Marilena Chinali Komesu

Double-blind, crossover, placebo-controlled clinical trial with clobetasol propionate in desquamative gingivitis

The aim of this study was to evaluate the efficacy of a 0.05% clobetasol propionate ointment administered in trays to 22 patients with desquamative gingivitis in a double-blind, crossover, placebo-controlled trial. Patients received container number 1 and were instructed to apply the ointment 3 times a day for 2 weeks, and to reduce the application to once a day in the third week. Next, the patients were then instructed to discontinue the treatment for 2 weeks, and were then given container 2, used in the same way and for the same length of time as container 1. Regarding signs, 17 patients presented some improvement, while 5 experienced worsening with clobetasol propionate. With the placebo, 14 patients presented some improvement, and 8 patients presented worsening. For symptoms, there was complete improvement in 2 patients, partial improvement in 12, no response in 7, and worsening in 1 with clobetasol propionate. With the placebo, there was partial improvement in 8 patients, no response in 12 and worsening in 2. No statistically significant difference was found between clobetasol and placebo (p>0.05). Within the period designed to treat the gingival lesions of the patients, clobetasol propionate did not significantly outperform the placebo.

Could leprosy reaction episodes be exacerbated by oral infections

INTRODUCTION This study evaluated whether leprosy reactions could be associated with oral infection. METHODS Leprosy patients (n = 38) with (Group I) and without (Group II) oral infections were selected. Reactions were identified from the clinical and histopathological features associated with serum C-reactive protein (CRP) and10kDa interferon-gamma-induced protein (IP-10) levels, determined before and after elimination of the foci of infection. RESULTS Group I presented more reactions than group II did, and improvement of the reactions after dental treatment. Serum CRP and IP-10 did not differ before and after the dental treatment, but differed between the groups. CONCLUSIONS Oral infection could be an exacerbating factor in leprosy reactions.

Attitudes of dental students and dental professionals caring for HIV-positive patients in São Paulo, Brazil.

Sao Paulo has a high incidence of AIDS. However many dentists are concerned about providing care for patients with AIDS/HIV. The reluctance of dentists to care for these patients is a matter of concern mostly because they are the health care providers who could easily detect the first signs and also observe the progression of the HIV infection. We sought to address the deficiencies in our community regarding the acceptance of HIV-infected patients. A self-administered survey questionnaire was given to graduate dental students (professors postgraduate students and fellows) and undergraduates working in the clinics of a dental school in Sao Paulo Brazil. All participants were informed that the survey participation was voluntary and confidential. The questionnaire consisted of questions focusing on knowledge about and attitudes toward AIDS/HIV. (excerpt)

Effects of Green Tea Use on Wound Healing

El te verde, producto de la planta Camellia sinensis, consiste en mas de 200 componentes. Los mas conocidos son las catequinas o compuestos polifenolicos o flavonoides, pero contiene tambien polisacaridos conjugados, aminoacidos, cafeina y vitaminas. Diversos estudios han sugerido que el consumo regular de te verde reduce el riesgo de cancer, protege contra los eventos iniciales y su progresion, puede actuar como antioxidante, tiene propiedades bactericidas, y su consumo puede ser un co-adyuvante en el tratamiento de la diabetes mellitus, hipertension e hipercolesterolemia. Nuestro estudio experimental fue realizado con ratas Wistar machos, separadas en dos grupos, experimental y control. Los animales del grupo control recibieron agua ad libitum y los animales del grupo experimental recibieron te verde. Despues de 2 semanas de experimentacion, en todos los animales fueron realizadas heridas quirurgicas en el dorso. Los animales fueron sacrificados 1, 3 y 7 dias despues de la cirugia. Muestras de piel fueron usadas para evaluacion microscopica. Nuestros resultados permitieron observar que el grupo experimental (tratado con te verde) presento una aceleracion en la neoformacion epitelial en el 3er dia posquirurgico, cuando la neoformacion esta en la fase inicial. En este periodo, las areas quirurgicas presentaron 48,20% de neoformacion epitelial en el grupo tratado contra 27,32% en el grupo control. Los resultados del presente estudio, junto con otras informaciones existentes en la literatura sobre el te verde, sugieren fuertemente que el uso regular de este producto puede ser benefico en situaciones quirurgicas, cuando se desea una rapida neoformacion epitelial.

Potential contribution of saliva to the sexual transmission of HIV through the secretion of CCL20 by genital epithelial cells

Saliva can be considered as an important actor during sexual intercourse. However, there is no data concerning its influence on HIV sexual transmission. The aim of this study was to evaluate the role of whole saliva on the in vitro secretion of CCL20 by monolayered HEC‐1A endocervical epithelium cells. HEC‐1A cells were cultivated in 96‐well microplates and incubated with specimens of whole saliva collected from 57 subjects tested seropositive (n = 34) or seronegative (n = 23) for HIV and presenting different oral conditions (healthy periodontally, n = 22, and gingivitis/periodontitis, n = 35). The production of CCL20 in the supernatants of HEC‐1A cells after overnight incubation at 37°C was quantified using ELISA. The salivary concentration of lactoferrin (Lf) and IL‐1β was tested by ELISA. Saliva samples were found able to stimulate dramatically the production of CCL20 by epithelial cells, increasing this synthesis by a mean factor of 38.1 with reference to untreated cells. This stimulation was equivalent to that observed with IL‐1β used as positive control. Although no difference was observed according to oral condition, HIV status or salivary concentration of Lf and IL‐1β, the high salivary concentration of the latter protein could acknowledge in large part for the overproduction of CCL20 by HEC‐1A cells when stimulated by saliva. Saliva was shown to significantly increase CCL20 secretion and may be responsible for an enhanced recruitment of dendritic/Langerhans cells at the genital level. These results suggest that saliva could facilitate HIV entry and possibly other pathogens through the genital mucosa during heterosexual intercourse. J. Med. Virol. 86:58–63, 2014.

Oral coinfection can stress peripheral lymphocyte to inflammatory activity in leprosy

INTRODUCTION This study evaluated the intracellular profile of interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-10 (IL-10) and interferon-γ (IFN-γ) in peripheral blood mononuclear cells (PBMCs) from leprosy patients based on oral infections presence to determine whether these coinfections could be associated with pro-inflammatory activity in leprosy. METHODS Leprosy patients regardless of clinical form and specific leprosy treatment (n=38) were divided into two groups: Group I - leprosy patients with oral infections (n=19), and Group II - leprosy patients without oral infections (n=19). Non-leprosy patients presenting oral infections were assigned to the control Group (n=10). Intracellular IL-2, IL-4, IL-10 and IFN-γ production was evaluated by flow cytometry (FACS) before and 7 days after controlling the oral infection in the Group I, before and 7 days after dental prophylaxis in the Group II, and during oral infection process in control Group. RESULTS Low percentages of CD3+ lymphocytes bearing IL-2, IL-10 and IFN-γ were observed in the Group I and Group II at baseline and 7 days after therapy or prophylaxis compared to controls. Group I showed reduced percentages of IL-4 at baseline and 7 days after therapy compared to controls, or at baseline of Group II, and the Group II showed reduced percentages of CD3+ cells bearing IL-4 compared to control. An increase of the percentages of CD3+cells bearing IL-4 was observed in the Group I after the oral infections treatment. CONCLUSIONS The occurrence of oral infections favors the intracellular cytokines expression and, probably, the inflammatory reaction operating as a stimulatory signal triggering the leprosy reactions.

The carcinogenic potential of cadmium in the palatal and gingival epithelium of rats: a morphologic and morphometric analysis

Cadmium (Cd) is a heavy metal that exerts a variety of toxic effects, chronic and acute, in exposed organisms. The aim of this study was to investigate the carcinogenic potential of Cd in the palatal and gingival epithelium of Wistar rats. Two groups of animals were studied: group 1 consisted of 5 rats exposed to cadmium chloride (CdCl2) in drinking water (300 mg/L) for 6 months; group 2 also consisted of 5 rats placed in the same conditions as those of group 1, but kept free of Cd for 6 additional months. Two other groups (C1 and C2) with the same number of animals, but not exposed to CdCl2, were used as a control for groups 1 and 2, respectively. All animals were weighed before and after the experimental period. After animals being killed, tissues of interest were fixed in solution of 10% formalin, processed by standard histologic techniques, stained with HE, and analyzed under light microscopy using karyometric and stereologic parameters. Loss of body weight, atrophy of the gingiva and soft-palate epithelium were the principal findings of this study, and verified only in the group 1 (p < 0.05). In conclusion, at the concentration tested, Cd presented no carcinogenic effect on the oral tissues within the experimental time period.

Corticosteróide tópico oclusivo no tratamento de manifestações gengivais de doenças vesicobolhosas auto-imunes

Management of gingival lesions of vesicobullous autoimmune diseases is one the main challenges to oral medicine, primarily because of their chronic nature. Systemic therapy is required in most severe lesions, however, whenever feasible, topic corticosteroid therapy is preferred. This article describes a technique to provide topical occlusive corticotherapy that has shown to be effective in controlling these lesions, especially in patients exclusively with gingival lesions.

PROGRESSIVE EFFECTS OF DIABETES MELLITUS ON THE SKIN EPITHELIUM OF THE RA

La piel sirve como una interface entre los medios interno y externo de nuesto cuerpo. Una de sus funciones es actuar como una barrera mecanica. Cambios en sus caracteristicas pueden conducir a una mayor patogenicidad y/o, a una menor capacidad de defensa. La diabetes mellitus se caracteriza por un grupo heterogeneo de alteraciones hiperglicemicas cronicas, siendo considerada un sindrome mas que una simple enfermedad. Las complicaciones de la diabetes estan asociadas, principalmente, con la cronicidad de la enfermedad, existiendo escasa informacion sobre los procesos patologicos desencadenantes. Los modelos animales son considerados muy utiles para el estudio de la diabetes inicial. Las ratas Wistar con diabetes inducida con aloxana, fueron utilizadas como modelo para estudiar los efectos progresivos de la diabetes mellitus sobre el epitelio de la piel. Cinco animales fueron sacrificados a los 7 dias (Fase I) y otros cinco a los 26 dias (Fase II) luego de comprobarse el estado hiperglicemico. Animales no inyectados con aloxana fueron usados como controles. Fueron usados metodos histometricos y estereologicos para el analisis de los tejidos. Nuestros resultados permitieron observar que no obstante la alteracion progresiva del grosor del epitelio durante la evolucion de la enfermedad, la alteracion del mismo ocurre muy precozmente en el curso de la diabetes. Nuestros resultados sugieren que, a pesar de ser la diabetes una enfermedad cronica, y de que muchas de sus complicaciones estan relacionadas con su cronicidad, es razonable pensar en una deficiencia en la capacidad de la piel en su accion de barrera, aun en las etapas iniciales de la enfermedad. Los profesionales deberia considerar estas caracteristicas en relacion a aquellos pacientes con alto riesgo de desencadeanar una diabetes mellitus

Protease Inhibitor and Metabolic Alteration

Los inhibidores de la proteasa (IP), que forman parte de la terapia HAART (terapia antirretroviral altamente activa), son inhibidores selectivos y competitivos de la proteasa, enzima crucial para la maduracion, infeccion y replicacion viral. Un sindrome lipodistrofico, asociado a hiperglucemia, hipercolesterolemia, hipertrigliceridemia, hiperlipidemia, hipertension e hiperinsulinemia, ha sido relatado en pacientes tratados con HAART. Las anomalias metabolicas asociadas a la HAART fueron relacionadas, inicialmente, a los inhibidores de la proteasa, principalmente el Ritonavir, pero los mecanismos que relacionados a estas alteraciones metabolicas son poco comprendidos. Dado que los IP son posibles candidatos a farmacos de eleccion para tratamiento de otras enfermedades, como hepatitis C, malaria y algunos tipos de cancer, es importante esclarecer las alteraciones metabolicas asociadas a los inhibidores de la proteasa. Ratas Wistar fueron tratadas dos veces por semana con 30 mg/kg de Ritonavir por 4 y 8 semanas. Fueron determinados los niveles de colesterol total, HDL, LDL, VLDL, trigliceridos y glucemia, al final de cada periodo considerado. Para evitar la interferencia de la ingestion de alimentos en las determinaciones de laboratorio, los animales fueron sometidos a un ayuno previo de 16 horas. Nuestros resultados mostraron un rapido aumento serico de los niveles de trigliceridos, colesterol total, LDL-C y glucemia. No se observaron diferencias significativas para los niveles sericos de HDL-C o VLDL. Nuestro estudio apunta a la importancia de considerar los posibles antecedentes familiares de dislipidemia o diabetes, y controlar cualquier otro factor de riesgo cardiovascular y de diabetes cuando se utilizan los inhibidores de la proteasa.