Mast Cells Released Inflammatory Markers Play a Vital Role in Mandibular Remodeling of Odontogenic Keratocyst Patients

Background: Odontogenic Keratocyst (OKC) falls among the distinctive and rare odontogenic developmental cyst which is derivative of the dental lamina and contains clear fluid along with a cheesy material which resembles keratin debris.  Treatment strategies for OKC are for the most part classified as conservative or aggressive. Mast Cells play an important role in the pathogenesis of inflammatory conditions. Objective: The goal of our study was to observe the participation of inflammatory mediators (RANKL, TNF-α, TGF-β and MMP-9) in the pathogenesis as well as the recovery process of OKC. Methods: Enrolled patients were divided into three groups while a fourth group was formed of the control individuals. Sampling of all groups was done once after required data collection. Blood samples were taken, mRNA extraction and cDNA was then subjected to qRT-PCR. IHC for mast cells was done on patient samples. Results: qRT-PCR showed higher expressions of inflammatory markers in patients undergoing treatment as compared to individuals with completed treatment procedure. Levels of RANKL were high in patients that were currently undergoing bone development as compared to other patients. The levels of TNF-α were comparatively higher in patients who  showed visible signs of inflammation like swelling and pain. TGF-β and MMP-9 expression levels showed correlation with each other in all three groups. Both these cytokines were also found to be in association with mast cells. The results of histochemical staining of mast cells suggested the involvement of these cells in the pathogenesis of the cystic lesion via inflammation. Conclusions: The findings of the study suggest that the expressions of inflammatory mediators correlate with the presence of mast cells, therefore, application of mast cells stabilizers in addition to marsupialization in the treatment of OKC can be a prospective treatment strategy in future clinical settings.