1
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Xiao X, Shi Z, Song Y, Li K, Liu S, Song Z. Oral microbiota in active and passive states of recurrent aphthous stomatitis: An analysis of case-control studies. Arch Oral Biol 2023; 153:105751. [PMID: 37379635 DOI: 10.1016/j.archoralbio.2023.105751] [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: 01/25/2023] [Revised: 05/21/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE This study was presented to reveal the most distinct microbial prevalence in recurrent aphthous stomatitis (RAS) lesions compared to healthy controls. DESIGN The case-control studies were selected in electronic databases until Nov 2022 with key search terms, and the eligible publications were screened and analyzed by independent authors. RESULTS A total of 14 studies were identified, which included 531 cases of active states of RAS (AS-RAS), 92 cases of passive states of RAS (PS-RAS) and 372 healthy controls. The most sample pattern was the mucosa swab performed in 8 of 14 studies, biopsies in 3 studies, followed by micro-brush, and saliva. A variety of bacteria in higher or lower abundance were observed in RAS lesions. CONCLUSIONS The etiopathogenesis of RAS may not be ascribed to a single pathogen. A possible explanation is that microbial interactions modify immune response or destroy the epithelial integrity, thus contributing to the development of the condition.
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Affiliation(s)
- Xuan Xiao
- Department of Oral Mucosa, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Zhaocheng Shi
- Department of Oral Mucosa, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Yuhan Song
- Department of Oral Mucosa, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Kaiyi Li
- Department of Oral Mucosa, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Shangfeng Liu
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.
| | - Zhifeng Song
- Department of Oral Mucosa, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.
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2
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Cai X, Shi W, Lian J, Zhang G, Cai Y, Zhu L. Characterization of immune landscape and development of a novel N7-methylguanine-related gene signature to aid therapy in recurrent aphthous stomatitis. Inflamm Res 2023; 72:133-148. [PMID: 36352034 DOI: 10.1007/s00011-022-01665-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Recurrent aphthous stomatitis (RAS) is the most common inflammatory disease of the oral mucosa resulting in an impaired life quality and even leading to tumors in susceptible populations. N7-Methylguanine (m7G) plays a vital role in various cellular activities but has not yet been investigated in RAS. We aimed at picturing the immune landscape and constructing an m7G-related gene signature, and investigating candidate drugs and gene-disease association to aid therapy for RAS. METHODS For our study, m7G-related differentially expressed genes (DEGs) were screened. We outlined the immune microenvironment and studied the correlations between the m7G-related DEGs and immune cells/pathways. We performed functional enrichment analyses and constructed the protein-protein interaction (PPI) and multifactor regulatory network in RAS. The m7G-related hub genes were extracted to formulate the corresponding m7G predictive signature. RESULTS We obtained 11 m7G-related DEGs and studied a comprehensive immune infiltration landscape, which indicated several immune markers as possible immunotherapeutic targets. The PPI and multifactor regulatory network was constructed and 4 hub genes (DDX58, IFI27, IFIT5, and PML) were identified, followed by validation of the corresponding m7G predictive signature for RAS. GO and KEGG analyses revealed the participation of JAK-STAT and several immune-related pathways. Finally, we suggested candidate drugs and gene-disease associations for potential RAS medical interventions. CONCLUSIONS The present study pictured a comprehensive immune infiltration landscape and suggested that m7G played a vital role in RAS through immune-related pathways. This study provided new insight for the future investigation of the mechanisms and therapeutic strategies for RAS.
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Affiliation(s)
- Xueyao Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Wenjun Shi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Jie Lian
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Guoyou Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Yuchen Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China.
| | - Lian Zhu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China.
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3
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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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4
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Kim TJ, Lee H. Benefits of Helicobacter pylori Eradication on Extragastric Diseases. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2021. [DOI: 10.7704/kjhugr.2021.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Helicobacter pylori (H. pylori) eradication can reduce the risk of gastric diseases such as gastritis, gastric ulcer, and gastric adenocarcinoma. Since H. pylori was discovered more than 30 years ago, many studies have reported associations between H. pylori infection and extragastric diseases such as immune thrombocytopenia and iron-deficiency anemia. Thus, recent guidelines recommended H. pylori eradication in patients with those diseases. In contrast, although the role of H. pylori eradication in other extragastric diseases remains controversial, there is growing evidence of its benefit on them, especially cardiovascular (ischemic heart disease and stroke), metabolic (dyslipidemia, diabetes mellitus, and non-alcoholic fatty liver disease), neurodegenerative (Parkinson’s disease and Alzheimer’s disease), autoimmune (Graves’ disease, Hashimoto’s thyroiditis, Raynaud’s syndrome, rosacea, and chronic urticaria), and other (cap polyposis, colorectal mucosa-associated lymphoid tissue lymphoma, periodontal disease, hyperemesis gravidarum, and osteoporosis) conditions. A recent prospective randomized study reported that H. pylori eradication improved insulin resistance and dyslipidemia. These findings were consistent with the results of a recent meta-analysis. Therefore, well-designed prospective interventional studies are needed to examine the effects of H. pylori eradication on various extragastric diseases.
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5
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Tsimpiris A, Grigoriadis A, Tsolianos I, Moschos I, Goulis DG, Kouklakis G. Periodontitis and Helicobacter pylori Infection: Eradication and Periodontal Therapy Combination. Eur J Dent 2021; 16:145-152. [PMID: 34598295 PMCID: PMC8890927 DOI: 10.1055/s-0041-1731928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objectives
This study was aimed to assess (1) the prevalence of salivary and gastric
Helicobacter pylori
(HP) infection in patients with and without periodontitis, (2) the prevalence of HP infection in patients with periodontitis according to its clinical classification, (3) the effect of periodontitis treatment in patients with or without gastric HP infection, and (4) if gastric HP eradication in combination with periodontitis treatment influences periodontitis clinical outcome.
Materials and Methods
Thirty-three adults with periodontitis treated by quadrant scaling and root planning (QSRP). The simplified plaque index (PI), bleeding on probing index (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed pretreatment and 3 months of posttreatment. The patients were tested for oral and gastric HP. Gastric HP (+) patients received eradication therapy. A control group of 32 periodontically healthy volunteers was tested for oral and gastric HP. Saliva samples were evaluated by real-time polymerase chain reaction (rtPCR); gastric HP was detected by urea breath test (UBT).
Statistical Analysis
Normality of variables assessed by the Kolmogorov–Smirnov test, while the differences of pre- and post-treatment were analyzed by paired samples
t
-test. Differences between subgroups were compared by a Student’s
t
-test or a Mann–Whitney
U
-test. Comparisons of nominal variables were made by Pearson’s Chi-square test.
Results
No saliva samples were positive for HP. Gastric HP was detected in six patients with periodontitis and seven controls (
p
> 0.05). HP infection affected patients with higher disease stages and grades. All HP (+) patients underwent successful eradication treatment. All clinical periodontitis indices improved following QSRP. HP (+) patients who received QSRP as adjunctive to eradication treatment showed improvement in BOP (
p
< 0.001), PI (
p
< 0.013), and CAL (
p
< 0.004) compared with HP (−) patients who received QSRP alone.
Conclusion
Periodontitis was not associated with gastric HP infection. Saliva was not a gastric HP supply reservoir. Gastric HP infection was associated with advanced stages and grades of periodontitis. Although all periodontal clinical markers improved after QSRP, BOP, PI, and CAL, they were further improved when combined with eradication treatment. Periodontal evaluation and treatment combined with HP eradication are recommended in patients with HP gastric infection.
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Affiliation(s)
- Athanasios Tsimpiris
- Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Andreas Grigoriadis
- Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece.,Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Tsolianos
- Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Moschos
- Department of Nursing, International Hellenic University, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Kouklakis
- A' Department of Pathology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Recurrent Aphthous Stomatitis Improved after Eradication Therapy for Helicobacter pylori. Case Rep Gastrointest Med 2021; 2021:5543838. [PMID: 33859848 PMCID: PMC8024073 DOI: 10.1155/2021/5543838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 01/22/2023] Open
Abstract
Helicobacterpylori (H. pylori) is a Gram-negative bacterium that colonizes gastric mucosa and is often transmitted through direct contact with saliva, contaminated food or water, and vomit. The majority of the infected individuals remain asymptomatic for a long period. Infection with H. Pylori often presents with dyspepsia, nausea, frequent belching, bloating, abdominal discomfort, burning abdominal pain, and peptic ulcer. A potential association between H. Pylori and recurrent aphthous stomatitis was previously reported; however, the presence of causative relationship between the two remained controversial. We are presenting a case of recurrent aphthous stomatitis of twenty-four-year history resolved after H. pylori treatment.
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7
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Zhu Z, He Z, Xie G, Fan Y, Shao T. Altered oral microbiota composition associated with recurrent aphthous stomatitis in young females. Medicine (Baltimore) 2021; 100:e24742. [PMID: 33725829 PMCID: PMC7969233 DOI: 10.1097/md.0000000000024742] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/22/2021] [Indexed: 01/05/2023] Open
Abstract
Oral microbiota has been implicated in pathogenesis of recurrent aphthous stomatitis (RAS), which is a common mucosal disorder with unclear etiology. This study has explored the association between oral microbiota disorder and RAS in high-risk young female population.Forty-five young females were enrolled, including 24 RAS patients and 21 healthy individuals. Oral microbiome was analyzed by Illumina Miseq sequencing.Oral microbiota associated with RAS was characterized by the lower alpha-diversity indices (Chao1 and ACE). Several infectious pathogens increased in RAS, such as genera Actinobacillus, Haemophilus, Prevotella and Vibrio. The PICRUSt analysis indicated that the oral microbiota might be related with the up-regulation of genes involving infectious and neurodegenerative diseases, environmental adaptation, the down-regulation of genes involving basal metabolism, such as carbohydrate, energy, and amino acid metabolism.This study indicated that oral microbiota may play a significant role in RAS development.
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Affiliation(s)
- Zhengyang Zhu
- The first clinical college, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Zhixing He
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Guanqun Xie
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yongsheng Fan
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Tiejuan Shao
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
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8
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Mazzoleni DS, Mazzoleni F, Mazzoleni LE, Francesconi CFDM, Milbradt TC, Uchoa DM, Birnfeld HR, Andrighetto LV, Ries SADS, Simon D, Talley NJ. Helicobacter pylori and other factors in recurrent aphthous stomatitis: A cross-sectional study. Oral Dis 2021; 28:390-397. [PMID: 33386646 DOI: 10.1111/odi.13765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/03/2020] [Accepted: 12/19/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the role of Helicobacter pylori and other risk factors in recurrent aphthous stomatitis (RAS). METHODS Patients with functional dyspepsia responded to questionnaires regarding demographic and clinical data, anxiety and depression, and a specific RAS questionnaire. They underwent upper digestive endoscopy and H. pylori evaluation. RESULTS 476 patients were included and of the 372 evaluated for H. pylori, 65.6% were H. pylori-positive. RAS was reported by 32.6% (155/476). In the bivariate analysis of the 372 patients evaluated for gastric H. pylori status, positive subjects had a lower RAS prevalence (29.9%; 73/244) than H. pylori-negative (41.4%; 53/128) (p = .026). Smoking (p = .005) and older age (p = .034) were also associated with a lower prevalence, while female gender (p = .032) and lower income (p = .046) presented higher RAS prevalence. In the multivariate analysis, H. pylori infection (p = .017), smoking (p = .001), and older age (p = .013) were protective factors, while lower income (p = .030) and anxiety (p = .042) were risk factors. In the multivariate analysis of all patients, female gender, lower income, and more schooling years were risk factors. CONCLUSIONS An unexpected lower prevalence of RAS was found in H. pylori-positive patients. Smoking, sex, age, income, education, and anxiety were associated with RAS.
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Affiliation(s)
- Daniel Schebela Mazzoleni
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Mazzoleni
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luiz Edmundo Mazzoleni
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Fernando de Magalhães Francesconi
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tobias Cancian Milbradt
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Clinical Research Unit, Hospital Ernesto Dornelles, Porto Alegre, Brazil
| | - Diego Mendonça Uchoa
- Department of Pathology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Luiza Vitelo Andrighetto
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Daniel Simon
- Human Molecular Genetics Laboratory, Universidade Luterana do Brasil, Canoas, Brazil
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Oral mucosal pellicle as an immune protection against micro-organisms in patients with recurrent aphthous stomatitis: A hypothesis. Med Hypotheses 2020; 146:110449. [PMID: 33359920 DOI: 10.1016/j.mehy.2020.110449] [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] [Received: 09/22/2020] [Revised: 10/29/2020] [Accepted: 12/02/2020] [Indexed: 12/12/2022]
Abstract
Recurrent Aphthous Stomatitis (RAS) is the most common ulcerative diseases of oral mucosa affecting an estimate of 20% of the world's population. Majority of the people affected by RAS are under 30 years of age. RAS is located on the lining (non-keratinized) oral mucosa, i.e. buccal mucosa, lateral side of the tongue, soft palate, lip mucosa, or the floor of mouth. An aphthous ulcer develops when lymphocytic cells infiltrate into the epithelium and cause an edema due to transient inflammatory stimuli. Bacteria, viruses and fungi have been suggested to cause aphthous lesions, but findings regarding oral pathogens are conflicting. Prior consensus has been that RAS is a multifactorial condition, with microbes, allergies, nutritional deficiencies, genetic factors, certain illnesses, immunodeficiency, hormonal changes, trauma and stress among others, contributing to the condition. In spite of many suggestions and investigations, the etiology and pathophysiology of RAS remains uncertain. Our hypothesis focuses on mucin proteins that have been shown to play a role in the formation of protective mucosal pellicle, which serves as the first line of defense between oral epithelium and pathogens within the oral cavity. Mucins, including transmembrane mucin 1 (MUC1), and salivary mucins MUC5B and MUC7 form a protein network that is strongly retained to oral epithelium. The role of the mucosal pellicle in pathophysiology of RAS is unknown. Structural variations have been found in the salivary MUC7 terminal end oligosaccharides in RAS patients, rendering the protein unable to agglutinate pathogens. Furthermore, low levels of MUC1 fail to provide a scaffold for assembly of salivary mucins. We introduce a new hypothesis, the alterations in the structure of these glycoproteins could have a profound impact on the oral mucosal barrier function. On the other hand, micro-organisms secreting their mucolytic enzymes destroy the mucosal pellicle causing oral ulcers.
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10
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Al-Amad S. Helicobacter pylori and gastric hyperacidity, and their association with recurrent aphthous stomatitis. Int J Oral Maxillofac Surg 2020; 49:1599-1604. [DOI: 10.1016/j.ijom.2020.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/12/2020] [Accepted: 05/20/2020] [Indexed: 02/07/2023]
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11
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Kia SJ, Mansourian A, Basirat M, Akhavan M, Mohtasham-Amiri Z, Moosavi MS. New concentration of curcumin orabase in recurrent aphthous stomatitis: A randomized, controlled clinical trial. J Herb Med 2020. [DOI: 10.1016/j.hermed.2020.100336] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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12
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Farhad-Mollashahi L, Honarmand M, Nakhaee A, Kamalzadeh S, Amini S. Salivary levels of IgE and ECP in patients with recurrent aphthous stomatitis. J Clin Exp Dent 2020; 12:e9-e12. [PMID: 31976038 DOI: 10.4317/medoral.56254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 11/04/2019] [Indexed: 11/05/2022] Open
Abstract
Background Recurrent aphthous stomatitis is a common oral mucosa disease, with no specific etiology. Atopy has been implicated in the development of this disease. In this study, the salivary levels of immunoglobulin E (IgE) and eosinophil cationic protein (ECP) were measured as allergy-related biomarkers in patients with aphthous stomatitis. Material and Methods In this case-control study, non-stimulated saliva was collected from 85 participants and IgE and ECP were measured. Data were analyzed in SPSS 20 through the Mann-Whitney test, and p<0.05 was considered significant. Results The salivary levels of IgE and ECP were 1.11±0.65 Iu/ml and 26.93±6.95 ng/ml in the case group and 0.73±0/39 Iu/ml and 21.97±6.72 ng/ml in the control group. There was a significant difference between the two groups in terms of salivary levels of IgE and ECP (p=0.001). Conclusions The results showed that patients with oral aphthous had higher levels of salivary IgE and ECP than controls. Therefore, measurement of these biomarkers may be useful in the initial evaluation of patients with aphthous stomatitis. Key words:Recurrent aphthous stomatitis, saliva, immunoglobulin E, eosinophil cationic protein.
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Affiliation(s)
- Leila Farhad-Mollashahi
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marieh Honarmand
- Oral and Dental Disease Research Center, Department of Oral Medicine, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Nakhaee
- Department of Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Sanaz Amini
- Dentist, Zahedan University of Medical Sciences, Zahedan, Iran
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13
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Farhad-Mollashahi L, Honarmand M, Nakhaee A, Kamalzadeh S, Amini S. Salivary levels of IgE and ECP in patients with recurrent aphthous stomatitis. J Clin Exp Dent 2020. [PMID: 31976038 PMCID: PMC6969959 DOI: 10.4317/jced.56254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Recurrent aphthous stomatitis is a common oral mucosa disease, with no specific etiology. Atopy has been implicated in the development of this disease. In this study, the salivary levels of immunoglobulin E (IgE) and eosinophil cationic protein (ECP) were measured as allergy-related biomarkers in patients with aphthous stomatitis.
Material and Methods In this case-control study, non-stimulated saliva was collected from 85 participants and IgE and ECP were measured. Data were analyzed in SPSS 20 through the Mann-Whitney test, and p<0.05 was considered significant.
Results The salivary levels of IgE and ECP were 1.11±0.65 Iu/ml and 26.93±6.95 ng/ml in the case group and 0.73±0/39 Iu/ml and 21.97±6.72 ng/ml in the control group. There was a significant difference between the two groups in terms of salivary levels of IgE and ECP (p=0.001).
Conclusions The results showed that patients with oral aphthous had higher levels of salivary IgE and ECP than controls. Therefore, measurement of these biomarkers may be useful in the initial evaluation of patients with aphthous stomatitis. Key words:Recurrent aphthous stomatitis, saliva, immunoglobulin E, eosinophil cationic protein.
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Affiliation(s)
- Leila Farhad-Mollashahi
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marieh Honarmand
- Oral and Dental Disease Research Center, Department of Oral Medicine, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Nakhaee
- Department of Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Sanaz Amini
- Dentist, Zahedan University of Medical Sciences, Zahedan, Iran
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14
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Oral Microbiota Composition and Antimicrobial Antibody Response in Patients with Recurrent Aphthous Stomatitis. Microorganisms 2019; 7:microorganisms7120636. [PMID: 31805744 PMCID: PMC6955784 DOI: 10.3390/microorganisms7120636] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
Recurrent aphthous stomatitis (RAS) is the most common disease of the oral mucosa, and it has been recently associated with bacterial and fungal dysbiosis. To study this link further, we investigated microbial shifts during RAS manifestation at an ulcer site, in its surroundings, and at an unaffected site, compared with healed mucosa in RAS patients and healthy controls. We sampled microbes from five distinct sites in the oral cavity. The one site with the most pronounced differences in microbial alpha and beta diversity between RAS patients and healthy controls was the lower labial mucosa. Detailed analysis of this particular oral site revealed strict association of the genus Selenomonas with healed mucosa of RAS patients, whereas the class Clostridia and genera Lachnoanaerobaculum, Cardiobacterium, Leptotrichia, and Fusobacterium were associated with the presence of an active ulcer. Furthermore, active ulcers were dominated by Malassezia, which were negatively correlated with Streptococcus and Haemophilus and positively correlated with Porphyromonas species. In addition, RAS patients showed increased serum levels of IgG against Mogibacterium timidum compared with healthy controls. Our study demonstrates that the composition of bacteria and fungi colonizing healthy oral mucosa is changed in active RAS ulcers, and that this alteration persists to some extent even after the ulcer is healed.
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15
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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: 67] [Impact Index Per Article: 11.2] [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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Saikaly SK, Saikaly TS, Saikaly LE. Recurrent aphthous ulceration: a review of potential causes and novel treatments. J DERMATOL TREAT 2018; 29:542-552. [PMID: 29278022 DOI: 10.1080/09546634.2017.1422079] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose of article: This review examines studies published between May 2012 and 2017 with a specific interest in potential recurrent aphthous ulceration (RAU) etiologies and treatment modalities/efficacy, including topical treatments, systemic regimens, vitamin repletion, and laser therapy, among others. MATERIALS AND METHODS PubMed MEDLINE and Cochrane Database of Systematic Reviews were searched using various combinations of: 'aphthous', 'ulcer', and 'treatment'. The titles and abstracts from the initial literature search were appraised to identify articles for full review and reference sections from each article were searched manually for relevant publications. Both randomized controlled trials and observational reports were included in this review, as some treatment types have not been formally examined in randomized trials. Relevant studies were reviewed, compared, and summarized. RESULTS RAU can result from systemic disease and trauma, but recent studies have shown a variety of potential etiologies, ranging from vitamin deficiencies, oral microbiota derangements, hematological considerations, stress, genetic polymorphisms to oxidant-antioxidant imbalances, among others. Many modalities of therapy are available and have proven efficacious. CONCLUSIONS As the exact etiology of RAU is still unknown, therapy is based on symptomatic relief.
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Affiliation(s)
- Sami Kameel Saikaly
- a Orlando Regional Medical Center , Orlando , FL , USA.,b University of Central Florida College of Medicine , Orlando , FL , USA
| | - Tanya Siham Saikaly
- c University of Alabama at Birmingham School of Dentistry , Birmingham , AL , USA
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17
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Zhang Z, Li S, Fang H. Enzymatic antioxidants status in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2017; 46:817-820. [PMID: 28054386 DOI: 10.1111/jop.12547] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Zichuan Zhang
- Department of Stomatology; Bethune International Peace Hospital; Shijiazhuang China
| | - Shan Li
- Department of Outpatient; Bethune Military Medical School; Shijiazhuang China
| | - Huiqing Fang
- Department of Stomatology; Bethune International Peace Hospital; Shijiazhuang China
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18
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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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19
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Gomes CC, Gomez RS, Zina LG, Amaral FR. Recurrent aphthous stomatitis and Helicobacter pylori. Med Oral Patol Oral Cir Bucal 2016; 21:e187-91. [PMID: 26827061 PMCID: PMC4788798 DOI: 10.4317/medoral.20872] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 10/13/2015] [Indexed: 01/02/2023] Open
Abstract
Background Recurrent aphthous stomatitis (RAS) is a recurrent painful ulcerative disorder that commonly affects the oral mucosa. Local and systemic factors such as trauma, food sensitivity, nutritional deficiencies, systemic conditions, immunological disorders and genetic polymorphisms are associated with the development of the disease. Helicobacter pylori (H. pylori) is a gram-negative, microaerophile bacteria, that colonizes the gastric mucosa and it was previously suggested to be involved in RAS development. In the present paper we reviewed all previous studies that investigated the association between RAS and H. pylori. Material and Methods A search in Pubmed (MEDLINE) databases was made of articles published up until July 2015 using the following keywords: Helicobacter Pylori or H. pylori and RAS or Recurrent aphthous stomatitis. Results Fifteen experimental studies that addressed the relationship between infection with H. pylori and the presence of RAS and three reviews, including a systematic review and a meta-analysis were included in this review. The studies reviewed used different methods to assess this relationship, including PCR, nested PCR, culture, ELISA and urea breath test. A large variation in the number of patients included in each study, as well as inclusion criteria and laboratorial methods was observed. H. pylori can be detected in the oral mucosa or ulcerated lesion of some patients with RAS. The quality of the all studies included in this review was assessed using levels of evidence based on the University of Oxford’s Center for Evidence Based Medicine Criteria. Conclusions Although the eradication of the infection may affect the clinical course of the oral lesions by undetermined mechanisms, RAS ulcers are not associated with the presence of the bacteria in the oral cavity and there is no evidence that H. pylori infection drives RAS development. Key words:Campylobacter, elisa, h. pylori, Helicobacter Pylori, RAS, recurrent aphthous stomatitis, PCR.
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Affiliation(s)
- Carolina-Cavaliéri Gomes
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Av. Antônio Carlos 6627, Pampulha - 31270-901 Belo Horizonte, Minas Gerais, Brazil,
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Wu Y, Liu R, Gu P, Cheng M, Zheng L, Liu Y, Ma P, Ding L. Highly sensitive method for simultaneous determination of nine alkaloids of Shuanghua Baihe tablets in human plasma by LC-MS/MS and its application. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 1007:81-92. [PMID: 26590879 DOI: 10.1016/j.jchromb.2015.10.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 10/10/2015] [Accepted: 10/14/2015] [Indexed: 02/07/2023]
Abstract
Shuanghua Baihe tablets (SBT) is a traditional Chinese medicinal formula which has been used to treat recurrent aphthous stomatitis for many years. To study the pharmacokinetic profiles of berberine, epiberberine, coptisine, palmatine, jatrorrhizine, magnoflorine, berberrubine, corynoline and acetylcorynoline in human after administration of SBT, a sensitive liquid chromatography-tandem mass spectrometry method was developed and fully validated for the simultaneous quantification of these nine alkaloids in human plasma. After protein precipitation, the nine alkaloids in human plasma sample was separated on a Hanbon C18 (150mm×2.1mm, 5μm) column with gradient elution using methanol and 0.5% formic acid water solution, and detected by a triple quadrupole mass spectrometer with an electrospray ionization source. It is a challenge to design different calibration ranges for different analytes in a bioanalytical method for simultaneous determination of multi-analytes in bio-samples. To ensure that each alkaloid in the plasma was determined accurately by the simultaneous quantitation method, the upper limits of quantification for the nine alkaloids were designed at 100, 300, 800, 1800 and 5000pg/mL, respectively, according to the maximum plasma concentration value of each alkaloid obtained from the pilot pharmacokinetic study. The lower limit of quantification was 15pg/mL for berberine, epiberberine, coptisine, magnoflorine, berberrubine, corynoline and acetylcorynoline, while for palmatine and jatrorrhizine it was 1.5pg/mL. This method was successfully applied to investigate the pharmacokinetic profiles of the nine alkaloids in healthy Chinese volunteers after a single oral administration of SBT.
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Affiliation(s)
- Yao Wu
- Department of Pharmaceutical Analysis, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, PR China; Nanjing Clinical Tech Laboratories Inc., 18 Zhilan Road, Jiangning District, Nanjing 211000, PR China
| | - Ruijuan Liu
- Department of Pharmaceutical Analysis, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, PR China; Nanjing Clinical Tech Laboratories Inc., 18 Zhilan Road, Jiangning District, Nanjing 211000, PR China
| | - Pan Gu
- Department of Pharmaceutical Analysis, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, PR China; Nanjing Clinical Tech Laboratories Inc., 18 Zhilan Road, Jiangning District, Nanjing 211000, PR China
| | - Minlu Cheng
- Department of Pharmaceutical Analysis, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, PR China; Nanjing Clinical Tech Laboratories Inc., 18 Zhilan Road, Jiangning District, Nanjing 211000, PR China
| | - Lu Zheng
- Yangtze River Pharmaceutical Group, Taizhou 225321, PR China
| | - Yujie Liu
- Yangtze River Pharmaceutical Group, Taizhou 225321, PR China
| | - Pengcheng Ma
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiangwangmiao Street, Nanjing 210042, PR China
| | - Li Ding
- Department of Pharmaceutical Analysis, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, PR China; Nanjing Clinical Tech Laboratories Inc., 18 Zhilan Road, Jiangning District, Nanjing 211000, PR China.
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21
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Morand GB, Fellmann J, Laske RD, Weisert JU, Soltermann A, Zbinden R, Probst R, Huber GF. Detection ofHelicobacter pyloriin patients with head and neck cancer: Results from a prospective comparative study combining serology, polymerase chain reaction, and rapid urease test. Head Neck 2015; 38:769-74. [DOI: 10.1002/hed.23958] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jonas Fellmann
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Roman D. Laske
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jan U. Weisert
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Alex Soltermann
- Institute of Surgical Pathology, University Hospital Zurich; Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich; Switzerland
| | - Rudolf Probst
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
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Chen DY, Wang K. Association between recurrent oral ulcers and gastrointestinal ulcers caused by Helicobacter pylori infection. Shijie Huaren Xiaohua Zazhi 2015; 23:1028-1031. [DOI: 10.11569/wcjd.v23.i6.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the relevance among Helicobacter pylori (H. pylori) infection, recurrent oral ulcers and peptic ulcers.
METHODS: One hundred and ten patients with recurrent oral ulcers (group A) and 120 patients with peptic ulcers treated at our hospital from January 2012 to December 2013 were included. H. pylori status in the saliva and gastric mucosa was detected, and association among H. pylori infection, recurrent oral ulcers and peptic ulcers was then analyzed.
RESULTS: The rate of H. pylori infection in the gastric mucosa was 45.5% in group A and 94.2% in group B (P < 0.05). The rates of H. pylori infection in the gastric mucosa in patients with superficial or erosive gastritis, gastric ulcers, duodenal ulcers and complex ulcers were 93.3%, 100.0%, 90.0%, and 95.6%, respectively, and the corresponding rates in the saliva were 51.7%, 60.0%, 60.0%, and 20.0% (P < 0.05).
CONCLUSION: There is a possible link between H. pylori infection in the mouse and in the gastrointestinal tract, and whether recurrent oral ulcers caused by H. pylori infection causes gastrointestinal ulcers needs to be further studied.
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Bankvall M, Sjöberg F, Gale G, Wold A, Jontell M, Östman S. The oral microbiota of patients with recurrent aphthous stomatitis. J Oral Microbiol 2014; 6:25739. [PMID: 25626771 PMCID: PMC4221501 DOI: 10.3402/jom.v6.25739] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Specific pathogenic bacteria have been implicated in recurrent aphthous stomatitis (RAS), a chronic inflammatory condition characterised by ulcerations in the oral mucosa. However, the aetiology behind this condition still remains unclear. OBJECTIVE The buccal microbiota of patients with RAS was compared to that of control subjects to investigate its potential role for this condition. DESIGN Buccal swabs were obtained from non-ulcerative areas of 60 patients, of whom 42 patients had lesions at the time of sampling, and 60 healthy age- and gender-matched controls. Bacterial DNA was extracted and analysed by Terminal-Restriction Fragment Length Polymorphism, using enzymatic digestion of the polymerase chain reaction-amplified 16S rRNA gene, yielding a series of peaks, each representing a bacterial taxon. RESULTS Two peaks, 60 and 489, were more prevalent in patients with RAS than controls. Conversely, peaks 58 and 490 were less common in patients than controls. When the patients were divided into subgroups, we found that the observed differences in peak-pattern were related to the presence of lesions during sampling. CONCLUSIONS The microbiota of the non-inflamed buccal mucosa differed between patients and controls. The differences were most pronounced in patients who presented with lesions during sampling, suggesting that a disturbance in the normal buccal microbiota triggers the presence of lesions or that presence of lesions alters the microbiota.
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Affiliation(s)
- Maria Bankvall
- Department of Oral Medicine & Pathology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Fei Sjöberg
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Gita Gale
- Department of Oral Medicine & Pathology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Agnes Wold
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Mats Jontell
- Department of Oral Medicine & Pathology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Sofia Östman
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden;
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Adler I, Muiño A, Aguas S, Harada L, Diaz M, Lence A, Labbrozzi M, Muiño JM, Elsner B, Avagnina A, Denninghoff V. Helicobacter pylori and oral pathology: Relationship with the gastric infection. World J Gastroenterol 2014; 20:9922-9935. [PMID: 25110422 PMCID: PMC4123373 DOI: 10.3748/wjg.v20.i29.9922] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 12/05/2013] [Accepted: 04/03/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) has been found in the oral cavity and stomach, and its infection is one of the most frequent worldwide. We reviewed the literature and conducted a Topic Highlight, which identified studies reporting an association between H. pylori-infection in the oral cavity and H. pylori-positive stomach bacterium. This work was designed to determine whether H. pylori is the etiologic agent in periodontal disease, recurrent aphthous stomatitis (RAS), squamous cell carcinoma, burning and halitosis. Record selection focused on the highest quality studies and meta-analyses. We selected 48 articles reporting on the association between saliva and plaque and H. pylori-infection. In order to assess periodontal disease data, we included 12 clinical trials and 1 meta-analysis. We evaluated 13 published articles that addressed the potential association with RAS, and 6 with squamous cell carcinoma. Fourteen publications focused on our questions on burning and halitosis. There is a close relation between H. pylori infection in the oral cavity and the stomach. The mouth is the first extra-gastric reservoir. Regarding the role of H. pylori in the etiology of squamous cell carcinoma, no evidence is still available.
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25
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Li L, Gu H, Zhang G. Association between recurrent aphthous stomatitis and Helicobacter pylori infection: a meta-analysis. Clin Oral Investig 2014; 18:1553-60. [DOI: 10.1007/s00784-014-1230-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 03/14/2014] [Indexed: 01/26/2023]
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Kariya S, Okano M, Nishizaki K. An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction? World J Gastroenterol 2014; 20:1470-1484. [PMID: 24587622 PMCID: PMC3925855 DOI: 10.3748/wjg.v20.i6.1470] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/03/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions.
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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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28
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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: 124] [Impact Index Per Article: 11.3] [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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29
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Roubaud Baudron C, Franceschi F, Salles N, Gasbarrini A. Extragastric diseases and Helicobacter pylori. Helicobacter 2013; 18 Suppl 1:44-51. [PMID: 24011245 DOI: 10.1111/hel.12077] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the last year, several diseases from outside of the gastrointestinal tract have been associated with Helicobacter pylori infection. Indeed, this bacterium produces a low-grade inflammatory state, induces molecular mimicry mechanisms, and interferes with the absorbance of nutrients and drugs possibly influencing the occurrence or the evolution of many diseases. In addition to its role in some hematologic conditions, such as immune thrombocytopenic purpura, idiopathic sideropenic anemia, and vitamin B12 deficiency, which were included in the current guidelines, several other conditions such as cardiovascular diseases, diabetes mellitus, hepatobiliary diseases, and neurologic disorders have also shown promising results.
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Affiliation(s)
- Claire Roubaud Baudron
- Université de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France; Pôle de Gérontologie Clinique, Bordeaux, France; INSERM U853, Bordeaux, France
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Grimm M, Munz A, Exarchou A, Polligkeit J, Reinert S. Immunohistochemical detection of Helicobacter pylori without association of TLR5 expression in oral squamous cell carcinoma. J Oral Pathol Med 2013; 43:35-44. [PMID: 23659788 DOI: 10.1111/jop.12082] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2013] [Indexed: 01/01/2023]
Abstract
BACKGROUND Approximately 15% of human deaths from cancer are associated with chronic viral or bacterial infections. Helicobacter pylori (HP), a flagellated, Gram-negative, spiral, microaerophilic bacteria is considered to be the most common chronic bacterial infection in humans. Toll-like receptor 5 (TLR5) is involved in recognition of bacterial flagella and is thought to promote tumour growth through inflammation-dependent mechanisms in epithelial cells. METHODS Expression of HP and TLR5 was analysed in OSCC specimen (n = 191) by immunohistochemistry. TLR5 expression specificity was conducted by Western blotting in cancer cell lines (BICR3, BICR56). TLR5-stained sections were scanned and digitally analysed using ImageJ and the immunomembrane plug-in. HP expression and TLR5 expression were associated with clinicopathological characteristics and impact on survival. RESULTS Helicobacter pylori detection was significantly associated with recurrence of the tumour, whereas TLR5 expression was not. Multivariate analysis demonstrated HP expression as an independent prognostic factor (P = 0.0260). TLR5 specificity was confirmed by Western blot analysis. CONCLUSIONS For the first time, this study provides evidence that immunohistochemically detected HP expression in OSCC is associated with reduced disease-free survival in a large patient cohort. Although TLR5 was not associated with any clinicopathological characteristics or impact on survival, investigation of the TLR family seems to be reasonable due to the possible existence of other pathogenic bacterial or viral compounds in oral cavity cancer.
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Affiliation(s)
- Martin Grimm
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Tuebingen, Germany
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