Thyroid autoimmunity associated with recurrent aphthous stomatitis

Assessing the thyroid autoimmunity association with recurrent aphthous stomatitis

BACKGROUND

Recent investigations have highlighted autoimmune origins and abnormal immune responses; particularly those related to T cell-mediated immunity and elevated T lymphocyte cells in the oral mucosa. Therefore, we investigated the relationship between recurrent aphthous stomatitis (RAS) and autoimmune thyroid diseases (ATDs) in an Iranian population.

METHODS

A cross-sectional study was performed on 102 patients diagnosed with ATD (cases) and 102 healthy patients (controls) who had been referred for the routine dental treatment. All participants were asked for the history of RAS and their age, gender, other systemic diseases, medications, and frequency of RAS in a year. Matching was performed based on the propensity scores for age and sex. In addition, the number of lesions in each recurrence in both groups was assessed and compared. The type of thyroid disease has been assessed for case participants and has been confirmed by the endocrinologist. The chi-square test, t-test, and Mann-Whitney U test were used to analyze the data using SPSS 18.

RESULTS

Patients with ATD had higher RAS than healthy controls (P = 0.040). ATD patients had 1.93 times more risk for RAS, and the frequency of RAS in a year was 3.15times higher in these patients (P = 0.011). Moreover, the frequency of RAS was higher in patients with hypothyroidism than in those with hyperthyroidism. However, there were no significant differences in the size and the number of lesions between the groups.

CONCLUSION

The risk and frequency of RAS were significantly higher in patients with ATDs. This would provide valuable insights into the underlying mechanisms and potential treatment strategies for both conditions.

Risk of cancer in patients with recurrent aphthous stomatitis in Korea: A nationwide population-based study

The relationship between recurrent aphthous stomatitis (RAS), a common mucosal lesion, and cancer has not been demonstrated. This study investigated the risk for developing cancer in patients with RAS, based on data from Korea's National Health Insurance Sharing Service (NHISS). Nationwide population-based cohort data from 2005 to 2009 provided by the NHISS was used. The group diagnosed with RAS for 5 years and an undiagnosed control group were constructed through 1:1 propensity score matching (PSM). The experimental design compared the incidence rate of a cancer diagnosis from 2010 to 2015 between these 2 groups. After identifying 13,808 people that met our inclusion criterion from a 1 million cohort group, 13,808 controls were included in the study through PSM. Among all cancers, pancreatic cancer had an adjusted hazard ratio of 1.26 (95% confidence interval: 1.01-1.57, P < .041). For the rest of the cancers, there was no significant incidence rate. RAS was associated with an increased risk of pancreatic cancer in the analysis using large population-based cohort data. Further long-term follow-up studies are needed.

Salivary Alpha-Amylase Enzyme, Psychological Disorders, and Life Quality in Patients with Recurrent Aphthous Stomatitis

Objective. The aim of this study was to evaluate stress, anxiety, and salivary alpha-amylase (SAA) activity in patients with recurrent aphthous stomatitis (RAS). The impact of this disease on the life quality was also evaluated. Design. Twenty-two patients with RAS and controls, matched by sex and age, were selected. Stress and anxiety were assessed using Lipp's Inventory of Stress Symptoms and Beck Anxiety Inventory. Life quality was assessed through the World Health Organization Quality of Life-bref (WHOQOL-BREF) and the Oral Health Impact Profile-14 (OHIP-14). Saliva samples were collected in the morning and afternoon and the SAA activity was analyzed by enzymatic kinetic method. Results. No significant difference was observed between the groups regarding the SAA activity (p = 0.306). Patients with RAS had higher scores of anxiety (p = 0.016). The scores of WHOQOL-BREF were significantly lower in patients with RAS. The values obtained through OHIP-14 were significantly higher in these patients (p = 0.002). Conclusion. RAS negatively affects the life quality. Patients with the disease have higher levels of anxiety, suggesting its association with the etiopathogenesis of RAS.

Is there any relationship between recurrent oral aphthous stomatitis and prediabetes?

Periodontal disease has been associated with glycaemia. Recurrent aphthous stomatitis (RAS) is one of the most common oral lesions and is characterized by painful recurrent oral ulcers. However, the exact cause and treatment of RAS is not yet well-known. Furthermore, there is still unknown the relationship between RAS and glycaemia. Prediabetes has shown to have role on worse metabolic profile. However, there is still no data on the relationship between prediabetes and clinical RAS. Therefore, the purpose of this hypothesis is to assess whether the prediabetes aggravate RAS.

Levels of salivary IgA in patients with minor recurrent aphthous stomatitis: a matched case-control study

OBJECTIVES

Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease. Despite plenty of studies on aetiopathogenesis of RAS, a definite cause is not clear. The objective of this study was to determine the potential changes of salivary IgA and salivary flow rate in patients affected with minor form of RAS.

MATERIALS AND METHODS

Levels of salivary IgA in 33 patients with acute RAS (minor form) and 33 matched healthy controls were determined using enzyme-linked immunosorbent assay. Resting salivary flow rates were determined too. Both measurements, levels of salivary IgA and resting salivary flow rate, were performed again for each RAS patient in remission phase.

RESULTS

Levels of salivary IgA were significantly increased in acute phase of RAS [median (interquartile range)-124.94 μg/mL (106.22-136.31)] in comparison with the levels in healthy controls [88.92 μg/mL (76.85-93.91; P < 0.001)] and with the levels in remission phase [102.4 μg/mL (84.6-120.16; P = 0.01)]. Even in the disease-free period (remission phase), levels of salivary IgA remained significantly higher in comparison with the levels in healthy controls (P = 0.01). Salivary flow rates, on the other side, were not influenced by the disease state (RAS vs. healthy), phase (acute vs. remission) or even gender (males vs. females).

CONCLUSION

Marked increase of salivary IgA in acute and remission phases of the minor RAS may suggest a potential role for this immunoglobulin in pathogenesis of the disease.

CLINICAL RELEVANCE

Salivary IgA may be an important aetiological agent in the pathogenesis of RAS, and hence, its immunomodulation may help prevent the disease.