Salivary proteomic biomarkers of oral squamous cell carcinoma

Objectives. The aim of the present study is to investigate the presence of proteomic signatures of Oral Squamous Cell Carcinoma (OSCC) in saliva and their use as potential biomarkers for early and non-invasive diagnosis, as well as prognostication. Methods. Saliva from 45 OSCC patients and 30 healthy controls was analysed by SELDI-TOF mass spectrometry and ProteinChip\uae technology. Proteomic profiles were tested with differential expression analysis and fold change of protein peaks, principal component analysis, Spearman rank correlation test and hierarchical clustering in order to identify a list of peaks of interest representative of controls, N- and N+ cases. Those peaks were used in a supervised artificial neural network in order to classify samples according to the following conditions: controls vs OSCC, controls vs N-, and controls vs N+. Results. When compared with controls, four peaks (i.e. 6913, 11948, 13287 and 27280 m/z) were significantly altered in both N- group and N+ group; four peaks (i.e. 3353, 3433, 3482 and 4136 m/z) were selectively altered in Ngroup; eight peaks were selectively altered in N+ group (i.e. 4038, 7133, 11755, 13746, 13841, 14264, 16807, 17127 m/z). Those peaks were capable to classify 100% of cases and controls, thus being potential diagnostic and prognostic biomarkers for OSC

Oral mucositis: a survey on changes in the proteomic profile

Objectives. Oral mucositis is the most severe complication of anticancer therapy. It occurs in 40-85% of patients during chemotherapy and radiotherapy but also in patients who have undergone hematopoietic stem cell transplantation. The symptoms for oral mucositis are burning and severe pain oral, spontaneous bleeding, dysphagia, dysarthria and odynophagia; especially pain and burning sensation on swallowing contribute to decreased quality of life for oncologic patients and, in severe cases, may also force the patient to feed parenterally (1). Furthermore, if the mucositis is severe it can lead to partial or complete interruption of radiotherapy before completion of the treatment protocol with consequent worsening of the prognosis (2, 3). Dentists must be familiar with the necessary intervents, in order to help the patient during the course of the treatment and prevent the interruption. Certain measures may help minimize the symptoms associated with oral mucositis; however, further research is required, focusing on lesion prevention prior to treatment initiation. To this end, it has been investigated the salivary proteome of cancer patients who developed oral mucositis, post chemotherapy and/or radiotherapy. In addition, we compared the salivary proteome of the same subjects before developing oral mucositis and immediately after the treatment for the mucositis. The analysis was made with SELDI technology. Methods. In the current study, 55 saliva samples of patients suffering from different types of cancer were analyzed. The saliva was collected in three times: before the development of mucositis, when it was diagnosed and after the resolution of this pathology. All samples were analyzed by SELDI-TOF/MS analysis. It was possible to create cluster peaks in spectra obtained using BIORAD DataManagerTM software (Ver 3.5). Results. From this analysis we identified a list of differently expressed mass peaks (clusters). We have selected some significant peaks in a range of values between 3000 m/z 15000 m/z. In particular, five were found to be differentially expressed: 3343, 3486, 3732, 4132 and 4786 m/z. The analysis of the cluster, we evaluated different patterns of peaks in the three groups; some of these were up regulated, as the peak 3732 m/z in samples pre mucositis, and down regulated, such as the 7101 m/z in the samples pre mucositis. It is noted, moreover, an important increase of the peak 4132 m/z in samples of mucositis. Conclusions. Oral mucositis is one of the most frequent complications of cancer therapies. It is, therefore, extremely important that the mucositis is prevented whenever possible, or at least treated to reduce its severity and possible complications. Knowing the salivary proteome and its variations in a state of pre mucositis, mucositis and post mucositis can be useful in order to intervene with preventive tools and better therapies. The association of the peaks 3343, 3486, 3732, 4132 and 4786 m / z, in particular the increase in expression of the peak 4132 m / z in samples of mucositis makes us think that it can be used as biomarker of this condition. Therefore, if these data will be confirmed on a larger series of patients could identify these proteins and study of targeted therapies. Furthermore, it would be helpful to understand whether these variations are associated with a particular chemotherapy and evaluate longer available cancer therapies replacement

Possible link between Hashimoto's thyroiditis and oral lichen planus: a novel association found

none5Lo Muzio L.; Santarelli A.; Campisi G.; Lacaita MG.; Favia G.Lo Muzio, L.; Santarelli, Andrea; Campisi, G.; Lacaita, M. G.; Favia, G

Osteonecrosis of the jaw after adjuvant endocrine therapy plus alendronate in a breast cancer patient

Background. Bisphosphonates-associated osteonecrosis of the jaws (BRONJ) is a serious complication, which has been defined by Bedogni et al. (1) as an adverse drug reaction consisting of progressive destruction and death of bone that affects the mandible and/or maxilla of patients exposed to the treatment with nitrogen-containing bisphosphonates (NBPs) in absence of a previous radiation treatment. Generally, IV NBPs have a strong association with BRONJ than oral NBPs as evidenced by the higher incidence of BRONJ (0-10%) in patients treated with IV drugs than in patients in oral therapy (<1%). Objectives. The aim of this study was to report a clinical case of BRONJ in an oncologic patient who has been treated with anastrozole and oral NBPs for secondary osteoporosis. Case report. In February 2014 a 75-year-old woman was referred because of history of pain in the left posterior mandibular region and hypoesthesia/anesthesia of the homolateral inferior lip and chin. In the anamnesis, she had referred to be in therapy with alendronate since 2004, for a history of severe osteoporosis and, in multimodal chemotherapy and anastrazole since 2010 for a diagnosis of breast cancer. Furthermore, left lower molar extraction was performed on March 2013. Clinical examination revealed swelling of the extraoral soft tissue in the left emimandible; intraorally, the presence of a mucosal fistula on the left mandibular angle was identified. CT was performed and BRONJ diagnosis was defined with a stage 2A according to Bedogni et al. Conclusions. Administration of NBP is indicated to treat also osteoporosis anastrazole-induced in oncological patients, showing that patients with hormone receptor-positive early-stage breast cancer taking oral BP could represent a subset in which it would be useful to apply BRONJ prevention protocols

The management of dental practices in the post-covid 19 era: An economic and operational perspective

Background: In order to protect dental teams and their patients during the COVID-19 pandemic, dentists have had to adopt several measures (operating and post-operating procedures) which may increase the total treatment time and costs relating to individual protective measures. This paper will propose a thorough analysis of operating dentistry procedures, comparing the economic performance of the activity in a dental surgery before and after the adoption of these protective measures, which are required to contain the risk of SARS-COV-2 infections. Methods: The economic analysis is articulated in three approaches. Firstly, it assesses a reduction in markup by maintaining current charges (A); alternatively, it suggests revised charges to adopt in order to maintain unvaried levels of markup (B). And the third Approach (C) examines available dental treatments, highlighting how to profitably combine treatment volumes to reduce markup loss or a restricted increase in dental charges. Results: Maintaining dental charges could cause a loss in markup, even rising to 200% (A); attempting to maintain unvaried levels of markup will result in an increase in dental charges, even at 100% (B); and varying the volumes of the single dental treatments on offer (increasing those which current research indicates as the most profitable) could mitigate the economic impact of the measures to prevent the transmission of SARS-COV-2 (C). Conclusions: The authors of this paper provide managerial insights which can assist the dentist-entrepreneur to become aware of the boundaries of the economic consequences of governmental measures in containing the virus infection

Spontaneous bisphosphonate-related osteonecrosis of the left hemi-mandible: Similarities with phossy jaw.

Intravenous bisphosphonates (BP) play a key role in the treatment of bone metastases. As a long-term side effects BP, a form of avascular osteonecrosis of the jaw has been reported. Although, invasive oral local procedures are often present in clinical history of patients suffering from bisphosphonates-related osteonecrosis of the jaws (BRONJ), about up to 50% of BRONJ are spontaneous. We report a case of a 68-year-old female with a spontaneous wide bone sequestration of the left mandibular body onset after infusion of zoledronic acid for 18 cycles for osseous metastasis due to metastatic anaplastic thyroidal carcinoma. Surprisingly the clinical aspects of the patient initially reminded us of the famous pathology described in 1899 called phossy jaw. This case is remarkable not only for the spontaneity of the osteonecrosis, but, above all, for the clinical similarity with cases of phossy jaw, described for the first time in the literature, thereby suggesting a potential common pathogenesis

Optical coherence tomography as a simple and non invasive tool for the diagnosis of oral disease: a case report

Introduction. Optical Coherence Tomography (OCT) is a new biomedical imaging modality that provides high reso- lution cross-sectional images of tissue. Conceptually, it has been compared with ultrasound scanning but it uses in- frared light and records reflections below the surface to produce a cross-sectional architectural image of the tissue. OCT has been applied in ophthalmology and recently in dermatology; several studies have shown the validity of the use of OCT in ex vivo oral lesions but, to date, it does not exist a bank of normative and pathological OCT data of the oral tissues to consent identification of cellular structures of normal and pathological processes. We report a case of fibroma, analyzing in vivo OCT use and comparing data with microscopic evaluation. Case report. A 44-year-old woman was referred to the Department Surgical, Oncological and Oral Sciences, Univer- sity of Palermo, with a neoformation on the apex region of the tongue, clinically compatible with the diagnosis of fi- broma or papilloma. Firstly, in vivo OCT analysis demonstrated the presence of a white area, due to the presence of hyper-reflective area for collagen storage that is strongly scattering. After, exeresis was performed and histological examination confirmed the diagnosis of fibroma. Conclusion. Optical coherence tomographic imaging can produce detailed cross-sectional images of tissue of oral cavity and it could be a new non-invasive approach that will help improve the diagnosis and the follow up of oral le- sions. The validity of OCT in ex vivo oral lesions is confirmed in literature, while in vivo OCT validity should be sup- ported by comparation of data of several oral disease: further researches are needed

Oral lichen planus in children: an italian case series with literature review

Objectives. Oral lichen planus is a chronic mucous inflammatory disease. The prevalence in adults ranges between 0.5% and 2%, whereas children are involved just in 0.03% of cases. The purpose of this paper is to review the current literature and to present six Italian cases of Oral Lichen Planus in children (OLPc). Methods. We reported the data about a retrospective study on 6 cases of oral lichen planus in children. A detailed history was retrieved from clinical notes of each patient. Patients younger than 18 years old were enrolled in the study. All of them had the OLP diagnosis confirmed by clinical findings, history, and histopathology. Results. The family history for lichen planus was negative in all patients, the mean age was 11 years (range 6-14); there was no cutaneous involvement, whereas 2 patients had concomitant autoimmune diseases. Topical corticosteroids was the only treatment used in 66.67% of patients with good response in a mean time of 4.75 weeks. Conclusions. The rarity of OLPc may be due to the lack of symptoms that prevents the patient or his family from noticing the presence of the condition, but also to misdiagnosis of the dentist or the paediatrician. Thus, though LP in children is uncommon and oral mucosal involvement extremely rare, clinicians should be aware of its existence and management, and this diagnosis should be taken into account in children presenting oral white lesions

Paraneoplastic Acanthosis Nigricans Maligna

Acanthosis Nigricans Maligna (ANM) is a paraneoplastic syndrome, defined as a condition that arises in association with a malignancy elsewhere in the body but without malignant nature per se. It’s a rare dermatopathy that occurs in men and women over age 40, without racial predilection or known familial association. Clinically, ANM showed symmetric,hyperpigmented plaques with variable amounts of epidermal hypertrophy, ranging in color from yellow to brown or black, often with overlaid papillomas. The most common affected sites are body flexures and the posterior neck, but also mucosal surface involvement is frequent and may be the only clinical symptom present. Any mucosal surface can be involved, and as regards the oral cavity, disease affects the lips, tongue, palate, buccal and gingival mucosa.ANM is primarily associated with adenocarcinomas, mostly of gastric origin. Accordingly, the progression of the tumor will lead to a worsening of the ANM, while regress in case of tumour treatment, and resurface with recurrence and metastases. A 62-year-old man was referred for evaluation of papillomatous lesions of the oral mucosa, appeared in previous months. The patient was diagnosed a gastric adenocarcinoma at an advanced stage 6 months before. Clinical examination showed diffuse papillomatous or wart-like areas of normal mucosal color and soft consistency involving lips,oral mucosa and hard palate. The tongue and the vestibular mucosa were thickened and furrowed. The lesions are asymptomatic. A biopsy was performed, and histopathological analysis revealed acanthosis and papillomatosis, hyperkeratosis,and lymphohistiocytic infiltrate. The patient was clinically diagnosed with ANM, according to clinical and histologic findings, and the patient’s medical history. Isotretinoin 0,05% was prescribed for local therapy. The patient did not return to follow-up due to complications of gastric adenocarcinoma, and died 6 months late