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Yu Y, Gao Y, Zeng Y, Ge W, Tang C, Xie X, Liu L. Multifunctional hyaluronic acid/gelatin methacryloyl core-shell microneedle for comprehensively treating oral mucosal ulcers. Int J Biol Macromol 2024; 266:131221. [PMID: 38554926 DOI: 10.1016/j.ijbiomac.2024.131221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
Oral ulceration is the most common oral mucosal disease. Oral mucosal ulcers are extremely painful, may interfere with eating and speaking, and potentially complicate systemic symptoms in severe cases. The humid and highly dynamic environment of the oral cavity makes local drug administration for treating oral mucosal ulcers challenging. To overcome these challenges, we designed and prepared a novel dissolving microneedle (MN) patch containing multiple drugs in a core-shell to promote oral ulcer healing. The MNs contained a methacrylate gelatin shell layer of basic fibroblast growth factor (bFGF), a hyaluronic acid (HA) core loaded with dexamethasone (DXMS), and zeolite imidazoline framework-8 (ZIF-8) encapsulated in the HA-based backplane. Progressive degradation of gelatin methacryloyl (GelMA) from the tip of the MN patch in the oral mucosa resulted in sustained bFGF release at the lesion site, significantly promoting cell migration, proliferation, and angiogenesis. Moreover, the rapid release of HA and, subsequently, DXMS inhibited inflammation, and the remaining MN backing after the tip dissolved behaved as a dressing, releasing ZIF-8 for its antimicrobial effects. This novel, multifunctional, transmucosal core-shell MN patch exhibited excellent anti-inflammatory, antimicrobial, and pro-healing effects in vivo and in vitro, suggesting that it can promote oral ulcer healing.
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Affiliation(s)
- Yi Yu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Yijun Gao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Yiyu Zeng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Wenhui Ge
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Chengxuan Tang
- The Third Affiliated Hospital of Wenzhou Medical university, Wenzhou 325200, China
| | - Xiaoyan Xie
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, China.
| | - Liangle Liu
- The Third Affiliated Hospital of Wenzhou Medical university, Wenzhou 325200, China..
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Hijazi AH, Al-Hamed FS, Tamimi F, Al-Maweri SA, Hamdan N, Psutka DJ, Ta P, Klieb H. Regenerative potential of platelet concentrates in chronic oral mucosal lesions. J Oral Biol Craniofac Res 2024; 14:216-221. [PMID: 38487393 PMCID: PMC10937318 DOI: 10.1016/j.jobcr.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/03/2024] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
Chronic oral mucosal diseases (COMDs) represent a significant challenge for clinicians and patients. They are commonly associated with chronic pain and negative effects on healing and patient's quality of life. Regenerative medicine including the use of biological autologous blood-derived substances (e.g., platelet concentrates [PCs]), has been reported to improve healing and reduce pain in orthopedic and maxillofacial surgeries as well as chronic oral mucosal diseases. In this review, we aim to describe the different types of PCs and their applications in the management of COMDs such as lichen planus, mucositis, pemphigus vulgaris, mucous membrane pemphigoid, and plasma cell mucositis, in terms of healing potential, pain control, and quality of life. Overall, PC applications seem to enhance healing and reduce pain in patients with COMDs. However, due to the small sample size and the lack of standardized clinical trials, further research is required to support these findings.
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Affiliation(s)
- Abdel-Hameed Hijazi
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Sinai University – Kantara Branch, Ismailia, 41636, Egypt
| | | | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Nader Hamdan
- School of Dentistry, University of Alberta, Edmonton, Canada
| | - David J. Psutka
- Faculty of Dentistry, University of Toronto, Ontario, Canada
- Senior Surgeon, Mount Sinai Hospital Center of Excellence for Advanced TMJ Reconstructive Surgery, Ontario, Canada
| | - Peter Ta
- Faculty of Dentistry, University of Toronto, Ontario, Canada
- Staff Surgeon, Sunnybrook Health Sciences Centre and Trillium Health Partners, Ontario, Canada
| | - Hagen Klieb
- Department of Oral and Maxillofacial Sciences, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
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Güneri P, Epstein JB, Bolukbasi G, Spielberger RT. Neutropenic ulcers in oncology: terminology, diagnosis, and management. Support Care Cancer 2023; 31:716. [PMID: 37991547 DOI: 10.1007/s00520-023-08187-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Neutropenic ulcerations are characterized by mucosal ulcerations which occur in the presence of neutropenia, suggesting a direct link between neutropenia and mucosal ulceration. An oral ulcer can be labeled as "neutropenic" only if the patients have primary (typically congenital) or secondary neutropenia, and neutropenia is the sole causative factor. Oral mucosal ulcers observed in patients undergoing oncologic therapy may also be termed as "neutropenic ulcers", but the pathogenesis of these oral ulcers more likely involves mucosal events related to trauma, microbial factors, and direct cytotoxicity. In cancer patients, the early appearance of oral ulcers is often attributed to oral mucositis which is a condition primarily caused by the direct mucosal cytotoxicity of chemotherapeutic agents and radiation therapy. Oral ulcers that develop later during or after active cancer therapy may result from intraoral trauma and typically manifest on non-keratinized areas of the oral mucosa which are more susceptible to mucosal damage. In patients undergoing chemotherapy, factors such as disturbances in mucosal barrier function as well as bone marrow suppression lead to reduced neutrophil count and function, and can contribute to the development of oral ulcers. While the etiology of oral ulcers in cancer therapy receiving patients can vary, it is important to emphasize that the host's response plays a crucial role in the progression and repair process of these lesions. This narrative review presents the etiopathogenesis, clinical presentation, and potential management approaches for oral ulcerations in neutropenic patients, with a particular focus on clarifying the usage of the term "neutropenic ulcer" since this term lacks diagnostic specificity and can be misleading in clinical practice regarding the underlying causes and treatment strategies.
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Affiliation(s)
- Pelin Güneri
- Department of Oral and Maxillofacial Radiology, Ege University School of Dentistry, İzmir, Turkey
| | - Joel B Epstein
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Cedars Sinai Health System, Los Angeles, CA, USA
| | - Gaye Bolukbasi
- Department of Oral and Maxillofacial Radiology, Ege University School of Dentistry, İzmir, Turkey.
| | - Ricardo T Spielberger
- Department of Hematology and Cellular Therapy, City of Hope Cancer Center, Duarte, CA, USA
- Department of BMT, Southern California Permanente Medical Group, Los Angeles, CA, USA
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Soares GC, Alves APNN, de Sousa AM, Dantas TF, de Barros Silva PG, Júnior EML, de Moraes Filho MO, Paier CRK, Rodrigues FAR, Mota MRL. Evaluation of the healing potential of Nile tilapia skin collagen in traumatic oral ulcers in male rats. Arch Oral Biol 2023; 155:105793. [PMID: 37633029 DOI: 10.1016/j.archoralbio.2023.105793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/06/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE To evaluate the healing potential of Nile tilapia skin collagen using a rat model with experimentally induced traumatic oral ulcers. DESIGN Male Wistar rats were segregated into three experimental groups (n = 8/group/euthanasia day). Ulcers were induced using a dermatological punch on the left buccal mucosa. The rats were then euthanized on days 1, 5, 10, 15, and 20 (ntotal=120 rats). Each group received topical treatment, 2x/day, with 1 % Nile tilapia skin collagen orabase (experimental group), only orabase (negative control), or Oncilom-A® orabase (positive control). Ulcer area, closure percentage, and body mass variation were measured. Slides were prepared for histological analysis, which included Picrosirius red staining (collagen analysis), and immunohistochemistry (platelet endothelial cell adhesion molecule, alpha-smooth muscle actin, and transforming growth factor-beta). RESULTS On day 15, the experimental and positive control groups displayed smaller ulcer areas, a higher percentage of closure, complete re-epithelialization, superior histological repair scores, and a reduced count of polymorphonuclear cells in comparison to the negative control group (p < 0.05). Additionally, the experimental group exhibited an increased number of blood vessels, total collagen (types I and III) and expression of platelet endothelial cell adhesion molecule, alpha-smooth muscle actin, and transforming growth factor-beta relative to the negative and positive control groups (p < 0.05). By day 20, the experimental group showed a more significant weight gain compared to the other groups (p < 0.0001). CONCLUSIONS Nile tilapia skin collagen orabase optimizes the healing of traumatic ulcers by stimulating re-epithelialization, angiogenesis, and collagenesis. Transforming growth factor-beta plays a significant role in this process.
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Affiliation(s)
- Guilherme Costa Soares
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil
| | | | - Alceu Machado de Sousa
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil
| | - Tales Freitas Dantas
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil
| | - Paulo Goberlânio de Barros Silva
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil; Ceara Cancer Institute, Hospital Haroldo Juaçaba, Fortaleza, Brazil
| | | | - Manoel Odorico de Moraes Filho
- Drug Research and Development Center, Federal University of Ceara, Fortaleza, Brazil; Translational Medicine Postgraduate Program, Federal University of Ceara, Fortaleza, Brazil
| | - Carlos Roberto Koscky Paier
- Drug Research and Development Center, Federal University of Ceara, Fortaleza, Brazil; Translational Medicine Postgraduate Program, Federal University of Ceara, Fortaleza, Brazil
| | - Felipe Augusto Rocha Rodrigues
- Drug Research and Development Center, Federal University of Ceara, Fortaleza, Brazil; Translational Medicine Postgraduate Program, Federal University of Ceara, Fortaleza, Brazil
| | - Mário Rogério Lima Mota
- Department of Dental Clinic, Stomatology and Oral Pathology Sector, Federal University of Ceara, Fortaleza, Brazil.
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Alsahaf S, Alkurdi KA, Challacombe SJ, Tappuni AR. Topical betamethasone and systemic colchicine for treatment of recurrent aphthous stomatitis: a randomised clinical trial. BMC Oral Health 2023; 23:709. [PMID: 37789351 PMCID: PMC10548625 DOI: 10.1186/s12903-023-03335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/19/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Recurrent Aphthous Stomatitis (RAS) is painful oral ulceration frequently treated with topical steroids. There is limited published evidence for the efficacy of any treatment for RAS and there remains a need for longitudinal randomised clinical trials to evaluate and compare the effectiveness of different therapies in the management of RAS. The aim of the current project was to assess the efficacy of betamethasone mouthwash and colchicine tablets, individually and combined, for the treatment of RAS, and to establish the optimum treatment period necessary for a significant reduction in the disease severity. METHODOLOGY A randomised, prospective, parallel-group clinical trial was conducted over one year, to compare the efficacy of three therapies in RAS. One hundred and six patients were randomized into three groups; 35 received betamethasone mouthwash, 35 had colchicine tablets and 36 received both therapies. The response was evaluated quantitatively every 3 months for 1 year, using the Ulcer Severity Score (USS). RESULTS For all three treatment regimes, the mean USS decreased by about 30% in the first 3 months (p < 0.001). Further improvement was noted for up to 9 months. At the end of the study, the mean USS had improved by 50% from 34.9 ± 7.2 before treatment to 17.5 ± 8.9 after treatment (p < 0.001). Of included participants, 86% showed significant clinical improvement by the end of the study. There were no significant differences in outcomes between the three regimes (p < 0.05). CONCLUSIONS This clinical trial has provided evidence for the efficacy of betamethasone mouthwash and for colchicine tablets in the treatment of RAS and has shown that at least six months of treatment may be required for optimum effect. CLINICAL TRIAL REGISTRATION NUMBER ISRCTN3267716. Date of clinical trial registration: 15/04/2018.
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Affiliation(s)
- Surab Alsahaf
- Oral Medicine, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, and Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Khlood A Alkurdi
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Office 7, Floor 4, London, E1 2AD, UK
| | - Stephen J Challacombe
- Oral Medicine, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, and Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Anwar R Tappuni
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Office 7, Floor 4, London, E1 2AD, UK.
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Zeng Y, Gao Y, He L, Ge W, Liu J, Yu Y, Xie X. Multifunctional polysaccharide composited microneedle for oral ulcers healing. Mater Today Bio 2023; 22:100782. [PMID: 37706204 PMCID: PMC10495667 DOI: 10.1016/j.mtbio.2023.100782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023] Open
Abstract
Oral ulcers have periodicity and recurrence, and the etiology and causative mechanisms remain unclear; therefore, it is difficult to treat oral ulcers effectively. Current clinical treatment methods mainly include pain relief and administration of anti-inflammatories to prevent secondary infections and a prolonged recurrence cycle. However, these traditional treatment methods are administered independently and are susceptible to muscle movements and constant salivary secretion in the mouth, resulting in ineffective drug functioning. Therefore, development of a novel treatment to reduce wound infection and accelerate wound healing for oral ulcers is required for effective treatment. Herein, we report a multifunctional polysaccharide composite microneedle patch based on hyaluronic acid (HA) and hydroxypropyl trimethyl ammonium chloride chitosan (HACC) loaded with dexamethasone (DXMS) and basic fibroblast growth factor (bFGF) for oral ulcer healing. DXMS and bFGF encapsulated the HA tip portion of the microneedle patch, endowing the microneedle patches with anti-inflammatory and angiogenic properties. HACC was applied to the back of the microneedle patch, adding antibacterial properties. The experimental results indicated that the prepared dressings exhibited good antibacterial activity and effectively promoted cell migration growth and angiogenesis. More importantly, animal experiments have shown that multifunctional microneedle patches can effectively promote oral ulcer healing. Thus, these novel multifunctional polysaccharide composite microneedle patches have great potential for oral ulcers treatment.
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Affiliation(s)
- Yiyu Zeng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, PR China
| | - Yijun Gao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, PR China
| | - Liming He
- Department of Stomatology, Changsha Stomatological Hospital, Changsha, 410004, PR China
| | - Wenhui Ge
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, PR China
| | - Junhui Liu
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410000, PR China
| | - Yi Yu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, PR China
| | - Xiaoyan Xie
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011, PR China
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Folayan MO, Zuñiga RAA, Virtanen JI, Aly NM, Ezechi OC, Lusher J, El Tantawi M, Nguyen AL. Risk indicators for oral ulcers among people living with HIV during the first wave of the pandemic: a cross sectional study. BMC Oral Health 2023; 23:600. [PMID: 37635219 PMCID: PMC10463981 DOI: 10.1186/s12903-023-03330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Little is currently known about HIV-related parameters that may increase the risk for oral ulcers during the COVID-19 pandemic. This study aimed to overcome this gap in research by assessing the associations between HIV viral load, antiretroviral adherence profile, co-morbidity status, SARS-CoV-2 infection and oral ulcers among people living with HIV (PLHIV). METHODS This was a secondary analysis of data generated from 21,206 to 18 years and above, recruited from 152 countries through an online survey between July and December 2020. Data were extracted for 874 people who reported living with HIV. The dependent variable was reporting having oral ulcer. The independent variables were the viral load, adherence to antiretroviral treatment and a history of SARS-CoV-2 infection. The confounding variables were age at last birthday and sex at birth. A multivariable logistic regression analysis was conducted to determine the associations between the dependent and independent variables after adjusting for the confounding variables. RESULTS Of the 874 participants, 99 (11.3%) reported having oral ulcers during the first wave of the COVID-19 pandemic. The odds of PLHIV having oral ulcers during the first wave of the COVID-19 pandemic was significantly higher for people who did not know their viral load than those who had undetectable viral load (AOR: 2.036; 95% CI: 1.204-3.443; p = 0.008); and people who did not adhere to the use of antiretroviral treatment than those who adhered (AOR: 4.113; 95% CI: 2.567-6.589; p < 0.001). Also, PLHIV who had SARS-CoV-2 infection had significantly higher odds of having oral ulcers than those who did not have the infection (AOR: 14.556; 95% CI: 4.500-47.078; p < 0.001). PLHIV who had co-morbidities had non-significantly higher odds of having oral ulcers than those without co-morbidities (AOR: 1.170; 95% CI: 0.656-2.085; p = 0.595). CONCLUSION Oral ulcers may be an indicator of poor adherence to antiretroviral therapy and unsuppressed viral load among PLHIV. It may also be an indicator of SARS-CoV-2 infection and a signal to take prompt and critical care of affected individuals because of the risk for severe COVID-19 for these individuals.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria.
| | - Roberto Ariel Abeldaño Zuñiga
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Postgraduate Department, University of Sierra Sur., Oaxaca, Mexico
| | - Jorma I Virtanen
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Nourhan M Aly
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Oliver C Ezechi
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Joanne Lusher
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Provost's Group, Regent's University London, London, UK
| | - Maha El Tantawi
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Annie L Nguyen
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Ge W, Gao Y, He L, Zeng Y, Liu J, Yu Y, Xie X, Xu RA. Combination therapy using multifunctional dissolvable hyaluronic acid microneedles for oral ulcers. Int J Biol Macromol 2023; 251:126333. [PMID: 37586633 DOI: 10.1016/j.ijbiomac.2023.126333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/11/2023] [Accepted: 08/12/2023] [Indexed: 08/18/2023]
Abstract
Oral ulcers are common in the oral mucosa. Frequent occurrences of oral ulcers commonly afflict patients, seriously impacting their daily life. Treatments with good anti-inflammatory and antibacterial properties are important for promoting the healing of oral ulcers. In this study, a multifunctional, soluble hyaluronic acid (HA) microneedle (MN) patch was prepared to promote oral ulcer healing. The tip layer of the MN patch was loaded with triamcinolone acetonide (TA) and epidermal growth factor (EGF) to inhibit inflammation and promote angiogenesis. Zeolitic imidazolate framework-8 (ZIF-8) was loaded onto the base layer of the MN patch, which effectively released Zn2+ to mediate antibacterial effects. In addition, HA exerts a protective effect on the mucous membrane. Owing to these properties, the multifunctional MN patches were found to have good anti-inflammatory, antibacterial, and tissue-healing abilities, indicating that the multifunctional MN patch design successfully promoted the healing of oral ulcers.
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Affiliation(s)
- Wenhui Ge
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, PR China
| | - Yijun Gao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, PR China
| | - Liming He
- Changsha Stomatological Hospital, Changsha 410005, PR China
| | - Yiyu Zeng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, PR China
| | - Junhui Liu
- Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, Changsha 410000, PR China
| | - Yi Yu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, PR China
| | - Xiaoyan Xie
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, PR China.
| | - Ren-Ai Xu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, PR China.
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Vaezi Moghaddam A, Mortazavi SA, Kobarfard F, Bafkary R, Darbasizadeh B. Synthesis and functionalization of mucoadhesive mesoporous silica particles containing diphenhydramine for treatment of aphthous ulcers. Bioimpacts 2023; 13:456-466. [PMID: 38022378 PMCID: PMC10676526 DOI: 10.34172/bi.2023.27548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/15/2022] [Accepted: 11/19/2022] [Indexed: 12/01/2023]
Abstract
Introduction Medications used to treat oral ulcers include corticosteroids, anesthetics, and antihistamines. These can be used as gels, mouthwashes, pastes, ointments, etc. Diphenhydramine hydrochloride (DPH) has local anesthetic properties that can help treat the aphthae. One of the drawbacks of the delivery to the transmucosal is the quick turnaround time of the gel, a mucous form that is located on the epithelial film surface. Methods Therefore, it seems that the preparation of a carrier that has the characteristics of adhesive mucus can increase the duration of drug retention on the mucous surface. To solve this problem, mesoporous silica nanoparticles (MSNPs) were synthesized and functionalized with amino and thiol groups and suggested as a system of drug delivery. The properties and structure of MSNPs were investigated by dynamic light scattering (DLS), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDS), thermal gravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR), and nitrogen adsorption-desorption isotherms (BET). Results Our outcomes indicated that the average sizes of bare MSNPs (MSN), amino modified MSNPs (MSN-NH2), and thiol modified MSNPs (MSN-SH) were obtained to be 611, 655, and 655 nm respectively and the average pore size of MSN, MSN-NH2, and MSN-SH were about 2.42 nm, 2.42 nm, and 2.44 nm, respectively, according to the BJH (Barrett-Joyner-Halenda) pore size distribution. The release kinetics and release of DPH from mesoporous silica carriers were evaluated. Conclusion Eventually, the mucoadhesive study and DPH-loaded particles were investigated. Also, the MSN-SH exhibited a high mucoadhesive capacity for buccal mucosa compared with MSN-NH2 and MSN.
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Affiliation(s)
- Azadeh Vaezi Moghaddam
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Mortazavi
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Kobarfard
- Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Bafkary
- Department of Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Behzad Darbasizadeh
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hasan S, Perween N, Saeed S, Kaur M, Gombra V, Rai A. Evaluation of 5% Amlexenox Oral Paste and Rebamipide Tablets in Treatment of Recurrent Apthous Stomatitis and Comparison with Dologel CT. Indian J Otolaryngol Head Neck Surg 2022; 74:5228-5234. [PMID: 36742475 PMCID: PMC9895324 DOI: 10.1007/s12070-020-01858-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/11/2020] [Indexed: 02/07/2023] Open
Abstract
Recurrent aphthous stomatitis (RAS) is a frequently seen oral ulcerative lesion, manifesting as multiple, recurrent, shallow, irregular ulcers encircled by an erythematous halo. The precise etiopathogenesis is obscure, although the recent understanding suggests an underlying immune-mediated etiology. However, there is no defined management protocol and the principal therapy aims to attain symptomatic respite. 150 clinically diagnosed RAS patients of both sexes in the age range of 15-65 years were randomly allocated and divided into two cohorts, namely Group A (75 RAS patients receiving 5% Amlexanox paste + 100 mg Rebamipide tab.) and Group B (75 RAS patients receiving Dologel CT). Effectiveness of 5% Amlexanox oral paste and Rebamipide tablets in diminution of the ulcer size, erythema and pain was assessed and compared with Dologel CT therapy. The study showed an equal gender distribution. Majority of the patients were in the younger age range (25-35 years) and labial and buccal mucosa were the commonest affected sites. Although, both 5% Amlexanox and Rebamipide tablets and Dologel CT showed statistically significant resolution in the ulcer size, erythema, and associated pain. However, 5% oral Amlexanox paste and Rebamipide tablets are more efficacious in the treatment of RAS and tend to heal the ulcer at a more accelerated pace. Our research concluded that 5% oral Amlexanox paste and Rebamipide tablets tend to heal the ulcer at a more accelerated pace as compared to Dologel CT.
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Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, 110025 India
| | - Naila Perween
- Final Year BDS Student-During Short Term Studentship (STS) ICMR -2015, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, 110025 India
| | - Shazina Saeed
- Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh India
| | - Mandeep Kaur
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, 110025 India
| | - Virender Gombra
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, 110025 India
| | - Arpita Rai
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, 110025 India
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11
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Ganesan A, Kumar S, Kaur A, Chaudhry K, Kumar P, Dutt N, Nag VL, Garg MK. Oral Manifestations of COVID-19 Infection: An Analytical Cross-Sectional Study. J Maxillofac Oral Surg 2022; 21:1326-1335. [PMID: 35153394 PMCID: PMC8817159 DOI: 10.1007/s12663-021-01679-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/26/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives The current COVID-19 pandemic has created a huge impact across the globe. Recent literature has reported the occurrence of varied oral lesions in COVID-19 patients in the form of sporadic case reports. This analytical cross-sectional study was carried out to gauge and understand the pattern of oral lesions in qualitative RT-PCR-confirmed COVID-19 patients. Methods A cross-sectional study involves a total of 500 qualitative RT-PCR confirmed, hospitalized COVID-19 patients who were meticulously scanned for any hard and soft tissue lesions developing concomitantly with the disease occurrence. Results This study included a total of 367 (73.4%) males and 133 (26.6%) female patients with a mean age of 53.46 ± 17.50 years. Almost 51.2% of patients presented with gustatory disturbance, 28% with xerostomia and 15.4% of patients were found to have oral findings like erythema, ulcers, depapillation of tongue. There was a statistically significant correlation between oral manifestations and disease severity (p ≤ 0.001). Conclusion COVID-19 is found to effect oral health with greater probability in patients with severe diseases (SARI) which may be due to disease itself, immune response and lack of motivation for personal hygiene measures. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-021-01679-x.
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Affiliation(s)
- Aparna Ganesan
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Shailendra Kumar
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Amanjot Kaur
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Kirti Chaudhry
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Pravin Kumar
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Naveen Dutt
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - M. K. Garg
- Department of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan India
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12
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Hoey J, Solomon JL, Kim B, Carsons S, Nusbaum J. Melanoma differentiation-associated gene 5 amyopathic dermatomyositis following an acute Mycoplasma pneumoniae infection: a case report. J Med Case Rep 2022; 16:401. [PMID: 36316755 PMCID: PMC9623992 DOI: 10.1186/s13256-022-03616-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A previously healthy young male of Southeast Asian descent presented with 6 weeks of fevers, cough, mucocutaneous ulcers, arthritis, and myalgias. Initial workup revealed positive Mycoplasma pneumoniae immunoglobulin M, and the patient was treated with antibiotics without relief of symptoms. Rheumatologic workup revealed highly positive melanoma differentiation-associated gene 5 antibody. Viral infections are thought to potentially trigger loss of self tolerance, and prompt the autoimmunity cascade that can result in conditions such as dermatomyositis. To our knowledge, this is the first case report demonstrating a non-viral infection, specifically Mycoplasma pneumoniae, as the inciting infectious trigger for the anti-melanoma differentiation-associated gene 5 dermatomyositis subtype. CASE PRESENTATION A 20-year-old southeast Asian-American male with no significant past medical history presented with symptoms of intermittent fevers, nonproductive cough, dry eyes, oral ulcers, rash, arthritis, and myalgias. The patient was noted to have erythematous papules across the bilateral hands along the lateral digits and palms, as well as synovitis involving the bilateral hands and feet. Immunoglobulin M antibodies were positive for Mycoplasma pneumoniae. The patient was diagnosed with mycoplasma pneumonia. The patient did not respond to a course of antibiotics, leading to rheumatological testing that found highly positive melanoma differentiation-associated gene 5 autoantibody. Muscle enzyme and electromyography testing were normal, indicating clinically amyopathic disease. Methylprednisolone was initiated, with resolution of fevers and improvement of arthritis and myalgias. The cutaneous lesions on the digits and palms improved. CONCLUSIONS This patient presented with symptoms of fever, cough, oral ulcers, rashes, and arthritis, and blood work demonstrated the presence of immunoglobulin M antibodies to Mycoplasma pneumoniae. Despite antibiotic treatment for the presumed diagnosis of Mycoplasma pneumoniae infection, the patient did not improve, prompting rheumatological workup and revealing melanoma differentiation-associated gene 5 autoantibodies. This case suggests that infections, other than viral, can trigger the autoinflammatory cascade, leading to the development of amyopathic melanoma differentiation-associated gene 5 dermatomyositis.
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Affiliation(s)
- Jessica Hoey
- Division of Rheumatology, Allergy, and Immunology, NYU Long Island School of Medicine, Mineola, NY USA
| | - Jenny Lue Solomon
- grid.281603.e0000 0001 0228 085XDepartment of Internal Medicine, NYU Langone Hospital, Long Island, Mineola, NY USA
| | - Brandon Kim
- grid.281603.e0000 0001 0228 085XDepartment of Internal Medicine, NYU Langone Hospital, Long Island, Mineola, NY USA
| | - Steven Carsons
- Division of Rheumatology, Allergy, and Immunology, NYU Long Island School of Medicine, Mineola, NY USA
| | - Julie Nusbaum
- Division of Rheumatology, Allergy, and Immunology, NYU Long Island School of Medicine, Mineola, NY USA
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13
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Gambino A, Cafaro A, Broccoletti R, Turotti L, Karimi D, Haddad GE, Hopper C, Porter SR, Chiusa L, Arduino PG. In vivo evaluation of traumatic and malignant oral ulcers with optical coherence tomography: A comparison between histopathological and ultrastructural findings. Photodiagnosis Photodyn Ther 2022; 39:103019. [PMID: 35850459 DOI: 10.1016/j.pdpdt.2022.103019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022]
Abstract
Ulcers in the oral mucosa is a relatively common, although challenging, entity in oral medicine, as it can arise due to a wide range of traumatic, infective, autoimmune, and neoplastic disorders. Although histopathology of lesional and peri‑lesional tissues remains the gold standard for persistent oral breaching, optical coherence tomography (OCT) has been recently suggested as a potential ally to enhance the early or non-invasive diagnosis of likely causation. The aim of the present study was to provide an in-vivo OCT analysis and description from a sample of 70 patients affected by traumatic or neoplastic-related ulcers, located on the buccal mucosa, tongue or gingiva, and compare the OCT data with those of 20 patients with healthy oral mucosa. OCT dynamic scans revealed clear distinction of epithelial layer (EP), lamina propria (LP) of healthy buccal mucosa, gingiva, and tongue as well as allowing observation of the keratin layer in gingiva, and the subepithelial vascularization of each site. Traumatic lesions had an EP of reduced in thickness, with an irregular, if not disrupted surface. Interestingly, LP seemed to preserve its reflectiveness and vascularization only in the traumatic lesions. Among neoplastic lesions, regardless their site of onset, both EP integrity/homogeneity, and LP reflectiveness/vascularization were lost and unrecognizable when compared to their healthy counterparts. OCT scanning allowed some differentiation between traumatic and malignant ulcers and thus may a useful and non-invasive means of determining the need and/or urgency of histopathological examination of oral lesions.
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Affiliation(s)
- Alessio Gambino
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Italy.
| | - Adriana Cafaro
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Italy
| | - Luca Turotti
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Italy
| | - Dora Karimi
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Italy
| | - Giorgia El Haddad
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Italy
| | - Colin Hopper
- Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Stephen R Porter
- Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Luigi Chiusa
- A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Paolo G Arduino
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Italy
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14
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Magdy E, Shafik S, Saadany BEL. Platelet rich fibrin a new approach in management of persistent oral ulcers in blistering skin diseases. Wound Repair Regen 2022; 30:491-497. [PMID: 35589608 DOI: 10.1111/wrr.13020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/18/2022] [Accepted: 05/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Eman Magdy
- Lecturer of Oral medicine, diagnosis and periodontology, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt
| | - Sherif Shafik
- Lecturer of Oral and Maxillofacial Radiology, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Basma E L Saadany
- Lecturer of Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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15
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Abstract
The prevalence of oral ulcers in children is reported to be 9%, however diagnosis of oral lesions can be challenging, being an unspecific symptom of several diseases. Differential diagnosis can range from classic infectious disease of childhood (e.g. herpangina, hand-foot-and-mouth-disease) over nutritional deficiencies, gastrointestinal disorders, inflammations (e.g. pemphigus vulgaris, lichen planus, mucous membrane pemphigoid) to side effects of medications (Stevens-Johnson Syndrome) or chronic dieseases (e.g. sarcoidosis, systemic Lupus erythematodes, familial Mediterrenean fever). Therefore, children with oral ulcers are treated by many different specialists such as dentists, family doctors, paediatricians, rheumatologists, haematologists, gastroenterologists and otorhinolaryngologists.A systematic literature search and a narrative literature review about the potential 48 diseases connected to oral ulcers were performed. According to the duration of symptoms and size of the lesions, a tabular overview was created to support the clinician in making a correct diagnosis, additionally different treatment options are presented.
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Affiliation(s)
- Corinne Légeret
- University Children’s Hospital of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- University Children’s Hospital Basel, Spitalstrasse 31, 4055 Basel, Switzerland
| | - Raoul Furlano
- University Children’s Hospital of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- University Children’s Hospital Basel, Spitalstrasse 31, 4055 Basel, Switzerland
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16
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Kechaou I, Abida R, Hamdi MS, Hassine LB. Palate Tuberculosis with Paradoxical Lymphadenitis. J Glob Infect Dis 2021; 13:94-96. [PMID: 34194177 PMCID: PMC8213087 DOI: 10.4103/jgid.jgid_266_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/05/2020] [Accepted: 12/22/2020] [Indexed: 11/04/2022] Open
Abstract
Oral cavity involvement in tuberculosis (TB), particularly palatine, is extremely rare and mostly described in case reports. Management of these cases usually responds to classic antitubercular therapy. Some serious complications such as paradoxical reactions (PRs) may however occur, making it more challenging for physicians to treat and to manage. We present a case of a 30-year-old female patient with a history of juvenile idiopathic arthritis and systemic lupus erythematosus who presented a bifocal form of TB involving the palate and the cervical lymph nodes. Follow-up after 2 months of proper antitubercular treatment revealed a PR of the lymph nodes contrasting with a favorable outcome of the oral lesions. It seems useful to raise all clinicians' awareness to suspect TB when they deal with chronic drug-resistant oral erosions and to keep in mind the diagnosis of PR when there is a worsening of one lesion and a favorable outcome of another.
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Affiliation(s)
- Ines Kechaou
- Department B of Internal Medicine, Faculty of Medicine, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Rym Abida
- Department B of Internal Medicine, Faculty of Medicine, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Salah Hamdi
- Department B of Internal Medicine, Faculty of Medicine, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Lamia Ben Hassine
- Department B of Internal Medicine, Faculty of Medicine, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
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17
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Andisheh-Tadbir A, Yaghoubi A, Tanideh N, Mardani M. The effect of indocyanine green-mediated photodynamic therapy in healing of experimentally induced oral mucosal traumatic ulcer in rat. Lasers Med Sci 2021; 36:611-618. [PMID: 32654066 DOI: 10.1007/s10103-020-03096-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 07/01/2020] [Indexed: 11/25/2022]
Abstract
Photodynamic therapy (PDT) is a promising approach for the healing of ulcerative lesions. This study aimed to investigate the effect of PDT using indocyanine green (ICG) in the healing of the experimentally induced oral mucosal traumatic ulcer in rat. Sixty adult male Sprague-Dawley rats were recruited in this experimental study. The ulceration was surgically made in the left cheek mucosa, and the rats were randomly assigned into four equal groups (n = 15). Oral ulcers in groups 1 and 2 were treated with the sterile saline solution (0.9%) and ICG (1 mg/ml). In group 3, laser irradiation was applied using the 810 nm diode laser in the continuous-wave mode for 30 s (light dose: 55 J/cm2, power: 300 mW, spot size: 4.5 mm). Following the topical application of ICG (1 mg/ml) in group 4, laser irradiation was performed in the same way as the previous group. After 24 h, treatments were repeated once more in all groups. The healing process was histopathologically assessed at the 3rd, 7th, and 14th days after ulceration. Wound healing was significantly accelerated in the ICG-mediated PDT group in comparison to the control group at all sampling time points (p < 0.005). However, the other groups displayed a similar healing rate (p > 0.05). Data suggest that ICG-mediated PDT has the potential to accelerate wound healing and prevent clinical infection in oral mucosal traumatic ulcers. However, further studies are required to confirm whether our results can be generalized to other wounds.
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Affiliation(s)
- Azadeh Andisheh-Tadbir
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Yaghoubi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Tanideh
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Mardani
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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18
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Mardani M, Sadeghzadeh A, Tanideh N, Andisheh-Tadbir A, Lavaee F, Zarei M, Moayedi J. The effects of adipose tissue-derived stem cells seeded onto the curcumin-loaded collagen scaffold in healing of experimentally- induced oral mucosal ulcers in rat. Iran J Basic Med Sci 2020; 23:1618-1627. [PMID: 33489037 PMCID: PMC7811821 DOI: 10.22038/ijbms.2020.48698.11171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/12/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Various therapeutic approaches, including stem-cell-based strategies and tissue engineering, have been proposed for oral ulcerative lesions. We investigated the effects of adipose tissue-derived stem cells (ADSCs) seeded onto the curcumin-loaded collagen scaffold in the mucosal healing of oral ulcers in rats. MATERIALS AND METHODS The current experimental study was conducted on 40 male Sprague-Dawley rats. Oral ulcers were created over both sides of buccal mucosa, and the rats were randomly divided into four equal groups: 1) an untreated group (negative control); 2) Teriadent-treated group (positive control); 3) group treated with curcumin-loaded collagen scaffold; and 4) group received the ADSCs (3 × 106 cells) seeded onto the curcumin-loaded collagen scaffold. Rats were sacrificed on 3rd and 7th day after ulceration for histopathological examination as well as measurement of tissue levels of myeloperoxidase (MPO), superoxide dismutase (SOD), and Interleukin-1 beta (IL-1β) activity. RESULTS Compared with the negative control, the tissue levels of MPO and IL-1β were significantly decreased in all treated groups (P<0.0001); however, the SOD activity was elevated (P<0.0001). The highest SOD activity as well as the lowest MPO and IL-1β levels were observed in the ADSCs-curcumin-loaded collagen scaffold group. The ulcer healing process at 3rd and 7th day follow-up was much more progressed in the ADSCs-curcumin-loaded collagen scaffold group in comparison with the untreated group (P=0.037 and P=0.004, respectively). CONCLUSION According to the findings of this study, ADSCs seeded onto the curcumin-loaded collagen scaffold seems to have a promising potential for oral ulcer healing applications.
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Affiliation(s)
- Maryam Mardani
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Sadeghzadeh
- Postgraduate Student, Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Tanideh
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Andisheh-Tadbir
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Lavaee
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Moein Zarei
- West Pomeranian University of Technology, Szczecin, Department of Polymer and Biomaterials Science, Al. Piastow 45, 71-311 Szczecin, Poland
| | - Javad Moayedi
- Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Center of Comparative and Experimental Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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19
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Chen P, Yao H, Yuan Q, Li P, Wang X, Su W, Wang Y, Li P. Discovery of the possible mechanisms in kouyanqing granule for treatment of oral ulcers based on network pharmacology. BMC Complement Med Ther 2020; 20:258. [PMID: 32811507 PMCID: PMC7436979 DOI: 10.1186/s12906-020-03043-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 08/05/2020] [Indexed: 12/02/2022] Open
Abstract
Background Oral ulcer diseases are complex inflammatory diseases caused by multi-factors, which severely impact patient quality of life. Kouyanqing Granule (KYQG) has been used to treat inflammatory diseases of the mouth and throat, including recurrent aphthous stomatitis (RAS), traumatic ulcers, oral leukoplakia and so on. However, the underlying molecular mechanisms of KYQG in treating these diseases are still unclear. We aimed to explore the possible mechanisms in KYQG for the treatment of oral ulcers. Methods An innovative network pharmacology method was established by incorporating targets searching and fishing, network analysis, and silico validation to discover the pharmacological mechanisms of action of KYQG for the treatment of oral ulcers. Then, we verified the reliability of this method by an animal experiment. Results Our data indicated that a total of 47 key targets were screened, which mainly involved in three function modules including the inhibition of inflammation, the regulation of immunological response, and the suppression of oxidative stress. The implementation of these functions relies on the complex multi-pathways network, especially TNF signaling pathway and HIF-1 signaling pathway. The results of the experimental verification indicated that KYQG significantly inhibited the serum levels of cyclooxygenase-2 (COX2), matrix metalloproteinase 9 (MMP9) and tumor necrosis factor-alpha (TNF-α) in rats with oral ulcer. Conclusion KYQG exhibited the therapeutic effects on oral ulcers probably by inhibiting inflammation, regulating immunological response, and suppressing oxidative stress through a complex multi-pathways network. Particularly, TNF signaling pathway and HIF-1 signaling pathway may play crucial roles in the protection of KYQG against oral ulcers. This work not only offers a method for understanding the functional mechanisms of KYQG for treating oral ulcer diseases from a multi-scale perspective but also may provide an efficient way for research and development of complex composition formula.
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Affiliation(s)
- Pan Chen
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Hongliang Yao
- Guangdong Key Laboratory of Animal Conservation and Resource Utilization, Guangdong Public Laboratory of Wild Animal Conservation and Utilization, Drug Synthesis and Evaluation Center, Guangdong Institute of Applied Biological Resources, Guangzhou, 510260, China
| | - Qing Yuan
- The school of Basic Medical Sciences, Southwest medical university, Luzhou, 646000, China
| | - Panlin Li
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Xinning Wang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Weiwei Su
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Yonggang Wang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China
| | - Peibo Li
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, 510275, China.
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20
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Abstract
Signs and symptoms representative of a systemic condition can manifest in the oral cavity and orofacial region. Such conditions may be previously diagnosed, or the orofacial manifestation may be the presenting sign of an acute or chronic systemic condition not previously diagnosed. Pathologic processes in the mouth, jaws, and contiguous structures could have a direct and indirect impact on the patient's overall systemic condition. Moreover, systemic conditions may result in compromised function of the orofacial region or impact patients' oral health profile. This article reviews selected systemic conditions that present or impact on the oral cavity and orofacial region.
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Affiliation(s)
- Joel J Napeñas
- Department of Oral Medicine, Atrium Health's Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA.
| | - Michael T Brennan
- Department of Oral Medicine, Atrium Health's Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232, USA
| | - Sharon Elad
- Division of Oral Medicine, Hospital Dentistry, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Avenue, Rochester, NY 14620, USA
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21
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Sánchez-Bernal J, Conejero C, Conejero R. Recurrent Aphthous Stomatitis. Actas Dermosifiliogr (Engl Ed) 2020; 111:471-480. [PMID: 32451064 DOI: 10.1016/j.ad.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/17/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
Recurrent aphthous stomatitis is a chronic inflammatory disease of the oral mucosa. It is characterized by painful mouth ulcers that cannot be explained by an underlying disease. Recurrent oral mucosal ulcers require a proper differential diagnosis to rule out other possible causes before recurrent aphthous stomatitis is diagnosed. The condition is common, with prevalence rates ranging from 5 to 60% in different series. Its pathogenesis is unknown, but multiple factors are considered to play a part. There are no standardized treatments for this condition and none of the treatments are curative. The goal of any treatment should be to alleviate pain, reduce the duration of ulcers, and prevent recurrence.
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Affiliation(s)
- J Sánchez-Bernal
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - C Conejero
- Unidad de Dermatología, Centro Médico Millenium, Zaragoza, España
| | - R Conejero
- Departamento de Dermatología, Hospital Royo Villanova, Zaragoza, España.
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22
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Samanta D, Ramakrishnaiah R. Recurrent Oral Ulcers in a Child With Seizures. Pediatr Neurol 2020; 103:89-90. [PMID: 31122835 DOI: 10.1016/j.pediatrneurol.2019.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/18/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Debopam Samanta
- Child Neurology Division, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| | - Raghu Ramakrishnaiah
- Division of Neuroradiology and Pediatric Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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23
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Abstract
Behçet syndrome (BS) is a multi-systemic complex disorder with unknown etiology and a unique geographic distribution. It could not be possible to include it into specific classification schemes and it is certainly not a uniform disease. Several cluster and association studies revealed that it has been composed of multiple phenotypes ascribing the principal problem such as skin-mucosa, joint, eye, vascular, neurological and gastrointestinal involvement. Each phenotype has its own characteristic demographic and clinical features as such their management strategies and prognosis differ substantially. Actually, the concept of phenotyping has been well known for some time and is considered one of the basic elements of the still continuing debate whether to call this entity 'disease' or 'syndrome'. Further supporting evidence comes from the observation of the geographical differences of disease expression. In this setting, BS resembles rather a construction made of several dynamic and interactive LEGO pieces of different shapes and colors. These pieces presenting phenotypes with their own disease mechanism have presumably different genetic determinants. The analysis of phenotyping could help us to identify this disorder and hence could contribute to find better ways of treatment.
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Affiliation(s)
- Emire Seyahi
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, 81310, Istanbul, Turkey.
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24
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Ropert S, Coriat R, Verret B, Perret A, Lucibello F, Chamseddine AN, Armand JP, Paci A, Mir O. Colchicine is an active treatment for everolimus-induced oral ulcers. Eur J Cancer 2017; 87:209-211. [PMID: 29037756 DOI: 10.1016/j.ejca.2017.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 09/12/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Stanislas Ropert
- Department of Medical Oncology, Antony Private Hospital, Antony, France
| | - Romain Coriat
- Department of Gastroenterology and Digestive Oncology, University Paris Descartes, Cochin Teaching Hospital, Paris, France
| | - Benjamin Verret
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Audrey Perret
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Francesca Lucibello
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Ali N Chamseddine
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean-Pierre Armand
- Department of Drug Development (DITEP), Gustave Roussy Cancer Campus, Villejuif, France
| | - Angelo Paci
- Department of Pharmacology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Olivier Mir
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France; Department of Pharmacology, Gustave Roussy Cancer Campus, Villejuif, France.
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25
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Doleschal B, Rödhammer T, Tsybrovskyy O, Aichberger KJ, Lang F. Disseminated Histoplasmosis: A Challenging Differential Diagnostic Consideration for Suspected Malignant Lesions in the Digestive Tract. Case Rep Gastroenterol 2016; 10:653-660. [PMID: 27920657 PMCID: PMC5126600 DOI: 10.1159/000452203] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/03/2016] [Indexed: 12/20/2022] Open
Abstract
Histoplasmosis is well characterized as an endemic fungal disease restricted to certain areas of the USA. In Middle Europe, most patients present with acute pulmonary symptoms after travelling to endemic areas. Here, we want to illustrate the case of a 67-year-old man who presented with persistent oral ulcers, hoarseness, dysphagia, diarrhea, and weight loss to our Department of Otorhinolaryngology in December 2014. He was a retired construction worker and had a history of soil-disruptive activities in Africa and Middle and South America during employment. A positron emission tomography-computed tomography scan revealed prominent hypermetabolic lesions in the cecum and the lung, pointing towards a malignant disease. Surprisingly, histological examination of colonic and oral biopsies revealed abundant intracellular fungal elements, highly suspicious of Histoplasma capsulatum. Diagnosis was finally confirmed by panfungal polymerase chain reaction. Upon treatment with liposomal amphotericin followed by itraconazole, the severely ill patient showed an impressive clinical response. This case describes a disseminated manifestation of H. capsulatum years after the first exposure in an otherwise immunocompetent patient descending from a nonendemic area.
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Affiliation(s)
- Bernhard Doleschal
- Department of Internal Medicine I, Hematology, Oncology and Gastroenterology, Hospital of the Sisters of Charity, Linz, Austria
| | - Therese Rödhammer
- Department of Otorhinolaryngology, Hospital of the Sisters of Charity, Linz, Austria
| | | | - Karl J Aichberger
- Department of Internal Medicine I, Hematology, Oncology and Gastroenterology, Hospital of the Sisters of Charity, Linz, Austria
| | - Franz Lang
- Department of Internal Medicine I, Hematology, Oncology and Gastroenterology, Hospital of the Sisters of Charity, Linz, Austria
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26
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Chaudhuri S, Dey S, Bajpai RC. Prevalence of oral ulcers and its association with addictions in rural population of western Uttar Pradesh and eastern Rajasthan. J Oral Biol Craniofac Res 2016; 6:179-186. [PMID: 27761381 DOI: 10.1016/j.jobcr.2016.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 04/15/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Head and neck cancer in Indian perspective predominantly relates to tobacco use. The present study explores the prevalence of oral ulcers and its association with addictions among the population of Uttar Pradesh and Rajasthan, India. METHODOLOGY The screening method in early detection of head and neck cancer is broadly symptom based. 1399 subjects from Uttar Pradesh and Rajasthan were screened by trained personnel between April and June 2015. RESULTS Study findings showed, mouth ulcers and trismus were common symptoms and tobacco chewing and smoking were common addictions. There were statistically significant associations among the symptoms and addictions as well as predominance in rural populations. The majority of smokers (27.1%) belonged to age ≥55 years whereas the tobacco chewers (29.2%) and alcohol abusers (45.8%) in the age group 25-34 years. Also the risk of developing mouth ulcers and trismus in this area are approximately 35 (MRR: 35.7, 95% CI: 15.5-81.9) and nearly eight (MRR: 7.7, 95% CI: 2.2-26.6) times higher respectively in males. However, joint use of smoked and smokeless tobacco increases nearly three times more risk of either mouth ulcers or trismus. CONCLUSION Male individuals are more exposed to certain addictions such as tobacco (smoked and smokeless) and alcohol. The prevalence of oral ulcers is primarily associated with the addictions. Therefore, these persons are more at risk of further developing head neck cancer. A large level community screening and awareness are required especially among the rural population of India.
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Affiliation(s)
- Santanu Chaudhuri
- Radiation Oncology, Nayati Healthcare and Research Centre, Block 3A, 3rd Floor, DLF Corporate Park, DLF City, Gurgaon, Haryana 122002, India
| | - Somnath Dey
- Radiation Oncology, Nayati Healthcare and Research Centre, Block 3A, 3rd Floor, DLF Corporate Park, DLF City, Gurgaon, Haryana 122002, India
| | - Ram Chandra Bajpai
- Biostatistics, Nayati Healthcare and Research Centre, Block 3A, 3rd Floor, DLF Corporate Park, DLF City, Gurgaon, Haryana 122002, India
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27
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Gambirazi L, Libório T, Nunes F, Sugaya N, Migliari D. Diagnosis and Intralesional Corticotherapy in Oral Ulcers Occurring as the Sole Manifestation of Langerhans Cell Histiocytosis. A Case Report. Open Dent J 2016; 10:330-7. [PMID: 27398106 PMCID: PMC4920974 DOI: 10.2174/1874210601610010330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 12/26/2022] Open
Abstract
This article reports a case of oral mucosa lesions as the sole manifestation in Langerhans cell histiocytosis (LCH). This is a very uncommon manifestation of LCH since this disease preferably affects the bones with frequent involvement of the jaws. LCH may also involve other organs, particularly the lungs, liver, lymph nodes, and skin. The highlights of this report are the differential diagnosis, immunohistochemical analysis and, mostly, the therapeutic approach.
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Affiliation(s)
- Liane Gambirazi
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Tatiana Libório
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fábio Nunes
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Norberto Sugaya
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Dante Migliari
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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28
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Mustafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmun Rev 2015; 14:930-51. [PMID: 26117595 DOI: 10.1016/j.autrev.2015.06.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023]
Abstract
A group of autoimmune diseases is characterised by autoantibodies against epithelial adhesion structures and/or tissue-tropic lymphocytes driving inflammatory processes resulting in specific pathology at the mucosal surfaces and the skin. The most frequent site of mucosal involvement in autoimmune diseases is the oral cavity. Broadly, these diseases include conditions affecting the cell-cell adhesion causing intra-epithelial blistering and those where autoantibodies or infiltration lymphocytes cause a loss of cell-matrix adhesion or interface inflammation. Clinically, patients present with blistering, erosions and ulcers that may affect the skin as well as further mucosal surfaces of the eyes, nose and genitalia. While the autoimmune disease may be suspected based on clinical manifestations, demonstration of tissue-bound and circulating autoantibodies, or lymphocytic infiltrates, by various methods including histological examination, direct and indirect immunofluorescence microscopy, immunoblotting and quantitative immunoassay is a prerequisite for definitive diagnosis. Given the frequency of oral involvement and the fact that oral mucosa is the initially affected site in many cases, the informed practitioner should be well acquainted with diagnostic and therapeutic aspects of autoimmune dermatosis with oral involvement. This paper reviews the pathogenesis and clinical presentation of these conditions in the oral cavity with a specific emphasis on their differential diagnosis and current management approaches.
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Affiliation(s)
- Mayson B Mustafa
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; Oral medicine section, Department of Oral and Maxillofacial Surgery, University of Khartoum, Faculty of Dentistry, Khartoum, Sudan
| | | | - Bruce R Smoller
- Department of Pathology, University of Rochester, School of Medicine and Dentistry, USA
| | - Cassian Sitaru
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; BIOSS Centre for Biological Signalling Studies, Signalhaus Freiburg, Schänzlestr. 18, 79104 Freiburg, Germany.
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29
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Ion D, Stevenson K, Woo SB, Ho VT, Soiffer R, Antin JH, Treister NS. Characterization of oral involvement in acute graft-versus-host disease. Biol Blood Marrow Transplant. 2014;20:1717-1721. [PMID: 24979731 DOI: 10.1016/j.bbmt.2014.06.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/23/2014] [Indexed: 01/08/2023]
Abstract
Acute graft-versus-host-disease (aGVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (HSCT). The purpose of this study was to characterize the oral features associated with aGVHD in patients who underwent HSCT between 1995 and 2010 and developed prominent oral aGVHD. Data was collected from patient medical records and analyzed descriptively. Twenty-one cases were identified, of which 5 (24%) demonstrated only oral features; the remaining 16 had variable involvement of skin (n = 14), liver (n = 7), and gut (n = 5). The median time to onset of any sign of aGVHD was 22 days (range, 8 to 154 days), and that for onset of oral aGVHD was 35 days (range, 11 to 159 days). Sites affected by nonspecific erythema and ulcerations included buccal mucosa (19 of 21; 90%) tongue (18 of 21; 86%; dorsum in 8), labial mucosa (16 of 21; 76%), palatal mucosa (15 of 21; 71%; hard palate in 7), and floor of mouth (7 of 21; 33%). Eight cases (38%) presented with lip ulceration and crusting. In addition to systemic therapies, topical solutions of dexamethasone, tacrolimus, and morphine were used for ancillary support. Oral features of aGVHD may be the initial manifestation and include nonspecific erythema and ulcerations of keratinized and nonkeratinized mucosa and lips. Intensive topical therapies may help reduce symptoms and promote healing.
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30
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Abstract
Childhood onsets of systemic lupus erythematosus (SLE) are quite rare and comprise less than 20% of all cases of lupus. Prepubertal onset is even rarer, as most children with SLE belong to the adolescent age group. SLE is an immune complex mediated disease with multiple organ system involvement, which may lead to high mortality and morbidity. We report a 12-year-old boy with SLE who presented clinically with malar rashes, joint pain and oral ulcers.
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Affiliation(s)
- Shilpashree Hs
- Senior Lecturer, Department of Oral Medicine and Radiology, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
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