Comparative immunohistochemical and quantitative analysis of inflammatory cells in symptomatic and asymptomatic chronic periapical lesions

Abstract

Background/Aim. It has been demonstrated that lymphocytes, plasma cells, macrophages and neutrophil granulocytes represent the predominant cells of the inflammatory lesion of the dental granulomas. Other cells, such as mast cells, eosinophils, dendritic cells comprise minor, but functionally important cell populations. Most of the data considering cells that take part in these processes have been derived from immunohistological studies. This study was undertaken with the aim to determine the phenotype profile of inflammatory cells of dental granulomas using immunohistochemical method in order to study the differences of their quantitative properties and distribution between symptomatic and asymptomatic lesions. Methods. The material for the analysis originated from 42 individuals with clinic and radiographic diagnosis of chronic periapical lesions. The tissue was take either during the periradicular surgery, or tooth extraction. Cryostat tissue sections were stained using the alkaline phosphatase-antialkaline phosphatase assay (APAAP). This method is highly valid and sensitive using a panel of specific monoclonal antibodies: CD3, CD4, CD8, CD19, CD38, CD14, CD1a, CD83, CD80, CD86, CD45 and CD123. Results. The composition of the cell population revealed that there was no homogenous and site-specific pattern of the distribution of inflammatory cells. The results of our investigation revealed that the majority of inflammatory cells comprised lymphocytes and plasma cells, followed by subpopulations CD4+, CD8+ and CD14+ cells. Much lower in number were CD80+, CD86+ and CD83+ and CD1a+ cells. There were no statistically significant differences in mean values of inflammatory cells number between symptomatic and asymptomatic lesions, with the exception of CD86+ cells, the number of which was statistically higher in symptomatic lesions. Conclusion. Inflammatory infiltrate cells in dental granulomas are dominated by T- and Blymphocytes. It points out the complexity of immunopathogenic events in imitiating and progressing of dental granulomas that involve mechanisms of both cellular and humoral immunity. Regarding the quantitative presence of immunocompetent cells in symptomatic and asymptomatic lesions no statistically significant difference was determined unless in mature dendritic cells present in symptomatic lesions.Uvod/Cilj. Rezultati ranijih imunohistohemijskih studija pokazali su da su najbrojnije celije u hronicnim periapeksnim lezijama limfociti, plazmociti, makrofagi i neutrofilni granulociti, dok ostale celije, pre svega mastociti, eozinofilni granulociti i dendritske celije predstavljaju manje, ali funkcionalno znacajne celijske populacije. Cilj ovog rada bio je da se koriscenjem relevantne imunohistohemijske metode determinise fenotipski profil celija zapaljenskog infiltrata dentalnih granuloma, kao i da se odrede razlike u kvantitativnim odnosima i distribuciji celija izmedju simptomatskih i asimptomatskih hronicnih periapeksnih lezija. Metode. Materijal za analizu dobijen je od 42 bolesnika sa klinickom i radiografskom dijagnozom hronicne periapeksne lezije. Tkivo je uzeto tokom periradikulne hirurske intervencije ili ekstrakcije zuba. Metoda primenjena na smrznutim iseccima bila je alkalna fosfatazaantialkalna fosfataza (APAAP). Koriscen je panel monoklonskih antitela: CD3, CD4, CD8, CD19, CD38, CD14, CD1a, CD83, CD80, CD86, CD45 i CD123. Rezultati. Rezultati analize pokazali su da nije postojalo homogeno podrucje zapaljenja, predodredjeno da bude infiltrisano odredjenim tipom zapaljenskih celija. Utvrdili smo da su najbrojnije celije zapaljenskog infiltrata bili limfociti i plazmociti, zatim CD4+, CD8+ i CD14+, dok je broj CD80+, CD86+ i CD83+ i CD1a+ celija bio znatno manji. Srednje vrednosti broja zapaljenskih celija nisu pokazivale statisticki znacajne razlike izmedju grupe simptomatskih i asimptomatskih periapeksnih lezija, osim CD86+ celija, ciji je broj bio statisticki znacajno veci u grupi simptomatskih lezija. Zakljucak. Medju celijama zapaljenskog infiltrata u dentalnim granulomima dominiraju T i B limfociti. To ukazuje na kompleksnost imunopatogenetskih zbivanja u inicijalnoj fazi i progresiji dentalnih granuloma u koje su ukljuceni mehanizmi celularnog i humoralnog imuniteta. U pogledu kvantitativne zastupljenosti imunokompetentnih celija u simptomatskim i asimptomatskim lezijama nije ustanovljena statisticki znacajna razlika, osim u pogledu zrelih dendritskih celija koje su bile zastupljenije kod simptomatskih lezija.