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Yap T, Khor S, Kim JS, Kim J, Kim SY, Kern JS, Martyres R, Varigos G, Chan HT, McCullough MJ, Thomas ML, Scardamaglia L. Intraoral human herpes viruses detectable by PCR in majority of patients. Oral Dis 2020; 27:378-387. [PMID: 32609943 DOI: 10.1111/odi.13523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To identify factors which influence the intraoral prevalence of human herpes viruses (HHVs) using mucosal swabs, saliva samples and qPCR analysis. METHODOLOGY In this cross-sectional observational study, matched saliva and oral swabs were collected from a total of 115 subjects: 70 immunocompetent subjects with no mucosal abnormalities, 22 with mucosal abnormalities and 23 therapeutically immunocompromised individuals. Extracted DNA was analysed by multiplex qPCR for detection and quantification of HHVs 1-6. RESULTS At least one human herpes virus was detected in 77.1% of immunocompetent individuals with no mucosal abnormalities, with EBV the most commonly detected at 61.4%. HHV-6 was detected in 17.1%, HSV-1 in 4.3% and CMV in 1.1%. Detection was higher in saliva than in oral swabs. There was no detection of HSV-2 or VZV. Neither presence of oral mucosal abnormality nor therapeutic immunocompromise was related to increased detection of human herpes virus. CONCLUSION Commensal detection rates of EBV are high, and caution in clinical correlation of positive detection is warranted. Commensal CMV rates are low, and detection is likely to be clinically relevant. This study presents a comprehensive commensal detection rate of HHVs 1-6 by qPCR in saliva and swabs.
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Affiliation(s)
- Tami Yap
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia.,Department of Dermatology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Vic., Australia
| | - Shuan Khor
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - Jung Seo Kim
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - Jaeyoung Kim
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - Sung Yun Kim
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Vic., Australia
| | - Johannes S Kern
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Vic., Australia
| | - Raymond Martyres
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Vic., Australia
| | - George Varigos
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Vic., Australia
| | - Hiu Tat Chan
- Department of Microbiology, Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Michael J McCullough
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Vic., Australia
| | | | - Laura Scardamaglia
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Vic., Australia
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2
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Abstract
Human immunodeficiency virus (HIV)-associated oral disease among people living with HIV infection includes oral candidiasis, oral hairy leukoplakia, Kaposi sarcoma, oral warts, herpes simplex virus ulcers, major aphthous ulcers or ulcers not otherwise specified, HIV salivary gland disease, and atypical gingival and periodontal diseases. Diagnosis of some oral lesions is based on clinical appearance and behavior, whereas others require biopsy, culture, or imaging for definitive diagnosis. Management strategies including pharmacologic and nonpharmacologic approaches are discussed in this article. Dentists also need to be cognizant of the potential oral side effects of HIV antiretroviral medications.
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MESH Headings
- AIDS-Related Opportunistic Infections/diagnosis
- AIDS-Related Opportunistic Infections/therapy
- Antiretroviral Therapy, Highly Active/adverse effects
- Candidiasis, Oral/diagnosis
- Candidiasis, Oral/etiology
- Candidiasis, Oral/therapy
- HIV Infections/complications
- Humans
- Leukoplakia, Hairy/diagnosis
- Leukoplakia, Hairy/etiology
- Leukoplakia, Hairy/therapy
- Mouth Mucosa/pathology
- Mouth Neoplasms/diagnosis
- Mouth Neoplasms/etiology
- Sarcoma, Kaposi/diagnosis
- Sarcoma, Kaposi/etiology
- Sarcoma, Kaposi/therapy
- Sialadenitis/diagnosis
- Sialadenitis/etiology
- Sialadenitis/therapy
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Affiliation(s)
- Lauren L Patton
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Room 467A, Brauer Hall, Chapel Hill, NC 27599-7450, USA.
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3
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Gallo CB, Borra RC, Rodini CO, Nunes FD, Sugaya NN. CC chemokine ligand 3 and receptors 1 and 5 gene expression in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 114:93-8. [PMID: 22727097 DOI: 10.1016/j.oooo.2012.02.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 01/27/2012] [Accepted: 02/29/2012] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the local and systemic expression of CC-chemokine ligand 3 (CCL3) and its receptors (CCR1 and CCR5) in tissue samples and peripheral blood mononuclear cells of recurrent aphthous stomatitis (RAS) patients. STUDY DESIGN This case-control study enrolled 29 patients presenting severe RAS manifestations and 20 non-RAS patients proportionally matched by sex and age. Total RNA was extracted from biopsy specimens and peripheral blood mononuclear cells for quatitative reverse-transcription polymerase chain reaction. The data obtained by relative quantification were evaluated by the 2(-ΔΔCt) method, normalized by the expression of an endogenous control, and analyzed by Student t test. RESULTS The results demonstrated overexpression in RAS tissue samples of all of the chemokines evaluated compared with healthy oral mucosa, whereas the blood samples showed only CCR1 overexpression in RAS patients. CONCLUSIONS These findings suggest that the increased expression of CCL3, CCR1, and CCR5 may influence the immune response in RAS by T(H)1 cytokine polarization.
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Affiliation(s)
- Camila B Gallo
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil.
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5
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Pereira CM, de Almeida OP, Corrêa MEP, Costa FF, de Souza CA, Barjas-Castro ML. Detection of human herpesvirus 6 in patients with oral chronic graft-vs-host disease following allogeneic progenitor cell transplantation. Oral Dis 2007; 13:329-34. [PMID: 17448218 DOI: 10.1111/j.1601-0825.2006.01294.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Chronic graft-vs-host disease (cGVHD) is a major cause of morbidity in long-term survivors of allogeneic hematopoietic progenitor cell transplantation. Herpesviruses are involved in the occurrence and progression of various oral diseases. AIM The aim of this study was to investigate the role of human herpesvirus 6 (HHV6) in patients with oral manifestations of cGVHD. MATERIALS AND METHODS Peripheral blood and oral fluids (whole saliva, gingival crevicular fluid and parotid gland saliva) from 19 cGVHD patients, and 28 blood donors were examined for HHV6. Oral tissue samples were collected from 12 cGVHD patients and 12 healthy individuals. Nested polymerase chain reaction was employed to identify the HHV6. RESULTS AND CONCLUSION The virus was detected in whole saliva in 13 cGVHD patients (68%) and in 19 blood donors (67%). HHV6 was not identified in any of the gingival crevicular fluid and parotid gland saliva samples in cGVHD patients. In the control group 14.3% of both, four gingival crevicular fluid and four parotid gland saliva samples were positive. Two oral tissue samples of cGVHD patients were positive for HHV6. These results indicate that patients with oral manifestations of cGVHD and healthy individuals present high and similar incidence of HHV6 in blood and oral fluids. These data do not support the importance of HHV6 in oral lesions of cGVHD.
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Affiliation(s)
- C M Pereira
- Oral Semiology and Oral Pathology, School of Dentistry of Piracicaba, State University of Campinas, São Paulo, Brazil.
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6
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Abstract
Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is a common condition which is characterized by multiple recurrent small, round or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors typically presenting first in childhood or adolescence. RAS occurs worldwide although it appears most common in the developed world. The aetiology of RAS is not entirely clear. Despite many studies trying to identify a causal microorganism, RAS does not appear to be infectious. A genetic predisposition is present, as shown by strong associations with genotypes of IL-1beta; IL-6 in RAS patients, and a positive family history in about one-third of patients with RAS. Haematinic deficiency is found in up to 20% of patients. Cessation of smoking may precipitate or exacerbate RAS in some cases. Ulcers similar to RAS may be seen in human immunodeficiency virus disease and some other immune defects, and drugs, especially non-steroidal anti-inflammatory drugs and nicorandil may produce lesions clinically similar to RAS. Topical corticosteroids can often control RAS. However, the treatment of RAS remains unsatisfactory, as most therapies only reduce the severity of the ulceration and do not stop recurrence.
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Affiliation(s)
- S Jurge
- Oral Medicine, Eastman Dental Institute, University College London, UK
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7
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Abstract
Ulcers commonly occur in the oral cavity, their main symptom being pain. There are different ways to classify oral ulcers. The most widely accepted form divides them into acute ulcers--sudden onset and short lasting--and chronic ulcers--insidious onset and long lasting. Commonest acute oral ulcers include traumatic ulcer, recurrent aphthous stomatitis, viral and bacterial infections and necrotizing sialometaplasia. On the other hand, oral lichen planus, oral cancer, benign mucous membrane pemphigoid, pemphigus and drug-induced ulcers belong to the group of chronic oral ulcers. It is very important to make a proper differential diagnosis in order to establish the appropriate treatment for each pathology.
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Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina Bucal y Periodoncia, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, Spain
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Victória JMN, Guimarães ALS, da Silva LM, Kalapothakis E, Gomez RS. Polymerase chain reaction for identification of herpes simplex virus (HSV-1), cytomegalovirus (CMV) and human herpes virus-type 6 (HHV-6) in oral swabs. Microbiol Res 2005; 160:61-5. [PMID: 15782939 DOI: 10.1016/j.micres.2004.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Considering that sensitive and specific methods to detect HSV-1, CMV and HHV-6 on oral mucosa have a great impact on oral diagnosis practice and research, together with the evidence that PCR is a rapid and reliable method, the purpose of the present study was to develop primer sets to detect HSV-1, CMV and HHV-6 in oral swabs by nested polymerase chain reaction (nested PCR). We developed a practical method for sample collection without tissue trauma, and the swabs were stored until used for DNA extraction. After the nested PCR a DNA fragment of 241 bp corresponding to HSV-1 was amplified. DNA fragments of 224 and 369 bp were amplified corresponding to CMV and HHV-6, respectively. DNA sequencing analysis confirmed the expected sequences of each virus. In conclusion, it was demonstrated that these new primer sets are able to identify HSV-1, CMV and HHV-6 in oral swab using nested PCR.
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Affiliation(s)
- Jùnia Maria Netto Victória
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, CEP 31270 901 Belo Horizonte-MG, Brazil
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Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg 2004; 33:221-34. [PMID: 15287304 DOI: 10.1006/ijom.2002.0446] [Citation(s) in RCA: 166] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Recurrent aphthous ulcers represent a very common but poorly understood mucosal disorder. They occur in men and women of all ages, races and geographic regions. It is estimated that at least 1 in 5 individuals has at least once been afflicted with aphthous ulcers. The condition is classified as minor, major, and herpetiform on the basis of ulcer size and number. Attacks may be precipitated by local trauma, stress, food intake, drugs, hormonal changes and vitamin and trace element deficiencies. Local and systemic conditions, and genetic, immunological and microbial factors all may play a role in the pathogenesis of recurrent aphthous ulceration (RAU). However, to date, no principal cause has been discovered. Since the aetiology is unknown, diagnosis is entirely based on history and clinical criteria and no laboratory procedures exist to confirm the diagnosis. Although RAU may be a marker of an underlying systemic illness such as coeliac disease, or may present as one of the features of Behcet's disease, in most cases no additional body systems are affected, and patients remain otherwise fit and well. Different aetiologies and mechanisms might be operative in the aetiopathogenesis of aphthous ulceration, but pain, recurrence, self-limitation of the condition, and destruction of the epithelium seem to be the ultimate outcomes. There is no curative therapy to prevent the recurrence of ulcers, and all available treatment modalities can only reduce the frequency or severity of the lesions.
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Affiliation(s)
- S S Natah
- Gastrointestinal Research Group, Department of Physiology & Biophysics, University of Calgary, AB, Canada;
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10
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Victória JMN, Kalapothakis E, Silva JDFC, Gomez RS. Helicobacter pylori DNA in recurrent aphthous stomatitis. J Oral Pathol Med 2003; 32:219-23. [PMID: 12653861 DOI: 10.1034/j.1600-0714.2003.00136.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Considering not only the fact that recurrent aphthous stomatitis (RAS) and stomach ulcers are immunologically mediated ulcers associated with Helicobacter pylori, but also the recent evidence that anaemia can be associated with both diseases, and the discovery of H. pylori in the oral mucosa led us to hypothesize that this bacteria may be related to RAS pathogenesis. METHODS Thirty-six consecutive subjects affected by minor and major forms of RAS and 48 healthy volunteers were included in the present study. The nested polymerase chain reaction (PCR) technique was used to detect the presence of H. pylori in the oral lesion, the normal contralateral mucosa of patients affected by RAS and the oral mucosa of control subjects. The chi2- and Fisher's tests were used for statistical analysis. RESULTS No association between RAS lesions and H. pylori was observed. However, 14 out of 36 (38.9%) of the patients with RAS were found to show the presence of H. pylori DNA in the lesion and/or contralateral mucosa. Sixteen out of 48 (33.3%) of the patients without RAS (control subjects) were positive (P > 0.05). CONCLUSION The present study does not give support to the assumption that H. pylori could be involved in RAS development.
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Affiliation(s)
- Júnia Maria Netto Victória
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Avenue Antonio Carlos 6627, Belo Horizonte-MG, Brazil CEP 31270-901
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11
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Abstract
OBJECTIVE It was hypothesized that serum levels of immunoglobulins may play a role in the pathogenesis of oral mucosal diseases, or reflect clinical changes in these conditions, but little is known about the role of salivary immunoglobulins in the pathogenesis of these diseases. The aim of this study was to investigate possible alterations in salivary immunoglobulin A (IgA) and IgG subclasses in patients with oral mucosal inflammatory diseases. SUBJECTS AND METHODS Levels of IgG1, IgG2, IgG3 and IgG4 were determined by enzyme-linked immunosorbent assay (ELISA), and IgA1 and IgA2 by radial immunodiffusion in the resting whole saliva of 31 patients with acute recurrent aphthous ulceration (RAU) (and followed in remission), 11 patients with chronic hyperplastic candidal infection (CHC), 12 patients with Sjogren's syndrome (SS), six patients with oral lichen planus (OLP), and 18 healthy volunteers using the normal saliva as a comparison point for all. RESULTS IgG and IgA subclasses were increased in OLP. In CHC all IgG subclasses were increased while IgA1 was decreased, IgG1, IgG3 and IgG4 levels were increased in SS, while all IgG subclasses as well as IgA2 were increased in acute RAU in comparison with healthy controls. No differences in any immunoglobulin subclasses between major and minor acute RAU were found. In remission, IgG1 and IgG4 returned to normal values while IgG2, IgG3, and IgA2 remained increased in patients with RAU. CONCLUSION Salivary immunoglobulin subclasses vary in different oral mucosal conditions and may play a role in oral mucosal inflammatory diseases and/or reflect clinical changes in these conditions.
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Affiliation(s)
- S Sistig
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Croatia.
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13
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Abstract
Pediatricians play an important role in promoting oral health care, and their advice regarding dental procedures or therapies may be solicited. This review is intended to provide answers for the more common questions that parents may have regarding the oral health of their children. The controversies surrounding early orthodontic therapy and mercury-containing amalgam fillings continue to be areas of contention. Why does the orthodontist want to initiate orthodontic treatment in a 7-year-old child? Is there justification for the banning of amalgam fillings, as has occurred in some countries? Also explored are the current therapies for two of the more common oral mucosal disorders: aphthous ulcers and recurrent herpes simplex labialis. These subjects have relevance not only for pediatric patients but also for adults (and for many providers) as well.
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Affiliation(s)
- A Sonis
- Department of Growth and Development, Harvard School of Dental Medicine, and Department of Dentistry, Children's Hospital, Boston, Massachusetts, USA.
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Affiliation(s)
- S R Porter
- University College London, London, England, UK
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