Gene expression alterations in salivary gland epithelia of Sjögren's syndrome patients are associated with clinical and histopathological manifestations

Sjögren's syndrome (SS) is a complex autoimmune disease associated with lymphocytic infiltration and secretory dysfunction of salivary and lacrimal glands. Although the etiology of SS remains unclear, evidence suggests that epithelial damage of the glands elicits immune and fibrotic responses in SS. To define molecular changes underlying epithelial tissue damage in SS, we laser capture microdissected (LCM) labial salivary gland epithelia from 8 SS and 8 non-SS controls for analysis by RNA sequencing (RNAseq). Computational interrogation of gene expression signatures revealed that, in addition to a division of SS and non-SS samples, there was a potential intermediate state overlapping clustering of SS and non-SS samples. Differential expression analysis uncovered signaling events likely associated with distinct SS pathogenesis. Notable signals included the enrichment of IFN-γ and JAK/STAT-regulated genes, and the induction of genes encoding secreted factors, such as LTF, BMP3, and MMP7, implicated in immune responses, matrix remodeling and tissue destruction. Identification of gene expression signatures of salivary epithelia associated with mixed clinical and histopathological characteristics suggests that SS pathology may be defined by distinct molecular subtypes. We conclude that gene expression changes arising in the damaged salivary epithelia may offer novel insights into the signals contributing to SS development and progression.

Longitudinal Evaluation of Radiopacity of Resin Composites: Influence of Photoactivation and Accelerated Photoaging

This study aimed to assess longitudinally the radiopacity of resin composites under the influence of photoactivation and photoaging processes. Ten specimens (1 mm thick and 4 mm in diameter) of three different microhybrid resin composites, Filtek Z250 XT (R1), TPH 3 Spectrum (R2), and Opallis (R3), were prepared for this study. For longitudinal assessment of radiopacity, radiographic images were obtained five times. The first time (T1), the specimens were not photoactivated; the second time (T2), the specimens were photoactivated; and the next three times, photoaging was carried out, with images obtained at 24 hours (T3), 48 hours (T4), and 72 hours (T5) after this process. The photoaging was conducted using LED light (700 lumens, 9 W, 6400 k) under controlled environmental conditions at 37°C (±1°C) and 65% (±5%) relative humidity. The digital system DIGORA Optime was used. The digital images were measured using the histogram function, and then the pixel intensity values were converted into mmAl (the standard unit of radiopacity) using a linear regression function, with minimal adjustment of R² ≥ 0.9. Data in mmAl were statistically analyzed using an analysis of variance (α=0.05). R2 resin composite showed higher values of radiopacity, R1 resin composite showed intermediate values, and R3 resin composite showed lower values. Only at T1 did the higher radiopacity of R2 composite differ significantly from other groups ( p = 0.0000). After application of treatments (photoactivation and photoaging), all radiopacity values were similar ( p-values to T2=0.0507, T3=0.0536, T4=0.0502, T5=0.0501) due to consecutive increase of radiopacity of R1 and R3 composites from T2. Photoactivation and photoaging processes influenced the radiopacity, but changes occurring in the degree of radiopacity were dependent on the composition and chemical characteristics of each composite used.

Overexpression of GαS in Murine Osteoblasts In Vivo Leads to Increased Bone Mass and Decreased Bone Quality

Gα_S is a heterotrimeric G protein that transduces signals from activated G protein-coupled receptors on the cell surface to stimulate adenylyl cyclase/cyclic adenosine monophosphate (AMP) signaling. Gα_S plays a central role in mediating numerous growth and maintenance processes including osteogenesis and bone turnover. Decreased Gα_S expression or activating mutations in Gα_S both affect bone, suggesting that modulating Gα_S protein levels may be important for bone health and development. To examine the effects of increased osteoblastic Gα_S expression on bone development in vivo, we generated transgenic mice with Gα_S overexpression in osteoblasts (HOM-Gs mice) driven by the 3.6-kilobase (kb) Col1A1 promoter. Both male and female HOM-Gs mice exhibit increased bone turnover with overactive osteoblasts and osteoclasts, resulting in a high bone mass phenotype with significantly reduced bone quality. At 9 weeks of age, HOM-Gs mice have increased trabecular number, volumetric BMD (vBMD), and bone volume; however, the bone was woven and disorganized. There was also increased cortical bone volume despite an overall reduction in size in HOM-Gs mice along with increased cortical porosity and brittleness. The skeletal phenotype of HOM-Gs mice progressed into maturity at 26 weeks of age with further accrual of trabecular bone, whereas WT mice lost trabecular bone at this age. Although cortical bone volume and geometry were similar between mature HOM-Gs and WT mice, increased porosity persisted and the bone was weaker. At the cellular level, these alterations were mediated by an increase in bone resorption by osteoclasts and an overwhelmingly higher increase in bone formation by osteoblasts. In summary, our findings demonstrate that high osteoblastic Gα_S expression results in aberrant skeletal development in which bone production is favored at the cost of bone quality. © 2017 American Society for Bone and Mineral Research.

The CRH-Transgenic Cushingoid Mouse Is a Model of Glucocorticoid-Induced Osteoporosis

Glucocorticoids (GCs) have unparalleled anti‐inflammatory and immunosuppressive properties, which accounts for their widespread prescription and use. Unfortunately, a limitation to GC therapy is a wide range of negative side effects including Cushing's syndrome, a disease characterized by metabolic abnormalities including muscle wasting and osteoporosis. GC‐induced osteoporosis occurs in 30% to 50% of patients on GC therapy and thus, represents an important area of study. Herein, we characterize the molecular and physiologic effects of GC‐induced osteoporosis using the Cushing's mouse model, the corticotropin releasing hormone (CRH) transgenic mouse (CRH‐Tg). The humeri, femurs, and tibias from wild‐type (WT) and CRH‐Tg male mice, aged 13 to 14 weeks old were subjected to multiple bone tests including, micro–computed tomography (μCT), static and dynamic histomorphometry, strength testing, and gene expression analyses. The CRH‐Tg mice had a 38% decrease in cortical bone area, a 35% decrease in cortical thickness, a 16% decrease in trabecular thickness, a sixfold increase in bone adiposity, a 27% reduction in osteoid width, a 75% increase in bone‐resorbing osteoclast number/bone surface, a 34% decrease in bone formation rate, and a 40% decrease in bone strength compared to WT mice. At the gene expression level, CRH‐Tg bone showed significantly increased osteoclast markers and decreased osteoblast markers, whereas CRH‐Tg muscle had increased muscle atrophy gene markers compared to WT mice. Overall, the CRH‐Tg mouse model aged to 14 weeks recapitulated many features of osteoporosis in Cushing's syndrome and thus, represents a useful model to study GC‐induced osteoporosis and interventions that target the effects of GCs on the skeleton. © 2017 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.

Overexpression of Gα11 in Osteoblast Lineage Cells Suppresses the Osteoanabolic Response to Intermittent PTH and Exercise

Intermittent parathyroid hormone (iPTH) treatment and mechanical loading are osteoanabolic stimuli that are partially mediated through actions on G protein-coupled receptors (GPCRs). GPCR signaling can be altered by heterotrimeric G protein Gα subunits levels, which can therefore lead to altered responses to such stimuli. Previous studies have suggested that enhanced signaling through the Gαq/11 pathway inhibits the osteoanabolic actions of PTH. The influence of Gαq/11 signaling on mechanotransduction, however, has not been reported in vivo. Using transgenic mice that specifically overexpress Gα11 in osteoblast lineage cells (G11-Tg mice), we investigated the skeletal effects of elevated Gα11 levels on iPTH and mechanical loading by treadmill exercise. Both regimens increased trabecular and cortical bone in Wild-Type (WT) mice as a result of increased bone formation. In G11-Tg mice, there was no change in trabecular or cortical bone and no increase in bone formation in response to iPTH or exercise. While exercise reduced osteoclast parameters in WT mice, these changes were diminished in G11-Tg mice as expression of M-csf and Trap remained increased. Collectively, our results suggest that osteoblastic upregulation of Gα11 is inhibitory to osteoanabolic actions of both PTH and exercise, and that its suppression may be a promising target for treating bone loss.

Elevated Gα11 expression in osteoblast lineage cells promotes osteoclastogenesis and leads to enhanced trabecular bone accrual in response to pamidronate

Osteoblastic cells indirectly induce osteoclastogenesis in the bone microenvironment by expressing paracrine factors such as RANKL and M-CSF, leading to increased bone resorption. These cytokines can be regulated by a variety of intracellular pathways, which include G protein-coupled receptor signaling. To explore how enhanced signaling of the Gαq/11 pathway in osteoblast lineage cells may mediate osteoclast formation, we cocultured wild-type (WT) preosteoclasts with BMSCs derived from either WT or transgenic mice with osteoblast-specific overexpression of Gα11 (G11-Tg). G11-Tg cocultures had elevated osteoclast numbers with greater resorptive capacity and increased expression of Rankl, Rankl:Opg (osteoprotegerin), and M-csf compared with cocultures with WT BMSCs. As well, cocultures with G11-Tg BMSCs required a higher concentration of OPG to inhibit osteoclast formation and less angiotensin II to increase osteoclast size. These indicate that G11-Tg osteoblasts drive the increased osteoclast formation and osteopenia seen in G11-Tg mice. Pamidronate treatment of G11-Tg mice restored the trabecular bone loss phenotype, as bone mineral density, bone volume, trabecular number, separation, and expressions of osteoblastic and osteoclastic genes were comparable with WT parameters. These changes were characterized by enhanced accumulation of calcified cartilage in trabecular bone, demonstrating that resorption of the cartilaginous intermediate by osteoclasts is more affected by bisphosphonate treatment in G11-Tg mice. In conclusion, overexpression of Gα11 in osteoblastic cells promotes osteoclastogenesis by upregulation of Rankl and M-csf and bone loss by increased osteoclast resorption of the trabecular bone and cartilaginous matrix.

Evaluation of low-contrast perceptibility in dental restorative materials under the influence of ambient light conditions

OBJECTIVES

This study aimed to assess how details on dental restorative composites with different radio-opacities are perceived under the influence of ambient light.

METHODS

Resin composite step wedges (six steps, each 1-mm thick) were custom manufactured from three materials, respectively: (M1) Filtek™ Z350 (3M/ESPE, Saint Paul, MN); (M2) Prisma AP.H™ (Dentsply International Inc., Brazil) and (M3) Glacier(®) (SDI Limited, Victoria, Australia). Each step of the manufactured wedge received three standardized drillings of different diameters and depths. An aluminium (Al) step wedge with 12 steps (1-mm thick) was used as an internal standard to calculate the radio-opacity as pixel intensity values. Standardized digital images of the set were obtained, and 11 observers independently recorded the images, noting the number of noticeable details (drillings) under 2 dissimilar conditions: in a light environment (light was turned on in the room) and in low-light conditions (light in the room was turned off). The differences between images in terms of the number of details that were observed were statistically compared using ANOVA, Cronbach's alpha coefficient and Wilcoxon and Kruskal-Wallis tests, with a significance level setting of 5% (α = 0.05).

RESULTS

The M2 showed higher radio-opacity, the M1 displayed intermediate radio-opacity and the M3 showed lower radio-opacity, respectively; however, all three were without significance (p > 0.05) compared with each other. The differences in radio-opacity resulted in a significant variation (p < 0.05) in the number of noticeable details in the image, which were influenced by characteristics of details, in addition to the ambient-light level.

CONCLUSIONS

The radio-opacity of materials and ambient light can affect the perception of details in digital radiographic images.

Reduced trabecular bone mass and strength in mice overexpressing Gα11 protein in cells of the osteoblast lineage

G protein-coupled receptors (GPCRs) require G proteins for intracellular signaling to regulate a variety of growth and maintenance processes, including osteogenesis and bone turnover. Bone maintenance events may be altered by changes in the activity or level of G proteins, which then modify signaling in bone cells such as osteoblasts. We have previously reported increased levels of Gα11 protein and signaling to phospholipase C/protein kinase C pathways in response to dexamethasone in osteoblastic UMR 106-01 cells. Here we generated pOBCol3.6-GNA11 transgenic mice that overexpress Gα11 protein in cells of the osteoblast lineage (G11-Tg mice). G11-Tg mice exhibit an osteopenic phenotype characterized by significant reductions in trabecular bone mineral density, thickness, number and strength. The numbers of osteoblasts and osteocytes were unchanged in G11-Tg bone, but early markers of osteoblast differentiation, Alp and Bsp, were increased while the late stage differentiation marker Ocn was not changed suggesting reduced osteoblast maturation in G11-Tg trabecular bone which was accompanied by a decreased bone formation rate. Furthermore, in vitro cultures of G11-Tg primary osteoblasts show delayed osteoblast differentiation and mineralization. Histological analyses also revealed increased osteoclast parameters, accompanied by elevated mRNA expression of Trap and Ctsk. mRNA levels of Rankl and M-csf were elevated in vitro in bone marrow stromal cells undergoing osteogenesis and in trabecular bone in vivo. Together, these findings demonstrate that increasing Gα11 protein expression in osteoblasts can alter gene expression and result in a dual mechanism of trabecular bone loss.

Influence of Radiopacity of Dental Composites on the Diagnosis of Secondary Caries: The Correlation Between Objective and Subjective Analyses

This study aimed to objectively evaluate the radiopacity of different dental composites and their subjective influence on diagnosing secondary caries–like lesions and how these results correlate. For objective analysis, three resin specimens (1 mm thick, with a 4-mm internal diameter) were made with four composites: 1) Charisma; 2) Filtek Z250; 3) Prisma AP.H; and 4) Glacier. Three human teeth were selected and then mesio-distally sectioned (1 mm thick) to make the dental specimens. An aluminum (Al) wedge (12 steps, 1 mm thick, 99.8% purity) was used as an internal standard to calculate the radiopacity. For subjective analysis, 20 human teeth were selected and then prepared with a mesio-occluso-distal (MOD) inlay cavity, with half the teeth receiving a round cavity to simulate the carious lesion. The MOD was restored using the composites at four different times. Standardized radiographs were acquired and then digitized (300 dpi and eight-bit TIFF) for both analyses. A histogram objectively measured the pixel intensity values of the images, which were converted into millimeters of Al using linear regressions. Eight observers subjectively evaluated the images using a five-point rating scale to diagnose the caries. The data were statistically analyzed using the Student t-test, the Kappa test, diagnostic testing, and the Pearson correlation coefficient (α=0.05). All materials showed radiopacity values compatible with dental tissues (p&gt;0.05); Glacier was similar to dentin and Prisma AP.H was similar to enamel, while the remaining materials showed a middle radiopacity. Prisma AP.H and Glacier differed (p&lt;0.05) in relation to their accuracy to caries diagnosis, with Glacier having greater accuracy. There was a correlation between objective and subjective analyses with negative linear dependence. An increase in the material's radiopacity could have a subjectively negative influence on the diagnosis of secondary caries; thus, an ideal radiopacity for a dental composite is closer to the dentin image and produces similar attenuation to X-rays than does dentin.

Prevalence and characteristics of pneumatization of the temporal bone evaluated by cone beam computed tomography

The aim of this study was to determine the prevalence and characteristics of pneumatization of the glenoid fossa and articular eminence by means of cone beam computed tomography (CBCT) images. CBCT images of 658 patients (1316 joints) were evaluated to determine pneumatization in the articular eminence (PAT) and roof of the glenoid fossa (PGF). Age and gender were recorded for all patients and, for the cases of pneumatization, laterality and type (unilocular or multilocular) were noted. Its prevalence was correlated with gender, age and laterality by statistical analyses. 21.3% of individuals presented with PAT and 38.3% presented with PGF. Considering the temporomandibular joint, PAT was in 15.5% and PGF in 30.2%. Of PAT cases, 54.3% were unilateral and 45.7% bilateral; 3.4% were unilocular and 96.6% were multilocular. In the PGF cases, 42.5% were unilateral and 57.5% bilateral; 0.02% was unilocular and 99.8% were multilocular. There was no statistical difference regarding gender and age; but there was statistical difference regarding laterality, with higher frequency on the left side. In conclusion, there was a significant prevalence of PAT and PGF in the studied population; their prevalence seems higher than has been previously supposed.

Clinical and MRI investigation of temporomandibular joint in major depressed patients

OBJECTIVE

The aim of the present study was to describe the clinical and MRI findings of the temporomandibular joint (TMJ) in patients with major depressive disorders (MDDs) of the non-psychotic type.

METHODS

40 patients (80 TMJs) who were diagnosed as having MDDs were selected for this study. The clinical examination of the TMJs was conducted according to the research diagnostic criteria and temporomandibular disorders (TMDs). The MRIs were obtained bilaterally in each patient with axial, parasagittal and paracoronal sections within a real-time dynamic sequence. Two trained oral radiologists assessed all images. For statistical analyses, Fisher's exact test and χ(2) test were applied (α = 0.05).

RESULTS

Migraine was reported in 52.5% of subjects. Considering disc position, statistically significant differences between opening patterns with and without alteration (p = 0.00) and between present and absent joint noises (p = 0.00) were found. Regarding muscular pain, patients with and without abnormalities in disc function and patients with and without abnormalities in disc position were not statistically significant (p = 0.42 and p = 0.40, respectively). Significant differences between mandibular pathway with and without abnormalities (p = 0.00) and between present and absent joint noises (p = 0.00) were observed.

CONCLUSION

Based on the preliminary results observed by clinical and MRI examination of the TMJ, no direct relationship could be determined between MDDs and TMDs.

Alternative X-ray filters for an intra-oral digital radiographic system

OBJECTIVE

The aim of this study was to evaluate the effect of the modulation of the radiation spectrum with the use of alternative X-ray filters in the quality of intra-oral digital images from storage phosphor plates.

METHODS

The radiographic exposures were performed in a GE 1000 X-ray machine (General Electric Co., Milwaukee, WI), operating at 65 kVp, 10 mA, 40 cm focus receptor distance using three different exposure times: 0.05 s, 0.16 s and 0.35 s. The control filter (GC) was 100% aluminium (Al) with a thickness of 1.5 mm. The tested filters were: G1, 97% Al and 3% copper (Cu) with 1.47 mm thickness; G2, 96% Al and 4% Cu with 1.53 mm thickness; G3, 95% Al and 5% zinc (Zn) with 1.56 mm thickness; G4, 98% Al and 2% Zn with 1.5 mm thickness; and G5, 95% Cu and 5% Zn with 1.6 mm thickness. For formation of the image, a 12-step Al wedge (each step with increments of 1 mm in thickness) was radiographed 10 times. Pixel values measured in digital images were converted into optical density (OD).

RESULTS

All replicates showed OD with high reproducibility (r > 0.95) for all exposure times and tested filters. In comparison between filters, statistically significant differences in density (p < 0.05) were observed. The OD curve of the G5 filter in all exposure times and G3 filter in an exposure time of 0.05 s showed changes in shape (p < 0.05).

CONCLUSIONS

Excluding the G5 filter, all others tested filters can be used as a substitute for GC without losses in image quality.

Influence of the intergonial distance on image distortion in panoramic radiographs

OBJECTIVES

The aim of this study was to evaluate the influence of the intergonial distance during the formation of panoramic radiographic images by means of horizontal and vertical measurements.

METHODS

30 macerated mandibles were categorized into 3 different groups (n = 10) according to their intergonial distances as follows: G1, mean distance 8.2 cm, G2, mean distance 9.0 cm and G3, mean distance 9.6 cm. Three metal spheres 0.198 cm in diameter and placed at an incline using an isosceles triangle were separately placed over the internal and external surfaces of the mandibles before radiographic exposure for the purpose of taking the horizontal and vertical measurements. The occlusal planes of the mandibles were horizontally placed on the chin rest of the panoramic machine Orthopantomograph® OP 100 (Instrumentarium Imaging, Tuusula, Finland) and were then radiographed. In the panoramic radiographs, an expert radiologist measured the distances between the metal spheres in the horizontal and vertical directions using a digital caliper. The data were tabled and statistically analysed by Student's t-test and analysis of variance with Tukey post-test (α = 0.05).

RESULTS

In all three groups magnification of the distances between spheres was observed when compared with the real distance in both horizontal and vertical measurements (p < 0.05). Differences in both horizontal and vertical measurements were observed between the different regions (p < 0.05), however there were no differences between groups in the same region (p > 0.05). Differences between horizontal and vertical measurements were observed in different regions in all evaluated groups (p < 0.05).

CONCLUSION

The intergonial distance is a factor that had no influence on image formation in the panoramic radiograph.