Robust production of reactive oxygen species (ROS) by phagocyte NADPH oxidase (phox) during the respiratory burst (RB) is a characteristic feature of eosinophil and neutrophil granulocytes. In these cells the voltage-gated proton channel (Hv1) is now considered as an ancillary subunit of the phox needed for intense ROS production. Multiple sources reported that the expression of phox subunits and RB is more intensive in eosinophils, than in neutrophils. In most of these studies the eosinophils were not isolated from healthy individuals, and a comparative analysis of Hv1 expression had never been carried out. We performed a systematic comparison of the levels of essential phox subunits, Hv1 expression, and ROS producing capacity between eosinophils and neutrophils of healthy individuals. The expression of phox components was similar, whereas the amount of Hv1 was ∼ 10-fold greater in eosinophils. Furthermore, Hv1 expression correlated with Nox2 expression only in eosinophils. Additionally, in confocal microscopy experiments co-accumulation of Hv1 and Nox2 at the cell periphery was observed in resting eosinophils but not in neutrophils. While phorbol-12-myristate-13-acetate-induced peak extracellular ROS release was ∼ 1.7-fold greater in eosinophils, oxygen consumption studies indicated that the maximal intensity of the RB is only ∼ 1.4fold greater in eosinophils. Our data reinforce that eosinophils, unlike neutrophils, generate ROS predominantly extracellularly. In contrast to previous works we have found that the two granulocyte types display very similar phox subunit expression and RB capacity. The large diff erence in Hv1 expression suggests that its support to intense ROS production is more important at the cell surface.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medication-related osteonecrosis of the jaw. Methods: Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. Results: Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). Conclusions: Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions.

Background/Aim: Diabetes mellitus (DM) is one of the most common chronic metabolic disorders. Our research aimed to demonstrate the relationship between DM and oral cancer. Patients and Methods: We pursued a retrospective research study in Hungary between January 2019 and December 2020. We investigated 597 inpatient records and compared them to the results of our previous studies (1998-2002 and 2012-2015). Results: The frequency of patients with DM in the oral cancer group is 2.45 times higher today than 20 years ago. The prevalence rate of DM and oral malignancies increased from 14.6% to 35.8%. In the oral cancer group, 54.4% of the patients had elevated blood glucose levels and of these, 61.1% of them had type 2 diabetes, 34.2% had impaired fasting glycemia, and only 4.7% had type 1 diabetes. We observed that 45.3% of them were smokers. Of those whose blood sugar levels were under 6.1 mmol/l, the mean body mass index was 25.33 [standard deviation (SD)=±4.5;, while among patients with DM, it was 26.92 (SD=±5.8;). Conclusion: It may be necessary to continuously monitor the patient's blood sugar level to maintain euglycemic levels when managing patients with malignant oral lesions.

Összefoglaló. Bevezetés: A diabetes mellitus és a különböző szájüregi elváltozások szoros kapcsolatát számos irodalmi adat bizonyítja. Munkacsoportunk az elsők között tárta fel az oralis malignus daganatok és a cukorbetegség epidemiológiai összefüggéseit. A nemzetközi szakirodalomban már megjelentek olyan publikációk, amelyek a cukorháztartás és a gyógyszer okozta állcsontnekrózis közötti kapcsolatot vizsgálták. Célkitűzés: Jelen tanulmányunkban arra a kérdésre kerestük a választ, hogy a hazai populációban a biszfoszfonát okozta állcsontnekrózisban szenvedő betegek körében milyen gyakorisággal fordul elő diagnosztizált cukorbetegség és emelkedett éhomi vércukor. Megvizsgáltuk továbbá, hogy van-e összefüggés a rendellenes cukorháztartás és a betegek alapbetegsége, valamint az állcsontnekrózis lokalizációja, súlyossága között. Módszer: Az adatgyűjtés során a 2018. június 1. és 2020. december 31. közötti időszak betegdokumentációját tanulmányoztuk. A vizsgálatba 349 főt vontunk be, akik ezen időszak alatt a Semmelweis Egyetem Arc-Állcsont-Szájsebészeti és Fogászati Klinikájának Fekvőbeteg Osztályán kerültek ellátásra. A betegeket két csoportra osztottuk: biszfoszfonát okozta állcsontnekrózisban szenvedőkre, valamint kontrollcsoportra. Eredmények: A két vizsgált csoportot összehasonlítva megállapítottuk, hogy a biszfoszfonát okozta állcsontnekrózisban szenvedő betegcsoportban szignifikánsan több a diabetes mellitusban szenvedő és az emelkedett éhomi vércukorral rendelkező beteg. Megbeszélés: Kutatásunk eredményei alapján felmerül, hogy a diabeteses vagy hyperglykaemiás betegek esetében a dysglykaemia microvascularis szövődményei miatt a biszfoszfonát okozta állcsontnekrózis előfordulási valószínűsége szignifikánsan gyakoribb. Következtetés: Az emelkedett vércukorszint szignifikánsan növeli az állcsontnekrózis valószínűségét invazív fogorvosi, illetve szájsebészeti beavatkozások után. Orv Hetil. 2022; 163(15): 599–605. Summary. Introduction: The close association between diabetes mellitus and various oral lesions is evidenced by several literature data. Our team was among the first to explore the epidemiological link between oral malignancies and diabetes mellitus. Publications have already been published in the international literature examining the relationship between glucose homeostasis and bisphosphonate-related jaw necrosis. Objective: In the present study, we sought to answer the question of the incidence of diagnosed diabetes mellitus and elevated fasting blood glucose in patients with bisphosphonate-related jaw necrosis in the Hungarian population. We also examined whether there is a correlation between abnormal diabetes mellitus and the patient’s underlying disease and the localization and severity of jaw necrosis. Method: During the data collection, we studied patient documentation from June 1, 2018 to December 31, 2020. The study included 349 people admitted during this period at the Department of Inpatient Care at the Department of Oromaxillofacial Surgery and Stomatology at Semmelweis University. Patients were divided into two groups, bisphosphonate-related jaw necrosis, and a control group. Results: Comparing the two groups, we found significantly more patients with diabetes mellitus and high fasting blood glucose in the bisphosphonate-related jaw necrosis group. Discussion: Based on the results of our research, we found that bisphosphonate-related jaw necrosis is significantly more likely to occur in diabetic or hyperglycemic patients due to microvascular complications of dysglycemia. Conclusion: Elevated blood glucose level significantly increases the likelihood of jaw necrosis after more invasive dental and oral surgery. Orv Hetil. 2022; 163(15): 599–605.

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. Previous research has shown that normoglycemia plays an important rolein the development and treatment of oral lesions. The current study aimed to evaluate the associationsbetween chronic vascular disease, inflammation, and immune deficiency during dysglycemia and the developmentof MRONJ. Materials and Methods: Our research group investigated data collected between January 1, 2019, and December 31, 2020. In total, 260 patients at the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University were selected. Results: There was a significant association between hyperglycemia and MRONJ. Vascular anomaly and immune dysfunction caused byhyperglycemia can leadto the development of necrosis after tooth extraction. The risk of jawbone necrosis can be reduced by premedication. Conclusions: Ischemia is a complication of abnormal glucose level, which is a possible risk factor of MRONJ development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis. Clinical relevance: Uncontrolled or poorly regulated plasma glucose levels significantly increasesthe risk of jawbone necrosis after invasive dental or oral surgical interventions. The number of patients with dysglycemia and anti-resorptive therapy is increasing. Therefore, patients with these conditions will be provided with medical care in dental offices more frequently.