Characterization of burning mouth syndrome profiles based on response to a local anaesthetic lozenge

Abstract

Objective Burning mouth syndrome (BMS) is a chronic oral pain condition with unknown aetiology but assumed to involve peripheral/central neuropathological and immune‐mediated inflammatory factors. We aimed at characterizing inflammatory and neurogenic profiles and oral symptomatology of patients with BMS based on response to a local anaesthetic lozenge. Methods Patients with BMS were divided into an Effect (n = 13), No effect (n = 8) or Unspecified (n = 2) group according to their response to a local anaesthetic lozenge on oral pain. Inflammation was assessed in blood plasma and saliva by analyses of IL‐6, IL‐8, IL‐17A, IL‐23 and TNF‐α levels. The degree of inflammation and distribution of oestrogen receptor, NGF, NGF‐receptor, TRPV‐1 and IL‐17F in buccal mucosal tissue were investigated by immunohistochemistry. Results Immunoreactivity to the oestrogen receptor was most intense in the Effect group, whereas the No effect group tended to have higher plasma levels of the pro‐inflammatory cytokines. Conclusions Our findings indicate that the response to treatment with local anaesthesia enables subgrouping of patients with BMS according to the potential pathogenic mechanisms. Effect of local anaesthesia indicates a peripheral neuropathology involving lack of oestrogen and upregulation of oestrogen receptors, and no effect indicates a systemic inflammation‐induced mechanism leading to increased levels of plasma cytokines.

Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review

“…Treldal et al [88] found that the plasma levels of IL-6, IL-8, IL-17, IL-23, and TNF-α were higher in BMS patients who were not given a local anaesthetic than in those who were, but without significant differences (p-values: 0.068-0.916). Only IL-6 was significantly elevated in the stimulated parotid saliva for the no effect group (p = 0.020).…”

“…Bio-Histopathological Study 3.5.1. Cytokine Levels Among the six articles, five were case-control studies [83][84][85][86][87] and one was an RCT [88] (Table 1).…”

“…Controversial results were obtained for cytokine levels, such as in the evaluation of IL-6, where the levels were sometimes higher [86,88], sometimes comparable [83], and sometimes lower [85] for BMS patients than the controls. It remains debatable whether increased or decreased cytokine levels contribute to the etiopathogenesis of BMS [27].…”

Investigation of Salivary Biomarkers IL-6, IL-1β, and TNF-α in Burning Mouth Syndrome: A Systematic Review

“…The disease often occurs in postmenopausal women and is often accompanied by dry mouth. Numerous local and systemic (40,41). This study aimed to systematically examine the salivary biomarkers IL-6, IL-1β, and TNF-α in BMS.…”

Ardência Bucal: Como o clínico deve interpretar?

“…Type 1 patients report no symptoms upon waking, with a gradual increase in pain throughout the day, reaching maximum intensity at night. This variant has been associated with systemic conditions such as nutritional deficiency and diabetes, reflecting the influence of metabolic and nutritional factors on the manifestation of BMS [5].…”