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Alterações endoteliais em lesões da cavidade oral : uma revisão sistemática
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Advisor(s)
Abstract(s)
Introdução: Na cavidade oral podem surgir vários tipos de lesões. Por vezes, alterações vasculares podem associar-se a este tipo de lesões. Nesse sentido, é importante distinguir o comportamento das células endoteliais perante as condições patológicas.
Objetivos: Analisar a importância do endotélio e o comportamento das células endoteliais nas lesões da cavidade oral.
Materiais e Métodos: Para a revisão sistemática foi efetuada uma pesquisa através de bases de dados das seguintes plataformas: Embase e Pubmed. Entre os critérios de inclusão foram considerados os artigos que descrevem lesões na cavidade oral mencionando a sua componente vascular. O levantamento bibliográfico foi feito sem estabelecer limite temporal.
Resultados: Verificou-se que existe um aumento da vascularização subepitelial em lesões orais como a Leucoplasia. A densidade capilar também está aumentada em pacientes com Líquen plano oral.
Discussão/Conclusões:
As alterações endoteliais são determinantes no desenvolvimento e progressão de lesões orais pré-malignas e malignas. A desregulação da angiogénese, mediada pela sinalização de fatores de crescimento como o VEGF, a mutação de genes supressores tumorais como o p53, e o aumento da densidade microvascular são fenómenos intimamente associados à disfunção endotelial e à progressão tumoral.
Mesmo na ausência de lesões orais, os estudos referem que a mucosa oral dos pacientes com hábitos alcoólicos e tabagismo apresenta uma maior densidade vascular; o predomínio de vasos sanguíneos de pequeno calibre subjacentes à membrana basal parece ser um aspeto ainda mais relevante nestes pacientes. As alterações ocorrem a nível do endotélio e parecem ser mais exuberantes nas lesões da cavidade oral. Atualmente, é evidente que o fator de crescimento endotelial vascular (VEGF) e outros fatores produzidos pelo endotélio, bem como alterações à sua expressão normal, vão condicionar e modificar o rumo do comportamento endotelial e, consequentemente, associam-se à progressão e severidade das próprias lesões.
Introduction: Various types of lesions can appear in the oral cavity. Sometimes, vascular changes can be associated with this type of injury. In this sense, it is important to distinguish the behavior of endothelial cells under pathological conditions. Aim: To analyze the importance of endothelium and the behavior of endothelial cells in oral cavity injuries. Materials and Methods: For the systematic review, a search was carried out through databases on the following platforms: Embase and Pubmed. Among the inclusion criteria, articles that describe lesions in the oral cavity mentioning their vascular component were considered. The bibliographic survey was carried out without establishing a time limit. Results: It was found that there is an increase in subepithelial vascularization in oral lesions, as evidenced in Leukoplakia. Capillary density is increased in patients with oral lichen planus. Discussion/Conclusion: Endothelial changes are decisive in the development and progression of pre-malignant and malignant oral lesions. The dysregulation of angiogenesis, mediated by the signaling of growth factors such as VEGF, the mutation of tumor suppressor genes such as p53, and the increase in microvascular density are phenomena closely associated with endothelial dysfunction and tumor progression. Even in the absence of oral lesions, studies report that the oral mucosa of patients with alcoholic habits and smoking has greater vascular density; the predominance of small blood vessels underlying the basement membrane seems to be an even more relevant aspect in these patients. The changes occur at the level of the endothelium and appear to be more exuberant in lesions of the oral cavity. Currently, it is evident that vascular endothelial growth factor (VEGF) and other factors produced by the endothelium, as well as changes to its normal expression, will condition and modify the course of endothelial behavior and, consequently, are associated with the progression and severity of injuries themselves.
Introduction: Various types of lesions can appear in the oral cavity. Sometimes, vascular changes can be associated with this type of injury. In this sense, it is important to distinguish the behavior of endothelial cells under pathological conditions. Aim: To analyze the importance of endothelium and the behavior of endothelial cells in oral cavity injuries. Materials and Methods: For the systematic review, a search was carried out through databases on the following platforms: Embase and Pubmed. Among the inclusion criteria, articles that describe lesions in the oral cavity mentioning their vascular component were considered. The bibliographic survey was carried out without establishing a time limit. Results: It was found that there is an increase in subepithelial vascularization in oral lesions, as evidenced in Leukoplakia. Capillary density is increased in patients with oral lichen planus. Discussion/Conclusion: Endothelial changes are decisive in the development and progression of pre-malignant and malignant oral lesions. The dysregulation of angiogenesis, mediated by the signaling of growth factors such as VEGF, the mutation of tumor suppressor genes such as p53, and the increase in microvascular density are phenomena closely associated with endothelial dysfunction and tumor progression. Even in the absence of oral lesions, studies report that the oral mucosa of patients with alcoholic habits and smoking has greater vascular density; the predominance of small blood vessels underlying the basement membrane seems to be an even more relevant aspect in these patients. The changes occur at the level of the endothelium and appear to be more exuberant in lesions of the oral cavity. Currently, it is evident that vascular endothelial growth factor (VEGF) and other factors produced by the endothelium, as well as changes to its normal expression, will condition and modify the course of endothelial behavior and, consequently, are associated with the progression and severity of injuries themselves.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Alterações endoteliais Células endoteliais Endotélio Lesões orais