Ultrastructural aspects of two different mast cell populations in human healthy gingival tissue

The results of our recent microscopy studies clearly have demonstrated the constant presence of numerous metachromatic cells in healthy human gingival connective tissue. Despite the great number of studies on mast cell population in many human organs (lung, skin, uterus, and bowel), at the present time few are the studies regarding the morphostructural aspects of mast cells in the human gingiva. The aim of this study was to assess by transmission electron microscopy the presence of mast cells in the healthy human gingiva and to characterize the ultrastructural aspects of mast cells populations. 30 specimens of human gingival tissue were collected from 30 patients with informed consent. The samples were prepared for T.E.M. examination. In all the ultrathin sections observed we detected numerous and ubiquitarious mast cells. These exhibited several morphological types of cytoplasmic granules with characteristic subgranular architectural variety in shape and density. This allowed us to divide mast cells into two groups: cells with granules consisted of compact coiled scrolls, fine granular material and lattice - grating configuration, and cells containing granules with discrete scrolls formed by more concentric lamellae and particulate structure. The two ultrastructural aspects observed correspond to McTC and McT of the international literature. Therefore in the human gingival connective tissue, like in other organs, two types of mast cells are clearly present. Surprisingly, the human gingival tissue shows, like the lung, McT as the prevailing subpopulation, in contrast to the skin, uterus and gastrointestinal submucosa where McTC prevail. Dans le cadre d’une étude sur la population cellulaire du tissu conjonctif gingival humain nous avons constaté, en microscopie optique, la présence constante de nombreuses cellules metachromatiques. Pour définir la nature de telles cellules et pour en déterminer les aspects ultra-structuraux, nous avons étudié au microscope électronique à transmission 30 biopsies du tissu gingival humain, cliniquement sain. Dans tous les échantillons examinés nous avons observé de nombreux mastocytes dont le contenu granulaire nous est apparu caractérisé par un aspect « à particules » et « en rouleaux » ou bien, dans d’autres éléments cellulaires, par un aspect «en grillage». Les deux aspects ultrastructuraux décrits nous permettent de distinguer les mastocytes gingivaux en deux sous-populations, différentes comme l’ont confirmé plusieurs auteurs, selon la localisation anatomique, selon la structure intérieure et le contenu enzymatique des granules, et, enfin, selon la réaction à des substances sécrétagogues

Determinants of Risk Infection During Therapy with Anti TNF-Alpha Blocking Agents in Rheumatoid Arthritis

The use of TNF-alpha antagonists (infliximab, etanercept, adalimumab) has changed the course of many rheumatic diseases including rheumatoid arthritis (RA). Since their approval, some questions regarding their safety including infections have been observed. The aim of the study was to evaluate the changes in cytokines levels and cells subsets in patients with RA during anti TNF blocking agents treatment and the possible effect on infections’ development. We evaluated in 89 RA patients [39 treated with etanercept (ETN), 29 with adalimumab (ADA) and 21 with infliximab (IFN)] at baseline and after 6 months the following parameters: procalcitonin, ESR, CRP, cytokines as TNF, IL-6, IL-10, IL-8 and the TNF/IL-10 ratio, and peripheral mononuclear cells as CD3+, CD3+/CD4+, CD3+/CD8+, CD19+, CD3- /CD16+/56+, CD14+HLADR+, CD20+, CD19+/CD38+. Peripheral mononuclear cells were detected by flow cytometric system Cytomics FC500 and cytokines circulating levels by a quantitative sandwich enzyme immunoassay technique (Human IL-8 Instant ELISAe Bioscience, Human IL-6 Instant ELISA e Bioscience, Human IL-10 Instant ELISAe Bioscience and Human TNF-a Quantikine immunoassay RD system). A lower reduction of CD14+HLADR+ in ADA group 54.6±10.4% vs ETA 48.4±15.7% vs INF 40.7±16.5%, p<0.039 was found. No differences in all three groups on peripheral mononuclear cells CD3+, CD3+/CD4+, CD3+/CD8+, CD19+, CD 20+, CD19+/CD38+, CD3-/CD16+/56+, and cytokine circulating levels were found. The number of infections at 6 months was: 10.3% in ADA group, 12.8% in ETN group and 19.04% in IFN group. A correlation was found between the reduction in CD14+HLADR+ cells and IFN treatment. Our data showed that the level of CD14+HLADR+ cells was reduced during therapy with IFN. ADA and ETN don’t reduce lymphocyte populations and their subsets such as CD14+HLADR+ cells that play an important role host defence

Three-dimensional morphological condylar and mandibular changes in a patient with juvenile idiopathic arthritis: Interdisciplinary treatment

Temporomandibular joint (TMJ) involvement is common but usually delayed in patients with juvenile idiopathic arthritis (JIA). We describe the case of a JIA patient with bilateral TMJ involvement, mandibular retrognathia, bone erosion, and severely restricted mouth opening. The use of cone beam computed tomography and a 3D diagnostic protocol in young patients with JIA provides reliable, accurate and precise quantitative data and images of the condylar structures and their dimensional relationships. Analgesics and conventional disease modifying antirheumatic drugs were ineffective, but interdisciplinary treatment with etanercept and a Herbst functional appliance improved functional TMJ movement and bone resorption

Pain in systemic sclerosis

Chronic pain is a healthcare problem that significantly affects the mental health, and the professional and private life of patients. It can complicate many disorders and represents a common symptom of rheumatologic diseases, but the data on its prevalence is still limited. Pain is a ubiquitous problem in systemic sclerosis (SSc). SSc-related pain has been studied on the basis of biomedical models and is considered a symptom caused by the disease activity or previous tissue damage. Effective pain management is a primary goal of the treatment strategy, although this symptom in SSc has not yet been investigated in detail. However, these patients do not all respond adequately to pharmacological pain therapies, therefore in these cases a multimodal approach needs to be adopted