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Bakgrund: Gingivit kännetecknas av svullet/lättblödande och ibland ömt tandkött. Gingivit är en inflammatoriskt orsakad reaktion som uppkommer i samband med närvaro av bakterier. För att motverka utvecklingen av gingivit rekommenderas munhygienvård regelbundet. Gingivit kan utvecklas till parodontit med skador på upphängningsapparaten och benstödet, orsaken till detta är idag dock ej helt klarlagd. Kliniska variabler (blödning vid sondering) är vedertagna diagnostiska metoderna för diagnostisk av gingivit idag. I pilotstudier har laktoferrinkoncentrationer setts vara förhöjda i stimulerad helsaliv och gingivalexsudat hos patienter med kronisk parodontit jämfört med patienter utan parodontit. Mål: Undersöka hur koncentrationen laktoferrin i ostimulerad helsaliv förändrades hos individer som utvecklade gingivit i en experimentell gingivitstudie och om C-reaktivt protein är en tillförlitlig markör för gingival inflammationsgrad.Material och metod: En experimentell gingivitstudie genomfördes med 13 försöksdeltagare där munhygienvanor kontrollerades och förändrades under 3 perioder á 2 veckor. Helsalivprov och mätning av CRP genomfördes. Resultat: Gingivalindex och CRP höjdes signifikant under försöksperioden Dag 0 till Dag 13(p=0,002 och p=0,027). Laktoferrin sågs först signifikant förhöjd under mitten av avslutningsperioden (Dag 20) (p=0,015). Laktoferrinkoncentrationen återgick inte till baselinevärdet under studien. Signifikant korrelation sågs mellan gingivalindex och laktoferrin från Dag 0 fram till Dag 13 (r=0,224, p=0,042). Utvecklingen av CRP sågs inte korrelera med någon variabel under försöket. Konklusion: Resultaten indikerar att utvecklingen av experimentell gingivit påverkar laktoferrinkoncentrationen över tid och kan därför vara en potentiell biomarkör för gingivit. De låga skillnader hos CRP visar att den inte är en tillförlitlig markör vid gingivit. / Background: Gingivitis is characterized by swollen and bleeding tissue, an inflammatory reaction with presence of pathological bacteria. To counteract the development of gingivitis, regular oral hygiene care is recommended. Gingivitis can progress into periodontitis which damages the periodontal tissue and bone. Clinical variables (bleeding on probing, plaque occurrence) are diagnostic methods for gingivitis. Elevated concentrations of lactoferrin in stimulated whole saliva and gingival crevicular fluid has been seen in patients with chronic periodontitis compared to patients without periodontitis.Objectives: Investigate the salivary concentration of lactoferrin in subjects enrolled in the experimental gingivitis model, the response of capillary CRP was also investigated.Methods: Thirteen individuals participated in a 14-day experimental gingivitis model and 10-day gingival healing period, measurements of whole saliva lactoferrin and CRP was performed. Results: Gingival index and CRP was increased statistical significant during the induction of gingivitis (p=0.002 and p=0,027). Lactoferrin increased during the experimental phase and reached a peak at day 20, which was statistical significant compared to baseline (p=0.015). A statistical significant correlation between gingival index and lactoferrin was seen from day 0 to day 13 (r=0.224, p=0.042). CRP did not match any correlation to any other measured variable from day 0 to day 24.Conclusion: These results indicate that gingivitis may have a systemic effect, which in this study has been expressed as increased levels of salivary lactoferrin. Lactoferrin may be a potential biomarker for gingivitis. Due to low changes in concentrations and because CRP is systemically affected it makes an unreliable biomarker for gingivitis.

Thesis (M. Tech.) - Central University of Technology, Free State, 2011

Κύριος σκοπός τη παρούσης μελέτης ήταν η εκτίμηση της επίδρασης της οξείας και χρόνιας εντατικής άσκησης και του χρόνιου αρνητικού ενεργειακού ισοζυγίου στα επίπεδα αντιπονεκτίνης, ρεζιστίνης και βισφατίνης. Επιπλέον, μελετήθηκε η συσχέτιση των επιπέδων των ανωτέρω λιποκινών με τα επίπεδα κορτιζόλης και ινσουλίνης, καθώς και με τις παραμέτρους έντασης της άσκησης. Ως μοντέλο ενεργειακής και μεταβολικής ομοιοστασίας χρησιμοποιήθηκαν αθλήτριες Ρυθμικής Γυμναστικής (RGs) υψηλού επιπέδου πρωταθλητισμού, Οι RGs υποβάλλονται σε χρόνια έντονη ψυχολογική και σωματική καταπόνηση, ενώ, στην προσπάθεια για επίτευξη και διατήρηση λεπτού σωματότυπου, υιοθετούν αυστηρές διαιτητικές συνήθειες και χρόνιο αρνητικό ενεργειακό ισοζύγιο. Υλικό και Μέθοδοι Η αδυναμία συλλογής δειγμάτων αίματος από αθλητές κορυφαίου επιπέδου πρωταθλητισμού επέβαλε τη συλλογή και επεξεργασία σιέλου για την πραγματοποίηση των ορμονικών προσδιορισμών. Ως εκ τούτου, προτού ξεκινήσει η υλοποίηση του πρωτοκόλλου της μελέτης (διαμόρφωση πληθυσμού και συλλογή δειγμάτων), σχεδιάστηκε και εκπονήθηκε μια μελέτη με σκοπό την ανίχνευση και τη μέτρηση των συγκεντρώσεών των λιποκινών αντιπονεκτίνη, βισφατίνη και ρεζιστίνη στο σίελο και τη συσχέτιση των συγκεντρώσεων τους στο σίελο με τις αντίστοιχες συγκεντρώσεις στο αίμα. Προσδιορισμός των συγκεντρώσεων λιποκινών στο σίελο Τα επίπεδα των λιποκινών αντιπονεκτίνη, ρεζιστίνη και βισφατίνη προσδιορίσθηκαν στο σάλιο και τον ορρό 50 υγιών άτομα (33 γυναίκες και 17 άνδρες), με ταυτόχρονη μέτρηση των ανθρωπομετρικών χαρακτηριστικών (ύψος και βάρος σώματος, υπολογισμός ΒΜΙ, ποσοστό λιπώδους μάζας) . Η επίδραση της άσκησης και του αρνητικού ενεργειακού ισοζυγίου στην ορμονική ομοιοστασία του λιπώδους ιστού Στη μελέτη συμπεριελήφθησαν 51 RGs υψηλού επιπέδου από 8 Ευρωπαϊκές χώρες, οι οποίες συμμετείχαν στη διοργάνωση «Κύπελλο Καλαμάτας 2010» τον Απρίλιο του 2010 στην Καλαμάτα. Επίσης, η μελέτη συμπεριέλαβε 27 υγιείς γυναίκες, μη αθλήτριες και χωρίς σημαντική διαφορά ως προς την ηλικία σε σύγκριση με τον πληθυσμό των αθλητριών (matched for age) ως πληθυσμό ελέγχου (μάρτυρες). Το πρωτόκολλο της μελέτης περιελάμβανε μη επεμβατικές κλινικές και εργαστηριακές εξετάσεις, καθώς και τη συμπλήρωση ενός ερωτηματολογίου. Ειδικότερα, προσδιορίσθηκαν τα ανθρωπομετρικά χαρακτηριστικά αθλητριών και πληθυσμού ελέγχου, οι αθλήτριες συμπλήρωσαν ένα ερωτηματολόγιο που αφορούσε σε στοιχεία γυναικολογικού και αθλητικού ιστορικού, ενώ συλλέχθηκαν δείγματα σιέλου από τις αθλήτριες και τις μάρτυρες. Οι ορμονικοί προσδιορισμοί στο σίελο αφορούσαν σε μετρήσεις επιπέδων ρεζιστίνης, βισφατίνης, αντιπονεκτίνης, κορτιζόλης και ινσουλίνης σε κατάσταση ηρεμίας και μετά από άσκηση. Αποτελέσματα Προσδιορισμός των συγκεντρώσεων λιποκινών στο σίελο Οι λιποκίνες ρεζιστίνη και αντιπονεκτίνη ανιχνεύονται στο σίελο του ανθρώπου και τα επίπεδά τους συσχετίζονται με τα αντίστοιχα επίπεδα στον ορρό (r=0.441, p=0.003 και r=0.347, p=0.019 αντίστοιχα). Αντίθετα, η λιποκίνη βισφατίνη ανιχνεύεται στο σίελο του ανθρώπου, όμως τα επίπεδά της δε συσχετίζονται με τα αντίστοιχα επίπεδα στον ορρό (r=-0.128, p=0.4431). Η επίδραση της άσκησης και του αρνητικού ενεργειακού ισοζυγίου στην ορμονική ομοιοστασία του λιπώδους ιστού Παρατηρήθηκαν μειωμένα επίπεδα αντιπονεκτίνης (p<0.001) και αυξημένα επίπεδα βισφατίνης (p<0.05) στο σάλιο RGs, ενώ δεν παρατηρήθηκαν διαφορές στα επίπεδα ινσουλίνης, κορτιζόλης και ρεζιστίνης στο σάλιο μεταξύ αθλητριών και πληθυσμού ελέγχου. Στις RGs κορυφαίου επιπέδου η επίδραση της μικρής διάρκειας, έντονης αναερόβιας άσκησης του επίσημου αγώνα οδήγησε σε αύξηση των επιπέδων ινσουλίνης (p<0.001), μείωση των επιπέδων αντιπονεκτίνης και βισφατίνης (p<0.001και p<0.05 αντίστοιχα) και καμιά μεταβολή στα επίπεδα κορτιζόλης και ρεζιστίνης στο σάλιο. Επίσης, καταγράφηκε απουσία διημερήσιας διακύμανσης της κορτιζόλης. Τέλος, τα επίπεδα αντιπονεκτίνης ηρεμίας παρουσίασαν σημαντική συσχέτιση με τις παραμέτρους έντασης της άσκησης. Συμπεράσματα Προσδιορισμός των συγκεντρώσεων λιποκινών στο σίελο Οι λιποκίνες ρεζιστίνη, αντιπονεκτίνη και βισφατίνη ανιχνεύονται στο σίελο του ανθρώπου. Όμως, τα ορμονικά επίπεδα στο σίελο συσχετίζονται με τα αντίστοιχα επίπεδα στον ορρό μόνο για τη ρεζιστίνη και την αντιπονεκτίνη. Η επίδραση της άσκησης και του αρνητικού ενεργειακού ισοζυγίου στην ορμονική ομοιοστασία του λιπώδους ιστού Σε RGs κορυφαίου επιπέδου η χρόνια εντατική άσκηση και το χρόνιο αρνητικό ενεργειακό ισοζύγιο αυξάνουν τα επίπεδα αντιπονεκτίνης και μειώνουν τα επίπεδα βισφατίνης στο σάλιο, ενώ η μικρής διάρκειας, έντονη αναερόβια άσκηση καταστέλλει τα επίπεδα τόσο της αντιπονεκτίνης, όσο και της βισφατίνης στο σάλιο. Επιπλέον, τα επίπεδα αντιπονεκτίνης στο σίελο συσχετίζονται με τη συνήθη ένταση της άσκησης, αντανακλώντας, μάλλον, την επιδείνωση του ενεργειακού ισοζυγίου παρά την κλιμάκωση της έντασης της άσκησης καθαυτής, υποδεικνύοντας έναν πιθανός ρόλο των συγκεντρώσεων αντιπονεκτίνης στο σάλιο στην εκτίμηση της επιδείνωσης του ενεργειακού ισοζυγίου, με ενδεχόμενη χρησιμότητα στην κλινική έρευνα και την ιατρική της άσκησης. / Exercise represents a physical stress challenging homeostasis, disturbing the energy balance and leading to adaptive changes in central and peripheral regulatory mechanisms. The aim of the present study was to evaluate the effect of negative energy balance, acute and chronic exercise on adiponectin, resistin and visfatin levels, their interaction with salivary cortisol and insulin levels and the relationship of the specific adipokines with training frequency and intensity. Elite Rhythmic Gymnasts (RGs) were used as a model of energy homeostasis and metabolism. Elite RGs begin exercise at an early age, undergo physical and psychological stress and adopt negative energy balance to retain a lean physique. The main problem in studying hormonal responses in elite athletes on the field of competition lies on the difficulty in obtaining blood samples. The determination of salivary hormone levels provides a convenient, non-invasive and stress-free alternative to blood analysis. As part of the study design, we invested interest in introducing the methodology for detecting and measuring adipokine levels in saliva and evaluating their association with relative serum levels. Materials and Methods Detection and measurement of adipokine levels in human saliva Resistin, visfatin and adiponectin levels were measured in serum and saliva of 50 healthy adult volunteers (17 male and 33 female) using commercial enzyme immunoassay kits for plasma with minor modifications. The influence of acute and chronic intensive physical training and negative energy balance on salivary adipokine levels in elite RGs The study included 51(fifty one) elite female athletes of RG from 8 European countries, participating in the top level tournament of “Kalamata 2010 Rhythmic Gymnastics World Cup” in Kalamata, Greece on April 2010. 24 (twenty four) healthy pubertal girls not engaged in strenuous sports activities were used as controls. The study protocol included noninvasive clinical and laboratory investigations as well as the completion of a questionnaire. The athletes completed a questionnaire including personal data (age of training onset, usual weekly training intensity and number of participations in international championships per year). Baseline and post exercise salivary cortisol, insulin, adiponectin, resistin and visfatin levels were measured. Results Detection and measurement of adipokine levels in human saliva The present study documented the determination of resistin and adiponectin levels in saliva and the significant correlation of salivary with their respective serum levels (r=0.441, p<0.01 and r=0.347, p<0.05, respectively). Moreover, the identification of visfatin in saliva was achieved, but no significant correlation with serum visfatin levels was observed. The influence of acute and chronic intensive physical training and negative energy balance on salivary adipokine levels in elite RGs At baseline, a significant inverse correlation was documented between salivary insulin and adiponectin levels (r=-0.316, p<0.05), after controlling for the effect of age and BMI. Salivary adiponectin levels were higher (p<0.001) and visfatin lower (p<0.05) in RG’s compared with controls, while no significant changes were observed regarding salivary cortisol, insulin and resistin levels. In elite RG’s short term intensive anaerobic exercise led to increased salivary insulin levels (p<0.001), reduced salivary adiponectin (p<0.001) and visfatin levels (p<0.05) and no changes in salivary resistin levels. Moreover, diurnal variation of salivary cortisol was lost. In addition, salivary adiponectin levels are associated with the intensity of training. Conclusions Detection and measurement of adipokine levels in human saliva The adipokines resistin, visfatin and adiponectin can be detected in human saliva. However, significant correlation between salivary and their relative serum levels are documented only for resistin and visfatin, but not for visfatin. The influence of acute and chronic intensive physical training and negative energy balance on salivary adipokine levels in elite RGs. Chronic intensive physical training and negative energy balance up-regulate salivary adiponectin and down-regulate salivary visfatin levels, while acute glucoregulatory response to short term intensive anaerobic exercise down-regulates salivary adiponectin and visfatin levels. Moreover, salivary adiponectin levels are associated with the intensity of training, reflecting the deterioration of energy balance rather than the training stress. Thus, salivary adiponectin could be introduced as a possible marker of significant energy deprivation, with potential usefulness in clinical and sports medicine.

En odontologie, la perte d'éléments naturels est palliée par l'utilisation de biomatériaux de reconstruction d'origine métallique ou céramique, celle-ci connait actuellement un fort développement avec une propension à supplanter le métal pour n'avoir que du « tout céramique ». Ces matériaux sont, par leur fonction, amenés à séjourner durablement dans le milieu buccal favorisant l'apparition de phénomènes corrosifs. La salive est un électrolyte efficace auquel viennent s'ajouter les variations de pH, de température, le polymétallisme, augmentant la vitesse de corrosion et le relargage des éléments constituants. L'étude porte sur cinq alliages couramment utilisés en odontologie prothétique : un précieux, un semi précieux et trois non précieux, et des céramiques d'infrastructure, visant à remplacer les alliages : zircone, alumine et disilicate de lithium. Tous les échantillons subissent en statique une attaque salivaire, et en dynamique une combinaison d'action salivaire et d'usure grâce à une machine unique, simulant le plus précisément possible les mouvements cuspidiens en présence constante de salive artificielle reproduisant de très près les conditions intra-buccales. L'analyse des échantillons au M.E.B.et les résultats de la spectrométrie montrent au niveau alliage un excellent comportement du Cr Co et du titane. Les céramiques montrent aussi des propriétés remarquables sur le plan biologique infirmant pour certaines les ressentis cliniques. Par contre une usure importante des dents naturelles antagonistes ne leur confère pas une biocompatibilité parfaite / In dentistry, the loss of natural elements is made up for by the use of reconstruction biomaterials of metal or ceramic origin. The use of the latter is now fastly developing and tends to supersede metal, to have only "all ceramic" elements. All these materials will remain in the mouth of the patients for a long time, which creates optimal conditions for the appearance of corrosion phenomena. Saliva is indeed an effective electrolyte. The variations in pH, temperature and polymetalism increase the speed of corrosion and the release of the component elements. The present study concerns five alloys usually used in prosthetic dentistry: one noble, one high noble, three basic alloys and several ceramics of infrastructure to replace alloys: zirconia, alumina and lithium disilicate. All the samples undergo a salivary attack in statics, and a combination of salivary action and wear in dynamics thanks to a unique machine, simulating as exactly as possible the buccal conditions. The analysis of the samples in the S.E.M., as well as the spectrometry results, suggest that the Co-Cr alloy and titanium present an excellent behaviour. Ceramics also show remarkable properties on the biological plan, in spite of certain people's clinical experience. However, an important wear of the opposing natural teeth does not give them a perfect biocompatibility

O objetivo deste trabalho foi avaliar a desmineralização do esmalte após períodos de 4, 7 e 10 dias de acúmulo de placa bacteriana in situ, além da influência de fatores salivares e microbiológicos no processo. Após a avaliação do fluxo salivar estimulado, capacidade tampão da saliva e níveis salivares de estreptococos do grupo mutans, 13 voluntários utilizaram dispositivos intrabucais palatinos contendo 4 blocos de esmalte bovino (4 X 4 X 2 mm) polidos, cobertos por uma tela plástica, durante 3 períodos cruzados de 4, 7 e 10 dias. Os voluntários utilizaram um dentifrício não fluoretado e gotejaram 10 vezes ao dia uma solução de sacarose a 20% sobre os blocos de esmalte. A microdureza superficial dos blocos foi determinada antes e após a desmineralização in situ, utilizando um penetrador Knoop e carga de 50 g por 5 s. Ao final de cada fase experimental, a placa bacteriana formada sobre os blocos foi coletada e a porcentagem de estreptococos mutans em relação ao número de bactérias totais foi determinada. Houve diferença estatisticamente significante, segundo o teste “t" pareado, entre a microdureza inicial e final nos três períodos estudados (p<0,05). A porcentagem de perda de dureza superficial (%PDS) foi em média de 13,8%, 19,3% e 48,3%, nos períodos de 4, 7 e 10 dias. Não houve diferença estatisticamente significante entre a %PDS com 4 e 7 dias, de acordo com a análise de variância e teste de Tukey (p<0,05). A correlação entre a %PDS e os fatores salivares e microbiológicos avaliados foi determinada por meio dos coeficientes de correlação de Pearson e Spearman, com p<0,05. Não foi encontrada correlação estatisticamente significante entre a %PDS e os fatores salivares avaliados inicialmente. Em aproximadamente metade das análises de placa bacteriana não foram detectados estreptococos mutans, embora tenha ocorrido desmineralização do esmalte. A porcentagem de estreptococos mutans na placa bacteriana não apresentou correlação com os níveis salivares dessas bactérias. Não foi encontrada correlação entre a %PDS e a porcentagem de estreptococos mutans na placa bacteriana formada sobre os blocos de esmalte. A %PDS nos blocos cobertos por placa bacteriana em que foram detectados estreptococos mutans foi estatisticamente maior do que nos blocos em que eles não foram detectados, apenas no período de 4 dias, de acordo com o teste de Mann-Whitney (p<0,05). Os resultados mostraram desmineralização do esmalte in situ após curtos períodos de acúmulo de placa bacteriana, não tendo sido encontrada relação com os fatores salivares avaliados ou com as contagens de estreptococos mutans na saliva e na placa. / The aim of this study was to evaluate the in situ enamel demineralization during 4, 7 and 10 days and some of the factors influencing the process. Before the beginning of the in situ phase, a stimulated whole saliva sample was collected from 13 volunteers for 5 min and the salivary secretion rate, buffering capacity and numbers of mutans streptococci were estimated. A palatal appliance containing 4 polished bovine enamel blocks (4 X 4 X 2 mm) covered by a plastic mesh was worn on 3 separate periods of 4, 7 and 10 days, throughout which time a non-fluoridated dentifrice was used. A 20% sucrose solution was dripped extra-orally onto the enamel blocks 10 times a day. All enamel blocks were evaluated by the analysis of enamel surface microhardness before and after in situ demineralization, using a 50 g, Knoop load for 5 s. At the end of each period, plaque covering the enamel blocks was collected and analyzed for the % of mutans streptococci of the total viable counts. Paired-t test showed that initial and final microhardness were statistically different at the three periods evaluated (p<0.05). Change in surface microhardness (%CSMH) was 13.8%, 19.3% and 48.3% during the 4, 7 and 10-day periods, respectively. There was no statistically significant difference on the %CSMH between 4 and 7 days, according to analysis of variance and Tukey’s test (p<0.05). Correlation between %CSMH and the salivary and bacteriological factors evaluated was determined using Pearson’s and Spearman’s coefficient of correlation (p<0.05). The %CSMH was not significantly correlated to the salivary factors determined initially. In about half of the plaque samples analyzed mutans streptococci were not detected, although the enamel showed some demineralization. The % of mutans streptococci in plaque samples was not correlated to its numbers in saliva. There was no statistically significant correlation between the %CSMH and the % of mutans streptococci in plaque over the enamel blocks. The presence of these bacteria in plaque significantly increased enamel demineralization when compared to the blocks where they were not detected only at 4 days, according to Mann-Whitney test (p<0.05). The results showed in situ enamel demineralization after short periods of plaque accumulation, which was not related to the salivary factors evaluated nor to the numbers of mutans streptococci in saliva or plaque.

Submitted by Edisangela Bastos (edisangela@ufpa.br) on 2013-04-29T22:16:17Z No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_PerfilClinicoEpidemiologico.pdf: 1551822 bytes, checksum: 837e684a10f55a1b030b4a209e391b3e (MD5) / Approved for entry into archive by Ana Rosa Silva(arosa@ufpa.br) on 2013-04-30T13:07:28Z (GMT) No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_PerfilClinicoEpidemiologico.pdf: 1551822 bytes, checksum: 837e684a10f55a1b030b4a209e391b3e (MD5) / Made available in DSpace on 2013-04-30T13:07:28Z (GMT). No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_PerfilClinicoEpidemiologico.pdf: 1551822 bytes, checksum: 837e684a10f55a1b030b4a209e391b3e (MD5) Previous issue date: 2009 / O objetivo deste estudo foi avaliar o perfil clínico-epidemiológico de saúde bucal em pacientes portadores de hanseníase em PQT através da avaliação clínica da mucosa bucal, dos indicadores epidemiológicos IPV (Índice de Placa Visível), ISG (ìndice de Sangramento Gengival), ICPOD (Índice de Dentes Cariados, Perdidos e Obturados) e mensuração do fluxo salivar pelo ISS (Índice de Secreção Salivar), além da capacidade tampão pelo pH salivar. A amostra foi de 80 pacientes na faixa etária de 8 a 73 anos submetidos ao exame clínico bucal e coleta estimulada de saliva, divididos em Grupo de Estudo (GE), constituído de 40 pacientes portadores de hanseníase em PQT, atendidos no CRTDS Dr. Marcello Candia Marituba-Pa; e Grupo Controle (GC), de pacientes não portadores de hanseníase. Os resultados apontaram, 62,5% de alterações inespecíficas da mucosa bucal, dentre as mais frequentes pigmentação racial na gengiva, linha alba mordiscada na mucosa jugal, inflamação gengival, varicosidade no ventre lingual e trauma por uso de prótese no GE, não havendo diferença estatística significante (p=0,14) com o GC. A média do IPV no GE foi de 50,4% das superfícies dentárias com acúmulo de placa bacteriana, não havendo também diferença estatisticamente significante (p=0,40) com o GC. O IPV foi maior nos indivíduos sem acesso ao serviço odontológico e à medida que aumentou o grau de incapacidade dos pacientes menor foi o acesso ao serviço. A média do ISG foi de 29,7% das superfícies dentárias com sangramento gengival, não havendo diferença estatística significante (p=0,35) com o GC. O ICPOD médio foi de 11,6 variando de 4,0 a 24, o que aumentou com o avanço da idade. O maior acúmulo de placa, o sangramento gengival e o consumo de alimentos carigênicos fora do horário da refeição também contribuiram para o aumento do ICPOD. Outro fator relacionado ao aumento de ICPOD foi o não acesso ao serviço odontológico por 70% dos pacientes hansenianos, havendo diferença estatisticamente significante (p=0,0005) com o GC e a falta de orientação de higiene bucal em 60%, havendo diferença estatisticamente significante (p=0,01) com o GC. O ISS médio foi de 0,9ml/min e não apresentou associação com as doses do PQT e nem com o uso de prednisona. Dos pacientes do GE, 25% apresentaram hipossalivação, mas não houve aumento de ICPOD e nenhum dos grupos revelou alteração de pH salivar, variando de 5,85 a 7,34, com capacidade tampão dentro do padrão de normalidade. Concui-se que perfil clínico-epidemiológico dos pacientes portadores de hanseníase assemelha-se a do grupo controle, não tendo sido diagnosticado nenhuma alteração da mucosa bucal específica para hanseníase, o que não anula, entretanto a póssibilidade da cavidade bucal ser fonte de infecção para hanseníase necessitando de confirmação histopatológica e/ou PCR para detecção de M. leprae viável. Além disso, os dados mostraram que a maioria dos pacientes hansenianos avaliados não tem acesso ao serviço odontológico, nem orientação de higiene bucal, resultante da falta de políticas públicas de saúde bucal para hansenianos. / The aim of this study was to evaluate the clinical-epidemiological profile of oral health in leprosy patients at multidrug terapy (MDT) through the oral mucosa clinic assessment, the VPI (visible plaque index), GBI (gum bleeding index), DMFTI (decayed, missing and filled teeth index) and salivary flow rate measure by SSI (salivary secretion index) as epidemiological indicators, well over buffeing capacity by salivary pH. The sample was 80 patients, aged from 8 to 73 years submited to the analysis of the oral conditions and stimulated saliva collection, divided in study group (SG) constituted of 40 leprosy patients in MDT carried in the CRTDS Dr. Marcello Candia Marituba-Pa, Brazil and control group (CG) of 40 no leprosy patients. The results pointed 62,5% unspecific oral lesions, among the most frequent was melanin pigmentation of the attached gingiva, mordiscatum line of the buccal mucosa, gingival inflammation, tongue varicose veins and trauma for use of prosthesis, without statistical significant difference (p=0,14) with the CG. The average of the VPI was 50,4 % of the dental surfaces with accumulation of bacterial plaque, without statistical significant difference (p=0,40) with the CG. The VPI was bigger in the individuals without access to the odontologic service and while it increased the degree of incapacity of the patients, juvenile was the access to the service. The average of the GBI was 29,7% of the dental surfaces with gingival bleeding, without statistical significant difference (p=0,35) with the CG. The middle DMFTI was of 11,6 varying from 4,0 to 24, which increases with the advancement of the age. The biggest accumulation of plaque, the gingival bleeding and the consumption of foods cariogenic out of the time-table of the meal also contributed to the increase of the DMFTI. Another factor made a list to the increase of I DMFTI was no access it to the odontologic service for 70 % of the leprosy patients, having statistical significant difference is (p=0,0005) with the CG and the lack of education of oral hygiene in 60 %, having statistical significant difference (p=0,01) with the CG. The middle SSI was of 0,9ml/min and did not present association with the MDT and not even with the use of prednisolone. The SG patients, 25 % presented hiposalivation, but there was no increase of DMFTI and none of the groups revealed alteration of salivary pH , varying from 5,85 to 7,34, with buffeing capacity inside the standard of normality. Conclusion that the clinical-epidemiological profile of leprosy patients is similar to the control group, do not have find specific oral lesions for leprosy, which does not cancel the possibility of the buccal cavity to be a fountain of infection for leprosy, needing histopathological confirmation and / or PCR for detection of viable M.leprae. Moreover, the data showed most of the leprosy patients do not have access to the odontologic service and not even education of oral hygiene, results absence of public politics of oral health for leprosy.

Les maladies à transmission vectorielle, qui représentent dix-sept pour cent de l’ensemble des maladies infectieuses, sont un réel problème de santé publique. Parmi elles, la borréliose de Lyme est la maladie vectorielle la plus répandue de l’hémisphère nord. Elle est causée par la transmission d’une bactérie, Borrelia burgdorferi sensu lato, par une tique dure du genre Ixodes. Le premier contact entre l’hôte vertébré et la tique, et donc a fortiori entre l’hôte vertébré et la bactérie, se fait au niveau cutané. La peau est donc une interface essentielle dans le développement précoce de l’immunité envers Borrelia. La tique effectue un repas de plusieurs jours qui induit une lésion cutanée par ses pièces piqueuses et sa salive, créant une cavité lui permettant de se nourrir. Ce processus facilite le repas sanguin, mais aussi la transmission de Borrelia. Nous avons caractérisé une protéine présente dans la salive de tique responsable de la formation de la cavité : l’histone H4. Celle-ci lyse les fibroblastes et possède une activité bactéricide envers les bactéries commensales de la peau. Ces deux activités pourraient être exploitées par Borrelia afin de favoriser sa transmission et son développement dans la peau. Une fois injectées, Borrelia et la salive interagissent avec les cellules de la peau telles que les kératinocytes de l’épiderme, les fibroblastes et les cellules immunitaires du derme. Nous avons montré que l’inflammation induite par la lésion augmente la réponse inflammatoire des kératinocytes contre Borrelia. Cependant, la salive de tique inhibe efficacement cette coopération inflammatoire dont la mise en place dépend des voies inflammatoires TLR3/TRIFF et TLR2/MyD88. Une fois la tique détachée de l’hôte vertébré et la salive de tique disparue, la coopération inflammatoire ne serait plus inhibée et pourrait expliquer en partie l’apparition de l’érythème migrans. L’inflammation cutanée précoce implique d’autres cellules que les kératinocytes et les fibroblastes telles que les macrophages, les cellules dendritiques ou encore les neutrophiles. Nous avons étudié l’implication d’un autre type cellulaire peu exploré dans le contexte de la borréliose de Lyme : les mastocytes. Ces cellules sont capables de répondre efficacement contre Borrelia par la sécrétion d’IL-6 et la dégranulation. Les antigènes bactériens nécessaires à l’activation des mastocytes semblent liés à la bactérie intacte et vivante. La salive de tique réduit la sécrétion d’IL-6 induite par Borrelia, mais ne l’inhibe pas complètement. A ce stade de nos études, les mastocytes ne semblent pas jouer un rôle majeur. Lors de la transmission, Borrelia exprime différents gènes qui lui permettront notamment de disséminer vers différents organes cibles de l’hôte vertébré : le système nerveux, l’articulation et la peau à distance. Nous avons identifié chez un clone de B. burgdorferi sensu stricto aux propriétés disséminatrices importantes, l'expression de deux gènes, bb0347 et bb0213, qui semblent associés à cette virulence. bb0347 code une protéine d’adhésion à la matrice extracellulaire, ce qui pourrait favoriser la migration de la bactérie à travers les tissus cutanés de l’hôte vertébré et donc sa dissémination. Le rôle de bb0213 n’est pas connu à ce jour. / Vector-borne diseases account for seventeen percent of world-wide infectious diseases. They are amajor threat to public health. Lyme borreliosis is the first vector-borne disease of the northernhemisphere. It is caused by a bacteria, Borrelia burgdorferi sensu lato, inoculated by a hard tickbelonging to the Ixodes genus. The first contact between the vertebrate host and the tick, and sobetween the vertebrate host and the bacteria, occurs at the skin interface. The skin is then of majorimportance for the early development of the immune response against Borrelia.The tick bite induces a skin injury owing to its biting pieces, the hypostome and two chelicerae. The ticksaliva also creates a feeding pool allowing the tick to feed efficiently. This process also facilitates Borreliatransmission. We have characterized a tick saliva protein which might participate to the formation ofthe feeding pool: histone H4. This protein lyses fibroblasts and harbors bactericidal properties againstcommensal bacteria. These two activities might help Borrelia to infect the vertebrate host by sustainingits development in the skin. Once bacteria have been injected into the skin, they interact with residentskin cells, keratinocytes and fibroblasts, and immune cells. We have shown that the inflammationinduced by the tick bite increases the keratinocyte inflammatory response against Borrelia. However,the saliva inhibits this cross-talk which depends on TLR3/TRIFF and TLR2/MyD88 pathways. Once thetick has detached and the saliva has disappeared, the cross-talk might explained the inflammationobserved during the erythema migrans.Other skin cells than keratinocytes and fibroblasts are involved in the early inflammatory responseagainst Borrelia such as dendritic cells, macrophages and neutrophils. We have explored theinvolvement of another poorly-studied cell-type: mast cells. We have shown that these cells can secreteIL-6 and degranulate in response to Borrelia. Bacteria antigens responsible of the activation mightdepends on the living state of Borrelia. The tick saliva is able to negatively control the secretion of IL-6,but not to completely inhibit it. At this point, we cannot conclude in a WSH mouse model deficient inmast cells, to a major role of these cells in the inflammatory response against Borrelia.While in the skin, Borrelia expresses many genes which will facilitate the dissemination across thevertebrate host, to reach different target organs (brain, joint, distant skin). We have characterized twogenes potentially involved in the dissemination of a virulent clone of B. burgdorferi sensu stricto: bb0347and bb0213. bb0347 encodes for an adhesion which can specifically interact with the extracellularmatrix of the skin while the role of bb0213 is unknown. bb0347 might help the bacteria to migratethrough skin tissues and then increases the infection rate.

<p>Булимија је у великом броју случајева праћена учесталим повраћањем, које у дужем временском периоду може резултирати иреверзибилним губитком зубних ткива и хиперсензитивношћу, као и квантитативним и квалитативним променама нестимулисане и стимулисане пљувачке. Циљ истраживања је био да се утврди присуство, локализација и степен денталних ерозија употребом BЕWЕ (Basic Erosive Wear Examination) индексног система, као и утврђивање вредности индекса меких наслага и гингивалног индекса папиларног крварења код пацијената са булимијом праћеном повраћањем и здравих испитаника. Циљ лабораторијских испитивања је био да се утврди количина и pH вредност нестимулисане и стимулисане пљувачке, као и концентрације јона калцијума, фосфата, бикарбоната и урее код пацијената са булимијом праћеном повраћањем и здравих испитаника. У истраживању је учествовало 30 испитаника оболелих од булимије праћене повраћањем и 30 здравих испитаника, а коришћене су анкетне методе (упитник), клиничко и лабораторијско испитивање. Клинички преглед обухватио је ектраоралну и интраоралну инспекцију, уз бележење статуса зуба и примену BЕWЕ индекса, индекса меких наслага и индекса гингивалног крварења. Лабораторијске методе подразумевале су обраду узорковане пљувачке уз утврђивање количине пљувачке, pH вредности и концентрације електролита. На основу резултата спроведеног истраживања утврђено је да пацијенти оболели од булимије праћене повраћањем значајно чешће имају денталне ерозије у односу на контролне испитанике, да су еродоване лезије тежег степена у булимичној групи што је праћено интензивнијим болним сензацијама на надражај, као и да су оне значајно чешће локализоване на оралним површинама зуба у оболелој групи. Утврђено је и да булимични испитаници имају више вредности гингивалног индекса папиларног крварења у односу на контролну групу, док су анализе пљувачке указале да булимични испитаници имају значајно мању количину нестимулисане пљувачке, значајно ниже pH вредности у обе фракције пљувачке, више концентрације калцијума у нестимулисаној пљувачки, ниже концентрације фосфата у обе фракције, ниже концентрације бикарбоната у нестимулисаној фракцији и ниже вредности урее у обе фракције пљувачке.</p> / <p>Bulimija je u velikom broju slučajeva praćena učestalim povraćanjem, koje u dužem vremenskom periodu može rezultirati ireverzibilnim gubitkom zubnih tkiva i hipersenzitivnošću, kao i kvantitativnim i kvalitativnim promenama nestimulisane i stimulisane pljuvačke. Cilj istraživanja je bio da se utvrdi prisustvo, lokalizacija i stepen dentalnih erozija upotrebom BEWE (Basic Erosive Wear Examination) indeksnog sistema, kao i utvrđivanje vrednosti indeksa mekih naslaga i gingivalnog indeksa papilarnog krvarenja kod pacijenata sa bulimijom praćenom povraćanjem i zdravih ispitanika. Cilj laboratorijskih ispitivanja je bio da se utvrdi količina i pH vrednost nestimulisane i stimulisane pljuvačke, kao i koncentracije jona kalcijuma, fosfata, bikarbonata i uree kod pacijenata sa bulimijom praćenom povraćanjem i zdravih ispitanika. U istraživanju je učestvovalo 30 ispitanika obolelih od bulimije praćene povraćanjem i 30 zdravih ispitanika, a korišćene su anketne metode (upitnik), kliničko i laboratorijsko ispitivanje. Klinički pregled obuhvatio je ektraoralnu i intraoralnu inspekciju, uz beleženje statusa zuba i primenu BEWE indeksa, indeksa mekih naslaga i indeksa gingivalnog krvarenja. Laboratorijske metode podrazumevale su obradu uzorkovane pljuvačke uz utvrđivanje količine pljuvačke, pH vrednosti i koncentracije elektrolita. Na osnovu rezultata sprovedenog istraživanja utvrđeno je da pacijenti oboleli od bulimije praćene povraćanjem značajno češće imaju dentalne erozije u odnosu na kontrolne ispitanike, da su erodovane lezije težeg stepena u bulimičnoj grupi što je praćeno intenzivnijim bolnim senzacijama na nadražaj, kao i da su one značajno češće lokalizovane na oralnim površinama zuba u oboleloj grupi. Utvrđeno je i da bulimični ispitanici imaju više vrednosti gingivalnog indeksa papilarnog krvarenja u odnosu na kontrolnu grupu, dok su analize pljuvačke ukazale da bulimični ispitanici imaju značajno manju količinu nestimulisane pljuvačke, značajno niže pH vrednosti u obe frakcije pljuvačke, više koncentracije kalcijuma u nestimulisanoj pljuvački, niže koncentracije fosfata u obe frakcije, niže koncentracije bikarbonata u nestimulisanoj frakciji i niže vrednosti uree u obe frakcije pljuvačke.</p> / <p>Bulimia is in many cases followed by frequent vomiting, which in long term can result in irreversible loss of dental tissue and hypersensitivity, as well as quantitative and qualitative changes of unstimulated and stimulated saliva. The aim of the research was to determine the presence, localization and degree of dental erosion using BEWE (Basic Erosive Wear Examination) index system, as well as to determine the values of soft debris index and papilla bleeding index in patients with purging bulimia and healthy subjects. The aim of laboratory research was to determine the amount and pH value of unstimulated and stimulated saliva, as well as the concentration of calcium, phosphate, bicarbonate and urea in patients with purging bulimia and healthy subjects. The study involved 30 bulimic patients and 30 healthy subjects. Used methods were survey (questionnaire), clinical and laboratory testing. The clinical examination included extraoral and intraoral inspection, assessment of dental status and application of BEWE index, soft debris index and papilla bleeding index. Laboratory methods involved the processing of sampled saliva and determination of saliva quantity, pH value and electrolyte concentrations. On the bases of conducted research, it has been found that purging bulimic patients have significantly more dental erosion than control subjects, that eroded lesions are more severe in the bulimic group, followed by more intense pain sensations on the stimulants, and that erosions are significantly more often located on oral surfaces of the teeth in the diseased group. It has been found that bulimic patients have higher values of papilla bleeding index then control subjects, while analyzes of saliva indicated that bulimic subjects had a significantly lower amount of unstimulated saliva, a significantly lower pH value in both salivary fractions, higher calcium levels in nonstimulated saliva, lower concentrations of phosphate in both fractions, lower bicarbonate concentrations in the unstimulated fraction and lower urea values in both salivary fractions.</p>

Am Beispiel der Wiederkäuer wurde unter Zuhilfenahme von biochemischen und molekularbiologischen Methoden die Adaptation von Pflanzenfressern (Herbivoren) an pflanzliche Sekundärmetabolite wie z.B. Tannine untersucht. Tannine können in nicht an ihren Verzehr adaptierten Spezies durch ihr Proteinbindungsvermögen die Nahrungsverwertung und damit Wachstum und Gesundheit des Pflanzenfressers beeinträchtigen (antinutritive Wirkung). <br /> Einige Wiederkäuerarten wie z.B. das Reh (Capreolus capreolus) haben in ihrem Nahrungsspektrum viele stark tanninhaltige Pflanzen, leiden aber nicht unter den erwähnten postdigestiven Konsequenzen. Eine Möglichkeit, die antinutritive Wirkung von Tanninen zu neutralisieren, besteht in der Produktion tanninbindender Speichelproteine. <br /> Der Speichel verschiedener Wiederkäuerarten wurde auf das Vorhandensein tanninbindender Proteine untersucht. Diese Arten wurden so ausgewählt, dass alle drei Ernährungstypen (Konzentratselektierer, Intermediärtyp, Gras- und Rauhfutterfresser) in den Vergleich eingeschlossen werden konnten. Als Referenzspezies wurde der Konzentratselektierer Reh herangezogen.<br /> Die Speichelproteine des Rehs und die der Intermediärtypen (Rentier, Rangifer tarandus; Damhirsch, Cervus dama; Moschusochse, Ovibos moschatus) banden ungefähr doppelt so effektiv an hydrolysierbare Tannine (Tanninsäure), wie die der untersuchten Gras- und Rauhfutterfresser (Rind, Bos taurus; und Mufflon, Ovis orientalis musimon). Diese Abstufung zeigte sich auch bei der Untersuchung der Bindung an kondensierte Tannine (Quebracho). Eine Ausnahme stellte Mufflonspeichel dar, dieser band ebenso gut an Quebracho wie die Speichelproteine der anderen Ernährungstypen.<br /> Über eine Aminosäuretotalanalyse konnte festgestellt werden, dass der Speichel einiger untersuchter Wiederkäuerarten prolinreiche Proteine (PRPs) enthielt. Unter Ausnutzung ihrer Trichloressigsäure (TCA)-Löslichkeit wurden diese angereichert und genauer untersucht. Die Analyse der TCA-löslichen Speichelproteine der Konzentratselektierer (Reh, Elch) ergab einen relativen Prolingehalt von über 35 %, während beim Moschusochsen noch 29 % gemessen wurden. In Damhirsch- und Rinderspeichel wurden keine prolinreichen Proteine gefunden.<br /> Für die TCA-löslichen Speichelproteine des Rehs konnte eine hohe Tanninbindungskapazität nachgewiesen werden. Diese banden 24 - 30 x effektiver an Tannine als die TCA-löslichen Speichelproteine des Rindes. Die Tanninbindungskapazitäten der TCA-löslichen Speichelproteine von Moschusochse und Damhirsch waren ebenfalls höher als die des Rindes, aber niedriger als die des Rehs. <br /> Die Kohlenhydrat-Analyse der TCA-löslichen Speichelproteine des Rehs erbrachte, dass es sich bei ihnen um Glykoproteine handelt. Mittels Gelfiltration und zweidimensionaler Polyacrylamidgelektrophorese konnten fünf Proteingruppen mit Molekulargewichten zwischen 15 und 50 kd sowie isoelektrischen Punkten zwischen 4,0 und 8,2 detektiert werden. <br /> Von 15 dieser Proteine konnten die N-terminalen Aminosäuresequenzen ermittelt werden. Ausgehend von diesen Informationen wurden Reh-PRP spezifische mRNAs isoliert und partiell sequenziert. Die meisten dieser Fragmente hatten eine gemeinsame 18 Aminosäuren lange C-terminale Sequenz PPPEEQPEE/QSPDEE/DSPSE. <br /> Die Suche nach Übereinstimmungen der analysierten Sequenzen mit anderen Säugetier-PRPs in der Genbank ergab keine sinnvollen Ähnlichkeiten. Die Ergebnisse können zu Informationen über tanninbindende Proteine anderer Wiederkäuer führen. Die Sequenzinformationen stellen einen Ausgangspunkt bei der Analyse der evolutiven Zusammenhänge der Cerviden dar. / Investigation of tannin binding salivary proteins of roe deer and other ruminants: <br /> In this work the adaptation of herbivores to plant secondary metabolites was investigated with help of biochemical and molecular biological methods. In unadapted species plant secondary metabolites as tannins can reduce food digestibility and thus diminish growth rate and health status (antinutritive action). Tannins act through its astringency, that means the high capacity to bind proteins, other macromolecules and metal ions. Some ruminant species feed on tannin containing plant but do not suffer from the mentioned nutritive consequences. The production of tannin binding proteins is one possible adaptation mechanism to neutralize the effects of the tannins.<br /> Saliva of six different ruminant species was investigated for the presence of tannin binding proteins. All three feeding types (concentrate selector, intermediate type and grass and roughage eater) were included in the comparison. <br /> Salivary proteins from roe deer (Capreolus capreolus, concentrate selector) and from the intermediate feeding types (rein deer, Rangifer tarandus; fallow deer, Cervus dama; musk ox, Ovibos moschatus) bound twice as effective to hydrolysable tannins (tannic acid) as those from the investigated grass and roughage eaters (cattle, Bos taurus; moufflon, Ovis orientalis). This differentiation could also be observed investigating the binding capacities to condensed tannins (quebracho) except for moufflon. Moufflon salivary proteins bound with the same intensity to quebracho as the salivary proteins from the other feeding types.<br /> Proline rich proteins (PRPs) could be accumulated from roe deer, moose and musk ox saliva by use of its solubility properties in 5 % trichloro acetic acid (TCA). Roe deer and moose TCA soluble salivary proteins contained more than 35 %, musk ox proteins 29 % proline. In fallow deer and cattle saliva PRPs could not be detected.<br /> A tannin binding assay demonstrated for the TCA soluble salivary proteins from roe deer, musk ox and fallow deer but not from cattle, that they are able to bind tannins. Roe deer salivary proteins bound 24 to 30 more effective to tannins as cattle proteins. Tannin binding capacity of the proteins from musk ox and fallow deer saliva was higher as those from cattle but lower as those from roe deer.<br /> For further analysis of ruminant tannin binding proteins we chose roe deer as reference species. Carbohydrate analysis of TCA soluble proteins from roe deer saliva showed that they were glycoproteins. With help of gel filtration and two dimensional polyacrylamid gel electrophoresis five proteins groups with molecular weights from 15 to 50 kd and isoelectric points from 4.0 to 8.2 could be detected.<br /> N-terminal amino acid sequences of 15 of the roe deer salivary TCA soluble proteins were determined by Edmann degradation. This information led to partially sequenced roe deer PRP specific cDNA. An 18 amino acid long C-terminal sequence was common in most of the clones. The obtained roe deer PRP sequences did not match with known mammalian PRP sequences from data banks. <br /> The finding in this work can lead to information about salivary tannin binding proteins in other ruminants. The sequence information represent a starting-point for the investigation of cervid evolution.