The objective of our study was to evaluate the T-helper (Th) and regulatory T (Treg) cell profile in ANCA-positive granulomatosis with polyangiitis (GPA) and its relation to disease activity. In a prospective study, we studied two groups of GPA patients: (i) disease flare (active-GPA, BVAS>6, n = 19), (ii) sustained remission (≥ 1-year prior enrollment, inactive-GPA, BVAS = 0, n = 18). 24 age-sex matched healthy subjects served as controls. Active-GPA patients were followed for 6 months and reevaluated during remission (early remission; n = 13). We analyzed subsets of Th-cells (flow cytometry), production of signature cytokines by in vitro stimulated lymphocytes, and broad spectrum of serum cytokines (Luminex). In all GPA patients we observed expansion of effector Th17 cells, and increased production of IL-17A by in vitro stimulated T cells, as compared to controls. Disease flare was characterized by marked reduction in Treg cells, whereas in sustained remission we showed expansion of both Treg and Th2 subset. Finally, analyzing the cytokine profile, we identified CCL23 and LIGHT, as potential biomarkers of active disease. We conclude that in GPA, expansion of Treg and Th2 lymphocytes in parallel to increased Th17 response is a characteristic feature of sustained remission. In contrast, Treg cells are markedly decreased in disease flare.

IntroductIon Crohn's disease (CD) is a chronic granulomatous inflammatory disease of the entire gastrointestinal tract. Its etiology is unknown. The disease manifests itself with exacerbation (and then remission) of such symptoms as abdominal pain, fever, and weight loss, and is associated with many general and gastrointestinal complications. 1 Therapy involves the use of mesalazine and azathioprine. In active CD, corticosteroids and anti-tumor necrosis factor α (TNF-α) are introduced. 2,3 Since the first description of inflammatory lesions in the oral cavity of patients with CD, it has been well established that the mouth may be involved in the disease. 4 The prevalence of oral lesions is particularly common in children (48%-80%) compared with adults (0.5%-20%), but only a small proportion of lesions with granulomatous inflammation is characteristic of oral CD. 5-10 Nonspecific lesions, including aphthous stomatitis, ulcerations, and atrophic glossitis,

Introduction Increased oxidative stress has been implicated in the pathogenesis of Crohn disease (CD). Except for C‑reactive protein (CRP), good biological markers of CD activity are lacking. Objectives We aimed to investigate the diagnostic usefulness of selected markers of oxidative stress in the serum and saliva of patients with active and inactive CD. Patients and methods A total of 58 patients with confirmed CD (32 with active CD, 26 with inactive CD, and 26 healthy controls) were prospectively enrolled to the study. The markers examined were malondialdehyde (MDA), ferric reducing ability of plasma (FRAP), reduced glutathione (GSH), and catalase (CAT). Results MDA levels were higher in the serum and saliva of patients with active CD than in those with inactive CD and controls and were positively correlated with the Crohn's Disease Activity Index (r = 0.8, P <0.001) and CRP (P <0.001). Serum and saliva antioxidant indicators (FRAP and GSH) were decreased in both CD groups compared with controls and were negatively correlated with clinical activity and inflammation (FRAP, r = -0.5, P <0.001; GSH, r = -0.5, P <0.001; and CAT, r = -0.5, P <0.001). Conclusions The increased lipid peroxidation and decreased antioxidant activity in serum and saliva confirm that CD patients are under oxidative stress. The positive correlations of MDA with the clinical activity and inflammation, as well as the comparison of the receiver operating characteristic curves for MDA and CRP, suggest that MDA could be a good diagnostic marker of CD.

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By means of a finite element method (FEM), the present study evaluated the effect of fiber post (FP) placement on the stress distribution occurring in endodontically treated upper first premolars (UFPs) with mesial–occlusal–distal (MOD) nanohybrid composite restorations under subcritical static load. FEM models were created to simulate four different clinical situations involving endodontically treated UFPs with MOD cavities restored with one of the following: composite resin; composite and one FP in the palatal root; composite and one FP in the buccal root; or composite and two FPs. As control, the model of an intact UFP was included. A simulated load of 150 N was applied. Stress distribution was observed on each model surface, on the mid buccal–palatal plane, and on two horizontal planes (at cervical and root-furcation levels); the maximum Von Mises stress values were calculated. All analyses were replicated three times, using the mechanical parameters from three different nanohybrid resin composite restorative materials. In the presence of FPs, the maximum stress values recorded on dentin (in cervical and root-furcation areas) appeared slightly reduced, compared to the endodontically treated tooth restored with no post; in the same areas, the overall Von Mises maps revealed more favorable stress distributions. FPs in maxillary premolars with MOD cavities can lead to a positive redistribution of potentially dangerous stress concentrations away from the cervical and the root-furcation dentin.

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Various material properties are involved in the success of endodontically treated restorations. At present, restorative composites are commonly employed as core build-up materials. This study aimed to systematically review the literature to assess the effect of using composite core materials on the in vitro fracture of endodontically treated teeth. Two different reviewers screened the literature, up to June 2021, in five distinct electronic databases: PubMed (MedLine), Scopus, Scielo, ISI Web of Science, and EMBASE. Only in vitro studies reporting the effect of the use of composite core materials on the fracture resistance of endodontically treated teeth were included. A meta-analysis was carried out using a software program (Review Manager v5.4.1; The Cochrane Collaboration, Copenhagen, Denmark). The risk of bias in each study was assessed following the parameters of another systematic review. A total of 5016 relevant papers were retrieved from all databases. After assessing the title and abstract, five publications remained for qualitative analysis. From these, only three studies remained for meta-analysis. The fracture strength of endodontically treated teeth where a core build-up composite was used was statistically significantly higher than the control (p = 0.04). Most of the analyses showed a high heterogenicity. The in vitro evidence suggests that the composite core build-up with higher filler content tended to improve the fracture resistance of the endodontically treated teeth, in comparison with conventional composite resins. This research received no external funding. Considering that this systematic review was only carried out on in vitro papers, registration was not performed. Furthermore, there were no identified clinical studies assessing core build-up materials; therefore, more well-designed research on these materials is needed.