Alpha-catenins play key functional roles in cadherin-catenin cell-cell adhesion complexes. We previously reported on αT-catenin, a novel member of the α-catenin protein family. αT-catenin is expressed predominantly in cardiomyocytes, where it colocalizes with αE-catenin at the intercalated discs. Whether αT- and αE-catenin have specific or synergistic functions remains unknown. In this study we used the yeast two-hybrid approach to identify specific functions of αT-catenin. An interaction between αT-catenin and plakophilins was observed and subsequently confirmed by co-immunoprecipitation and colocalization. Interaction with the amino-terminal part of plakophilins appeared to be specific for the central `adhesion-modulation' domain of αT-catenin. In addition, we showed, by immuno-electron microscopy, that desmosomal proteins in the heart localize not only to the desmosomes in the intercalated discs but also at adhering junctions with hybrid composition. We found that in the latter junctions, endogenous plakophilin-2 colocalizes with αT-catenin. By providing an extra link between the cadherin-catenin complex and intermediate filaments, the binding of αT-catenin to plakophilin-2 is proposed to be a means of modulating and strengthening cell-cell adhesion between cardiac muscle cells. This could explain the devastating effect of plakophilin-2 mutations on cell junction stability in intercalated discs, which lead to cardiac muscle malfunction.
In the long term, the most important future challenge of oral health care policies is to identify older adults before they begin to manifest such oral health deterioration. Regular dental visits should be strongly promoted by all (oral) health care workers during the lifespan of all persons including older adults.
Good oral health in old age is particularly important for maintaining adequate oral function, preventing pain and discomfort, controlling localized or systemic inflammation, sustaining social interaction and preserving quality of life. Given that oral health is an integral part of general health and well-being, and that major chronic systemic and oral diseases share common risk factors, oral health prevention and promotion should be embedded within routine medical assessment and care provision. The role of medical physicians, particularly primary care physicians, geriatricians and elderly care physicians, in community and long-term care facilities in assessing and promoting oral health in frail older adults is critical and has been emphasized in recent European recommendations. All physicians should appreciate the importance of oral health and incorporate an initial oral health screening into routine medical assessment and care. A short interview with patients and carers on current oral health practices may help to assess the risk for rapid oral health deterioration. The interview should be followed by an oral health assessment, using validated tools, for non-dental health care providers. Based on these findings the physician should decide on necessary follow-up procedures which may include oral health counseling and/or dental referral. Oral health counseling should include advice on daily oral, mucosal and denture hygiene, denture maintenance, dietary advice, smoking cessation, limitation of harmful alcohol consumption, management of xerostomia and frequent dental review. To enable physicians to perform the tasks recommended in this publication appropriate teaching at both undergraduate and postgraduate levels must be delivered in addition to provision of appropriate continuing education courses.
The integration of a dental professional team in nursing home organisations should be encouraged because it could be valuable to tackle barriers for the provision of daily oral hygiene and to support the continuous integration of oral health care into general care.
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