benzofurans and Oral-Submucous-Fibrosis

The aim of this study was to investigate the effectiveness of triamcinolone acetonide (TA) and salvianolic acid B (SA-B) intralesional combined injection in the treatment of oral submucous fibrosis (OSF).. A randomized clinical trial was performed. TA, SA-B, and TA combined with SA-B were consecutively applied intralesionally weekly for 20 weeks. Mouth opening and burning sensation improvement as determined by a 100-mm visual analog scale were evaluated at weeks 10, 20, and 44.. Forty-two subjects fulfilled the study without obvious adverse reactions. The net gain in mouth opening was 2.00 ± 1.21 mm in the TA group, 3.48 ± 2.23 mm in the SA-B group, and 5.50 ± 1.80 mm in the TA + SA-B group at week 44. The burning sensation improved by 3.05 ± 0.76 in the TA group, 4.96 ± 0.97 in the SA-B group, and 6.11 ± 0.93 in the TA + SA-B group by the end of the study.. TA + SA-B intralesional injections improved mouth open and burning sensation in these OSF patients.

Topics: Adult; Anti-Inflammatory Agents; Benzofurans; Drug Combinations; Drugs, Chinese Herbal; Female; Follow-Up Studies; Glucocorticoids; Humans; Injections, Intralesional; Male; Mouth Mucosa; Oral Submucous Fibrosis; Pain Measurement; Paresthesia; Salvia miltiorrhiza; Treatment Outcome; Triamcinolone Acetonide

To introduce the methods of triamcinolone acetonide (TA) and salvianolic acid B(SA-B) intralesional injection in the treatment of oral submucous fibrosis and evaluate the treatment effects.. TA combined with SA-B were consecutively applied intralesionally 1 time weekly for 30 times. The technique of intralesional injection was that syringe needle be emptied into submucous tissues 1 cm posterior to the corner of oral cavity running from the front to retromolar area by pushing the injection, then the syringe needle retained to the original point and upward from the front to retromolar area by pushing the injection, finally the syringe needle returned to the starting point and downward from the front to retromolar area by pushing the injection. Mouth opening, the color change of the buccal mucosa and the increase of capillary vessels as determined by degree I-IV visual analog scale were evaluated at 12, 24, and 36 month. The data were analyzed with SPSS 21.0 software package.. One hundred and fourteen subjects fulfilled the study without obvious adverse reactions. After treatment for 36 months , the net gain in mouth opening of the early stage group，middle stage group and advanced stage group was (12.0±1.2) mm, (14.5±2.4) mm and (15.5±1.5) mm, respectively. The response rate of color change of the buccal mucosa and the increase of capillary vessels in early stage group, middle stage group and advanced stage group after treatment for 36 months was 100%, 94.7% and 90.7%, respectively.. Triamcinolone acetonide and salvianolic acid B intralesional injection is effective in the treatment of oral submucous fibrosis.

Topics: Benzofurans; Glucocorticoids; Humans; Injections, Intralesional; Mouth Mucosa; Oral Submucous Fibrosis; Pain Measurement; Treatment Outcome; Triamcinolone Acetonide

Salvia miltiorrhiza Bunge has been reported to possess excellent antifibrotic activity. In this study, we have investigated the effect and mechanism of tanshinone IIA (Tan-IIA), salvianolic acid A (Sal-A) and salvianolic acid B (Sal-B), the important active compounds of Salvia miltiorrhiza Bunge, on areca nut extract (ANE)-induced oral submucous fibrosis (OSF) in vitro. Through human procollagen gene promoter luciferase reporter plasmid assay, hydroxyproline assay, gelatin zymography assay, qRT-PCR, ELISA and Western blot assay, the influence of these three compounds on ANE-stimulated cell viability, collagen accumulation, procollagen gene transcription, MMP-2/-9 activity, MMP-1/-13 and TIMP-1/-2 expression, cytokine secretion and the activation of PI3K/AKT, ERK/JNK/p38 MAPK and TGF-β/Smads pathways were detected. The results showed that Tan-IIA, Sal-A and Sal-B could significantly inhibit the ANE-stimulated abnormal viability and collagen accumulation of mice oral mucosal fibroblasts (MOMFs), inhibit the transcription of procollagen gene COL1A1 and COL3A1, increase MMP-2/-9 activity, decrease TIMP-1/-2 expression and inhibit the transcription and release of CTGF, TGF-β1, IL-6 and TNF-α; Tan-IIA, Sal-A and Sal-B also inhibited the ANE-induced activation of AKT and ERK MAPK pathways in MOMFs and the activation of TGF-β/Smads pathway in HaCaT cells. In conclusion, Tan-IIA, Sal-A and Sal-B possess excellent antifibrotic activity in vitro and can possibly be used to promote the rehabilitation of OSF patients.

Topics: Abietanes; Animals; Areca; Benzofurans; Caffeic Acids; Cell Line; Cell Survival; Collagen; Enzyme Activation; Extracellular Signal-Regulated MAP Kinases; Fibroblasts; Gene Expression Regulation; Humans; In Vitro Techniques; Lactates; Matrix Metalloproteinase 2; Matrix Metalloproteinase 9; Mice; Nuts; Oral Submucous Fibrosis; Plant Exudates; Proto-Oncogene Proteins c-akt; Signal Transduction; Smad Proteins; Tissue Inhibitor of Metalloproteinase-1; Tissue Inhibitor of Metalloproteinase-2; Transforming Growth Factor beta