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Clinical manifestations of recurrent aphthous stomatitis. (A) Representative images of ulcers. Lesions were ovoid with an erythematous halo. (B) Anatomical sites where lesions occurred. The most affected regions were labial mucosa, vestibule, and cheeks. (C) Clinical history associated with ulcers. Lesions were smaller than 5 mm accompanied by moderate pain.
Source publication
There are currently no preventative options for recurrent aphthous stomatitis, and the only available treatments are palliative. This is partly due to a poor understanding of its etiopathogenesis. In this case–control study, we characterized the salivary proteome of patients with recurrent aphthous stomatitis in the presence and absence of lesions....
Contexts in source publication
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... red was used as the loading control. The uncropped scans of the gels and blots are shown in Supplementary Fig. S1. ELISAs were performed using 13 μg of total salivary protein as the sample with HBB (Abcam #ab235654), CST1 (Sigma-Aldrich #RAB1036), and A2M (Sigma-Aldrich #RAB0600) kits, according to the manufacturer's instructions. ...
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... profile of our population agrees with that reported in the international literature, both in age and in the predisposition for the appearance of these lesions in women 44,45 . Figure 1 shows representative ulcers observed in this research. Most lesions occurred in the non-keratinized oral mucosa, where the lips were the most affected territory (Supplementary Table S1). ...
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... red was used as the loading control. The uncropped scans of the gels and blots are shown in Supplementary Fig. S1. ELISAs were performed using 13 μg of total salivary protein as the sample with HBB (Abcam #ab235654), CST1 (Sigma-Aldrich #RAB1036), and A2M (Sigma-Aldrich #RAB0600) kits, according to the manufacturer's instructions. ...
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... profile of our population agrees with that reported in the international literature, both in age and in the predisposition for the appearance of these lesions in women 44,45 . Figure 1 shows representative ulcers observed in this research. Most lesions occurred in the non-keratinized oral mucosa, where the lips were the most affected territory (Supplementary Table S1). ...
Citations
... 53 In comparison, Ink-M2-2 could not retain the indentation from the fork and hence align with IDDSI Level 3 (liquidized/moderately thick food), indicating that IDDSI Level 3 foods are also soft enough for patients with oral ulcers. Furthermore, the food ingredients, such as Russula mushroom and milk powder, are rich in vitamin B 15,54,55 and are believed to possess the capacity to accelerate the healing of oral ulcers. Figure S2A (Supplementary File) depicts the infrared spectrum of the six ink formulations, and Figure S2B (Supplementary File) presents the infrared spectrum of International Journal of Bioprinting the five raw ingredients. ...
The global prevalence of diabetes mellitus is experiencing a notable increase. Diabetic patients need to consistently monitor their fluctuating glucose levels caused by the changing diet. Meanwhile, patients with diabetes face a higher risk of developing oral ulcer than healthy individuals. Fortunately, three-dimensional (3D)-printed food, which is design- and texture-customizable, presents a potential solution to alleviate the discomfort caused by ulcer while providing personalized nutrition for patients with unique dietary requirements. In this study, 3D-printable food inks were created based on four food ingredients with low glycemic index, namely milk powder, wheat bran powder, Russula alutacea Fr., (russula mushroom), and Agaricus bisporus (button mushroom) content. Rheological testing and texture profile analysis were performed, affirming that the 3D-printed food possesses a soft texture, which minimizes oral mucosal irritation for patients with diabetic ulcers. The effectiveness of 3D-printed food in diabetes management was corroborated by monitoring the blood glucose levels of streptozotocin-induced diabetic rats via gavage. Food with personalized nutritional composition was custom-printed to cater for the protein requirements of patients with diabetic nephropathy. This innovative approach to personalizing nutrition through 3D food printing has the potential to reshape the future of dietary management, ultimately improving the overall health outcomes and quality of life for individuals with diabetes and its complications.
... Furthermore, there is currently no radical cure for RAU, and current treatment mainly focuses on alleviating symptoms and lowering the frequency of relapses. Even for the most widely used topical corticosteroids, high-quality evidence of efficacy is lacking 165 , and repeated usage may result in oral candidiasis 166 . ...
The fruit of Phyllanthus emblica Linn., which mainly grows in tropical and subtropical regions, is well-known for its medicine and food homology properties. It has a distinctive flavor, great nutritional content, and potent antioxidant, anti-inflammatory, anti-cancer and immunoregulatory effects. According to an increasing amount of scientific and clinical evidence, this fruit shows significant potential for application and development in the field of oral health management. Through the supplementation of vitamins, superoxide dismutase (SOD) and other nutrients reduce virulence expression of various oral pathogens, prevent tissue and mucosal damage caused by oxidative stress, etc. Phyllanthus emblica fruit can promote saliva secretion, regulate the balance of the oral microecology, prevent and treat oral cancer early, promote alveolar bone remodeling and aid mucosal wound healing. Thus, it plays a specific role in the prevention and treatment of common oral disorders, producing surprising results. For instance, enhancing the effectiveness of scaling and root planing in the treatment of periodontitis, relieving mucosal inflammation caused by radiotherapy for oral cancer, and regulating the blood glucose metabolism to alleviate oral discomfort. Herein, we systematically review the latest research on the use of Phyllanthus emblica fruit in the management of oral health and examine the challenges and future research directions based on its chemical composition and characteristics.
... Найчастіше визначали низький рівень заліза, фолієвої кислоти, цинку, вітамінів B 1 , B 2 , B 6 і B 12 . Дефіцит вітамінів і мікроелементів пов'язують з основними захворюваннями: мальабсорбцією, залізодефіцитною анемією, глютеновою ентеропатією тощо [13]. ...
... Важливе місце в лікуванні хронічного РАС (ХРАС) належить вітамінотерапії (зокрема вітамінам групи В і С) та призначенню харчових добавок, що містять вітамінні та мікро-макроелементні комплекси. Вважають за необхідне виключити дефіцит поживних речовин (вітамін B 12 , фолієва кислота, залізо, цинк тощо) у пацієнтів із РАС [13]. ...
Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating.
The study on RAS remains relevant over many years and continues to be a priority in modern dentistry.
The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention.
Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions.
This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention.
Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity.
Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.
... RAS are 90% more likely to develop in children of parents who have them than in children of parents who don't [3]. RAS has an unknown etiology, but a number of local, systemic, immunologic, genetic, allergic, dietary, and microbial factors have been suggested as potential contributors [4][5][6][7]. ...
Background The increased rate of apoptosis is one of the major causes of ulcer formation. A variety of factors can influence the rate of apoptosis. Ceramide (CER) is one such factor that has been proposed to play a role in signaling apoptosis induced by extracellular agents. Recurrent aphthous stomatitis (RAS) is a common condition that initially presents in children or adolescents. Multiple recurrent small, round, or ovoid ulcers with erythematous haloes and circumscribed margins are its characteristic features. Its pathogenesis is still a mystery. Ceramide synthase 1 (CERS1) aids in the production of C18 CER. Although the role of CERS1 in aphthous is well understood, its possible intricate role in pathogenesis remains unknown. Aim To evaluate the expression of salivary CERS1 in patients with RAS and healthy individuals. Materials and methods 30 patients were included in the present study. Ethical clearance for this study was obtained, and there were no gender or age limits for enrollment. After obtaining informed consent, 30 salivary samples were collected from patients with RAS (n=15) and from healthy individuals (n=15). Enzyme-linked immunosorbent assay (ELISA) was performed using the CERS1 kit by MyBioSource Inc (San Diego, USA) and the results were recorded. The Chi-square test and Independent t-test were used for statistical analysis with SPSS v23.0 (IBM, Chicago, USA) with a significant p-value of <0.05. Results CERS1 expression was identified in the saliva of all participants. There was a decrease in the salivary CERS1 level in RAS patients (7.6 +/- 2.0 pg/ml) when compared to healthy individuals (8.3 +/- 1.8 pg/ml) but it did not achieve statistical significance. Conclusion We found that salivary CERS1 levels decreased in RAS patients. More research is required to understand CERS1's pathogenetic role.
... This also applies to RAS. Although the etiology of RAS is unclear, many microbiological and immunological studies have presented evidence for the involvement of microbial factors in the pathogenic process [10,127,128]. Probiotic therapy for RAS was thus pioneered and implemented in many practices [129]. In our study, probiotics were involved in the management of RAS in the form of topical administration. ...
Background and objectives: To compare the efficacy and safety of topical interventions used for recurrent aphthous stomatitis. Materials and Methods: This network meta-analysis was conducted in accordance with the PRISMA statement. We searched four electronic databases, PubMed, Web of Science (WOS), Cochrane Central Register of Controlled Trials and Embase, for randomized controlled trials reporting efficacy and safety data on topical interventions for recurrent aphthous stomatitis. We performed a quality evaluation using a methodology based on the Cochrane Handbook. Two authors independently extracted data on healing effect, size reduction effect, symptom reduction effect, recurrence and safety assessment. Network meta-analysis was then performed using ADDIS and RevMan. Results: A total of 72 trials (5272 subjects) involving 29 topical interventions were included. Honey, lnsulin liposome gel, laser, amlexanox, glycyrrhiza and triamcinolone had better efficacy performance. Probiotics and chlorhexidine helped to prolong ulcer intervals and reduce recurrence. Doxycycline and penicillin had a high risk of adverse events. Hematologic evaluation showed no preference. The rank possibility of size-reducing effect and symptom-reducing effect supported the short-term effect of laser and the long-term effect of probiotics. Conclusions: We recommend the use of laser as a short-term intervention during the exacerbation phase of RAS and probiotics as a long-term intervention during the exacerbation and remission phases of RAS.
Chronic recurrent aphthous stomatitis (ChRAS) is currently one of the most common diseases affecting the oral mucosa, affecting 5 to 66 % of the population in different countries worldwide. The pathogenesis of ChRAS is unknown, and it is considered a multifactorial disease associated with local and systemic factors. Further research can be valuable for the prevention and treatment of ChRAS. The aim of the study – to analyze data from scientific literature sources regarding potential risk factors, mechanisms of pathogenesis, including the immune response of mucous membranes and mechanisms of its modification to optimize the diagnosis and treatment of ChRAS. Materials and Methods. The bibliosemantic method was applied to clarify the state of the problem, study the analysis of results of previous scientific research based on literature sources and electronic resources. Results and Discussion. Clinical characteristics of ChRAS are well-defined, but its etiology and pathogenesis remain unresolved. The comprehensive investigation of the occurrence and recurrence of the disease is crucial for understanding the fundamental pathogenetic links, which would be valuable for the prevention and treatment of ChRAS. Potential risk factors for ChRAS, such as a family history, psychological stress, hormonal changes, food allergies, nutritional deficiencies, vitamins and minerals deficiencies, gastrointestinal disorders, certain viral and bacterial infections, medication use, and mechanical trauma to the oral mucosa, are reported. Genetic predisposition and genetic risk factors altering individual susceptibility to ChRAS play a significant role. Various DNA polymorphisms, widespread throughout the human genome, especially those associated with changes in interleukin metabolism, are involved. The unbalanced composition of the oral microbiota may play a key role, although no specific causative agents have been conclusively proven. Food markers related to vitamin and micro- and macroelement deficiencies are also reported, and these are more common in patients with ChRAS. These findings preliminarily explain the main mechanisms through which the oral mucosa is a potential high-risk site for ChRAS, providing evidence for future prevention and treatment strategies. Conclusions. The results of the processed literature sources show that ChRAS is considered a multifactorial disease, but little is known about the mechanisms of pathogenesis and the possibilities of influencing its main links. Therefore, a comprehensive approach and the development and organization of complex rehabilitation plans are extremely important and decisive for assessing the condition of patients suffering from ChRAS.
A special place in the pathogenesis of recurrent aphthous stomatitis is occupied by the state of local immunity, which can affect the clinical course and prognosis of chronic diseases of the oral mucosa. The inflammatory process in recurrent aphthous stomatitis is initiated by stimulation of keratinocytes of the oral mucosa by a currently unknown antigen, which leads to stimulation of T-lymphocytes and the release of cytokines and various interleukins. Cytokines are the main nonspecific humoral factor of immunity, providing the initiation and development of an inflammatory response during the development of a protective immune response. A huge number of works are devoted to the study of cytokine status in recurrent aphthous stomatitis, which plays one of the key roles in the pathogenesis of the disease. However, most of the studies were conducted in patients over the age of 18, in addition, the results obtained are contradictory. This determined the purpose of this study – to assess the cytokine status of oral fluid in children with recurrent aphthous stomatitis. The study examined 70 children who were divided into 2 groups. The main group consisted of 45 children aged 7 to 14 years, patients with recurrent aphthous stomatitis, during the relapse of the disease. The main group was divided into 2 subgroups: A – 20 children with the duration of recurrent aphthous stomatitis up to 5 years, group B – 25 children with the duration of recurrent aphthous stomatitis more than 5 years. All patients in the main group had concomitant diseases, in most cases, diseases of the gastrointestinal tract. The control group consisted of 25 practically healthy children without recurrent aphthous stomatitis. In children with recurrent aphthous stomatitis in the oral fluid, a significant increase in the concentration of the anti-inflammatory cytokine TNF-α and a decrease in the concentration of IL-10, an imbalance in the level of IL-2 depending on the duration of the disease, as evidenced by a pronounced inflammatory process of the oral mucosa with epithelial destruction.
