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Teng F, Jin Q. Evaluation of cytokine expressions in patients with recurrent aphthous stomatitis: A systematic review and meta-analysis. PLoS One 2024; 19:e0305355. [PMID: 38861558 PMCID: PMC11166324 DOI: 10.1371/journal.pone.0305355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the expression levels of various T helper (Th) cell-secreted cytokines in recurrent aphthous stomatitis (RAS). Case-control studies comparing the serum or salivary levels of cytokines between RAS patients and healthy controls were searched in PubMed, EMBASE, Web of Science, and Google Scholar prior to September 30, 2023. Cytokines produced by Th1 (interleukin [IL]-1, IL-2, IL-8, IL-12, tumor necrosis factor alpha [TNF-α], interferon gamma [IFN-γ]), Th2 (IL-4, IL-5, IL-6, IL-10, IL-13), and Th17 (IL-17A) cells were investigated. The standard mean difference (SMD) with 95% confidence interval (CI) was calculated to detect the difference. A total of 20 studies comprising 1070 RAS patients and 536 healthy controls were included. RAS patients had significantly higher salivary levels of IL-2 (SMD = 4.15, 95%CI 0.83-7.48), IL-5 (SMD = 0.53, 95%CI 0.05-1.00), IL-6 (SMD = 0.48, 95%CI 0.12-0.84), IL-12 (SMD = 0.94, 95%CI 0.18-1.71), and TNF-α (SMD = 1.31, 95%CI 0.44-2.18) compared to healthy controls. Serum levels of IL-6 (SMD = 0.48, 95%CI 0.30-0.66), TNF-α (SMD = 0.70, 95%CI 0.22-1.17), and IFN-γ (SMD = 0.72, 95%CI 0.17-1.28) were significantly increased, while serum IL-10 levels (SMD = -2.25, 95%CI -3.99 to -0.52) were reduced in RAS patients. Patients diagnosed with major RAS had markedly elevated serum IL-8 levels (SMD = 0.39, 95%CI 0.07-0.71) and a trend toward higher serum IL-6 levels (SMD = 0.51, 95%CI -0.02 to 1.04) than those with minor RAS. In conclusion, Th1/Th2-related cytokines, especially IL-2, IL-6, and TNF-α, are involved in the pathogenesis of RAS development and progression and are potential therapeutic targets for RAS.
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Affiliation(s)
- Fangjun Teng
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Qiuchen Jin
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Wei W, Deng Y, Wang Y, Yao H, Du G, Tang G. Dynamic salivary cytokine profile of recurrent aphthous stomatitis patients in thalidomide maintenance treatment. Clin Oral Investig 2024; 28:140. [PMID: 38334890 DOI: 10.1007/s00784-024-05531-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To dynamically compare the longitudinal (time axis) and transverse (between groups) differences of the salivary cytokines during thalidomide maintenance treatment of recurrent aphthous stomatitis. METHODS A randomized, controlled, clinical trial was performed. After the initial prednisone treatment, thalidomide (50 mg/d vs. 25 mg/d) was used as a maintenance drug for 4 or 8 weeks. The salivary IL-4, 5, 6, 10, TNF-α, and IFN-γ were dynamically detected with a cytometric bead array. RESULTS Overall, the level of six elevated salivary cytokines after prednisone treatment was significantly downregulated, remained low during thalidomide maintenance, and rebounded at recurrence. The effect of 50 mg/d thalidomide on the salivary cytokines was not superior to 25 mg/d medication. The relapse-free period following drug withdrawal was the longest in the subgroup using 25 mg/d thalidomide for 8 weeks. The order of magnitude of IL-6 was the most obvious, and at week 8, only the level of IL-6 in the group (25 mg/d thalidomide for 8 weeks) continued to decline compared with the other groups. CONCLUSION Thalidomide maintenance treatment can effectively sustain low levels of salivary IL-4, 5, 6, 10, TNF-α, and IFN-γ of recurrent aphthous stomatitis patients. IL-6 displayed a good correlation with the disease and is expected to become an index for diagnosis and follow-up. CLINICAL RELEVANCE Low-dose long-term thalidomide maintenance treatment was supported for recurrent aphthous stomatitis. TRIAL REGISTRATION Trial registration number of ChiCTR-IPR-16009759 at http://www.chictr.org/index.aspx .
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Affiliation(s)
- Wei Wei
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University School of Medicine Ear Institute, Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases, Shanghai, 200092, China
| | - Yiwen Deng
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Yufeng Wang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Hui Yao
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Guanhuan Du
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
| | - Guoyao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
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Xiao X, Deng Y, Long Y, Liu W, Shi H. Evaluation of cytokines as diagnostic and therapeutic indicators for recurrent aphthous stomatitis: A statistical study. J Dent Sci 2022; 18:883-888. [PMID: 37021216 PMCID: PMC10068362 DOI: 10.1016/j.jds.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 02/07/2023] Open
Abstract
Increasing evidence indicates that inflammatory cytokines are involved in the pathogenesis of recurrent aphthous stomatitis (RAS). A wide range of over ten cytokines in peripheral blood of RAS patients have been investigated in different studies. Yet, which of the ones are the most prominent indicators contributed for the process of RAS are uncertain. Herein, a total of 16 eligible case-control studies including 1051 cases of RAS and 616 health controls were summarized. The bubble chart analysis showed that the most prominent cytokines for RAS were interleukin (IL)-6 (646 cases, 308 controls), TNF-α (498 cases, 298 controls), and IL-2 (371 cases, 264 controls). On the other hand, 9 studies on cytokines as therapeutic indicators of RAS were identified. The effect of levamisole and thalidomide on cytokines mainly were IL-6, TNF-α, and IL-8. Collectively, an optimum panel of IL-6, TNF-α, and IL-2 maybe serve as the potential significant indicators for RAS investigations.
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Affiliation(s)
- Xuan Xiao
- Department of Oral Mucosal Diseases, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Yiwen Deng
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanyuan Long
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wei Liu
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial–Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Corresponding author. Department of Oral and Maxillofacial–Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai 200011, China.
| | - Huan Shi
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Corresponding author. Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai 200011, China.
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Al-Kuraishy HM, Al-Gareeb AI, Alkazmi L, Alexiou A, Batiha GES. Levamisole Therapy in COVID-19. Viral Immunol 2021; 34:722-725. [PMID: 34388031 DOI: 10.1089/vim.2021.0042] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) a global infectious disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) affects various organs, primarily the respiratory system, and presented with pulmonary manifestations such as acute lung injury (ALI) and acute respiratory distress syndrome. Levamisole (LVM) is an anthelminthic drug; it has immune-modulating effects through induction of type 1 immune response. Based on these findings several recent studies highlighted that LVM might be effective in preventing and treating SARS-CoV-2 infections. The aim of this report is to illustrate the potential role of LVM in SARS-CoV-2 infection and in the management of COVID-19. Different studies proposed that LVM may inhibit proliferation of SARS-CoV-2 through inhibition of papain-like protease. LVM may prevent ALI and acute kidney injury through activation of glucocorticoid receptors. In general, LVM has strong immune stimulant effects by modulating cellular and humoral immune responses. This effect is beneficial in the early phase of COVID-19 and harmful in the late phase. In the early phase, immune stimulation facilitates SARS-CoV-2 clearance and tissue repair, however, in the late phase, immune stimulation in COVID-19 may increase propagation risk of cytokine storm. In conclusion, LVM therapy in COVID-19 has bidirectional effects, beneficial in the early phase and harmful effects in the late phase of COVID-19. Clinical trial and prospective studies are warranted in this regard to confirm the efficacy and timing administration of LVM in the management of COVID-19.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Therapeutic, College of Medicine, ALmustansiriyiah University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Therapeutic, College of Medicine, ALmustansiriyiah University, Baghdad, Iraq
| | - Luay Alkazmi
- Biology Department, Faculty of Applied Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Athanasios Alexiou
- Department of Social Studies and Arts, Novel Global Community Educational Foundation, Hebersham, Australia.,AFNP Med Austria, Wien, Austria
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, AlBeheira, Egypt
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Effect of Omega-3 on Recurrent Aphthous Stomatitis and Improvement Quality of Life. Int J Dent 2021; 2021:6617575. [PMID: 33628246 PMCID: PMC7889386 DOI: 10.1155/2021/6617575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Recurrent aphthous stomatitis is one of the most common chronic inflammatory diseases in oral mucosa. Beneficial effects of omega-3 supplements on some inflammatory diseases have been proved. The aim of present study was to evaluate the effect of omega-3 supplements in recurrent aphthous stomatitis management and improve oral health-related quality of life. Methods In this double-blind clinical trial, 40 patients with minor recurrent aphthous stomatitis were randomly divided into case and control groups. The case group received 1000 mg capsules of omega-3, while the control group received placebo capsules for 6 months. The questionnaires of the ulcer severity score and the chronic oral mucosal disease questionnaire were filled by the patients in three steps, at the baseline session, after 3 months, and after 6 months. The data were analyzed by SPSS 22 software through ANOVA, Mann-Whitney, and chi-square tests. P < 0.05 was considered as significant. Results In the omega-3 group, the ulcer severity score showed significant reduction by three-month and six-month follow-ups (P < 0.0001, P < 0.0001, respectively). The mean score of the chronic oral mucosal disease questionnaire significantly improved by three-month and six-month follow-ups in the omega-3-receiving group. Conclusion Use of omega-3 oral supplements decreased the severity of aphthous ulcer and improved oral health-related quality of life.
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Zeng Q, Shi X, Yang J, Yang M, Zhao W, Zhao X, Shi J, Zhou H. The efficacy and safety of thalidomide on the recurrence interval of continuous recurrent aphthous ulceration: A randomized controlled clinical trial. J Oral Pathol Med 2019; 49:357-364. [PMID: 31514233 DOI: 10.1111/jop.12960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/29/2019] [Accepted: 09/09/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Qingxiang Zeng
- State Key Laboratory of Oral Diseases Department of Oral Medicine West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
| | - Xueke Shi
- State Key Laboratory of Oral Diseases Department of Oral Medicine West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
| | - Jin Yang
- State Key Laboratory of Oral Diseases Department of Oral Medicine West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
| | - Miao Yang
- State Key Laboratory of Oral Diseases Department of Oral Medicine West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
| | - Wei Zhao
- State Key Laboratory of Oral Diseases Department of Oral Medicine West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
| | - Xiaoyi Zhao
- Department of pharmacy West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
| | - Jiahong Shi
- State Key Laboratory of Oral Diseases Department of Oral Medicine West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
| | - Hongmei Zhou
- State Key Laboratory of Oral Diseases Department of Oral Medicine West China Hospital of Stomatology Sichuan University Chengdu Sichuan China
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Hegde S, Ajila V, Babu S, Kumari S, Ullal H, Madiyal A. Evaluation of salivary tumour necrosis factor-alpha in patients with recurrent aphthous stomatitis. Eur Oral Res 2018; 52:157-161. [PMID: 30775720 DOI: 10.26650/eor.2018.543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/09/2018] [Accepted: 05/10/2018] [Indexed: 11/20/2022] Open
Abstract
Purpose Present study was undertaken to evaluate and compare the salivary levels of tumour necrosis factor alpha (TNF-α) in subjects with RAS, traumatic ulcers (TUs) in the oral mucosa and in healthy controls. Materials and Methods Present study involved 90 participants of which 30 subjects were diagnosed with RAS, 30 subjects with TUs and 30 healthy controls grouped as group 1, group 2 and group 3 respectively. Unstimulated saliva was collected from the subjects through 'Spit Technique' and the estimation of TNF-α was done by enzyme linked immunosorbent assay. The data collected was statistically analysed. Results Salivary level of TNF-α was significantly higher in RAS patients than in patients with TUs and healthy controls. Difference between the Salivary TNF-α level in our study groups were statistically significant (p<0.001). Conclusion Present study suggests that saliva is a convenient and ideal medium for the detection of TNF-α. Statistically significant difference in the level of salivary TNF-α between the RAS and TUs subjects as well as controls suggests the significant contribution of TNF-α in pathogenesis of RAS.
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Affiliation(s)
- Shruthi Hegde
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Vidya Ajila
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Subhas Babu
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Suchetha Kumari
- Department of Biochemistry, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
| | - Harshini Ullal
- Central research laboratory, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
| | - Ananya Madiyal
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
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Xue Y, Liu J, Zhao W. A Comparison of Immunomodulatory Monotherapy and Combination Therapy for Recurrent Aphthous Stomatitis. INT J PHARMACOL 2018. [DOI: 10.3923/ijp.2018.377.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chaudhuri K, Nair KK, Ashok L. Salivary levels of TNF-α in patients with recurrent aphthous stomatitis: A cross-sectional study. J Dent Res Dent Clin Dent Prospects 2018; 12:45-48. [PMID: 29732020 PMCID: PMC5928473 DOI: 10.15171/joddd.2018.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/07/2018] [Indexed: 12/03/2022] Open
Abstract
Background. Recurrent aphthous stomatitis (RAS) is a disorder characterized by recurring ulcers involving the oral mucosa in patients with no other signs of disease. The current concept of etiopathogenesis is that RAS is a clinical syndrome with several possible etiologies. The process seen in RAS is probably initiated through an as yet unidentified antigenic stimulation of the mucosal keratinocytes, which stimulates secretion of T-cell activation cytokines ‒ interleukins and tumor necrosis factor alpha (TNF-α). TNF-α causes inflammation by its effect on endothelial cell adhesion and neutrophil chemotaxis. The rele-vance of TNF-α to the pathogenesis of RAS has stemmed from the observations that anti- TNF-α drugs such as thalidomide and pentoxifylline have been found to be effective in the treatment of RAS. Therefore, the present study was an attempt to measure the levels of salivary TNF-α in patients with RAS, which will reflect the local production of cytokines at the site of the disease. The aim was to evaluate the salivary levels of TNF-α in patients with recurrent aphthous stomatitis.
Methods. The study comprised of 60 subjects, of whom 30 clinically proven RAS patients of either sex were selected as cases and 30 healthy, age- and gender- matched subjects were selected as controls. After taking informed consent, 5 mL of unstimulated saliva were collected from both the study and control group subjects. Determination of salivary TNF-α levels was carried out by Enzyme-Linked Immunosorbent Assay (ELISA) and expressed in pg/mL. Statistical analysis of the RAS and control groups was carried out using unpaired t-test. Gender-wise comparison of salivary TNF-α levels in the study and control groups was carried out using one-way ANOVA.
Results. Mean salivary TNF-α levels were significantly higher in the RAS group compared to the control group (P<0.001). It was also revealed that the mean salivary TNF-α levels in females were significantly higher than in males in the study group (PP<0.05).
Conclusion. It is fair to suggest that TNF-α plays a very important mediatory role in the pathogenesis of RAS and may play an important role in the search for a definitive treatment for the disease.
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Affiliation(s)
- Kanad Chaudhuri
- Former Postgraduate Student, Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Keerthi Krishnankutty Nair
- Former Postgraduate Student, Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Lingappa Ashok
- Professor and HOD, Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Bao ZX, Shi J, Yang XW, Liu LX. Hematinic deficiencies in patients with recurrent aphthous stomatitis: variations by gender and age. Med Oral Patol Oral Cir Bucal 2018; 23:e161-e167. [PMID: 29476670 PMCID: PMC5911348 DOI: 10.4317/medoral.21885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 12/26/2017] [Indexed: 11/26/2022] Open
Abstract
Background The aim of this study was to evaluate the association between hematinic deficiencies and recurrent aphthous stomatitis (RAS). Material and Methods 517 RAS patients and 187 healthy controls were enrolled in the present study. Hematinic deficiencies, including serum ferritin, folic acid, and vitamin B12 deficiencies were assessed for each participant. Gender and age were taken into account and the collected data were statistically analysed. Results Compared with the healthy controls, a significantly higher overall frequency of hematinic deficiencies was found in RAS patients (p<0.001). When gender and age were taken into account, significant differences in hematinic deficiencies were observed among RAS patients. Serum ferritin deficiency was much more common in young and middle-aged female RAS patients (age<60). Serum folate deficiency and serum vitamin B12 deficiency were both much more common in the young adult group of male RAS patients (21–40 years of age). Logistic regression analysis revealed that both gender and age have significant correlation with the presence of hematinic deficiencies in the RAS patients. Conclusions Significant variations in hematinic deficiencies were demonstrated in RAS patients across different genders and age groups. We suggest that further studies on the hematinic deficiencies of RAS patients should take into account the gender and age of participants. Key words:Recurrent aphthous stomatitis, hematinic deficiencies, gender, age.
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Affiliation(s)
- Z-X Bao
- Department of Gastroenterology and Hepatology, The First Clinical Hospital of Shanxi Medical University, Mailbox 427, 85 Jiefang South Road, Taiyuan, Shanxi Province, China 030001,
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Hajizadeh Maleki B, Tartibian B, Mooren FC, FitzGerald LZ, Krüger K, Chehrazi M, Malandish A. Low-to-moderate intensity aerobic exercise training modulates irritable bowel syndrome through antioxidative and inflammatory mechanisms in women: Results of a randomized controlled trial. Cytokine 2018; 102:18-25. [PMID: 29274540 DOI: 10.1016/j.cyto.2017.12.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 12/12/2017] [Accepted: 12/14/2017] [Indexed: 02/07/2023]
Abstract
Our aim was to explore the putative beneficial effects of low-to-moderate intensity exercise training program in patients with irritable bowel syndrome (IBS). This study evaluated the changes in blood oxidative stress status, inflammatory biomarkers and IBS severity symptoms following 24 weeks of moderate aerobic exercise in sedentary IBS patients. A total of 109 female volunteers (aged 18-41 yrs) who fulfilled Rome III criteria for the diagnosis of IBS were screened and 60 were randomized to exercise (EX, n = 30) and non-exercise (NON-EX, n = 30) groups. Exercise intervention favorably attenuated inflammation as indicated by plasma cytokines (IL-1β, IL-6, IL-8, IL-10 and TNF-α), adenosine deaminase, oxidative stress (XO, MDA and NO) and enhanced antioxidants (SOD, CAT and GSH-Px) (P < .05), and these alterations correlate with promising improvements in IBS symptoms (P < .05). Taken together, low-to-moderate intensity exercise training program attenuates symptoms in IBS. Symptom improvement was associated with a reversal of the ratio of anti- to pro-inflammatory cytokines as well as facilitating blood redox homeostasis, suggesting an immune- and redox modulating function for exercise training.
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Affiliation(s)
| | - Bakhtyar Tartibian
- Department of Sport Injuries, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran.
| | - Frank C Mooren
- Department of Sports Medicine, Justus-Liebig-University, Giessen, Germany.
| | - Leah Z FitzGerald
- Department of Nursing, Mount Saint Mary's University, Los Angeles, CA, United States.
| | - Karsten Krüger
- Leibniz University, Hannover, Department of Sports Science, Hannover, Germany.
| | - Mohammad Chehrazi
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Abbas Malandish
- Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, Urmia, Iran.
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Mozaffari HR, Ramezani M, Mahmoudiahmadabadi M, Omidpanah N, Sadeghi M. Salivary and serum levels of tumor necrosis factor-alpha in oral lichen planus: a systematic review and meta-analysis study. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:e183-e189. [PMID: 28823317 DOI: 10.1016/j.oooo.2017.06.117] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 06/14/2017] [Accepted: 06/17/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Tumor necrosis factor-α (TNF-α) has a role in the progression of the oral lichen planus (OLP). The aim of this meta-analysis study was to evaluate the salivary and serum TNF-α levels in patients with OLP. STUDY DESIGN We searched in the databases of PubMed/Medline, Science direct, Scopus, Web of Science, and Cochrane Library for studies reported from 1983 to 2016. All studies were checked for evaluation of salivary and serum levels of TNF-α in patients with OLP compared with healthy controls. RESULTS Twelve studies were included in the meta-analysis. The mean difference of 7 studies reporting salivary TNF-α levels in patients with OLP versus healthy controls was 25.90 pg/mL (95% confidence interval [CI] 15.31-36.49; P < .00001) and 7 studies reporting serum TNF-α levels was 1.65 pg/mL (95% CI -0.82 to 4.11; P = .19). CONCLUSIONS In patients with OLP, the higher levels of TNF-α in saliva compared with serum suggest that measurement of this marker in saliva may be more useful than in serum for determining diagnostic and therapeutic aims.
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Affiliation(s)
- Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran; Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mazaher Ramezani
- Molecular Pathology Research Center, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Neda Omidpanah
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Sharma S, Ali FM, Saraf K, Mudhol A. Anti-helminthic drugs in recurrent apthous stomatitis: A short review. J Pharm Bioallied Sci 2014; 6:65-8. [PMID: 24741272 PMCID: PMC3983748 DOI: 10.4103/0975-7406.129169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/12/2013] [Accepted: 01/22/2014] [Indexed: 11/05/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) is a common mucosal condition producing painful ulcerations in the oral cavity and considerable clinical morbidity. The etiology remains obscure, though local trauma, psychologic stress, hematinic deficiencies and immune dysregulation have been implicated. Though the primary goals of therapy are symptomatic relief of pain, the clinicians are aiming toward reducing the frequency, duration, number of ulcerations and increasing ulcer free periods with systemic drug therapy if topical medications appear ineffective. Levamisole, an antihelminthic drug has been tried with promising results in patients with severe RAS providing long-term benefits.
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Affiliation(s)
- Shilpa Sharma
- Department of Oral Medicine and Radiology, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
| | - Fareedi Mukram Ali
- Department of Oral and Maxillofacial Surgery, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
| | - Kedar Saraf
- Department of Oral Medicine and Radiology, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
| | - Anupama Mudhol
- Department of Oral and Maxillofacial Surgery, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
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Efficacy of omega-3 in treatment of recurrent aphthous stomatitis and improvement of quality of life: a randomized, double-blind, placebo-controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 117:191-6. [PMID: 24268387 DOI: 10.1016/j.oooo.2013.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 08/31/2013] [Accepted: 09/07/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study assessed the effects of systemic omega-3 on the treatment of recurrent aphthous stomatitis and on the improvement of quality of life. STUDY DESIGN Fifty participants were randomly assigned to receive either omega-3 (1 g, 3 times daily) or placebo for 6 months. Assessment of outcome measures including monthly number of new ulcers, average duration of ulcer episodes, and pain level of ulcers was carried out at baseline and monthly for 6 months. Analysis of potential impact on quality of life using the Oral Health Impact Profile 14 was carried out at baseline and 6 months. RESULTS Daily omega-3 treatment achieved a significant reduction in number of ulcers, duration of ulcers, and level of pain by 3 months that persisted for 6 months. Mean score on Oral Health Impact Profile 14 also significantly improved by 6 months. CONCLUSIONS A daily omega-3 regimen shows promise as therapy for treatment and management of patients with recurrent aphthous stomatitis.
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Mete R, Tulubas F, Oran M, Yılmaz A, Avci BA, Yildiz K, Turan CB, Gurel A. The role of oxidants and reactive nitrogen species in irritable bowel syndrome: a potential etiological explanation. Med Sci Monit 2013; 19:762-6. [PMID: 24029778 PMCID: PMC3781198 DOI: 10.12659/msm.889068] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background The aim of this study was to evaluate the plasma concentrations of malondialdehyde (MDA) and nitric oxide (NO) and the plasma activities of oxidant and antioxidant enzymes in patients with IBS. Material/Methods A total of 36 patients with IBS were included in the study. Thirty-five healthy subjects were selected to form the control group. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), xanthine oxidase (XO), adenosine deaminase (AD) activities, and malondialdehyde (MDA) and nitric oxide (NO) concentrations were studied in the serum samples of all patients and controls. Results Plasma XO and AD activities, and MDA and NO concentrations were significantly higher in IBS patients than in controls. The SOD, CAT, and GSH-Px activities in the serum of patients with IBS were significantly lower than that of controls. Conclusions These results suggest that lipid peroxidation and alterations in the oxidant-antioxidant enzymatic system may play a role in the pathogenesis of IBS. Increased lipid peroxidation in IBS may be related to an increase in NO level and XO activity and a decrease in antioxidant enzymes activities. In addition, increased AD activity may have a role in immunological changes of IBS patients.
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Affiliation(s)
- Rafet Mete
- Gastroenterology Department, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey
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Repurposing of yunnan baiyao as an alternative therapy for minor recurrent aphthous stomatitis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:284620. [PMID: 23258985 PMCID: PMC3521495 DOI: 10.1155/2012/284620] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 10/22/2012] [Indexed: 11/24/2022]
Abstract
The study was designed to evaluate the efficacy and safety of an herbal extract of Yunnan Baiyao formulated in toothpaste as an alternative therapy for minor RAS. A randomized, double-blind, placebo-controlled clinical trial (from March 2010 to March 2011) was conducted on a cohort of 227 minor RAS patients. The toothpaste containing Yunnan Baiyao was used twice daily as part of the patient's routine oral hygiene for 5 days. An assessment of ulcerative size and pain was recorded on day 0 (baseline), day 3, and day 5. Any noted adverse reactions were recorded. All data were analyzed using the SAS software 8.0. As a result, the toothpaste containing Yunnan Baiyao began to present noticeable effectiveness on ulcer healing (ulcer size) by day 3 (27.5% versus 15.8%, P < 0.05), which further improved by day 5 when compared to the placebo (66.4% versus 50.0%, P = 0.01). A significant difference in alleviating pain was noted on day 5 for those who used the toothpaste containing Yunnan Baiyao (66.4% versus 51.8%, P < 0.05). No side effects were noted as a result of the Yunnan Baiyao. Therefore, Yunnan Baiyao may provide an alternative therapy for minor ulcers by promoting healing.
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Kaya E, Ozbilge H, Ustundag M, Torun Y. The effects on immune response of levamisole treatment following infection of U-937 macrophages with Candida albicans. Acta Microbiol Immunol Hung 2011; 58:279-88. [PMID: 22207286 DOI: 10.1556/amicr.58.2011.4.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to investigate the effects on the immune response of levamisole alone and in conjunction with Candida albicans stimulation in human macrophage cell culture by determining the alterations in the levels of cytokine release. Levamisole treatment was performed before, during and after infecting U-937 human macrophage cells with C. albicans. In cell supernatants, interleukin (IL)-1b, IL-12, IL-18, tumour necrosis factor alpha (TNF-α) levels were measured by ELISA. In vitro levamisole treatment accompanied by C. albicans stimulation significantly increased IL-12, IL-1β and IL-18 production in macrophage cells (p < 0.05). It was observed that when administered before C. albicans infection, levamisole significantly increased IL-12 and IL-1β production in macrophage cells (p < 0.05). Another finding was that when applied to macrophage cells simultaneously with C. albicans infection, or before infection with C. albicans, levamisole suppressed the TNF-β production stimulating effect of C. albicans (p < 0.05). These results indicated that levamisole could be useful in treating patients infected with C. albicans or in protecting individuals under the risk of being infected with this pathogen. There is a need for further experimental and clinical studies on this hypothesis.
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Affiliation(s)
- Esma Kaya
- 1 Erciyes University Department of Pharmaceutical Microbiology, Faculty of Pharmacy Kayseri Turkey
| | - Hatice Ozbilge
- 1 Erciyes University Department of Pharmaceutical Microbiology, Faculty of Pharmacy Kayseri Turkey
| | - Mustafa Ustundag
- 1 Erciyes University Department of Pharmaceutical Microbiology, Faculty of Pharmacy Kayseri Turkey
| | - Yasemin Torun
- 2 Kayseri Education and Research Hospital Department of Pediatric Hematology Kayseri Turkey
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Hibi D, Imazawa T, Kijima A, Suzuki Y, Ishii Y, Jin M, Umemura T, Nishikawa A. Investigation of carcinogenicity for levamisole administered in the diet to F344 rats. Food Chem Toxicol 2010; 48:3321-6. [PMID: 20837086 DOI: 10.1016/j.fct.2010.08.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 08/19/2010] [Accepted: 08/20/2010] [Indexed: 11/20/2022]
Abstract
A two year carcinogenicity study of anthelmintic drug levamisole (LV) was performed using 50 male and 50 female F344 rats at dietary drug concentrations of 0, 60, or 300 ppm. The daily intakes of LV were calculated to be 2.6, 12.9 mg/kg b.w./day for males and 2.9, 14.1mg/kg b.w./day for females, respectively. No significant differences in general condition and survival rate (82%, 74%, 80% in males and 84%, 84%, 84% in females, respectively) were observed. In the 300 ppm group, suppression of body weight gain was observed from the onset of treatment and reduction in final body weights was 6% in males and 11% in females. Significant increases in the absolute and/or relative weights of the lungs, heart, spleen, liver, kidneys, and adrenals were observed in males and/or females treated with 300 ppm. Some of high incidences neoplasms were observed, and there were also tendencies to increase for mammary gland fibroma and thoracic/abdominal cavity mesothelioma in males. However, there were no significant inter-group differences in incidences, histopathological types or differences compared with historical control data. Thus, it was concluded that LV was not carcinogenic to male and female F344 rats under the experimental conditions.
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Affiliation(s)
- D Hibi
- Division of Pathology, National Institute of Health Sciences, Setagaya-ku, Tokyo, Japan
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Picciani BLS, Silva-Junior GO, Barbirato DS, Ramos RT, Cantisano MH. Regression of major recurrent aphthous ulcerations using a combination of intralesional corticosteroids and levamisole: a case report. Clinics (Sao Paulo) 2010; 65:650-2. [PMID: 20613944 PMCID: PMC2898545 DOI: 10.1590/s1807-59322010000600015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Pilot study on recurrent aphthous stomatitis (RAS): a randomized placebo-controlled trial for the comparative therapeutic effects of systemic prednisone and systemic montelukast in subjects unresponsive to topical therapy. ACTA ACUST UNITED AC 2010; 109:402-7. [DOI: 10.1016/j.tripleo.2009.10.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Revised: 10/03/2009] [Accepted: 10/11/2009] [Indexed: 01/16/2023]
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Sun A, Wang YP, Chia JS, Liu BY, Chiang CP. Treatment with levamisole and colchicine can result in a significant reduction of IL-6, IL-8 or TNF-alpha level in patients with mucocutaneous type of Behcet's disease. J Oral Pathol Med 2009; 38:401-5. [PMID: 19434815 DOI: 10.1111/j.1600-0714.2009.00774.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mucocutaneous type of Behcet's disease (MCBD) is a multisystemic inflammatory disease with oral and genital ulcers with or without skin lesions. METHODS A solid phase, two-site sequential chemiluminescent immunometric assay was used to measure serum levels of interleukin (IL)-6, IL-8 and tumour necrosis factor (TNF)-alpha in 54 normal control subjects and in 64 MCBD patients before and after treatment with levamisole plus colchicine. RESULTS We found that 67%, 83% or 67% of MCBD patients had a serum IL-6, IL-8 or TNF-alpha level greater than the upper normal limit of 4.7, 8.7 or 7.4 pg/ml, respectively. The mean serum level of IL-6 (9.9 +/- 2.4 pg/ml, P < 0.005), IL-8 (107.5 +/- 21.4 pg/ml, P < 0.001) or TNF-alpha (22.5 +/- 4.1 pg/ml, P < 0.001) in 64 MCBD patients was significantly higher than that (2.1 +/- 0.2, 5.7 +/- 0.2 or 3.8 +/- 0.2 pg/ml for IL-6, IL-8 or TNF-alpha level, respectively) in normal control subjects. In 43 MCBD patients with all the serum IL-6, IL-8 and TNF-alpha levels higher than their upper normal limits, treatment with levamisole plus colchicine for a period of 0.5-11.5 (mean, 3.2 +/- 2.4) months could significantly reduce the mean serum IL-6, IL-8 and TNF-alpha levels from 9.0 +/- 1.7 to 1.6 +/- 0.2 pg/ml (P < 0.001), 134.6 +/-28.2-6.0 +/- 0.4 pg/ml (P < 0.001) and 25.7 +/- 5.6-3.5 +/- 0.4 pg/ml (P < 0.001), respectively. CONCLUSIONS Treatment with levamisole and colchicine can result in a significant reduction of serum IL-6, IL-8 or TNF-alpha level in MCBD patients.
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Affiliation(s)
- Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Treatment of recurrent aphthous stomatitis with clofazimine. ACTA ACUST UNITED AC 2009; 108:714-21. [PMID: 19699111 DOI: 10.1016/j.tripleo.2009.05.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Revised: 04/20/2009] [Accepted: 05/05/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim was to investigate the safety and efficacy of clofazimine for the treatment of recurrent aphthous stomatitis. STUDY DESIGN In this randomized controlled partially blind study, 23 patients received clofazimine 100 mg daily for 30 days and then 100 mg every other day. Twenty-three patients received colchicine 0.5 mg 3 times daily. Twenty patients received 1 placebo pill 2 times daily. All subjects received medications for 6 months. The chi-squared or Fisher exact tests were used to assess drug efficacy with respect to objective findings and symptoms. RESULTS A greater percentage of individuals in the clofazimine group had no further aphthous episodes (17%-44% compared with <or=6% in the other groups). A significantly greater percentage of treatment interruption occurred in the colchicine group because of gastrointestinal effects (23%-45%). Individuals in the clofazimine group who continued to suffer from aphthous stomatitis presented with better results for the evaluated variables. CONCLUSION Clofazimine should be considered for the treatment of recurrent aphthous stomatitis.
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Gurel A, Altinyazar HC, Unalacak M, Armutcu F, Koca R. Purine catabolic enzymes and nitric oxide in patients with recurrent aphthous ulceration. Oral Dis 2007; 13:570-4. [DOI: 10.1111/j.1601-0825.2006.01338.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Femiano F, Lanza A, Buonaiuto C, Gombos F, Nunziata M, Piccolo S, Cirillo N. Guidelines for diagnosis and management of aphthous stomatitis. Pediatr Infect Dis J 2007; 26:728-32. [PMID: 17848886 DOI: 10.1097/inf.0b013e31806215f9] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aphthous ulcers are the most common oral mucosal lesions in the general population. These often are recurrent and periodic lesions that cause clinically significant morbidity. Many suggestions have been proposed but the etiology of recurrent aphthous stomatitis (RAS) is unknown. Several precipitating factors for aphthous ulcers appear to operate in subjects with genetic predisposition. An autoimmune or hypersensitivity mechanism is widely considered possible. Sometimes aphthous ulcers can be the sign of systemic diseases, so it is essential to establish a correct diagnosis to determine suitable therapy. Before initiating medications for aphthous lesions, clinicians should determine whether well-recognized causes are contributing to the disease and these factors should be corrected. Various treatment modalities are used, but no therapy is definitive. Topical medications, such as antimicrobial mouth-washes and topical corticosteroids (dexamethasone, triamcinolone, fluocinonide, or clobetasol), can achieve the primary goal to reduce pain and to improve healing time but do not improve recurrence or remission rates. Systemic medications can be tried if topical therapy is ineffective.
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Affiliation(s)
- Felice Femiano
- Stomatology Department, II University of Medicines and Surgery, Naples, Italy.
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Sun A, Chia JS, Wang JT, Chiang CP. Levamisole can reduce the high serum tumour necrosis factor-? level to a normal level in patients with erosive oral lichen planus. Clin Exp Dermatol 2007; 32:308-10. [PMID: 17397355 DOI: 10.1111/j.1365-2230.2006.02343.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this study, we measured the baseline serum levels of tumour necrosis factor (TNF)-alpha in 158 patients with oral lichen planus (OLP) and in 54 normal control subjects. In total, 60 patients with erosive OLP (EOLP) with relatively high TNF-alpha levels were treated with levamisole and the serum TNF-alpha levels measured after treatment. We found that the mean +/- SD serum level of TNF-alpha in patients with either type of EOLP (12.0 +/- 1.7 pg/mL, P<0.005), major EOLP (15.5 +/- 4.4 pg/mL, P<0.001), minor EOLP (11.1 +/- 1.8 pg/mL, P<0.01), or nonerosive OLP (6.1 +/- 1.7 pg/mL, P<0.05) was significantly higher than that (3.8 +/- 0.2 pg/mL) of normal control subjects. Treatment with levamisole for a period of 0.5-7.5 months significantly reduced the mean serum TNF-alpha level from 22.6 +/- 3.4 pg/mL to 6.2 +/- 0.8 pg/mL (P<0.001) in 60 patients with EOLP. We conclude that levamisole can reduce high serum TNF-alpha levels to normal in patients with EOLP.
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Affiliation(s)
- A Sun
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
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