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Gama-Cuellar AG, Díaz KP, Calleja MM, Saavedra GA, Ramírez-Amador V, Corro JR, Ramón-Ramírez V, Albuquerque-Júnior RL, Gondak R. Impaired intratumoral dendritic cell function and potential predictive value of dendritic cell markers for metastasis in malignant salivary gland tumors. Med Oral Patol Oral Cir Bucal 2024; 29:e273-e279. [PMID: 37992142 PMCID: PMC10945878 DOI: 10.4317/medoral.26248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/09/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The differentiation between primary and metastatic salivary gland neoplasms (SGNs) helps in determining appropriate management strategies, including the need for additional diagnostic tests, surveillance, or aggressive treatment. The purpose of this study was to identify and quantify the immature and mature dendritic cells (DCs) in metastatic and no metastatic SGNs and determine its association with clinicopathological findings. MATERIAL AND METHODS Cross-sectional, observational, and descriptive study that includes 33 malignant salivary gland neoplasms [MSGN (6, 18.1% metastatic)], and 22 pleomorphic adenomas (PA), as a control group. Clinical and histopathological characteristics were obtained. Immunohistochemistry for human leukocyte antigen D-related (HLA-DR), CD1a, CD83, and Ki-67 proteins was done. Positive intra- and peritumoral DCs were counted. RESULTS Individuals with MSGN had a lower density of intratumoral HLA-DR+ cells than those with PA (p=0.001), Ki-67 immunostaining was significantly higher in MSGN than in PA (6% vs. 1.4%, p<0.001). Metastatic MSGN showed less intratumoral CD1a+ than non-metastatic (3.2 vs. 165.1, p=0.001). No differences in intra- and peritumoral CD83+ cells were found between benign and malignant SGN. CONCLUSIONS These results suggest that the immune-protective function of intratumoral DCs is compromised in MSGNs. DCs markers may represent useful prediction tools for metastases in salivary gland malignancies, with crucial implications in the implementation of appropriate disease management strategies.
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Affiliation(s)
- A-G Gama-Cuellar
- Universidade Federal de Santa Catarina UFSC, Departmento de Patologia Delfino Conti St. Trindade Post code: 88040-370. Florianópolis, SC, Brazil
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Maldonado-Mendoza J, Ramírez-Amador V, Anaya-Saavedra G. Primary oral and sinonasal mucosal melanomas in Latin America: a systematic review. Int J Oral Maxillofac Surg 2023:S0901-5027(23)00877-9. [PMID: 38040520 DOI: 10.1016/j.ijom.2023.11.002] [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: 03/29/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/03/2023]
Abstract
Primary oral and sinonasal mucosal melanomas (POSNMMs) are aggressive neoplasms with limited therapeutic alternatives. The aim of this review was to characterize the demographic, clinical, immunohistochemical, and molecular information regarding these tumors in the Latin American population. Articles published in English, Spanish, or Portuguese (1990-2022) retrieved from the PubMed/MEDLINE, Scopus, CAS, Web of Science, EBSCO, and Google Academic databases were included. Thirty-three studies, with a total of 1212 cases, were identified. Clinicopathological data were available for 870 cases and immunohistochemical and/or molecular information for 342. Nineteen studies (57.6%) reported cases of oral melanoma, three (9.1%) sinonasal melanoma, and 11 (33.3%) oral and sinonasal melanoma. Fifteen studies (45.5%) provided only clinicopathological data, 12 (36.4%) reported only immunohistochemical data, two (6.1%) shared clinicopathological and immunohistochemical data, one (3.0%) offered clinicopathological, immunohistochemical, and molecular data, one (3.0%) provided immunohistochemical and molecular data, one (3.0%) clinicopathological and molecular data, and one (3.0%) only molecular data. The mean age of individuals with POSNMMs was 58 years, and slightly more were male (male 51.3%, female 48.7%). In Latin America, POSNMMs are a rare but aggressive malignancy with a poor prognosis and limited treatment options. Although molecular data and targeted therapy are still being researched, data from Latin America indicate the need for multicenter collaborative clinical trials to unite individual and isolated efforts.
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Affiliation(s)
- J Maldonado-Mendoza
- Oral Pathology and Medicine Master Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - V Ramírez-Amador
- Oral Pathology and Medicine Master Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - G Anaya-Saavedra
- Oral Pathology and Medicine Master Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico.
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Ramírez-Amador V, Anaya-Saavedra G, Castro-García ME, Valdez AMC, Calva JJ. THE CHALLENGING DIAGNOSIS OF SERONEGATIVE ORAL SYPHILIS IN AN HIV-INFECTED PATIENT. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.137] [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: 10/21/2022]
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Camacho-Aguilar S, Ramírez-Amador V, Rosendo-Chalma P, Guido-Jiménez M, García-Carrancá A, Anaya-Saavedra G. Human papillomavirus load in benign HPV-associated oral lesions from HIV/AIDS individuals. Oral Dis 2018; 24:210-214. [PMID: 29480634 DOI: 10.1111/odi.12732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 08/07/2017] [Accepted: 08/09/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although HPV emerged as a crucial carcinogenic and prognostic biomarker in head and neck cancer, and considering the increase in HPV-associated oral lesions (HPV-OLs) in HIV individuals, molecular information about HPV-OLs is scarce; thus, our aim was to determine viral loads in HPV-OLs from HIV/AIDS individuals. METHODS HIV/AIDS subjects with HPV-OL were included in this cross-sectional study. Following informed consent, biopsies were obtained. HPV detection and typing were carried out by PCR and sequencing (MY09/11, GP5+/6+). HPV-13 and HPV-32 loads were determined by a high-resolution melting assay. For statistical analysis, X2 , Fisher's exact, and Mann-Whitney U tests were applied, using SPSS software (v.23). RESULTS Twenty-nine HIV subjects (median age 38 years, 93% males) were included. Most were AIDS individuals (72.4%) under HAART (89.7%). Twenty-two (75.9%) participants had more than one HPV-OL (four with florid presentations), mostly multifocal epithelial hyperplasia (62%), being HPV-13 (26%) and HPV-32 (31%) the most frequent types. HPV load was higher in individuals with multiple HPV-OLs than in solitary lesions (4.9 vs. 3.2 Log10 copies/ml, p = .090) and in HPV-32+ than in HPV-13+ (8.3 vs. 6.4 Log10 copies/ml, p = .014). CONCLUSIONS Multiple HPV-OLs showed high HPV loads, possibly indicating transcriptional activity of the virus; however, in the HIV setting, the individual and local immunological response could be the key process.
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Affiliation(s)
- S Camacho-Aguilar
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - V Ramírez-Amador
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - P Rosendo-Chalma
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México City, Mexico
| | - M Guido-Jiménez
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México City, Mexico
| | - A García-Carrancá
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México City, Mexico
| | - G Anaya-Saavedra
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
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Ramírez-Amador V, Anaya-Saavedra G, Labardini-Méndez J, Ponce de León-Rosales S. Double-blind placebo-controlled randomized clinical trial evaluating doxycycline effects on chemotherapy-induced oral mucositis. J Clin Pharm Ther 2017; 43:202-208. [PMID: 28948645 DOI: 10.1111/jcpt.12633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/31/2017] [Accepted: 09/07/2017] [Indexed: 01/05/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Chemotherapy (CT)-associated oral mucositis (OM) is one of the most debilitating and painful side effects in oncology patients, with limited effective management options. During CT, matrix metalloproteinases (MMPs) are upregulated, causing damage in mucosal and submucosal tissues, and playing a key role in OM; therefore, the use of subantimicrobial doxycycline as a MMP inhibitor may represent a potential approach for OM management. The aim of this clinical trial was to evaluate the efficacy and safety of low doses of doxycycline in OM development in individuals with acute leukaemia (AL) during CT. METHODS Randomized controlled clinical trial (Registration No. NCT01087476) performed in adult AL patients scheduled to receive CT (September 2010-October 2014). Individuals were stratified by leukaemia type and assigned randomly to receive doxycycline hyclate (50 mg/d) (doxycycline group: DG) or placebo (placebo group: PG) before and during CT. Included subjects had a baseline oral examination and thereafter 3 times a week during 21 days. The primary outcome was OM development. RESULTS AND DISCUSSION One hundred and forty-seven AL subjects were enrolled: 74 in DG and 73 in PG; baseline characteristics between groups were comparable. During follow-up, 15 (10.2%) individuals developed OM; no differences between treatment groups were found (DG:8.1%, PG:12.3%; P = .59). The mean OM Assessment Scale score was 2.51, without differences between groups (DG:2.7, PG:2.4; P = .65). Low baseline blood albumin levels in the OM-affected individuals were identified, revealing the effect of systemic deterioration as a predisposing factor for OM development. No adverse effects were observed. WHAT IS NEW AND CONCLUSION Subantimicrobial doses of doxycycline did not reduce the incidence, onset, duration or severity of OM.
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Affiliation(s)
- V Ramírez-Amador
- Oral Pathology and Oral Medicine Master, Universidad Autonoma Metropolitana, Mexico City, Mexico
| | - G Anaya-Saavedra
- Oral Pathology and Oral Medicine Master, Universidad Autonoma Metropolitana, Mexico City, Mexico
| | - J Labardini-Méndez
- Hemato-Oncology Department, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - S Ponce de León-Rosales
- Clinical Epidemiology Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Ramírez-Amador V, Zambrano JG, Anaya-Saavedra G, Zentella-Dehesa A, Irigoyen-Camacho E, Meráz-Cruz N, Ponce de León-Rosales S. TNF as marker of oral candidiasis, HSV infection, and mucositis onset during chemotherapy in leukemia patients. Oral Dis 2017; 23:941-948. [PMID: 28403570 DOI: 10.1111/odi.12677] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 01/27/2017] [Revised: 03/09/2017] [Accepted: 04/05/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess changes in the salivary expression of IL-1α, IL-1β, IL-2, IL-6, IL-10, IL-17, and TNF in acute leukemia (AL) patients before and during chemotherapy, and its association with HSV infection, oral candidiasis (OC), and oral mucositis (OM) onset. METHODS Cohort study in AL patients >15 years starting induction chemotherapy at a Mexican oncological center (2013-2014). Onset of oral lesions (OLs) was assessed during follow-up, and saliva was obtained at baseline, at visit 2 (days 4-12), and at visit 3 (days 13-21) after chemotherapy, treated with a protease inhibitor and stored at -70°C. An enzyme-linked immunosorbent assay was performed. Cox proportional hazards regression models were constructed to estimate hazard ratios and its 95% CI (HR, 95% CI) for OL development. RESULTS Forty-one patients were followed up, and 17 (41.5%) developed OLs. OL patients had higher baseline salivary IL-1α than those without lesions (p = 0.040). During visit 2, OL patients had higher levels of IL-1α (p = 0.033), IL-1β (p = 0.016), IL-6 (p = 0.035), and TNF (p = 0.019) than those who did not develop OLs. Patients with HSV infection, OC, and OM showed higher salivary TNF levels during follow-up (HR: 3.52, 95% CI: 1.35-9.14, p = 0.010). CONCLUSION AL patients undergoing chemotherapy with high salivary TNF levels were more likely to develop HSV infection, OC, and OM.
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Affiliation(s)
- V Ramírez-Amador
- Master's Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, México
| | - J G Zambrano
- Master's Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, México
| | - G Anaya-Saavedra
- Master's Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, México
| | - A Zentella-Dehesa
- Biochemical Unit, Department of Genomic Medicine and Environmental Toxicology, Biomedical Research Institute, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Universidad Nacional Autónoma de México, Mexico City, México
| | - E Irigoyen-Camacho
- Master's Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, México
| | - N Meráz-Cruz
- Liason Unit of the Faculty of Medicine, Instituto Nacional de Medicina Genómica, Universidad Nacional Autónoma de México, Mexico City, México
| | - S Ponce de León-Rosales
- Clinical Epidemiology Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Maldonado-Mendoza J, Ramírez-Amador V, Anaya-Saavedra G, Irigoyen-Camacho ME, Ruíz-Godoy L, Ruíz-García E, Meneses-García A. Clinicopathological characterization of primary oral and sinonasal melanoma in a referral centre in Mexico City: 2000-2012. Int J Oral Maxillofac Surg 2014; 44:427-32. [PMID: 25467736 DOI: 10.1016/j.ijom.2014.10.022] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 10/22/2014] [Accepted: 10/29/2014] [Indexed: 02/03/2023]
Abstract
In Mexico, there have been few studies on primary oral and sinonasal melanoma, an aggressive neoplasm with a low survival rate and few therapeutic alternatives. Further, there is limited information about its clinical and histopathological characteristics. The aim of this retrospective study was to describe the clinicopathological profile of these tumours in patients attending a major oncology reference centre in Mexico City over a 12-year period. Demographic and clinical data were obtained from the clinical charts, and histopathological features were evaluated. χ(2), Fisher's exact, and Mann-Whitney U-tests were used for analysis; significance was set at P<0.05. Thirty-three cases were studied (73% sinonasal melanoma (SNM) and 27% oral melanoma (OM)); 58% were female and the median age was 66 (Q1-Q3 55.5-75) years. Compared with OM patients, SNM patients had a shorter time to diagnosis (16.7 vs. 11.7 months, P=0.022), were identified at earlier stages (33.3% vs. 58.3%, P=0.010), and all presented symptoms (66.7% vs. 100%, P=0.015). All samples showed vertical growth and 96.9% exhibited pleomorphism. A higher proportion of cases with pleomorphism developed metastases at follow-up than those without (60% vs. 12.5%, P=0.026). The present study provides valuable information that could form the basis of future studies in the search for advanced therapy modalities.
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Affiliation(s)
- J Maldonado-Mendoza
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - V Ramírez-Amador
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico.
| | - G Anaya-Saavedra
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - M E Irigoyen-Camacho
- Health Care Department, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - L Ruíz-Godoy
- Tumour Bank, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - E Ruíz-García
- Translational Research Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - A Meneses-García
- Translational Research Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
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González-Ramírez I, Irigoyen-Camacho ME, Ramírez-Amador V, Lizano-Soberón M, Carrillo-García A, García-Carrancá A, Sánchez-Pérez Y, Méndez-Martínez R, Granados-García M, Ruíz-Godoy LM, García-Cuellar CM. Association between age and high-risk human papilloma virus in Mexican oral cancer patients. Oral Dis 2013; 19:796-804. [DOI: 10.1111/odi.12071] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 01/01/2013] [Indexed: 12/21/2022]
Affiliation(s)
- I González-Ramírez
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - ME Irigoyen-Camacho
- Departamento de Atención a la Salud; Universidad Autónoma Metropolitana Xochimilco; Mexico City; Mexico
| | - V Ramírez-Amador
- Departamento de Atención a la Salud; Universidad Autónoma Metropolitana Xochimilco; Mexico City; Mexico
| | - M Lizano-Soberón
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México; Mexico City; Mexico
| | - A Carrillo-García
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - A García-Carrancá
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México; Mexico City; Mexico
| | - Y Sánchez-Pérez
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - R Méndez-Martínez
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - M Granados-García
- Departamento de Tumores de Cabeza y Cuello; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - LM Ruíz-Godoy
- Instituto Nacional de Cancerología, Banco de Tumores; Mexico City; Mexico
| | - CM García-Cuellar
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
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González-Ramírez I, Ramírez-Amador V, Irigoyen-Camacho M, Sánchez-Pérez Y, Anaya-Saavedra G, Granados-García M, García-Vázquez F, García-Cuellar C. hMLH1 promoter methylation is an early event in oral cancer. Oral Oncol 2011; 47:22-6. [DOI: 10.1016/j.oraloncology.2010.10.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Revised: 10/04/2010] [Accepted: 10/05/2010] [Indexed: 12/21/2022]
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Ramírez-Amador V, Martínez-Mata G, González-Ramírez I, Anaya-Saavedra G, De Almeida OP. Clinical, histological and immunohistochemical findings in oral Kaposi's sarcoma in a series of Mexican AIDS patients. Comparative study. J Oral Pathol Med 2009; 38:328-33. [DOI: 10.1111/j.1600-0714.2008.00740.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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García-López S, Meikle MC, Villanueva RE, Montaño L, Massó F, Ramírez-Amador V, Bojalil R. Mechanical deformation inhibits IL-10 and stimulates IL-12 production by mouse calvarial osteoblasts in vitro. Arch Oral Biol 2005; 50:449-52. [PMID: 15748698 DOI: 10.1016/j.archoralbio.2004.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2004] [Indexed: 11/24/2022]
Abstract
The skeleton is continuously remodelled throughout life, a process that is orchestrated by cells of the osteoblast lineage. Remodelling involves a complex network of cell-cell signalling involving systemic hormones, locally produced cytokines, growth factors and the mechanical environment of the cells. Here, we report on the effect of mechanically-induced strain on the synthesis by mouse calvarial osteoblasts in monolayer culture of IL-10 and IL-12, two cytokines that inhibit osteoclast formation in bone marrow cultures; IL-10 also suppresses osteoblast differentiation suggesting a role for both cytokines in bone physiology. A tensile strain was applied to the cells intermittently for 6s, every 90s, for 2-96h. After 2-h culture, supernatants from deformed cells contained significantly less IL-10 than control cultures. In contrast, mechanical deformation had a stimulatory effect on IL-12 synthesis; however, by 48h both had returned to control levels. These data suggest that IL-10 and IL-12 can be added to the growing list of mechanical stress-responsive genes. The down-regulation of IL-10 and stimulation of IL-12 further suggests that the initial response of the cells to mechanical deformation was an osteogenic one.
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Affiliation(s)
- S García-López
- Health Science Department/ Building H-104, Universidad Autonóma Metropolitana, Calzada del Hueso 1100, Villa Quietud 04960 Mexico City, Mexico.
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Ramírez-Amador V, Esquivel-Pedraza L, Lozada-Nur F, De la Rosa-García E, Volkow-Fernández P, Súchil-Bernal L, Mohar A. Intralesional vinblastine vs. 3% sodium tetradecyl sulfate for the treatment of oral Kaposi's sarcoma. A double blind, randomized clinical trial. Oral Oncol 2002; 38:460-7. [PMID: 12110340 DOI: 10.1016/s1368-8375(01)00100-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In this double-blind, randomized trial, we compared the clinical efficacy of intralesional vinblastine (VNB) and 3% sodium tetradecyl sulfate (STS) in the treatment of oral Kaposi's sarcoma (OKS). Subjects with OKS were randomly assigned to receive a single intralesional injection of either VNB or STS, at a standard dose (0.2 mg/cm(2)). Differences were evaluated by the Mann-Whitney U and Fisher's exact tests. Sixteen HIV-infected patients were included, eight received VNB and eight received STS; clinical response was evaluated at days 7, 14, and 28 following treatment. Tumor size reduction was 0.68 and 0.61 cm in the VNB and STS groups, respectively (P=0.80). Two VNB patients had complete or partial response whereas four STS subjects had partial responses (P=0.61). Patients in both groups experienced minimal toxicity. We conclude that intralesional vinblastine or STS are adequate for the management of OKS. The benefits of STS are its low cost and ease of use.
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Affiliation(s)
- V Ramírez-Amador
- Universidad Autónoma Metropolitana-Xochimilco, Calzada del Hueso 1100, 04960 Mexico City, Mexico.
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Ramírez-Amador V, Esquivel-Pedraza L, Sierra-Madero J, Soto-Ramirez L, González-Ramírez I, Anaya-Saavedra G, Rodriguez-Diaz R, Vick-Fragoso R, Ponce-de-Leon S. Oral clinical markers and viral load in a prospective cohort of Mexican HIV-infected patients. AIDS 2001; 15:1910-1. [PMID: 11579265 DOI: 10.1097/00002030-200109280-00032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ramírez-Amador V, Esquivel-Pedraza L, Mohar A, Reynoso-Gómez E, Volkow-Fernández P, Guarner J, Sánchez-Mejorada G. Chemotherapy-associated oral mucosal lesions in patients with leukaemia or lymphoma. Eur J Cancer B Oral Oncol 1996; 32B:322-7. [PMID: 8944835 DOI: 10.1016/0964-1955(96)00020-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In order to determine the incidence rate of oral lesions associated with chemotherapy, as well as well as its association with clinical and laboratory parameters and potential risk factors, 50 in-patients with non-Hodgkin's lymphoma or leukaemia under chemotherapy were followed from January 1993 to May 1994. Basal and weekly oral examinations were performed. Clinical and laboratory data were registered. Wilcoxon's rank sum test, chi square test, univariate and multivariate logistic regression analyses were used, 36 individuals with leukaemia and 14 with non-Hodgkin's lymphoma were followed for 158 weeks; mean age was 33 years (range 15-85). Oral lesion incidence rate was 45/100 patients-week. Exfoliative cheilitis and infections (herpes and candidosis) were the most common oral complications, followed by haemorrhagic lesions and mucositis. Haemorrhagic lesions correlated with thrombocytopenia (RR = 30.5). Etoposide administration (RR = 8.6), alkylating agents (RR = 15.6), a prior course of chemotherapy (RR = 23.2) and neutropenia (RR = 4.16) were predictors of mucositis. Oral lesions were a common complication in this study, and a possible association of mucositis with several factors is suggested.
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Affiliation(s)
- V Ramírez-Amador
- Department of Health Care, Universidad Autonoma Metropolitana-Xochimilco, Mexico City, Mexico
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Abstract
Oral findings of 42 Mexican AIDS patients with cancer were reviewed. Kaposi's sarcoma (KS) was the most frequent malignancy (81%) followed by non-Hodgkin's lymphoma (NHL) (12%). All cases of NHL were of high or intermediate grade and most of them were extranodal. Out of the 34 individuals with KS, 22 (65%) showed oral KS and in 21 of them the palate was involved. The clinical features of oral KS including site, appearance and size are described. Pseudomembranous candidosis (PC), hairy leukoplakia (HL) and exfoliative cheilitis (ECh) were also found in these patients. There was no association of these lesions with any type of cancer. A strong association of oral candidosis and history of this infection was found, RR = 7.0 (1.3-4.1). There was evidence of severe immunosuppression in most patients, with mean average CD4 counts of 116 mm3 (range 4-841/mm3). Oral KS, ECh, PC and HL were more common in patients with lower CD4 counts. Our findings illustrate the most frequent oral lesions associated with HIV-1 infection in patients with AIDS and cancer, and further support the importance of oral examination in HIV infected patients.
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Affiliation(s)
- V Ramírez-Amador
- Department of Health Care, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
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Abstract
We report the cases of three AIDS patients who developed major recurrent oral ulcers with severe odynophagia and weight loss. The patients were treated successfully with systemic steroids. Within the first week of prednisone therapy (40 mg/day), the symptoms improved and the lesions entirely healed. We suggest, on the bases of recent literature, that superantigens and the cytokine network could be involved and they should be considered in the immunopathogenic mechanisms of this type of ulcers.
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Affiliation(s)
- G Reyes-Terán
- Department of Infectious Diseases, Instituto Nacional de la Nutrición Salvador Zubirán, México City, México
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