Expressão imuno-histoquímica da MMP-9, VEGF e FVW em granulomas periapicais, cistos periapicais e cistos periapicais residuais




Angiogenesis has been related to the pathogenesis of periapical lesions. So that it occurs is necessary the action of powerful angiogênic factors and the participation of MMPs in the degradation of the extracellular matrix. The purpose of this study was to investigate the immunoexpression of MMP-9, VEGF and vWF in periapical granulomas (PG), periapical cysts (PC) and residual periapical cysts (RPC) to ensure the participation of angiogenesis in the development of these injuries. The quantitative analysis of VEGF in the connective tissue cells revealed similar average number of cells expressing this factor in PG and PC (564,9 e 565,0, respectively) and higher than in RPC (443,9), without statistically significant difference. There was a positive association between the intensity of the inflammatory infiltrate and the average number of cells expressing VEGF (p<0.01). In the epithelial lining, VEGF was strongly expressed by both PC (55%) as RPC (70%), pattern observed also in cases of atrophic (66,7%) and hyperplastic epithelium (55,6%), without difference statistically significant between the two types of cysts (p>0.05) and between atrophic and hyperplastic epithelial lining cysts (p>0.05). The average number of vessels expressing vWF was higher in PC (250,8) than in PG (210,4) and the RPC (217,0), without statistically significant difference between groups (p>0.05). Injuries showing intense inflammatory infiltrate exhibited greater number of vessels immunoreactive than those with mild or moderate inflammatory infiltrate (p<0.05). There was no correlation between the number of cells immunoreactive to VEGF and the number of vessels immunoreactive to the anti-vWF (r=0.224, p=0.118). The MMP-9 showed marked tendency to strong expression in most cases of GP (70%) and PCs (70%) and low expression in cases of CPR (60%). There was strong association between the expression of MMP-9 on endothelial cells and an intense inflammatory infiltrate (p=0055). Moreover, it was observed greater number of cells immunexpressing VEGF (p<0.01) and highest number of vessels immunoreactive to vWF (p=0051) in lesions with strong expression of MMP-9. The results of this study suggest that VEGF can act as an important stimulus for expression of MMP-9 in endothelial cells of blood vessels, influencing the angiogenic process in PG, PC and PRC. Additionally, the intensity of the inflammatory infiltrate plays important influence on the number of blood vessels, identified by the expressions of vWF, in the expression of MMP-9 in endothelial cells and the expression of VEGF in connective tissue cells in the lesions of this study. Finally, the strong expression of VEGF in the epithelial lining of the RPC suggests that there is a potential for growth in these injuries, probably because of the maintenance of a increased vascular permeability status.


angiogenesis cisto periapical fvw cisto periapical residual ciencias da saude vegf periapical granuloma residual periapical cyst mmp-9 mmp-9 granuloma periapical vegf angiogênese vwf periapical cyst

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