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Mimura MAM, Hirota SK, Sugaya NN, Sanches JA, Migliari DA. Systemic treatment in severe cases of recurrent aphthous stomatitis: an open trial. Clinics (Sao Paulo) 2009; 64:193-8. [PMID: 19330244 PMCID: PMC2666466 DOI: 10.1590/s1807-59322009000300008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2008] [Accepted: 11/21/2008] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study aimed to evaluate the efficacy of the systemic drugs thalidomide, dapsone, colchicine, and pentoxifylline in the treatment of severe manifestations of RAS. METHODS An open, 4-year clinical trial was carried out for 21 consecutive patients with severe RAS. Initially, patients were given a 2-week course of prednisone to bring them to a baseline status. Simultaneously, one of the four test drugs was assigned to each patient to be taken for a period of 6 months. During the course of the trial, patients were switched to one of the other three drugs whenever side effects or a lack of satisfactory results occurred, and the 6-month limit of the treatment was then reset. RESULTS The most efficient and best-tolerated drug was thalidomide, which was administered to a total of eight patients and resulted in complete remission in seven (87.5%). Dapsone was prescribed for a total of nine patients, of whom eight (89%) showed improvement in their symptoms, while five showed complete remission. Colchicine was administered to a total of ten patients, with benefits observed in nine (90%), of whom four showed complete remission. Pentoxyfilline was administered to a total of five patients, with benefits observed in three (60%), of whom one patient showed complete remission. CONCLUSION The therapeutic methods used in this trial provided significant symptom relief. Patients experienced relapses of the lesions; however, this occurred after withdrawal of their medication during the follow-up period.
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Affiliation(s)
| | - Silvio Kenji Hirota
- Department of Stomatology, School of Dentistry, University of São Paulo - São Paulo/SP, Brazil
| | - Norberto Nobuo Sugaya
- Department of Stomatology, School of Dentistry, University of São Paulo - São Paulo/SP, Brazil
| | - José Antonio Sanches
- Division of Dermatology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil. Tel.: 55 11 3091.7883,
| | - Dante Antonio Migliari
- Department of Stomatology, School of Dentistry, University of São Paulo - São Paulo/SP, Brazil
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Effect of Lentinus edodes polysaccharide on oxidative stress, immunity activity and oral ulceration of rats stimulated by phenol. Carbohydr Polym 2009. [DOI: 10.1016/j.carbpol.2008.07.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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204
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Çağlayan F, Miloglu, Altun O, Erel, Yılmaz AB. Oxidative stress and myeloperoxidase levels in saliva of patients with recurrent aphthous stomatitis. Oral Dis 2008; 14:700-4. [DOI: 10.1111/j.1601-0825.2008.01466.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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205
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Abstract
There are many types of diseases associated with the oral cavity. As an adjunct to professional oral dental care, various drug delivery systems have been developed to improve the treatment or prevention of these diseases. In this manuscript, the current status of drug delivery strategies for these common orofacial diseases is reviewed. Biomineral-binding drug delivery and on-demand drug release are suggested to be considered in the future design of drug delivery systems for orofacial diseases. Apparently, this research field deserves much more attention from both pharmaceutical scientists and dental health professionals.
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Affiliation(s)
- Xin-Ming Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6025, USA
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206
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Campisi G, Compilato D, Iacono G, Maresi E, Di Liberto C, Di Marco V, Di Fede G, Craxì A, Carroccio A. Histomorphology of healthy oral mucosa in untreated celiac patients: unexpected association with spongiosis. J Oral Pathol Med 2008; 38:34-41. [PMID: 18673416 DOI: 10.1111/j.1600-0714.2008.00677.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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207
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Corticoides tópicos en la estomatitis aftosa recurrente. Revisión sistemática. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s0001-6519(08)73314-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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208
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Karaca S, Seyhan M, Senol M, Harputluoglu MM, Ozcan A. The effect of gastric Helicobacter pylori eradication on recurrent aphthous stomatitis. Int J Dermatol 2008; 47:615-7. [PMID: 18477159 DOI: 10.1111/j.1365-4632.2008.03667.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) has been suggested to be associated with recurrent aphthous stomatitis (RAS) as well as many other diseases. METHODS We conducted a prospective study on a total of 23 patients with RAS to investigate the relationship between H. pylori and RAS as well as the effect of eradication therapy on the recurrence. All patients underwent endoscopic examination and gastric biopsy. The biopsy materials were examined histopathologically whether they contained H. pylori or not. The density of H. pylori was also noted. The patients with H. pylori infection were followed up for up to 1 year after starting the eradication therapy. RESULTS Gastric mucosal H. pylori colonization was + in 39%, ++ in 39%, +++ in 9%, and - in 13% of the patients, respectively. There were statistically significant decreases in the recurrence rate and amelioration time of RAS by eradication therapy. There were no significant correlations among the intensity of H. pylori with the recurrence rate, number, diameter, and amelioration time of the lesions in 1-year follow-up. CONCLUSIONS We concluded that eradication of H. pylori may have reducing effects on the recurrence and amelioration period of the RAS.
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Affiliation(s)
- Semsettin Karaca
- Department of Dermatology, School of Medicine, Inonu University, Malatya, Turkey
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Zand N, Ataie-Fashtami L, Djavid GE, Fateh M, Alinaghizadeh MR, Fatemi SM, Arbabi-Kalati F. Relieving pain in minor aphthous stomatitis by a single session of non-thermal carbon dioxide laser irradiation. Lasers Med Sci 2008; 24:515-20. [DOI: 10.1007/s10103-008-0555-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2007] [Accepted: 02/21/2008] [Indexed: 11/30/2022]
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Scully C, Porter S. Oral mucosal disease: Recurrent aphthous stomatitis. Br J Oral Maxillofac Surg 2008; 46:198-206. [PMID: 17850936 DOI: 10.1016/j.bjoms.2007.07.201] [Citation(s) in RCA: 221] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2007] [Indexed: 11/28/2022]
Abstract
Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is common worldwide. Characterised by multiple, recurrent, small, round, or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors, it usually presents first in childhood or adolescence. Its aetiology and pathogenesis is not entirely clear, but there is genetic predisposition, with strong associations with interleukin genotypes, and sometimes a family history. Diagnosis is on clinical grounds alone, and must be differentiated from other causes of recurrent ulceration, particularly Behçet disease - a systemic disorder in which aphthous-like ulcers are associated with genital ulceration, and eye disease (particularly posterior uveitis). Management remains unsatisfactory, as topical corticosteroids and most other treatments only reduce the severity of the ulceration, but do not stop recurrence.
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Affiliation(s)
- Crispian Scully
- University College London, Eastman Dental Institute, London, UK.
| | - Stephen Porter
- University College London, Eastman Dental Institute, London, UK
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211
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Lewkowicz N, Lewkowicz P, Dzitko K, Kur B, Tarkowski M, Kurnatowska A, Tchórzewski H. Dysfunction of CD4+CD25high T regulatory cells in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2008; 37:454-61. [PMID: 18318707 DOI: 10.1111/j.1600-0714.2008.00661.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease of unknown etiology characterized by recurring formation of painful oral ulcers. RAS may result from oral epithelium damage caused by T-cell-mediated immune response. CD4(+)CD25(+) T regulatory (Treg) cells suppress proliferation and effector functions of other immune cells, and therefore are crucial in regulating the immune response. METHODS We tested the function of peripheral CD4(+)CD25(high) Treg cells in active RAS through their ability to inhibit proliferation and cytokine production of conventional CD4(+) T cells. We also attempted to detect the presence of FOXP3 and indoleamine 2,3-dioxygenase (IDO) mRNA in the lesional and non-lesional oral mucosa of RAS patients and healthy individuals using real-time PCR assay. RESULTS Treg cells derived from RAS patients were less efficient in the suppression of cytokine production of CD4(+) T effector cells than Treg cells from healthy individuals. Moreover, in RAS, Treg cells were nearly twice less potent in the inhibition of CD4(+)CD25(-) T cell proliferation than in healthy donors. Furthermore, we have demonstrated the decreased proportion of CD4(+)CD25(+)FOXP3(+) Treg cells in peripheral blood of RAS patients compared with controls. We failed to detect FOXP3 mRNA, while IDO mRNA expression was decreased in non-lesional mucosa biopsies from RAS patients compared with ulcer biopsies or normal mucosa from healthy donors. CONCLUSIONS These findings suggest that CD4(+)CD25(high) Treg cells are both functionally and quantitatively compromised in RAS and that decreased constitutive expression of IDO in oral mucosa in RAS may lead to the loss of local immune tolerance.
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Affiliation(s)
- Natalia Lewkowicz
- Department of Periodontology and Oral Medicine, Medical University of Lodz, Lodz, Poland.
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Abstract
INTRODUCTION Contrary to early beliefs, celiac disease (CD) is relatively common; however, it still remains underdiagnosed since most cases are atypical, with few or no gastrointestinal symptoms and predominance of extraintestinal manifestations. As a consequence, the diagnosis of the disorder often requires a multidisciplinary approach. Also some oral ailments have been described in celiac patients. In this study, we review the papers that have reported oral manifestations in subjects with CD. METHODS A comprehensive literature search was conducted in Medline and Embase databases using appropriate key words. Additional papers were selected by cross-referencing from the retrieved articles. RESULTS Dental enamel defects are the oral lesions most closely related to CD. There are conflicting data on the association between CD and recurrent aphthous stomatitis. A correlation of CD with atrophic glossitis has been reported, although robust evidence in support of it is lacking. Patients with CD have caries indexes seemingly lower than healthy individuals, but they may experience delay in tooth eruption. Occurrence of other oral mucosal lesions in CD subjects is likely occasional. CONCLUSIONS Patients with systematic dental enamel defects should be screened for CD even in the absence of gastrointestinal symptoms. CD screening tests for patients with oral aphthae or idiopathic atrophic glossitis should be selectively considered during a medical evaluation that focuses on all aspects of the patient's status.
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213
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Quijano D, Rodríguez M. Topical Corticosteroids in Recurrent Aphthous Stomatitis. Systematic Review. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s2173-5735(08)70242-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gurel A, Altinyazar HC, Unalacak M, Armutcu F, Koca R. Purine catabolic enzymes and nitric oxide in patients with recurrent aphthous ulceration. Oral Dis 2007; 13:570-4. [DOI: 10.1111/j.1601-0825.2006.01338.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Porter S. Transient benefits for topical hyaluronic acid in recurrent aphthous ulceration. Evid Based Dent 2007; 8:52. [PMID: 17589493 DOI: 10.1038/sj.ebd.6400498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
DESIGN A randomised controlled trial. INTERVENTION A topical application of 0.2% hyaluronic acid (HA) gel or placebo was initially applied by a clinician to the ulcerated area. Patients were instructed how to apply gel for subsequent applications. OUTCOME MEASURE Patients recorded discomfort from the ulcerated area on a 100-mm visual analogue scale (VAS). The boundaries of the scale were marked "no soreness" and "worst possible soreness". Recordings were made at baseline (before gel application) and at 5, 10, 15, 20, 30, 45, 60, 120, 180 and 240 min after dosing. The first 60 min of the recording were supervised and the remaining observations were carried out in a log diary. Discomfort recordings were made 1 h after application (after breakfast and after the evening meal and at one other time if desired) for 7 days. Patients were also asked to record number of ulcers present in their mouth and the occurrence of any new ulcers during the treatment period. RESULTS Both topical HA and placebo resulted in a significant reduction in ulcer soreness following immediate application (P 0.0004). Throughout the rest of the investigation period, there were no significant differences (P>0.05) between the treatments at reducing soreness. Patients using topical HA recorded fewer ulcers on day 5 of the investigation than those in the placebo group (P<0.001). Likewise, the occurrence of new ulcers was lower in the HA-treated group on day 4 compared with placebo (P 0.047). CONCLUSIONS Topical application of 0.2% HA does appear to be of benefit in the management of recurrent aphthous ulceration (RAS). Immediate application reduces discomfort but this is purely a barrier or protective mechanism from stimuli arising in the oral environment.
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Affiliation(s)
- Stephen Porter
- Oral Medicine and Special Needs Dentistry Unit, Division of Maxillofacial Diagnostic, Medical and Surgical Sciences, Eastman Dental Institute-University College London, London, UK
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217
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Abstract
INTRODUCTION Recurrent aphthous ulcers are common lesions of the oral mucosa of which the etiology is unknown. This study aimed to estimate the bacterial diversity in the lesions and in control mucosa in pooled samples using a culture-independent molecular approach. METHODS Samples were collected from ten healthy individuals and ten individuals with a clinical history of recurrent aphthous ulcers. After DNA extraction, the 16S ribosomal RNA bacterial gene was amplified by polymerase chain reaction with universal primers; amplicons were cloned, sequenced and matched to the GenBank database. RESULTS A total of 535 clones were analyzed, defining 95 bacterial species. We identified 62 putative novel phylotypes. In recurrent aphthous ulcer lesions 57 phylotypes were detected, of which 11 were known species. Control samples had 38 phylotypes, five of which were already known. Only three species or phylotypes were abundant and common to both groups (Gemella haemolysans, Streptococcus mitis strain 209 and Streptococcus pneumoniae R6). One genus was found only in recurrent aphthous ulcer samples (Prevotella) corresponding to 16% of all lesion-derived clones. CONCLUSION The microbiota found in recurrent aphthous ulcers and in the control groups diverged markedly and the rich variety of genera found can provide a new starting point for individual qualitative and quantitative analyses of bacteria associated with this oral condition.
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Affiliation(s)
- L Marchini
- Laboratory of Molecular Genetics and Genomics, University of Vale do Paraíba, São José dos Campos, São Paulo, Brazil
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218
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Procaccini M, Campisi G, Bufo P, Compilato D, Massaccesi C, Catassi C, Muzio LL. Lack of association between celiac disease and dental enamel hypoplasia in a case-control study from an Italian central region. Head Face Med 2007; 3:25. [PMID: 17537244 PMCID: PMC1891285 DOI: 10.1186/1746-160x-3-25] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Accepted: 05/30/2007] [Indexed: 01/18/2023] Open
Abstract
Background A close correlation between celiac disease (CD) and oral lesions has been reported. The aim of this case-control study was to assess prevalence of enamel hypoplasia, recurrent aphthous stomatitis (RAS), dermatitis herpetiformis and atrophic glossitis in an Italian cohort of patients with CD. Methods Fifty patients with CD and fifty healthy subjects (age range: 3–25 years), matched for age, gender and geographical area, were evaluated by a single trained examiner. Diagnosis of oral diseases was based on typical medical history and clinical features. Histopathological analysis was performed when needed. Adequate univariate statistical analysis was performed. Results Enamel hypoplasia was observed in 26% cases vs 16% in controls (p > 0.2; OR = 1.8446; 95% CI = 0.6886: 4.9414). Frequency of RAS in the CD group was significantly higher (36% vs 12%; p = 0.0091; OR = 4.125; 95% CI = 1.4725: 11.552) in CD group than that in controls (36% vs 12%). Four cases of atrophic glossitis and 1 of dermatitis herpetiformis were found in CD patients vs 1 and none, respectively, among controls. Conclusion The prevalence of enamel hypoplasia was not higher in the study population than in the control group. RAS was significantly more frequent in patients with CD.
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Affiliation(s)
- Maurizio Procaccini
- Istituto di Scienze Odontostomatologiche, Università Politecnica delle Marche, Italy
| | | | - Pantaleo Bufo
- Dip. Scienze Chirurgiche, Università di Foggia, Italy
| | | | - Claudia Massaccesi
- Istituto di Scienze Odontostomatologiche, Università Politecnica delle Marche, Italy
| | - Carlo Catassi
- Istituto di Clinica Pediatrica, Università Politecnica delle Marche, Italy
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Abstract
Recurrent aphthous ulceration (RAU) is the second most common type of ulceration seen in the oral cavity. Notwithstanding an extensive literature and numerous proposed aetiologies, the cause of the disease remains obscure. In addition to the current conservative management of RAU lesions with corticosteroids, new treatment options are available and some have proven successful in open trials. This paper reviews patient work-up and management.
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Affiliation(s)
- V Vucicevic Boras
- Oral Medicine and Pathology, School of Dentistry, The University of Queensland, Brisbane, Queensland
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220
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Guimarães ALS, Correia-Silva JDF, Sá ARD, Victória JMN, Diniz MG, Costa FDO, Gomez RS. Investigation of functional gene polymorphisms IL-1β, IL-6, IL-10 and TNF-α in individuals with recurrent aphthous stomatitis. Arch Oral Biol 2007; 52:268-72. [PMID: 17052682 DOI: 10.1016/j.archoralbio.2006.08.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Revised: 07/20/2006] [Accepted: 08/01/2006] [Indexed: 12/23/2022]
Abstract
UNLABELLED Recurrent aphthous stomatitis (RAS) is characterized by recurrent episodes of oral ulceration in an otherwise healthy individual. Some reports in the literature indicate that RAS may have immunological, psychological, genetic and microbiological bases. OBJECTIVE The purpose of the present study was to investigate, using binary logistic regression analyses, a possible association between the functional IL-1beta +3954 (C/T), IL-6 -174 (G/C), IL-10 -1082 (G/A) and TNF-alpha -308 (G/A) genetic polymorphism and RAS in a sample of Brazilian patients, using a multivariate statistical analysis. DESIGN Sixty-four consecutive subjects affected by minor and major forms of RAS and 64 healthy volunteers were genotyped. To investigate the association between the single nucleotide polymorphisms and risk of RAS, binary logistic regression models were fitted. The associations were expressed by odd ratios (ORs) and adjusted for age and gender, with the corresponding 95% CIs. P-values less than 0.05 were considered significant. RESULTS A significant increase in the IL-1beta and TNF-alpha heterozygous genotypes were associated with an increased risk of RAS development (OR 2.40 and 3.07, respectively), in the multivariate model. CONCLUSION Our findings demonstrate that polymorphisms of high IL-1beta and TNF-alpha production were associated with an increased risk of RAS development. Our findings also give additional support to a genetic basis for RAS pathogenesis.
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Affiliation(s)
- André Luiz Sena Guimarães
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal, de Minas Gerais, Belo Horizonte, Brazil
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221
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Chuang P, Langone AJ. Clobetasol ameliorates aphthous ulceration in renal transplant patients on sirolimus. Am J Transplant 2007; 7:714-7. [PMID: 17250555 DOI: 10.1111/j.1600-6143.2006.01678.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Aphthous ulceration is a common side effect of sirolimus. These lesions of the oral mucous membranes are often painful and debilitating, leading to either dose reduction or discontinuation of sirolimus in a significant number of patients. We report that the direct application of clobetasol, a high potency topical steroid, led to prompt resolution of the aphthous ulcers that developed in our renal transplant patients on sirolimus-based immunosuppression.
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Affiliation(s)
- P Chuang
- Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, S-3223 Medical Center North, Nashville, TN 37232, USA.
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Ozkan Y, Yardim-Akaydin S, Sepici A, Engin B, Sepici V, Simşek B. Assessment of homocysteine, neopterin and nitric oxide levels in Behcet's disease. Clin Chem Lab Med 2007; 45:73-7. [PMID: 17243919 DOI: 10.1515/cclm.2007.018] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Behçet's disease is a multisystemic immunoinflammatory disease with a wide variety of clinical manifestations, whereas recurrent aphthous stomatitis is a local oral disease. The aim of this study was to examine the distribution of homocysteine levels in patients with active Behçet's disease, possible association of homocysteine with nitric oxide and neopterin levels, and to characterize the differences between patients with Behçet's disease and those with recurrent aphthous stomatitis in terms of these parameters compared with healthy controls. METHODS A total of 23 patients with active Behçet's disease, 25 patients with recurrent aphthous stomatitis as positive controls, and 21 healthy subjects were included in this study. Serum homocysteine and neopterin levels were measured flourimetrically by HPLC. Serum nitric oxide production was assayed by measuring total nitrite levels with Griess reagent. RESULTS Significantly higher homocysteine (12.9+/-3.3 micromol/L) and lower nitric oxide (41.5+/-10.9 micromol/L) and neopterin (6.4+/-1.0 nmol/L) levels were observed in patients with Behçet's disease compared with healthy controls (10.7+/-2.0 micromol/L, 49.7+/-16.2 micromol/L, 8.7+/-2.2 nmol/L, respectively) (p<0.03 for neopterin, p<0.04 for homocysteine and nitric oxide). However, homocysteine, nitric oxide, biopterin and neopterin levels and the neopterin/biopterin ratio for recurrent aphthous stomatitis patients were not significantly different compared to healthy controls. A significant positive correlation was observed between serum homocysteine and serum neopterin/biopterin ratio in patients with Behçet's disease (r=0.975, p<0.005). CONCLUSIONS In contrast to recurrent aphthous stomatitis, there is a higher prevalence of hyperhomocysteinemia in Behcet's disease. Homocysteine may have deleterious effects on the pathology of Behcet's disease by decreasing nitric oxide levels and interfering with the immune system.
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Affiliation(s)
- Yeşim Ozkan
- Department of Biochemistry, Faculty of Pharmacy, Gazi University, Ankara, Turkey.
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223
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Shrivastava R, John GW. Treatment of Aphthous Stomatitis with Topical Alchemilla vulgaris in Glycerine. Clin Drug Investig 2006; 26:567-73. [PMID: 17163290 DOI: 10.2165/00044011-200626100-00003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND OBJECTIVE Recurrent aphthous ulceration is the most common oral mucosal disease known. It presents as three types: minor (most prevalent), major and herpetiform. However, there are no well established effective and reliable treatments of this condition. Alchemilla vulgaris (Lady's Mantle) has traditionally been used in oral hygiene and was recently shown to accelerate wound healing when used in combination with glycerine. The objective of this study was to determine whether this combination is effective in the treatment of the most prevalent form of aphthous ulcers. METHODS An open-label study was conducted in 48 otherwise healthy male and female patients aged 4-44 years to determine the putative healing properties and tolerability of a standard 3% extract of A. vulgaris in glycerine (Aphtarine) on common minor oral ulcers. Patients with major or herpetiform ulcers were excluded from the study. RESULTS Topical application three times daily of Aphtarine gel to minor mouth ulcers relieved discomfort and produced complete healing in the majority of patients (60.4%) within 2 days and in 75% within 3 days, compared with 10.4% and 33.3%, respectively, without treatment and 15% and 40%, respectively, with commonly available treatments. Most patients appreciated the product's ease of application, taste and texture. Aphtarine was well tolerated locally and most patients rated the product good to excellent overall. CONCLUSION Aphtarine is a safe, well tolerated and highly effective promising new treatment for healing common mouth ulcers.
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Affiliation(s)
- Ravi Shrivastava
- Naturveda-Vitro-Bio Research Institute, ZAC de Lavaur, Issoire, France
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