Diagnostic Value of Neutrophil–Lymphocyte Ratios and Mean Platelet Volumes in the Activation of Recurrent Aphthous Stomatitis

Abstract

Recurrent aphthous stomatitis (RAS) is associated with endothelial dysfunction and chronic inflammation. The neutrophil-to-lymphocyte ratio (NLR) and mean platelet voume (MPV) are markers of inflammation and endothelial dysfunction, respectively. In the present report, we discuss the NLR and MPV values of patients with active and inactive RAS. In total, 42 patients (24 females and 18 males) with inactive RAS, 19 patients (12 females and 7 males) with active RAS and 40 healthy controls (24 females and 16 males) were enrolled. MPVs were measured and NLRs calculated. We sought correlations among the MPV and NLR findings in the active and inactive RAS groups and compared them with those of healthy controls. The MPV and NLR values were significantly higher in patients with active than inactive RAS (MPV, 10.6 ± 2.9 vs. 7.1 ± 2.4 fL, p \ 0.001; NLR, 3.74 ± 1.9 vs. 2.1 ± 1.43, p = 0.015). In addition, both MPV and NLR values in patients with inactive RAS didn't differ significantly compared to values observed in the controls (MPV, 7.1 ± 2.4 vs. 6.9 ± 2.1 fL, p = 0.126; NLR, 2.1 ± 1.43 vs. 2.07 ± 0.96, p = 0.525). Both the NLR and MPV were significantly higher in patients with active RAS, emphasising the importance of inflammation and endothelial dysfunction in the pathophysiology of RAS activation.

Systemic immune inflammation index in patients with recurrent aphthous stomatitis

“…It is also known that the increase in NLR correlates with the increase in disease activity. 2 , 12 In our study, NLR and PLR were found to be statistically significantly higher in RAS patients as supporting the literature.…”

“…Endothelial dysfunction, chronic inflammation and thrombosis trigger the formation of aphthous lesions. 2 Neutrophils and lymphocytes are responsible for the subclinical inflammation process, and platelet dysfunction is responsible for thrombosis. NLR and PLR are recently frequently used markers indicating the presence and severity of subclinical inflammation.…”

“… 1 They are most commonly located in the buccal mucosa, the lower surface of the tongue and the floor of the mouth. 2 The most common form (approximately 80%) of RAS, which has 3 clinical forms as major, minor and herpetiform, is the minor form. 3 Painful ulcers affect negatively the quality of life of the person because of causing difficulty in eating and speaking.…”

“…Possible triggers may be listed hematinic deficiencies such as ferritin, vitamin B12, folate deficiency, stress and anxiety, mucosal trauma, food allergies, genetic predisposition, connective tissue diseases and hormonal changes. 1 , 2 , 3 , 4 Besides, oxidative stress caused by systemic inflammation is thought to play a role in the etiopathogenesis of RAS. 1 By reason of the fact that the pathogenesis is unclear, its treatment is symptomatic.…”

Mean platelet volume as a predictor in the differentiation of Behçet's disease from recurrent aphthous stomatitis – A single centre, prospective, case‐control study

“…Besides, in a meta‐analysis, it was highlighted that MPV is not higher in BD patients than in healthy individuals 28 . Although RAS has been studied less on this subject, similar conflicting results draw attention 21,22,56 …”