β-Defensins are small (3 to 5 kDa in size) secreted antimicrobial and antiviral proteins that are components of innate immunity. β-Defensins are secreted by epithelial cells, and they are expressed at high levels in several mucosae, including the mouth, where the concentration of these proteins can reach 100 μg/ml. Because of these properties, we wondered whether they could be part of the defenses that lower oral transmission of human immunodeficiency virus (HIV) compared to other mucosal sites. Our data show that select β-defensins, especially human β-defensin 2 (hBD2) and hBD3, inhibit R5 and X4 HIV infection in a dose-dependent manner at doses that are compatible with or below those measured in the oral cavity. We observed that β-defensin treatment inhibited accumulation of early products of reverse transcription, as detected by PCR. We could not, however, detect any reproducible inhibition ofenv-mediated fusion, and we did not observe any modulation of HIV coreceptors following treatment with hBD1 and hBD2, in both resting and phytohemagglutinin-activated cells. Our data instead suggest that, besides a direct inactivation of HIV virions, hBD2 inhibits HIV replication in the intracellular environment. Therefore, we speculate that β-defensins mediate a novel antiretroviral mechanism that contributes to prevention of oral HIV transmission in the oral cavity. Immunohistochemical data on hBD2 expression in oral mucosal tissue shows that hBD2 is constitutively expressed, forming a barrier layer across the epithelium in healthy subjects, while in HIV-positive subjects levels of hBD2 expression are dramatically diminished. This may predispose HIV-positive subjects to increased incidence of oral complications associated with HIV infection.
1 September 2006 in Journal of Cranio-Maxillofacial Surgery
There is no consensus about the surgical treatment of odontogenic myxoma. The aim of the current study was to present our experience and discuss the surgical management and outcome in 10 patients diagnosed with odontogenic myxoma. A retrospective review of charts of patients who were surgically treated for odontogenic myxoma was performed. Patients were recalled, and eventual recurrences were investigated. Eight lesions were mandibular, whereas 2 were maxillary. In 3 patients, enucleation and curettage was performed. Instead, in the remaining 7 patients, segmental resection and immediate reconstruction were decided. At follow-up, no patient showed recurrence of the lesion. Our protocol is to perform conservative surgery by enucleation and curettage when lesions were smaller than 3 cm, whereas a segmental resection with immediate reconstruction is preferred in patients affected by bigger tumors. Long-term follow-up is required, in particular when conservative surgery is preferred.
1 August 2004 in Journal of Cranio-Maxillofacial Surgery