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Craneosinostosis

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Biología molecular y genética de la craneosinostosis @munevarjuan

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Craneosinostosis

  1. 1. UNIVERSIDAD EL BOSQUE BIOLOGIA DEL MOVIMIENTO DENTALPROFESOR: Dr. JUAN CARLOS MUNEVAR.CRANEOSINOSTOSIS MULTIFACTORIAL MULTIDISCIPLINARIA SANDRA P. CASTAÑO D.
  2. 2. SUTURASSon bandas fibrosasde tejido que conectanlos huesos del cráneoTHOLPADY, Tensional forces influence geneexpression and sutural state of rat calvariae in vtro . Plastic surgeons september 2007
  3. 3. CRANEOSINOSTOSIS Cierre prematuro de la sutura THOLPADY, Tensional forces influence gene expression and sutural state of rat calvariae in vtro . Plastic surgeons september 2007
  4. 4. PROPOSITOHacer una recopilación de los principalesfactores que influyen en la craneosinostosisincluyendo ambientales, hormonales, eintrínsecosy la importancia deun equipo de apoyoprofesional.
  5. 5. MULTIFACTORIALFACTORES AMBIENTALES:Fuerzas mecánicas : estas fuerzas puedenmantener abierta una sutura destinada alcierre , permite cambios enel comportamiento celulary la expresión de losgenes. THOLPADY, Tensional forces influence gene expression and sutural state of rat calvariae in vtro . Plastic surgeons september 2007
  6. 6.  Recientes publicaciones en el 2007 se encontraron resultados muy satisfactorios en donde pequeñas cantidades de fuerza tensil por cortos períodos de tiempo podían alterar el cierre de la sutura THOLPADY, Tensional forces influence gene expression and sutural state of rat calvariae in vtro . Plastic surgeons september 2007
  7. 7. FACTORES GENETICOS Los factores externos mecánicos pueden modular los factores genéticos con la regulación de factores de crecimiento, proteínas de transcripción . THOLPADY, Tensional forces influence gene expression and sutural state of rat calvariae in vtro . Plastic surgeons september 2007
  8. 8. SEÑALIZACIÓN www.herkules.oulu.fi/.../html/equation33.png 2003 Oulu University Library
  9. 9. Sistema microelectromecánico, fabricadopara realizar una fuerza tensil de pequeñacantidad , adicionando terapiafarmacológica y dentro de los16 meses de vida podría proporcionar cambios deseables en el cierre de la sutura. YU, JACK DISCUSSION : Tensional forces influence gene expression and sutural state of rat calvariae in vitro. September 2007
  10. 10. FACTORES HORMONALESEstudios recientes demostraron los efectos mitogénicos y osteogénicos de la dihidrotestosterona en las células de la dura madre y osteoblastos de la calvaria que promueven la fusión sutural .Promueve proliferación y diferenciación osteoblástica . 5 –alfa dihidrotestosterona LIN, INES, SLEMP, ALISON . Dihidrotestosterona stimulates proliferation And differentiation of fetal calvarial osteoblasts and dural cells and induces Cranial suture fusion. American Society of plastic surgeons. October 2007
  11. 11.  Otro mecanismo de la suturogénesis inducida por los andrógenos es el incremento de los mediadores intercelulares como los factores de crecimiento TGF-B, resultando en una estimulación de la actividad osteoblástica. LIN, INES, SLEMP, ALISON . Dihidrotestosterona stimulates proliferation and differentiation of fetal calvarial osteoblasts and dural cells and induces Cranial suture fusion. American Society of plastic surgeons. October 2007
  12. 12. MULTIDISCIPLINARIO SICOLOGO ORTODONCISTA CIRUJANO ODONTOPEDIATRA FONOAUDIOLOGO AVANTAGGIATO A, CARINCI F. APERT´S SINDROME Cefalometric evaluation and consideration on patogenesis . J. Craneofacial Surgery 1996
  13. 13. CONCLUSIONES
  14. 14.  Existe una serie de factores involucrados con el cierre de la sutura
  15. 15. PROLIFERACION APOPTOSIS El estímulo mecánico regula la proliferación de células suturales, alcanzando remodelado óseo por equilibrio proliferación- apoptosis
  16. 16. DIHIDROTESTOSTERONA TGF-B Cambios en la expresión de los genes , por la transducción de señales a través de TGF-B, SMAD. La estimulación andrógena de las células dural y osteoblastos de la calvaria fetal promueven la proliferación celular y diferenciación osteoblástica induciendo a una fusión de la sutura craneal.
  17. 17.  A pesar de recopilar los últimos estudios en sutura craneofacial , no se tiene evidencia que se puede extrapolar a humanos . Es importante tener en cuenta estos factores para llegar a un diagnóstico, pronóstico y plan de tratamiento, lo más acertadamente posible, priorizando, aminorando costos , ahorro de tiempo. Variabilidad individual Apoyo profesional.
  18. 18. PERSPECTIVAS
  19. 19.  Todos estos factores se encuentran relacionados unos con otros, sería importante crear estudios de diseño experimental que involucraran la mayoría de variables en una sola muestra para medir su comportamiento. Teniendo en cuenta los alcances de severidad a la que puede llegar esta condición, sería importante crear más vías de investigación en humanos.
  20. 20.  Así como Yu, Jack trata de idealizar un aparato que transcriba la cantidad de “fuerza y tiempo ideal”, se debe incentivar los trabajos en esta vía de invención, creando medios que se acerquen al manejo y control de la craneosinostosis.
  21. 21. BIBLIOGRAFIA Lin, Inés C.M.D. Slemp, Alison . Dihidrotestosterona stimulates proliferation and differentiation of fetal calvarial osteoblasts and dural cells and induces cranial suture fusion. October 2007. Tholpady, Sunil. Tensional forces influence gene expression and sutural state of rat calvariae in vitro. September 2007. Yu, Jack C.M.D. Discussion of tensional forces influence gene expression and sutural state of rat calvariae in vitro. September 2007. Frost, H.M. Bone´s mechanostat a 2003. Anat. Rec. A discov. Mol. Cell. Evol. Biol, 2003. Medline Plus , Enciclopedia médica U.S. National library of Medicine 2007. Avantaggiato, Carinci F. APERT´S SINDROME Cefalometric evaluation and consideration on patogenesis . J. Craneofacial Surgery 1996

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