1.
Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy of necrotic immature permanent teeth? A systematic review and meta-analysis
Tang Q, Jin H, Lin S, Ma L, Tian T, Qin X
BMC oral health. 2022;22(1):589
Abstract
BACKGROUND The effectiveness of platelet concentrates in promoting root development of necrotic immature permanent teeth is unclear. The present study evaluated whether the platelet concentrate protocol was superior to the traditional blood clot protocol in regeneration therapy. METHODS We searched Electronic databases, such as PubMed, Cochrane Library, ClinicalTrials and EMBASE. Randomized controlled trial studies, cohort studies, case-control studies and cross-sectional studies were included, in which platelet-rich concentrates were tested for periapical healing and root development, with the blood clot treatment protocol as the control group. Clinical and radiographic outcomes were considered. Selected articles were assessed for risk of bias. Pooled risk ratios (risk ratio, RR) were calculated for clinical success, responses to cold and electric pulp tests, periapical lesions, apex closure, root lengthening, and thickening of the dentin walls. Subgroup meta-analysis were conducted according to the type of platelet concentrate used. RESULTS Of the 1272 screened studies, 13 randomized controlled studies, 2 case-control studies and 1 cohort study were selected, in which 465 immature necrotic permanent teeth, particularly incisors and premolars, were treated. Of these 465 teeth, 457 (98.2%) in both the control and experimental groups remained clinically asymptomatic for the entire study duration, whereas eight (1.8%) showed signs and symptoms of failure, including spontaneous pain, sensitivity to percussion or reinfection. Compared with control teeth, teeth treated with PRP achieved better apical healing than BC group (RR 1.13, 95% CI 1.01-1.26, P = 0.03), and teeth treated with platelet concentrates showed improved apical closure (RR 1.04, 95% CI 0.86-1.25, P = 0.69), root lengthening (RR 1.01, 95% CI 0.74-1.39, P = 0.93), and thickening of the dentin walls (RR 1.35, 95% CI 0.95-1.93, P = 0.09), although these differences were not statistically significant. CONCLUSIONS Platelet concentrates can be used as successful scaffolds for regenerative endodontic treatment of necrotic immature permanent teeth, and PRP as a scaffold may achieve better periapical healing of teeth with periapical inflammation, although they did not differ significantly from conventional blood clot scaffolds in development of the root.
2.
Efficacy and safety of intravenous immunoglobulin for treating refractory livedoid vasculopathy: a systematic review
Gao Y, Jin H
Therapeutic advances in chronic disease. 2022;13:20406223221097331
Abstract
INTRODUCTION Intravenous immunoglobulin (IVIG) was reported to be the third most used monotherapy in livedoid vasculopathy (LV). There is currently a lack of randomized controlled clinical trials and no standardized therapeutic regimen for IVIG therapy in LV. METHODS We performed a systematic review of the efficacy and safety of IVIG in treating patients with LV using PubMed, Cochrane, and Embase databases. RESULTS Eighty LV patients from 17 articles were included, receiving IVIG therapy at a dose of 1-2.1 g/kg body weight every 4 weeks. The effective rate of IVIG therapy in LV patients was 95% (76/80) in published studies, showing a good clinical response for resolution of pain, skin ulcerations, and neurological symptoms, and reducing the dependence on glucocorticoids and immunosuppressive agents. IVIG therapy was well tolerated, and no severe adverse events were observed. CONCLUSION Overall, to a certain degree, IVIG is probably a safe and effective treatment alternative for refractory LV patients, which still need to be confirmed by large-scale randomized controlled clinical trials.
3.
Efficacy and safety of long-term immunotherapy in adult patients with MOG antibody disease: a systematic analysis
Lu Q, Luo J, Hao H, Liu R, Jin H, Jin Y, Gao F
Journal of neurology. 2020
Abstract
OBJECTIVE To summarise the evidence of the efficacy and safety of current long-term immunotherapies in patients with myelin oligodendrocyte glycoprotein antibody disease (MOG-AD). METHODS We performed a sensitive literature search in MEDLINE and EMBASE for selected studies or case series discussing the long-term treatments and outcomes in adult patients with MOG-AD and conducted a qualitative analysis of each therapy. RESULTS A total of 33 articles, including 712 patients with MOG-AD, matched our inclusion criteria, and seven kinds of drugs were analysed accordingly. Efficacy was mainly reflected by the change in the annual relapse rate before and after treatment. First, maintenance steroids, azathioprine, mycophenolate mofetil, and rituximab were demonstrated to be effective in multiple studies. However, relapses could still happen after therapy especially under specific circumstances. Second, regular intravenous immunoglobulin G (IVIG) and tocilizumab might be effective. IVIG reduced annual relapse rate and expanded disability status scale in five adult patients, and tocilizumab succeeded in preventing relapse in four refractory patients, though with scant evidence. Finally, multiple sclerosis-disease-modifying therapy seemed ineffective for patients with MOG-AD. As for safety, six patients experienced severe neutropenia during rituximab therapy. No other serious adverse events were reported for these treatments. CONCLUSIONS Several preventive immunotherapies have been demonstrated to be effective and safe for adult patients with MOG-AD; however, large controlled studies for subgroups with specific manifestations are still needed in the future.
4.
A meta-analysis of re-treatment for intravenous immunoglobulin-resistant Kawasaki disease
Yang X, Liu G, Huang Y, Chen S, Du J, Jin H
Cardiology in the Young. 2015;25((6)):1182-90
Abstract
OBJECTIVE To determine the optimal drug therapy for intravenous immunoglobulin-resistant Kawasaki disease. METHODS Studies regarding drug therapy for intravenous immunoglobulin-resistant Kawasaki disease were selected from medical electronic databases including PubMed, Medline, Elsevier, and Springer Link. The effectiveness in terms of temperature recovery and coronary artery damage was compared between a second intravenous immunoglobulin treatment and glucocorticosteroid treatment for children with intravenous immunoglobulin-resistant Kawasaki disease using meta-analysis with Review Manager 5.3 software. Indices to evaluate the effects were body temperature, biomarker levels, and coronary artery lesions detected by echocardiography. Results are reported as relative risks or odds ratio with a 95% confidence interval and p<0.05. RESULTS Meta-analysis included 52 patients in the second intravenous immunoglobulin treatment group and 75 patients in the glucocorticosteroid treatment control group from four studies that met our inclusion criteria. Temperatures of patients who received glucocorticosteroid treatment were effectively controlled compared with those who received a second intravenous immunoglobulin treatment (relative risk=0.73, 95% confidence interval: 0.58-0.92, p=0.007). There were no differences, however, in the incidence of coronary artery lesions between the two groups (odds ratio=1.55, 95% confidence interval: 0.57-4.20, p=0.39). CONCLUSIONS Glucocorticosteroids are more effective in controlling body temperature compared with intravenous immunoglobulin re-treatment in intravenous immunoglobulin-resistant Kawasaki disease children; however, glucocorticosteroids and intravenous immunoglobulin re-treatment showed no difference in the prevention of coronary artery lesions.