Evaluation and Comparison of Total Antioxidant Capacity of Saliva Between Patients with Recurrent Aphthous Stomatitis and Healthy Subjects

Morphology-dependent nanoplasmonic assay: a powerful signaling platform for multiplexed total antioxidant capacity analysis

Assessing the total antioxidant capacity (TAC) in biological samples, such as saliva, is essential for health monitoring and disease prevention. TAC plays a critical role in protecting cells from damage caused by free radicals and oxidative stress, which are associated with various conditions, including cancer, cardiovascular diseases, and aging. Key antioxidants, including ascorbic acid (AA), cysteine (CYS), glutathione (GSH), and uric acid (UA), significantly contribute to this protective effect, with salivary levels of these antioxidants reflecting their concentrations in the bloodstream. Therefore, there is a strong demand for a robust, non-toxic colorimetric sensor that can effectively monitor these antioxidants using an innovative approach. This study introduces a multi-colorimetric probe capable of generating high-resolution, naked-eye-detectable color readouts for evaluating salivary TAC. The probe utilizes the morphology-dependent properties of plasmonic nanostructures as recently developed colorimetric sensors, enabling precise and efficient analysis of salivary antioxidants. The assessment of antioxidants was conducted using the probe in combination with pattern recognition analysis for accurate identification and regression analysis for quantification. The probe exhibited linear responses to pure antioxidants and TAC over a broad concentration range: 3.1-60.0, 2.6-60.0, 1.2-20.0, 0.8-20.0, and 0.7-14.0 μmol L-1, with detection limits of 1.1, 0.9, 0.4, 0.3, and 0.2 μmol L-1 for AA, CYS, GSH, UA, and TAC-mixture, respectively. Moreover, performance metrics highlight the robustness and efficacy of the probe in detecting and quantifying antioxidant levels in saliva samples. The efficacy of the developed multi-colorimetric probe was rigorously validated through the analysis of real saliva samples for on-site TAC monitoring. This rapid, cost-effective, user-friendly, non-toxic, and non-invasive method allows for a comprehensive analysis of both individual and total antioxidants, making it highly applicable for health monitoring and disease prevention. Additionally, the probe generates unique response profiles based on varying ratios of endogenous antioxidants, enabling precise TAC quantification in saliva-an essential factor for clinical diagnostics.

Systemic and local effect of oxidative stress on recurrent aphthous stomatitis: systematic review

Recurrent aphthous stomatitis (RAS) is a chronic and recurrent inflammatory disease of the mouth. It is characterised by the appearance of painful ulcers in the oral mucosa. RAS is believed to be a multifactorial disease with genetic predisposition, environmental factors and alterations in the immune system. Oxidative stress, caused by an imbalance between free radicals and the antioxidant system, also appears to be involved in the pathogenesis of RAS. Several risk factors, such as smoking, iron and vitamin deficiency and anxiety, may contribute to the development of the disease. Understanding the underlying mechanisms may help in the prevention and treatment of RAS. We searched PubMed, Scopus and Web of Science databases for articles on oxidative stress in patients with RAS from 2000 to 2023. Studies analysing oxidant and antioxidant levels in the blood and saliva of RAS patients and healthy controls were selected. Of 170 potentially eligible articles, 24 met the inclusion criteria: 11 studies on blood samples, 6 on salivary samples and 7 on both blood and salivary samples. Multiple oxidative and antioxidant markers were assessed in blood and saliva samples. Overall, statistically significant differences were found between RAS patients and healthy controls for most markers. In addition, increased oxidative DNA damage was observed in patients with RAS. Patients with RAS show elevated levels of oxidative stress compared to healthy controls, with a significant increase in oxidative markers and a significant decrease in antioxidant defences in saliva and blood samples.

Systematic review and meta-analysis of oxidative stress and antioxidant markers in recurrent aphthous stomatitis

BACKGROUND

We performed this systematic review and meta-analysis to synthesize all studies that reported the level of oxidative and antioxidative markers in recurrent aphthous stomatitis (RAS) patients compared to controls.

METHODS

We registered our study in PROSPERO (CRD42023431310). PubMed, ProQuest, Scopus, EMBASE, Google Scholar, and Web of Science were searched to find relevant publications up to June 5, 2023. The standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. We included 30 articles after multiple stags of screening.

RESULTS

We found that erythrocyte superoxide dismutase and Glutathione peroxidase activity were significantly lower in patients with RAS compared to healthy controls (SMD = - 1.00, 95%CI = -1.79 to -0.21, p = 0.013, and SMD = - 1.90, 95%CI = -3.43 to -0.38, p = 0.01, Respectively). However, there was not any difference between patients with RAS and healthy controls in erythrocyte Catalase (SMD = - 0.71, 95%CI = -1.56-0.14, p = 0.10). The total antioxidant status (TAS) level, in serum was significantly lower in patients than healthy controls (SMD = - 0.98, 95%CI = -1.57 to -0.39, p = 0.001). In addition, RAS patients had higher levels of serum Malondialdehyde (MDA), Serum total oxidant status, and serum oxidative stress index than healthy controls (SMD = 2.11, 95%CI = 1.43-2.79, p < 0.001, SMD = 1.53, 95%CI = 0.34-2.72, p = 0.01, and SMD = 1.25, 95%CI = 0.25-2.25, p = 0.014, Respectively); However, salivary MDA and TAS, and serum uric acid, vitamin E and C, and reduced glutathione levels of patients with RAS were not different from that of healthy controls.

CONCLUSIONS

The relationship between oxidative stress and RAS is well established in this meta-analysis. Although the molecular processes underlying the etiology of this pathology remain unknown, evidence indicating oxidative stress has a significant role in the pathogenesis of RAS has been revealed.

Hematological parameters, obesity, stress and oxidant - antioxidant indicators in patients with or without recurrent aphthous stomatitis: A case control study

INTRODUCTION

Recurrent Aphthous Stomatitis (RAS) is a frequent chronic disease of the oral cavity that affects 5-25 % of the population with a plethora of predisposing factors. Despite its equivocal etiology, immune alterations, hematologic deficiencies and oxidative stress has been reported to be significant etiologic factors. Stress and obesity are other environmental factors that have been studied to understand associations with RAS.

OBJECTIVES

This study investigated the association of stress, hematologic parameters, oxidative indices and other selected salivary factors in a case control study on RAS Methods: Twenty-two participants each in both case and control groups were recruited with saliva and serum samples collected from them after a self-administered Recent Life Changing Questionnaire (RLCQ). OHI-S and salivary flow rate (SFR) were calculated with selected hematologic parameters and oxidative indices such as Total oxidant (TOS) and anti-oxidant (TAS) levels and their ratio - Oxidative Stress Index (OSI). Anti-oxidative indices of Ferric-Reducing Antioxidant Power (FRAP) and Glutathione Peroxidase Activity (GsPHx) were also estimated.

RESULTS

The RAS group had a significantly higher RLCQ scores at a median of 145 more than the control (57.5). There was no significant in their obesity indices, however there was a significant higher mean in the ESR (p< 0.0001) and Vit B12 (p = 0.0001); OHI-S was also significantly higher in the RAS group with a median of 1.65. Both the salivary and serum TOS were significantly higher in the RAS (10.0 ± 3.8, 15.4 ± 8.9) compared to the control group (7.92 ± 1.49, 9.56 ± 3.5). GsPHx activity was significantly higher in both the saliva and serum in the control group (0.08 ± 0.08, 0.19 ± 0.11) while nil significant difference was found in the FRAP activity. Regression showed most important variables to be the salivary GsPHx activity, followed by serum OSI and GsPHx activity.

CONCLUSION

The oxidative indices of TOS, TAS and GsPHx can serve as significant biomarkers in detecting RAS. This further corroborates the role of immune dysregulation in the etiology and predisposition to RAS.

Evaluation of Salivary and Serum Total Antioxidant Capacity and Lipid Peroxidation in Postmenopausal Women

Objective

In menopause, reduction of estrogen hormone affects oxidative stress process in serum. Oxidative stress in saliva plays a significant role in the pathogenesis of oral diseases. The aim of this study was to investigate the total antioxidant capacity and lipid peroxidation in the serum and saliva of premenopausal and postmenopausal women.

Methods

In this case control study, 50 postmenopausal women (case group) and 48 premenopausal women (control group) were selected. The unstimulated whole saliva and serum of the postmenopausal and premenopausal women were collected. The total antioxidant capacity (TAC) of the saliva and serum was measured by ferric reducing antioxidant power (FRAP). Also, malondialdehyde (MDA) was measured by thiobarbituric acid reactive substance (TBARS) method for serum and saliva. Then, the obtained data were analyzed by SPSS 17, whereby Mann–Whitney test and Spearman's correlation test were used. P < 0.05 was considered statistically significant.

Results

The postmenopausal group had significantly lower mean serum TAC and higher mean serum MDA than the control group (P < 0 < 001 and P < 0.01, respectively). The mean salivary TAC and MDA, however, did not differ significantly between the case and control group (P = 0.64 and P = 0.08, respectively).

Conclusion

In postmenopausal women, with elevation of serum MDA and reduction of serum TAC, the extent of serum oxidative stress grows, but MDA and TAC levels of saliva do not change.

Assessment of salivary antioxidant status and immunoglobulin E in patients with geographic tongue

Objective:

One of the possible ways of changing human health might be through the oral mucosa. One of tongue disorders is geographic tongue (GT), which classic manifestation is an area of erythema, with atrophy of filiform papillae of the tongue, surrounded by a serpiginous, white, hyperkeratotic border. Saliva is a rich source of antioxidant and fulfills an important role in maintaining the normal function of the oral cavity. The purpose of the present study was to investigate the status of salivary antioxidant and immunoglobulin E in patients with GT and healthy people.

Materials and Methods:

In this case-control study, samples were gathered from high school students in three municipal regions of Kermanshah, Iran by using multistage random cluster sampling method. The samples included 30 patients with GT (15 men and 15 women with the mean age of 17.6 ± 0.72) and 30 healthy volunteers (15 men and 15 women with the mean age of 17.1 ± 0.61). Saliva samples were collected through standard method, and total antioxidant capacity (TAC), catalase (CAT), and salivary immunoglobulin E were measured.

Results:

In patients with GT, unstimulated salivary shows increased level of immunoglobulin compared with that of control group (P = 0.013). However, there was no significant relationship between control and GT patient groups regarding TAC of saliva (P = 0.91) and CAT (P = 0.83).

Conclusion:

It seems that the activity of CAT enzyme and TAC of saliva does not play primary role in the pathogenesis of GT. However, the level of immunoglobulin E present in saliva can function as an indicator of increased sensitivity in GT.

Comparison of salivary epidermal growth factor in patients with recurrent aphthous stomatitis, smokers, and healthy individuals

Background

Recurrent aphthous stomatitis (RAS) is one of the most common oral ulcerative diseases with unknown etiology. Epidermal growth factor (EGF) has been suggested to play a similar role in RAS. Therefore, this study investigated the salivary EGF level in patients with RAS, the patients without RAS, and smokers.

Materials and Methods

A total of 91 samples were recruited in this case-control study: 30 RAS patients, 30 controls, and 31 smokers. Age and gender were matched in the groups. In the case group, the salivary sample was taken during the infection and remission periods. Salivary EGF concentration was measured by Crystal Dibiotic assay (made in China) using ELISA technique. Finally, the data were analyzed by SPSS software (Version 18.0, Inc., Chicago, IL, USA).

Results

The results of paired t-test showed no statistically significant difference in salivary EGF between the infection and remission periods (P = 0.987). ANOVA test showed a statistically significant difference in EGF between the study groups (P < 0.001), as the mean salivary EGF was significantly lower in the smokers than the case and control groups during the infection and remission periods.

Conclusion

The present study showed a lower level of salivary EGF in the smokers without a history of RAS. There was no statistically significant difference between the infection and remission periods in salivary EGF in the patients with RAS. Furthermore, salivary EGF showed no statistically significant difference between the patients with RAS and the controls.