, India
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Chopra A, Sudhanshu S, Chen Y, Mangla P, Dabadghao P, Bhatia E, Arora P, Bano S, Bhatia V. The impact of free medical supplies and regular telephonic contact on glycemic control in Indian children and adolescents with type 1 diabetes. Pediatr Diabetes 2019; 20:444-449. [PMID: 30861594 DOI: 10.1111/pedi.12844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/06/2019] [Accepted: 02/24/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND/OBJECTIVE The effect of economic assistance to underprivileged families with type 1 diabetes has never been described. Such a study is relevant as logistic and cultural factors may preclude an anticipated good outcome. The objective of the study is to determine the impact of economic and educational intervention on hemoglobin A1c (HbA1c) and diabetes knowledge. METHODS Eighty-five consecutive participants were prospectively provided insulin and glucose strips for 1 year. From the 6th to 12th month, patients were randomized such that half of them (telephone group) received proactive telephonic advice by a diabetes educator, while the non-telephone group received usual care. HbA1c and diabetes knowledge were measured at baseline, 6 and 12 months. RESULTS Significant improvement was seen in HbA1c with provision of free diabetes supplies, when patients were compared with their own HbA1c values during the prior 36 months (baseline [8.38 ± 2.0%], at 3 months [8.0 ± 1.6%] and at 6 months [8.1 ± 1.5%, P = 0.0106]). Knowledge score increased from baseline (48 ± 15) to 6 months (58 ± 13, P < 0.001). No difference was seen between the telephone and non-telephone groups in HbA1c from the 6th to 9th and 12th month. The knowledge score showed significant improvement in the telephone group during the proactive telephonic advice study compared with the non-telephone group (P = 0.002). CONCLUSIONS The provision of free medical supplies improved HbA1c and diabetes knowledge. Intensive telephone contact improved knowledge, not HbA1c. These results provide important background for policy makers and diabetes management teams.
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Affiliation(s)
- Aditi Chopra
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Siddhnath Sudhanshu
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Yanjun Chen
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pragya Mangla
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Preeti Dabadghao
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Eesh Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Pratibha Arora
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sayda Bano
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vijayalakshmi Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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49
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Mangla P, Chopra A, Sudhanshu S, Bhatia E, Dabadghao P, Gupta S, Bhatia V. Validation of a diabetes knowledge test for Indian children, adolescents and young adults with type 1 diabetes mellitus. Prim Care Diabetes 2019; 13:283-287. [PMID: 30581070 DOI: 10.1016/j.pcd.2018.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 11/29/2018] [Accepted: 12/02/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Diabetes knowledge has a large impact on glycemic control. There is a pressing need for creation of validated tests of knowledge for different ethnic groups. OBJECTIVE To create and validate a diabetes knowledge test (DKT) for young Indians with type 1 diabetes mellitus (T1DM). METHODS We created a 34 item Hindi language DKT, with basic (19-questions) and advanced (15-questions) components. It was administered to 77 consecutive patients who had previously received in-hospital diabetes education. We hypothesized that the test scores would be higher for patients residing in urban regions, for patients with higher maternal education, and those with lower HbA1c. Cronbach's alpha (α) was used to calculate the test reliability. RESULTS The DKT score was significantly higher in families with higher (>class 12th) maternal formal education compared with lower [70.0 (95% C.I. 67.2-73.5) vs 54.2 (95% C.I. 44.0-57.3), p<0.001] and urban residence compared with rural [68.5 (95% C.I. 63.4-70.6) vs 54.5 (95% C.I. 42.5-61.7), p<0.001]. It had negative correlation with HbA1c (r=-0.268, p=0.019). The Cronbach's α was 0.87 for the entire test, and for the basic and advanced components was 0.78 and 0.74 respectively. CONCLUSION The DKT India is a valid and reliable instrument to evaluate diabetes knowledge in Hindi speaking Indian children, adolescents and young adults with T1DM.
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Affiliation(s)
- Pragya Mangla
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India
| | - Aditi Chopra
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India
| | - Siddhnath Sudhanshu
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India
| | - Eesh Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India
| | - Preeti Dabadghao
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India
| | - Suchit Gupta
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India
| | - Vijayalakshmi Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India.
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50
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Abstract
Periodontitis is a potential source of permanent systemic inflammation that initiates renal dysfunction and contributes to the development of chronic kidney diseases (CKDs). Although numerous studies have confirmed the bidirectional role of periodontal infection and renal inflammation, no literature has yet highlighted the sophisticated pathogenic mechanisms by which periodontal pathogens, particularly Porphynomonas Gingivalis, induce renal dysfunction and contributed in the development of CKDs. The present review aims to critically analyze and highlight the novel pathogenesis of periodontitis induced CKDs.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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