Keratinous Research Articles

The Transcription Factor StuA Regulates the Glyoxylate Cycle in the Dermatophyte Trichophyton rubrum under Carbon Starvation.

Trichophyton rubrum is the primary causative agent of dermatophytosis worldwide. This fungus colonizes keratinized tissues and uses keratin as a nutritional source during infection. In T. rubrum-host interactions, sensing a hostile environment triggers the adaptation of its metabolic machinery to ensure its survival. The glyoxylate cycle has emerged as an alternative metabolic pathway when glucose availability is limited; this enables the conversion of simple carbon compounds into glucose via gluconeogenesis. In this study, we investigated the impact of stuA deletion on the response of glyoxylate cycle enzymes during fungal growth under varying culture conditions in conjunction with post-transcriptional regulation through alternative splicing of the genes encoding these enzymes. We revealed that the ΔstuA mutant downregulated the malate synthase and isocitrate lyase genes in a keratin-containing medium or when co-cultured with human keratinocytes. Alternative splicing of an isocitrate lyase gene yielded a new isoform. Enzymatic activity assays showed specific instances where isocitrate lyase and malate synthase activities were affected in the mutant strain compared to the wild type strain. Taken together, our results indicate a relevant balance in transcriptional regulation that has distinct effects on the enzymatic activities of malate synthase and isocitrate lyase.

Modified phenol chloroform protocol for genomic DNA extraction from keratinous tissue

DNA extraction enables the isolation and purification of genetic material by physical-chemical methods. There are specific protocols for different types of samples as animal and plant tissue. However, there are variations and particularities according to the nature of the fabric, such as the high presence of keratin. Thus, the present work aimed to develop and optimize a DNA extraction protocol from feather based on the Phenol-Chloroform method. Feather samples werw collected from 9 birds native to the Amazon region for the genetic material extraction. The DNA was precipitated with isopropanol and washed with 70% ethanol. Subsequently, the pellet was disolved in the TE buffer. The results indicated satisfactory concentrations for post-extraction molecular biology techniques such as PCR. The protocol showed a significant reduction in the incubation time to 1 hour compared to other protocols aimed at feather samples. Addition proteinase K to the lysis solution was the main factor that led to the optimization of the extraction time. The A260/230 and A260/280 absorbance ratios indicated the quality of the extracted DNA being close to what expected. Therefore, the results demonstrate the potential protocol use for molecular biology studies in birds from feather samples. However volume of phenol-chloroform and 70% ethanol can still be adjusted to suit the type sample.

IDENTIFIKASI DERMATOFITA PADA SISIR TUKANG PANGKAS DI KOTA BARU PONTIANAK

Abstract: Dermatophytes are fungi that parasitize keratinized tissues such as human skin, nails and hair. Dermstophytosis is also called tinea and has variations according to its anatomical location, such as tinea capitis, tinea barre, tinea krkuris, tinea pedis and tinea corporis. Tinea capitis is a skin disease caused by dermatophyte fungi. Transmission of this disease is very easy through shoes, clothes, hats and combs that are used interchangeably, such as at barbershops and other public facilities. Barbershops are public places where disease transmission can occur from person to person through shavers, combs, scissors and razors. Symptoms of this infection can vary, generally the scalp will feel itchy, round bald spots appear, small boils in groups, scaly, red. This study aims to determine whether or not there are dermatophyte fungi on barber combs in the new city of Pontianak. This research uses a descriptive research design. The population of this research is barbers in the Pontianak New City area. The sample for this research was 30 combs used by barbers. The examination was carried out using the spread method on Sabouraud Dextrose Agar media.The results of examining samples of combs used by barbers in Pontianak Baru City showed that the combs were infected with Dermatophyte fungi. Of the 30 comb samples examined, 16 samples (53.3%) were found to be positive for Dermatophyte fungi and 14 samples (46.7%) were negative for fungi Dermatophytes. Based on the results of research conducted on barber combs in the new city of Pontianak, it was found that samples of combs were infected with dermatophyte fungi with microscopic characteristics, namely, the Trichophyton rubrum fungus is in the form of many small microconidia and arranged one by one, while Trichophyton mentagrophytes has the characteristics of shaped microconidia. round and clustered like grapes.

Comparison between the efficacy of terbinafine and itraconazole orally vs. the combination of the two drugs in treating recalcitrant dermatophytosis

Fungal infections are a challenging to treat cutaneous condition. Approximately 20–25% of humans are affected by superficial fungal infections that invade and multiply within keratinized tissues. To compare the efficacy of either terbinafine or itraconazole orally versus the combination of the two drugs in the treatment of recalcitrant dermatophytosis. The current study included 45 patients with recalcitrant dermatophytosis who were distributed into 3 groups (each of 15 patients); Group A received terbinafine 250 mg twice a day for 4 weeks. Group B received itraconazole 200 mg twice a day for 4 weeks. Group C received terbinafine 250 mg once daily and itraconazole 200 mg once daily for 4 weeks. The patients were followed up for 12 weeks after initiation of treatment by clinical and microbiological assessment to determine the cure rate. At the end of twelve weeks, 12 (80%) patients in group A; 13 (86.7%) patients in group B and 15 (100%) patients in group C were completely cured. Despite of cure rates being higher in the combined group C; yet results were not statistically significant (p = 0.207). Clinical cure rates were non significantly higher in itraconazole + terbinafine combined group (p = 0.207). Combination of terbinafine and itraconazole had a higher clinical and mycological cure rate when compared to the use of either drug alone as monotherapy. Further randomized, multicenter, large cohort studies are warranted to validate the use of combination antifungal treatments.

Research Article In-vitro Anti-dermatophytic Activity of Different Medicinal Plant Extracts

Background: Dermatophytosis is most common superficial skin infection and dermatophytes are fungi that invade within keratinized tissues; skin, hair and nails. In many studies reported that some medicinal plant are very useful to treat various skin disease included dermatophyte, because these medicinal plants are natural so have low cost, high availability, few side effects and valuable resources. Objective: To evaluate the antifungal activity of Melaleuca alternifolia, Zingiber officinale, Allium sativum, Azadirachta indica, Citrus limonum, Curcuma longa, and Cocos nucifera against the different dermatophytes causing skin infections. Methods: The Melaleuca alternifolia (tea tree oil), Azadirachta indica (neem oil), Cocos nucifera (coconut oil) and fresh juice of Citrus limonum (Lemon) and aqueous extracts of Zingiber officinale, Allium sativum and Curcuma longa were explored for antifungal susceptibility testing as per CLSI guidelines by agar well diffusion method. Results: Anti-fungal potentials of the oils and aqueous extracts of different medicinal plants were tested against Trichophyton mentagrophytes, T. rubrum, T. tonsurans, T. verrucosum, Epidermophyton floccosum, Microsporum gypseum, M. canis. All the seven dermatophytes were susceptible to Melaleuca alternifolia, Zingiber officinale and Allium sativum, showed inhibitory zone ranges from 40±2.0mm to 45±2.0mm. Whereas, Azadirachta indica showed inhibitory zone ranges from 18±2.0 mm to 35±2.0mm for all the seven dermatophytes followed by Citrus limonum. On the contrary Curcuma longa and Cocos nucifera not effective against any tested dermatophytes. Conclusion: The current research provides a scientific validation for the use of these medicinal plants in the treatment of dermatophytic infection and could be used in future for dermatophytic infection and other skin infection.

Combining Residue and Macroscopic Use-wear Analysis of Quartz Objects in Kraakanmäki 3 Late Neolithic Settlement Site, Western Finland

Microscopic remains of plants, hairs, blood, bone, and sinew have been detected on Stone Age implements as evidence of the ways the tools were used. Together with use-wear analysis, microresidues enable us to obtain additional information of artefact biographies. However, the preservation of residues is not a straightforward issue. Although bones, plant matter, and wood have a tendency to decompose rapidly in acidic podzol soils, the acidity favours the preservation of keratinous tissues such as hairs and feathers. Because the analysis of microresidues has not been applied on Finnish quartz artefacts, this paper presents a preliminary testing of the method in a Late Stone Age settlement site in Kraakanmäki 3, western Finland. As a result, we found microscopic remains of hairs, feathers, and plants, which enable us to speak for the careful handling of quartz and stone tools at the excavations for further analyses.

BITACORA: An isotopic database of modern human tissues (keratin, teeth) for Argentina

As a consequence of the recent history of Argentina related to crimes against humanity, the country has positioned itself as a leader on Forensic Anthropology in human rights contexts. To some extent it can even be argued that Forensic Genetics for human identification had its origins in human rights work in the early 1980s in Argentina. However, there are still hundreds of unidentified human remains recovered from the dictatorial regimes’ crimes. Additionally, every year there are dozens of unidentified deceased buried in public cemeteries. Thus, there is an urgent need to adopt new techniques that could increase the biological profile of a person, and therefore increase the chances of positive identifications. One of such initiatives is the development of isotopic databases and models that can provide information on the population and region of origin of unidentified victims. We present the development of an isotopic database of modern human tissues named BITACORA (from its name in Spanish: Base de Información Isotópica de Tejidos Actuales Como Referencia Argentina). BITACORA holds isotopic data (δ18O, δ2H, δ13C, δ15N and δ34S values) from teeth (enamel and dentine) and keratin tissues (scalp hair, beard and fingernails) obtained from volunteers of known origin, as well as individual information of the donors (age, gender, biometrics, dietary preferences, and relocation history). BITACORA is associated with a tap water isotope database. Currently, we have 345 keratin, 273 teeth and 287 tap water samples gathered from across the country. We present preliminary analyses on the geographic distribution of these isotopic markers, and provide an overall discussion of the current status and future development of the databases.

Clinical and histologic evaluation of heterotopic mucosa transpositioning at teeth and dental implants.

To investigate the healing after heterotopic mucosa transpositioning at dental implants and teeth. One hemimandible per dog (n = 4) was allocated to receive 3 implants (test), whereby 3 premolars on the contralateral side served as controls. After osseointegration, a Z-plasty was performed on the buccal aspect of the test and control sites to heterotopically move the zone of keratinized tissue (KT) into a region with non-keratinized tissue (nKT) and vice versa. Clinical measurements were performed before (T0) and at 12 weeks following heterotopic transposition (T1). Thereafter, specimens were processed for histological analysis. Clinical measurements revealed that at T1, a band of KT was reestablished at teeth (mean: 2.944 ± 1.866 mm), whereas at implants, the transpositioned nKT resulted in a mucosa without any signs of keratinization (mean: 0 mm; p < .0001). At implant sites, the probing attachment level loss was more pronounced compared to tooth sites (-1.667 ± 1.195 mm and -1.028 ± 0.878 mm, respectively; p = .0076). Histologically, the transpositioned nKT, was accompanied by the formation of KT at the tooth but not at implant sites. The supracrestal soft tissues were statistically significantly higher at tooth compared to implant sites (2.978 ± 0.483 mm and 2.497 ± 0.455 mm, p = .0083). The transpositioned KT remained mostly unaltered in its morphological characteristics. The findings of this study indicate that: (a) transpositioned KT may retain its morphological characteristics; and (b) transpositioned nKM was accompanied by the formation of KT at the tooth but not at implant sites.

Subtilisin 3 production from Microsporum canis is independent of keratin substrate availability.

Dermatophytes are highly infectious fungi that cause superficial infections in keratinized tissues in humans and animals. This group of fungi is defined by their ability to digest keratin and encompasses a wide range of species. We investigated a critical adhesion protein, subtilisin 3, utilized by Microsporum canis during initial stages of infection, analyzing its production and expression under varying growth conditions. Additionally, as this protein must be expressed and produced for dermatophyte infections to occur, we developed and optimized a diagnostic antibody assay targeting this protein. Subtilisin 3 levels were increased in culture when grown in baffled flasks and supplemented with either l-cysteine or cat hair. As subtilisin 3 was also produced in cultures not supplemented with keratin or cysteine, this study demonstrated that subtilisin 3 production is not reliant on the presence of keratin or its derivatives. These findings could help direct future metabolic studies of dermatophytes, particularly during the adherence phase of infections.

Digital and clinical approach to quantifying periodontal tissue changes after crown lengthening surgery: A case series pilot study

Crown lengthening surgery is a common periodontal procedure carried out to increase the amount of tooth exposure for aesthetic or restorative purposes. It is crucial for clinicians to understand the effect of crown lengthening surgery on the periodontal tissues to prevent relapse or over treatment. Even though various clinical parameters have been used by researchers in the past to quantify the amount of suprastructure exposed, the use of digital technology has not been widely adopted. The aim of this case series was to evaluate the changes in periodontal tissue after crown lengthening surgery with both clinical and digital approaches. This case series included five patients who underwent surgery at the Postgraduate Periodontics Clinic at the University of Otago over the period of six months. Clinical parameters such as probing depth, gingival recession, keratinised tissue height, plaque accumulation, gingival inflammation, crown height, gingival phenotype, and bone height were measured with a customised probing stent at baseline and 1-, 3-, and 6-month post-surgery. Digital impressions were also taken along with the clinical parameters to measure the volumetric changes. Most significant changes were observed in crown exposure, gingival recession and bone levels, followed by probing depth reduction for treated sites. Minimal changes were seen for the width of keratinised tissues, plaque levels and gingival scores. Volumetric changes were only significantly reduced after 6 months of healing. This case series found that crown lengthening resulted in an increase in tooth exposure and a reduction in tissue volume. Volumetric changes measured through sequential digital impressions were also comparable to clinical findings.

Effect of post-surgical flap position on soft tissue regrowth and keratinized tissue increase following fibre retention osseous resective surgery: a 6-month randomized study with multilevel analysis

BackgroundThe aim of this randomized split-mouth study was to assess the influence of primary flap position on the amount of coronal soft tissue regrowth and keratinized tissue (KT) 6 months after osseous resective surgery with fiber retention technique (FibReORS).Materials and methodsTwo contralateral posterior sextants in 16 patients were treated with FibReORS and randomly assigned to flap positioning either 2 mm below the bone crest (apical group) or at the level of bone crest (crestal group). Clinical parameters were recorded at 1, 3 and 6 months and patient-related outcomes during the first two post-operative weeks.ResultsHealing period was uneventful. Patient’s discomfort was similar in both groups. The overall soft tissue rebound was higher in the apical than in the crestal group (2.0 ± 1.3 mm versus 1.3 ± 0.7 mm), but the difference was statistically significant only interproximally (2.2 ± 1.3 mm versus 1.6 ± 0.8 mm). Multilevel analyses showed higher soft tissue rebound in sites with normal compared to thin phenotype (1.5 mm, p < 0.0001) and treated with flap positioned 2 mm apically to the bone crest (0.7 mm, p < 0.001). An additional 0.5 mm KT increase was observed at interdental sites in the apical group.ConclusionsApical flap positioning increases soft tissue rebound and KT width, mainly at the interdental sites, with reduced patient discomfort.Trial registrationThe trial was registered at ClinicalTrials.gov (ID: NCT05140681, Registration date: 1/12/2021, retrospectively registered).

Long term stability of corticosterone in feathers

Measuring corticosterone in feathers allows researchers to make long-term, retrospective assessments of physiology with non-invasive sampling. To date, there is little evidence that steroids degrade within the feather matrix, however this has yet to be determined from the same sample over many years. In 2009, we made a pool of European starling (Sturnus vulgaris) feathers that had been ground to a homogenous powder using a ball mill and stored on a laboratory bench. Over the past 14 years, a subset of this pooled sample has been assayed via radioimmunoassay (RIA) 19 times to quantify corticosterone. Despite high variability across time (though low variability within assays), there was no effect of time on measured feather corticosterone concentration. In contrast, two enzyme immunoassays (EIA) produced higher concentrations than the samples assayed with RIA, though this difference is likely due to different binding affinities of the antibodies used. The present study provides further support for researchers to use specimens stored long-term and from museums for feather corticosterone quantification, and likely applies to corticosteroid measurements in other keratinized tissues.

Three-dimensional changes of a porcine collagen matrix and free gingival grafts for soft tissue augmentation to increase the width of keratinized tissue around dental implants: a randomized controlled clinical study

BackgroundEmerging clinical data points to the relevance of the presence of keratinized tissue (KT). Although apically positioned flap/vestibuloplasty along with free gingival graft (FGG) is considered as a standard intervention for augmenting KT, substitute materials appear to be a viable treatment alternative. So far, there is a lack of data investigating the dimensional changes at implant sites treated with soft-tissue substitutes or FGG.AimThe present study aimed at comparing three-dimensional changes of a porcine derived collagen matrix (CM) and FGG for increasing KT at dental implants over a 6-month follow-up period.Materials and MethodsThe study enrolled 32 patients exhibiting deficient KT width (i.e., < 2 mm) at the vestibular aspect who underwent soft tissue augmentation using either CM (15 patients/23 implants) or FGG (17 patients/31 implants). The primary outcome was defined as tissue thickness change (mm) at treated implant sites between 1- (S0), 3- (S1), and 6-months (S2). Secondary outcomes considered changes of KT width over a 6-month follow-up period, surgical treatment time, and patient-reported outcomes.ResultsDimensional analyses from S0 to S1 and from S0 to S2 revealed a mean decrease in tissue thickness of − 0.14 ± 0.27 mm and − 0.04 ± 0.40 mm in the CM group, and − 0.08 ± 0.29 mm and − 0.13 ± 0.23 mm in the FGG group, with no significant differences noted between the groups (3 months: p = 0.542, 6 months: p = 0.659). Likewise, a comparable tissue thickness decrease was observed from S1 to S2 in both groups (CM: − 0.03 ± 0.22 mm, FGG: − 0.06 ± 0.14 mm; p = 0.467). The FGG group exhibited a significantly greater KT gain after 1, 3 and 6 months compared to the CM group (1 month: CM: 3.66 ± 1.67 mm, FGG: 5.90 ± 1.58 mm; p = 0.002; 3 months: CM: 2.22 ± 1.44; FGG: 4.91 ± 1.55; p = 0.0457; 6 months: CM: 1.45 ± 1.13 mm, FGG: 4.52 ± 1.40 mm; p < 0.1). Surgery time (CM: 23.33 ± 7.04 min.; FGG: 39.25 ± 10.64 min.; p = 0.001) and postoperative intake of analgesics were significantly lower in the CM group (CM: 1.2 ± 1.08 tablets; FGG: 5.64 ± 6.39 tablets; p = 0.001).ConclusionsCM and FGG were associated with comparable three-dimensional thickness changes between 1 and 6 months. While a wider KT band could be established with FGG, the use of CM significantly reduced surgical time and patients´ intake of analgesics.Graphical abstract

Super Glue Production by Dermatophytes: Review

Dermatophytosis can be caused on by the invasion and infection of keratinized tissues in people and animals via a group of filamentous fungus known as dermatophytes. About a quarter of the world’s population is affected by it which is one of the most prevalent superficial fungal diseases. Some of these fungi have the capacity to develop complex 3-D biofilm structures, or “biofilm,” which are distinguished by the creation of extracellular polymeric molecules and a heightened drug resistance. The assessment of biofilm now relies on a variety of different methods, which frequently results in various evaluations of the microbial strains’ capacity to create biofilms. It has only recently been discovered the architecture and growth features of dermatophytic biofilms (Trichophyton spp., Microsporum spp.). Additionally, the structural complexity and lack of research on filamentous fungal biofilms make therapy challenging. Therefore, there is a demand for newer antifungals or methods for treating resistant dermatophytosis to offer an efficient, original, and safe substitute to current treatments. Therefore, this review highlighted on the significance, characterization and evaluation of biofilm that produced from dermatophytes.

Naftifine: A Topical Allylamine for Superficial Dermatophytosis.

Dermatophytosis is a very common public health problem with high prevalence. Dermatophytes are a highly specialized set of filamentous fungi, which are adapted to keratinized tissues of humans and animals. Dermatophytosis is the most common fungal infection worldwide, affecting approximately 20-25% of the world's population. The etiological agents of dermatophytosis, called dermatophytes, change with geography and socioeconomic status. Trichophyton rubrum (T. rubrum) is the prime species for skin and nail infections followed by T. mentagrophytes/ T. interdigital complex. There is a shift from T. rubrum to T. mentagrophytes in India for superficial fungal infections. In order to deal with fungal infections, treatment strategies involve the use of systemic antifungals and/or topical antifungal agents. Naftifine is a synthetic allylamine antifungal first reported in 1974 and in 1985 became the first commercially available allylamine. The highly lipophilic nature of allylamine allows efficient penetration and reasonably high concentrations in the stratum corneum (SC) and hair follicles. Naftifine is fungicidal as well as fungistatic. The higher efficacy rates of allylamines over imidazoles for the treatment of fungal infections, even for months after cessation of treatment, is thought to be due to their fungicidal effect, as well as to potentially greater keratin binding and slower release from the SC. The effectiveness of naftifine is also demonstrated against various bacteria belonging to both gram-negative and gram-positive classes. The antiinflammatory property of naftifine has been reported in various preclinical studies where it has been shown to target the prostaglandin pathway. Naftifine 1 and 2% gel and cream is approved by The United States Food and Drug Administration (USFDA), recently naftifine has been approved in India by the Indian regulatory authority Drug Controller General of India (DCGI) for the treatment of dermatophytosis. Naftifine 2% also appears to be a promising treatment, requiring fewer applications than the 1% formulation. Naftifine appears to be effective in a single dose and has a shorter treatment duration than azoles. Naftifine demonstrated its efficacy and safety in various clinical studies of tinea infections. Naftifine offers a very useful and promising option for treating dermatophytosis.

Aesthetic evaluation of free gingival graft applied by partial de-epithelialization and free gingival graft applied by conventional method: a randomized controlled clinical study.

The aim of this clinical study was to compare the partially de-epithelialized free gingival grafts (d-FGGs) with the conventional free gingival grafts (FGGs) aesthetically using photographic analysis and Visual Analogue Scale (VAS). A total of 30 defects were treated in 15 patients with attached gingiva insufficiency. In the split-mouth study, d-FGGs were applied on one side (test group), while FGGs were applied on the contralateral side (control group). Results of clinical periodontal parameters were evaluated in 6-month follow-up, and aesthetic evaluation results were evaluated in 1-, 3-, and 6-month follow-ups. Among the periodontal clinical parameters examined, only the keratinized tissue (KT) width was found to be statistically significantly higher in the test group compared to the control group. In the photo analysis evaluation, the ΔE value at the 3rd month was statistically significantly higher in the test group. In VAS evaluation, there was no significant difference between the two groups in the time periods examined. Photo analysis is an objective, sensitive, reproducible, and safe method that can be used in dentistry and medicine by detecting the slightest changes and giving more detailed and superior results than visual evaluation. The d-FGG application could provide acceptable aesthetic results by providing an appearance compatible with the gingival contour and gingiva in the adjacent region in creating keratinized gingiva. While the free gingival graft has color differences with the recipient area, the deep-thelialized gingival graft has a compatible appearance with the recipient area. Partially, de-epithelialized free gingival graft is a method with acceptable aesthetic results. U.S. National Institutes of Health Clinical Trials: NCT04970524.

Spontaneous regeneration of keratinized tissue at implants and teeth.

To investigate the spontaneous regeneration of the implanto-mucosal and dento-gingival unit after complete removal of keratinized tissue (KT). One hemi-mandible per dog (n = 4) was allocated to receive three dental implants (test sites, premolar region), whereas three premolars on the contralateral side were controls. After osseointegration, the entire KT (buccal + lingual) was surgically excised on all test and control sites, leaving the bone exposed. Clinical measurements were performed before excision (T0 ) and after 12 weeks (T1 ). Following healing, the animals were euthanized, and the specimens were histologically processed. Descriptive statistical analyses were performed. Clinical measurements revealed that at T1 , on all teeth, a band of KT was spontaneously regenerated (mean width: 2.60 ± 0.66 mm), whereas on implants, KT was detected only occasionally at mesial or distal but not at buccal sites (mean total: 0.35 ± 0.53 mm; p < .0001). Histologically, spontaneous regeneration of the dento-gingival unit was evident, displaying masticatory mucosa. At the implant sites, on the other hand, the implanto-mucosal unit was characterized by a non-keratinized epithelium and elastic fibres, indicating the characteristics encountered in alveolar mucosa. After excision of KT at implant sites, the spontaneous regeneration of the soft tissue is characterized by a non-keratinized epithelium typical for alveolar mucosa, while at tooth sites the spontaneous regeneration was characterized by soft tissue resembling gingiva.

790 Alterations in keratin expression, cell identity and tissue homeostasis in skin diseases

790 Alterations in keratin expression, cell identity and tissue homeostasis in skin diseases

Relationship between supracrestal soft tissue dimensions and other periodontal phenotypic features: A cross-sectional study.

The purpose of this study was to determine the association between periodontal supracrestal soft tissue dimensions (PSSTDs) and other phenotypic features in non-molar maxillary teeth. Adult subjects in need of comprehensive dental treatment were recruited. Periodontal phenotypic variables (i.e., facial and palatal gingival thickness [GT], alveolar bone thickness [BT], and PSSTDs, namely distance from the gingival margin to the bone crest defined as periodontal supracrestal tissue height [PSTH] and distance from the cementoenamel junction to the bone crest [CEJ-BC]) were recorded using cone-beam computed tomography scans. Standardized intraoral photographs were obtained to assess facial keratinized tissue width (KTW) and other anatomical parameters (i.e., tooth type, gingival architecture, and interproximal papilla height). The study sample was constituted of 87 participants that contributed with a total of 522 maxillary anterior teeth. Differences in mean values of PSSTDs, KTW, GT, and BT were observed between tooth types and gender. Males exhibited a thicker GT and BT, and taller PSTH and KTW compared to females. Shorter CEJ-BC was associated with shorter PSTH, wider KTW, and thicker GT and BT. Shorter PSTH was associated with thicker facial BT. Notably, BT and GT were positively correlated at both facial and palatal sites, meaning that the thicker the gingival phenotype, the thicker the bone morphotype. Facial BT and facial GT were positively correlated with KTW. A flat gingival architecture was associated with the thick periodontal phenotype. Square teeth had shorter CEJ-BC, wider KTW, and thicker GT. Periodontal phenotypic features vary across and within subjects, between facial and palatal sites at different apico-coronal levels, and as a function of gender and tooth type. The shorter the PSSTDs, the wider the KTW and the thicker the GT and BT. PSSTDs, particularly PSTH, should be considered an integral component of the periodontal phenotype.

Review on host-pathogen interaction in dermatophyte infections.

Dermatophytosis is a common superficial fungal infection of the skin and its appendages caused by dermatophytes. Recent times have witnessed a dynamic evolution of dermatophytes driven by their ecology, reproduction, pathogenicity and host immune response, influenced by population migration and socioeconomic status. Dermatophytes establish infection following successful adherence of arthroconidia to the surface of keratinized tissues. The proteolytic enzymes released during adherence and invasion not only ascertain their survival but also allow the persistence of infection in the host. While the cutaneous immune surveillance mechanism, after antigen exposure and presentation, leads to activation of T lymphocytes and subsequent clonal expansion generating effector T cells that differentially polarize to a predominant Th17 response, the response fails to eliminate the pathogen despite the presence of high levels of IFN-γ. In chronic dermatophytosis, antigens are a constant source of stimulus promoting a dysregulated Th17 response causing inflammation. The host-derived iTreg response fails to counterbalance the inflammation and instead polarizes to Th17 lineage, aggravating the chronicity of the infection. Increasing antifungal resistance and recalcitrant dermatophytosis has impeded the overall clinical remission. Human genetic research has the potential to generate knowledge to explore new therapeutic targets. The review focuses on understanding specific virulence factors involved in pathogenesis and defining the role of dysregulated host immune response against chronic dermatophytic infections for future management strategies.