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Wang Y, Yue H, Jiang Y, Huang Q, Shen J, Hailili G, Sun Z, Zhou X, Pu Y, Song H, Yuan C, Zheng Y. Oral Microbiota Linking Associations of Dietary Factors with Recurrent Oral Ulcer. Nutrients 2024; 16:1519. [PMID: 38794756 PMCID: PMC11124033 DOI: 10.3390/nu16101519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Recurrent oral ulcer (ROU) is a prevalent and painful oral disorder with implications beyond physical symptoms, impacting quality of life and necessitating comprehensive management. Understanding the interplays between dietary factors, oral microbiota, and ROU is crucial for developing targeted interventions to improve oral and systemic health. Dietary behaviors and plant-based diet indices including the healthful plant-based diet index (hPDI) were measured based on a validated food frequency questionnaire. Saliva microbial features were profiled using 16S rRNA gene amplicon sequencing. In this cross-sectional study of 579 community-based participants (aged 22-74 years, 66.5% females), 337 participants had ROU. Participants in the highest tertile of hPDI exhibited a 43% lower prevalence of ROU (odds ratio [OR] = 0.57, 95%CI: 0.34-0.94), compared to the lowest tertile, independent of demographics, lifestyle, and major chronic diseases. Participants with ROU tended to have lower oral bacterial richness (Observed ASVs, p < 0.05) and distinct bacterial structure compared to those without ROU (PERMANOVA, p = 0.02). The relative abundances of 16 bacterial genera were associated with ROU (p-FDR < 0.20). Of these, Olsenella, TM7x, and unclassified Muribaculaceae were identified as potential mediators in the association between hPDI and ROU (all p-mediations < 0.05). This study provides evidence of the intricate interplays among dietary factors, oral microbiota, and ROU, offering insights that may inform preventive and therapeutic strategies targeting diets and oral microbiomes.
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Affiliation(s)
- Yetong Wang
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Haiyan Yue
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Yuzhou Jiang
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Qiumin Huang
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Jie Shen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Gulisiya Hailili
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Zhonghan Sun
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Xiaofeng Zhou
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Yanni Pu
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Huiling Song
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
| | - Changzheng Yuan
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200438, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200032, China
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, 1609 Xietu Road, Shanghai 200032, China
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Reddy SM, Kumar Vadivel J, Ramalingam K. Prevalence of Aphthous Stomatitis: A Cross-Sectional Epidemiological Study. Cureus 2023; 15:e49288. [PMID: 38143711 PMCID: PMC10748215 DOI: 10.7759/cureus.49288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Recurrent aphthous stomatitis (RAS) is a common ulcer of idiopathic etiology but is recurrent, causing painful ulcers in the non-keratinized mucosa. The disease is commonly seen in people aged 10-40 years. The etiology of RAS has yet to be well established, but several risk factors that lead to the development of RAS have been proven in the literature. With an unknown etiology, developing a definitive cure and maintaining disease remission remains challenging. An epidemiological survey will shed some light on the disease's prevalence, which could provide insights into disease management. This study aimed to study the prevalence of aphthous stomatitis among the patients visiting the dental outpatient services of a dental college in South India. The objectives were to discover the different subtypes of aphthous stomatitis and the age predominance of the type of ulcer. Materials and methods The data was collected from the case records of Saveetha Dental College and Hospitals, Chennai, India, dated from June 2019 to June 2023. The age and gender of the patients with RAS were recorded. The details collected were systematically arranged in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and further analyzed using IBM SPSS Statistics for Windows, Version 24.0 (Released 2016; IBM Corp., Armonk, New York, United States) and chi-square tests were run to check for statistical significance. Results A total of 1,44,056 patients visited the Dental OPD during the study period. Of these, 1115 patients had RAS. When the data was analyzed, there was a three-fold increase in the occurrence of RAS during the coronavirus disease 2019 (COVID-19) pandemic, which was statistically significant (p=0.043). The most commonly affected age group was 26-40 years. Among the clinical variants of RAS, it was found that 82.5% of RAS patients had a minor variant of aphthous stomatitis. Conclusion This study shows the prevalence of different types of aphthous stomatitis, wherein we noticed that the minor clinical variant was the most common, followed by the major variant. The lesions were more commonly seen in women. However, the age group most commonly affected was 26-40 years.
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Affiliation(s)
- Shweta Mary Reddy
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Jayanth Kumar Vadivel
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Bhargava S, Dubey SP, Haldipur D, Hathiram B, Jagtap C, Khattar V, Kulkarni SV, Kotamkar A, Muralidharan P, Kumar P, Qamra A, Ramadhin A, Venkatraman S. Management of Recurrent Aphthous Stomatitis: An Indian Expert Consensus. Indian J Otolaryngol Head Neck Surg 2023; 75:2672-2680. [PMID: 37636607 PMCID: PMC10447672 DOI: 10.1007/s12070-023-03708-2] [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: 08/23/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Recurrent aphthous stomatitis (RAS) is characterized by painful, oral mucosal ulcers with wide range of prevalence ranging from 2 to 78%. Etiology of RAS is idiopathic and multifactorial. There are numerous gaps in assessment and management of RAS and the absence of guidelines or a consensus document makes the treatment further difficult. The aim of this document is to provide an Indian expert consensus for management of RAS. Experts from different specialties such as Otorhinolaryngology, Oral Medicine/Dentistry and Internal Medicine from India were invited for face to face and online meetings. After a deliberate discussion of current literature, evidence and clinical practice during advisory meetings, experts developed a consensus for management of RAS. We identify that the prevalence of RAS may lie between 2 and 5%. In defining RAS, we advocate three or more recurrences of aphthous ulcers per year as criterion for RAS. Investigation should include basic hematological (complete blood count) and nutritional (serum vitamin B12, and iron studies) parameters. Primary aim of treatment is to reduce the pain, accelerate ulcer healing, reduce the recurrences and improve the quality of life. In treating RAS, initial choice of medications is determined by pain intensity, number and size of ulcers and previous number of recurrences. Topical and systemic agents can be used in combination for effective relief. In conclusion, this consensus will help physicians and may harmonize effective diagnosis and treatment of RAS.
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Affiliation(s)
| | | | | | - Bachi Hathiram
- Department of ENT and Head and Neck Surgery, TN Medical College and Nair Hospital, Mumbai, India
| | - Charuhas Jagtap
- Consultant ENT Surgeon, Vertigo and Deafness Specialist, Jagtap Hospital, Dhule, India
| | - Vicky Khattar
- Department of ENT and Head and Neck Surgery, TN Medical College and Nair Hospital, Mumbai, India
| | - Shriram Vasant Kulkarni
- Associate Professor of Medicine, , MGM Medical College and UHS, Kamathe,, Navi Mumbai, India
| | - Ashwin Kotamkar
- Medical Affairs, Macleods Pharmaceuticals Ltd, Mumbai, India
| | | | | | - Amit Qamra
- Medical Affairs, Macleods Pharmaceuticals Ltd, Mumbai, India
| | | | - Sreenivasan Venkatraman
- Department of Oral Medicine and Radiology, Bharati Vidyapeeth Dental College, Navi Mumbai, India
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Rizvi Z, Choudhry N, Gondal AJ, Yasmin N. Association of Surfactant Protein D Single Nucleotide Polymorphisms rs721917, rs2243639, rs3088308 with Recurrent Aphthous Stomatitis in Pakistani Population. Genes (Basel) 2023; 14:genes14051119. [PMID: 37239479 DOI: 10.3390/genes14051119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Recurrent aphthous stomatitis (RAS) is a benign ulcerative condition, defined by the recurrent formation of non-contagious mucosal ulcers. Surfactant protein D (SP-D) is secreted frequently at surfaces exposed directly to body fluids. This study aims to investigate the association of SP-D single nucleotide polymorphisms (SNPs) with the onset of RAS. Blood samples from 212 subjects (106 cases/controls each) were collected during 2019 and genotyped for SP-D SNPs (rs721917, rs2243639, rs3088308) by polymerase chain reaction and restriction fragment length polymorphism followed by 12% polyacrylamide gel electrophoresis. Minor aphthous (75.5%) was the commonly observed ulcer type as compared to herpetiform (21.7%) and major aphthous ulcers (2.8%). A family history of RAS was reported in 70% of cases. RAS was found significantly associated with rs3088308 genotypes T/A (95% (Cl): 1.57-5.03, p = 0.0005), A/A (95% (Cl): 1.8-6.7, p = 0.0002), T-allele (95% (Cl): 1.09-2.36, p = 0.01), A-allele (95% (Cl): 1.42-3.91, p = 0.01), rs721917 genotype T/T (95% (Cl): 1.15-25.35, p = 0.03), and T-allele (95% (Cl): 1.28-3.10, p = 0.002). Female gender and obese body mass index (BMI) were significantly associated with rs3088308 genotypes T/A (95% (CI): 1.89-15.7, p = 0.001), T/T (95% (Cl): 1.52-11.9, p = 0.005), A-allele (95% (Cl): 1.65-7.58, p < 0.001), and T-allele (95% (Cl): 1.4-10.1, p <0.001) and rs721917 genotype T/T (95% (CI) = 1.3-33, p = 0.02), respectively. This study describes the association of SP-D SNPs (rs721917, rs3088308) with RAS in the Pakistani population.
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Affiliation(s)
- Zainab Rizvi
- Department of Oral Pathology, de' Montmorency College of Dentistry, Lahore 54000, Pakistan
| | - Nakhshab Choudhry
- Department of Biochemistry, King Edward Medical University, Lahore 54000, Pakistan
| | - Aamir Jamal Gondal
- Department of Biomedical Sciences, King Edward Medical University, Lahore 54000, Pakistan
| | - Nighat Yasmin
- Department of Biomedical Sciences, King Edward Medical University, Lahore 54000, Pakistan
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Manoj MA, Jain A, Madtha SA, Cherian TM. Prevalence and risk factors of recurrent aphthous stomatitis among college students at Mangalore, India. PeerJ 2023; 11:e14998. [PMID: 37214085 PMCID: PMC10194064 DOI: 10.7717/peerj.14998] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 02/13/2023] [Indexed: 05/24/2023] Open
Abstract
Background Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases affecting an approximate 25% of the world's population. Some common etiological factors are genetics, nutritional deficiencies, stress and immune dysfunction. There is currently no specific medication to treat the condition but RAS tends to heal by itself within a week or two. We aimed to explore about the prevalence and related risk factors of recurrent aphthous ulcers among college students aged 18-30 years who had been affected within the preceding six months prior to the study duration. Methods A questionnaire survey was conducted among 681 students from four colleges in Mangalore, Karnataka, India after obtaining the approval for the same from the respective colleges. Consenting participants returned a survey containing various questions. The collected data was then analyzed using descriptive statistics. The study was approved by the Institutional Ethics Committee. Results Of the 681 participants, 322 (47.2%) were affected with RAS in the past six months which included 131 (40.6%) males and 191 (59.3%) females. Single mouth ulcers were the most common presentation seen among the study participants (74.2%). Factors showing statistically significant association were: family history of RAS (P < 0.001), known diabetics (P < 0.001), history of smoking (P < 0.001), oral trauma (P < 0.001), history of wearing braces/dentures (P < 0.001) as well as those using toothpastes containing sodium lauryl sulphate (P < 0.001), stress and lack of sleep (P < 0.001). The most common form of medication used were topical agents (43.1%) (P < 0.001). Conclusions There was a statistically significant association between the occurrence of RAS and family history of RAS, diabetes, smoking, history of braces/dentures, oral trauma, sodium lauryl sulphate toothpastes, lack of sleep, stress, menstruation, consumption of particular foods and beverages. Further research is needed in this field to truly understand the prevalence and risk factors of RAS and to help in discovering a treatment modality for this condition.
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Affiliation(s)
- Matthew Antony Manoj
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Animesh Jain
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Saanchia Andria Madtha
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Tina Mary Cherian
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Detection and Analysis of the Oral Flora in Patients with Recurrent Aphthous Stomatitis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1705193. [PMID: 36276851 PMCID: PMC9584670 DOI: 10.1155/2022/1705193] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
The present study detected differences in the oral mucosal flora in healthy people and patients diagnosed with recurrent aphthous stomatitis (RAS) using the 16S ribosomal RNA high-throughput sequencing (rRNA-seq). All samples were collected from the lower lip mucosa of 100 healthy individuals and 100 patients with RAS. After the extraction, DNA was subjected to PCR amplification for the bacterial 16S rRNA gene, before subjecting to high-throughput sequencing, and matched to a database. Most bacterial species and most unique bacteria were from the healthy control group, and the amount of operational taxonomic units (OTUs) calculated was similar in the ulcer and nonulcer sites. Firmicutes, Proteobacteria, and Bacteroidetes were most abundant in the healthy group and in ulcer, nonulcer, and healed ulcer sites at the phylum level. Meanwhile, the number of Prevotella was significantly elevated in ulcer sites (P < 0.05). Healthy people had more species of bacteria inhabiting their oral mucosa than did RAS patients, and patients with ulcers had the lowest abundance of bacterial species. We suggest that the number of Prevotella is associated with RAS.
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Taheri MH, Eshraqi AM, Anwari A, Stanikzai AM. Prevalence of Recurrent Aphthous Ulcers Among Dentistry Students' in Kabul, Afghanistan: A Questionnaire-Based Study. Clin Cosmet Investig Dent 2022; 14:275-279. [PMID: 36132195 PMCID: PMC9482951 DOI: 10.2147/ccide.s378171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Recurrent aphthous stomatitis (RAS) is the mouth’s most common and painful inflammatory ulcerative condition, also called aphthae or canker sores. Its prevalence is about 20% and predisposition factors involve genetics, environmental factors, and immune dysfunctions. Objective Reviewing the literature and no study was found to show the prevalence and associated factors of recurrent aphthous ulceration in the context of Afghanistan. Therefore, this study aimed to determine the lifetime prevalence and associated factors of recurrent aphthous ulceration among dentistry students at Kabul University of Medical Sciences, Afghanistan. Methods A cross-sectional questionnaire-based study was carried out among 223 dentistry students. A descriptive and inferential analysis was performed to find the association. Results The prevalence of (RAS) in our sample group was 30%. (68.7%) of participants had one or more family members who experienced aphthous ulcers and the association was found to be significant (X2 = 134.940; p < 0, 05). (81%) of participants experienced the condition to eating certain types of food (X2 = 165.906; p < 0, 05) and (53.7%) of them reported the same about trauma (X2 = 99.958; p < 0, 05). Regarding stress the difference was also statistically significant (X2 = 56.830; p < 0, 05). Conclusion We found that a considerable proportion of the study sample had experienced recurrent aphthous ulceration. Family history, stress, trauma, and dietary factors have an impact on the occurrence of RAS with no association with gender and smoking.
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Affiliation(s)
| | - Ali Maisam Eshraqi
- Faculty of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Abdurrahman Anwari
- Faculty of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
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KURKU H, YAVUZ C. Evaluation of Total Oxidant Status, Antioxidant Status and Oxidative Stress Index in Patients with Recurrent Aphthous Stomatitis. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1033896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Xu K, Zhou C, Huang F, Duan N, Wang Y, Zheng L, Wang X, Wang W. Relationship between dietary factors and recurrent aphthous stomatitis in China: a cross-sectional study. J Int Med Res 2021; 49:3000605211017724. [PMID: 34057842 PMCID: PMC8753793 DOI: 10.1177/03000605211017724] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective Recurrent aphthous stomatitis (RAS), a common oral mucosal disorder characterized by chronic, inflammatory, and ovoid ulcers, has a complex etiology. The purpose of the study was to investigate the specific dietary factors influencing the prevalence of RAS. Methods A total of 754 participants aged 18 to 59 years were enrolled in this descriptive cross-sectional study. An anonymous questionnaire was adopted to investigate the distribution of RAS, dietary factors, self-reported trigger factors, and therapeutic methods. Results Among all participants, the prevalence rate of RAS was 21.4%. Univariable analysis showed that fruit, dairy products, vegetables, and water, but not fried foods, fermented foods, spicy foods, and eggs, were preventive factors against RAS. After adjusting for age and sex, multivariable regression analysis suggested that fruit (adjusted odds ratio [aOR] = 0.430, 95% confidence interval [CI] = 0.218–0.847) and water (aOR = 0.294, 95% CI = 0.119–0.726) were protective factors against RAS. Conclusion This study found that the consumption of fruit and water was negatively associated with RAS. These results imply a potential adjunctive and complementary role of food in RAS treatment and some feasible means of RAS prevention.
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Affiliation(s)
- Kaiyuan Xu
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chongchong Zhou
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Fan Huang
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ning Duan
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yanyi Wang
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lichun Zheng
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiang Wang
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenmei Wang
- Department of Oral Medicine, 144984Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Warrier A, Sruthi M, Anbarasi K. Comprehensive management of major aphthous ulcer. BMJ Case Rep 2021; 14:14/5/e241010. [PMID: 33986008 PMCID: PMC8126288 DOI: 10.1136/bcr-2020-241010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Recurrent aphthous ulcers are the most prevalent oral mucosal disease, but the subset major aphthous ulcer is a less frequent type. These ulcers are refractory, may persist for several weeks to months, and interfere with the normal state of health. The aetiology is multifactorial and so is the treatment. We present a case of an adolescent male patient reported with multiple oral ulcers. He developed three ulcers simultaneously and suffered for 10 months despite using topical medications prescribed by different dental practitioners. We executed a multidisciplinary treatment approach that resulted in a long-term disease-free state. The treatment methods followed in our case could be a successful model to implement by medical practitioners and oral physicians when the situation demands.
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Affiliation(s)
- Aravind Warrier
- Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Maguluru Sruthi
- Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - K Anbarasi
- Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Luo K, Zhao H, Bian B, Wei X, Si N, Brantner A, Fan X, Gu X, Zhou Y, Wang H. Huanglian Jiedu Decoction in the Treatment of the Traditional Chinese Medicine Syndrome "Shanghuo"-An Intervention Study. Front Pharmacol 2021; 12:616318. [PMID: 33995016 PMCID: PMC8120301 DOI: 10.3389/fphar.2021.616318] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/05/2021] [Indexed: 01/16/2023] Open
Abstract
“Shanghuo” (“excessive internal heat”) is caused by exuberant endogenous fire, which does not have a comprehensive and systematic traditional Chinese medicine theory. In previous study, we had evaluated the therapeutic effect of Huanglian Jiedu Decoction (HLJDD) (granule) on patients with “Shanghuo”, however, the specific mechanism was not clear, which need further exploration. To explain its intervention mechanism, we select 57 patients with oral diseases caused by “Shanghuo” and 20 health volunteers to divide into oral disease group, HLJDD intervention group and healthy control group. Firstly, biochemical indicators before and after HLJDD intervention are detected, such as inflammatory factors, oxidative stress factors and energy metabolism factors. The results exhibit that HLJDD significantly decreases indicators succinic acid (p < 0.001); tumor necrosis factor-alpha, adenosine triphosphate, citric acid (p < 0.01); interleukin-8 (IL-8), 4-hydroxynonenal, pyruvic acid, lactate dehydrogenase (p < 0.05). The levels of glucocorticoid, adrenocorticotropic hormone (p < 0.01); lactic acid, IL-4, IL-10 (p < 0.05) significantly increase after HLJDD intervention. In addition, we adopt multi-omics analysis approach to investigate the potential biomarkers. Nontargeted metabolomics demonstrate that the levels of 7 differential metabolites approach that in the healthy control group after HLJDD intervention, which are correlated with histidine metabolism, beta-alanine metabolism and sphingolipid metabolism through metabolic pathway analysis. Targeted lipidomics results and receiver operating characteristic curve analysis show that 13 differential lipids are identified in the three groups mainly focuse on lysophosphatidylcholines, lysophosphatidylethanolamines. Finally, the network associations of those differential biomarkers reveal the regulation of adenosine triphosphate and tricarboxylic acid cycle play essential role in the therapeutic effect mechanism of HLJDD in “Shanghuo”. The study has laid the foundation for further revealing the mechanism and finding clinical biomarkers related to “Shanghuo”.
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Affiliation(s)
- Keke Luo
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Haiyu Zhao
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Baolin Bian
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaolu Wei
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Nan Si
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Adelheid Brantner
- Institute of Pharmaceutical Sciences, University of Graz, Graz, Austria
| | - Xiaorui Fan
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinru Gu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanyan Zhou
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongjie Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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The Impact of DNA Methylation on IL6 mRNA Levels in Hematinic Deficiency and Atopy-Associated Recurrent Aphthous Stomatitis Patients. Int J Dent 2021; 2021:5560695. [PMID: 33936205 PMCID: PMC8055433 DOI: 10.1155/2021/5560695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/28/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate the DNA methylation using pyrosequencing and its effects on the upregulation of IL6 mRNA in patients with recurrent aphthous stomatitis (RAS) in connection with hematinic deficiency and atopy. Material and Methods. This cross-sectional study was conducted at Dr. Hasan Sadikin Hospital, Bandung, from January–March 2019 and was approved by the Health Research Ethics Committee of Universitas Padjadjaran (Ethics No. 990/UN6.KEP/EC/2018). Furthermore, the subjects had RAS ulcers with a history of at least twice a year along with atopy and dietary imbalance with no history of recurrent intraoral herpes or any systemic diseases. This study was performed on 23 RAS patients and 21 healthy subjects, and the sampling was carried out consecutively. The blood samples were collected from all the subjects, and then, the DNA and RNA were extracted from the peripheral blood mononuclear cells (PBMCs). Consequently, the bisulfite-modified DNA was used to confirm the methylation status of the IL6 gene promoter through the pyrosequencing method. The methylation levels of the IL6 promoter were assessed by a reverse transcriptase-polymerase chain reaction technique. The gene expression of RAS and the control group was analyzed by the 2−ΔΔCT method. The statistical analysis using the Mann–Whitney U test was conducted to evaluate IL6 mRNA levels and DNA methylation with p value <0.05 considered to be statistically significant. Result The IL6 mRNA levels were approximately 1.88-fold in RAS patients, and there was a significant relationship between the expression of the IL6 gene and the increased risk of RAS (p < 0.001). It was reported that four out of six sites in the cytosine phosphate guanine (CpG) island IL6 promoter had a lower degree of methylation, and two other sites in patients with RAS had greater methylation compared with control, but not statistically significant. Conclusion This study showed the upregulation of IL6 mRNA levels in RAS patients compared to control. DNA methylation in the present study is at sites 566–658, whereas the location of the IL6 promoter is at sites 1–1684. Thus, it would be necessary conducting some research at other CpG sites of IL6 promoter islands to determine the status of DNA methylation.
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Wang Z, Cao H, Xiong J, Lu Y, Deng Y, Nan H, Zheng S, Ye H, Cao Z. Recent advances in the aetiology of recurrent aphthous stomatitis (RAS). Postgrad Med J 2021; 98:57-66. [PMID: 33574180 DOI: 10.1136/postgradmedj-2020-139421] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 11/04/2022]
Abstract
Recurrent aphthous stomatitis (RAS) is the most common disease of oral mucosa, which almost attacks each individual once in their lifespan. Although plenty of factors have been suggested to play a role in the pathogenesis of RAS, the aetiology of RAS is still controversial, which might lead to limited clinical therapies in accordance with each RAS patient. This review mainly illustrates recent advances in potential causes associated with RAS in detail. Deeper comprehension of the aetiology of RAS will support doctors and researchers to make a better management of RAS patients and to discover new treatments. The aetiology of RAS is complicated, hence we should take a comprehensive view into its aetiology, with multiple potential factors being considered. Sample collection of RAS patients have greatly limited the progress in the aetiology of RAS. A research model of multiagency cooperation can help achieve perfect sample collection of year-round and multiposition.
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Affiliation(s)
- Zihan Wang
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Haibo Cao
- Clinical Medicine School, Hebei University of Engineering, Handan, China
| | - Jianqi Xiong
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yilong Lu
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yixiao Deng
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Han Nan
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Shutian Zheng
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Hui Ye
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Zhensheng Cao
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
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Bao J, Chen J, Zhang X, Xu L, Fan Y, Dou X. Combined signatures of serum proteome and transcriptome in patients with recurrent aphthous ulcer. Oral Dis 2021; 28:691-702. [PMID: 33576097 DOI: 10.1111/odi.13800] [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: 10/15/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Recurrent aphthous ulcer (RAU) is a common oral disease with unclear mechanism. This study aimed to explore the serum signatures of RAU patients via proteomic and transcriptomic analysis. METHODS This study was based on clinical observation. Part of serum was used for clinical tests, while the rest was processed for isobaric tags for relative and absolute quantitation (ITRAQ) labeling coupled with two-dimensional liquid chromatography-tandem mass spectrometry (2D LC-MS/MS) combined with microRNA (miRNA) microarrays. Bioinformatic analysis was then used to obtain significant signatures, which was verified by ELISA, qRT-PCR, and dual-luciferase reporter gene assays. RESULTS Clinical data showed that triglyceride level, white blood cell count, and neutrophils percentage were increased in RAU group, while lymphocytes percentage was decreased. ITRAQ-2D LC-MS/MS identified 22 upregulated and 33 downregulated proteins in RAU group. Simultaneously, miRNA microarrays identified 64 upregulated and 31 downregulated miRNAs. After integrative bioinformatic analysis and verification, three miRNA-protein pairs, mainly involved in oxidative stress and inflammation responses, were obtained. Additionally, the interaction network indicated the crucial role of complement and coagulation cascade pathway in RAU. CONCLUSIONS Our study revealed that complement and coagulation cascade pathway, oxidative stress, and inflammation responses may act as vital factors in pathogenesis of RAU.
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Affiliation(s)
- Jie Bao
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Juan Chen
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - XiZhao Zhang
- School of 1st Clinical Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Xu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - YongSheng Fan
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - XiaoBing Dou
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
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Wang K, Ding L, Yang C, Hao X, Wang C. Exploring the Relationship Between Psychiatric Traits and the Risk of Mouth Ulcers Using Bi-Directional Mendelian Randomization. Front Genet 2020; 11:608630. [PMID: 33424931 PMCID: PMC7793678 DOI: 10.3389/fgene.2020.608630] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/09/2020] [Indexed: 12/26/2022] Open
Abstract
Background Although the association between mouth ulcers and psychiatric traits has been reported by observational studies, their causal relationship remains unclear. Mendelian randomization (MR), powered by large-scale genome-wide association studies (GWAS), provides an opportunity to clarify the causality between mouth ulcers and psychiatric traits. Methods We collected summary statistics of mouth ulcers (sample size n = 461,106) and 10 psychiatric traits from the largest publicly available GWAS on Europeans, including anxiety disorder (n = 83,566), attention deficit/hyperactivity disorder (n = 53,293), autism spectrum disorder (n = 46,350), bipolar disorder (n = 51,710), insomnia (n = 1,331,010), major depressive disorder (n = 480,359), mood instability (n = 363,705), neuroticism (n = 168,105), schizophrenia (n = 105,318), and subjective wellbeing (n = 388,538). We applied three two-sample bi-directional MR analysis methods, namely the Inverse Variance Weighted (IVW) method, the MR pleiotropy residual sum and outlier (MR-PRESSO) method, and the weighted median method, to assess the causal relationship between each psychiatric trait and mouth ulcers. Results We found significant effects of autism spectrum disorder, insomnia, major depressive disorder, and subjective wellbeing on mouth ulcers, with the corresponding odds ratio (OR) from the IVW method being 1.160 [95% confidence interval (CI): 1.066–1.261, P = 5.39 × 10–4], 1.092 (1.062–1.122, P = 3.37 × 10–10), 1.234 (1.134–1.342, P = 1.03 × 10–6), and 0.703 (0.571–0.865, P = 8.97 × 10–4), respectively. We also observed suggestive evidence for mood instability to cause mouth ulcers [IVW, OR = 1.662 (1.059–2.609), P = 0.027]. These results were robust to weak instrument bias and heterogeneity. We found no evidence on causal effects between other psychiatric traits and mouth ulcers, in either direction. Conclusion Our findings suggest a protective effect of subjective wellbeing and risk effects of autism spectrum disorder, insomnia, major depressive disorder, and mood instability on mouth ulcers. These results clarify the causal relationship between psychiatric traits and the development of mouth ulcers.
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Affiliation(s)
- Kai Wang
- Key Laboratory for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Ding
- Key Laboratory for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Can Yang
- Department of Mathematics, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Xingjie Hao
- Key Laboratory for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaolong Wang
- Key Laboratory for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Darjani A, Joukar F, Naghipour M, Asgharnezhad M, Mansour-Ghanaei F. Lifetime prevalence of recurrent aphthous stomatitis and its related factors in Northern Iranian population: The PERSIAN Guilan Cohort Study. Clin Oral Investig 2020; 25:711-718. [PMID: 33030579 DOI: 10.1007/s00784-020-03611-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/28/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Recurrent aphthous stomatitis (RAS) is one of the most prevalent oral inflammatory ulcerative lesions. The aim of this large population base study was estimated lifetime prevalence of RAS and its related factors among the Northern Iranian population. MATERIALS AND METHODS This study was conducted on 10,520 participants aged 35-70 years based on the PERSIAN Guilan Cohort Study (PGCS). Prevalence proportions and multivariate logistic regression models were constructed for lifetime RAS prevalence using the SPSS software. Data on potential correlates of RAS including demographic profiles, lifestyle habits, and self-reported past medical histories were obtained. RESULTS The lifetime prevalence of RAS was 8.3%. Multivariate logistic models showed that urbanization (adjusted odds ratio (AOR) = 1.2) and having a history of systemic disease, including rheumatic disease (AOR = 2.1), genital aphthous disease (AOR = 11.7), depression (AOR = 1.3), chronic headaches (AOR = 1.8), diabetes mellitus (AOR = 1.6), and epilepsy (AOR = 2), were independent predictors of RAS. In addition, smokers (AOR = 0.5) and individuals older than 50 years of age (AOR = 0.8) were less likely to have a history of RAS. The lifetime prevalence of RAS among the Northern Iranian population was relatively low. CONCLUSIONS It seems that predisposing factors, such as younger age, urbanization, and systemic disease, including rheumatic disease, genital aphthous disease, depression, chronic headaches, diabetes mellitus, epilepsy, and not smoking, could contribute to RAS prevalence.
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Affiliation(s)
- Abbas Darjani
- Department of Dermatology, School of Medicine Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- GI Cancer Screening and Prevention Research center and Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammareza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences , Razi Hospital, Sardar-Jangle Ave., Rasht, 41448-95655, Iran
| | - Mehrnaz Asgharnezhad
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences , Razi Hospital, Sardar-Jangle Ave., Rasht, 41448-95655, Iran
| | - Fariborz Mansour-Ghanaei
- GI Cancer Screening and Prevention Research center and Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran. .,Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences , Razi Hospital, Sardar-Jangle Ave., Rasht, 41448-95655, Iran.
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shirzaiy M, Sarabadani J. Recurrent Aphthous Stomatitis and Related Factors Among 12-17-Year-Old Students in Zahedan, Iran. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2020. [DOI: 10.29252/jrdms.5.1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Zhang Z, Zhang Q, Xue Y, Chen G, Wu Z, Fang H. Serum levels of total antioxidant status, nitric oxide and nitric oxide synthase in minor recurrent aphthous stomatitis patients. Medicine (Baltimore) 2019; 98:e14039. [PMID: 30653111 PMCID: PMC6370179 DOI: 10.1097/md.0000000000014039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/28/2018] [Accepted: 12/13/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is one of the most common inflammatory ulcerative conditions of oral cavity with uncertain etiology. Several studies have reported that oxidative stress may be associated with RAS. The aim of this study was to compare the serum levels of total antioxidant status (TAS), nitric oxide (NO) and nitric oxide synthase (NOS) in minor RAS (MiRAS) patients with healthy individuals and determine the possible association of MiRAS with the 3 physiological parameters mentioned above. METHODS Ninety patients with idiopathic MiRAS and 90 race-, age- and sex-matched healthy individuals were included in this study. All these subjects were allocated to 3 groups: MiRAS patients in the active stage (Group A); the same MiRAS patients in Group A in the inactive stage (Group B); healthy individuals without MiRAS (Group C). Serum levels of TAS, NO and NOS were determined by the spectrophotometric method. Independent sample t test and paired t test were performed for statistical evaluation. RESULTS Serum TAS level of Group A was significantly decreased than that of Group C, whereas the serum level of NO was significantly higher in Group A as compared to Group C (P < .05). The serum levels of TAS and NO in Group B were no significant differences when compared with those in Group A or Group C. No significant differences in NOS activities were also found between the 3 groups (P > .05). CONCLUSIONS MiRAS is associated with decreased TAS and increased NO levels, but NOS may not play an important role in the aetiopathogenesis.
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Affiliation(s)
- Zichuan Zhang
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Air Force Medical University, Xi’an, PR China
| | - Qian Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Air Force Medical University, Xi’an, PR China
| | - Yi Xue
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
| | - Guang Chen
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
| | - Zhongyin Wu
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
| | - Huiqing Fang
- Department of Stomatology, the 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Shijiazhuang
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