RESUMO
OBJECTIVE: The aim was to investigate a possible association between the immunoexpression of interleukin (IL)-4 and clinicopathological parameters with the periodontal breakdown observed in gingival pyogenic granuloma (PG). MATERIALS AND METHODS: Paraffin-embedded samples of gingival PG (n = 46) were prepared for histological and immunohistochemical assessment. Demographic and clinical parameters were assessed by criteria based on age stratum, gender, smoking habit, evolution course, location, lesion size, macroscopic appearance, predisposing factors, recurrence, and periodontal breakdown. Histological assessment included the appearance of epithelial lining, microvessel density, inflammatory infiltrate density, interstitial fibrosis, and histological arrangement. A staining intensity distribution (SID) score was used to assess IL-4 immunoreactivity. The association between candidate predictor variables and periodontal breakdown was analyzed individually and adjusted for confounding using a bivariate binary logistic regression model. RESULTS: Mean IL-4 SID values were significantly increased for long-standing and large lesions, presence of periodontal breakdown, high microvessel density, and moderate-to-severe inflammatory infiltrate density. While bivariate and univariate analyses revealed a positive association of the evolution course ≥12 months, lesion size >1 cm, high microvessel density, moderate-to-severe inflammatory infiltrate density, and IL-4 SID score ≥8.04 with periodontal breakdown, after bivariate logistic regression analysis, only the evolution course ≥12 months, moderate-to-severe inflammatory infiltrate density, and IL-4 SID score ≥8.04 remained as robust predictors of periodontal damage. Confounding and interaction effects between candidate predictor variables were also noted. CONCLUSION: These findings suggest that while evolution course, inflammatory infiltrate density, and the overexpression of IL-4 may act as predictors of periodontal breakdown in gingival PG, there are mutual confounding and synergistic biological interactive effects with respect to the lesion size and microvessel density in the susceptible host that may be also associated with the bone resorption and tissue destruction. CLINICAL RELEVANCE: Although the first-line therapy of gingival PG continues to be the surgical excision, this approach poses unwanted complications such as severe mucogingival defects and recurrence. Hence, early diagnosis and detection of these three significant predictor variables as well as timely surgical excision might help prevent the periodontal tissue destruction observed in some of these lesions.
Assuntos
Granuloma Piogênico/imunologia , Granuloma Piogênico/metabolismo , Interleucina-4/metabolismo , Periodontite/imunologia , Periodontite/metabolismo , Adolescente , Adulto , Idoso , Criança , Feminino , Granuloma Piogênico/patologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Periodontite/patologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVE: The aim was to investigate the relationship between patient clinical background, histological features, and immunoexpression of COX-2 and IL-10 in oral pyogenic granuloma (PG). DESIGN: Paraffin-embedded samples of oral PG (n=57) were prepared for histological and immunohistochemical assessment. Based on the histological features, the samples were categorised into lobular capillary hemangioma (LCH) and non-LCH subtypes. The epithelial lining, angiogenic index, inflammatory infiltrate density, and interstitial fibrosis, were assessed in haematoxylin-eosin stained sections. In addition, the marker expression estimation (stained cells/total cell number) was used to assess immunoreactivity for each sample. RESULTS: Although there were no significant differences between histological subtypes regarding demographic and clinical parameters, mean values of microvessel count and inflammatory infiltrate density were significantly greater in the non-LCH PG subtype. Also, whilst cellular immunolocalisation patterns of COX-2 and IL-10 were similar, mean values of expression estimation of each immunomarker were significantly higher in non-LCH PGs in comparison with LCH subtypes. Furthermore, significant variations for immunohistochemical parameters were evident regarding to angiogenic index and inflammatory infiltrate density, but not concerning demographic and clinical data. Finally, linear regression analysis showed a significant positive correlation between the expression estimation of the two immunomarkers. CONCLUSION: These findings suggest a role for COX-2 and IL-10 in the etiopathogenesis of oral PG and indicate that LCH and non-LCH histological subtypes represent different stages in the evolution of a single lesion with varying degrees of proliferative, angiogenic, and inflammatory activity.
Assuntos
Ciclo-Oxigenase 2/metabolismo , Granuloma Piogênico/metabolismo , Interleucina-10/metabolismo , Adulto , Análise de Variância , Biomarcadores/metabolismo , Biópsia , Distribuição de Qui-Quadrado , Ciclo-Oxigenase 2/imunologia , Feminino , Granuloma Piogênico/imunologia , Humanos , Imuno-Histoquímica , Interleucina-10/imunologia , Modelos Lineares , Masculino , Distribuição Aleatória , Reprodutibilidade dos Testes , Coloração e Rotulagem , Estatísticas não ParamétricasRESUMO
The objective of this study was to assess angiogenic activity by analyzing anti-CD105 and anti-CD34 immunostaining in 20 cases of vascular malformations (VMs) and 20 cases of oral pyogenic granulomas (OPG). In addition, the usefulness of these markers for the differential diagnosis of these two oral tumors was evaluated. The results showed no significant difference in mean microvessel count between the anti-CD105 (P = 0.803) and anti-CD34 (P = 0.279) antibody. The mean number of vessels was 18.75 and 59.72 for oral VMs immunostained with anti-CD105 and anti-CD34 antibody, respectively, whereas in OPG the mean number was 20.22 and 48.09, respectively. CD34 was found to be more effective than CD105 in identifying blood vessels. However, the anti-CD105 antibody seems to be more related to vascular neoformation. Overall, this study supports the role of angiogenic factors in the etiopathogenesis of oral VMs and PG, but the results showed that quantification of angiogenesis cannot be used as a marker for the differential diagnosis of these two types of lesions.