Born too young and likely to die : Should this continue?

Peer reviewe

Smoker's melanosis or early melanoma- misdiagnosis trap?

Objective: First used by Hedin in 1977, “smokers' melanosis” is currently recognized as a clinical diagnosis without recourse to biopsy. Current research findings however suggest the disturbing possibility of mistaking a “silent” oral malignant melanoma for a benign smokers' melanosis. The objective of the current review is to stimulate an evidence-based rethink.Method: This manuscript is based on a Pubmed search phrase “smokers' melanosis".Result: A total of 24 studies resulted of which 16 were analyzed and 8 non-oral melanomas were excluded. Reports ranged from claims of a  “protective” role of melanosis to cases of melanoma from pre-existing melanosis. Alcohol synergistic potentiation of intra-oral melanosis and a categorization of smokers' melanoma as a differential for intra-oral smokers' melanosis were also found.Conclusion: Since many cases of confirmed intra-oral malignant melanomas were preceded with a history of pre-existing “innocent” oral pigmented lesions, adopting a principle of universal biopsy is strongly suggested. This would change this age-long paradigm but would definitely save a few lives. Keywords: Smokers' melanosis, early malignant melanoma, misdiagnosi

Regulation of matrix metalloproteinases-8, -9 and endogenous tissue inhibitor-1 in oral biofluids during pregnancy and postpartum

PubMed: 335567882-s2.0-85100375687Objective: During pregnancy, mothers undergoe considerable physiological changes affecting the whole body including periodontal tissues. Susceptibility to gingival inflammation during pregnancy could be mediated by modulation of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). Therefore, the aim of this study was to investigate salivary and gingival crevicular fluid (GCF) levels of MMPs and TIMPs during the second and third trimester of pregnancy and postpartum. Design: Saliva and GCF samples were collected from 96 pregnant women (PW) before and after giving birth. The sixty matched non-pregnant women (N-PW) were recruited as a control group and full-mouth periodontal examination was performed. The levels of MMP-8, MMP-9 and TIMP-1 were determined by immunofluorometric and enzyme-linked immunosorbent assays. Results: The PW group exhibited significantly higher levels of MMP-8 and MMP-9 in their saliva than the N-PW group while corresponding salivary TIMP-1 levels were significantly lower in NPW compared to the postpartum stage. This resulted in significantly higher MMP-8/TIMP-1 and MMP-9/TIMP-1ratio in the saliva from PW before and after birth than in that from N-PW. MMP-8, MMP-9 and TIMP-1 levels were higher in GCF from PW and postpartum than in that from N-PW. Conclusions: MMP-8 and MMP-9 levels in saliva and GCF reflect inflammatory burden during pregnancy. They could be used for monitoring the inflammatory state of gingival tissues during pregnancy. © 20212292018, 2512017, TYH2512016, Y1149SUL32 Karolinska Institutet, KI: 10488415B2The research in our laboratories has been supported by grants from the Helsinki University Hospital Research Foundation (TYH2512016, 2512017, 2292018, Y1149SUL32), Apollonia Foundation, Scientific and Technological Research Council of Turkey (T?bitak Grant program 2219) and the strategic funds from Karolinska Institutet, Stockholm, Sweden. Prof Timo Sorsa is an inventor of US-patents 10488415B2 and Japan Patent 2016 -554676.The research in our laboratories has been supported by grants from the Helsinki University Hospital Research Foundation ( TYH2512016 , 2512017 , 2292018 , Y1149SUL32 ), Apollonia Foundation, Scientific and Technological Research Council of Turkey (Tübitak Grant program 2219 ) and the strategic funds from Karolinska Institutet, Stockholm, Sweden . Prof Timo Sorsa is an inventor of US-patents 10488415B2 and Japan Patent 2016 -554676