title: T-helper cell type 17/regulatory T-cell immunoregulatory balance in human radicular cysts and periapical granulomas.
abstract: BACKGROUND
  Cysts and granulomas are chronic periapical lesions mediated by a set of inflammatory mediators that develop to contain a periapical infection. This study analyzed the nature of the inflammatory infiltrate, presence of mast cells, and in situ expression of cytokines (interleukin [IL]-17 and transforming growth factor [TGF]-beta), chemokines (macrophage inflammatory protein [MIP]-1beta and monocyte chemotactic protein [MCP]-1), and nuclear transcription factor (FoxP3) in human periapical granulomas and cysts compared with a control group.
  
  
  METHODS
  Fifty-five lesions (25 periapical cysts, 25 periapical granulomas, and 5 controls) were analyzed. The type of inflammatory infiltrate was evaluated by hematoxylin-eosin staining, and the presence of mast cells was analyzed by toluidine blue staining. Indirect immunohistochemistry was used to evaluate the expression of cytokines, chemokines, and FoxP3.
  
  
  RESULTS
  The inflammatory infiltrate mainly consisted of mononuclear cells. In cysts, mononuclear infiltrates were significantly more frequent than mixed (polymorphonuclear/mononuclear) infiltrates (P = .04). Mixed inflammatory infiltrates were significantly more frequent in patients with sinus tract (P = .0001). The number of mast cells was significantly higher in granulomas than in cystic lesions (P = .02). A significant difference in the expression of IL-17 (P = .001) and TGF-beta (P = .003) was observed between cysts and granulomas and the control group. Significantly higher IL-17 levels were also observed in cases of patients with sinus tract (P = .03).
  
  
  CONCLUSIONS
  We observed that chronic periapical lesions might experience a reagudization process that is correlated with an increased leukocyte infiltration, with the predominance of neutrophils attracted by a chemokine milieu, as well as the increased presence of IL-17.
authors.affiliation: Laboratory of Immunology, University of Uberaba-UNIUBE, Uberaba, Brazil.
authors.forename: Juliana R B
authors.initials: JR
authors.lastname: Marçal
authors.forename: Renata O
authors.initials: RO
authors.lastname: Samuel
authors.forename: Danielle
authors.initials: D
authors.lastname: Fernandes
authors.forename: Marcelo S
authors.initials: MS
authors.lastname: de Araujo
authors.forename: Marcelo H
authors.initials: MH
authors.lastname: Napimoga
authors.forename: Sanivia A L
authors.initials: SA
authors.lastname: Pereira
authors.forename: Juliana T
authors.initials: JT
authors.lastname: Clemente-Napimoga
authors.forename: Polyanna M
authors.initials: PM
authors.lastname: Alves
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Mattar
authors.forename: Virmondes
authors.initials: V
authors.lastname: Rodrigues
authors.forename: Denise B R
authors.initials: DB
authors.lastname: Rodrigues
mesh_terms: D000328:Adult; D002452:Cell Count; D018932:Chemokine CCL2 / Q000032:analysis; D054407:Chemokine CCL4 / Q000032:analysis; D002634:Chemotaxis, Leukocyte / Q000276:immunology; D005260:Female; D051858:Forkhead Transcription Factors / Q000032:analysis; D006801:Humans; D020381:Interleukin-17 / Q000032:analysis; D007958:Leukocyte Count; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000473:pathology; D008297:Male; D008407:Mast Cells / Q000276:immunology / Q000473:pathology; D020556:Neutrophil Infiltration / Q000276:immunology; D009504:Neutrophils / Q000276:immunology / Q000473:pathology; D016155:Oral Fistula / Q000276:immunology / Q000473:pathology; D010484:Periapical Granuloma / Q000276:immunology* / Q000473:pathology; D011842:Radicular Cyst / Q000276:immunology* / Q000473:pathology; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D016212:Transforming Growth Factor beta / Q000032:analysis
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D054407:Chemokine CCL4; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D020381:Interleukin-17; D016212:Transforming Growth Factor beta