Aspetti eziopatogenetici, clinico - diagnostici e terapeutici della sindrome della bocca bruciante: protocolli di ricerca e cura su un gruppo di pazienti.

BACKGROUND: Burning mouth syndrome (BMS) is a frequently seen pathology characterised by burning tongue and oral pain without macroscopic structural lesions to the mucose. BMS etiopathology isn't known and therapy is merely empirical and unsatisfactory. METHODS: To evaluate the hypothesis that this syndrome would originate by a small diameter peripheral neuropathy combined to a mucosal trophic lesion, 37 patients, (7 male, 30 female, between 36 and 79 years, mean 54 years) affected by BMS, consecutively observed in our dispensary were submitted to a series of examinations and to therapeutical approach used in neuropathic painful syndromes. All patients were submitted to a complete stomatological exam and X-ray pantomography to exclude mucosal macroscopical lesions and dentistry illnesses. All patients executed sierological exams (glycemia, etc.), neurological exam, tongue and foot dorsum quantitative sensory examination, tongue and face telethermography. A few patients (3 male, 10 female; age 34 to 53, mean 49) were submitted to mucosal tongue biopsy, analyzed by optic microscopy and immunofluorescency following treatment with anticytoplasmatic neuronal proteins antibodies (protein gene product 9.5). RESULTS: These examinations showed subclinical polyneuropathy in 50% of patients. In particular, a loss of function in small diameter nervous fibres in about 50% of patients was observed. Histological examination of tongue mucose revealed a moderate atrophy in 70% patients. CONCLUSIONS: All patients were submitted to an antalgic therapy, with non-antiflammatory drugs used in neuropathic painful syndromes (quercetine, antiepileptic drugs benzodyazepinein and gabaergic, topical application of capsaicine solutions)

Candidosi delle mucose oro-faringee. Aspetti clinici ed epidemiologici in un gruppo di pazienti HIV positivi e con AIDS.

Immune system deficiencies, particularly cell-mediated immunity are the main events of HIV infection. The resulting syndrome is removies: AIDS. This immune deficiency encourages neoplasms such as the Kaposi sarcoma and non Hodgkin lymphoma, above all, it explains the reason why infections supported by opportunist germs, normally not pathogenic for immuno-competent people, are the main reason for morbidity and mortality in this kind of patients. Since among mycotic infections, the main one in these patients is candidiasis, particularly oro-pharyngeal candidiasis, we have carried out a research with the aim of evaluating the main mucosae oris pathologies in HIV and AIDS patients and, among them, the most directly correlated to HIV infection with reference to oro-pharyngeal candidiasis. We have based our research on the analysis of 237 patients case-histories. From January 1993 to December 1994 these patients have been examined at the Odontological Surgery by the "Centro San Luigi" for HIV-correlated pathologies researches and treatments (Istituto Scientifico Ospedale San Raffaele-Milano

Protective Efficacy in Sheep of Adenovirus-Vectored Vaccines against Bluetongue Virus Is Associated with Specific T Cell Responses.

Bluetongue virus (BTV) is an economically important Orbivirus of the Reoviridae family that causes a hemorrhagic disease in ruminants. Its control has been achieved by inactivated-vaccines that have proven to protect against homologous BTV challenge although unable to induce long-term immunity. Therefore, a more efficient control strategy needs to be developed. Recombinant adenovirus vectors are lead vaccine candidates for protection of several diseases, mainly because of their potency to induce potent T cell immunity. Here we report the induction of humoral and T-cell mediated responses able to protect animals against BTV challenge by recombinant replication-defective human adenovirus serotype 5 (Ad5) expressing either VP7, VP2 or NS3 BTV proteins. First we used the IFNAR(-/-) mouse model system to establish a proof of principle, and afterwards we assayed the protective efficacy in sheep, the natural host of BTV. Mice were completely protected against BTV challenge, developing humoral and BTV-specific CD8+- and CD4+-T cell responses by vaccination with the different rAd5. Sheep vaccinated with Ad5-BTV-VP2 and Ad5-BTV-VP7 or only with Ad5-BTV-VP7 and challenged with BTV showed mild disease symptoms and reduced viremia. This partial protection was achieved in the absence of neutralizing antibodies but strong BTV-specific CD8+ T cell responses in those sheep vaccinated with Ad5-BTV-VP7. These data indicate that rAd5 is a suitable vaccine vector to induce T cell immunity during BTV vaccination and provide new data regarding the relevance of T cell responses in protection during BTV infection

Phenotypes of Candida spp. isolates in HIV-infected and AIDS patients.

The phenotypic strain variations among isolates of Candida spp. from single patients were studied. From the oral cavity of 5 asymptomatic and 5 AIDS patients with oral candidiasis 39 Candida spp. were collected. After the macroscopic and microscopic features of colonies were recorded, the following 6 examinations were performed: germ-tube test, auxanogram, morphotype, resistogram, adhesivity to human keratinocytes and susceptibility to 6 antifungal compounds. Replacement of C. albicans either with C. tropicalis or C. glabrata was found for 3 patients. A strain of C. albicans (case 1) differed from the others in all the tests studied MICs on isolates recovered from AIDS patients were higher, or grew over time, than MICs on those from asymptomatic subjects. No correlation was demonstrable between the antifungal susceptibility and the other parameters. Strain variations in the oral microflora of HIV-positive and AIDS patients really may occur