T-helper cell type 17/regulatory T-cell immunoregulatory balance in human radicular cysts and periapical granulomas.

Abstract

INTRODUCTION:

Cysts and granulomas are chronic periapical lesions mediated by a set of inflammatory mediators that develop to contain a periapical infection. This study analyzed the nature of the inflammatory infiltrate, presence of mast cells, and in situ expression of cytokines (interleukin [IL]-17 and transforming growth factor [TGF]-beta), chemokines (macrophage inflammatory protein [MIP]-1beta and monocyte chemotactic protein [MCP]-1), and nuclear transcription factor (FoxP3) in human periapical granulomas and cysts compared with a control group.

METHODS:

Fifty-five lesions (25 periapical cysts, 25 periapical granulomas, and 5 controls) were analyzed. The type of inflammatory infiltrate was evaluated by hematoxylin-eosin staining, and the presence of mast cells was analyzed by toluidine blue staining. Indirect immunohistochemistry was used to evaluate the expression of cytokines, chemokines, and FoxP3.

RESULTS:

The inflammatory infiltrate mainly consisted of mononuclear cells. In cysts, mononuclear infiltrates were significantly more frequent than mixed (polymorphonuclear/mononuclear) infiltrates (P = .04). Mixed inflammatory infiltrates were significantly more frequent in patients with sinus tract (P = .0001). The number of mast cells was significantly higher in granulomas than in cystic lesions (P = .02). A significant difference in the expression of IL-17 (P = .001) and TGF-beta (P = .003) was observed between cysts and granulomas and the control group. Significantly higher IL-17 levels were also observed in cases of patients with sinus tract (P = .03).

CONCLUSIONS:

We observed that chronic periapical lesions might experience a reagudization process that is correlated with an increased leukocyte infiltration, with the predominance of neutrophils attracted by a chemokine milieu, as well as the increased presence of IL-17.

• Authors: Juliana R B Marçal, Renata O Samuel, Danielle Fernandes, Marcelo S de Araujo, Marcelo H Napimoga, Sanivia A L Pereira, Juliana T Clemente-Napimoga, Polyanna M Alves, Rinaldo Mattar, Virmondes Rodrigues Jr, Denise B R Rodrigues
• Journal: Journal of endodontics (J Endod) Vol. 36 Issue 6 Pg. 995-9 (Jun 2010) ISSN: 1878-3554 [Electronic] United States
• PMID: 20478453 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Chemical References

• CCL2 protein, human
• Chemokine CCL2
• Chemokine CCL4
• FOXP3 protein, human
• Forkhead Transcription Factors
• Interleukin-17
• Transforming Growth Factor beta

Topics

• Adult
• Cell Count
• Chemokine CCL2 (analysis)
• Chemokine CCL4 (analysis)
• Chemotaxis, Leukocyte (immunology)
• Female
• Forkhead Transcription Factors (analysis)
• Humans
• Interleukin-17 (analysis)
• Leukocyte Count
• Leukocytes, Mononuclear (immunology, pathology)
• Male
• Mast Cells (immunology, pathology)
• Neutrophil Infiltration (immunology)
• Neutrophils (immunology, pathology)
• Oral Fistula (immunology, pathology)
• Periapical Granuloma (immunology, pathology)
• Radicular Cyst (immunology, pathology)
• T-Lymphocyte Subsets (immunology)
• T-Lymphocytes, Helper-Inducer (immunology)
• T-Lymphocytes, Regulatory (immunology)
• Transforming Growth Factor beta (analysis)