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Pan Z, Zhang X, Xie W, Cui J, Wang Y, Zhang B, Du L, Zhai W, Sun H, Li Y, Li D. Revisited and innovative perspectives of oral ulcer: from biological specificity to local treatment. Front Bioeng Biotechnol 2024; 12:1335377. [PMID: 38456005 PMCID: PMC10917957 DOI: 10.3389/fbioe.2024.1335377] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Mouth ulcers, a highly prevalent ailment affecting the oral mucosa, leading to pain and discomfort, significantly impacting the patient's daily life. The development of innovative approaches for oral ulcer treatment is of great importance. Moreover, a deeper and more comprehensive understanding of mouth ulcers will facilitate the development of innovative therapeutic strategies. The oral environment possesses distinct traits as it serves as the gateway to the digestive and respiratory systems. The permeability of various epithelial layers can influence drug absorption. Moreover, oral mucosal injuries exhibit distinct healing patterns compared to cutaneous lesions, influenced by various inherent and extrinsic factors. Furthermore, the moist and dynamic oral environment, influenced by saliva and daily physiological functions like chewing and speaking, presents additional challenges in local therapy. Also, suitable mucosal adhesion materials are crucial to alleviate pain and promote healing process. To this end, the review comprehensively examines the anatomical and structural aspects of the oral cavity, elucidates the healing mechanisms of oral ulcers, explores the factors contributing to scar-free healing in the oral mucosa, and investigates the application of mucosal adhesive materials as drug delivery systems. This endeavor seeks to offer novel insights and perspectives for the treatment of oral ulcers.
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Affiliation(s)
- Ziyi Pan
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
- School of Stomatology, Jilin University, Changchun, China
| | - Xu Zhang
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
| | - Wangni Xie
- School of Stomatology, Jilin University, Changchun, China
| | - Jing Cui
- School of Stomatology, Jilin University, Changchun, China
| | - Yue Wang
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, China
| | - Boya Zhang
- School of Stomatology, Jilin University, Changchun, China
| | - Liuyi Du
- School of Stomatology, Jilin University, Changchun, China
| | - Wenhao Zhai
- School of Stomatology, Jilin University, Changchun, China
| | - Hongchen Sun
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
- School of Stomatology, Jilin University, Changchun, China
| | - Yunfeng Li
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, China
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, The First Hospital of Jilin University, Changchun, China
| | - Daowei Li
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
- School of Stomatology, Jilin University, Changchun, China
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Guareschi V, Mathevet P, Jacot-Guillarmod M. Ulcus Vulvae Acutum Lipschütz-UVAL: case series at a Swiss university hospital emergency room. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 5:1333620. [PMID: 38292466 PMCID: PMC10824935 DOI: 10.3389/frph.2023.1333620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024] Open
Abstract
Background Ulcus Vulvae Acutum Lipschütz (UVAL) is a largely unknown disease with a broad and complex differential diagnosis. Objectives To provide a description of the main characteristics of UVAL, determine the most appropriate diagnostic process and describe the current therapeutic approach. Methods We designed a retrospective, descriptive cohort study using the gynecological-ER database of our institution. Inclusion criteria: female patients aged between 10 and 20 years old with suspicion of a UVAL diagnosis at CHUV's gynecological ER. Data extraction: epidemiological characteristics, clinical presentation, laboratory tests, established diagnostics, treatment, and ulcer outcomes. Results 15 patients were included for the analysis; average age: 15 years old; 60% of patients were virgo at the time of ulcer onset; all patients had at least one flu-like symptom concomitant with the vulvar lesion; the most-performed serology was for EBV and acute disease was present in only one patient; for diagnostic purposes two biopsies were performed with both inconclusive histopathology analysis; the main prescribed treatments were: oral NSAIDs, Paracetamol, and Lidocaine gel; 93% of cases presented signs of regression; the average follow-up time was 10 days. The diagnostic algorithm of Sadoghi et al: 10 out of 15 cases were retrospectively diagnosed with UVAL by the algorithm; half were diagnosed with UVAL, and the other half received a diagnosis of "ulcers of unknown origin" at the time of the gynecological ER visit. Conclusions We highly recommend the diagnostic and therapeutic algorithms developed by Sadoghi et al. as valuable tools to guide clinical reasoning and, consequently, improve acute vulvar ulcers management.
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Affiliation(s)
- Vittoria Guareschi
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
| | - Patrice Mathevet
- Department of Obstetrics and Gynecology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Martine Jacot-Guillarmod
- Department of Obstetrics and Gynecology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Yuan Z, Li M, Rahhal O. The effect of Jiaweidaochi powder on Th1/Th2 in rats with recurrent aphthous ulcer. Arch Oral Biol 2023; 156:105828. [PMID: 37890261 DOI: 10.1016/j.archoralbio.2023.105828] [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] [Received: 08/16/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To elucidate the effect of Jiaweidaochi powder on the Th1/Th2 ratio in rats with recurrent aphthous ulcers (RAU). DESIGN 40 Sprague-Dawley rats were included in this study, randomly divided into a control group, a model group, and three treatment groups (0.5 g/ ml, 1 g/ml, 2 g/ml Jiaweidaochi powder). The RAU model of rats was established by autoantigen injection. The effects of Jiaweidaochi powder on the expression of INFG, IL-4, TBX21, and GATA3 mRNA were detected by real-time PCR. The expression of IFN-γ, IL-4, and IFN-γ/IL-4 proteins in oral ulcer tissue and serum of rats were analyzed by Western blot and ELISA, respectively. The proportion of Th1 cells and Th2 cells in RAU rats was analyzed by flow cytometry. RESULTS Jiaweidaochi powder reduced the number, diameter, and duration of oral ulcers in RAU rats. Real-time PCR showed that middle and high-dose Jiaweidaochi powder decreased the expression of INFG TBX21 mRNA and increased the expression of IL-4 and GATA3 mRNA in the oral tissue of RAU rats. ELISA and western blot confirmed that the expression of IFN-γ protein was significantly decreased, and the level of IL-4 protein was increased both in oral tissue and serum of RAU rats treated with middle or high doses of Jiaweidaochi powder. Flow cytometry found that the Jiaweidaochi powder decreased the proportion of Th1 cells and increased the proportion of Th2 cells in RAU rats. CONCLUSION This study found that Jiaweidaochi powder promoted the balance of Th1/Th2 in RAU rats, contributing to the healing of RAU.
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Affiliation(s)
- Zhenying Yuan
- Changsha Stomatological Hospital, Changsha 410000, China
| | - Ming Li
- Xiangya Stomatological Hospital, Central South University, Changsha 410000, China.
| | - Omar Rahhal
- Xiangya Stomatological Hospital, Central South University, Changsha 410000, China
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Sajewicz-Radtke U, Radtke BM, Jurek P, Olech M, Skurska A, Ślebioda Z, Dorocka-Bobkowska B, Pietuch K, Sulewska M, Błażek M. Psychological Functioning of Women Diagnosed with Lichen Planus and Other Diseases of the Oral Cavity-Explorative Study. Healthcare (Basel) 2023; 11:healthcare11081118. [PMID: 37107951 PMCID: PMC10137810 DOI: 10.3390/healthcare11081118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/16/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The role of psychosocial factors in the development of changes in lichen planus and other diseases of the oral cavity has been implicated, but is still understudied. Therefore, the aim of our study was to describe the specific profile of psychological functioning of patients with these diseases, including the role of temperamental traits, action-oriented personality components, and self-esteem. In total, 94 adult women participated in the study: (1) with lichen planus (LP; n = 46; Mage = 54.80, SD = 12.53), (2) with other oral conditions (n = 25; Mage = 34.76, SD = 16.03), (3) without chronic disease (n = 24; Mage = 40.96, SD = 13.33). The following questionnaires were used: ZKA-PQ/SF, Polish Adaptive and Maladaptive Perfectionism Questionnaire, ACS-90, PROCOS, and MSEI. Results indicated no significant differences in temperament dimensions between studied groups. However, women diagnosed with LP presented lower levels of maladaptive perfectionism and social support than healthy women. Furthermore, women with LP also obtained lower scores for social resourcefulness and higher scores for moral self-approval than healthy women. Summarizing, patients with LP often use compensatory mechanisms that negatively affect their social functioning; thus diagnostic/therapeutic programs directed towards those group should be holistic, including psychologists and psychiatrists who support patients' psychological well-being.
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Affiliation(s)
| | - Bartosz M Radtke
- Laboratory of Psychological and Pedagogical Tests, Czarnieckiego 5A, 80-239 Gdansk, Poland
| | - Paweł Jurek
- Institute of Psychology, University of Gdansk, Bażyńskiego 4, 80-952 Gdansk, Poland
| | - Michał Olech
- Department of Psychology, Medical University of Gdańsk, M. Skłodowskiej-Curie 3a, 80-210 Gdansk, Poland
| | - Anna Skurska
- Periodontologia Anna Skurska Private Dental Practice, Warszawska 14 lok. 2D, 15-063 Bialystok, Poland
| | - Zuzanna Ślebioda
- Department of Oral Surgery, Periodontology and Oral Mucosa Diseases, Poznan University of Medical Sciences, ul. Bukowska 70, 60-812 Poznan, Poland
| | - Barbara Dorocka-Bobkowska
- Department of Prosthetic Dentistry and Gerodontology, Poznan University of Medical Sciences, ul. Bukowska 70, 60-812 Poznan, Poland
| | - Katarzyna Pietuch
- Department of Obstetrics, Gynecology and Oncological Gynecology, Medical University of Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland
| | - Magdalena Sulewska
- PerioClinica Magdalena Sulewska Dental Practice, Kujawska 53/1, 15-548 Bialystok, Poland
| | - Magdalena Błażek
- Department of Psychology, Medical University of Gdańsk, M. Skłodowskiej-Curie 3a, 80-210 Gdansk, Poland
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Fu H, Yang J, Shen Z, Zhang Y, Kuang S, Li L, Lin Z, Shi X. Antibacterial, wet adhesive, and healing-promoting nanosheets for the treatment of oral ulcers. Biomater Sci 2023; 11:3214-3226. [PMID: 36927992 DOI: 10.1039/d2bm02063g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The severe pain caused by oral ulcers seriously affects food intake and speech, bringing great inconvenience in daily life. Drug-loaded patches are mostly used to treat oral mucosal diseases such as oral ulcers and oral lichen planus, but their effects are limited because of the influences of saliva and muscle movement. To enhance the adhesion of drug-loaded patches used in the oral cavity, we designed antimicrobial peptides (AMPs)-modified polycaprolactone (PCL)-collagen nanosheets (APCNs). The internal layer is a bioactive and antibacterial collagen layer modified with antimicrobial peptides. The backing layer is a hydrophobic PCL layer with good mechanical strength that can reduce external influences. We have characterized and tested the APCNs. First, the APCNs exhibited continuous and strong adhesion to irregular buccal mucosa surfaces under wet conditions and external force action. Antibacterial experiments showed that the APCNs had high antibacterial activity against both Gram-positive bacteria and Gram-negative bacteria. Moreover, the APCNs showed good biocompatibility and promoted the adhesion of fibroblasts in vitro. Furthermore, APCNs treatment accelerated ulcer healing in a Sprague Dawley rat oral ulcer model. Our study developed antibacterial, wet-adhesive, and healing-promoting PCL-collagen nanosheets and demonstrated that these nanosheets could be promising adhesive therapeutic agents for the treatment of oral mucosal ulcers.
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Affiliation(s)
- Haijun Fu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou, Guangdong, China.
| | - Jiayu Yang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou, Guangdong, China.
| | - Zongshan Shen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou, Guangdong, China.
| | - Yong Zhang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou, Guangdong, China.
| | - Shuhong Kuang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou, Guangdong, China.
| | - Lifeng Li
- Guangzhou SoonHeal Medical Technology Co., Ltd., Guangzhou 510000, China
| | - Zhengmei Lin
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou, Guangdong, China.
| | - Xuetao Shi
- National Engineering Research Centre for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong, China. .,Key Laboratory of Biomedical Engineering of Guangdong Province, South China University of Technology, Guangzhou, China
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Lucinda Tan S, Ho CY, Tey HL. Successful treatment of a case of recalcitrant recurrent aphthous stomatitis using steroid-embedded dissolving microneedles. Indian J Dermatol Venereol Leprol 2022; 88:553-555. [PMID: 35593286 DOI: 10.25259/ijdvl_521_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | - Chong Yao Ho
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Hong Liang Tey
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Recurrent Aphthous Stomatitis – An Overview. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Recurrent aphthous ulcers are common painful mucosal conditions affecting the oral cavity. Despite their high prevalence and knowledge of many etiological factors, the exact mechanism of disease is still not fully understood. There are three different clinical forms of recurrent aphthous stomatitis and the therapy differs depending on it.
The aim of this article is to provide an overview of current knowledge about the possible causes and treatment of recurrent aphthous stomatitis. We discuss its pathogenesis which is currently the least explained in the literature. This review offers scientists and clinicians useful information about clinical presentation, diagnosis, predisposing aetiological factors and recent trends in the management of recurrent aphthous stomatitis.
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Chen J, Wang X, Wang K, Liu Z, Lv X, Wang M, Sun S. Fire needle for recurrent aphthous stomatitis: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2022; 101:e28731. [PMID: 35147094 PMCID: PMC8830842 DOI: 10.1097/md.0000000000028731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS), are common inflammatory lesions of the oral mucous, usually round or ovoid, circumscribed by erythematous haloes with a yellow-grey floor and mostly painful. The purpose of this study was to evaluate the efficacy and safety of fire needle in the treatment of RAS. METHODS PubMed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database were searched by 2 reviewers from the inception until December 2021. The original study that randomized control trials of fire needle for RAS will be selected and is not limited by country or language. In addition, researches in progress, the reference lists and the citation lists of identified publications will be retrieved similarly. Study selection, data extraction, and assessment of the quality will be performed independently by 2 reviewers who have been trained prior to data extraction. A meta-analysis will be conducted if the quantity and quality of the original studies included are satisfactory; otherwise, a descriptive analysis will be conducted. Review Manager V5.4 software will be using for data synthesis and assessment of the risk of bias according to Cochrane Handbook. RESULTS This study will provide a comprehensive review of current evidence for the treatment of fire needle on RAS. CONCLUSION The conclusion of this study will provide a judging basis that whether the treatment of RAS with fire needle is effective. INPLASY REGISTRATION NUMBER INPLASY2021120118.
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Affiliation(s)
- Jun Chen
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xingxin Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Kai Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Zhihao Liu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiaoya Lv
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Ming Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shoudan Sun
- Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Baioumy SA, Fouad SH, Abdalgeleel SA, Baiomy AA, Sallam DE, Taha SI. Mannose-binding lectin serum levels and (Gly54asp) gene polymorphism in recurrent aphthous stomatitis: A case-control study. Int J Immunopathol Pharmacol 2021; 35:20587384211064454. [PMID: 34907799 PMCID: PMC8689634 DOI: 10.1177/20587384211064454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives: Dysregulation of the immune response appears to play a significant role in recurrent aphthous stomatitis (RAS) development. The main objective of this case–control study is to investigate the blood levels of mannose-binding lectin (MBL) and the frequency of the MBL2 gene (gly54asp) polymorphism in RAS patients, including 40 RAS patients and 40 healthy controls. Methods: Serum MBL levels were determined by ELISA, while the PCR-restriction fragment length polymorphism was used in MBL2 genotyping. Results: The median serum MBL level was significantly lower in the RAS group than in the control group (975 ng/mL (545–1320) vs. 1760 ng/mL (1254–2134); p≤ 0.001). The MBL levels were significantly lower in the BB genotype, whereas they were significantly higher in the wild type AA with a median of 525 and 1340 ng/mL, respectively (p =0.005). The B allele was expressed in significantly higher percentages of RAS patients than in controls. There was no significant association between MBL serum levels (p=0.685) or MBL2 codon 54 genotypes (p=0.382) with the type of ulcers. Conclusion: There was an association between low MBL serum levels and the variant allele B of the MBL2 (gly54asp) gene, and the susceptibility to RAS. As a result, potential novel therapeutic options for RAS patients with MBL deficiency should be investigated.
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Affiliation(s)
- Shereen A Baioumy
- Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Shaimaa H Fouad
- Department of Internal Medicine / Allergy and Clinical Immunology, 68792Ain Shams University, Cairo, Egypt
| | - Shaimaa A Abdalgeleel
- Department of Biostatistics and Epidemiology, National Cancer Institute, 63526Cairo University, Cairo, Egypt
| | - Ahmed A Baiomy
- Department of Fixed prosthodontics, Egyptian Russian University, Badr City, Egypt
| | - Dina E Sallam
- Department of Pediatrics & Pediatric Nephrology, Faculty of Medicine, 68792Ain-Shams University, Cairo, Egypt
| | - Sara I Taha
- Department of Clinical Pathology/ Immunology, Faculty of Medicine, 68792Ain Shams University, Cairo, Egypt
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Arroyo GP, Lofters A, Clarkson E. Pharmacological Management of Common Soft Tissue Lesions of the Oral Cavity. Oral Maxillofac Surg Clin North Am 2021; 34:99-114. [PMID: 34728147 DOI: 10.1016/j.coms.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Soft tissue lesions commonly seen in the oral cavity tend to overlap in their onset, presentation, and location making it difficult to appreciate their etiology. In some instances, common oral soft tissue lesions can create confusion due to similar clinical appearance or unusual presentation; therefore, proper diagnosis of the lesion is key in pharmacologic management. In ulcerative conditions, topical steroids can decrease the symptoms and improve healing time, but do not affect the recurrence rate. Always be suspicious of soft tissue lesions that are nonresolving or recurrent lesions as they may warrant further investigation to rule out malignancy or associated systemic conditions. This article discusses key clinical presentations and the proper topical and systemic pharmacologic treatments.
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Affiliation(s)
- Guillermo Puig Arroyo
- Department of Oral and Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway, Room 2C319, Brooklyn, NY 11206, USA.
| | - Ashley Lofters
- Department of Oral and Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway, Room 2C319, Brooklyn, NY 11206, USA.
| | - Earl Clarkson
- Department of Oral and Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway, Room 2C319, Brooklyn, NY 11206, USA
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Ossama M, Lamie C, Tarek M, Wagdy HA, Attia DA, Elmazar MM. Management of recurrent aphthous ulcers exploiting polymer-based Muco-adhesive sponges : in-vitro and in-vivo evaluation. Drug Deliv 2021; 28:87-99. [PMID: 33342321 PMCID: PMC7758044 DOI: 10.1080/10717544.2020.1858999] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Recurrent aphthous ulcer (RAU) is a well-known painful, inflammatory disease with uncertain etiology for which local symptomatic therapy is only available. The aim of this study was to formulate and characterize muco-adhesive sponges containing a mixture of tenoxicam and miconazole nitrate to manage pain, inflammation and avoid candida infection that may accompany RAU due to poor oral hygiene. Two polymers at different concentrations were used to prepare sponges applying simple freeze-drying. Medicated chitosan (2%) sponges (mC2) showed acceptable physical appearance, surface pH (6.3 ± 0.042), porosity (25.7% ± 1.8), swelling index (5.7 ± 0.11), in-vivo and ex-vivo muco-adhesion time (115 min.±0.813 and 155 min.±1.537, respectively), ex-vivo muco-adhesion force (0.09 N ± 0.002) and scanning electron microscope (SEM) images. For concurrent clear-cut determination of tenoxicam and miconazole nitrate from mC2, a new UPLC method was developed and validated. mC2 sponges exhibited superior in-vitro drug release profiles where ∼100% of tenoxicam released within 5 min for fast pain relief with a more prolonged miconazole nitrate release. Furthermore, in-vivo animal study revealed that mC2 caused a significant decrease in the acetic acid-induced ulcer size in rats after 6 days of treatment (p < .0001) compared to negative and positive controls. Additionally, histopathological examination showed faster healing with complete restoration of the normal oral histology in rats. The present study concludes that chitosan sponge loaded with a combination of tenoxicam and miconazole nitrate could improve healing of RAU cases.
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Affiliation(s)
- Muhammed Ossama
- Department of Pharmaceutics and Pharmaceutical Technology, The British University in Egypt (BUE), Cairo, Egypt
| | - Caroline Lamie
- Department of Pharmaceutics and Pharmaceutical Technology, The British University in Egypt (BUE), Cairo, Egypt
| | - Mohamed Tarek
- Department of Pharmaceutical Chemistry, The British University in Egypt (BUE), Cairo, Egypt
| | - Hebatallah A Wagdy
- Department of Pharmaceutical Chemistry, The British University in Egypt (BUE), Cairo, Egypt
| | - Dalia A Attia
- Department of Pharmaceutics and Pharmaceutical Technology, The British University in Egypt (BUE), Cairo, Egypt
| | - Mohamed M Elmazar
- Department of Pharmacology and Biochemistry, The British University in Egypt (BUE), Cairo, Egypt
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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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14
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Ozeki I, Yamaguchi M, Suii H, Tatsumi R, Arakawa T, Nakajima T, Kuwata Y. The association between serum zinc levels and subjective symptoms in zinc deficiency patients with chronic liver disease. J Clin Biochem Nutr 2020; 66:253-261. [PMID: 32523253 DOI: 10.3164/jcbn.19-99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/04/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the association between serum zinc levels and major subjective symptoms in zinc deficiency patients with chronic liver disease. 578 patients with chronic liver disease were enrolled. The patients, whose serum zinc level of <80 µg/dl, completed a questionnaire to determine whether they had subjective symptoms of the five conditions (taste disorder, aphthous stomatitis, dermatitis, alopecia, and anorexia). Then, the association between these subjective symptoms and serum zinc levels was analyzed. In total, 193 patients (33.4%) experienced any subjective symptoms. The prevalence of each symptom was as follows: 36 patients with taste disorder (6.2%), 46 with aphthous stomatitis (8.0%), 77 with dermatitis (13.3%), 46 with alopecia (8.0%), and 53 with anorexia (9.2%). In total, 70.8%, 34.1%, and 26.1% patients with serum zinc levels of <40, ≥40 to <60, and ≥60 to <80 µg/dl, respectively, had these symptoms. When zinc deficiency was defined as a serum zinc level of <80 µg/dl, approximately one-third of patients displayed symptoms presumably originating from zinc deficiency. As serum zinc levels decreased, the prevalence of these symptoms increased. Dermatitis, especially, was relevant to zinc.
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Affiliation(s)
- Itaru Ozeki
- Department of Hepatology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan
| | - Masakatsu Yamaguchi
- Department of Hepatology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan
| | - Hirokazu Suii
- Department of Hepatology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan
| | - Ryoji Tatsumi
- Department of Hepatology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan
| | - Tomohiro Arakawa
- Department of Hepatology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan
| | - Tomoaki Nakajima
- Department of Hepatology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan
| | - Yasuaki Kuwata
- Department of Hepatology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan
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Sánchez-Bernal J, Conejero C, Conejero R. Recurrent Aphthous Stomatitis. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:471-480. [PMID: 32451064 DOI: 10.1016/j.ad.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/17/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
Recurrent aphthous stomatitis is a chronic inflammatory disease of the oral mucosa. It is characterized by painful mouth ulcers that cannot be explained by an underlying disease. Recurrent oral mucosal ulcers require a proper differential diagnosis to rule out other possible causes before recurrent aphthous stomatitis is diagnosed. The condition is common, with prevalence rates ranging from 5 to 60% in different series. Its pathogenesis is unknown, but multiple factors are considered to play a part. There are no standardized treatments for this condition and none of the treatments are curative. The goal of any treatment should be to alleviate pain, reduce the duration of ulcers, and prevent recurrence.
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Affiliation(s)
- J Sánchez-Bernal
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - C Conejero
- Unidad de Dermatología, Centro Médico Millenium, Zaragoza, España
| | - R Conejero
- Departamento de Dermatología, Hospital Royo Villanova, Zaragoza, España.
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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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17
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The effects of pomegranate peel extract on recurrent aphthous stomatitis. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2019. [DOI: 10.2478/cipms-2019-0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
As high as 20% of the population is thought to have recurrent aphthous stomatitis (RAS), hence, finding new therapeutic agents may be needed. Pomegranate (Punica granatum), has been extensively used in the folk medicine of many cultures, as it possesses antioxidant, anti-inflammatory and anti-bacterial properties. In this study, it is hypothesized that a topical form of pomegranate peel extract (PPE) may shorten the duration, accelerate the healing and reduce the pain of RAS patients. The presented randomized, double-blind study was conducted on 56 patients. Herein, 28 patients were advised to apply PPE gel, and the other 28 patients were given placebo gel, twice daily for one week. Efficacy evaluations were made at days 0 (before using the gel), 3, 5 and 7. The mean values of ulcer size, pain and healing duration of ulcers were compared in both groups. PPE gel was significantly effective in reducing the pain (p<0.001), ulcer size (p<0.001), and healing duration of ulcers (p<0.001) over a period of one week. PPE in the form of oral gel can be used in the management of aphthous ulcers.
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Habibzadeh S, Sheikh Rahimi M, Edalatkhah H, Piri H, Maleki N. Effectiveness of booster dose of tetanus and diphtheria toxoids (Td) vaccine in management of recurrent aphthous stomatitis: a prospective, randomized, triple-blind and placebo-controlled clinical trial. J DERMATOL TREAT 2019; 32:361-366. [PMID: 31403361 DOI: 10.1080/09546634.2019.1654597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is the most common oral disease. The activation of the immune system by vaccines might reduce the interactions between oral mucosa and microorganisms. AIM To evaluate the effect of the tetanus-diphtheria toxoids (Td) vaccine in management of RAS. DESIGN AND SETTING This prospective, randomized, triple-blind and placebo-controlled clinical trial study was conducted on 70 eligible patients with minor RAS at the dermatology outpatient clinic. METHOD Finally, a total of 66 participants (48 male, 18 female; mean age: 38.56 ± 10.98 years) completed the study in two groups, one in which colchicine and a single dose of vitamin B6 (placebo group) was treated and one in which colchicine and a single dose of Td vaccine (intervention group) was treated. RESULTS After six months of follow-up, the patients were evaluated, which revealed significant effects of the Td vaccine on pain intensity, ulcer size, recovery time, and the interval between episodes. At the end of the six month follow-up, 27 patients (81.8%) in the intervention group and 13 patients (39.4%) in the placebo group showed partial or complete recovery, and there was statistically significant difference between the groups (p < .001). Recovery was not significantly associated with sex, education level, marital status and duration of RAS. However, occupation and positive family history of RAS had significant relations with recovery. CONCLUSIONS A booster dose of Td vaccine had relatively favorable effects on pain intensity and recurrence of RAS, but further research is needed to confirm its efficacy.
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Affiliation(s)
- Shahram Habibzadeh
- Department of Infectious Disease, Imam Khomeini Hospital, Ardebil University of Medical Sciences, Ardebil, Iran
| | - Mehdi Sheikh Rahimi
- Department of Infectious Disease, Imam Khomeini Hospital, Ardebil University of Medical Sciences, Ardebil, Iran
| | - Hasan Edalatkhah
- Department of Dermatology, Imam Khomeini Hospital, Ardebil University of Medical Sciences, Ardebil, Iran
| | - Hadi Piri
- Department of Microbiology, Imam Khomeini Hospital, Ardebil University of Medical Sciences, Ardebil, Iran
| | - Nasrollah Maleki
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
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19
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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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Uluyol S, Kilicaslan S. Diagnostic Value of Neutrophil-Lymphocyte Ratios and Mean Platelet Volumes in the Activation of Recurrent Aphthous Stomatitis. Indian J Otolaryngol Head Neck Surg 2019; 71:120-123. [PMID: 30906727 DOI: 10.1007/s12070-017-1059-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 01/09/2017] [Indexed: 12/14/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) is associated with endothelial dysfunction and chronic inflammation. The neutrophil-to-lymphocyte ratio (NLR) and mean platelet voume (MPV) are markers of inflammation and endothelial dysfunction, respectively. In the present report, we discuss the NLR and MPV values of patients with active and inactive RAS. In total, 42 patients (24 females and 18 males) with inactive RAS, 19 patients (12 females and 7 males) with active RAS and 40 healthy controls (24 females and 16 males) were enrolled. MPVs were measured and NLRs calculated. We sought correlations among the MPV and NLR findings in the active and inactive RAS groups and compared them with those of healthy controls. The MPV and NLR values were significantly higher in patients with active than inactive RAS (MPV, 10.6 ± 2.9 vs. 7.1 ± 2.4 fL, p < 0.001; NLR, 3.74 ± 1.9 vs. 2.1 ± 1.43, p = 0.015). In addition, both MPV and NLR values in patients with inactive RAS didn't differ significantly compared to values observed in the controls (MPV, 7.1 ± 2.4 vs. 6.9 ± 2.1 fL, p = 0.126; NLR, 2.1 ± 1.43 vs. 2.07 ± 0.96, p = 0.525). Both the NLR and MPV were significantly higher in patients with active RAS, emphasising the importance of inflammation and endothelial dysfunction in the pathophysiology of RAS activation.
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Affiliation(s)
- Sinan Uluyol
- Department of Otorhinolaryngology, Van Training and Research Hospital, Van, Turkey
- Van Eğitim ve Araştırma Hastanesi KBB Kliniği, İpekyolu Caddesi, Hava Yolu Kavşağı 1. Kilometre, 65300 Edremit, Van Türkiye
| | - Saffet Kilicaslan
- Department of Otorhinolaryngology, Van Training and Research Hospital, Van, Turkey
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21
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Rocca JP, Zhao M, Fornaini C, Tan L, Zhao Z, Merigo E. Effect of laser irradiation on aphthae pain management: A four different wavelengths comparison. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2018; 189:1-4. [DOI: 10.1016/j.jphotobiol.2018.09.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
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Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Wu YC, Sun A. Recurrent aphthous stomatitis - Etiology, serum autoantibodies, anemia, hematinic deficiencies, and management. J Formos Med Assoc 2018; 118:1279-1289. [PMID: 30446298 DOI: 10.1016/j.jfma.2018.10.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/31/2018] [Indexed: 12/31/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases characterized by recurrent and painful ulcerations on the movable or nonkeratinized oral mucosae. Clinically, three types of RAS, namely minor, major, and herpetiform types, can be identified. RAS more commonly affects labial mucosa, buccal mucosa, and tongue. Previous studies indicate that RAS is a multifactorial T cell-mediated immune-dysregulated disease. Factors that modify the immunologic responses in RAS include genetic predisposition, viral and bacterial infections, food allergies, vitamin and microelement deficiencies, systemic diseases, hormonal imbalance, mechanical injuries, and stress. Our previous study found the presence of serum gastric parietal cell antibody, thyroglobulin antibody, and thyroid microsomal antibody in 13.0%, 19.4%, and 19.7% of 355 RAS patients, respectively. We also found anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in 20.9%, 20.1%, 4.8%, 2.6%, and 7.7% of 273 RAS patients, respectively. Therefore, it is very important to examine the complete blood count, serum autoantibody, hematinic, and homocysteine levels in RAS patients before we start to offer treatments for RAS. Because RAS is an immunologically-mediated disease, topical and systemic corticosteroid therapies are the main treatments of choice for RAS.
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Affiliation(s)
- Chun-Pin Chiang
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yang-Che Wu
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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23
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Polat C, Düzer S, Ayyıldız H, Seç S, Aksoy N, Sakallıoğlu Ö, Akyiğit A, Çetiner H. Association Between Anxiety, Depression, and Salivary Cortisol Levels in Patients with Recurrent Aphthous Stomatitis. Turk Arch Otorhinolaryngol 2018; 56:166-169. [PMID: 30319874 DOI: 10.5152/tao.2018.3242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 06/18/2018] [Indexed: 11/22/2022] Open
Abstract
Objective Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease of the oral mucosa that commonly affects the general population. The objective of this study was to conduct a research in assesing the relationship between psychological disorders including anxiety, depression and salivary cortisol levels in patients with RAS. Methods Thirty-nine patients suffering from minor RAS were enrolled in the study after obtaining an informed consent. The control group consisted of 25 age and gender matched healthy individuals. All subjects were evaluated by using both psychological tests (Hamilton's anxiety rating scale [HARS] and Hamilton's depression rating scale [HDRS]) and physiological testing instrument (salivary cortisol level). Results While no statistical difference was found between the patients with RAS and controls for both salivary cortisol levels and anxiety, there was statisticaly significant difference between the groups for depression. Conclusion There was no significant increase in salivary cortisol levels in patients with active disease when compared to the healthy subjects. But we found that depression scale values were significantly higher in patients with RAS.
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Affiliation(s)
- Cahit Polat
- Department of Otorhinolaryngology, Elazığ Training and Research Hospital, Elazığ, Turkey
| | - Sertaç Düzer
- Department of Otorhinolaryngology, Elazığ Training and Research Hospital, Elazığ, Turkey
| | - Hakan Ayyıldız
- Department of Biochemistry, Elazığ Training and Research Hospital, Elazığ, Turkey
| | - Semih Seç
- Department of Psychiatry, Elazığ Training and Research Hospital, Elazığ, Turkey
| | - Neval Aksoy
- Department of Biochemistry, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Öner Sakallıoğlu
- Department of Otorhinolaryngology, Elazığ Training and Research Hospital, Elazığ, Turkey
| | - Abdulvahap Akyiğit
- Department of Otorhinolaryngology, Elazığ Training and Research Hospital, Elazığ, Turkey
| | - Hasan Çetiner
- Department of Otorhinolaryngology, Elazığ Training and Research Hospital, Elazığ, Turkey
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Najafi S, Mohammadzadeh M, Rajabi F, Zare Bidoki A, Yousefi H, Farhadi E, Rezaei N. Interleukin-4 and Interleukin-4 Receptor Alpha Gene Polymorphisms in Recurrent Aphthous Stomatitis. Immunol Invest 2018; 47:680-688. [PMID: 29985726 DOI: 10.1080/08820139.2018.1480033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is a common oral condition with a major impact on the quality of life. The condition is thought to be due to the overexpression of T helper-1(Th1)-related cytokines. Since interleukin-4 (IL-4) and its receptor (IL-4Rα) are antagonistic to Th-1 pathways, polymorphisms in their genes may also be involved in the pathogenesis of aphthous stomatitis. METHODS Sixty-four patients diagnosed with minor RAS and 141 (age- and sex-matched) healthy controls were assessed for 3 single-nucleotide polymorphisms (SNPs) within the promoter region of the IL-4 gene (-1098G/T, -590C/T, and -33C/T), and 1 SNP in IL-4Rα gene (+1902 A/G). RESULTS No significant differences were detected between the patient and the control group regarding IL-4 allele frequencies. However, the patient group demonstrated a higher frequency of IL-4 -590 CC genotype and a lower rate of IL-4 -590 TC genotype. The TCT, GTT, GCT, and GTC haplotypes of the IL-4 gene (-1098, -590, -33) were significantly more frequent in the patients and the GCC, and TTT haplotypes were more common in healthy controls. No significant differences were found in IL-4Rα gene polymorphism between the 2 groups. CONCLUSIONS Certain polymorphisms of IL4 gene could predispose individuals to RAS.
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Affiliation(s)
- Shamsolmoulouk Najafi
- a Department of Oral Medicine , School of Dentistry, Tehran University of Medical Sciences , Tehran , Iran.,b International Campus, Dental Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | | | - Fateme Rajabi
- d Department of Dermatology , School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran , Iran.,e Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA) , Universal Scientific Education and Research Network (USERN) , Tehran , Iran
| | - Alireza Zare Bidoki
- f The John Curtin School of Medical Research , Australian National University , Canberra Australia.,g Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA) Universal Scientific Education and Research Network (USERN) , Canberra , Australia
| | - Hila Yousefi
- c Dental Branch , Islamic Azad University , Tehran , Iran
| | - Elham Farhadi
- h Molecular Immunology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Nima Rezaei
- i Research Center for Immunodeficiencies, Children's Medical Center , Tehran University of Medical Sciences , Tehran , Iran.,j Department of Immunology , School of Medicine, Tehran University of Medical Sciences , Tehran , Iran.,k Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA) , Universal Scientific Education and Research Network (USERN) , Sheffield , UK
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Wu D, Xin J, Liu J, Zhou P. The association between interleukin polymorphism and recurrent aphthous stomatitis: A meta-analysis. Arch Oral Biol 2018; 93:3-11. [PMID: 29800802 DOI: 10.1016/j.archoralbio.2018.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/28/2018] [Accepted: 05/13/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the association between interleukin gene polymorphism and recurrent aphthous stomatitis (RAS). DESIGNS Two electronic databases, PubMed and Embase, were utilized to assemble potentially relevant studies meeting the inclusion criteria. A meta-analysis was conducted using Revman 5.3 software (London, UK), and the pooled odds ratio (OR) and 95% confidence interval (CI) were then used to evaluate the strength of the relationship between the gene polymorphisms of IL-1beta(-511C/T), IL-1beta(+3954C/T), IL-6(-174G/C) and IL-10(-1082G/A) and the risk of RAS. RESULTS Ten studies were included in the final meta-analysis, with 884 cases and 1104 controls participating. The results demonstrated that the polymorphism of IL-1beta(-511C/T) significantly increased the probability of the development of RAS in Europeans. (T vs. C: OR = 1.35, 95%CI = 1.09-1.67; CC vs. CT + TT: OR = 1.77, 95%CI = 1.24-2.53; CC vs. TT: OR = 1.86, 95%CI = 1.18-2.95). Furthermore, the C allele in IL-1beta(+3954C/T) was determined to be related to the risk of RAS in Americans (C vs. T: OR = 1.52, 95%CI = 1.07-2.17) and the presence of the C gene was considered a risk variant (CC + CT vs. TT: OR = 1.46, 95%CI = 1.01-2.11), but no relationship was found between the polymorphism of IL-10(-1082G/A) and the risk of RAS. CONCLUSIONS The meta-analysis suggested that the mutation of IL-1beta(-511C/T) in Europe and IL-1beta(+3954C/T) in America tend to increase the risk of RAS, but the polymorphism of IL-10(-1082G/A) appears to have no association with RAS risk in America. Further study is required to confirm the above conclusions.
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Affiliation(s)
- Donglei Wu
- College of Stomatology, Jinan University, Guangzhou 510632, China; Department of Stomatology, First Affiliated Hospital, Jinan University, Guangzhou 510632, China
| | - Jinglei Xin
- Department of Stomatology, Guangdong Women and Children Hospital of Guangzhou Medical University, Guangzhou 511442, China
| | - Jing Liu
- College of Stomatology, Jinan University, Guangzhou 510632, China.
| | - Peng Zhou
- Department of Stomatology, Guangdong Women and Children Hospital of Guangzhou Medical University, Guangzhou 511442, China
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Kiran MS, Vidya S, Aswal GS, Kumar V, Rai V. Systemic and Topical Steroids in the Management of Oral Mucosal Lesions. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2017; 9:S1-S3. [PMID: 29284925 PMCID: PMC5730992 DOI: 10.4103/jpbs.jpbs_91_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
From the time of its introduction in the 1040s, glucocorticoids have provided a panacea for many diseases. The therapeutic benefit of corticosteroids lies in their anti-inflammatory and immunosuppressive properties which makes them highly effective in the management of oral mucosal lesions. This article aims to present to the clinician, the plethora of options available as steroid therapy and enables one to choose based on the underlying disease and the properties of the drug.
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Affiliation(s)
- M Shashi Kiran
- Department of Oral Medicine and Radiology, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | - S Vidya
- Department of Oral Pathology, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | | | - Vinod Kumar
- Department of Dentistry, Jimma University, Jimma, Ethiopia
| | - Vineet Rai
- Department of Dentistry, Jimma University, Jimma, Ethiopia
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Wyles SP, Lehman JS, Lohse CM, Bruce AJ, Torgerson RR. Recurrence of genital aphthosis in girls: A retrospective analysis. J Am Acad Dermatol 2017; 77:982-984. [DOI: 10.1016/j.jaad.2017.06.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 06/12/2017] [Accepted: 06/17/2017] [Indexed: 11/17/2022]
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Abstract
Behçet disease is currently considered an "autoinflammatory disease" triggered by infection and environmental factors in genetically predisposed individuals. Although the disease is characterized by recurrent oral and genital aphthous ulcers and ocular involvement, it can affect multiple organ systems. Complex aphthosis is characterized by recurrent oral and/or genital aphthous ulcers. It is important to evaluate the patient with complex aphthosis for Behçet disease and related systemic disorders. We discuss the etiopathogenesis, clinical features, diagnostic criteria, and treatment approaches for complex aphthosis and Behçet disease in light of the current literature.
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Affiliation(s)
- Isil Bulur
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Dermatology, Eskisehir, Turkey.
| | - Meltem Onder
- Gazi University Faculty of Medicine, Department of Dermatology Emeritus Prof, Ankara, Turkey; Dermatology and Laser Center, Reduitstrasse 13, Landau, Germany.
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Chen H, Sui Q, Chen Y, Ge L, Lin M. Impact of haematologic deficiencies on recurrent aphthous ulceration: a meta-analysis. Br Dent J 2016; 218:E8. [PMID: 25720915 DOI: 10.1038/sj.bdj.2015.100] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Recurrent aphthous ulceration (RAU) is one of the most common oral mucosal diseases, some of which may be secondary to haematologic deficiencies. This meta-analysis aims to evaluate the association between haematologic deficiencies and RAU. MATERIALS AND METHODS Case control studies were identified using a predefined search strategy that compared the difference in haematologic deficiencies between a RAU group and a control group. A meta-analysis was performed to estimate the combined odds ratios (ORs) and 95% confidence intervals (95% CIs) in a fixed-effects model and a random-effects model, as appropriate. RESULTS In this meta-analysis, nine case control studies, including total 710 cases in RAU groups and 602 cases in control groups, were considered eligible for inclusion. Overall, the combined results based on all studies showed that the rate of haematinic deficiencies was significantly high in the RAU group (vitamin B12: OR=3.75, 95% CI: 2.38-5.94; folic acid: OR=7.55, 95% CI: 3.91-14.60; ferritin: OR=2.62, 95% CI: 1.69-4.06; and haemoglobin: OR=1.77, 95% CI: 1.12-2.80). CONCLUSION This meta-analysis suggests that haematologic deficiencies could be a significant risk factor for RAU. Thus, screening and treating any haematologic deficiencies may play an important role in preventing the occurrence of RAU.
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Affiliation(s)
- H Chen
- State Key Laboratory of Oral Diseases, Sichuan University
| | - Q Sui
- State Key Laboratory of Oral Diseases, Sichuan University
| | - Y Chen
- State Key Laboratory of Oral Diseases, Sichuan University
| | - L Ge
- Department of Oral medicine, West China School of Stomatology, Sichuan University
| | - M Lin
- Department of Oral medicine, West China School of Stomatology, Sichuan University
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Abstract
Accurate diagnosis of acute oral ulcers can be challenging. Important historic details include the pattern of recurrence, anatomic areas of involvement within the mouth and elsewhere on the mucocutaneous surface, associated medical symptoms or comorbidities, and symptomology. Careful mucocutaneous examination is essential. When necessary, biopsy at an active site without ulceration is generally optimal. Depending on the clinical scenario, supplemental studies that may be useful include cultures; perilesional biopsy for direct immunofluorescence testing; and evaluation for infectious diseases, gluten sensitivity, inflammatory bowel disease, human immunodeficiency virus infection, connective tissue diseases, or hematinic deficiencies. Clinicians should maintain a broad differential diagnosis when evaluating patients with acute oral ulcers.
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Affiliation(s)
- Julia S Lehman
- Departments of Dermatology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
| | - Roy S Rogers
- Department of Dermatology, Mayo Clinic, Scottsdale, AZ
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Abstract
Recurrent aphthous stomatitis (RAS) is the most common acute oral ulcerative condition in North America. RAS is divided into a mild, common form, simple aphthosis, and a severe, less common form, complex aphthosis. Aphthosis is a reactive condition. The lesions of RAS can represent the mucosal manifestation of a variety of conditions. These include conditions with oral and genital aphthae such as ulcus vulvae acutum, reactive nonsexually related acute genital ulcers, and Behçet disease. The mouth is the beginning of the gastrointestinal (GI) tract, and the lesions of RAS can be a manifestation of GI diseases such as gluten-sensitive enteropathy, ulcerative colitis, and Crohn disease. Complex aphthosis may also have correctable causes. The clinician should seek these in a careful evaluation. Successful management of both simple and complex aphthosis depends on accurate diagnosis, proper classification, recognition of provocative factors, and the identification of associated diseases. The outlook for patients with both simple and complex aphthosis is positive.
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Affiliation(s)
- Ricky Z Cui
- Department of Dermatology, Mayo Clinic, Rochester, MN
| | - Alison J Bruce
- Department of Dermatology, Mayo Clinic, Jacksonville, FL.
| | - Roy S Rogers
- Department of Dermatology, Mayo Clinic, Scottsdale, AZ
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Sakly A, De Wever B, Jutla B, Satia M, Bogaert JP. The safety and efficacy of AphtoFix® mouth ulcer cream in the management of recurrent aphthous stomatitis. BMC Oral Health 2016; 16:17. [PMID: 26868504 PMCID: PMC4750241 DOI: 10.1186/s12903-016-0177-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/05/2016] [Indexed: 11/25/2022] Open
Abstract
Background Recurrent Aphthous stomatitis (RAS) is a prevalent ulcerative and painful disorder of the oral cavity with unknown etiology and for which no efficient treatment is currently available. The present study aimed to evaluate the safety and the efficacy of AphtoFix®, a new mouth ulcer cream that was developed to help treat RAS. Prior to launching the product on the market, two initial safety assessment studies were performed. Subjects and methods In a first study, the in vitro biocompatibility of AphtoFix® was evaluated on reconstructed human gingival tissue models according to ISO guidelines 10993. In a second study, the tolerability of AphtoFix® was evaluated in 20 subjects during a 4-weeks daily application in the mouth. The third study investigated both the safety and efficacy of AphtoFix® treatment on 19 patients suffering from RAS. This study was done in compliance with the Helsinki Declaration. Results The results of in vitro biocompatibility study showed that AphtoFix® mouth ulcer cream did not induce any detectable cytotoxicity and irritation. These observations were confirmed in the 4 weeks tolerability study where no undesired of adverse reactions were noticed. The results of the post-market clinical efficacy study demonstrated a clear reduction in ulcer size from baseline after 3 days treatment (p < 0.05). Pain intensity reduction was also observed in all subjects. Conclusion The application of AphtoFix® did not induce any undesired skin or mucosa reactions. These initial findings demonstrate that AphtoFix® is safe and efficient in reducing ulcer size and decreasing the pain intensity induced by ulcers. Trial registration Clinical trial Registry India Nr. CTRI201408004918, Date of registration: 22/08/2014 Electronic supplementary material The online version of this article (doi:10.1186/s12903-016-0177-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amina Sakly
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein. .,Bonyf AG, Heiligkreuz 16, FL-9490, Vaduz, Liechtenstein.
| | - Bart De Wever
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein.
| | - Balraj Jutla
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein. .,Bonyf AG, Heiligkreuz 16, FL-9490, Vaduz, Liechtenstein.
| | - Milan Satia
- Ethicare Clinical Trial Services; Satellite, Ahmedabad, 380015, Gujarat, India.
| | - Jean Pierre Bogaert
- MSI (Medical Sanitizing Innovations) Laboratories AG, Vaduz, Liechtenstein. .,Bonyf AG, Heiligkreuz 16, FL-9490, Vaduz, Liechtenstein.
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34
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Affiliation(s)
- T Yap
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - M McCullough
- Melbourne Dental School; The University of Melbourne; Victoria Australia
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35
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Effect of bedtime on recurrent aphthous stomatitis in college students. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:196-201. [DOI: 10.1016/j.oooo.2014.10.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 10/09/2014] [Accepted: 10/18/2014] [Indexed: 11/22/2022]
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36
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Abstract
Oral mucosal disease has a variety of causes, some of which are due to dysfunction of the immune system. Recurrent aphthous stomatitis and oral lichen planus are the mucosal diseases of unknown cause seen most frequently in dental practice, and the most likely mucosal diseases for which a dentist will prescribe. This paper briefly reviews the clinical features of these conditions, their causation and pertinent information for managing them in a primary care setting. The prescribing of appropriate medications to treat the conditions in a general dental practice is described and discussed.
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Le Doare K, Hullah E, Challacombe S, Menson E. Fifteen-minute consultation: a structured approach to the management of recurrent oral ulceration in a child. Arch Dis Child Educ Pract Ed 2014; 99:82-6. [PMID: 24052593 DOI: 10.1136/archdischild-2013-304471] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To present a structured approach for an outpatient consultation of a child with recurrent mouth ulcers. METHOD Review of literature and description of approach followed in our unit. CONCLUSIONS The literature emphasises the need to consider local and systemic causes for oral ulceration in a child. Focused history and examination are key in establishing the cause and in order to ensure appropriate management.
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Affiliation(s)
- Kirsty Le Doare
- Department of Paediatric Infectious Diseases, Evelina Children's Hospital, London, UK
| | - Esther Hullah
- Department of Oral Medicine, Guys's and St Thomas' Hospital NHS Trust, London, UK
| | - Stephen Challacombe
- Department of Oral Medicine, Guys's and St Thomas' Hospital NHS Trust, London, UK
| | - Esse Menson
- Department of Paediatric Infectious Diseases, Evelina Children's Hospital, London, UK
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39
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Abstract
Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease affecting the oral mucosa. RAS occurs mostly in healthy individuals and has an atypical clinical presentation in immunocompromised individuals. The etiology of RAS is still unknown, but several local, systemic, immunologic, genetic, allergic, nutritional, and microbial factors, as well as immunosuppressive drugs, have been proposed as causative agents. Clinical management of RAS using topical and systemic therapies is based on severity of symptoms and the frequency, size, and number of lesions. The goals of therapy are to decrease pain and ulcer size, promote healing, and decrease the frequency of recurrence.
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Affiliation(s)
- Sunday O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Martin S Greenberg
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA 19104, USA
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40
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Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz) 2013; 62:205-15. [PMID: 24217985 PMCID: PMC4024130 DOI: 10.1007/s00005-013-0261-y] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 10/28/2013] [Indexed: 12/31/2022]
Abstract
Recurrent aphthous stomatitis (RAS; recurrent aphthous ulcers; canker sores) belongs to the group of chronic, inflammatory, ulcerative diseases of the oral mucosa. Up to now, the etiopathogenesis of this condition remains unclear; it is, however, considered to be multifactorial. The results of currently performed studies indicate that genetically mediated disturbances of the innate and acquired immunity play an important role in the disease development. Factors that modify the immunologic response in RAS include: food allergies, vitamin and microelement deficiencies, hormonal and gastrointestinal disorders (e.g., celiac disease, Crohn’s disease, ulcerative colitis), some viral and bacterial infections, mechanical injuries and stress. In this paper, we presented the main etiopathogenetic factors of RAS with a special emphasis on the mechanisms of the immune response modification. Moreover, we discussed the crucial clinical symptoms and types of RAS together with epidemiologic data based on the current medical literature reports and our own observations.
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Affiliation(s)
- Zuzanna Slebioda
- Department of Oral Mucosa Diseases, University of Medical Sciences, Bukowska 70, 60-812, Poznan, Poland,
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41
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Kalkan G, Yigit S, Karakus N, Baş Y, Pancar GŞ, Balta I. Association between MEFV gene mutations and recurrent aphthous stomatitis in a cohort of Turkish patients. J Dermatol 2013; 40:516-21. [PMID: 23663176 DOI: 10.1111/1346-8138.12159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 03/04/2013] [Indexed: 11/28/2022]
Abstract
Recurrent aphthous stomatitis (RAS) has a multifactorial etiopathogenesis, an interaction between predisposing factors and/or systemic conditions and immunological components in genetically predisposed subjects. The Mediterranean fever (MEFV) gene has already been identified as being responsible for familial Mediterranean fever. Because the association between MEFV gene mutations and Behçet's disease has been reported before in several studies, we considered that the role of MEFV gene mutations should be studied in patients with RAS, because of the clinical similarities of both diseases. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations in a cohort of Turkish patients with RAS. The study population comprised 100 unrelated patients with a clinical diagnosis of RAS and 156 healthy controls. Genomic DNA was isolated and genotyped using polymerase chain reaction and restriction fragment length polymorphism for the four MEFV gene mutations (M694V, M680I, V726A and E148Q). There were statistically significant differences of the MEFV gene mutation carrier rates and allele frequencies between RAS patients and healthy controls (P = 0.042, odds ratio [OR] = 1.9, 95% confidence interval [CI] = 1.01-3.41; and P = 0.039, OR = 1.8, 95% CI = 1.02-3.14, respectively). Even if it is not statistically significant, the E148Q allele frequency was higher in patients with RAS than the control group. A statistically significant increased prevalence of MEFV variants in RAS patients was found. This is the first study to report that missense mutations of MEFV is associated with RAS in the Turkish population.
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Affiliation(s)
- Göknur Kalkan
- Department of Dermatovenerology, Gaziosmanpasa University, Tokat, Turkey.
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42
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Recurrent aphthous stomatitis: genetic aspects of etiology. Postepy Dermatol Alergol 2013; 30:96-102. [PMID: 24278055 PMCID: PMC3834687 DOI: 10.5114/pdia.2013.34158] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 09/03/2012] [Accepted: 09/23/2012] [Indexed: 11/17/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS; recurrent aphthous ulcers - RAU; canker sores) is a chronic inflammatory, ulcerative condition of the oral mucosa. Its prevalence in the general population ranges between 5% and 20%, depending on the method and group studied. The etiopathogenesis of the disease is considered to be multifactorial, but remains still not fully understood. In patients with RAS, an enhanced immunologic response occurs to some trigger factors that may include: mechanical injury, stress or bacterial and viral antigens. Higher prevalence of aphthae in relatives may also indicate the genetic background of the condition. The inheritance of some specific gene polymorphisms, especially those encoding proinflammatory cytokines, which play a role in the formation of aphthous ulcer, may predispose family members to RAS. The purpose of this paper was to present the main clinical features of recurrent aphthous stomatitis, epidemiologic data and crucial etiopathogenetic factors with a special emphasis on genetic background of the condition.
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43
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Baccaglini L, Theriaque DW, Shuster JJ, Serrano G, Lalla RV. Validation of anamnestic diagnostic criteria for recurrent aphthous stomatitis. J Oral Pathol Med 2012; 42:290-4. [PMID: 23106421 DOI: 10.1111/jop.12015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is characterized by painful recurrent oral ulcers and is typically diagnosed via history and clinical examination. Our aim was to validate a set of anamnestic diagnostic criteria (RASDX) to increase the accuracy of RAS diagnosis, particularly when a clinical examination is not feasible. METHODS Participants were enrolled during an unmatched case-control study. RASDX consisted of an initial phone screening using standardized questionnaires and recognition of RAS photographs in the clinic. The proportion of agreement with an examination by an oral medicine expert was calculated. RESULTS A total of 115 participants were scheduled for a clinical diagnostic visit and 11 were withdrawn. The remaining 104 participants were aged 18-50 years, 54% women, 64% White and 20% Hispanic. Of these, all 49 controls with negative RASDX had no clinical ulcers. Of the 54 cases diagnosed with RAS by RASDX, 53 were clinically confirmed to have RAS lesions (99% agreement; exact one-sided 95% CI = 95-100%). CONCLUSIONS RASDX, based on a combination of history and photograph recognition, was highly accurate compared with a diagnosis that employed an oral examination.
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Affiliation(s)
- Lorena Baccaglini
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE 68198-4395, USA.
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Fernandes KS, Kokron CM, Barros MT, Kalil J, Gallottini M. Oral manifestations in patients with hypogammaglobulinemia. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:e19-24. [PMID: 22703644 DOI: 10.1016/j.oooo.2012.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Revised: 01/13/2012] [Accepted: 02/11/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The overall objective of this study was to assess the oral manifestations and their association with immunologic status and health history, of individuals with hypogammaglobulinemia. STUDY DESIGN A case-controlled study of 100 subjects with hypogammaglobulinemia and 93 control individuals was performed. All participants were examined for dental caries, periodontal disease, mucosal lesions/infections, and general oral health problems. Decayed, missing, filled teeth and community periodontal index were recorded. Complete blood count, serum immunoglobulins, and lymphocyte immunophenotyping were measured on the same day of the oral health assessment. RESULTS Individuals with hypogammaglobulinemia showed higher prevalence of enamel hypoplasia and complaints of dry mouth, and lower prevalence of dental caries and periodontal disease. CONCLUSIONS The systemic conditions associated with hypogammaglobulinemia were not associated with enhanced susceptibility to caries, gingivitis, or periodontitis; however, individuals with hypogammaglobulinemia were more likely to report more episodes of recurrent aphthous ulcers compared with control individuals.
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Affiliation(s)
- Karin Sá Fernandes
- Post-graduate student, Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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45
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Jiang XW, Zhang Y, Song GD, Li FF, Peng HY, Yang SK, Sun GL. Clinical evaluation of allicin oral adhesive tablets in the treatment of recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:500-4. [DOI: 10.1016/j.oooo.2011.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/17/2011] [Accepted: 09/18/2011] [Indexed: 02/01/2023]
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46
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La aftosis oral recurrente en Reumatología. ACTA ACUST UNITED AC 2011; 7:323-8. [DOI: 10.1016/j.reuma.2011.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 05/13/2011] [Accepted: 05/17/2011] [Indexed: 12/20/2022]
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47
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DUA KULWINDER, SURAPANENI SRINAVEEN, KURIBAYASHI SHIKO, HAFEEZULLAH MOHAMMED, SHAKER REZA. Protective role of aerodigestive reflexes against aspiration: study on subjects with impaired and preserved reflexes. Gastroenterology 2011; 140:1927-33. [PMID: 21420407 PMCID: PMC3425443 DOI: 10.1053/j.gastro.2011.03.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 01/04/2011] [Accepted: 03/04/2011] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Direct evidence to support the airway protective function of aerodigestive reflexes triggered by pharyngeal stimulation was previously demonstrated by abolishing these reflexes by topical pharyngeal anesthesia in normal subjects. Studies have also shown that these reflexes deteriorate in cigarette smokers. Aim of this study was to determine the influence of defective pharyngeal aerodigestive reflexes on airway protection in cigarette smokers. METHODS Pharyngoglottal Closure reflex; PGCR, Pharyngo-UES Contractile reflex; PUCR, and Reflexive Pharyngeal Swallow; RPS were studied in 15 healthy non-smokers (24.2±3.3 SD y, 7 males) and 15 healthy chronic smokers (27.3±8.1, 7 males). To elicit these reflexes and to evaluate aspiration, colored water was perfused into the hypopharynx at the rate of 1 mL/min. Maximum volume of water that can safely dwell in the hypopharynx before spilling into the larynx (Hypopharyngeal Safe Volume; HPSV) and the threshold volume to elicit PGCR, PUCR, and RPS were determined in smokers and results compared with non-smokers. RESULTS At baseline, RPS was elicited in all non-smokers (100%) and in only 3 of 15 smokers (20%; P<.001). None of the non-smokers showed evidence of laryngeal spillage of water, whereas 12 of 15 smokers with absent RPS had laryngeal spillage. Pharyngeal anesthesia abolished RPS reflex in all non-smokers resulting in laryngeal spillage. The HPSV was 0.61±0.06 mL and 0.76±0.06 mL in non-smokers and smokers respectively (P=.1). CONCLUSIONS Deteriorated reflexive pharyngeal swallow in chronic cigarette smokers predispose them to risks of aspiration and similarly, abolishing this reflex in non-smokers also results in laryngeal spillage. These observations directly demonstrate the airway protective function of RPS.
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Affiliation(s)
- KULWINDER DUA
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin,VA Medical Center, Milwaukee, Wisconsin
| | - SRI NAVEEN SURAPANENI
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - SHIKO KURIBAYASHI
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - MOHAMMED HAFEEZULLAH
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - REZA SHAKER
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin,VA Medical Center, Milwaukee, Wisconsin
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O’Neill I. Efficacy of tumour necrosis factor-α antagonists in aphthous ulceration: review of published individual patient data. J Eur Acad Dermatol Venereol 2011; 26:231-5. [DOI: 10.1111/j.1468-3083.2011.04041.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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50
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Sawair FA. Recurrent aphthous stomatitis: do we know what patients are using to treat the ulcers? J Altern Complement Med 2010; 16:651-5. [PMID: 20569032 DOI: 10.1089/acm.2009.0555] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The objectives of this study were to determine prevalence and types of treatments used by patients with recurrent aphthous stomatitis (RAS), and to study the sources of information about treatments used. METHODS The study was a cross-sectional survey. The participants were 530 students who had a history of RAS and were studying at the University of Jordan, Amman. RESULTS Of the 530 patients, 267 (50.4%) have attempted treatment of RAS. Of those who treated RAS, 86 (32.2%) have used alternative treatments (ATs). Topical anaesthetics/analgesics, antiseptic mouthwashes, and topical steroids represented 84.5% of the conventional medicines used. Of those who used ATs, 34 (39.5%) used tahini, 21 (24.4%) used salt/salt and warm water mouthrinse, and 7 (8.1%) used lemon/lemon salt. The tendency to treat RAS or not was not significantly affected by sociodemographic variables, but ATs were more significantly used by students living in rural areas. Relatives were the most frequently cited source of information about treatment (44.6%), followed by medical practitioners (22.9%), and only 9.4% sought treatment advice from dentists. Interestingly, 7% of the ATs were recommended by health care providers and 38.7% of the conventional treatments were recommended by non-health-care providers including 15 cases of topical steroids. CONCLUSIONS This survey revealed a high prevalence of ATs use among Jordanian patients with RAS. There is a need to educate patients with RAS on the treatment options available to reduce their distress and to improve their quality of life. Health care providers such as medical practitioners and pharmacists are frequently consulted by patients with oral lesions, so they should provide patients with better education in the diagnosis and treatment of oral diseases. Randomized clinical trials are needed to examine the potential usefulness of the commonly used ATs in this study such as tahini/sesame oil in the treatment of RAS.
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Affiliation(s)
- Faleh A Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan.
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