El impacto de la infección del VIH y sus consecuencias como ninguna otra enfermedad en la historia viene propagándose en el mundo. Según estimaciones del Programa Conjunto de las Naciones Unidas sobre el VIH/sida, ONUSIDA en su Reporte Global del año 2010 informa que a nivel mundial existían aproximadamente 2.5 millones (1.6 - 3.4 millones) de niños menores de 15 años infectados con VIH. En América latina existían 36 000 (25 000 - 50 000) casos y en el Caribe 17 000 (8 500 - 26 000). La transmisión materno-infantil es la principal vía de adquisición del virus VIH en los niños. Actualmente la clasificación del grado de infección en la población pediátrica infectada con el virus del VIH se basa en criterios clínicos y de laboratorio (índice CD4), siendo las patologías orales asociadas al VIH/sida las primeras manifestaciones en presentarse, además algunas de estas se consideran marcadores del avance de dicha enfermedad, tales como la candidiasis. La salud oral es muy importante, especialmente para los niños con VIH por diversas razones. Al estar inmunodeprimidos los niños con VIH presentan vulnerabilidad a las infecciones oportunistas por lo cual una buena nutrición es fundamental, siendo la boca la vía que garantiza la alimentación. Las enfermedades y afecciones orales pueden dar origen a infecciones sistémicas cuando el sistema inmunológico es débil, y los signos y síntomas orales son a menudo parte del estado de salud general, algunas patologías como la candidiasis pueden empezar en la boca y extenderse hacia el esófago o incluso afectar el aparato respiratorio. También es importante mencionar que la salud oral esta vinculada en aspectos sociales y psicológicos como el poder sonreír y comunicarse. El desarrollo de las drogas antirretrovirales y la aplicación del tratamiento antirretroviral de gran actividad han provocado un cambio radical en la calidad de vida de los niños con VIH. Al realizar el proyecto de investigación no se encontró en la población del departamento de infectología – pediatría del HNHU pacientes adolescentes. Por lo cual las bases teóricas de la investigación se centran en su totalidad en los pacientes niños para un mejor estudio. Conociendo esta situación y la importancia de la salud oral en esta población pediátrica, en el presente estudio buscamos conocer las patologías orales en los niños con VIH que se encuentran en tratamiento antirretroviral de gran actividad en el hospital nacional Hipólito Unanue. Para poder proporcionar información que brinde al estomatólogo herramientas para que tome las medidas necesarias y promueva la disminución de morbilidad, mejoras en la calidad de vida, nutrición y autoestima a largo plazo en los niños con VIH.

Call number: LD2668 .T4 1950 C66 / Master of Science

A research report submitted to the faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in the partial fulfillment of the requirements for the Degree of Master of Science in Dentistry, Johannesburg, 2017 / Chemotherapy and radiation therapy are the most widely used interventions for the treatment of cancer. Several adverse effects including mucositis are associated with these therapies, which affect a patient’s quality of life, resulting in morbidity and mortality. Cancer therapy also causes an imbalance in the oral flora which allows colonization of the oral cavity with uncommon bacteria, including aerobic gram negative bacteria and less commonly, Candida. These organisms can become established in the lesions of oral mucositis. These gram negative bacteria produce endotoxins. Although the involvement of endotoxins in the development of systemic infections is well described, the role of endotoxins in oral mucositis is not known. Therefore, this study investigated the presence of aerobic gram negative bacteria and endotoxins in the oral cavities of patients receiving cancer treatment and their role in the development of oral mucositis. Oral cavity rinse samples were collected from 100 cancer patients on cancer treatment and 50 healthy individuals. Ethical clearance was obtained from The Committee for Research on Human Subjects (Medical). The demographic and clinical data were recorded. Samples were serially diluted and cultured onto Mitis Salivarius Agar for Streptococci, Baird Parker Agar for Staphylococcus aureus, MacConkey Agar for aerobic gram negative bacteria (AGNB) and Chromagar for Candida species. Colony counts were obtained and the cultures of AGNB and Candida species were further identified at the species level using the API technique. An antimicrobial susceptibility test was performed on AGNB. Oral rinse samples were further tested for the presence of endotoxin using the Hycult Biotech Limulus Amebocyte Lysate (LAL) assay. Results were analysed using the Mann-Whitney and chi-square test. P-values of ≤ 0.05% were considered significant. Eighty percent of cancer patients were females with breast (58%) or cervical cancer (9%). The majority of these patients were on chemotherapy (61%), were receiving a combination of chemotherapeutic drugs and had completed many cycles of chemotherapy treatment. Twelve percent of patients had oral mucositis of various grades. Healthy individuals also comprised of mainly females (76%). All cancer patients and 98% of healthy individuals carried Streptococci. No significant difference in the carriage of S. aureus was found between the two groups. However, the Candida carrier rate was significantly high in cancer patients (55%) compared to the healthy (20%) individuals (p<0.01). Although the Candida counts were not different between the groups (p>0.05), cancer patients carried a variety of Candida species and some patients carried more than one type of Candida species in their oral cavity. In addition, C. glabrata was only found in cancer patients. Between the groups of cancer patients and healthy individuals, no significant difference in the carrier rate of AGNB was found (cancer 24% vs 14% healthy). However, cancer patients carried a variety of AGNB. Enterobacter cloacae and Klebsiella pneumonia was isolated from the oral cavities of both the study groups. These bacteria were resistant to many antibiotics. When the prevalence of these oral bacteria was compared between patients with and without oral mucositis, it was found that the percentage prevalence of Candida species was significantly high in patients with oral mucositis. A mean endotoxin concentration of 3.65ng/ml and 3.37ng/ml was detected in the oral rinse samples of cancer patients and healthy individuals respectively. The difference in the endotoxin between the two groups was not significant (p=0.5). Mean values of 4.1ng/ml and 3.53ng/ml were found in cancer patients with and without oral mucositis respectively. The difference in the quantities of endotoxins between the two groups was not significant (p=0.6). In addition, endotoxin present in cancer patients with AGNB (3.39ng/ml) and without AGNB (3.8ng/ml) was also not significantly different. These results suggest that although cancer patients carry aerobic gram negative bacteria and endotoxins in their oral cavities, they may not contribute in the exacerbation of oral mucositis. However, Candida species may contribute in the exacerbation of oral mucositis and therefore, during cancer treatment, it is important to take preventative measures to reduce the colonization of Candida to prevent infection. / MT2017

PhD, Faculty of Health Sciences, University of the Witwatersrand / Many studies have shown a negative effect of depot-medroxyprogesterone acetate (DMPA) hormonal contraception on bone mineral density (BMD) in women. There is limited information on the effect of norethisterone enanthate (NET-EN) on BMD and the effect of combined oral contraceptives (COCs) on BMD is inconclusive, however emerging evidence is showing that low-dose COCs maybe detrimental to BMD in young women. The aim of this research was to evaluate, in a 5-year follow-up study, the possible effect of DMPA, NET-EN and COCs on BMD among young (15-19 years) and older (40-49 years) South African women. Method: This prospective study was conducted at the Commercial City Family Planning clinic in Durban, South Africa between 2000 and 2007. In the adolescent group women with no history of hormonal contraception who were initiating use of DMPA (n=115), NET-EN (n=115) or COCs (n=116) and 144 nonuser controls were recruited. In the older group, one hundred and twenty seven users of DMPA, 102 NET-EN users and 106 COC users of at least one year were compared to 161 nonuser controls. BMD was measured at the distal radius and midshaft of the ulna using dual x-ray absorptiometry. In the crosssectional component of the study conducted at the end of the longitudinal phase, BMD was measured at the hip, spine and femoral neck in a sub-group of 96 of the younger women. Results: In the longitudinal study of adolescents, BMD increased in all four groups during follow-up (p<.001). There was evidence for lower BMD increases per annum in NET-EN (p=.050) and COC (p=.010) users compared to nonusers but no difference between DMPA and nonusers (p=.76). In 14 NET-EN discontinuers, an overall reduction of 0.61% per year BMD was followed, upon cessation, by an increase of 0.69% per year (p=.066). The cross-sectional sub-study found that young women in the injectables-only user group had lower BMDs compared to the non-user group after adjusting for BMI at the spine (p=0.042), hip (p=0.025), and femoral neck (p=0.023). The mixed COC/injectable user group BMD values were lower than controls; however, they were not significant at any of the three sites. In the older women, there was no significant difference in radius BMD between the contraceptive user groups and the non-user controls (p=.26) with and without adjustment for age at baseline, or after two and a half years of follow-up (p=0.52). Conclusion: This study suggests that BMD increases in adolescents may be less in NETEN and COC users; however, recovery of BMD in NET-EN users was found in the small sample of adolescents followed post-discontinuation. The cross-sectional sub-study showed similar findings in long-term injectable users, but not when women had mixed injectable and COC use. There was no evidence that long-term use of DMPA, NET-EN and COCs affected BMD in the older women.

A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the Degree of Master of Dentistry (Community Dentistry) Johannesburg, 2015 / This study aims to assess Oral Health-Related Quality of Life among children with special needs, from the caregiver’s perspective. The objectives of the study were: (i) To describe the demographic profile of the caregivers in terms of age, gender and socio-economic status,(ii) To assess the dental caries status of children with special needs,(iii) To establish the caregivers’ perceived Oral Health-Related Quality of Life of the children with special needs using the short-form Parent-Caregiver Perception Questionnaire, (iv) To assess the impact of the dental caries status on the families of children with special needs using the Family Impact Scale questionnaire. Results: The study consisted of 150 caregiver child pairs, the mean age of the caregivers was 39.52 years (SD 9.26) and mean age of children was 8.72 years (SD 6.07). There was a high prevalence of untreated caries regardless of the type of disability. The highest caries prevalence in both the primary and permanent dentition was found in the Epilepsy and the Autism groups (75%-83%) while the lowest was found among Down syndrome and Cerebral palsy groups (30%-47%).All the caregivers expressed impact on the Oral Health-Related Quality of Life.The mean Parent-Caregiver Perception Questionnaire score was 12.88 (SD 12.14) while the mean Family Impact score was 6.05 (SD 6.77). The highest Parent-Caregiver Perception score of 20.5 (SD 11.07) was found in the complex disability group followed by the Down syndrome group 15.87 (SD 13.87). The highest scores were found in the oral symptoms, functional limitation and emotional wellbeing domains which contributed more to the parent perception score. Conclusion: Caregivers of children with special needs in the current study experienced a negative impact on Oral Health-Related Quality of Life. Caries experience of the children with special needs was slightly lower than in the general population irrespective of disabilities and had no impact on the FIS and overall global rating-well-being.

Background Oral candidiasis is the most common infection of the oral mucosa of HIV-seropositive patients, although its frequency is rapidly decreasing with the advent of highly active antiretroviral therapy (HAART). Many questions regarding its complex pathogenesis remain unanswered. The diagnosis is usually established with non-invasive techniques such as mucosal smears. Oral lesions of HIV-associated Kaposi sarcoma (HIV-KS) are routinely biopsied and frequently show secondary infection with Candida albicans or other Candida species. Aims and objectives The aim of this investigation was to determine the frequency and histomorphology of secondary Candidal infection of the surface epithelium of oral HIV-associated KS lesions (HIV-KS), which are routinely biopsied in HIV infected patients. Materials and methods Haematoxylin and eosin (HE), and Periodic Acid-Schiff (PAS) stains of 133 cases of oral Kaposi sarcoma diagnosed between the period 2003 and 2007 within the Division of Oral Pathology were examined histologically for intensity and morphology of Candidal colonisation, depth of invasion, number of organisms, epithelial reactions and associated inflammatory response. The depth of Candidal invasion and severity of infection were correlated with the available CD4 T cell counts of HIV seropositive patients at the time of biopsy. Results Almost forty one percent (40.62%) of all oral HIV-KS cases were secondarily infected with Candida species. The intensity varied from an isolated single pseudohyphus to matted colonies of vegetative yeasts and psuedohyphae. Whilst in most cases the organisms did not invade beyond the parakeratin layer, pseudohyphae were noted extending into the stratum spinosum in 2 cases, and a single case showed a pseudohyphus within the lamina propria. A further 2 cases showed pseudohyphae growing in the pyogenic membrane. Neutrophilic permeation of the epithelium and Munro micro-abscess formation, features commonly associated with Candidal infection, were frequently present even in the absence of Candidal infection. Candidal organisms were often present in the absence of inflammation. Conclusion Oral lesions of HIV-KS are commonly secondarily infected with large numbers of Candidal organisms. The morphological characteristics of secondary Candidal infection within the surface epithelium of HIV-KS lesions suggest an altered pathogenetic pathway. Further studies are necessary in this regard.

Dental caries prevalence in many developing countries is low but an increased prevalence has recently been reported from some of these countries. This is in contrast to the data from the industrialised countries which show a consistent decrease in caries prevalence, particularly in urban populations. The phenomenon of a low caries experience in areas having an optimal fluoride concentration in water is well documented. On the other hand, many reports show that higher than optimal levels of fluoride in drinking water are associated with varying degrees of fluorosis (Murry et. al, 1991). In developing countries, a high prevalence of periodontal disease has been reported in both teenagers and adults. The present study compared the caries profile, periodontal disease and fluorosis among children and adults residing in low, "optimal" and high fluoride areas in four villages in the Mankwe region, North-West Province of South Africa. The population of the Mankwe region was approximately 63 000 in 1993 and fifty percent of whom were children (Development Bank of South Africa, 1994). The climateis hot and dry, and until recently, people depended on underground and rain water. Access to tap water was costly. Oral health facilities were limited and there were inadequate oral health personnel. The method of sampling, examination techniques, instruments used and the statistical analysis were carried out under supervision of experienced epidemiologist and in consultation with expert statisticians. The indices used included the Decayed, Missing and Filled Teeth (DMFT, drnft), Community Periodontal Index of Treatment Needs (CPITN) (WHO 1987; Ainamo et al, 1982), Dean's Index (Dean et al. 1942) and the Tooth Surface Index of Fluorosis (TSIF) (Horowitz et at,1984). A total of 360 subjects aged 6-7,12-13 and 30-55 years were examined. More than 90 percent of the 6-7 year old children were caries-free in the permanent dentition at all four study villages. Both ttmft and DMFT scores were very low. DMFT values for the 12-13 year old group was also well within the WHO goals in all the villages but increased in the adult group. The D-component was dominant in all groups with the occlusal surfaces most affected. There was a high percentage of periodontal disease but with low severity. Less than 30 percent of the adults aged 30-55 years demonstrated bleeding on probing at all the four villages. In the 30-55 year age groups, calculus was predominantly found at Lerome and less than 32 percent and 20 percent had shallow and deep pockets respectively at all the four villages. All those in the 12-13 and 30-55 year age groups were assessed as needing oral hygiene instructions and less than 20 percent of the adults needed advanced periodontal care. When using Dean's index in the 12-13 year age group, the highest percentage with fluorosis was found at Ruighoek which had an excessive amount of fluoride in drinking water, but fluorosis was also pronounced at Lerome. The central incisors were more affected than the lateral incisors when using the TSIF. Also, mandibular first molars were more affected than maxillary first molars. In the 30-55 year olds, there was a decrease in the severity of fluorosis with age at the high fluoride villages, but all of the adults examined had brown discolouration at Ruighoek. Based on the finding of this study it is suggested that greater efforts be made to introduce proven preventive treatment programmes in these communities. More human resources particularly in the form of auxiliaries should also be employed in order to promote oral health education and provide basic periodontal intervention. The fluorosis problem could be addressed by introducing potable water and the unsightly brown discolouration in adolescents could be eliminated by either bleaching, composite veneers or crowns, However, the latter solution is expensive and Is dependent on sophisticated equipment and highly trained dental personnel.

Para se determinar a prevalência dos protozoários bucais Entamoeba gingivalis (GROS, 1849) e Trichomonas tenax (MULLER, 1773) procedeu-se o exame bucal de 700 indivíduos através do exame direto e de cultura. Esta amostra foi subdividida em cinco grupos de pessoas. O Grupo I, composto por 100 pacientes de clínicas odontológicas, revelou uma prevalência de 3,0 por cento com relação a presença da Entamoeba gingivalis e de 1,0 por cento com relação ao Trichomonas tenax. O Grupo II, composto por 100 estudantes universitários revelou-se ausente de infestações. O Grupo III, composto por 250 indivíduos da Clínica de Semiologia, revelou um percentual de 16,0 por cento de infestações por Entamoeba gingivalis e de 2,0 por cento de infestações por Trichomonas tenax. O Grupo IV, composto por 200 escolares do 1º grau, demonstrou uma positividade de 11,0 por cento para a Entamoeba gingivalis e de 1,0 por cento para o Trichomonas tenax. O Grupo V, composto por 50 mulheres do Serviço de Atendimento da Mulher do SESA, apresentou uma prevalência de 26,0 por cento para a Entamoeba gingivalis e de ausência para o Trichomonas tenax. O grau de infestação verificado no total dos 700, pacientes, examinados foi de 11,0 por cento para a Entamoeba gingivalis e de 2,0 por cento para o Trichomonas tenax. Estes resultados são discutidos e relacionados às variáveis: sexo, estado civil, escolaridade, idade, profissão, renda familiar e pH bucal. / In order to determine the prevalence of oral protozoan Entamoeba gingivalís and Tríchomonas tenax 700 person were examined. The sample was subdivided into five groups. Group I composed by 100 patients of dentistry clinics, revealed a prevalence of 3,0 per cent relacionated with the presence of Entamoeba gingivalís and 1,0 per cent relative to Tríchomonas tenax. Group II, constituted by 100 university students, showed the absence of oral infestation. Group III, composed by 250 patients of the semiology clinic, revelated a prevalence of 16,0 per cent of Entamoeba gingivalis infestations and 2,0 per cent of Trichomonas tenax infestations. Group IV, constituted of 200 schoolchildren of the 1st grade, showed a positivity of 11,0 per cent of Entamoeba gingivalis and 1,0 per cent of Trichomonas tenax. Group v, composed by 50 women of the \"Serviço de Atendimento da Mulher do SESA\" (Women\'s Attendance Clinic in a Public Health Service), presented a prevalence of 26,0 per cent of Entamoeba gingivalis and ausence of Trichomonas tenax infestations. The general degree of infestation found in all the 700, patients, examinated was 11,0 per cent for Entamoeba gingivalis and 2,0 per cent for Trichomonas tenax. These results are discussed and relacionated with the following variables: sex, age, warriage situation, education degree, profession, familiar financial statement and oral pH.

Objetivou-se fazer um estudo retrospectivo avaliando quais as afecções da cavidade oral foram mais frequentes nos gatos domésticos atendidos no Laboratório de Odontologia Comparada da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, relatando estatisticamente a prevalência das afecções da cavidade oral de gatos, enfatizando se há correlação entre elas e com características como raça, sexo, faixa etária e estado reprodutivo. Os dados analisados dos 754 prontuários foram raça, idade, sexo, estado reprodutivo, diagnóstico, tratamento e, no caso de neoplasia, sua localização e diagnóstico histopatológico. As principais doenças diagnosticadas foram doença periodontal, fratura dentária, gengivoestomatite crônica felina, lesão de reabsorção dentária felina, neoplasia oral e traumatismo do sistema estomatognático (luxação de articulação temporomandibular, fenda palatina, fratura de processo coronoide, fratura de zigomático, disjunção de sínfise, fratura de maxila e mandíbula). A idade dos animais variou de menos de um ano a 20 anos, sendo que, os animais tinham, em média 7,2 anos (desvio padrão &#61; 4,9) e a faixa etária mais frequente foi de um a cinco anos. Os gatos sem raça definida (66,5%), siameses (19,0%) e persas (10,2%) totalizaram 95,7% de todos os felinos atendidos no LOC. A doença periodontal foi a afecção mais frequente e esteve presente em 38,3% da população estudada. A fratura dentária, segunda mais frequente, esteve presente em 27,2% dos animais. Houve associação estatisticamente significativa (p&#61;0,026) entre fratura dentária e faixa etária, já que a proporção de animais entre um e cinco anos de idade com fratura foi maior do que a das outras faixas etárias. A lesão de reabsorção dentária felina (LRDF) esteve presente em 19,6% dos gatos estudados, sendo a terceira afecção mais prevalente dentre as pesquisadas. Esta lesão foi mais frequente em gatos com idade entre 11 e 15 anos e houve associação estatisticamente significativa entre a LRDF e a doença periodontal e entre LRDF e gengivite. A prevalência de gengivoestomatite crônica felina foi de 15,7% entre os felinos pesquisados e a proporção de animais com idades entre seis e dez anos com esta doença foi maior do que em outras faixas etárias. As neoplasias estavam presentes em 9,8% dos gatos, sendo que em 46 dos 72 animais que apresentaram alguma neoplasia tinham mais de dez anos de idade. O carcinoma de células escamosas foi o neoplasma mais comum, correspondendo a 63,2% das neoformações que foram submetidas ao exame histopatológico. As fraturas ósseas do sistema estomatognático corresponderam a 19,3% dos atendimentos, sendo a sínfise mentoniana e o corpo da mandíbula os locais mais comuns de fraturas. Concluiu-se que: existe grande variedade de afecções que acometem a cavidade oral de gatos, sendo a doença periodontal, fratura dentária, lesão de reabsorção dentária, gengivite, gengivoestomatite crônica, neoplasias orais e fraturas dos ossos do sistema estomatognático as mais prevalentes delas; é de extrema importância que as anotações nas fichas de atendimento sejam feitas da maneira mais completa possível, para que informações não sejam perdidas / This study aimed to make a retrospective study assessing which diseases of the oral cavity were more common in domestic cats attended at Comparative Dental Laboratory of the School of Veterinary Medicine and Zootechny of the University of São Paulo, and to report statistically the prevalence of diseases in the oral cavity of cats, emphasizing the correlation between them and with characteristics such as breed, gender, age and reproductive status. The data analyzed from 754 records were breed, age, gender, reproductive status, diagnosis, treatment and in the case of neoplasia, its location and histological diagnosis. The main diagnosed diseases were periodontal disease, tooth fracture, feline chronic gingivostomatitis, tooth resorption lesions, oral cancer and trauma of the stomatognathic system (dislocation of temporomandibular joint, cleft palate, coronoid fracture, zygomatic fracture, symphyseal separation, maxilla and mandible fracture). The age of the animals ranged from less than one year to 20 years, and the animals had an average of 7.2 years (SD &#61; 4.9) and the most frequent age range was from one to five years. Three breeds totaled 95.7% of all cats attended at LOC, which were, Persian (10.2%), Siamese (19.0%) and SRD (66.5%). Periodontal disease was the most common condition and it was present in 38.3% of the studied population. Dental fracture was present in 27.2% of the animals. There was a statistically significant association (p &#61; 0.026) between dental fracture and age, since the proportion of animals between one and five years old with fracture was higher than that of other age groups. The tooth resorption lesions (LRD) were present in 19.6% of the studied cats, being the third most prevalent disease among the survey. This injury was more common in cats aged between 11 and 15 years and there was a statistically significant association between LRD and periodontal and between gum disease and LRD. The prevalence of feline chronic gingivostomatitis was 15.7% among those surveyed cats and the proportion of animals aged between six and ten years with this disease was higher than other age groups. Neoplasia was present in 9.8% of cats, and in 46 of 72 animals that showed some malformation had more than ten years old. The squamous cell carcinoma was the most common neoplasm, corresponding to 63.2% of neoformations that were submitted to histopathology. Bone fractures of the stomatognathic system accounted for 19.3% of cases, the mandibular symphysis and the body of the mandible were the most common sites of fractures. It was concluded that there is a wide range of diseases that affect the oral cavity of cats, and periodontal disease, tooth fracture, dental resorption lesions, gingivitis, gingivostomatitis, oral cancer and fractures of the bones of the stomatognathic system were the most prevalent of them; it is a matter of utmost importance that the notes in all pacient records are done as thoroughly as possible, so that information will not be lost

Thesis (Ph.D.)--Boston University / Resolvins are endogenous anti-inflammatory I pro-resolving lipid mediators derived from omega-3 fatty acids. Resolvin E1 (RvE1) reverses periodontitis and promotes regeneration of alveolar bone in vivo. The goal of this project was to determine the mechanism of RvE1 impact on bone formation. RvE1 significantly enhanced bone formation relative to a vehicle control in a mouse craniotomy model of bone healing. Since RvE1 is reported to act through receptors expressed by cells of the innate immune system, the initial hypothesis tested was that RvE1 actions are mediated through bone macrophages. The hypothesis was rejected, as no impact of RvE1 on macrophage mediated bone formation was demonstrable. The alternative hypothesis was that RvE1 acts directly on osteoblasts. Using mouse neonatal osteoblasts, calcification of osteoblast cultures was demonstrated. Osteoblasts express the RvE1 receptor, ChemR23, at the mRNA and protein level. Examination of intracellular signaling by RvE1 demonstrated increased phosphorylation of rpS6 through the AKT-mTOR pathway. The specificity of RvE1 signaling through ChemR23 was demonstrated with ChemR23 specific blocking antibody that abrogated the phosphorylation of rpS6. Rapamycin, an inhibitor of mTOR, also blocked rpS6 phosphorylation. To examine the mechanism of RvE1 treated osteoblast enhanced bone formation, secretion of bone specific proteins by osteoblasts after pro-inflammatory stimulation (IL-6) was examined with a focus on the osteoprotegerin (OPG) and receptor activator of NF-κB ligand (RANKL) axis, which regulates osteoclast differentiation. Secretion of RANKL and OPG by mouse neonatal osteoblasts stimulated with IL-6 and treated with RvE1 was measured by ELISA. IL-6 stimulation did not impact RANKL levels but decreased OPG production, thereby changing the RANKL/OPG to favor osteoclast activation and bone resorption. RvE1 blocked OPG changes, however, maintaining a RANKL/OPG more favorable to bone formation. In conclusion, RvE1 has anabolic actions in a mouse model of bone healing mediated through RANKL/OPG. RvE1 signals the receptor ChemR23 on the osteoblast surface through the mTOR pathway and phosphorylation of rpS6. Functionally, RvE1 shifts the balance between OPG and RANKL to favor bone formation. Mediators of innate immunity thus also directly regulate bone cells.