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Reis VP, Bezerra AR, Maia ABP, Marques LC, Conde DC. An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings? Int J Dermatol 2021; 61:278-290. [PMID: 34541674 PMCID: PMC8653326 DOI: 10.1111/ijd.15881] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/01/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
We conducted an integrative review on oral manifestations in patients with COVID‐19 based on the current available literature evidence. A bibliographic search was carried out on March 11, 2021, among published studies in the years 2019–2021 in the PubMed database and based on the search strategy (“COVID‐19” AND “oral lesions” OR “oral mucositis” OR “oral manifestation”). After applying the inclusion and exclusion criteria, 29 articles were considered suitable for this review. A total of 110 cases of patients with COVID‐19 who had oral manifestations were reported. The presence of ulcerated lesions was the most common finding, having a herpetiform and aphthous clinical pattern observed in most cases. Macules, petechiae, hemorrhagic blisters, pustular enanthem, mucositis, and halitosis were also among the most frequently described oral manifestations. The tongue was the most commonly affected site, followed by the palate and lip. Most of the reported cases were diagnosed only by the clinical aspect of the lesion associated with a positive SARS‐CoV‐2 test or the presence of other COVID‐19 symptoms. Current scientific evidence still could not affirm that most of the oral lesions observed in patients with COVID‐19 are related to the virus's direct or indirect action on the oral mucosa. To confirm this association, prospective and longitudinal studies are further needed, together with a larger number of patients, complemented by histopathological examination of these lesions. Additionally, molecular techniques, such as immunohistochemistry and in situ hybridization, may be necessary to perform the differential diagnosis with other oral lesions.
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Affiliation(s)
- Vanessa Paiva Reis
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Polyclinic of Cascadura (Policlínica da Polícia Militar de Cascadura), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Adriana Raymundo Bezerra
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Central Dental Clinic (Odontoclínica Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Adriane Batista Pires Maia
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Central Hospital (Hospital Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Letícia Côgo Marques
- Dentistry Sector, Healthcare and Social Assistance Section of The Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.,Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Danielle Castex Conde
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil.,Oral Maxillofacial Surgery and Traumatology Service and Anatomical Pathology Service, Military Police Central Hospital (Hospital Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
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Hernández-Olivos R, Muñoz M, Núñez E, Camargo-Ayala PA, Garcia-Huidobro J, Pereira A, Nachtigall FM, Santos LS, Rivera C. Salivary proteome of aphthous stomatitis reveals the participation of vitamin metabolism, nutrients, and bacteria. Sci Rep 2021; 11:15646. [PMID: 34341431 PMCID: PMC8329211 DOI: 10.1038/s41598-021-95228-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/22/2021] [Indexed: 11/10/2022] Open
Abstract
There are currently no preventative options for recurrent aphthous stomatitis, and the only available treatments are palliative. This is partly due to a poor understanding of its etiopathogenesis. In this case-control study, we characterized the salivary proteome of patients with recurrent aphthous stomatitis in the presence and absence of lesions. Through mass spectrometry-based proteomics and bioinformatics tools, we identified that the presence of oral ulcers is associated with several specific biological processes, including the metabolic pathways of vitamin B9, B12, nitrogen, selenium, and the bacterium Neisseria meningitidis. These changes occurred only in the presence of clinically visible lesions, and there were no relevant differences between patients in anatomical regions unaffected by ulcers. Additionally, using western blot and ELISA assays, we verified that carbonic anhydrase 1 (CA1) and hemoglobin subunit beta (HBB) proteins are highly expressed during the ulcerative and remission phases of recurrent aphthous stomatitis. Our results cumulatively support saliva as an indicator of the pathophysiological changes, which occur during the clinical course of lesions. From a clinical perspective, we suggest that recurrent aphthous stomatitis is a condition triggered by temporary biological changes in people with lesions.
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Affiliation(s)
- Romina Hernández-Olivos
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Mariagrazia Muñoz
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Esteban Núñez
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Paola Andrea Camargo-Ayala
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Jenaro Garcia-Huidobro
- Centro de Investigaciones Médicas, Escuela de Medicina, Universidad de Talca, Talca, Chile
| | - Alfredo Pereira
- Instituto de Química de Recursos Naturales, Universidad de Talca, Talca, Chile
| | - Fabiane M Nachtigall
- Instituto de Ciencias Químicas Aplicadas, Universidad Autónoma de Chile, Talca, Chile
| | - Leonardo S Santos
- Instituto de Química de Recursos Naturales, Universidad de Talca, Talca, Chile
| | - César Rivera
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile.
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53
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Dental enamel defects and oral cavity manifestations in Asian patients with celiac disease. Indian J Gastroenterol 2021; 40:402-409. [PMID: 34244963 DOI: 10.1007/s12664-021-01175-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 03/24/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND While the small intestine is the main site of disease, many other organs are affected by celiac disease (CeD). Dental enamel defects (DED) are common in patients with CeD, and these are one of the indicators of CeD, even when no other symptom of CeD is present. Data on dental and oral cavity manifestations in Asian patients with CeD are scanty. The purpose of the current study was to evaluate dental and oral manifestations in Asian patients with CeD. METHODS We recruited 118 patients with biopsy-confirmed CeD (36 treatment naïve and 82 on follow-up for at least 1 year on gluten-free diet [GFD]) and 40 controls. Diagnosis was made as per the standard criteria. Oral and dental manifestations were evaluated by a dental surgeon. The DED were evaluated according to Aine's criteria. RESULTS Overall higher number of patients with CeD (66.9%), both treatment naïve (69.4%) and those on GFD (65.8%) had DED in comparison to controls (20%) (odds ratio, 8.1, 95% confidence interval [CI] 3.4-19.2; p<0.001). Specific/bilaterally symmetrical DED were significantly higher in patients with CeD than controls. Recurrent aphthous ulcers were also significantly higher in patients with CeD. Approximately 80.6% and 63.4% treatment-naïve patients and those on GFD, respectively reported dry mouth sensation, which was significantly higher than the controls. CONCLUSION Almost two-third of patients with CeD had DED. Physicians and dietitians caring for patients with CeD should be trained in identification of DED and other oral manifestations of CeD.
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Abstract
A variety of acute oral lesions may be encountered in the scope of dermatology. Oral lesions may be single or multiple; may arise secondary to infectious, immune, congenital, medication use, or idiopathic causes; and may take a variety of forms. A thorough evaluation of the oral cavity is required to assess patients with oral lesions. Affected patients may be monitored, treated, or referred to an appropriate specialist for further management as needed. Many acute oral lesions are self-limiting in nature and patients may require only assessment and reassurance. Several common acute oral lesions are discussed in this article.
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Affiliation(s)
- Katherine France
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, 513 Parnassus Avenue, Suite 512A, San Francisco, CA 94143, USA
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Tohidinik HR, Rodríguez A, Regueira-Méndez C, Takkouche B. Sleep quality and risk of recurrent aphthous ulcers: A Spanish cohort study. Oral Dis 2021; 28:1882-1890. [PMID: 34242451 DOI: 10.1111/odi.13955] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Recurrent aphthous stomatitis (RAS) is a condition that affects 20% of the world population and is characterized by painful ulcers in the oral mucosa. So far, the epidemiology and risk factors of RAS have been infrequently studied. Our objective was to determine whether sleep-related factors are related to the occurrence of RAS in the first prospective study carried out on this topic. METHODS A cohort of 11210 Spanish students, 13-17 years old, was followed up for one year. Sleep disorders were assessed at baseline using a standard validated questionnaire. RESULTS We detected 2655 new cases of RAS with a total of 287,262 person-week of follow-up. Subjects with high (4th quartile) Insomnia Index showed an incidence rate ratio (IRR) of RAS of 1.29 (95% confidence interval (CI) 1.15-1.45), while subjects with high Hypersomnia Index presented an IRR of 1.42 (95% CI 1.26-1.61). A high score of sleep-related phenomena was also associated with an increased IRR: 1.53 (95% CI 1.37-1.69). Adolescents with high level of sleep satisfaction were at lower risk of RAS: 0.88 (95% CI 0.77-1.01). CONCLUSION These findings suggest that sleep disorders are moderately associated with RAS in adolescents.
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Affiliation(s)
- Hamid Reza Tohidinik
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Almudena Rodríguez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Regueira-Méndez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP, Madrid, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP, Madrid, Spain
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56
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Mutalik VS, Neppalli V, Dale C, Penner C. Multiple painful ulcerated lesions in a 73-year-old patienti. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:3-7. [PMID: 34518139 DOI: 10.1016/j.oooo.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/11/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Vim S Mutalik
- Assistant Professor, Department of Dental Diagnostic and Surgical Science, Dr. Gerald Niznick College of Dentistry, Winnipeg, Manitoba, Canada.
| | - Vishala Neppalli
- Assistant Professor, Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Catherine Dale
- Assistant Professor, Dental Diagnostic and Surgical Sciences, Dr. Gerald Niznick College of Dentistry, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carla Penner
- Pathologist and Assistant Professor, Department of Pathology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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57
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Yuan H, Qiu J, Zhang T, Wu X, Zhou J, Park S. Quantitative changes of Veillonella, Streptococcus, and Neisseria in the oral cavity of patients with recurrent aphthous stomatitis: A systematic review and meta-analysis. Arch Oral Biol 2021; 129:105198. [PMID: 34167010 DOI: 10.1016/j.archoralbio.2021.105198] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aimed to investigate that these bacteria counts in the oral cavity were modulated by the recurrent aphthous stomatitis (RAS) status according to age and ethnicity with a systematic review and meta-analysis. DESIGN The relevant case-control studies were searched in the literature database in English, Korean, and Chinese until June 2020 using keywords, and the literature was screened and collated for Review Manager analysis. Sensitivity analysis and quality check of the included literature were conducted. RESULTS From the selection process, oral bacteria counts were measured by polymerase chain reaction (PCR) in 8 studies and next-generation sequencing in 4 studies. Healthy control, ulcerative phases of RAS (UC-RAS), non-ulcerative phases of RAS (Non-UC-RAS) groups included 442, 473, and 386 participants in a total of 12 studies. For PCR detection, mean differences (95 % confidence intervals) of Veillonella and Streptococcus counts between the healthy-control and RAS groups were -1.91 (-2.41 ∼ -1.41) and -1.34 (-1.85 ∼ -0.83)(P < 0.0001). The bacteria count results by "Next-generation" sequencing (NGS) and PCR methods were similar. Significantly lower Veillonella and Streptococcus counts were observed in the UC-RAS group than in the non-UC-RAS group (P < 0.0001). Veillonella and Streptococcus count differences between RAS and controls aged ≥30 years were greater than those aged <30 years. At the species level, the prevalence of RAS had a negative relation with Veillonella dispar count. CONCLUSIONS Counts of Veillonella and Streptococcus are strongly correlated with the recovery and progression of RAS, especially in middle-aged patients. Adjustment of oral microbiota should be considered in the treatment of RAS.
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Affiliation(s)
- Heng Yuan
- Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea
| | - Jingyi Qiu
- Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea
| | - Ting Zhang
- Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea
| | - Xuanhao Wu
- Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea
| | - Junyu Zhou
- Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea
| | - Sunmin Park
- Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea.
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58
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Recurrent Aphthous Stomatitis Improved after Eradication Therapy for Helicobacter pylori. Case Rep Gastrointest Med 2021; 2021:5543838. [PMID: 33859848 PMCID: PMC8024073 DOI: 10.1155/2021/5543838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 01/22/2023] Open
Abstract
Helicobacterpylori (H. pylori) is a Gram-negative bacterium that colonizes gastric mucosa and is often transmitted through direct contact with saliva, contaminated food or water, and vomit. The majority of the infected individuals remain asymptomatic for a long period. Infection with H. Pylori often presents with dyspepsia, nausea, frequent belching, bloating, abdominal discomfort, burning abdominal pain, and peptic ulcer. A potential association between H. Pylori and recurrent aphthous stomatitis was previously reported; however, the presence of causative relationship between the two remained controversial. We are presenting a case of recurrent aphthous stomatitis of twenty-four-year history resolved after H. pylori treatment.
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Occurrence of Recurrent Aphthous Stomatitis (RAS) as a Rare Oral Manifestation in a Patient with Gilbert's Syndrome. Case Rep Dent 2021; 2021:6648729. [PMID: 33953989 PMCID: PMC8068538 DOI: 10.1155/2021/6648729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022] Open
Abstract
Recurrent aphthous stomatitis is an ulcerative disease of the oral cavity and can occur in isolation or as a manifestation of many systemic diseases. It is a quite common entity and may hence often be overlooked as an isolated lesion. Gilbert's syndrome is a genetic disorder where a deficiency of an enzyme associated with the conjugation of bilirubin results in unconjugated hyperbilirubinemia. The disease is generally asymptomatic and is aggravated by certain trigger factors. No associated oral manifestations are known. In this case report, we discuss the concomitant presence of recurrent aphthous stomatitis in a patient of Gilbert's syndrome. The presence of such recurrent stomatitis may represent as an oral manifestation of Gilbert's syndrome. Early identification of these entities may improve the overall quality of life of the patient.
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Zhu Z, He Z, Xie G, Fan Y, Shao T. Altered oral microbiota composition associated with recurrent aphthous stomatitis in young females. Medicine (Baltimore) 2021; 100:e24742. [PMID: 33725829 PMCID: PMC7969233 DOI: 10.1097/md.0000000000024742] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/22/2021] [Indexed: 01/05/2023] Open
Abstract
Oral microbiota has been implicated in pathogenesis of recurrent aphthous stomatitis (RAS), which is a common mucosal disorder with unclear etiology. This study has explored the association between oral microbiota disorder and RAS in high-risk young female population.Forty-five young females were enrolled, including 24 RAS patients and 21 healthy individuals. Oral microbiome was analyzed by Illumina Miseq sequencing.Oral microbiota associated with RAS was characterized by the lower alpha-diversity indices (Chao1 and ACE). Several infectious pathogens increased in RAS, such as genera Actinobacillus, Haemophilus, Prevotella and Vibrio. The PICRUSt analysis indicated that the oral microbiota might be related with the up-regulation of genes involving infectious and neurodegenerative diseases, environmental adaptation, the down-regulation of genes involving basal metabolism, such as carbohydrate, energy, and amino acid metabolism.This study indicated that oral microbiota may play a significant role in RAS development.
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Affiliation(s)
- Zhengyang Zhu
- The first clinical college, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Zhixing He
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Guanqun Xie
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yongsheng Fan
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Tiejuan Shao
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
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Wang Z, Cao H, Xiong J, Lu Y, Deng Y, Nan H, Zheng S, Ye H, Cao Z. Recent advances in the aetiology of recurrent aphthous stomatitis (RAS). Postgrad Med J 2021; 98:57-66. [PMID: 33574180 DOI: 10.1136/postgradmedj-2020-139421] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 11/04/2022]
Abstract
Recurrent aphthous stomatitis (RAS) is the most common disease of oral mucosa, which almost attacks each individual once in their lifespan. Although plenty of factors have been suggested to play a role in the pathogenesis of RAS, the aetiology of RAS is still controversial, which might lead to limited clinical therapies in accordance with each RAS patient. This review mainly illustrates recent advances in potential causes associated with RAS in detail. Deeper comprehension of the aetiology of RAS will support doctors and researchers to make a better management of RAS patients and to discover new treatments. The aetiology of RAS is complicated, hence we should take a comprehensive view into its aetiology, with multiple potential factors being considered. Sample collection of RAS patients have greatly limited the progress in the aetiology of RAS. A research model of multiagency cooperation can help achieve perfect sample collection of year-round and multiposition.
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Affiliation(s)
- Zihan Wang
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Haibo Cao
- Clinical Medicine School, Hebei University of Engineering, Handan, China
| | - Jianqi Xiong
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yilong Lu
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yixiao Deng
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Han Nan
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Shutian Zheng
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Hui Ye
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Zhensheng Cao
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
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Bao J, Chen J, Zhang X, Xu L, Fan Y, Dou X. Combined signatures of serum proteome and transcriptome in patients with recurrent aphthous ulcer. Oral Dis 2021; 28:691-702. [PMID: 33576097 DOI: 10.1111/odi.13800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Recurrent aphthous ulcer (RAU) is a common oral disease with unclear mechanism. This study aimed to explore the serum signatures of RAU patients via proteomic and transcriptomic analysis. METHODS This study was based on clinical observation. Part of serum was used for clinical tests, while the rest was processed for isobaric tags for relative and absolute quantitation (ITRAQ) labeling coupled with two-dimensional liquid chromatography-tandem mass spectrometry (2D LC-MS/MS) combined with microRNA (miRNA) microarrays. Bioinformatic analysis was then used to obtain significant signatures, which was verified by ELISA, qRT-PCR, and dual-luciferase reporter gene assays. RESULTS Clinical data showed that triglyceride level, white blood cell count, and neutrophils percentage were increased in RAU group, while lymphocytes percentage was decreased. ITRAQ-2D LC-MS/MS identified 22 upregulated and 33 downregulated proteins in RAU group. Simultaneously, miRNA microarrays identified 64 upregulated and 31 downregulated miRNAs. After integrative bioinformatic analysis and verification, three miRNA-protein pairs, mainly involved in oxidative stress and inflammation responses, were obtained. Additionally, the interaction network indicated the crucial role of complement and coagulation cascade pathway in RAU. CONCLUSIONS Our study revealed that complement and coagulation cascade pathway, oxidative stress, and inflammation responses may act as vital factors in pathogenesis of RAU.
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Affiliation(s)
- Jie Bao
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Juan Chen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - XiZhao Zhang
- School of 1st Clinical Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Xu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - YongSheng Fan
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - XiaoBing Dou
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
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Shen C, Ye W, Gong L, Lv K, Gao B, Yao H. Serum interleukin-6, interleukin-17A, and tumor necrosis factor-alpha in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2021; 50:418-423. [PMID: 33432616 DOI: 10.1111/jop.13158] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recurrent aphthous stomatitis remains the most common disease of the oral mucosa. The aim of this study was to investigate the clinical significance of serum interleukin-6, interleukin-17A, and tumor necrosis factor-alpha in recurrent aphthous stomatitis. METHODS Using flow cytometry analysis, we detect the level of serum interleukin-2, interleukin-6, interleukin-17A, tumor necrosis factor-alpha, and interferon-gamma in 127 patients with recurrent aphthous stomatitis and 20 healthy control cases; compare; and analyze the correlation of each index. RESULTS The levels of serum interleukin-2, interleukin-6, tumor necrosis factor-alpha, and interferon-gamma in the recurrent aphthous stomatitis group were higher than in the control group, and the differences were statistically significant (P < .05). There was no significant difference in interleukin-17A between the two groups. CONCLUSION The levels of serum interleukin-6 and tumor necrosis factor-alpha in recurrent aphthous stomatitis patients were significantly increased. Considering that serum TNF-α was mostly within the normal range, its role in the pathology of RAS needed to be further explored.
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Affiliation(s)
- Chenlu Shen
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Weijia Ye
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Lijun Gong
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Kejia Lv
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Bicong Gao
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Hua Yao
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University, Hangzhou, China
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Subclinical ocular inflammation in patients with recurrent aphthous stomatitis. Can J Ophthalmol 2021; 56:294-298. [PMID: 33417849 DOI: 10.1016/j.jcjo.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Recurrent aphthous stomatitis (RAS) is the major finding of Behçet's disease as well as an inflammatory disease. We compared the choroidal thickness (CT) in patients with RAS with healthy volunteers. METHODS Patients with RAS (n = 34) and age- and sex-matched controls (n = 34) were evaluated using spectral-domain optical coherence tomography (OCT). CT measurements were executed at 3 different points (subfoveal, nasal, and temporal). Laboratory parameters were determined for patients and controls. RESULTS The mean subfoveal CT in the RAS and control groups were 356.7 ± 91.7 μm and 326.3 ± 86.6 μm, respectively. The RAS group demonstrated significantly higher subfoveal CT than the control group (p = 0.008). CONCLUSION This was the first reported study demonstrating a significantly higher subfoveal CT in patients with RAS. Further studies investigating the risk for subclinical ocular inflammation in this patient population are warranted.
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Al-Amad S. Helicobacter pylori and gastric hyperacidity, and their association with recurrent aphthous stomatitis. Int J Oral Maxillofac Surg 2020; 49:1599-1604. [DOI: 10.1016/j.ijom.2020.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/12/2020] [Accepted: 05/20/2020] [Indexed: 02/07/2023]
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do Nascimento EG, de Azevedo EP, Alves-Silva MF, Aragão CFS, Fernandes-Pedrosa MF, da Silva-Junior AA. Supramolecular aggregates of cyclodextrins with co-solvent modulate drug dispersion and release behavior of poorly soluble corticosteroid from chitosan membranes. Carbohydr Polym 2020; 248:116724. [PMID: 32919548 DOI: 10.1016/j.carbpol.2020.116724] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/13/2020] [Accepted: 06/30/2020] [Indexed: 01/29/2023]
Abstract
In this study, the ability of different beta-cyclodextrins to facilitate homogeneous dispersion of triamcinolone acetonide (TA) into chitosan membranes is assessed. Drug loading was assessed through atomic force microscopy (AFM), scanning electron microscopy (MEV-FEG), and X-ray diffraction analyses. Drug interactions with the co-polymer were investigated with Fourier transform infrared spectroscopy, thermal analyses. Swelling assay, and in vitro drug release experiment were used to assess TA release behavior. Undispersed particles of drug were observed to remain in the simple chitosan membranes. Hydroxypropyl-β-cyclodextrin enabled the dispersion of TA into chitosan membranes and subsequent sustained drug release. In addition, the membrane performance as a drug delivery device is improved by adding specified amounts of the co-solvent triethanolamine. The experimental data presented in this study confirm the utility of our novel and alternative approach for obtaining a promising device for slow and controlled release of glucocorticoids, such as triamcinolone acetonide, for topical ulcerations.
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Affiliation(s)
- Ednaldo Gomes do Nascimento
- Laboratory of Pharmaceutical Technology and Biotechnology, Department of Pharmacy, Federal University of Rio Grande do Norte, UFRN, Gal. Gustavo Cordeiro de Farias, Petrópolis, 59072-570, Natal, RN, Brazil
| | - Eduardo Pereira de Azevedo
- Department of Pharmacy, Federal University of Potiguar, UnP, Av. Sen. Salgado Filho, 1610, Lagoa Nova, 59056-000, Natal, RN, Brazil
| | - Mariana Farias Alves-Silva
- Laboratory of Pharmaceutical Technology and Biotechnology, Department of Pharmacy, Federal University of Rio Grande do Norte, UFRN, Gal. Gustavo Cordeiro de Farias, Petrópolis, 59072-570, Natal, RN, Brazil
| | - Cícero Flávio S Aragão
- Laboratory of Quality Control of Pharmaceuticals, Department of Pharmacy, Federal University of Rio Grande do Norte, UFRN, Gal. Gustavo Cordeiro de Farias, Petrópolis, 59072-570, Natal, RN, Brazil
| | - Matheus F Fernandes-Pedrosa
- Laboratory of Pharmaceutical Technology and Biotechnology, Department of Pharmacy, Federal University of Rio Grande do Norte, UFRN, Gal. Gustavo Cordeiro de Farias, Petrópolis, 59072-570, Natal, RN, Brazil
| | - Arnóbio Antônio da Silva-Junior
- Laboratory of Pharmaceutical Technology and Biotechnology, Department of Pharmacy, Federal University of Rio Grande do Norte, UFRN, Gal. Gustavo Cordeiro de Farias, Petrópolis, 59072-570, Natal, RN, Brazil.
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Zhang F, Zhou H, Ding S, Zhang D, Lian D, Chen X, Wang C. Efficacy and safety of acupuncture for recurrent aphthous stomatitis: a systematic review protocol. BMJ Open 2020; 10:e037603. [PMID: 33033019 PMCID: PMC7542930 DOI: 10.1136/bmjopen-2020-037603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Recurrent aphthous stomatitis (RAS) is a distressing symptom. There are many ways to treat RAS, such as pudilan anti-inflammatory oral liquid and doxycycline and laser therapy, but these take a long time to produce positive effects and compliance is low. Previous reviews of acupuncture treatment for RAS has been growing, but a systematic review is not available. To assess the efficacy and safety of acupuncture for the management of RAS. METHODS AND ANALYSIS The following databases will be searched from their inception to 1 February 2020: PubMed, Embase, Cochrane Library, CINAHL, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure and Wanfang. The randomised controlled trials in English or Chinese associated with acupuncture for patients with RAS will be included. Eligible study conference abstracts and reference lists of manuscripts will also be searched. Two reviewers will select the studies, extract data independently. The Cochrane risk of bias tool will be used to assess the risk of bias for the studies. According to heterogeneity testing, data will be synthesised using a random-effects model. A meta-analysis will be performed using Rev Man V.5.3.5 statistical software for each outcome. Subgroup analysis and sensitivity analysis are planned according to clinical evidence. Mean difference or standardised mean difference for continuous data and risk ratio for dichotomous data will be calculated. ETHICS AND DISSEMINATION No ethical approval is required. This protocol will not involve individual patient information and endangering participant rights. The results will be reported in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/QASUY.
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Affiliation(s)
- Feng Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hao Zhou
- Sub-Health Center, Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Songyi Ding
- Sub-Health Center, Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Da Zhang
- Sub-Health Center, Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Daoshi Lian
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingliang Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sub-Health Center, Sichuan Integrative Medicine Hospital, Chengdu, China
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Kavita K, Singh R, Singh R, Gonuguntla S, Luke AM, Jois HS. Assessment of Efficacy of 5% Topical Amlexanox and 0.1% Topical Triamcinolone Acetonide in Management of Recurrent Aphthous Stomatitis. J Pharm Bioallied Sci 2020; 12:S444-S447. [PMID: 33149503 PMCID: PMC7595536 DOI: 10.4103/jpbs.jpbs_133_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/08/2020] [Accepted: 03/02/2020] [Indexed: 11/19/2022] Open
Abstract
Aim: The aim of this study was to assess the efficacy of 5% topical amlexanox and 0.1% topical triamcinolone acetonide in recurrent aphthous stomatitis (RAS) management. Materials and Methods: Sixty adult patients of RAS of both genders were divided into two groups with each group having 30 patients. In group I, 0.1% topical triamcinolone acetonide was prescribed. In group II, 5% topical amlexanox was prescribed. Patients were recalled regularly and size of ulcer, erythema, and pain score was recorded on days 1, 3, and 5. Results: The mean ulcer size (mm) on day 1 in group I was 4.3 and in group II it was 4.1, on day 3 it was 3.5 in group I and in group II it was 3.6, on day 5 in group I it was 1.3 and in group II it was 1.7. The result was not statistically significant (P > 0.05). The mean pain score recorded on visual analog scale was in descending grade day by day on first, third, and fifth days. In group I, healing was seen in 29 (96.6%) patients and in 28 (93.3%) patients in group II. Partially healing was seen in 1 (3.3%) patient in each group, whereas in group II nonhealing was observed in 1 (3.3%) patient. The statistical significance was not achieved as P > 0.05. Conclusion: Authors found that above drugs were effective in reducing pain, size of ulcer, erythema, and improving healing in patients with recurrent aphthous stomatitis. There were better results with triamcinolone acetonide as comparison of amlexanox.
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Affiliation(s)
- Kumari Kavita
- Department of Dentistry, Nalanda Medical College and Hospital, Patna, Bihar, India
| | - Rohit Singh
- Department of Prosthodontics, Crown, Bridge and Implantology, Patna Dental College & Hospital, Patna, Bihar, India
| | - Revati Singh
- Department of Dentistry, Patna Medical College and Hospital (PMCH), Patna, Bihar, India
| | - Sudhir Gonuguntla
- Department of Oral and Maxillofacial Pathology, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India
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Chen P, Yao H, Yuan Q, Li P, Wang X, Su W, Wang Y, Li P. Discovery of the possible mechanisms in kouyanqing granule for treatment of oral ulcers based on network pharmacology. BMC Complement Med Ther 2020; 20:258. [PMID: 32811507 PMCID: PMC7436979 DOI: 10.1186/s12906-020-03043-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 08/05/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Oral ulcer diseases are complex inflammatory diseases caused by multi-factors, which severely impact patient quality of life. Kouyanqing Granule (KYQG) has been used to treat inflammatory diseases of the mouth and throat, including recurrent aphthous stomatitis (RAS), traumatic ulcers, oral leukoplakia and so on. However, the underlying molecular mechanisms of KYQG in treating these diseases are still unclear. We aimed to explore the possible mechanisms in KYQG for the treatment of oral ulcers. METHODS An innovative network pharmacology method was established by incorporating targets searching and fishing, network analysis, and silico validation to discover the pharmacological mechanisms of action of KYQG for the treatment of oral ulcers. Then, we verified the reliability of this method by an animal experiment. RESULTS Our data indicated that a total of 47 key targets were screened, which mainly involved in three function modules including the inhibition of inflammation, the regulation of immunological response, and the suppression of oxidative stress. The implementation of these functions relies on the complex multi-pathways network, especially TNF signaling pathway and HIF-1 signaling pathway. The results of the experimental verification indicated that KYQG significantly inhibited the serum levels of cyclooxygenase-2 (COX2), matrix metalloproteinase 9 (MMP9) and tumor necrosis factor-alpha (TNF-α) in rats with oral ulcer. CONCLUSION KYQG exhibited the therapeutic effects on oral ulcers probably by inhibiting inflammation, regulating immunological response, and suppressing oxidative stress through a complex multi-pathways network. Particularly, TNF signaling pathway and HIF-1 signaling pathway may play crucial roles in the protection of KYQG against oral ulcers. This work not only offers a method for understanding the functional mechanisms of KYQG for treating oral ulcer diseases from a multi-scale perspective but also may provide an efficient way for research and development of complex composition formula.
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Affiliation(s)
- Pan Chen
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Hongliang Yao
- Guangdong Key Laboratory of Animal Conservation and Resource Utilization, Guangdong Public Laboratory of Wild Animal Conservation and Utilization, Drug Synthesis and Evaluation Center, Guangdong Institute of Applied Biological Resources, Guangzhou, 510260, China
| | - Qing Yuan
- The school of Basic Medical Sciences, Southwest medical university, Luzhou, 646000, China
| | - Panlin Li
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Xinning Wang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Weiwei Su
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Yonggang Wang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Peibo Li
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China.
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Common oral sores and infections. J Am Dent Assoc 2020; 151:640. [DOI: 10.1016/j.adaj.2020.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 11/19/2022]
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Bankvall M, Östman S, Jontell M, Torinsson Naluai Å. A family-based genome-wide association study of recurrent aphthous stomatitis. Oral Dis 2020; 26:1696-1705. [PMID: 32558109 DOI: 10.1111/odi.13490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 04/29/2020] [Accepted: 06/04/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The aetiology of recurrent aphthous stomatitis (RAS) remains unknown. Individuals may share features of genetic susceptibility, and there may also be a hereditary component. The aim was to identify patterns of association and segregation for genetic variants and to identify the genes and signalling pathways that determine the risk of developing RAS, through a family-based genome-wide association study (GWAS). SUBJECTS AND METHODS DNA was extracted from buccal swabs of 91 individuals in 16 families and analysed in an Illumina core exome single nucleotide polymorphism (SNP) array. A family-based association test (dFAM) was used to derive SNP association values across all chromosomes. RESULTS None of the final 288,452 SNPs reached the genome-wide significant threshold of 5 × 10-8 . The most significant pathways were the Ras and PI3K-Akt signalling pathways, pathways in cancer, circadian entrainment and the Rap 1 signalling pathway. CONCLUSIONS This confirms that RAS is not monogenic but results as a consequence of interactions between multiple host genes and possibly also environmental factors. The present approach provides novel insights into the mechanisms underlying RAS and raises the possibility of identifying individuals at risk of acquiring this condition.
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Affiliation(s)
- Maria Bankvall
- Department of Oral Medicine & Pathology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
| | - Sofia Östman
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Mats Jontell
- Department of Oral Medicine & Pathology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Torinsson Naluai
- Department of Microbiology and Immunology, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bardellini E, Veneri F, Amadori F, Conti G, Majorana A. Photobiomodulation therapy for the management of recurrent aphthous stomatitis in children: clinical effectiveness and parental satisfaction. Med Oral Patol Oral Cir Bucal 2020; 25:e549-e553. [PMID: 32388522 PMCID: PMC7338059 DOI: 10.4317/medoral.23573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/10/2020] [Indexed: 01/26/2023] Open
Abstract
Background This study aims to evaluate the effectiveness of the photobiomodulation therapy (PBMT) in the treatment of minor recurrent aphthous stomatitis (MiRAS) in children, in terms of pain relief, lesion size reduction and the parental satisfaction of the therapy.
Material and Methods This randomized controlled study was carried out on 60 children with clinical diagnosis of MiRAS. Patients were randomized into two groups: group A receiving laser therapy and group B receiving sham therapy (placebo). Laser therapy (diode laser, λ: 645 nm) was administered on day 1 (T0) for three consecutive days. Patients were evaluated also on day 4 (T1), on day 7 (T2) and on day 10 (T3). Oral aphthous lesions size was assessed through a periodontal probe to measure the diameter length (mm); pain was evaluated through the Visual Analogue Scale (VAS); parental satisfaction was assessed through a questionnaire.
Results The difference in the reduction of ulcers diameters between the two groups resulted statistically significant at T1 and at T2 (p<0.05). A statistically significant difference in pain reduction between two groups was found at T1 (p<0.05). No statistically significant difference between the two groups of parents was found as concerns the parental acceptance of the procedure and the discomfort for the need of multiple appointments.
Conclusions PBMT is to be considered effective in the treatment of MiRAS in children and well- accepted by the parents of the children themselves. Key words:Ulcers, children, lasers
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Affiliation(s)
- E Bardellini
- Dental Clinic, p.le Spedali Civili n.1 25133 Brescia
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Chen P, Yao H, Su W, Zheng Y, Fan W, Zhang L, Chen T, Wu S, Zhang W, He Y, Yan Z, Wang Y, Li P. Pharmacodynamic and Metabolomics Studies on the Effect of Kouyanqing Granule in the Treatment of Phenol-Induced Oral Ulcer Worsened by Sleep Deprivation. Front Pharmacol 2020; 11:824. [PMID: 32694994 PMCID: PMC7338550 DOI: 10.3389/fphar.2020.00824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/19/2020] [Indexed: 01/26/2023] Open
Abstract
Oral ulcers are the most prevalent oral mucosal diseases globally, and no specific treatment schemes are currently available due to the complexity of oral ulcer diseases. Sleep deprivation increases the risk of a deterioration in oral health. Kouyanqing Granule (KYQG) has been used for decades in China to treat inflammatory diseases of the mouth and throat associated with the hyperactivity of fire due to yin deficiency syndrome. However, the mechanisms underlying the effects of KYQG in the treatment of oral ulcers are still unclear. The aims of this study were to investigate whether KYQG treatment could attenuate the symptoms of oral ulcers worsened by sleep deprivation and identify the involved metabolic pathways. First, we conducted chemical profiling of KYQG via UPLC–MS analysis. We then combined pharmacological and metabolomics approaches in a phenol-induced rat model of oral ulcers worsened by sleep deprivation. A total of 79 compounds were initially identified. Our observations showed that KYQG treatment induced a significantly higher healing rate in oral ulcers worsened by sleep deprivation. KYQG significantly reduced the levels of 5-HT and GABA in serum, and only decreased the 5-HT level in brain tissue after phenol injury followed by sleep deprivation. Moreover, KYQG administration significantly suppressed systemic inflammation by inhibiting TNF-α, IL-1β, IL-6, IL-18, and MCP-1. Immunohistochemical analysis further revealed that KYQG inhibited IL-6 expression in buccal mucosa tissues. KYQG treatment also significantly decreased the serum levels of ACTH, CORT, IgM, and 8-OHdG. Serum metabolomics analysis showed that a total of 30 metabolites showed significant differential abundances under KYQG intervention, while metabolic pathway analysis suggested that the altered metabolites were associated with the dysregulation of eight metabolic pathways. Taken together, our results indicated that KYQG attenuates the symptoms of oral ulcers worsened by sleep deprivation probably through the regulation of the neuroimmunoendocrine system, oxidative stress levels, and tryptophan metabolism. This study also provides a novel approach for addressing the increased health risks resulting from sleep deficiency using an herbal medicine formula.
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Affiliation(s)
- Pan Chen
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Hongliang Yao
- Guangdong Key Laboratory of Animal Conservation and Resource Utilization, Guangdong Public Laboratory of Wild Animal Conservation and Utilization, Drug Synthesis and Evaluation Center, Guangdong Institute of Applied Biological Resources, Guangzhou, China
| | - Weiwei Su
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Yuying Zheng
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Weiyang Fan
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Liping Zhang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Tingting Chen
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Shuling Wu
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Weijian Zhang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Yan He
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Zenghao Yan
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Yonggang Wang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Peibo Li
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
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Dominguez-Santas M, Diaz-Guimaraens B, Fernandez-Nieto D, Jimenez-Cauhe J, Ortega-Quijano D, Suarez-Valle A. Minor aphthae associated with SARS-CoV-2 infection. Int J Dermatol 2020; 59:1022-1023. [PMID: 32557570 PMCID: PMC7323002 DOI: 10.1111/ijd.15004] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 01/06/2023]
Affiliation(s)
| | | | | | - Juan Jimenez-Cauhe
- Dermatology Department, Ramon y Cajal University Hospital, Madrid, Spain
| | | | - Ana Suarez-Valle
- Dermatology Department, Ramon y Cajal University Hospital, Madrid, Spain
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Yılmaz S, Tuna Kırsaçlıoğlu C, Şaylı TR. Celiac disease and hematological abnormalities in children with recurrent aphthous stomatitis. Pediatr Int 2020; 62:705-710. [PMID: 31957941 DOI: 10.1111/ped.14155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/12/2019] [Accepted: 01/15/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is one of the most common diseases of the oral mucosa and may be related to vitamin deficiencies or systemic diseases such as celiac disease (CD). The aim of this study was to investigate the frequency of hematinic deficiency and CD in children with RAS. METHODS The medical records of patients diagnosed with RAS were reviewed for the presence of hematinic deficiencies (hemoglobin, mean corpuscular volume, ferritin, vitamin B12 , folic acid), and CD. The study group included 108 children with RAS and 57 healthy children who were evaluated for hematological abnormalities in routine evaluation. RESULTS The frequency of a family history of RAS was significantly higher in the RAS group compared to the control group (34.2% vs 7%, respectively; P < 0.001). A hematological abnormality was detected in 32.4% of the RAS group and 10.5% of the control group (P = 0.02). The prevalence of iron deficiency anemia was significantly higher in the RAS group (P = 0.037). Three (2.7%) patients with RAS were diagnosed with CD, which is a significantly higher frequency than that observed in healthy children in Turkey (P < 0.01; OR 6.03, 95% CI [2.37, 4.56]). These children had mild malnutrition, iron deficiency, and iron deficiency anemia. CONCLUSIONS Children with RAS should be evaluated for nutritional status and hematological indices, and in the case of hematological abnormalities and malnutrition screening for CD should be considered.
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Affiliation(s)
- Songül Yılmaz
- Department of Pediatrics, Turkish Republic Health Ministry, Ankara Child Health Diseases, Hematology and Oncology Training and Research Hospital, Ankara, Turkey
| | - Ceyda Tuna Kırsaçlıoğlu
- Department of Pediatric Gastroenterology, Turkish Republic Health Ministry, Ankara Child Health Diseases, Hematology and Oncology Training and Research Hospital, Ankara, Turkey
| | - Tülin Revide Şaylı
- Department of Pediatrics, Turkish Republic Health Ministry, Ankara Child Health Diseases, Hematology and Oncology Training and Research Hospital, Ankara, Turkey
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Akbari N, Asadimehr N, Kiani Z. The effects of licorice containing diphenhydramine solution on recurrent aphthous stomatitis: A double-blind, randomized clinical trial. Complement Ther Med 2020; 50:102401. [PMID: 32444056 DOI: 10.1016/j.ctim.2020.102401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/24/2020] [Accepted: 04/03/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The aim of this study was to compare the efficacy of the diphenhydramine solution (DS) and diphenhydramine-containing glycyrrhiza glabra (DSG) in the treatment of recurrent aphthous stomatitis (RAS). DESIGN It was a double-blind randomized clinical trial that was conducted from July to September 2018 at the Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran. INTERVENTION DSG was made by adding 5% hydroethanolic extract of licorice to the diphenhydramine elixir. A total of 70 patients diagnosed with RSA were randomly assigned to the DS and DSG groups, each containing 35 patients. Participants were instructed to swish 3 ml of either solution around their mouth for about three minutes four times a day (at least 20 min before each meal and before bedtime) until the complete healing of the oral lesions. MAIN OUTCOME MEASURES The primary outcome of this study was to assess the severity of pain prior to the intervention and on the first, third, and fifth days of it. This was done using the visual analog scale (VAS). The duration of wound healing was also measured through photography. The secondary outcome was to record the adverse effects of the intervention. This trial was registered at the Iranian Registry of Clinical Trials under number1 IRCT20180407039213N1. RESULTS The average pain score before the treatment in the DS and DSG groups was 8. 1 ± 1.17 and 7.97 ± 1.72, respectively, and there was apparently no significant difference between them. However, there was a significant difference between the two groups in terms of the average pain scores on the first (7 ± 1.28 versus 5.31 ± 1.28), third (4.02 ± 1.8 vs. 2.86 ± 1.56) and fifth days (1.71 ± 1.69 vs. 0.54 ± 1.31) of the intervention. Indeed, DSG significantly reduced the average wound healing duration by 1.5 days, as compared to DS (P = 0.0001). No adverse effects were observed with the intervention. CONCLUSION According to our results, DSG appeared to be more effective in treating RAS than DS alone. TRIAL REGISTRATION The trial was registered at Iranian Registry of Clinical Trials before the enrolment of the first patient on June 29, 2019 (registration no: IRCT20180407039213N1, http://www.irct.ir/trial/31497).
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Affiliation(s)
- Narjes Akbari
- Faculty of Dentistry, Birjand University of Medical sciences, Birjand, Iran.
| | - Neda Asadimehr
- Faculty of Dentistry, Birjand University of Medical sciences, Birjand, Iran.
| | - Zahra Kiani
- Pharmacology Department, Medical School, Birjand University of Medical Sciences, Birjand, 9717853577, Iran.
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77
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Panos G, Kakoullis L, Louppides S, Emmanuil A. Behçet's disease presenting as recurrent oral aphthosis in a 9-year-old boy from Greece. BMJ Case Rep 2020; 13:e229527. [PMID: 32107255 PMCID: PMC7046425 DOI: 10.1136/bcr-2019-229527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 11/03/2022] Open
Abstract
We report a case of Behçet's disease in a 9-year-old boy from Greece, presenting with a history of recurrent ulceration of the oral cavity. Following inspection of the oral cavity, which revealed lesions on both the upper and lower labial mucosa, as well as a large ulcer on the apex of the tongue, the diagnosis of Behçet's disease was immediately suspected. The diagnosis was confirmed using the International Criteria for Behçet's Disease. Nevertheless, as multiple diseases can cause recurrent oral aphthosis, an extensive differential diagnosis was made, and pertinent tests were undertaken to exclude other causes of oral ulceration. The approach to a patient with Behçet's disease, as well as its various clinical presentations and complications, is discussed.
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Affiliation(s)
- George Panos
- Infectious Diseases Section, University General Hospital of Patras, Patras, Achaia, Greece
- Internal Medicine, University Cyprus School of Medicine, Nicosia, Cyprus
| | - Loukas Kakoullis
- Internal Medicine, Nicosia General Hospital, University of Cyprus Medical School, Nicosia, Cyprus
- Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Stylianos Louppides
- Internal Medicine, Nicosia General Hospital, University of Cyprus Medical School, Nicosia, Cyprus
| | - Andreas Emmanuil
- Biochemical Laboratory, University General Hospital of Patras, Patras, Greece
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78
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Hariyani N, Bramantoro T, Nair R, Singh A, Sengupta K. Depression symptoms and recurrent aphthous stomatitis-Evidence from a population-based study in Indonesia. Oral Dis 2020; 26:948-954. [PMID: 32031742 DOI: 10.1111/odi.13303] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/13/2019] [Accepted: 02/05/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aims to report the prevalence and distribution of recurrent aphthous stomatitis (RAS) among Indonesian adults and to test the relationship between symptom of depression and RAS. METHODS Data from the 2007 Indonesia Family Life Survey (IFLS 2007) were analysed to assess the association between symptom of depression and RAS. The prevalence of RAS in the previous month was self-reported. Symptom of depression was measured using the 10-item Center for Epidemiologic Studies Depression (CES-D) scale. The distribution of RAS according to age, sex and level of stress was also presented in the bivariate analysis. Multivariable logistic regression models were fitted to test associations between symptom of depression and RAS, controlling for age, sex and the stress level. RESULTS The previous month prevalence of RAS in Indonesian population was 12%. The adjusted odds ratios (ORs) from the logistic regression models indicate that, for each unit increase in the CES-D depression score (range: 0-30), there was a 9% increase in the odds of having RAS (OR: 1.09, 95%CI: 1.08-1.10). Being older and being male was related with lower prevalence of RAS. CONCLUSIONS A higher score of depression was related to a higher prevalence of RAS. This association was persistent even after controlling for age, sex and the level of stress.
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Affiliation(s)
- Ninuk Hariyani
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.,Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Taufan Bramantoro
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Rahul Nair
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Ankur Singh
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - Kaushik Sengupta
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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79
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Abo-shady AZ, Elkammar H, Elwazzan VS, Nasr M. Formulation and clinical evaluation of mucoadhesive buccal films containing hyaluronic acid for treatment of aphthous ulcer. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2019.101442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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80
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shirzaiy M, Sarabadani J. Recurrent Aphthous Stomatitis and Related Factors Among 12-17-Year-Old Students in Zahedan, Iran. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2020. [DOI: 10.29252/jrdms.5.1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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81
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Wiriyakijja P, Porter S, Fedele S, Hodgson T, McMillan R, Shephard M, Ni Riordain R. Validation of the HADS and PSS-10 and a cross-sectional study of psychological status in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2020; 49:260-270. [PMID: 31919894 DOI: 10.1111/jop.12991] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/04/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To validate the Hospital Anxiety and Depression Scale (HADS) and the 10-item Perceived Stress Scale (PSS-10) for use in clinical studies of recurrent aphthous stomatitis (RAS) and to provide cross-sectional assessment of anxiety, depressive, and distress symptoms and perceived stress in patients with RAS. METHODS The validity and reliability of the HADS and PSS-10 were evaluated in 120 individuals with RAS through confirmatory factor analysis and calculation of Cronbach's alpha and omega coefficients. The prevalence of comorbid anxiety, depression, distress, and moderate-to-high perceived stress, and their association with demographics and clinical factors were assessed through cutoff scores of the HADS and PSS-10 and bivariate analyses, respectively. RESULTS A bi-factor model, with all items loading onto general factor with two group factors, provides the best fit to the HADS and PSS-10 data of this RAS cohort. While omega values suggested adequate reliability of total score of both scales, relatively low ranges of coefficient omega hierarchical limit utility of their subscale scores. The prevalence of anxiety, depression, distress, and moderate-to-high perceived stress was 42.5%, 18.33%, 28.33%, and 71.67%, respectively. Ethnicity, alcohol consumption, disease comorbidities, clinical type of RAS, ulcer size, pain, and RAS disease activity were found to be associated with negative psychological symptoms. CONCLUSION The HADS and PSS-10 are valid and reliable as general scales of psychological distress and stress in patients with RAS. Significant mental burden among RAS patients makes the use of these validated instruments a sensible and prudent practice for psychological assessment of this patient group.
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Affiliation(s)
- Paswach Wiriyakijja
- UCL Eastman Dental Institute, London, UK.,Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Stefano Fedele
- UCL Eastman Dental Institute, London, UK.,NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Tim Hodgson
- Eastman Dental Hospital, UCLH Foundation NHS Trust London, London, UK
| | - Roddy McMillan
- Eastman Dental Hospital, UCLH Foundation NHS Trust London, London, UK
| | - Martina Shephard
- Eastman Dental Hospital, UCLH Foundation NHS Trust London, London, UK
| | - Richeal Ni Riordain
- UCL Eastman Dental Institute, London, UK.,Department of Oral Medicine, Cork University Dental School and Hospital, Cork, Ireland
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82
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Cheng LL. Limited Evidence Suggests That Patients With Recurrent Aphthous Stomatitis May Benefit From Using Sodium Lauryl Sulfate-free Dentifrices. J Evid Based Dent Pract 2019; 19:101349. [PMID: 31843182 DOI: 10.1016/j.jebdp.2019.101349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Effect of sodium lauryl sulfate on recurrent aphthous stomatitis: A systematic review. Alli BY, Erinoso OA, Olawuyi AB. J Oral Pathol Med. 2019;48(5):358-64. SOURCE OF FUNDING None. The authors declared no conflict of interest. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data from double-blind randomized controlled trials.
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83
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Oral Microbiota Composition and Antimicrobial Antibody Response in Patients with Recurrent Aphthous Stomatitis. Microorganisms 2019; 7:microorganisms7120636. [PMID: 31805744 PMCID: PMC6955784 DOI: 10.3390/microorganisms7120636] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
Recurrent aphthous stomatitis (RAS) is the most common disease of the oral mucosa, and it has been recently associated with bacterial and fungal dysbiosis. To study this link further, we investigated microbial shifts during RAS manifestation at an ulcer site, in its surroundings, and at an unaffected site, compared with healed mucosa in RAS patients and healthy controls. We sampled microbes from five distinct sites in the oral cavity. The one site with the most pronounced differences in microbial alpha and beta diversity between RAS patients and healthy controls was the lower labial mucosa. Detailed analysis of this particular oral site revealed strict association of the genus Selenomonas with healed mucosa of RAS patients, whereas the class Clostridia and genera Lachnoanaerobaculum, Cardiobacterium, Leptotrichia, and Fusobacterium were associated with the presence of an active ulcer. Furthermore, active ulcers were dominated by Malassezia, which were negatively correlated with Streptococcus and Haemophilus and positively correlated with Porphyromonas species. In addition, RAS patients showed increased serum levels of IgG against Mogibacterium timidum compared with healthy controls. Our study demonstrates that the composition of bacteria and fungi colonizing healthy oral mucosa is changed in active RAS ulcers, and that this alteration persists to some extent even after the ulcer is healed.
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84
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Al-Amad SH, Hasan H. Vitamin D and hematinic deficiencies in patients with recurrent aphthous stomatitis. Clin Oral Investig 2019; 24:2427-2432. [DOI: 10.1007/s00784-019-03102-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022]
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85
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Minhas S, Sajjad A, Kashif M, Taj F, Waddani HA, Khurshid Z. Oral Ulcers Presentation in Systemic Diseases: An Update. Open Access Maced J Med Sci 2019; 7:3341-3347. [PMID: 31949540 PMCID: PMC6953949 DOI: 10.3889/oamjms.2019.689] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Diagnosis of oral ulceration is always challenging and has been the source of difficulty because of the remarkable overlap in their clinical presentations. AIM The objective of this review article is to provide updated knowledge and systemic approach regarding oral ulcers diagnosis depending upon clinical picture while excluding the other causative causes. METHODS For this, specialised databases and search engines involving Science Direct, Medline Plus, Scopus, PubMed and authentic textbooks were used to search topics related to the keywords such as oral ulcer, oral infections, vesiculobullous lesion, traumatic ulcer, systematic disease and stomatitis. Associated articles published from 1995 to 2019 in both dental and medical journals including the case reports, case series, original articles and reviews were considered. RESULTS The compilation of the significant data reveals that ulcers can be classified according to (i) duration of onset, (ii) number of ulcers and (iii) etiological factors. Causation of oral ulcers varies from slight trauma to underlying systemic diseases and malignancies. CONCLUSION Oral manifestations must be acknowledged for precise diagnosis and appropriate treatment.
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Affiliation(s)
- Sadia Minhas
- Department of Oral Pathology, Akhtar Saeed Dental College, Lahore, Pakistan
| | - Aneequa Sajjad
- Department of Oral Pathology, Akhtar Saeed Dental College, Lahore, Pakistan
| | - Muhammad Kashif
- Department of Oral Pathology, Bakhtawar Amin Medical & Dental College, Multan, Pakistan
| | - Farooq Taj
- Department of Prosthetic, Khyber Medical University Institute of Dental Sciences, Kohat, Pakistan
| | - Hamed Al Waddani
- Department of Medicine and Surgery, College of Dentistry, King Faisal University, Hofuf, Al-Ahsa Governorate, Saudi Arabia
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Hofuf, Al-Ahsa Governorate, Saudi Arabia
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86
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Rivera C. Essentials of recurrent aphthous stomatitis. Biomed Rep 2019; 11:47-50. [PMID: 31384457 DOI: 10.3892/br.2019.1221] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/05/2019] [Indexed: 12/17/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS), also known as canker sores, is the most common disease of the oral mucosa. Unlike caries and periodontal disease, patients with RAS are unable to prevent it. The clinical picture of RAS is characterized by recurrent episodes of solitary or multiple painful ulcerations without association with systemic diseases. The objective of this review is to present the essential characteristics of RAS, including its definition, pathogenesis, clinical and microscopic characteristics, proposed experimental models and recommended pharmacological management. This understanding can serve as a theoretical framework for research proposals.
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Affiliation(s)
- César Rivera
- Oral Medicine and Pathology Research Group, Department of Basic Biomedical Sciences, Faculty of Health Sciences, University of Talca, Talca, Maule 3460000, Chile
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87
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Shao Y, Zhou H. Clinical evaluation of an oral mucoadhesive film containing chitosan for the treatment of recurrent aphthous stomatitis: a randomized, double-blind study. J DERMATOL TREAT 2019; 31:739-743. [PMID: 31179773 DOI: 10.1080/09546634.2019.1610548] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Yanxiong Shao
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Haiwen Zhou
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
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88
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Ito K, Okuno T, Sawada A, Sakai K, Kato Y, Muro K, Yanagita M, Teramoto Y, Yamasaki T, Inoue T, Ogawa O, Kobayashi T. Recurrent Aphthous Stomatitis Caused by Cytomegalovirus, Herpes Simplex Virus, and Candida Species in a Kidney Transplant Recipient: A Case Report. Transplant Proc 2019; 51:993-997. [PMID: 30979493 DOI: 10.1016/j.transproceed.2019.01.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/20/2018] [Accepted: 01/17/2019] [Indexed: 12/13/2022]
Abstract
Recipients of organ transplants are immunosuppressed and at high risk of oral infection. Oral diseases are often neglected compared with infections of other organs that typically confer higher morbidity. However, severe local symptoms hinder oral intake, decrease quality of life, and are sometimes lethal. Here we describe a case of a 57-year-old woman who developed recurrent aphthous stomatitis after kidney transplantation; the cause of the infection was complex and included cytomegalovirus, herpes simplex virus, and Candida species. Since misdiagnosis of oral diseases impairs patient quality of life and increases morbidity, clinicians should be aware of possible etiologies of oral infections in renal transplant recipients.
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Affiliation(s)
- K Ito
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - T Okuno
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - A Sawada
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - K Sakai
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - Y Kato
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - K Muro
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - M Yanagita
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - Y Teramoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - T Yamasaki
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - T Inoue
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - O Ogawa
- Department of Urology, Kyoto University Hospital, Kyoto, Japan.
| | - T Kobayashi
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
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89
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Dudding T, Haworth S, Lind PA, Sathirapongsasuti JF, Tung JY, Mitchell R, Colodro-Conde L, Medland SE, Gordon S, Elsworth B, Paternoster L, Franks PW, Thomas SJ, Martin NG, Timpson NJ. Genome wide analysis for mouth ulcers identifies associations at immune regulatory loci. Nat Commun 2019; 10:1052. [PMID: 30837455 PMCID: PMC6400940 DOI: 10.1038/s41467-019-08923-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/05/2019] [Indexed: 12/23/2022] Open
Abstract
Mouth ulcers are the most common ulcerative condition and encompass several clinical diagnoses, including recurrent aphthous stomatitis (RAS). Despite previous evidence for heritability, it is not clear which specific genetic loci are implicated in RAS. In this genome-wide association study (n = 461,106) heritability is estimated at 8.2% (95% CI: 6.4%, 9.9%). This study finds 97 variants which alter the odds of developing non-specific mouth ulcers and replicate these in an independent cohort (n = 355,744) (lead variant after meta-analysis: rs76830965, near IL12A, OR 0.72 (95% CI: 0.71, 0.73); P = 4.4e−483). Additional effect estimates from three independent cohorts with more specific phenotyping and specific study characteristics support many of these findings. In silico functional analyses provide evidence for a role of T cell regulation in the aetiology of mouth ulcers. These results provide novel insight into the pathogenesis of a common, important condition. Oral ulcerations are sores of the mucous membrane of the mouth and highly prevalent in the population. Here, in a genome-wide association study, the authors identify 97 loci associated with mouth ulcers highlighting genes involved in T cell-mediated immunity and TH1 responses.
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Affiliation(s)
- Tom Dudding
- Medical Research Council Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.,Bristol Dental School, University of Bristol, Bristol, BS1 2LY, UK
| | - Simon Haworth
- Medical Research Council Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.,Bristol Dental School, University of Bristol, Bristol, BS1 2LY, UK
| | - Penelope A Lind
- Department of Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Queensland, Australia
| | | | | | - Joyce Y Tung
- Research, 23andMe, Inc, Mountain View, 94041, CA, USA
| | - Ruth Mitchell
- Medical Research Council Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Lucía Colodro-Conde
- Department of Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Queensland, Australia
| | - Sarah E Medland
- Department of Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Queensland, Australia
| | - Scott Gordon
- Department of Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Queensland, Australia
| | - Benjamin Elsworth
- Medical Research Council Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Lavinia Paternoster
- Medical Research Council Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Paul W Franks
- Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, 221 00, Sweden.,Department of Public Health & Clinical Medicine, Umeå University, Umeå, 901 87, Sweden.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, 02115, MA, USA
| | - Steven J Thomas
- Bristol Dental School, University of Bristol, Bristol, BS1 2LY, UK
| | - Nicholas G Martin
- Department of Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Queensland, Australia
| | - Nicholas J Timpson
- Medical Research Council Integrative Epidemiology Unit, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
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Sardaro N, Della Vella F, Incalza MA, DI Stasio D, Lucchese A, Contaldo M, Laudadio C, Petruzzi M. Oxidative Stress and Oral Mucosal Diseases: An Overview. In Vivo 2019; 33:289-296. [PMID: 30804105 PMCID: PMC6506298 DOI: 10.21873/invivo.11474] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 12/07/2018] [Accepted: 12/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Reactive oxygen species (ROS) and free radicals are physiologically produced during cellular metabolism. When their balance is disrupted in favor of ROS, a condition called oxidative stress occurs. Oxidative stress represents a widespread phenomenon involved in several pathological conditions. The aim of the present review was to report current knowledge on oxidative stress related to oral mucosal diseases. MATERIALS AND METHODS Articles from 2000 to 2018 were selected for relevance, validity and quality, from results obtained in PubMed, MEDLINE and Google Scholar using the following search terms: oxidative stress and oral lichen, oral pemphigus, aphthous stomatitis, oral leukoplakia, oral cancer, oral squamous cell carcinoma and oral carcinoma. All articles were independently screened for eligibility by the authors. RESULTS This narrative review integrates extensive information from all relevant published studies focusing on oxidative stress in oral mucosal diseases. We outline the pathogenetic function of oxidative stress in the most frequent inflammatory, potentially malignant and malignant diseases of the oral mucosa and provide detailed findings from human research. CONCLUSION Although variability in findings between individual studies exists, it justifies the conclusion that oxidative stress is a significant process in the oral mucosal diseases pathogenesis.
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Affiliation(s)
- Nicola Sardaro
- Section of Biochemistry, Department of Basic Medical Science, Neuroscience and Organs of Sense, School of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Fedora Della Vella
- Section of Dentistry, Interdisciplinary Department of Medicine, School of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Maria Angela Incalza
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, School of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Dario DI Stasio
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Claudia Laudadio
- Section of Dentistry, Interdisciplinary Department of Medicine, School of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Massimo Petruzzi
- Section of Dentistry, Interdisciplinary Department of Medicine, School of Medicine, Aldo Moro University of Bari, Bari, Italy
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91
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Batu ED. Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome: main features and an algorithm for clinical practice. Rheumatol Int 2019; 39:957-970. [PMID: 30798384 DOI: 10.1007/s00296-019-04257-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/14/2019] [Indexed: 01/20/2023]
Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a recurrent fever syndrome of early childhood with increasing number of adult-onset cases. Although it is a self-limited disease, it may negatively affect the quality of life. The aim of this review is to present a detailed analysis of PFAPA syndrome and an algorithm for diagnosis, therapeutic options, and evaluation of outcome. A comprehensive literature search was conducted through the Cochrane Library, Scopus, and MEDLINE/PubMed databases. The main topics covered are the epidemiology, clinical manifestations, diagnosis, differential diagnosis, etiopathogenesis, genetics, management, disease course and prognosis, disease in adults, unsolved issues, and unmet needs in PFAPA. The diagnosis of PFAPA is mainly based on clinical classification criteria. The most relevant hypothesis for pathogenesis is that dysregulated immune system in a genetically predisposed individual responds to a yet unidentified trigger in an exaggerated way. The pedigree analyses suggest a genetic background for the disease with an autosomal dominant pattern of inheritance. For management, single-dose corticosteroids during attacks and tonsillectomy remain the most effective therapies, while colchicine is a promising option to decrease attack frequency. There remain unsolved issues in PFAPA such as the exact etiopathogenesis and genetic background, the reason why the inflammation is restricted to the oropharyngeal lymphoid tissue, reasons for clock-work regularity of attacks, and self-limited disease course. There is need for a valid diagnostic criteria set with a high performance for both children and adults and consensus on management of PFAPA.
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Affiliation(s)
- Ezgi Deniz Batu
- Division of Rheumatology, Department of Pediatrics, Ankara Training and Research Hospital, University of Health Sciences, 06100, Ankara, Turkey.
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92
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Zhang Z, Zhang Q, Xue Y, Chen G, Wu Z, Fang H. Serum levels of total antioxidant status, nitric oxide and nitric oxide synthase in minor recurrent aphthous stomatitis patients. Medicine (Baltimore) 2019; 98:e14039. [PMID: 30653111 PMCID: PMC6370179 DOI: 10.1097/md.0000000000014039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/28/2018] [Accepted: 12/13/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is one of the most common inflammatory ulcerative conditions of oral cavity with uncertain etiology. Several studies have reported that oxidative stress may be associated with RAS. The aim of this study was to compare the serum levels of total antioxidant status (TAS), nitric oxide (NO) and nitric oxide synthase (NOS) in minor RAS (MiRAS) patients with healthy individuals and determine the possible association of MiRAS with the 3 physiological parameters mentioned above. METHODS Ninety patients with idiopathic MiRAS and 90 race-, age- and sex-matched healthy individuals were included in this study. All these subjects were allocated to 3 groups: MiRAS patients in the active stage (Group A); the same MiRAS patients in Group A in the inactive stage (Group B); healthy individuals without MiRAS (Group C). Serum levels of TAS, NO and NOS were determined by the spectrophotometric method. Independent sample t test and paired t test were performed for statistical evaluation. RESULTS Serum TAS level of Group A was significantly decreased than that of Group C, whereas the serum level of NO was significantly higher in Group A as compared to Group C (P < .05). The serum levels of TAS and NO in Group B were no significant differences when compared with those in Group A or Group C. No significant differences in NOS activities were also found between the 3 groups (P > .05). CONCLUSIONS MiRAS is associated with decreased TAS and increased NO levels, but NOS may not play an important role in the aetiopathogenesis.
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Affiliation(s)
- Zichuan Zhang
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Air Force Medical University, Xi’an, PR China
| | - Qian Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Air Force Medical University, Xi’an, PR China
| | - Yi Xue
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
| | - Guang Chen
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
| | - Zhongyin Wu
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
| | - Huiqing Fang
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
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93
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Bakshi S, Bakshi S. Recurrent aphthous stomatitis. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2019. [DOI: 10.4103/amhs.amhs_105_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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94
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Bahramian A, Falsafi P, Abbasi T, Ghanizadeh M, Abedini M, Kavoosi F, Kouhsoltani M, Noorbakhsh F, Dabbaghi Tabriz F, Rajaeih S, Rezaei F. Comparing Serum and Salivary Levels of Vitamin D in Patients with Recurrent Aphthous Stomatitis and Healthy Individuals. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2018; 19:295-300. [PMID: 30680302 PMCID: PMC6338692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
STATEMENT OF THE PROBLEM Recurrent aphthous stomatitis (RAS) is the most prevalent ulcerative condition of the oral mucosa. Many studies have emphasized on immunologic factors as the reason of inducing RAS; however, the exact etiologic cause of RAS has not been identified yet. Vitamin D has an endocrine function and regulatory effects on the immune system. It has potential therapeutic effects on autoimmune diseases, psoriasis, and neoplasms. Vitamin D deficiency has been detected in some autoimmune diseases such as rheumatoid arteritis. PURPOSE The aim of the present study was to compare the serum and salivary levels of vitamin D in patients with RAS and healthy individuals. MATERIALS AND METHOD In this cross sectional study, patients with RAS, referring to the Department of Oral Medicine, Tabriz Faculty of Dentistry, were evaluated after taking medical history, clinical examinations, and completing an informed consent form. The serum and salivary vitamin D levels were compared between case (n=26) and control (n=26) groups. RESULTS The mean serum vitamin D levels in the case and control groups were 33.0.7±12.41 and 50.89±9.30 (ng/dL), respectively, with a statistically significant difference (p<0.001). On the other hand, the mean salivary vitamin D levels in the case and control groups were 17.36± 8.01 and 20.79±6.31 (ng/dL), respectively, with no statistically significant difference (p= 0.09). In addition, the correlation between the serum and salivary levels of vitamin D was 56%, being statistically significant (p< 0.001). CONCLUSION The serum levels of vitamin D in patients with RAS were significantly less than that in healthy individuals; however, there were no significant differences in salivary vitamin D levels between patients with RAS and healthy individuals. In addition, there was a significant and positive correlation between serum and salivary levels of vitamin D in all patients.
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Affiliation(s)
- Ayla Bahramian
- Dept. of Oral Medicine, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Falsafi
- Dept. of Oral Medicine, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Milad Ghanizadeh
- Postgraduate Student, Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Maryam Kouhsoltani
- Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Noorbakhsh
- Dept. of Periodontology, School of Dentistry, Tabriz Azad University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Dabbaghi Tabriz
- Dept. of Operative Dentistry, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahin Rajaeih
- Otorhinolaryngologist, Fellow ship of rhinology, Firoozgar hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Rezaei
- Dept. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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95
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Abstract
Soft tissue disorders of the mouth encompass a wide expanse of pathophysiology. This article focuses on the identification, etiology, management, and complications of common infectious processes (candidiasis, dental caries, and herpes labialis), inflammatory lesions (sialolithiasis, oral lichen planus, and aphthous ulcer), and benign entities (bony tori and mucocele).
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96
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İris M, Özçıkmak E, Aksoy A, Alibaz-Öner F, İnanç N, Ergun T, Direskeneli H, Mumcu G. The assessment of contributing factors to oral ulcer presence in Behçet's disease: Dietary and non-dietary factors. Eur J Rheumatol 2018; 5:240-243. [PMID: 30501850 PMCID: PMC6267742 DOI: 10.5152/eurjrheum.2018.18094] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 08/08/2018] [Indexed: 12/14/2022] Open
Abstract
Objective The aim of this study was to assess the contributing factors for oral ulcer activity in Behçet’s disease (BD). Methods Ninety-two patients with BD (F/M: 42/50, mean age: 38.7±10.02 years) participated in this cross-sectional study. Data regarding disease-related factors, smoking patterns, and self-reported dietary/non-dietary triggering factors for oral ulcer activity were collected by a questionnaire. Treatment protocol was categorized as mild and intensive groups associated with organ involvements. Results A mild treatment protocol was more common in females (52.4% vs 20%) than in males (p=0.002). During the last three months, the number of oral ulcers in female patients was higher in the mild treatment group (6.4±6.5) than in the intensive treatment group (3.3±4.9) (p=0.045). In patients with active oral ulcers (n=63), rate of being a non-smoker was also higher in females (86.7% vs 63.6%) than in males. Daily frequency of tooth brushing was 1.2±0.8 in patients with BD, and was higher in females (1.5±0.9 vs 0.9±0.6) (p=0.001). Stress and fatigue (78.3%) were reported as the most frequent triggering factors for oral ulcer presence in patients with BD. A total of 148 different dietary factors associated with oral ulcer presence were reported in the study. Conclusion A mild treatment protocol and being a non-smoker were found to be the contributing factors associated with oral ulcer activity in patients with BD. Being motivated for oral hygiene and being non-smokers were positive health behaviors observed in females. Irrespective of gender, stress and fatigue were defined as the most common self-reported triggering factors for oral ulcer presence in BD. In addition, the roles of some dietary factors were also reported.
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Affiliation(s)
- Merve İris
- Marmara University School of Medicine, İstanbul, Turkey
| | - Ezgi Özçıkmak
- Marmara University School of Medicine, İstanbul, Turkey
| | - Aysun Aksoy
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Fatma Alibaz-Öner
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Nevsun İnanç
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Tülin Ergun
- Department of Dermatology, Marmara University School of Medicine, İstanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Gonca Mumcu
- Deparment of Health Management, Faculty of Health Sciences, Marmara University, İstanbul, Turkey
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97
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Sharma R, Pallagatti S, Aggarwal A, Sheikh S, Singh R, Gupta D. A Randomized, Double-Blind, Placebo-Controlled Trial on Clinical Efficacy of Topical Agents in Reducing Pain and Frequency of Recurrent Aphthous Ulcers. Open Dent J 2018; 12:700-713. [PMID: 30369980 PMCID: PMC6183024 DOI: 10.2174/1745017901814010700] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/13/2018] [Accepted: 09/04/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction Recurrent Aphthous Ulcers (RAU) is one of the most common oral ulcerative Disease of the oral mucosa with high recurrence rate. Standard topical treatment options provide symptomatic relief with few have been found to be effective in treating or relieving the symptoms. Aim The study aimed to evaluate the clinical efficacy of various topical agents in order to find the better treatment modality so as to decrease the number, size, exudate level and discomfort associated with pain with RAU. Materials and methods The patients diagnosed with minor recurrent aphthous ulcers fulfilling the inclusion and exclusion criteria were enrolled. All the baseline parameters were measured by the principal investigator. The treatment modality was assigned by generating a randomization list by computer software, double-blinded in consecutively numbered sealed envelopes. The topical treatment modalities that were included: 5% Amlexanox, 0.1% Triamcinolone Acetonide, 20% Benzocaine gel, 100 mg Doxycycline hyclatemixed with denture adhesive and normal saline (20:2:1); The study was placebo controlled in which placebo gel 10 gm was used. The size, no of ulcers, pain, erythema and exudate level were measured by the principal investigator at days 1, 4, 8 and 10. All quantitative variables were estimated using measures of central tendency (mean, median) and measures of dispersion (standard deviation). Qualitative or categorical variables were described as frequencies or proportions. Proportions were compared using Post Hoc Test and N Par Tests. Effectiveness was checked using p-value (< 0.005). Results It was observed that 0.1% Triamcinolone Acetonide and 5% Amlexanox proven to be more efficacious in the reduction of size, Number, Pain, Erythema and Exudate Levels at day 8, (p = .000*) and at day 10 (p =. 000*) as compared to single application of 100 mg Doxycycline Hyclate, 20% Benzocaine gel and the placebo, which was statistically significant. VAS scale was significant for 100 mg Doxycycline Hyclate and 20% Benzocaine gel. Conclusion The selected topical treatment modality can deliver cheap, effective and safe drug therapy which benefits the patient in refining their regular activities and everyday events of life.
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Affiliation(s)
- Renu Sharma
- Department of Oral Medicine and Radiology, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh, Punjab- 147301, India
| | - Shambulingappa Pallagatti
- Department of Oral Medicine and Radiology, Maharishi Markandeshwar College of Dental Science and Research, Mullana, Ambala, India
| | - Amit Aggarwal
- Department of Oral Medicine and Radiology, Maharishi Markandeshwar College of Dental Science and Research, Mullana, Ambala, India
| | - Soheyl Sheikh
- Department of Oral Medicine and Radiology, Maharishi Markandeshwar College of Dental Science and Research, Mullana, Ambala, India
| | - Ravinder Singh
- Department of Oral Medicine and Radiology, Maharishi Markandeshwar College of Dental Science and Research, Mullana, Ambala, India
| | - Deepak Gupta
- Department of Oral Medicine and Radiology, Maharishi Markandeshwar College of Dental Science and Research, Mullana, Ambala, India
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98
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The Antimicrobial Peptide Nal-P-113 Exerts a Reparative Effect by Promoting Cell Proliferation, Migration, and Cell Cycle Progression. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7349351. [PMID: 30298136 PMCID: PMC6157167 DOI: 10.1155/2018/7349351] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 12/11/2022]
Abstract
Objective The primary purpose of this study was to evaluate the reparative efficacy of a novel antimicrobial peptide, Nal-P-113, in shortening the healing time of oral mucosal ulcers by promoting cell proliferation and migration and accelerating the cell cycle. Methods Cell counting kit-8 (CCK-8) and wound-healing assays were used to evaluate the proliferation and migration of human immortalized oral epithelial cells (HIOECs). The cell cycle distribution of HIOECs was analyzed by flow cytometry. Additionally, the RNA levels of EGF, FGF-2, and TGF-β1 of HIOECs were assessed by real-time PCR. Rats were divided into three groups randomly: (a) blank control group; (b) 20 μg/mL Nal-P-113; and (c) 10 ng/mL rhEGF. An oral mucosal ulcer was induced in every rat by the application of 30% acetic acid. An immunohistochemical assay was used to assess the expression of EGF, FGF-2, and TGF-β1 in the rat oral mucosa. Results In the CCK-8 assay, the optical density values in the Nal-P-113 and rhEGF groups were found to be significantly higher than that in the blank control group. In addition, the scratch areas in the Nal-P-113 and rhEGF groups were found to be significantly smaller (P<0.05). Cell cycle analysis showed that Nal-P-113 accelerated the entry of HIOECs into the S phase and expedited their cell cycles. The RT-PCR results suggested that Nal-P-113 upregulated the RNA levels of EGF and FGF-2 but downregulated that of TGF-β1 at 24 h and 48 h. Lastly, the immunohistochemical assay verified that Nal-P-113 changed the expression of the above cytokines in rat mucosal ulcers. Conclusion Nal-P-113 promoted the repair of oral mucosal ulcers by increasing the EGF and FGF-2 expression and decreasing that of TGF-β1 in HIOECs, accelerating their proliferation and cell cycle progression. The application of Nal-P-113 might serve as an effective therapeutic approach for recurrent aphthous stomatitis.
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99
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Qin L, Kao YW, Lin YL, Peng BY, Deng WP, Chen TM, Lin KC, Yuan KSP, Wu AT, Shia BC, Wu SY. Combination of recurrent oral aphthae and dry eye syndrome may constitute an independent risk factor for oral cavity cancer in elderly women. Cancer Manag Res 2018; 10:3273-3281. [PMID: 30233243 PMCID: PMC6130548 DOI: 10.2147/cmar.s168477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Few studies have evaluated the risk of oral cavity cancer (OC) in patients with recurrent oral aphthae (ROA) and dry eye syndrome (DES). This study assessed the risk of OC in patients who had received diagnoses of ROA and DES in Taiwan. Methods A population-based frequency-matched case–control study was conducted in which data were analyzed from the National Health Insurance Research Database of Taiwan. Patients with ROA and DES were identified as the case cohort. Patients and controls without ROA and DES were frequency matched (1:4) on the basis of age, sex, monthly income, geographical location, and urbanization level. Chi-squared tests were conducted to compare demographic factor distributions between the patients and controls. Cox proportional hazards models were used to calculate the adjusted hazard ratios (aHRs) and 95% CI of OC diagnoses among the patients and controls. Risk consistency between the two cohorts was determined using subgroup analysis. Results A total of 7,110 patients with ROA and DES and 28,388 controls were identified. The OC risk was significantly higher for female patients than controls (aHR=3.41, 95% CI=1.69–6.86). Furthermore, women aged 50–69 years exhibited a higher risk of OC than those in the other age groups. Female patients aged 50–59 years exhibited the highest aHR for OC (aHR=5.56, 95% CI=1.70–18.25), followed by those aged 60–69 years (aHR=4.34, 95% CI=1.26–15.99). Conclusion ROA and DES may be associated with a high risk of OC in elderly women.
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Affiliation(s)
- Lei Qin
- School of Statistics, University of International Business and Economics, Beijing, China
| | - Yi-Wei Kao
- Graduate Institute of Business Administration, Fu Jen Catholic University, Taipei, Taiwan
| | - Yueh-Lung Lin
- School of Mathematical Sciences, University of Nottingham, Ningbo, China
| | - Bou-Yue Peng
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Win-Ping Deng
- Graduate Institute of Biomedical Materials and Engineering, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Ming Chen
- Department of Otorhinolaryngology, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Chou Lin
- Department of Oral and Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kevin Sheng-Po Yuan
- Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Alexander Th Wu
- PhD Program for Translational Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ben-Chang Shia
- College of Management, Taipei Medical University, Taipei, Taiwan,
| | - Szu-Yuan Wu
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China, .,Department of Radiation Oncology, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan, .,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, .,Epidemiology and Bioinformatics Center, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan,
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100
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Hegde S, Ajila V, Babu S, Kumari S, Ullal H, Madiyal A. Evaluation of salivary tumour necrosis factor-alpha in patients with recurrent aphthous stomatitis. Eur Oral Res 2018; 52:157-161. [PMID: 30775720 DOI: 10.26650/eor.2018.543] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/09/2018] [Accepted: 05/10/2018] [Indexed: 11/20/2022] Open
Abstract
Purpose Present study was undertaken to evaluate and compare the salivary levels of tumour necrosis factor alpha (TNF-α) in subjects with RAS, traumatic ulcers (TUs) in the oral mucosa and in healthy controls. Materials and Methods Present study involved 90 participants of which 30 subjects were diagnosed with RAS, 30 subjects with TUs and 30 healthy controls grouped as group 1, group 2 and group 3 respectively. Unstimulated saliva was collected from the subjects through 'Spit Technique' and the estimation of TNF-α was done by enzyme linked immunosorbent assay. The data collected was statistically analysed. Results Salivary level of TNF-α was significantly higher in RAS patients than in patients with TUs and healthy controls. Difference between the Salivary TNF-α level in our study groups were statistically significant (p<0.001). Conclusion Present study suggests that saliva is a convenient and ideal medium for the detection of TNF-α. Statistically significant difference in the level of salivary TNF-α between the RAS and TUs subjects as well as controls suggests the significant contribution of TNF-α in pathogenesis of RAS.
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Affiliation(s)
- Shruthi Hegde
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Vidya Ajila
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Subhas Babu
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Suchetha Kumari
- Department of Biochemistry, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
| | - Harshini Ullal
- Central research laboratory, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
| | - Ananya Madiyal
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
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