Assessment of cases of lichenoid granulomatous stomatitis in respect to demographics, histological features, and subcategories in known population

Introduction: Lichenoid granulomatous dermatitis (LGD) is widely encountered lesions with both oral as well as dermal manifestation. Present study was done to evaluate lichenoid granulomatous stomatitis cases. Materials and methods: 226 biopsies were exposed to special stains such as acid-fast bacilli (AFB), immunohistochemical staining for CD 68 and Grocott methenamine-silver (GMS), and periodic acid‐Schiff (PAS) stains. Results: Out of 226 patients, males were 84 and females were 142. Maximum cases were seen in age group 40–60 years (122) followed by >60 years (56) and 20–40 years (48). The common site was buccal mucosa seen in 128 (56.6%) cases followed by vestibule in 30 (13.2%), gingiva in 26 (11.5%), tongue in 20 (8.8%), lip in 12 (5.3%) and palate in 10 (4.4%). The common lesion was oral lichen planus seen in 142 (62.8%), carcinoma in situ in 12 (5.3%), squamous cell carcinoma in 8 (3.53%), pemphigus vulgaris in 10 (4.42%), leukoplakia in 24 (10.6%) and pemphigoid in 30 (13.2%) cases. Most lesions were of type I seen in 117 (51.7%) cases. Conclusion: Lichenoid granulomatous dermatitis poses variety of clinical as well as oral features. A long standing follows up and consideration of differential diagnosis is mandatory for better management of patients.

Deciduoid Mesothelioma of Peritoneum Masquerading as Peritoneal Carcinomatosis.

Mesothelioma is an insidious neoplasm that develops from mesothelial cells. About 80 % of mesotheliomas originate in the pleural cavity. Other sites where it has been reported are the peritoneal cavity, tunica vaginalis, and the pericardium. A 45-year-old female presented with complaints of abdominal distention and pain for three months. Physical examination revealed signs of wasting of the appendicular and axial skeleton muscles, loss of subcutaneous fat, and hollowing of the eye sockets. There was pitting edema in the bilateral lower limbs. Per abdomen, examination revealed abdominal distension with umbilicus in the midline. On palpation, gross ascites was present, and no organomegaly, definitive mass, or lump was palpable. On percussion, the dull note was heard all over the abdomen, and fluid thrill was appreciated. The ascitic fluid examination revealed the presence of atypical cells. Omentectomy was done and sent for histopathological examination.The specimen of omentectomy was in multiple fragments and measured 17x16x3cm. Few of the fragments were nodular, soft to firm. On serial slicing, the cut section was gray-white with areas of necrosis. Microscopic examination showed sheets of malignant cells. These tumor cells were immunoreactive to EMA, Cytokeratin, Vimentin, Calretinin, WT-1, and D2-40 and immunonegative to Desmin (highlighting only the entrapped reactive mesothelial cells), Inhibin, BerEP4, TTF-1, CD 68, Napsin, ER, CEA, CDX2, PR, PAX-8, and SALL4. Ki 67 labelling index was 15%. The features were of Malignant Mesothelioma, Deciduoid variant. Deciduoid mesothelioma is a rare subtype with a poor prognosis. So, the mesothelioma should be distinguished from deciduosis.

Inner Retinal Layer Thickness Alterations in Early Age Related Macular Degeneration in Eyes with Subretinal Drusenoid Deposits or Conventional Drusen

The purpose of this study was to evaluate central and parafoveal inner retinal layer thickness in patients with subretinal drusenoid deposits (SDD) or conventional drusen (CD). Participants underwent comprehensive ophthalmoscopic examination. Evidence of SDD or CD was evaluated with near infrared reflectance and spectral domain optical coherence tomography. Quantification of subfoveal lesions was made through a qualitative analysis of vertical and horizontal SD-OCT scans centered on the fovea. Inner retinal layer macular thickness measurements were obtained for central circles with 1, 3, and 5 mm diameter. Continuous variables were compared by the analysis of covariance (ANCOVA) with post-hoc Tukey HSD correction for multiple comparison analysis. Fifty-five patients were included in the study; 18 eyes with SDD alone, 19 eyes with CD alone, and 18 eyes of healthy age-matched subjects. Eight eyes with SDD (44%) and 13 eyes with CD (68%) had subfoveal lesions. There was significant reduction in the inner retinal layer thickness in the central 1mm area and in the superior 3 mm area in the SDD and CD group compared to controls. In conclusion the inner retinal layer is thinner in the central macula and in the superior parafovea in eyes.

Clinical and morphological characteristics of COVID-19-associated myocarditis

Background COVID-19 is accompanied by the development of a wide range of cardiovascular lesions. The goal: to study the clinical and morphological features of SARS-CoV-2-associated myocarditis (SCM), determining the presence of viral RNA and proteins in myocardial tissue. Methods The study was based on 32 autopsies with a confirmed diagnosis of myocarditis. The average age of the patients was 72.7±15.5 years. Men predominated in the group (53%). The immunohistochemical determination of the surface markers of CD45, CD3, CD20, CD 68 inflammatory infiltrates and SARS-CoV-2 nucleocapsid and spike protein has been done. Detection of coronavirus RNA was performed. Results The clinical manifestations SCM included heart failure and variety of rhythm disturbances. Increased level of anticardiac antibodies was detected. Lymphomacrophage infiltrates (more than 7 CD3+ T-lymphocytes, more than 14 CD45+ lymphocytes and more than 7 CD68+ macrophages per 1 mm2) were found in 100% of cases. RNA of the virus was detected in myocardial tissue. Virus proteins were identified in macrophages of the inflammatory infiltrate and cardiomyocytes. Conclusion The results suggest persistence of the virus in the myocardium and the development of chronic myocarditis. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Russian Foundation for Fundamental Research

Modulation of Macrophage Polarization by Carbon Nanodots and Elucidation of Carbon Nanodot Uptake Routes in Macrophages

Atherosclerosis represents an ever-present global concern, as it is a leading cause of cardiovascular disease and an immense public welfare issue. Macrophages play a key role in the onset of the disease state and are popular targets in vascular research and therapeutic treatment. Carbon nanodots (CNDs) represent a type of carbon-based nanomaterial and have garnered attention in recent years for potential in biomedical applications. This investigation serves as a foremost attempt at characterizing the interplay between macrophages and CNDs. We have employed THP-1 monocyte-derived macrophages as our target cell line representing primary macrophages in the human body. Our results showcase that CNDs are non-toxic at a variety of doses. THP-1 monocytes were differentiated into macrophages by treatment with 12-O-tetradecanoylphorbol-13-acetate (TPA) and co-treatment with 0.1 mg/mL CNDs. This co-treatment significantly increased the expression of CD 206 and CD 68 (key receptors involved in phagocytosis) and increased the expression of CCL2 (a monocyte chemoattractant and pro-inflammatory cytokine). The phagocytic activity of THP-1 monocyte-derived macrophages co-treated with 0.1 mg/mL CNDs also showed a significant increase. Furthermore, this study also examined potential entrance routes of CNDs into macrophages. We have demonstrated an inhibition in the uptake of CNDs in macrophages treated with nocodazole (microtubule disruptor), N-phenylanthranilic acid (chloride channel blocker), and mercury chloride (aquaporin channel inhibitor). Collectively, this research provides evidence that CNDs cause functional changes in macrophages and indicates a variety of potential entrance routes.

Cellular composition of macrophage infiltration in patients with acute decompensation of ischemic HFrEF depending on the diagnosed human herpes virus type 6

Funding Acknowledgements Type of funding sources: None. Objective To determine the cellular composition of macrophage infiltration in patients with acute decompensation of ischemic heart failure (ADHF) depending on the diagnosed human herpes virus type 6 (HHV6) antigen expressions in myocardial tissue. Methods This open-label, nonrandomized, single-center, prospective trial was registered at clinicaltrials.gov (#NCT02649517) and included 25 patients (84% men, LVEF of 29.17 ± 9.4%) with ADHF. Inclusion criteria were ADHF, not earlier than 6 months after optimal surgery (PCI or/and CABG) and optimal drug treatment for HF according to ESC guidelines. Invasive coronary angiography was performed in all patients to exclude the progression of coronary atherosclerosis. All patients underwent endomyocardial biopsy with immunohistochemically analysis (IHC) for presence of HHV6. Immunohistochemical criteria of myocarditis were at least 14 leukocytes per sq. mm in the myocardium including up to 4 monocytes and 7 or more CD3+ T lymphocytes per sq. mm. Macrophage infiltration in the heart was assessed by double immunofluorescence. CD68 was a marker for the cells of the macrophage lineage, CD80 was considered as M1-like macrophage and CD163, CD206, stabilin-1 were as M2-like macrophage biomarkers. Each area was evaluated in 5 random fields. The 1 patient who did not have IHC was excluded from the analysis. Results After IHC, HHV6 antigen expression were detected in 63% (n = 15). There were HHV6-positive myocarditis in 42% (n = 10) and HHV6-positive patients without myocarditis - 21% (n = 5). HHV6-negative myocarditis was identified in 25% (n = 6) cases. HHV6-negative patients without myocarditis were founded in 12% (n = 3). Group with HHV6-positive myocarditis had a greater number of CD 45 (19.5 [14.0;31.0] & 14.0 [12.0;21.0], p = 0.446) and CD 68 (18.0 [14.0;30.0] & 12.0 [9.0;15.0], p = 0.075) cells than group with HHV6-negative myocarditis. The number of CD 68 (18.0 [14.0;30.0] & 12.0 [8.0; 14.0], p = 0.049) and CD 45 (19.5 [14.0;31.0] & 8.0 [7.0;8.0], p = 0.003) significantly were differed between groups with HHV6-positive myocarditis and with HHV6-positive patients without myocarditis. The analysis of macrophage infiltrate in the groups showed differences between groups with HHV6-positive myocarditis and HHV6-negative myocarditis only in the number of CD68-/CD80+ macrophages (57.0 [33.0;68.0] & 85.0 [75.5;110.0], p = 0.009). Cellular composition of macrophage infiltration is presented in pic. 1. Conclusions The incidence of myocardial HHV6 antigen expression was 63% in patients with ADHF. There were HHV6-positive myocarditis in 42% and carriage of HHV6 in 21% in this study. HHV6-positive myocarditis has been associated with a lot of number of CD 45 and CD 68 in myocardial tissue. The predominance of M2-like macrophages was observed in patients with HHV6-positive myocarditis and carriage of HHV6. There were the largest number of CD 68-/CD 80+ macrophages (M1) were detected in patients with HHV6-negative myocarditis. Abstract Figure.

IMMUNOLOGICAL CHARACTERISTICS OF THE INFLAMMATORY PROCESS IN THE PULP

The paper presents the immunological characteristics of the pathological process of the tooth pulp of an inflammatory nature. The content of key markers of inflammatory processes was studied: CD-68, which plays a role in the phagocytic activity of tissue macrophages and type 4 collagen - the main component of the basement membrane of epithelial cells, found in the wall of arterial vessels and the intrinsic substance of connective tissue. An increase in the number of macrophages and a significant increase in the expression of type 4 collagen in pulp inflammation were found. It has been shown that the inflammatory reaction in the pulp is characterized by a sufficient immunological potential for the involvement of a complex of periapical and periradicular tissues in the pathological process and its subsequent long-term completion.

Cerebellar ataxia and exercise intolerance in Erdheim-Chester disease

Background Erdheim-Chester disease (ECD), a rare disorder of monocyte/macrophage lineage, has been related to cerebellar dysfunction. To increase the awareness of this rare, protean disease, an unusual, myasthenia-like onset of ECD is reported. Case presentation A 42-year-old man presented with a 6-year history of mild evening fatigability in his four limbs followed by motor and cognitive symptoms associated with cerebellar atrophy, dentate nuclei and dentato-thalamic pathway degeneration. Magnetic resonance imaging revealed hyperintense signals in T2 and fluid-attenuated inversion recovery sequences within the pons, cerebellar white matter, dentate nuclei and globi pallidi in the absence of any contrast enhancement. Whole-body bone scintigraphy with 99Technetium - methylene diphosphonate and fluorodeoxyglucose-positron emission tomography both revealed symmetric uptake in the lower extremities a finding suggestive of a diagnosis of ECD. Histological examination revealed diffuse infiltration of CD 68+ histiocytes with foamy cytoplasms in the presence of B-type of Rapidly Accelerated Fibrosarcoma protein kinase (BRAF)V600E activating mutation in tumor cells. Conclusion In patients with myasthenia-like symptoms who test negatively for myasthenia gravis, neurodegenerative diseases, and disorders of the hypothalamus, a diagnosis of ECD should be taken into consideration.

IMPREGNATION OF ORAL MUCOSA OVER IMPACTED TEETH BY SUBPOPULATIONS OF MACROPHAGES M1 AND M2

The aim: Of the study is to research quantitative parameters of mucous membrane macrophages populations M1 (CD68+) and M2 (CD163+) over vestibularly and palatally impacted teeth. Materials and methods: A group of 21 people aged from 10 to 16 years was formed to conduct the research. Clinical situation according to diagnostic criteria was identical in all the patients. The group was divided into two groups - control and experimental, which in their turn were fragmented into two subgroups. Immunohistochemical studies of mucosal biopsies were performed in accordance with the recommendations for selection. Results: Study of ratio of CD68+/CD163+ cells revealed imbalance in individuals with vestibularly impacted teeth due to higher infiltration density of CD163+ (p<0,05), compared to CD68+ of control group. In individuals with palatally impacted teeth, ratio of CD68+/CD163+ increased 3,6 times, as well as compared with control group, but due increased infiltration density of CD68+. Conclusions: In the epithelium of oral mucosa located over impacted teeth, both on vestibular and palatal surface, number of CD 68+ and CD163+ cells had no significant differences compared to control group. In biopsies of the lamina propria of mucosa over vestibularly impacted teeth, the ratio M1/M2=0,91±0,11 (p<0,05) decreases, with predominance of macrophages CD163+ subpopulation activity, and over palatally impacted teeth balance of M1/ M2 macrophages elevated (M1/M2= 2,10 ± 0,32, p<0,05), due to increased infiltration density of CD68+.