Effect of Oral Care Gel for Burning Mouth Syndrome in a Patient with Hepatitis C: A Case Report

Human papilloma virus-16-specific CD8+ T-cell expansions characterize different clinical forms of lichen planus and not lichen sclerosus et atrophicus

Lichen planus (LP) is a cutaneomucosal chronic inflammatory disease characterized by a CD8+ cytotoxic T-lymphocytes (CTL) infiltrate. In erosive oral LP, we found HPV16-specific activated CTL in lesions, supporting a pathogenic contribution of HPV16. Here, we investigated whether a similar scenario occurs in other clinical forms of LP and in lichen sclerosus et atrophicus (LSA), another chronic disease also affecting the mucosa and/or the skin. Blood CTL from LP and LSA patients expressed significant higher levels of granzyme B, perforin and CD107a proteins than healthy donors. Expansions of TCRVß3+ CTL, with presence of TCR clonotypes identical to those previously detected in erosive oral LP, were found both in blood and mucosal/skin lesions of LP, and not of LSA patients. These expansions were enriched with HPV16-specific CD8+ T-cells as shown by their recognition of the E711-20 immunodominant epitope. In LSA patients, the peripheral repertoire of CTL was oligoclonal for TCRVß6+ CTL. Finally, although patients with LP and LSA have developed antibodies against HPV16 capsid L1, antibodies against HPV16 E6 were only observed in patients with LP. Overall, our data collectively suggest an involvement of HPV16-specific CTL in different clinical forms of LP, not only in erosive oral LP, while a different scenario operates in LSA.

Effect of Oral Care in a Patient with Depression and Burning Mouth Syndrome during the COVID-19 Pandemic

Burning mouth syndrome (BMS) is a burning sensation that occurs in the mouth without any underlying cause. There is no satisfactory treatment for BMS, so far. Herein, we report the case of a 74-year-old female with untreated depression who presented with BMS. Despite taking antidepressants, she developed suicidal thoughts, particularly due to the increasing number of coronavirus disease 2019 (COVID-19) cases and suicides in Japan. The symptoms of BMS and the oral discomfort were eliminated using a multifaceted approach, which included the following: continuous application of the oral care gel "REFRECARE-H®" to the mucous membranes, regular dental visits, collaboration with medical and dental professionals, and administration of zinc preparations. Her suicidal thoughts had disappeared, and her quality of life, assessed using the visual analogue scale, was improved following the treatment. Dentists should strive to provide oral care, while providing treatment in collaboration with specialists, for the early detection of depression and zinc deficiency in patients with BMS.

Evaluation of IL-6 levels and +3954 polymorphism of IL-1β in burning mouth syndrome: A systematic review and meta-analysis

This study evaluated IL-6 salivary levels as well as the +3954 polymorphism of IL-1β in patients with burning mouth syndrome and healthy individuals, through case-control studies. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted this research in PubMed/MEDLINE, Cochrane Library and Web of Science databases. The risk of bias was measured based in the Newcastle-Ottawa Scale. Researches with a group of patients with burning mouth syndrome and a control group in which the presence of the +3954 polymorphism of IL-1β and/ or IL-6 salivary levels through non-stimulated saliva were evaluated to detect if this interleukin concentrations are increased in patients and if the polymorphism is a risk factor for this syndrome. We identified seven studies with total of 440 participants, 229 patients with burning mouth syndrome and 211 healthy controls, ages 24-84 years old. The female gender was predominant. Patients in the majority of studies did not present increased levels of IL-6 and the +3954 polymorphism of IL-1β is not a risk factor for this syndrome. A few studies researched biomarkers in this pathology and more investigations are required not only to identify salivary levels and the polymorphism evaluated, but also other interleukins and polymorphisms in order to clarify the etiopathogenesis of this syndrome as well as for propose new diagnostic methods and treatments.