Antibiotic prophylaxis for skin toxicity induced by antiepidermal growth factor receptor agents: a systematic review and meta-analysis

Summary

Topical and systemic prophylactic measures, which are administered before the development of epidermal growth factor receptor (EGFR)-related acneiform rash, are appropriate interventions to mitigate the intensity of skin toxicity. We have performed a systematic review and meta-analysis to evaluate whether prophylactic antibiotics may reduce the occurrence and severity of anti-EGFR drug-related skin rashes. A systematic review was performed by searching Medline, Scopus, Embase, CINAHL, LILACS, Web of Science and the Cochrane Library from inception until March 2016 for publications regarding the pre-emptive role of antibiotics for EGFR-induced skin rashes. Fixed- or random-effects meta-analyses, according to heterogeneity, were used to summarize odds ratios of skin toxicity with antibiotic use. Of the 827 citations found in the search, 13 studies comprising 1073 patients were included in the analysis. In 12 studies, patients in the prophylactic antibiotic arms had a lower risk of developing a skin rash (odds ratio 0·53, 95% confidence interval 0·39–0·72, P < 0·01) than patients without antibiotic prophylaxis. In particular, moderate-to-severe toxicities (grades 2–4) were reduced by nearly two-thirds (odds ratio 0·36, 95% confidence interval 0·22–0·60, P < 0·01) in 13 studies. This translated to a 26% absolute difference of high-grade skin rash compared with the control arms (from 50% to 24%). The results of this meta-analysis show that the risk of skin rash after treatment with anti-EGFR agents for solid tumours was significantly lower in patients taking prophylaxis with antibiotics than in those who were not. Therefore, taking pre-emptive tetracyclines for several weeks at the start of anti-EGFR treatment can significantly reduce the incidence and severity of cutaneous acneiform rash.

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Chronic, intractable nodules after filler injection successfully treated with a bipolar radiofrequency device

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Superficial malignant peripheral nerve sheath tumor with overlying intradermal melanocytic nevus mimicking spindle cell melanoma

ABSTRACT

Malignant peripheral nerve sheath tumors are rare soft tissue sarcomas with histological and immunohistochemical similarities to spindle cell melanoma. Although spindle cell melanoma is significantly more common, both tumors may express S100 and lack staining for HMB-45, Melan-A, or MITF. Here we present a case of superficial malignant peripheral nerve sheath tumor with diffuse S100 positivity arising in a subtle neurofibroma in close proximity to an intradermal melanocytic nevus. This configuration had led to prior misdiagnosis as a desmoplastic melanoma arising in the nevus and to sentinel lymph node biopsy. Identification of the background neurofibroma, as well as CD34 positivity raised consideration of a low grade malignant peripheral nerve sheath tumor, which was confirmed via observation of Schwannian differentiation on electron microscopy. The importance of distinguishing these two tumors is stressed owing to the difference in management.

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Chemotherapy Reaction Induced by Ixabepilone, a Microtubule Stabilizing Agent, Mimicking Extramammary Paget's Disease in a Patient with Breast Carcinoma

Abstract

The histopathologic characteristics of reactions caused by the many novel anticancer agents are under-recognized. We report a case of a 67-year-old female with locally advanced metastatic breast cancer, who initially presented with an extensive reticulated erythematous patch on the trunk caused by intravascular metastases confirmed by a skin biopsy. Due to disease progression, she was started on ixabepilone, a mitotic inhibitor. While receiving ixabepilone, another skin biopsy was obtained and initially interpreted as extramammary Paget's disease. However, the biopsy showed metaphase arrest of numerous keratinocytes in the basilar and suprabasilar epidermis. Atypical epithelial cells were only present in the intravascular spaces similar to the initial biopsy. Given the temporal association between the initiation of ixabepilone therapy and the epidermal mitotic arrest, a diagnosis of chemotherapy reaction to ixabepilone was rendered. Ixabepilone is an analog of epothilone, a microtubule stabilizer causing mitotic arrest of the cell cycle approved for the treatment of metastatic and locally advanced treatment-resistant breast cancer. The demonstration of epidermal mitotic arrest caused by ixabepilone is without precedent. The case emphasizes the importance of considering a chemotherapy reaction in the histologic differential diagnosis of epidermal mitotic arrest in a cancer patient receiving chemotherapy.

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Concomitant and discrete expressions of aldose reductase and sorbitol dehydrogenase in the male reproductive tract

Publication date: Available online 29 September 2016
Source:Acta Histochemica
Author(s): Muktanand Tripathi, Akhand Pratap Singh, Gopal Gupta, Singh Rajender
This study aimed at investigating the expression and localization of the polyol pathway enzymes; aldose reductase (AR) and sorbitol dehydrogenase (SDH), in the male reproductive tract of rat. Gene expression analysis showed maximum expression of AR and SDH in the coagulating glands. Western blot analysis showed a coordinated presence of the two enzymes in the coagulating glands, seminal vesicle and epididymis. Immunohistochemistry showed a concordant expression of the two enzymes in the coagulating gland, which goes well with its function of fructose production in rats. A less concordant expression of the two enzymes in the seminal vesicle was also seen. Discrete expression of AR was seen in the Sertoli cells without SDH. Germ cells including sperm in the seminiferous tubules lacked AR, but SDH was present in all stages of developing germ cells including sperm present in the seminiferous tubules. The epithelial layer of epididymis showed the presence of AR, but it was negligible in vas deferens and prostate. SDH was not seen in the epithelial layer of epididymis, vas deferens or prostate. Though sperm in the seminiferous tubules lacked AR, sperm extracted from cauda showed the presence of both AR and SDH. Immunofluorescence localization of AR and SDH on sperm showed the presence of both the enzymes all over sperm. Discrete expression of AR in the Sertoli cells may be linked to detoxification of a number of metabolism by-products. Similarly, the presence of polyol enzymes on sperm in epididymis and beyond may be to tackle toxic metabolites they may encounter during their journey along the male or female reproductive tract.



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Effect of core ceramic grinding on fracture behaviour of bilayered zirconia veneering ceramic systems under two loading schemes

Publication date: Available online 29 September 2016
Source:Dental Materials
Author(s): Yu-tao Jian, Tian-yu Tang, Michael V. Swain, Xiao-dong Wang, Ke Zhao
ObjectiveThe aim of this in vitro study was to evaluate the effect of core ceramic grinding on the fracture behaviour of bilayered zirconia under two loading schemes.MethodsInterfacial surfaces of sandblasted zirconia disks (A) were ground with 80 (B), 120 (C) and 220 (D) grit diamond discs, respectively. Surface roughness and topographic analysis were performed using a confocal scanning laser microscope (CSLM) and a scanning electron microscopy (SEM). Relative monoclinic content was evaluated using X-ray diffraction analysis (XRD) then reevaluated after simulated veneer firing. Biaxial fracture strength (σ) and Weibull modulus (m) were calculated either with core in compression (subgroup Ac-Dc) or in tension (subgroup At-Dt). Facture surfaces were examined by SEM and energy dispersive X-ray spectroscopy (EDS). Maximum tensile stress at fracture was estimated by finite element analysis. Statistical data analysis was performed using Kruskal–Wallis and one-way ANOVA at a significance level of 0.05.ResultsAs grit size of the diamond disc increased, zirconia surface roughness decreased (p<0.001). Thermal veneering treatment reversed the transformation of monoclinic phase observed after initial grinding. No difference in initial (p=0.519 for subgroups Ac-Dc) and final fracture strength (p=0.699 for subgroups Ac-Dc; p=0.328 for subgroups At-Dt) was found among the four groups for both loading schemes. While coarse grinding slightly increased final fracture strength reliability (m) for subgroups Ac-Dc. Two different modes of fracture were observed according to which material was on the bottom surface. Components of the liner porcelain remained on the zirconia surface after fracture for all groups.SignificanceTechnician grinding changed surface topography of zirconia ceramic material, but was not detrimental to the bilayered system strength after veneer application. Coarse grinding slightly improved the fracture strength reliability of the bilayered system tested with core in compression. It is recommended that veneering porcelain be applied directly after routine lab grinding of zirconia ceramic, and its application on rough zirconia cores may be preferred to enhance bond strength.



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Is the hypothalamic–pituitary–adrenal axis disrupted in type 2 diabetes mellitus?

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Folliculitis in prurigo pigmentosa: a proposed pathogenesis based on clinical and pathological observation

ABSTRACT

Background

Prurigo pigmentosa is a rare inflammatory dermatosis whose exact etiology is not understood yet. The purpose of this study was to provide evidence of hair follicle involvement in the pathogenesis by analyzing its clinicopathologic features.

Methods

Patients who fulfilled both the clinical and histological diagnostic criteria of prurigo pigmentosa were recruited. Their histopathologic findings, clinical features, and medical histories were analyzed.

Results

Thirty-two confirmed patients were enrolled from 2002 to 2013. Their ages ranged from 11–79 years with a female predominance. Patient lesions were primarily reddish-brown and located on the back. Twenty-five patients (78%) had pathological involvement of hair follicles, either bacterial colonies in the hair follicles (21/32, 66%), folliculitis (8/32, 25%), or perifolliculitis (15/32, 47%). There was a significantly higher proportion of patients with hair follicle involvement compared to control groups with either non-inflammatory (5/43, 12%, p < 0.001) or inflammatory skin diseases (12/32, 38%, p = 0.002) on the back. Minocycline was an effective antibiotic treatment either singly or in combination with steroids.

Conclusions

The frequent presence of bacterial colonies along with sequelae of inflammatory changes on biopsy provides new evidence to support the theory that prurigo pigmentosa is a reactive inflammation associated with bacterial folliculitis.

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MYC amplification in angiosarcomas arising in the setting of chronic lymphedema of morbid obesity

Abstract

Background

Angiosarcoma is a malignancy of vascular endothelial cells which may arise secondarily as a complication of lymphedema, including chronic lymphedema of morbid obesity. Amplifications in MYC are frequently present in secondary angiosarcoma (arising in irradiated sites and chronic lymphedema) and less frequently in primary cutaneous angiosarcoma.

Objective

To describe the presence of MYC amplifications in two cases of cutaneous angiosarcoma secondary to chronic lymphedema of morbid obesity.

Methods

This study is a case series of two patients with cutaneous angiosarcoma. Clinical data was retrieved from the medical records. Histopathological analysis of the biopsy specimens was performed, including immunohistochemistry, along with fluorescence in situ hybridization.

Results

Angiosarcoma arose in the setting of massive chronic lymphedema complicating morbid obesity without other predisposing risk factors. Both cases exhibited epithelioid cell morphology and high-level MYC amplification.

Conclusion

We report MYC amplification in two cases of angiosarcoma arising in massive chronic lymphedema of morbid obesity.

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THE UTILIZATION OF SPITZ-RELATED NOMENCLATURE IN THE HISTOLOGICAL INTERPRETATION OF CUTANEOUS MELANOCYTIC LESIONS BY PRACTICING PATHOLOGISTS

ABSTRACT

Background

Spitz nevi, atypical Spitz tumors and spitzoid melanomas ("spitzoid lesions") represent controversial and poorly understood cutaneous melanocytic lesions that are difficult to diagnose histologically. It is unknown how these terms are used by pathologists.

Methods

We describe use of Spitz-related terminology using data from the Melanoma Pathology (M-Path) study database comprising pathologists' interpretations of biopsy slides, a nation-wide study evaluating practicing U.S. pathologists' (N = 187) diagnoses of melanocytic lesions (8,976 independent diagnostic assessments on 240 total test cases, with one slide per case).

Results

Most pathologists (90%) used the Spitz-related terminology. However, significant variation exists in which specific lesions were diagnosed as spitzoid and in the corresponding treatment recommendations. Recommendations ranged from 'no further treatment' to 'wide excision of 10 mm or greater' with no category capturing more than 50% of responses. For spitzoid melanoma diagnoses, 90% of pathologists recommended excision with ≥10 mm margin. Pathologists report less confidence in diagnosing these lesions compared with other melanocytic proliferations and are more likely to request second opinions and additional clinical information (all p < 0.05).

Conclusions

Spitzoid lesions are often not classified in any standardized way, evoke uncertainty in diagnosis by pathologists, and elicit variability in treatment recommendations.

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Cutaneous Nodular Fasciitis with Genetic Analysis: A Case Series

Abstract

Nodular fasciitis is a benign self-limited myofibroblastic neoplasm, which usually involves the upper extremities and trunk of young patients. These tumors have been shown to harbor a translocation involving the MYH9 and USP6 genes, leading to overexpression of the latter. We report seven cases of nodular fasciitis with cutaneous presentations. All cases involved the dermis, with six involving the superficial subcutis, and one auricular tumor extending into cartilage. All cases showed USP6 rearrangement by fluorescence in situ hybridization; in two of three cases, the characteristic MYH9-USP6 fusion was demonstrated by RT-PCR. All patients underwent conservative resection. Nodular fasciitis is an uncommon mesenchymal neoplasm that can occasionally present in superficial locations and is sometimes mistaken for a malignant process. Molecular testing can be useful to distinguish this entity from other cutaneous spindle cell tumors.

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Scholar : Aphasiology, Volume 30, Issue 12, December 2016 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Aphasiology, Volume 30, Issue 12, December 2016 is now available online on Taylor & Francis Online. This new issue contains the following articles: Original Articles The language of the cerebellum Kim van Dun, Mario Manto & Peter Mariën Pages: 1378-1398 | DOI: 10.1080/02687038.2015.1132297 Theory of mind impairment after right-hemisphere damage Noga Balaban, Naama Friedmann & Margalit Ziv Pages: 1399-1423 | DOI: 10.1080/02687038.2015.1137275 The effect of theory of mind impairment on language: Referring after right-hemisphere damage Noga Balaban, Naama Friedmann & Mira Ariel Pages: 1424-1460 | DOI: 10.1080/02687038.2015.1137274 Incorporating principles of the collaborative contextualised intervention approach with the empirical study of learning and communication in traumatic brain injury Rupa Gupta Gordon & Melissa C. Duff Pages: 1461-1482 | DOI: 10.1080/02687038.2015.1136050 Auditory-verbal analysis in aphasia Laurence Schneider, Lucas Spierer, Philippe Maeder, Jocelyne Buttet Sovilla & Stephanie Clarke Pages: 1483-1511 | DOI: 10.1080/02687038.2016.1140119 Miscellaneous Editorial Board Pages: ebi-ebi | DOI: 10.1080/02687038.2016.1243298 Routledge Pioneers of Psychoanalysis Free Access Article Collection - Click here: http://ift.tt/2cwV9Xh This message is personalised to your status as a society member. Please do not forward this email. To recommend content, please use the social sharing tools on the website. To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

The effects of konjac oligosaccharide on TNBS-induced colitis in rats

Publication date: November 2016
Source:International Immunopharmacology, Volume 40
Author(s): Ruixue Liu, Yongchao Li, Bo Zhang
The purpose of the study was to assess the effects and the protective mechanism of konjac oligosaccharide (KOS) on the ulcerative colitis (UC) model induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS) in rats. KOS (1.0 and 4.0g/kg/day) was administered for 14days after the induction of colitis with TNBS. The status of the rats was assessed by morphological and biochemical methods. The effect of KOS on the colonic microflora was also assessed by studying the bacteria profile and short chain fatty acids (SCFAs) production in feces by standard culture techniques and gas chromatography, respectively. KOS administration improved rat weight, colonic length, damage score, structure of gut microbiota, production of SCFA, and reduced colon tissue levels of malondialdehyde (MDA), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β). Therefore, our results indicate that KOS is an anti-inflammatory and could be useful as a prebiotic to design functional foods for UC.



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Anticancer effect of SZC015 on lung cancer cells through ROS-dependent apoptosis and autophagy induction mechanisms in vitro

Publication date: November 2016
Source:International Immunopharmacology, Volume 40
Author(s): Bin Sun, Lei Gao, Anil Ahsan, Peng Chu, Yanlin Song, Hailong Li, Zonghui Zhang, Yuan Lin, Jinyong Peng, Zhicheng Song, Shisheng Wang, Zeyao Tang
Oleanolic acid (OA) and its several derivatives possess various pharmacological activities, such as antitumor and anti-inflammation. In present study, anticancer effect of SZC015, an OA derivative, and its underlying mechanisms were investigated. We demonstrated that cell viability was significantly decreased in SZC015-treated lung cancer cells, but has less cytotoxicity in human bronchial epithelial cell line. Further investigation verified that apoptosis and autophagy induction and G0/G1 phase arrest were observed in SZC015-treated H322 cells. Mechanically, the level of Akt, p-Akt, p-IκBα, and total p65, the p-p65 in the cytoplasm and nucleus were suppressed by SZC015 in H322 cells, respectively. Inhibition of p65 nuclear translocation was also confirmed by immunofluorescence staining. In addition, co-treatment with chloroquine, an autophagy inhibitor, significantly inhibited SZC015-induced autophagy and enhanced SZC015-induced apoptotic cell death. Intracellular ROS was increased in a concentration-dependent manner, which could be prevented by N-Acetyl l-Cysteine, an ROS scavenger. Moreover, the level of Akt and procaspase-3 were increased, while the ratio of LC3 II/I was decreased. Taken together, our study demonstrates that the inhibitory effect of SZC015 against H322 cells is mediated by excessive ROS generation that could suppress Akt/NF-κB signaling pathway, which thereby leads to apoptotic and autophagic cell death.

Graphical abstract

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Targeting mast cells: Uncovering prolific therapeutic role in myriad diseases

Publication date: November 2016
Source:International Immunopharmacology, Volume 40
Author(s): Jatinder Singh, Ramanpreet Shah, Dhandeep Singh
The mast cells are integral part of immune system and they have pleiotropic physiological functions in our body. Any type of abnormal stimuli causes the mast cells receptors to spur the otherwise innocuous mast cells to degranulate and release inflammatory mediators like histamine, cytokines, chemokines and prostaglandins. These mediators are involved in various diseases like allergy, asthma, mastocytosis, cardiovascular disorders, etc. Herein, we describe the receptors involved in degranulation of mast cells and are broadly divided into four categories: G-protein coupled receptors, ligand gated ion channels, immunoreceptors and pattern recognition receptors. Although, activation of pattern recognition receptors do not cause mast cell degranulation, but result in cytokines production. Degranulation itself is a complex process involving cascade of events like membrane fusion events and various proteins like VAMP, Syntaxins, DOCK5, SNAP-23, MARCKS. Furthermore, we described these mast cell receptors antagonists or agonists useful in treatment of myriad diseases. Like, omalizumab anti-IgE antibody is highly effective in asthma, allergic disorders treatment and recently mechanistic insight of IgE uncovered; matrix mettaloprotease inhibitor marimistat is under phase III trial for inflammation, muscular dystrophy diseases; ZPL-389 (H4 receptor antagonist) is in Phase 2a Clinical Trial for atopic dermatitis and psoriasis; JNJ3851868 an oral H4 receptor antagonist is in phase II clinical development for asthma, rheumatoid arthritis. Therefore, research is still in inchoate stage to uncover mast cell biology, mast cell receptors, their therapeutic role in myriad diseases.



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LOX-1 and TLR4 affect each other and regulate the generation of ROS in A. fumigatus keratitis

Publication date: November 2016
Source:International Immunopharmacology, Volume 40
Author(s): Xinran Gao, Guiqiu Zhao, Cui Li, Jing Lin, Nan Jiang, Qian Wang, Liting Hu, Qiang Xu, Xudong Peng, Kun He, Guoqiang Zhu
PurposeTo explore the relationship between LOX-1 and TLR4 in Aspergillus fumigatus (A. fumigatus) keratitis. To determine LOX-1 and TLR4 can affect each other and regulate inflammation through regulation of the generation of reactive oxygen species (ROS) in A. fumigatus keratitis.MethodsThe cornea and abdominal cavity extracted neutrophils of susceptible C57BL/6 mice were infected with A. fumigatus. The cornea and neutrophils were pretreated with LOX-1 neutralizing antibody, Polyinosinic acid (Poly(I)) (the inhibitor of LOX-1) or CLI-095 (the inhibitor of TLR4) separately before infection. LOX-1, TLR4 and IL-1β expression were detected in normal and infected cornea by PCR and Western Blot, while ROS was detected in the neutrophils by flow cytometry.ResultsLOX-1, TLR4, IL-1β mRNA and protein levels were up-regulated in C57BL/6 cornea after infection. LOX-1 neutralizing antibody or Poly(I) pretreatment decreased the expression of LOX-1, TLR4 and IL-1β in C57BL/6 cornea after infection and CLI-095 pretreatment decreased the expression of LOX-1, TLR4 and IL-1β in C57BL/6 cornea after infection. ROS generation was increased in C57BL/6 neutrophils after infection, however, ROS generation was decreased in C57BL/6 neutrophils after infection by LOX-1 neutralizing antibody or Poly(I) or CLI-095 pretreatment.ConclusionLOX-1, TLR4 and IL-1β expression and ROS generation are increased after infection. LOX-1 and TLR4 can affect each other and regulate the generation of ROS in A. fumigatus keratitis. Inhibition of LOX-1 and TLR4 can reduce ROS generation.



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Occult Primary Neuroendocrine Tumor Metastasis to the Breast Detected on Screening Mammogram

Fabiana Policeni, Brittany Pakalniskis, Limin Yang

Journal of Clinical Imaging Science 2016 6(1):41-41

Metastatic tumors are rare in the breast. Well-differentiated neuroendocrine tumors (WDNETs) are slow-growing neoplasms that arise from neuroendocrine cells, particularly in the gastrointestinal tract and bronchial tree. Metastatic WDNET to the breast is a rare entity. We present a case report of ileal WDNET metastatic to the breast which was initially identified as a small mass in the patient's left breast on screening mammography. Targeted ultrasound identified a suspicious mass, and ultrasound-guided percutaneous core biopsy was performed. Pathology revealed metastatic WDNET. Breast magnetic resonance imaging (MRI) was then performed and demonstrated left axillary Level 2 lymphadenopathy, and liver lesions were suspicious for metastasis. The patient underwent abdominal computed tomography (CT) to evaluate for distant metastatic disease. A spiculated mass was found near the ileocecal valve, suggestive of primary ileal WDNET. In addition, CT identified multiple liver lesions, most compatible with metastasis. Indium 111 OctreoScan confirmed radiotracer uptake in the ileum consistent with primary neuroendocrine tumor. In this report, we review the imaging characteristics of metastatic WDNET to the breast by different imaging modalities including mammogram, ultrasound, and breast MRI.

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Enabling the Next 25 Years of Cell Biology

Publication date: Available online 29 September 2016
Source:Trends in Cell Biology
Author(s): Jim Woodgett, Danielle T. Loughlin




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Distinct and overlapping DNMT1 interactions with multiple transcription factors in erythroid cells: Evidence for co-repressor functions

Publication date: Available online 28 September 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Dimitris N. Papageorgiou, Elena Karkoulia, Alexandra Amaral-Psarris, Pavel Burda, Katarzyna Kolodziej, Jeroen Demmers, Jörg Bungert, Tomas Stopka, John Strouboulis
DNMT1 is the maintenance DNA methyltransferase shown to be essential for embryonic development and cellular growth and differentiation in many somatic tissues in mammals. Increasing evidence has also suggested a role for DNMT1 in repressing gene expression through interactions with specific transcription factors. Previously, we identified DNMT1 as an interacting partner of the TR2/TR4 nuclear receptor heterodimer in erythroid cells, implicated in the developmental silencing of fetal β-type globin genes in the adult stage of human erythropoiesis. Here, we extended this work by using a biotinylation tagging approach to characterize DNMT1 protein complexes in mouse erythroleukemic cells. We identified novel DNMT1 interactions with several hematopoietic transcription factors with essential roles in erythroid differentiation, including GATA1, GFI-1b and FOG-1. We provide evidence for DNMT1 forming distinct protein subcomplexes with specific transcription factors and propose the existence of a "core" DNMT1 complex with the transcription factors ZBP-89 and ZNF143, which is also present in non-hematopoietic cells. Furthermore, we identified the short (17a.a.) PCNA Binding Domain (PBD) located near the N-terminus of DNMT1 as being necessary for mediating interactions with the transcription factors described herein. Lastly, we provide evidence for DNMT1 serving as a co-repressor of ZBP-89 and GATA1 acting through upstream regulatory elements of the PU.1 and GATA1 gene loci.



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Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review

Abstract

The aim of the study was to assess the efficacy of adjunctive use of laser therapy (LT) alone or antimicrobial photodynamic therapy (aPDT) to improve clinical periodontal and HbA1c levels in patients with both chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). Electronic search of the MEDLINE, PubMed, EMBASE, Science Direct, and SCOPUS databases were combined with hand searching of articles published from 1975 up to and including March 2016 using relevant MeSH terms. Six studies were selected for this review. In these six studies, laser treatment was applied, after scaling and root planing (SRP), in two ways: Three studies used laser alone and three studies used laser with photosensitizer. All the six included studies reporting clinical periodontal and glycemic parameters showed that LT and aPDT were effective in the treatment of CP in T2DM subjects at follow-up. Two studies showed significantly better periodontal outcomes for LT as an adjunct to SRP as compared to SRP alone, whereas four studies showed comparable periodontal outcomes among adjunctive LT or aPDT with SRP. Two studies showed significant reduction of HbA1c levels in LT and aPDT as compared to SRP, whereas three studies showed comparable percentage levels at follow-up. It remains debatable whether LT or aPDT as adjunct to SRP is more effective as compared to SRP alone in the improvement of clinical periodontal and glycemic control in patients with both CP and T2DM, given that the scientific evidence is weak.

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