Análise da expressão de MMP-9 na mucosa jugal de pacientes com epidermólise bolhosa residentes no Espírito Santo
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Data
2026-02-25
Autores
Corrêa, Raphaella Thayná Rodrigues
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Universidade Federal do Espírito Santo
Resumo
Epidermolysis Bullosa (EB) is a rare genetic disorder characterized by mucocutaneous fragility, blister formation, and functional impairments affecting multiple organ systems, including the oral cavity. Cellular and molecular studies of affected tissues may contribute to a better understanding of the diverse clinical phenotypes observed in EB. Matrix metalloproteinases (MMPs) are enzymes involved in tissue remodeling, embryonic development, and wound healing; however, their activity has also been associated with pathological conditions, including inflammation, carcinogenesis, and cell migration. Among the different MMPs, MMP-9 plays a role in both physiological and pathological processes, and its expression has been particularly described in the context of tumorigenesis, in both tumor and inflammatory cells. Within this context, the present study investigated MMP-9 expression in exfoliative cytology samples of the buccal mucosa from individuals with EB and explored potential clinicopathological correlations. Exfoliative cytology was selected due to its simplicity, reproducibility, atraumatic nature for fragile mucosae, and suitability for serial sampling. Immunocytochemistry with DAB chromogen was used for labeling. A total of 1,000 cells per patient were evaluated in a blinded manner by a single, previously calibrated investigator. The EB group comprised 20 patients, and the control group (n = 20) was matched for sex and age. Cells were classified as positive or negative for MMP-9 expression, and the Mann–Whitney test was applied for statistical analysis. Intragroup analysis revealed a significantly higher number of negative cells compared to positive cells in both the control and EB groups (p < 0.0001). When comparing groups, although an increase in MMP-9–positive cells was observed in the EB group, this finding was subtle and not statistically significant (p = 0.9948). No differences in staining patterns were observed when comparing severe EB subtypes (junctional EB and dystrophic EB) with their respective control group. Similarly, no sex-related differences in MMP-9 expression were identified (p = 0.2141). Qualitative analysis revealed the presence of an inflammatory infiltrate in 7 cases (35%) of the EB group, including 6 cases of dystrophic EB and 1 case of EB simplex; this finding was not observed in the control group. Overall, the results suggest a similar pattern of MMP-9 expression in buccal mucosa exfoliative cytology samples from EB and non-EB individuals. Conversely, inflammatory cells were detected exclusively in EB cases. Finally, exfoliative cytology proved to be a minimally invasive, cost-effective approach for oral mucosal surveillance, with potential value as an adjunctive tool for the longitudinal monitoring of patients with EB
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Palavras-chave
Citologia , Epidermólise bolhosa , Imunocitoquímica , Inflamação , Metaloproteinase 9 da Matriz , Cytology , Epidermolysis bullosa , Immunohistochemistry , Inflammation , Matriz Metalloproteinase 9